Private equity ownership across the US health care system is rapidly increasing, yet ownership structures are complex and opaque. We used an economic data set tracking mergers and acquisitions linked to Medicare data to identify private equity hospice acquisitions. Given the influence of for-profit ownership on hospice quality, transparent data on private equity investment are fundamental to ensuring high-quality end-of-life care.

BACKGROUND:  Continuing professional development (CPD), a compulsory requirement of the Health Professions Council of South Africa (HPCSA), is undertaken by healthcare professionals (HCPs), including audiologists, to remain up-to-date with the latest developments, technology and best practices within their discipline. However, the low compliance rates of audiologists engaging in CPD need to be investigated to establish the barriers that audiologists encounter as well as possible interventions to improve their participation.
OBJECTIVE:  This study aimed to explore the barriers that audiologists encounter when participating in CPD activities and to highlight their suggestions for improving its uptake.
METHODS:  The descriptive qualitative research design entailed the use of semi-structured online interviews with 11 audiologists practising within the private sector in the province of KwaZulu-Natal, South Africa, their responses being thematically analysed.
RESULTS:  Three barriers were identified, namely: (1) personal, (2) financial and (3) structural barriers, with eight subthemes and nine recommendations provided by participants.
CONCLUSIONS:  It is anticipated that implementing the proposed strategies will address the barriers and allow active engagement of audiologists in their continued education.Contribution: Limited literature has been documented on the barriers that young, private sector audiologists encounter within the South African context while also providing suggestions to address these barriers.

BACKGROUND:  The coronavirus disease 2019 (COVID-19) pandemic triggered unprecedented disruptions to continuing professional development (CPD) activities, which are essential for healthcare professionals (HCPs) to stay abreast on best practices, current knowledge and emerging technologies, ultimately enhancing patient care. Audiologists encountered multiple challenges during the pandemic, necessitating adaptations and innovations in their CPD practices. While literature was published during the pandemic on shifting education systems to online platforms, little is known about its impact on the CPD of young audiologists working in the private sector.
METHODS:  A descriptive, qualitative research design was adopted to collect rich data from 11 audiologists using online semi-structured interviews which were thematically analysed using Braun and Clark\'s steps.
RESULTS:  COVID-19 brought about both positive adaptations and negative disruptions to the CPD activities of young audiologists. Eight major themes were identified in this study. These include (1) the adoption of online learning, (2) improved flexibility, (3) cost-effectiveness, (4) diverse learning opportunities, (5) keeping current, (6) isolation and networking, (7) limited interactivity and (8) uncertain quality assurance.
CONCLUSIONS:  The COVID-19 pandemic had a considerable influence on the CPD activities of young audiologists in the private sector. While presenting significant challenges, including disruptions to traditional learning modalities, the pandemic also catalysed innovation and adaptation within the profession.Contribution: This study highlights the resilience exhibited by young audiologists towards their CPD and also provides actionable insights for informing professional development initiatives, tailored to the evolving needs of audiologists in the post-COVID-19 era.

BACKGROUND: Lower-level urban private-for-profit health service providers are actively engaged in the delivery of immunization services. However, not much is known about their everyday endeavours to improve data quality and ensure the submitted data meets the quality and timeliness requirements as per established guidelines. The objective of this paper was to examine the coping mechanisms and strategies adopted to improve the quality and timeliness of immunization data among lower-level private-for-profit service providers in Kampala Capital City, Uganda.
METHODS: A qualitative study design was adopted with in-depth interviews (n = 17) and key informant interviews (n = 8) completed among frontline health workers, district health managers and immunization implementing partners. Analysis followed a thematic approach with coding conducted using Atlas. ti, a qualitative data management software.
RESULTS: Overall, coping mechanisms and strategies adopted to improve the data quality among lower-level urban private-for-profit immunization service providers included; Experiential attachment for practical skills acquisition in data management, data quality peer-to-peer learning among private-for-profit immunization service providers, registration using cohort system for easy tracking of records during subsequent visits, separation of visiting service user records from regular attendants, service delivery modifications such as reward for better performance, engagement of Village Health Teams (VHTs) in outreaches and data completion, and data quality checks through review of monitoring charts to identify gaps in data quality.
CONCLUSIONS: Within the urban context, the delivery of immunization services by lower-level private-for-profit services faces data quality challenges some of which stem from the implementation context. Different coping strategies focusing on frontline health worker skills, enhanced experience sharing through peer-to-peer learning, modifications to registration and routine review of monitoring charts. However, these efforts were often faced with chronic barriers such as the high staff turnover calling for dedicated efforts to optimize the available implementation opportunities like guidelines mandating the public health facilities to supervise the lower-level private immunization service providers within their catchment areas to respond to the identified gaps.

BACKGROUND: The vital importance of engaging in physical activity for the maintenance and improvement of health is undeniable. The advent of digital technology has significantly enhanced the encouragement of physical activity (PA) through numerous interventions. Our study\'s goal is to examine the usage and prescription practices of mobile applications and fitness trackers by doctors operating in the private sector.
METHODS: cross-sectional study, which targeted doctors in the private sector, whether general practitioners or specialists was carried out in January and February 2024, A paper questionnaire was distributed to the doctors\' offices.
RESULTS: the mean age was 44.3±11.7 years, 77% of doctors are physically active, the prevalence of use of mobile applications and fitness trackers among private sector physicians for improving and monitoring their physical activity was 32% with a CI ranging from [26-40] % and only 15% recommend mobile apps to patients. This reluctance was attributed to the applications\' lack of customization and the challenges patients faced in using them.
CONCLUSIONS: In our research, we found that doctors rarely utilized mobile applications to enhance their practice of physical activity and were hesitant to recommend them to their patients.

BACKGROUND: Understanding healthcare-seeking behavior and examining health expenditures can help determine possible barriers to accessing healthcare and direct more effective and inclusive healthcare systems. This study aimed to evaluate healthcare-seeking behavior and out-of-pocket healthcare expenditure in a sample of the population in Erbil, Iraq.
METHODS: We conducted this cross-sectional study in Erbil, Kurdistan Region of Iraq, from October to December 2023. A convenience sample of 414 adults completed a self-administered online survey. The following data were collected: recent illness, sociodemographic characteristics, type of healthcare received, and cost of healthcare.
RESULTS: The most common health conditions reported were communicable diseases (16.3%), musculoskeletal problems (13.1%), and noncommunicable diseases (12.7%). Approximately 85% of patients with health conditions requiring care sought healthcare; most visited private clinics (46.3%) and private hospitals (18.6%). The median total out-of-pocket healthcare expenditure in US dollars was 117.3 (interquartile range (IQR) = 45.6-410.0). The median total cost was much greater for participants who first visited a private health facility (USD 135.5, IQR = 57.3-405.6) than those who first visited a public facility (USD 76.8, IQR = 16.1-459.7). Participants ≥ 60 years spent significantly more than those < 14 years (USD 332, 95% CI = 211-453, p < 0.001). Evermarried participants spent significantly more than unmarried (USD 97, 95% CI = 1 to 192, p = 0.047). Health expenditures were significantly greater for noncommunicable diseases than infectious diseases (USD 232, 95% CI = 96-368, p = 0.001). After adjusting for covariates, age ≥ 60 years was independently associated with higher spending (USD 305, 95% CI = 153-457, p < 0.001).
CONCLUSIONS: Most participants sought care from formal health services, preferring the private sector. Seeking care from private facilities incurred significantly higher costs than seeking care from public ones, which suggests potential barriers to accessing healthcare, particularly affordability. The findings underscore the importance of evaluating existing healthcare policies to enhance effectiveness and identify areas for improvement. This study can help policymakers and healthcare providers design effective interventions, allocate resources efficiently, and improve healthcare delivery.

BACKGROUND: Countries in the Middle East have some of the lowest rates of physical activity and some of the highest rates of obesity in the world. Policies can influence population levels of physical activity. However, there is a dearth of research on physical activity policies in the Gulf region. This qualitative study analyses cross-sectoral barriers and facilitators for the development, implementation and evaluation of physical activity policies in Saudi Arabia and Oman, two of the largest countries in the region.
METHODS: Semi-structured interviews were conducted with 19 senior policymakers from the Ministries of Health, Education, and Sport in Saudi Arabia and Oman, and were examined using thematic analysis.
RESULTS: We identified seven themes related to physical activity policies in Saudi Arabia and Oman: leadership; existing policies; physical activity programs related to policies; private sector policies; challenges; data/monitoring; and future opportunities. Both countries have a central document that guides policy-makers in promoting physical activity, and the available policies in both countries are implemented via multiple programs and initiatives to increase physical activity. Compared with Oman, in Saudi Arabia, programs from the non-profit sector, represented by community groups, play a more significant role in promoting physical activity outside the government framework. The private sector has contributed to promoting physical activity in both countries, but interviewees stated that more financial support is required. Policy limitations differ between Saudi Arabia and Oman: intersectoral collaboration in Oman is limited and mainly based on individuals\' own initiative, while the health transformation in Saudi Arabia tends to slow down policy implementation in relevant areas. Physical education in Saudi Arabia and Oman is similar; however, increased support and collaboration between government agencies and the private sector for out-of-school sports academies are needed.
CONCLUSIONS: This study addresses key gaps in analysing physical activity policies in Gulf Cooperation Council countries. Our study highlights the importance of increasing financial support, improving collaboration between governmental agencies and between them and the private sector and consolidating efforts to back physical activity policies and dismantle cross-sectoral barriers in Saudi Arabia and Oman. Educational institutions in Saudi Arabia and Oman play a crucial role in promoting physical activity from early childhood to young adults. Our insights assist policy-makers, public health officials and stakeholders in shaping effective physical activity-promoting policies, programs and interventions to prevent non-communicable diseases. Challenges identified in Saudi Arabia and Oman\'s policies will inform their future development.

The approaches to analysis of medical personnel of stomatological service continue to be based on principles formed in relation to state health care system that makes it difficult to objectively assess situation due to increasing proportion of specialists employed in its private sector. The study, targeted to comprehensive comparative analysis of stomatological medical personnel of state and private medical organizations in the Irkutsk Oblast, for the first time made it possible to assess provision of population of large region and its municipalities with stomatologists, considering specialists employed in private medical organizations, in dynamics and in context of separate specialties. The decrease in provision of population with stomatologists in state medical organizations by 12.3% in 2019-2023 against the background of its increase in private ones by 14.5% was revealed. In 2023, 50.5% of stomatologists were concentrated in private sector of stomatological service and 30.8% in state sector. Yet another 18.7% combined their work in medical organizations of both types. The stomatologists employed in private sector of stomatological service were mainly concentrated in metropolises, especially in regional center, where their provision exceeds average regional level by 2.6 times.

We conducted a cross-sectional study of hypertension care in public and private services, analyzing gender, color, and socioeconomic status. Using data from the 2013 (n = 60,202) and 2019 (n = 90,846) national health surveys, hypertension prevalence increased from 21.4 to 23.9%. Quality of care declined from 41.7 to 35.4%, particularly in public services, disproportionately affecting low-income Black women. Poisson regression estimated prevalence ratios (PRs), with the lowest adjusted PR for high-quality care among low-income Black women. These findings highlight persistent health inequalities and the urgent need for intersectoral policies to promote health equity.

OBJECTIVE: Health education programmes that utilizes multicomponent classroom teaching strategies have the potential to enhance knowledge, attitudes, and actions of adolescents concerning health risk behaviors (HRBs). This study assessed the effect of a school-based context-specific health education intervention (CsHEI) on knowledge of HRBs among in-school adolescents in public- and private-owned secondary schools in Nigeria.
METHODS: In-school adolescents were recruited into this quasi-experimental study using stratified random sampling from secondary schools in Ile-Ife, Osun-State, Nigeria. Knowledge of HRBs was assessed pre- and post-implementation of a CsHEI. The intervention was a four-week instructor-led health education class on HRBs, delivered over a 2-h class activity per week. Data was summarized using descriptive statistics as well as Inferential statistics.
RESULTS: With a mean age of 14.9 ± 1.56 years, a total of 145 females (54.3 %) and 122 males (45.7 %) participated in this study. Over 70 % of the participants had good knowledge of HRBs prior to the intervention with the pre-test mean general knowledge of HRB (t=-3.13, p=0.002) and knowledge of personal safety (t=-2.99, p=0.003) being significantly lower between students in public-schools compared to their private-school counterparts. Post-intervention, a significant improvement in participants\' knowledge was observed in all HRB domains with over 90 % of participants having a good knowledge of HRBs.
CONCLUSIONS: The CsHEI improved knowledge of in-school adolescents in public- and private-owned secondary schools in Osun state, Nigeria in all domains of HRBs. Integrating the CsHEI with other health behavioral change strategies can mitigate prevalence of HRBs among adolescents, thereby improving health-outcomes and well-being of adolescents.