About

It seems intuitive that public-private engagement models—under which the health services are financed by the public sector and provided by the private sector-- can effectively address the rising NCD burden. Evidence indicates that such models can reduce provider fragmentation, create incentives for quality, provide subsidies for targeted populations and high-impact interventions, and use technologies that expand access and improve quality. In these mixed health systems, where there is a lack of information on the financial viability of large-scale diabetes prevention programs, we aim to identify existing models of public-private engagement in India and understand how these can effectively operationalize the current mixed-health systems to reduce health systems costs over the long term. This could be through reduced emergency care and hospitalizations at the hospital level, increased use of the primary care facilities, and improved coordination between primary and secondary care levels to avoid care duplication; thus saving precious time and resources for both patients and the system. Our study objectives are:

1. To identify the existing public-private engagement models in India for diabetes (and other major NCDs) prevention and management.
2. To assess the cost involved in implementing a diabetes prevention and management program at a community level via public-private engagement.
3. To identify the prospective payer(s) for implementing such models at scale.

Methodology

This mixed methods study will integrate data from qualitative interviews with multiple stakeholders and quantitative survey data collected from programs on diabetes prevention and control. The scope includes:

1. To review the existing public-private engagement models in India for diabetes prevention and management (and other major NCDs). To understand past models on technical (e.g., provider payment methods, poor uptake of services, human resource constraints, supply chain constraints, etc.) and political (pushback from organised providers, etc.) aspects.
2. To assess the cost involved in implementing a diabetes prevention and management program at a community level via public-private engagement. To evaluate various cost structures to provide OR to seek diabetes care under public, private, public-private domain AND draw insights on the novel cost-effective model of diabetes prevention and control.
3. To assess the prospective payer(s) for implementing such models at scale. To determine the incentives among various stakeholders to fund a delivery model.

Funder

ACCESS Health