Conference Agenda

Overview and details of the sessions of this conference. Please select a date or location to show only sessions at that day or location. Please select a single session for detailed view (with abstracts and downloads if available).

Session Overview
RN26_05: Healthcare policies and provision
Thursday, 22/Aug/2019:
11:00am - 12:30pm

Session Chair: Ingrid Fylling, Nord University
Location: GM.307
Manchester Metropolitan University Building: Geoffrey Manton, Third Floor 4 Rosamond Street West Off Oxford Road

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What is Social Isolation? Exploring Isolation as Theoretical Concept and Empirical Phenomenon in Science

Erik Børve Rasmussen, Lars E. F. Johannessen, Marit Haldar

OsloMet, Norway

Social isolation is receiving widespread political attention – especially in Western societies, where it is considered a growing problem due to increasing individualization and compartmentalization. The issue also attracts much academic attention, with studies particularly addressing the extent and consequences of social isolation, asking questions such as ‘who and how many people are isolated’, ‘is the isolation problem increasing’ and ‘what kind consequences can social isolation have’. These studies are inevitably based on assumptions about what social isolation is and implies; however, while social isolation is often conceptualized within each article, there has been little research into how the concept is defined and operationalized across current studies. In this study, we thus ask how social isolation is understood in the research context. Based on a critical and explorative document analysis of the 100 most cited articles on ‘social isolation’ (published in English between 1998 and 2018), we show that the literature is dominated by articulations of social isolation as a health problem for the isolated individual. As such, it is a personal problem of reduced physical and mental well-being, and primarily a matter of health care for the sick and elderly. Moreover, we show that the literature asks many questions about how to amend this problem by technological interventions, but few questions about its societal causes. We then discuss some seminal blind spots regarding the understanding and management of social isolation in existing conceptualizations, and suggest how these may be overcome in future research and debates on this highly pertinent topic.

Government-market Conflict in Chinese Health Policy Development: A focus on Public-Private-Partnerships

Qiuxian Cheng

University of Sydney, Australia

Chinese health policy has been undergoing a pendulum-like movement since 1978. This paper traces the development of Chinese health policy from a centrally planned system to a market-oriented one since 1978, a recovery of government’s leading role in 2009, and a swing back to the market with the introduction of Public-private-partnerships in recent decades. The major conflicts producing such a movement are discussed, with specific focus on conflicts underpinning the use of Public-private-partnerships. Conflict between improving the efficiency and guaranteeing the fairness of healthcare system, as well as the big context of economic reform since 1978 and people’s growing medical and health need jointly drove the historical change of health policy both endogenously and exogenously, and the conflict sharpened with the health field opening up to private investment. As a consequence, an unfair healthcare system has emerged, where accessibility and the quality of health care is decided by a patients’ payment ability. These problems with China's health system serve as a critical lesson for other countries.

Regulatory Challenges in Turkish Internal Market in Health Care: The Case of Financial Protection of Patients

Volkan Yilmaz

Bogazici University, Turkey

Establishment of internal markets in health care in publicly funded health care systems brings forth a number of new regulatory challenges. During the 2003 health care reform in Turkey, achieving universal health coverage (UHC) occurred in concurrence with the establishment of an internal market in service provision and a subsequent increase in private sector activity in health care provision. In this context, this paper explores how internal market in health care, as practiced in the Turkish context, has influenced the financial protection of patients in the Turkish health care system. In doing so, the paper examines the emergent modalities of informal payments in patient access to public service providing private hospital services and reasons behind the emergence of informal payments. Data for the study came from the customer complaints appeared on a private online platform and 20 patient interviews. The study found that internal market in health care in service provision has undermined the publicness of the system by engendering new forms of informal payments that include unregistered payments and registered overpayments. Two reasons, information asymmetry between patients and providers and the contestations over the norms upon which the hybrid health care system rests upon, underpin the emergence of informal payments.

How Public Perception And Expectation Affect Welfare Evaluation: An Empirical Study Of The Chinese Public Healthcare Provision

Chang Cai

Nankai University, China, People's Republic of

The Chinese government has invested heavily to establish a more universal and equitable public healthcare system for welfare provision since 2009, but the satisfaction of public healthcare system remains relatively low. Previous researches have demonstrated that individual socioeconomic characteristics and service quality are influential factors affecting their perception of a satisfactory system. However, few studies shed light on the process of cognitive reasoning, which affects an individual’s characteristics and perception of satisfaction.

Using the data from 2015 Chinese General Social Survey, this research explores how socioeconomic factors are associated with (1) people’s perception of distribution inequality and (2) expectation of the government as welfare provider, as well as how these two cognitive factors determine the satisfaction of public healthcare provision.

The structural equation model showed that socioeconomic factors have both direct and indirect impacts on public satisfaction, while people’s perception of distribution equality is the most important factor in determining their satisfaction. Educated individuals have a higher expectation of the government and inequality perception, contrary to upper-class people. Although socioeconomic factors affect people’s cognitive reasoning differently, there is an overall coherence that people may express more dissatisfaction due to the relatively high expectation of government and perception of inequality. This paper addresses the importance of establishing widely accepted distribution rules and coverage of welfare. It provides a different perspective to reduce people’s deprivation and enhance public evaluation of welfare provision.

Keywords: inequality perception; expectation; satisfaction; public healthcare