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Privatisation worsens health outcome of patients: Lancet study

May 16,2024

New Delhi: Privatisation reduces the quality of care and worsens health outcomes of patients, a study published in Lancet suggests. The study analysed several studies conducted in high-income countries on the fallout of public hospitals being converted to for-profit or not-for-profit facilities and of services by public hospitals being outsourced.

The paper published by researchers at the department of social policy and intervention in Oxford University reviewed studies from the US, Germany, the UK, Sweden, South Korea etc. It found that hospitals converting from public to private ownership status tended to make higher profits than public hospitals that do not convert, primarily through the selective intake of patients and reductions in staff numbers. The authors stated that their analysis provided evidence that challenges the justifications for healthcare privatisation and concluded that the scientific support for further privatisation of healthcare services is weak.

The review found that the conversion reduced “the comprehensiveness and generosity of care”. Privatised hospitals decreased their staffing levels, especially of the highest qualified nurses. It found that outsourcing corresponded with fewer staff members employed per patient, especially true of cleaning staff. Interestingly, the number of physicians was not reduced after privatisation, whereas most other staffing categories were.

“Overall, the results suggest that accessibility of care might be affected in different ways, with more precise appointment times and reduced waiting times in some cases, but with effects that could disadvantage some groups, particularly those whose treatments have low profits for the private sector,” stated the paper.

Those who advocate outsourcing services to the private sector argue that financial accountability compels private companies to ensure patients’ well-being and eliminates unnecessary bureaucracy. It is also argued that competition from private facilities improves performance across the entire health system as all providers are incentivised to deliver better quality services, especially in a single-payer or purchaser system when the pricesare largely fixed. However, the review noted that “the profit motive might not always result in desired outcomes”. It pointed out that competitive markets could also discourage providers from revealing information on the quality of their services.

“The evidence compiled here does not align with the expectations of mixed markets, namely that they would improve quality by increasing competition,” stated the study, adding that the findings suggested that some areas of the welfare state, such as education and health care, might be structured in ways that make them less amenable to the kinds of incentives that operate in other markets.

Source: Healthworld

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