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Purpose

– The purpose of this paper is to explore regulation in India’s healthcare sector and makes recommendations needed for enhancing the healthcare service.

Design/methodology/approach

– The literature was reviewed to understand healthcare’s regulatory context. To understand the current healthcare system, qualitative data were collected from state-level officials, public and private hospital staff. A patient survey was performed to assess service quality (QoS).

Findings

– Regulation plays a central role in driving healthcare QoS. India needs to strengthen market and institutional co-production based approaches for steering its healthcare in which delivery processes are complex and pose different challenges.

Research limitations/implications

– This study assesses current healthcare regulation in an Indian state and presents a framework for studying and strengthening regulation. Agile regulation should be based on service delivery issues (pull approach) rather than monitoring and sanctions based regulatory environment (push approach).

Practical implications

– Healthcare pitfalls across the world seem to follow similar follies. India’s complexity and experience is useful for emerging and developed economies.

Originality/value

– The author reviewed around 70 publications and synthesised them in healthcare regulatory contexts. Patient’s perception of private providers could be a key input towards steering regulation. Identifying gaps across QoS dimensions would be useful in taking corrective measures.

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