ETD Collection

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Subject: search.filters.subject.National health services--South Africa

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    Health insurance coverage and the preference for public and private healthcare providers in South Africa: the case of outpatient healthcare services
    (2019) Godi, Khanani Theodora
    The paper sought to test if medical/health insurance coverage influences one’s preference or choice between a public and private service provider when seeking healthcare. Using the South African National Health and Nutrition Examination Survey (SANHANES) dataset conducted in 2012, we ran several regressions to test this theory. The methodology employed is based on Grossman’s theory of the demand for health. Logit and Probit regression models were used where the preference between a private/public service provider (dependent variable), is regressed against the determinants of demand for healthcare. We find that being insured (having medical aid) influences choice of healthcare facility with the likelihood of choosing private healthcare facilities over public ones. More specifically, the odds ratio of using a public facility decreases by 4.9 times when one is insured. This finding is consistent with that of Ataguba and Goudge (2012) who found that health insurance increases the use of private healthcare services. With the proposed National Health Insurance, it is likely that consumers will flood the private sector for the good quality service they could not afford without insurance. This influx may have an adverse impact on the efficiency and quality service delivery that the private healthcare sector boasts. As such, healthcare reforms such as the NHI should be coupled with quality improvement measures to enhance, monitor and maintain the performance and quality service in healthcare.
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    On being a doctor in an acute NHS hospital trust: a classic grounded theory
    (2016) Craayenstein, Mogamat Reederwan
    The aim of this study was to give an account of what it means to be a hospital consultant in a national health service that has been undergoing change for almost three decades. Classic grounded theory was used to identify the main concern of hospital consultants sampled for the study and how they resolved this concern on a routine basis. Data were obtained from three sources: interviews, observation and document analyses. Classic grounded theory procedures of constant comparison and theoretical sampling were used and Rolling with the Punches emerged as the pattern of behaviour through which the hospital consultants dealt with their main concern, which was managerialism. Rolling with the Punches involves four modes: Stabilising Temporarily, Resisting, Limiting the Impact and Adjusting to/Living with. The mode of behaviour was contingent on a central and on-going Weighing-up process, in which the hospital consultants used their personal narratives, beliefs and commitment structures to make sense of what was happening and what they could possibly do about it. Hence, the mode of behaviour was contingent, historicised and in flux. The Weighing-up process can set off triggers that can lead to a change of mode that need not be linear. Key words: doctors, managers, grounded theory, weighing up, stabilising temporarily, resisting, subverting, quibbling, limiting the impact, lying low, faking it, living with, adjusting to, going with the flow, complying, waiting it out.