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Practices, regulation and accountability in the evolving private healthcare sector: lessons from Maharashtra State, India

不断发展的私营医疗保健行业的实践、监管和问责制：印度马哈拉施特拉邦的经验教训

基本信息

批准号：
MR/R003009/1
负责人：
Susan Fairley Murray
金额：
$ 22.77万
依托单位：
King's College London
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2017
资助国家：
英国
起止时间：
2017 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=MR%2FR003009%2F1
关键词：
Practices regulation accountability evolving private

项目摘要

This research is about the expansion and changing face of private sector hospital care and related diagnostic services through an organised, and increasingly transnational, healthcare industry. It responds to concerns, expressed in a recent paper in the Lancet, about how incentive structures within health services may become distorted to meet the economic interests of this industry, and about the risks of regulatory capture and disempowerment of communities and citizens. The research team is composed of social scientists from King's College London and public health researchers and health rights activists from India. To explore this issue, we will construct a detailed case study of the sector in Maharashtra State, India which has many expanding healthcare hubs. Our objectives are first to examine the implications of these emerging forms of healthcare delivery and their business and management practices for the healthcare sector, for medical practitioners and for healthcare users. As there is no central register, we will conduct a mapping of facilities by collating information from various registers and business media reports; we will interview a wide range of medical practitioners, managers, facility owners, regulators, policy makers, patient organisations and health rights advocates; and we will conduct a 'witness seminar' to explore the contemporary history of corporatisation of healthcare in the State. Second, we will consider the nature, successes and failures of past attempts at regulation of the private medical sector in the State. For this we will hold a stakeholder consultation and a witness seminar exploring recent regulations, and obstacles and distortions in implementation. The final stages of the project will be to develop and advocate for mechanisms of 'social regulation', such as patient and citizen involvement in monitoring of enforcement of rules and regulations from a rights-based perspective, and to draw lessons for other low and middle income countries.

这项研究是关于私营部门医院护理和相关诊断服务通过一个有组织的、日益国际化的医疗保健行业的扩张和面貌的变化。它回应了《柳叶刀》最近发表的一篇论文中表达的关切，即卫生服务内部的激励结构可能会被扭曲，以满足该行业的经济利益，以及监管俘获和剥夺社区和公民权力的风险。研究小组由来自伦敦国王学院的社会科学家和来自印度的公共卫生研究人员和健康权利活动人士组成。为了探讨这个问题，我们将构建一个详细的案例研究，在印度马哈拉施特拉邦，那里有许多不断扩大的医疗保健中心。我们的目标是首先研究这些新兴的医疗保健提供形式及其业务和管理做法对医疗保健部门、医生和医疗保健用户的影响。由于没有中央登记册，我们将通过整理各种登记册和商业媒体报道的信息来绘制设施地图；我们将采访广泛的医生、管理人员、设施所有者、监管者、政策制定者、患者组织和健康权利倡导者；我们将举办一个“证人研讨会”，探讨该州医疗保健公司化的当代历史。其次，我们将考虑过去监管该州私营医疗部门的尝试的性质、成功和失败。为此，我们将举行利益攸关方磋商和见证者研讨会，探讨最近的法规以及执行中的障碍和扭曲。该项目的最后阶段将是发展和倡导“社会监管”机制，例如病人和公民从基于权利的角度参与监测规则和条例的执行情况，并为其他低收入和中等收入国家吸取教训。