Monitoring Equality in Digital Public Services (report)

The impact of public versus private health care services in the treatment of diffuse large B-cell lymphoma in Brazil: An analysis from the bra-DLBCL multicenter, retrospective real-world registry

Background Ensuring equitable access to public services for people with disabilities remains a persistent challenge in digital governance. Despite advancements in data governance frameworks, disparities in accessibility continue to exclude marginalized populations. While government-led digital initiatives f ocus on efficiency and compliance, their impact on vulnerable groups remains underexplored. This study examines the causal factors influencing audit data governance in Thailand’s public sector, with a particular focus on the contrasting perspectives between government officials, who are responsible for delivering public services, and people with disabilities, who rely on these services. Methods This research employs Multi-Group Structural Equation Modeling (MG-SEM) to analyze survey responses from 711 participants, including policymakers, policy implementers, auditors, and people with disabilities (specifically individuals with visual and physical impairments). The study utilizes a quantitative approach, ensuring that all analyses are based on structured survey data. Key constructs examined include public service delivery for people with disabilities (measured by perception of public service, enablers for access to data, citizen-oriented policy, and fair & efficient administrative procedures), data-driven culture, which ultimately influence audit data governance. Results The findings reveal significant disparities in how data governance is perceived. Government officials emphasize efficiency, compliance, and regulatory adherence, whereas people with disabilities prioritize accessibility, usability, and inclusivity in digital public services. These contrasting perspectives highlight systemic barriers that hinder the equitable implementation of digital governance frameworks, exacerbating the digital divide in public service accessibility. Conclusions To address these challenges, the study proposes targeted policy interventions, including the integration of AI-driven auditing mechanisms, the establishment of universal digital accessibility standards, and the implementation of participatory governance strategies. These recommendations provide valuable insights for policymakers, auditors, and public administrators aiming to foster transparency, trust, and inclusivity in digital public services.

Since one of the goals of dental services is to reduce the effects of social inequality on dental health, it was assessed whether there are inequalities among those seeking dental care from private, public and unionized services. The study population consisted of adults aged 18 years or more living in the city of Bambuí, Brazil. Participants were interviewed using a structured questionnaire. Data analysis was carried out using Pearson's chi-square test, odds ratio and 95% confidence intervals (Woolf's method). There were included 656 subjects who met the study's inclusion criteria. Adjusted results using multiple logistic regression showed that those using private services were more likely to be satisfied with their teeth's looks (OR=3.03; 95%CI =1.70-5.39) and chewing ability (OR=2.27; 95%CI=1.17-4.40) compared to those using public services. Also, they were less likely to perceive their need for dental treatment (OR=0.39; 95%CI=0.18-0.86) and were more likely to have had restorative (OR=9.57; 95%CI=4.72 - 19.43) and/or preventive (OR=5.57; 95%CI=2.31 - 13.40) treatment in their last visit to the dentist's. Those using unionized services were more likely to have had restorative (OR=8.51; 95%CI=2.80 - 25.92) and/or preventive treatment (OR=11.42; 95%CI=3.49 - 37.43) in their last visit to the dentist's when compared to those using public services. However, there were no differences regarding satisfaction with their teeth's looks, chewing ability, and perceived treatment needs. Public dental care services have not been able to reduce social inequalities related to oral health care.

This article aimed to describe the levels of user satisfaction in different age groups and to study the association between user satisfaction and different types of dental services in a representative sample of Brazilians. This study is based on the Brazilian Oral Health Survey, which evaluated the dental health of adolescents, adults and older adults in 177 Brazilian cities. The outcome variable was user satisfaction, related to the last dental visit, evaluated in a five-level Likert-type scale. The main exposure variable was the type of dental service (public service, private service, health plan or insurance). The independent variables were DMFT (decay, missing and filled teeth); pain intensity in the past six months; reason for the last dental visit; perceived need for treatment; frequency of use of dental services; sex; equivalent income; and educational level. An ordered logistic regression analysis was performed separately for each age group. Few participants evaluated the services as bad or very bad (4.3% of adolescents, 6.1% of adults and 4.1% of older adults). In the crude model, the use of public services was associated with lower satisfaction than the use of private services and health plans between all groups. However, after adjusting by covariates, this association remained only in adolescents, who showed lower satisfaction with the public service compared to the private service and health plans. In general, Brazilians are satisfied with dental services, but, among adolescents, the use of public services was associated with lower satisfaction. Public services may be focused on issues related to children, adults and older adults, and not to the adolescent audience, which has specific demands.

The authors offer a comparative account of the administration of the community service order under two different regimes: as a ‘public service’ in England and Wales, and as a ‘private service’ in Ontario. The paper's comparative focus, its analysis of the similarities and differences between public and private services, and its theoretical and practical suggestions about the possible effects of privatization on the administration and enforcement of the community service order in England and Wales are related to current debates about private-sector involvement in the criminal justice system and directions in penal policy in general.

Introduction. Digital technologies have become a part of everyday life of most people, and they have become an expected element of interaction with both enterprises and state and municipal authorities. This has opened up the world of digital public services to provide a simple online experience combined with efficiency and innovation for every citizen. This allows everyone to freely communicate with government agencies and access the necessary information at the touch of a button. Waiting hours in long queues have turned into online forms with drop-down menus and simple instructions. It has become possible to access the data you need from the comfort of your home or on the go using your smartphone. Goal. Highlighting the problems and prospects of using the super services of the tax service by taxpayers and the tax authorities themselves. Materials and methods. The study is based on the analysis of the digital environment, the digital tax field. The following methods were used: monographic, statistical grouping, comparative and subject-object analysis. Results and discussion. In the course of the research, information was structured concerning all aspects of digitalization of tax administration in modern conditions, proposals were made for the development of digital tax control that can be used in the implementation of the project of digital transformation of public services for the population, "growth points" of a friendly digital field for taxpayers were formulated. Conclusion. Based on the results of the study, it can be concluded that digital government is a general administrative process related to the provision of open and effective services to the population using digital technologies. The work of the government on digital transformation is more than just posting forms on the Internet; it includes an assessment of the needs and interests of its citizens and appropriate adaptation. The interaction provided by public digital services can be carried out within three main categories: between a public institution or within it and another public institution, between a government and a citizen, or between a government and a business.

Three basic themes played indispensable roles in Reinhold Niebuhr’s engagements with economic issues: (1) the foundational importance of a theological anthropology for his critical assessment of complex social, economic, and political issues; (2) his focus on two clashing theories of economic order: Adam’s Smith’s doctrine of laissez-faire capitalism and Karl Marx’s revolutionary vision for the collective ownership of property within a centralized state system; and (3) his endorsement of a realistic yet viable alternative to these two classic theories, one that involved pragmatic and incremental steps toward fostering economic justice through the public regulation and oversight of a free-market economy. These pragmatic measures included allocating government resources for vitally important public goods and services at federal, state, and local levels. Though Niebuhr was initially drawn to some form of democratic socialism, he embraced this incremental strategy within the context of President Franklin Delano Roosevelt’s implementation of his New Deal agenda. My analysis of Niebuhr’s contributions concludes with attention to new challenges confronting contemporary quests for economic justice in a post–New Deal era, one marked Soundings, Vol. 95, No. 4, 2012 Copyright © 2012 The Pennsylvania state University, University Park, Pa di sc us sio n diussion

This article examines the implementation of e-government in Indonesia, focusing on the synchronization and integration of public service systems between central and local governments. The case study is based on Semarang City, which has operated the Si Imut digital self-service system since 2017. While Si Imut has improved the efficiency, security, and transparency of local services, challenges arose when the central government introduced the Mall of Digital Public Services (MPPD) as a national platform. The lack of preparedness in data migration, limited technical assistance, and absence of security and backup mechanisms have hindered effective its implementation. The findings show that successful e-government integration depends on synergistic collaboration between central and local authorities, the provision of clear technical guidelines, and equitable information and communication technology (ICT) infrastructure. This study highlights the regulatory gap between existing policy frameworks and practical implementation, emphasizing the need for automatic data integration mechanisms, strengthened security systems, and inclusive access to services. The paper recommends policy reformulation through a participatory approach to ensure that digital public services operate more efficiently, transparently, and accountably. The results are expected to provide strategic insights for policymakers in advancing national digital bureaucracy reform oriented toward improved public services.

Objective To compare treatments for localised prostate cancer for men diagnosed in private and public health services in Victoria. Design Retrospective analysis of Victorian Cancer Registry data linked to population-based administrative health datasets. Setting, participants 29 325 Victorian men diagnosed with prostate cancer during 2011-2017. Main outcome measures Proportions of men in private and public health services receiving radical prostatectomy (with or without curative radiation therapy) or curative external beam radiation therapy alone within 12 months of diagnosis. Results After adjusting for age, tumour classification and comorbidity, men diagnosed in private health services received radical treatment more frequently than men diagnosed in public health services (odds ratio [OR], 1.40; 95% confidence interval [CI], 1.31-1.49). The proportion of private patients who underwent radical prostatectomy was larger than that for public patients (44% v 28%; OR, 2.28; 95% CI, 2.13-2.44) and the proportion of private patients who received curative external beam radiation therapy alone (excluding brachytherapy) was smaller (9% v 19%; OR, 0.45; 95% CI, 0.42-0.49). These differences were apparent for all International Society of Urological Pathology (ISUP) tumour grades. The magnitude of the difference for prostatectomy was greater for men aged 70 years or more; for radiation therapy alone, it was larger for those diagnosed before age 70. The differences between private and public services narrowed during 2011-2017 for men with ISUP grade 1 disease, but not ISUP grade 2-5 tumours. Conclusion Prostate cancer treatment choices differ substantially between men diagnosed in private and public health services in Victoria. These differences are not explained by disease severity or comorbidity.

Recent decades have witnessed the increased use of advanced technology, new innovations, and AI-startups. All these enhance the efficiency and the effectiveness of the government in public services. To sustain in the competitive environment and meeting expectations of the citizens' and business in their country, governments are continuously analyzing their strategies to choose the right set of digital technologies. The objective of this research is to suggest an optimal strategy using MCDM-AHP (analytic hierarchy process) decision model based on principal component analysis (PCA) for the government to improve their public service delivery. The study selects and analyzes top 100 countries according to Governments' Artificial Intelligence Readiness index score provided by the Oxford Insights and IDRC 2019. Analysis reveals that the improvement in data capabilities should be preferred over the other alternatives available such as digital public services, procurement of advanced technology, data capabilities and innovation capabilities of a nation can be significant in effectiveness of the Government in public services.

Framework for interoperable service architecture development

The opportunity to use public services supports older people’s livelihoods, although out-of-pocket fees can be a burden, especially for low-income pensioners. In this article, we analyse the use of health and social care services among the elderly in Finland. The objectives are two-fold: first, to study the distribution of public spending on services across income groups, and second, to investigate the related costs to the service-user. The article contributes to the debate on the welfare states’ redistributive function. The study is based on register data covering the total Finnish population in 2015. In our descriptive analysis, we focus on the distribution of the cost of production (based on detailed unit costs), user fees (calculated based on legislation) as well as reimbursements by social insurance and out-of-pocket payments for medicine, private services and travel costs. The results show that the amount of in-kind benefits is the largest in the two bottom income quintiles both in absolute and relative terms. We also see that the related costs to the client are small in relation to the monetary value of the service, although they amount to 9% of the disposable income in the lowest income quintile. It is noteworthy that benefits are highly concentrated on a small group of individuals. Public services create an important context for the evaluation of adequacy of cash income. Likewise, when we want to understand economic conditions of elderly people in a more comprehensive way, studying the share of disposable income going to health and social care is one important dimension. However, we also argue that we need to be cautious when making claims about redistribution through public services.

This study aims to develop a Village Economy model based on the integration of Village Information Systems to strengthen the MSME economy in Sokop Village, Meranti Islands Regency. The study used a mixed methods approach with a sequential explanatory design with 60 respondents consisting of village officials, MSMEs, and the community. Analysis was conducted by comparing the utilization rate of the village website before and after the integration of marketplace features and digital public services. The results showed an increase in system utilization in aspects such as public information access (52% to 82%), online complaints (35% to 70%), and MSME product promotion (28% to 75%). This increase indicates that the integration of the marketplace into the village information system contributes to expanding the visibility of local products and increasing community participation in technology-based public services. Theoretically, this study enriches the study of e-government integration and the village economy through a four-component model: digital governance, digital public service, digital market integration, and digital literacy empowerment. Practically, this model can serve as an implementation reference for other villages in building an integrated technology-based economic ecosystem.

Background of study: The digital transformation of public services in Indonesia has prompted institutions like BPJS Ketenagakerjaan to adopt technology-based platforms to enhance accessibility and efficiency. One such initiative is the Jamsostek Mobile (JMO) application, designed to provide participants with self-service access to essential features such as checking balances and submitting claims. The perceived ease of use of such platforms plays a critical role in determining user satisfaction and long-term engagement. Aims and scope of paper: This paper aims to analyze the influence of the perceived ease of use of the JMO application on user satisfaction and loyalty among BPJS Ketenagakerjaan participants. The scope of the study is conceptual, focusing on the theoretical relationships between ease of use, satisfaction, and loyalty within the context of digital public services. Methods: This study employs a conceptual literature review method based on the Technology Acceptance Model (TAM). Data were sourced from peer-reviewed journals, reports, and previous research published between 2021 and 2025, using keywords such as “ease of use,” “user satisfaction,” “loyalty,” and “digital public services.” Result: The findings indicate that intuitive design, clear navigation, and accessible features significantly influence user satisfaction. In turn, satisfaction strongly contributes to user loyalty. However, external factors such as digital literacy, service responsiveness, and internet infrastructure also moderate these relationships. Conclusion: To ensure the sustainability of the JMO application, BPJS Ketenagakerjaan must continuously improve usability, technical infrastructure, and user support systems. Enhancing ease of use is essential not only for increasing satisfaction but also for fostering long-term user loyalty in digital public services.

ABSTRACTOBJECTIVE to evaluate whether advanced maternal age (AMA) is associated with prelabor cesarean section and to identify the factors associated with prelabor cesarean section in AMA women, according to the mode of type of labor financing (private or public).METHODS Based on the Birth in Brazil survey, the research was conducted on representative sample of mothers for the country (Brazil), regions, type of hospital and location (capital or not), in 2011/2012. This study included 15,071 women from two age groups: 20–29 years and ≥ 35 years. The information was collected from interviews with puerperal woman, prenatal cards, and medical records of mothers and newborns. Multiple logistic regression modelling was used to verify the association between prelabor cesarean section and maternal, prenatal and childbirth characteristics, according to the mode of financing.RESULTS Our results showed a higher use of prelabor cesarean section for AMA (≥ 35 years) women in the public service (OR = 1.63; 95%CI 1.38–1.94) and in the private service (OR = 1.44; 95%CI 1.13–1.83), compared with women aged 20–29 years. In the adjusted model, we recorded three factors associated with the prelabor cesarean section in AMA women in both, public and private sectors: the same professional in prenatal care and childbirth (OR = 4.97 and OR = 4.66); nulliparity (OR = 6.17 and OR = 10.08), and multiparity with previous cesarean section (from OR = 5.73 to OR = 32.29). The presence of obstetric risk (OR = 1.94; 95%CI .44–2.62) also contributed to the occurrence of prelabor cesarean section in women who gave birth in the public service.CONCLUSIONS AMA was an independent risk factor for prelabor cesarean in public and private services. In the public, prelabor cesarean in AMA was more influenced by clinical criteria. Higher chance of prelabor cesarean section in nulliparous women increases the chance of cesarean section in multiparous women, as we showed in this study, which increases the risk of anomalous placental implantation.