Assessment of the Impact of Healthcare Coverage Reforms on Operational Efficiency and Strategic Performance in Varied Socioeconomic Healthcare Environments
Keywords:
Healthcare Coverage Reforms, Operational Efficiency, Strategic Performance, Socioeconomic Disparities, Healthcare Systems, Equity in Healthcare, Healthcare Policy Analysis, Mixed-Methods StudyAbstract
This study evaluates the impact of healthcare coverage reforms on operational efficiency and strategic performance across diverse socioeconomic healthcare environments. Healthcare systems globally have undergone significant reforms aimed at improving access, equity, and quality. However, the effects of these reforms on organizational performance and their adaptability in varied socioeconomic contexts remain inadequately explored. Using a mixed-methods approach, this research examines reforms' influence on efficiency metrics, service delivery, and strategic outcomes, integrating data from multiple countries with distinct healthcare frameworks.
The findings reveal substantial efficiency improvements in healthcare delivery within well-resourced settings, while low-income regions experience mixed outcomes due to infrastructural limitations. Strategic performance indicators, including patient satisfaction and equity metrics, display uneven gains, highlighting socioeconomic disparities. The study underscores the need for context-sensitive reforms and adaptive strategies that prioritize equity and efficiency across all socioeconomic strata.
References
Blanchet, N. J., Fink, G., & Osei-Akoto, I. (2012). The Effect of Ghana’s National Health Insurance Scheme on Health Care Utilisation. Ghana Medical Journal, 46(2), 76–84.
Manca DP. Do electronic medical records improve quality of care? Yes. Can Fam Physician. 2015 Oct;61(10):846-7, 850-1. PMID: 26472786; PMCID: PMC4607324.
Ikegami, N., & Campbell, J. C. (2004). Japan's Health Care System: Containing Costs and Attempting Reform. Health Affairs, 23(3), 26–36.
Kaplan, R. S., & Norton, D. P. (1996). Using the Balanced Scorecard as a Strategic Management System. Harvard Business Review, 74(1), 75–85.
Lagomarsino, G., Garabrant, A., Adyas, A., Muga, R., & Otoo, N. (2012). Moving Towards Universal Health Coverage: Health Insurance Reforms in Nine Developing Countries in Africa and Asia. The Lancet, 380(9845), 933–943.
Marmot, M., Allen, J., Goldblatt, P., Boyce, T., McNeish, D., Grady, M., & Geddes, I. (2010). Fair Society, Healthy Lives. Strategic Review of Health Inequalities in England Post-2010. The Marmot Review.
McClellan, M. (2010). Accountable Care Organizations and Evidence-Based Reforms. Journal of the American Medical Association, 304(15), 1715–1716.
Porter, M. E., & Teisberg, E. O. (2006). Redefining Health Care: Creating Value-Based Competition on Results. Harvard Business School Press.
Prinja, S., Bahuguna, P., Gupta, I., & Chowdhury, S. (2019). Coverage and Financial Risk Protection for Outpatient Care under Universal Health Coverage in India. PLoS Medicine, 16(9), e1002866.
Reid, R. J., MacWilliam, L., Verhulst, L., Roos, N., & Atkinson, M. (2009). Performance of the Canadian Healthcare System: An Analysis of Hospital Readmission Rates. Canadian Medical Association Journal, 170(3), 343–349.
Sommers, B. D., Gunja, M. Z., Finegold, K., & Musco, T. (2017). Changes in Self-Reported Insurance Coverage, Access to Care, and Health under the Affordable Care Act. Journal of the American Medical Association, 317(4), 365–372.
Tandon, A., Murray, C. J. L., Lauer, J. A., & Evans, D. B. (2018). Measuring Overall Health System Performance for 191 Countries. Health Economics, 11(1), 1–20.
Wagstaff, A., & van Doorslaer, E. (2000). Equity in Health Care Finance and Delivery. Handbook of Health Economics, 1, 1803–1862.
Wendt, C. (2009). Mapping European Healthcare Systems: A Comparative Analysis of Financing, Service Provision, and Access. Journal of Comparative Policy Analysis, 11(1), 75–90.
Agyepong, I. A., & Adjei, S. (2008). Public social policy development and implementation: A case study of the Ghana National Healthcare insurance Scheme. Health Policy and Planning, 23(2), 150–160.
Blumenthal, D., Abrams, M., & Nuzum, R. (2015). The Affordable Care Act at 5 years. The New England Journal of Medicine, 372(25), 2451–2458.
Dixon, A., Robertson, R., Appleby, J., Burge, P., Devlin, N., & Magee, H. (2011). Patient choice: How patients choose and how providers respond. The King's Fund.
Enthoven, A. C. (1993). The history and principles of managed competition. Health Affairs, 12(suppl 1), 24–48.
Moon, M. (1996). Medicare now and in the future. The Milbank Quarterly, 74(4), 639–661.
Yip, W., Hsiao, W., Chen, W., Hu, S., Ma, J., & Maynard, A. (2012). Early appraisal of China’s huge and complex health-care reforms. The Lancet, 379(9818), 833–842.
Zweifel, P., & Manning, W. G. (2000). Moral hazard and consumer incentives in health care. Handbook of Health Economics, 1, 409–459.
McIntyre, D., & Ataguba, J. E. (2012). How to achieve universal health coverage: A perspective from South Africa. The Lancet, 380(9845), 1187–1195.
Frenk, J., & Gómez-Dantés, O. (2009). Health systems in low- and middle-income countries: The imperative for reform. Health Policy, 375(9708), 863–864.
Kutzin, J. (2013). Health financing for universal coverage and health system performance: Concepts and implications for policy. Bulletin of the World Health Organization, 91(8), 602–611.
Mills, A., & Ranson, K. (2006). The design of health systems in developing countries. Oxford Review of Economic Policy, 22(2), 213–234.
Wagstaff, A., & Yu, S. (2007). Do health sector reforms have their intended impacts? The World Bank’s policy research report on health reforms. Health Policy, 84(1), 65–74.
Savedoff, W. D., & Gottret, P. (2008). Health financing revisited: A practitioner's guide. World Bank Publications.
Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health care spending in the United States and other high-income countries. JAMA, 319(10), 1024–1039.
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Lakshmi Narasimhan Srinivasagopalan (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.