Concentration and fragmentation: analyzing the implications of the structure of Georgia’s private healthcare market for quality and accessibility (ConFrag)

Introduction and Overview

The research project aims to understand what are the risks to quality and accessibility of patient care from excessive concentration and/or fragmentation in private healthcare markets, and what health system policies are available to address these?

The overall aim of this study is to elaborate this conceptual framing of risks of harm from concentration and fragmentation of healthcare markets and develop a set of tools for undertaking healthcare market analysis that can inform policy options for shaping healthcare markets in the context of UHC. We will achieve this aim through 4 specific research questions (RQs):

  1. What is the structure and nature of the healthcare market in Georgia: to what extent is the market characterized by fragmentation and concentration, and by horizontal and vertical integration?
  2. What demand, supply, and policy factors are driving this pattern?
  3. What are the risks and benefits for patients, and for the health system, of fragmented and consolidated health service provision?
  4. What policy levers are available to shape the private healthcare market to better serve the needs of UHC?
Organizations involved

The project is funded through the Joint Health Systems Research Initiative which is jointly funded by the Department of International Development (DFID), the Economic and Social Research Council (ESRC), the Medical Research Council (MRC) and the Wellcome Trust (WT).

The study will be implemented by CIF (Georgia) and the London School of Hygiene and Tropical Medicine (UK).

Expected Results and Their Application

The study is expected to benefit three main groups, such as 1. policymakers in Georgia, 2.regional and global policy actors, and 3. researchers globally. Patients and populations also have the potential to benefit from the project, through better policies that improve the quality and efficiency of health services provided by the private sector, in the context of UHC.

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