Tax-Exempt Hospitals' Investments in Community Health and Local Public Health Spending: Patterns and Relationships.

Science.gov (United States)

Singh, Simone R; Young, Gary J

2017-12-01

To investigate whether tax-exempt hospitals' investments in community health are associated with patterns of governmental public health spending focusing specifically on the relationship between hospitals' community benefit expenditures and the spending patterns of local health departments (LHDs). We combined data on tax-exempt hospitals' community benefit spending with data on spending by the corresponding LHD that served the county in which a hospital was located. Data were available for 2 years, 2009 and 2013. Generalized linear regressions were estimated with indicators of hospital community benefit spending as the dependent variable and LHD spending as the key independent variable. Hospital community benefit spending was unrelated to how much local public health agencies spent, per capita, on public health in their communities. Patterns of local public health spending do not appear to impact the investments of tax-exempt hospitals in community health activities. Opportunities may, however, exist for a more active engagement between the public and private sector to ensure that the expenditures of all stakeholders involved in community health improvement efforts complement one another. © Health Research and Educational Trust.

Best Manufacturing Practices. Report of Survey Conducted at Stafford County Public Schools, Stafford County, VA

National Research Council Canada - National Science Library

1994-01-01

During the week of August 8, 1994, a Best Manufacturing Practices (BMP) survey was conducted at the Stafford County Public Schools located in Stafford County, Virginia, considered one of the fastest growing counties in the state...

School Progress Report 2012. Montgomery County Public Schools

Science.gov (United States)

Montgomery County Public Schools, 2013

2013-01-01

The 2012 School Progress Report for Montgomery County Public Schools (MCPS) provides state, county, and individual school performance data, as well as information on student attendance, high school graduation rates, and the professional qualifications of teachers at the state, district, and school levels. Montgomery County primary schools are…

Impact of free delivery policy on utilization of maternal health services in county referral hospitals in Kenya.

Science.gov (United States)

Njuguna, John; Kamau, Njoroge; Muruka, Charles

2017-06-21

Kenya has a high maternal mortality rate. Provision of skilled delivery plays a major role in reducing maternal mortality. Cost is a hindrance to the utilization of skilled delivery. The Government of Kenya introduced a policy of free delivery services in government facilities beginning June 2013. We sought to determine the impact of this intervention on facility based deliveries in Kenya. We compared deliveries and antenatal attendance in 47 county referral hospitals and 30 low cost private hospitals not participating in the free delivery policy for 2013 and 2014 respectively. The data was extracted from the Kenya Health Information System. Multiple regression was done to assess factors influencing increase in number of deliveries among the county referral hospitals. The number of deliveries and antenatal attendance increased by 26.8% and 16.2% in county referral hospitals and decreased by 11.9% and 5.4% respectively in low cost private hospitals. Increase in deliveries among county referral hospitals was influenced by population size of county and type of county referral hospital. Counties with level 5 hospitals recorded more deliveries compared to those with level 4 hospitals. This intervention increased the number of facility based deliveries. Policy makers may consider incorporating low cost private hospitals so as to increase the coverage of this intervention.

Returns on Investment in California County Departments of Public Health

Science.gov (United States)

2016-01-01

Objectives. To estimate the average return on investment for the overall activities of county departments of public health in California. Methods. I gathered the elements necessary to estimate the average return on investment for county departments of public health in California during the period 2001 to 2008–2009. These came from peer-reviewed journal articles published as part of a larger project to develop a method for determining return on investment for public health by using a health economics framework. I combined these elements by using the standard formula for computing return on investment, and performed a sensitivity analysis. Then I compared the return on investment for county departments of public health with the returns on investment generated for various aspects of medical care. Results. The estimated return on investment from $1 invested in county departments of public health in California ranges from $67.07 to $88.21. Conclusions. The very large estimated return on investment for California county departments of public health relative to the return on investment for selected aspects of medical care suggests that public health is a wise investment. PMID:27310339

The Rural Inpatient Mortality Study: Does Urban-Rural County Classification Predict Hospital Mortality in California?

Science.gov (United States)

Linnen, Daniel T; Kornak, John; Stephens, Caroline

2018-03-28

Evidence suggests an association between rurality and decreased life expectancy. To determine whether rural hospitals have higher hospital mortality, given that very sick patients may be transferred to regional hospitals. In this ecologic study, we combined Medicare hospital mortality ratings (N = 1267) with US census data, critical access hospital classification, and National Center for Health Statistics urban-rural county classifications. Ratings included mortality for coronary artery bypass grafting, stroke, chronic obstructive pulmonary disease, heart attack, heart failure, and pneumonia across 277 California hospitals between July 2011 and June 2014. We used generalized estimating equations to evaluate the association of urban-rural county classifications on mortality ratings. Unfavorable Medicare hospital mortality rating "worse than the national rate" compared with "better" or "same." Compared with large central "metro" (metropolitan) counties, hospitals in medium-sized metro counties had 6.4 times the odds of rating "worse than the national rate" for hospital mortality (95% confidence interval = 2.8-14.8, p centers may contribute to these results, a potential factor that future research should examine.

Vulnerability to extreme-heat-associated hospitalization in three counties in Michigan, USA, 2000-2009

Science.gov (United States)

Ogbomo, Adesuwa S.; Gronlund, Carina J.; O'Neill, Marie S.; Konen, Tess; Cameron, Lorraine; Wahl, Robert

2017-05-01

With climate change, extreme heat (EH) events are increasing, so it is important to understand who is vulnerable to heat-associated morbidity. We determined the association between EH and hospitalizations for all natural causes; cardiovascular, respiratory, and renal diseases; diabetes mellitus; and acute myocardial infarction in Michigan, USA, at different intensities and durations. We assessed confounding by ozone and how individual characteristics and health insurance payer (a proxy for income) modified these associations. We obtained Michigan Inpatient Database, National Climatic Data Center, and US Environmental Protection Agency ozone data for May-September, 2000-2009 for three Michigan counties. We employed a case-crossover design and modeled EH as an indicator for temperature above the 95th, 97th, or 99th percentile thresholds for 1, 2, 3, or 4 days. We examined effect modification by patient age, race, sex, and health insurance payer and pooled the county results. Among non-whites, the pooled odds ratio for hospitalization on EH (97th percentile threshold) vs. non-EH days for renal diseases was 1.37 (95 % CI = 1.13-1.66), which increased with increasing EH intensity, but was null among whites (OR = 1.00, 95 % CI = 0.81, 1.25). We observed a null association between EH and cardiovascular hospitalization. EH (99th percentile threshold) was associated with myocardial infarction hospitalizations. Confounding by ozone was minimal. EH was associated with hospitalizations for renal disease among non-whites. This information on vulnerability to heat-associated morbidity helps characterize the public health burden of EH and target interventions including patient education.

Technical efficiency and productivity of Chinese county hospitals: an exploratory study in Henan province, China

Science.gov (United States)

Cheng, Zhaohui; Tao, Hongbing; Cai, Miao; Lin, Haifeng; Lin, Xiaojun; Shu, Qin; Zhang, Ru-ning

2015-01-01

Objectives Chinese county hospitals have been excessively enlarging their scale during the healthcare reform since 2009. The purpose of this paper is to examine the technical efficiency and productivity of county hospitals during the reform process, and to determine whether, and how, efficiency is affected by various factors. Setting and participants 114 sample county hospitals were selected from Henan province, China, from 2010 to 2012. Outcome measures Data envelopment analysis was employed to estimate the technical and scale efficiency of sample hospitals. The Malmquist index was used to calculate productivity changes over time. Tobit regression was used to regress against 4 environmental factors and 5 institutional factors that affected the technical efficiency. Results (1) 112 (98.2%), 112 (98.2%) and 104 (91.2%) of the 114 sample hospitals ran inefficiently in 2010, 2011 and 2012, with average technical efficiency of 0.697, 0.748 and 0.790, respectively. (2) On average, during 2010–2012, productivity of sample county hospitals increased by 7.8%, which was produced by the progress in technical efficiency changes and technological changes of 0.9% and 6.8%, respectively. (3) Tobit regression analysis indicated that government subsidy, hospital size with above 618 beds and average length of stay assumed a negative sign with technical efficiency; bed occupancy rate, ratio of beds to nurses and ratio of nurses to physicians assumed a positive sign with technical efficiency. Conclusions There was considerable space for technical efficiency improvement in Henan county hospitals. During 2010–2012, sample hospitals experienced productivity progress; however, the adverse change in pure technical efficiency should be emphasised. Moreover, according to the Tobit results, policy interventions that strictly supervise hospital bed scale, shorten the average length of stay and coordinate the proportion among physicians, nurses and beds, would benefit hospital efficiency

The impact of public hospital closure on medical and residency education: implications and recommendations.

Science.gov (United States)

Walker, Kara Odom; Calmes, Daphne; Hanna, Nancy; Baker, Richard

2008-12-01

Challenges around safety-net hospital closure have impacted medical student and resident exposure to urban public healthcare sites that may influence their future practice choices. To assess the impact of the closure of a public safety-net teaching hospital for the clinical medical education of Charles Drew University medical students and residents. Retrospective cohort study of medical students' and residents' and clinical placement into safety-net experiences after the closure of the primary teaching hospital. The hospital closure impacted both medical student and residency training experiences. Only 71% (17/24) of medical student rotations and 13% (23/180) of residents were maintained at public safety-net clinical sittings. The closure of the public safety-net hospital resulted in the loss of 36% of residency training spots sponsored by historically black medical schools in the United States and an even larger negative impact on the number of physicians training in underserved urban areas of Los Angeles County. While the medical educational program changes undertaken in the wake of hospital closure have negatively affected the immediate clinical educational experiences of medical students and residents, it remains to be seen whether the training site location changes will alter their long-term preferences in specialty choice and practice location.

School Progress Report 2013. Montgomery County Public Schools

Science.gov (United States)

Montgomery County Public Schools, 2014

2014-01-01

The 2013 School Progress Report for Montgomery County Public Schools (MCPS) provides state, county, and individual school performance data, as well as information on student attendance, high school graduation rates, and the professional qualifications of teachers at the state, district, and school levels for the 2012-2013 school year. Montgomery…

Technical efficiency and productivity of Chinese county hospitals: an exploratory study in Henan province, China.

Science.gov (United States)

Cheng, Zhaohui; Tao, Hongbing; Cai, Miao; Lin, Haifeng; Lin, Xiaojun; Shu, Qin; Zhang, Ru-Ning

2015-09-09

Chinese county hospitals have been excessively enlarging their scale during the healthcare reform since 2009. The purpose of this paper is to examine the technical efficiency and productivity of county hospitals during the reform process, and to determine whether, and how, efficiency is affected by various factors. 114 sample county hospitals were selected from Henan province, China, from 2010 to 2012. Data envelopment analysis was employed to estimate the technical and scale efficiency of sample hospitals. The Malmquist index was used to calculate productivity changes over time. Tobit regression was used to regress against 4 environmental factors and 5 institutional factors that affected the technical efficiency. (1) 112 (98.2%), 112 (98.2%) and 104 (91.2%) of the 114 sample hospitals ran inefficiently in 2010, 2011 and 2012, with average technical efficiency of 0.697, 0.748 and 0.790, respectively. (2) On average, during 2010-2012, productivity of sample county hospitals increased by 7.8%, which was produced by the progress in technical efficiency changes and technological changes of 0.9% and 6.8%, respectively. (3) Tobit regression analysis indicated that government subsidy, hospital size with above 618 beds and average length of stay assumed a negative sign with technical efficiency; bed occupancy rate, ratio of beds to nurses and ratio of nurses to physicians assumed a positive sign with technical efficiency. There was considerable space for technical efficiency improvement in Henan county hospitals. During 2010-2012, sample hospitals experienced productivity progress; however, the adverse change in pure technical efficiency should be emphasised. Moreover, according to the Tobit results, policy interventions that strictly supervise hospital bed scale, shorten the average length of stay and coordinate the proportion among physicians, nurses and beds, would benefit hospital efficiency. Published by the BMJ Publishing Group Limited. For permission to use (where

The Public's Attitude Toward Public Library Services in Essex County, New Jersey; A Research Study Conducted for the Essex County Library Directors Group Public Relations Committee.

Science.gov (United States)

Market Dynamics, Inc., Princeton, NJ.

In order to structure an effective campaign aimed at increasing the usage of the public libraries in Essex County, New Jersey, this research project was undertaken to determine the consumer attitudes toward various aspects of public library services. These aspects include: extent of public library usage; awareness of library services offered,…

Association of public health initiatives with outcomes for out-of-hospital cardiac arrest at home and in public locations

DEFF Research Database (Denmark)

Christopher B., Fordyce; Carolina M., Hansen; Kragholm, Kristian

2017-01-01

Importance  Little is known about the influence of comprehensive public health initiatives according to out-of-hospital cardiac arrest (OHCA) location, particularly at home, where resuscitation efforts and outcomes have historically been poor.Objective  To describe temporal trends in bystander...... cardiopulmonary resuscitation (CPR) and first-responder defibrillation for OHCAs stratified by home vs public location and their association with survival and neurological outcomes.Design, Setting, and Participants  This observational study reviewed 8269 patients with OHCAs (5602 [67.7%] at home and 2667 [32.......3%] in public) for whom resuscitation was attempted using data from the Cardiac Arrest Registry to Enhance Survival (CARES) from January 1, 2010, through December 31, 2014. The setting was 16 counties in North Carolina.Exposures  Patients were stratified by home vs public OHCA. Public health initiatives...

Financial Management In Public Secondary Schools In Kenya A Case Study Of Lurambi Sub-County Kakamega County

Directory of Open Access Journals (Sweden)

Rose Kahavizakiriza

2015-08-01

Full Text Available Abstract This study set out to identify knowledge skills and attitudes required by principals of public secondary schools in Lurambi Sub-county in Kakamega County Kenya for effective financial management. The rationale for focusing on the financial management of public secondary schools was based on evidence in contemporary literature showing that there existed problems in schools over the management of funds because parents complained of financial mismanagement. The main objective of this study was to find outfinancial management in public secondary schools in Kenya. The specific objectives were To find out whether principals of public secondary schools identify and mobilize financial resources for their institutions to find out whether principals draw up budgets for their schools according to priorities of the school needs to find out whether supervision monitoring and control of the budget is carried out by principals of public secondary schools. Therefore there was need to find out ways of ensuring efficient financial management in schools. The study was carried out in public secondary schools in Lurambi Sub-county of Kakamega County covering Lurambi and Municipality. The target population for this study consisted of seventeen 17 principals of public secondary schools seventeen 17 school bursars one hundred and thirty six 136 H.O.Ds and seventeen 17 B.O.G representatives giving a total of one hundred and eighty seven 187 people. Sample population was purposively selected from twelve 12 public secondary schools in Lurambi Sub-county through simple random within the clusters of principals school bursars H.O.Ds representatives of B.O.G. The study adopted a descriptive survey design which helped to establish and describe the knowledge skills and attitudes principals of public secondary schools require for effective performance. Reliability coefficient of the instruments was calculated using cronbachs reliability test. Data analysis revealed that

75 FR 51841 - Notice of Realty Action: Proposed sale of Public Lands, Churchill County, NV

Science.gov (United States)

2010-08-23

... Lands, Churchill County, NV AGENCY: Bureau of Land Management, Interior. ACTION: Notice of realty action... value, approximately 800 acres of public lands in Churchill County, Nevada, through direct [email protected] . SUPPLEMENTARY INFORMATION: The following described public lands in Churchill County...

77 FR 55496 - Notice of Temporary Closure of Public Lands in Eastern Lassen County, California, and Western...

Science.gov (United States)

2012-09-10

... Temporary Closure of Public Lands in Eastern Lassen County, California, and Western Washoe County, Nevada...-managed public lands in the area affected by the Rush Fire in eastern Lassen County, California, and western Washoe County, Nevada, are closed to public access because of dangers posed by the Rush Fire...

Soft Budget Constraints in Public Hospitals.

Science.gov (United States)

Wright, Donald J

2016-05-01

A soft budget constraint arises when a government is unable to commit to not 'bailout' a public hospital if the public hospital exhausts its budget before the end of the budget period. It is shown that if the political costs of a 'bailout' are relatively small, then the public hospital exhausts the welfare-maximising budget before the end of the budget period and a 'bailout' occurs. In anticipation, the government offers a budget to the public hospital that may be greater than or less than the welfare-maximising budget. In either case, the public hospital treats 'too many' elective patients before the 'bailout' and 'too few' after. The introduction of a private hospital reduces the size of any 'bailout' and increases welfare. Copyright © 2015 John Wiley & Sons, Ltd.

Southern Stalemate: Five Years without Public Education in Prince Edward County, Virginia

Science.gov (United States)

Bonastia, Christopher

2012-01-01

In 1959, Virginia's Prince Edward County closed its public schools rather than obey a court order to desegregate. For five years, black children were left to fend for themselves while the courts decided if the county could continue to deny its citizens public education. Investigating this remarkable and nearly forgotten story of local, state, and…

China Dimensions Data Collection: Chinese County-Level Data on Hospitals and Epidemiology Stations, 1950-1985

Data.gov (United States)

National Aeronautics and Space Administration — Chinese County-Level Data on Hospitals and Epidemiology Stations, 1950-1985 consists of hospital and epidemiological station data for the administrative regions of...

Strategic management of Public Hospitals' medical services.

Science.gov (United States)

Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua

2016-01-01

Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.

Rationalization of Public Road Passenger Transport by Merging Bus Lines on the Example of Zadar County

OpenAIRE

Goran Kos; Predrag Brlek; Igor Franolić

2012-01-01

This study consists of the analysis of public passenger transport in Zadar County, that is, transport on the County and school lines and suggestions of transport rationalization. The rationalization comprises the application of the County and school lines integration, as well as suggestions of other measures which aim to reduce transport costs financed by Zadar County. The objectives to rationalize public passenger transport have been defined, all County transport lines of schoolchildren and ...

Health Behaviour among Nurses Working in Public Hospitals in Kakamega County, Kenya

Directory of Open Access Journals (Sweden)

Mchidi Kiguhe Nebert

2017-01-01

Full Text Available Health behaviour refers to actions undertaken by a person who perceives self to be ill for the purpose of finding an appropriate remedy. Nurses as gate keepers of health are expected to seek formal treatment when they are taken ill because this is what they teach their patients. Nurses’ working conditions all over the world are described as squalid with long working hours and workload. This scenario predisposes them to occupational health hazards and at the same time denies them time for self-care. Although nurses are knowledgeable about disease and its treatment and have access to health care, they engage in self-treatment in contrast to what they teach patients. Health behaviour among nurses in Kakamega County was investigated using a cross-sectional design. Data was collected using self-administered questionnaires and subjected to bivariate and logistic regression analyses. The study found that health behaviour of nurses in Kakamega County is below expectation, as 33% (n=61 engaged in voluntary screening services. Further, 34.8% (n=65 said that their health would improve if they engaged in health promotion activities. The study recommends empowering nurses to engage in positive health behaviour through education. The county should also provide affordable screening services to its nurses.

The Mecklenburg County Interlocal Agreement: An 18-Year Collaboration Between Medicine and Public Health.

Science.gov (United States)

Piper, Crystal N; Plescia, Marcus; Keener, Stephen R; DeHaven, Mark

Better integration of public health and medical services has been a long-standing goal in the United States and has been widely discussed in the scientific literature. To identify key lessons and outcomes of the Mecklenburg County Interlocal Agreement, one of the longest running efforts integrating health care delivery and public health services in a major metropolitan area. In-depth key informant interviews and brief questionnaires of leaders involved in the Mecklenburg County Interlocal Agreement. Charlotte-Mecklenburg County, North Carolina. Convenience sample of 15 past and present employees and administrative leaders of the Mecklenburg County Privatization Initiative from the Mecklenburg County Health Department (N = 7) and Carolinas Healthcare System (N = 8). Attitudes reflecting the effects of the Mecklenburg County Privatization Initiative, based on 6 "synergies" for evaluating the effectiveness of health care and public health system collaboration. Mean scores were calculated for 21 questionnaire items, using 5-point Likert scales (1 = no impact; 5 = great impact). Mean scores were calculated by averaging the multiple-item question sets reflecting each of the 6 synergies. Synergy scores ranged from a low of 3.1 (3 items reflecting whether the collaboration "Used clinical practice to identify and address community health problems") to a high of 3.7 (3 items reflecting whether the collaboration "Improved health care by coordinating services for individuals"). The in-depth interviews indicated a clear impact for the 2 synergies linked to individual care. Increased access to care emerged as a strong theme, along with the belief that medical care services were improved and that these improvements persist. The findings of this study provide perspective from an 18-year contractual agreement for a large health care system to operate county public health functions. Implications include the need to incorporate well-defined public health principles in any

Organizational culture and its relationship with hospital performance in public hospitals in China.

Science.gov (United States)

Zhou, Ping; Bundorf, Kate; Le Chang, Ji; Huang, Jin Xin; Xue, Di

2011-12-01

To measure perceptions of organizational culture among employees of public hospitals in China and to determine whether perceptions are associated with hospital performance. Hospital, employee, and patient surveys from 87 Chinese public hospitals conducted during 2009. Developed and administered a tool to assess organizational culture in Chinese public hospitals. Used factor analysis to create measures of organizational culture. Analyzed the relationships between employee type and perceptions of culture and between perceptions of culture and hospital performance using multivariate models. Employees perceived the culture of Chinese public hospitals as stronger in internal rules and regulations, and weaker in empowerment. Hospitals in which employees perceived that the culture emphasized cost control were more profitable and had higher rates of outpatient visits and bed days per physician per day but also had lower levels of patient satisfaction. Hospitals with cultures perceived as customer-focused had longer length of stay but lower patient satisfaction. Managers in Chinese public hospitals should consider whether the culture of their organization will enable them to respond effectively to their changing environment. © Health Research and Educational Trust.

Radon in Public Waterworks at the Cities of Pozega-Slavonia County

International Nuclear Information System (INIS)

Radolic, V.; Saric, I.; Miklavcic, I.

2008-01-01

At the end of year 2005, there was a sampling campaign of water samples from the public waterworks at the cities and municipalities of Pozega-Slavonia County. Number of measuring locations was defined by the number of inhabitants in each city or municipality with criterion of 1 location per 3000 inhabitants. Samples were taken from private wells as well, at those municipalities without public waterworks infrastructure. Radon measurements in water samples were performed by Alpha GUARD measuring system using standard procedure for quick measurements. The obtained values were in range of 3.5 to 35.9 Bq l -1 with arithmetic mean of 15.0 Bq l -1 and standard deviation of 8.2 Bq l -1 . These values are significantly lower than reference level of 100 Bq l -1 recommended by the European Commission; a concentration above this level warrants consideration of possible remedial action. Statistical t-test pointed out there is significant difference between average radon concentrations in water sampled from public supply and those from private wells. The estimation of annual effective dose received by an inhabitant of Pozega-Slavonia County from ingestion of water from public supply containing averaged 15.0 Bq l -1 of radon is 38 μSv/year. In addition, the annual effective dose due to inhalation of radon and its short lived daughters for the population of Pozega-Slavonia County is around 50 times greater (1.9 mSv/year) so as the risk for public health.(author)

HMO penetration: has it hurt public hospitals?

Science.gov (United States)

Clement, J P; Grazier, K L

2001-01-01

The purpose of this study is to determine the extent to which health maintenance organization (HMO) penetration within the public hospitals' market area affects the financial performance and viability of these institutions, relative to private hospitals. Hospital- and market-specific measures are examined in a fully interacted model of over 2,300 hospitals in 321 metropolitan statistical areas (MSAs) in 1995. Although hospitals located in markets with higher HMO penetration have lower financial performance as reflected in revenues, expenses and operating margin, public hospitals are not more disadvantaged than other hospitals by managed care.

Outsourcing in public hospitals: a Greek perspective.

Science.gov (United States)

Moschuris, Socrates J; Kondylis, Michael N

2006-01-01

The purpose of this research is to investigate the extent of outsourcing, the decision-making process, the impact of outsourcing, and the future trend of outsourcing in public hospitals in Greece. A survey instrument was designed and mailed to a random sample of 100 public hospitals in Greece and 43 usable questionnaires were received, representing a response rate of 43 percent. The survey instrument focused on the extent to which public hospitals outsource services, the decision-making process for choosing an external service provider, the impact of outsourcing, and the future trend of outsourcing in public healthcare organisations. Public hospitals in Greece outsource a variety of activities. Cost savings and customer satisfaction are the main factors affecting the outsourcing decision. The cooperation with a contract service provider has led to significant improvement in service quality levels. Most users are satisfied with the performance of these companies and believe that there will be an increase in the usage of these services in the future. It provides a decision-making framework regarding outsourcing in public healthcare organisations. This research fills the gap in the area of outsourcing in public hospitals in Greece.

Public knowledge and attitudes towards the 60Co incident in Qixian County, Henan Province

International Nuclear Information System (INIS)

Lei Cuiping; Cheng Xiaojun; Zhang Qinfu

2011-01-01

Objective: To investigate radiation risk perception and nuclear acceptance after the 60 Co stuck source incident in June 2009 in Qixian County, Henan Province. Methods: From March to April 2010, 23 hamlets and 2 schools from 5 towns in Qixian County were selected, while 3 hamlets and 2 schools from 3 towns were used as control in Huixian County, 135 km away where no any impact of the incident was found. Face-to-face questionnaire survey was conducted among three groups including mass public, elite public (representatives of public opinion, such as physicians, teachers, governmental officials, administrative personnel, private entrepreneurs), and middle school students (the third grade students in junior middle schools and the first grade students in senior middle schools). Results: A total of 1 340 valid questionnaires were collected. The public knowledge levels about radiation and nuclear power were low among all groups in two areas and public knowledge levels in Qixian County were higher than those in Huixian County. In both areas.the knowledge levels of the students were higher than those among the elite public, and that among the general public were the lowest. The knowledge levels of males and those with higher educational levels were higher than those of females and those with lower educational levels. More than 40.0% of the respondents supported the idea to build nuclear power plants in China, but only a small part of them supported to build nuclear power plants in their own areas. The percentages of opponents against local nuclear power plant construction were especially higher among the students and those with higher educational levels. More than 60% of the mass public and elite public believed the explanation of the government. More than 80% of the respondents held negative attitudes towards the performance of the Qixian County Government in dealing with this incident. The student gave the lowest evaluation of the credibility and the specific performance

75 FR 79018 - Notice of Realty Action: Proposed Sale of Public Lands in Bear Lake County, ID

Science.gov (United States)

2010-12-17

...-10-0001] Notice of Realty Action: Proposed Sale of Public Lands in Bear Lake County, ID AGENCY... Management (BLM) proposes the sale of 26 parcels of public lands totaling 1,543.14 acres in Bear Lake County... Bear Lake County, Idaho, are proposed for sale under the authority of Sections 203 and 209 of FLPMA (90...

Rationalization of Public Road Passenger Transport by Merging Bus Lines on the Example of Zadar County

Directory of Open Access Journals (Sweden)

Goran Kos

2012-07-01

Full Text Available This study consists of the analysis of public passenger transport in Zadar County, that is, transport on the County and school lines and suggestions of transport rationalization. The rationalization comprises the application of the County and school lines integration, as well as suggestions of other measures which aim to reduce transport costs financed by Zadar County. The objectives to rationalize public passenger transport have been defined, all County transport lines of schoolchildren and other passengers have been analysed as well as actual deficiencies in the city, County and school transport needs. Road transport infrastructure, carriers and transportation vehicles have been analysed. The future transport demand has been reviewed and the prediction of passengers on lines has been provided. Within the next five to ten years no relevant changes will take place, meaning that the balance in transport supply and demand will not be disrupted significantly. This study presents the measures for transport cost reduction and increase in the safety level in the performance of public transport.

Allegheny County Public Swimming Pool, Hot Tub, and Spa Inspections

Data.gov (United States)

Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Public swimming pool, hot tub, and spa facilities are licensed and inspected once each year to assure proper water quality, sanitation, lifeguard coverage and...

Additional funding mechanisms for Public Hospitals in Greece: the case of Chania Mental Health Hospital.

Science.gov (United States)

Rentoumis, Anastasios; Mantzoufas, Nikolaos; Kouris, Gavriil; Golna, Christina; Souliotis, Kyriakos

2010-11-10

To investigate whether the long term lease of public hospital owned land could be an additional financing mechanism for Greek public (mental) health hospitals. We performed a financial analysis of the official 2008 data of a case - study hospital (Mental Health Hospital of Chania). We used a capital budgeting approach to investigate whether value is created for the public hospital by engaging its assets in a project for the development of a private renal dialysis Unit. The development of the private unit in hospital owned land is a good investment decision, as it generates high project Net Present Value and Internal Rate of Return. When the project commences generating operating cash flows, nearly €400.000 will be paid annually to the Mental Health Hospital of Chania as rent, thereby gradually decreasing the annual deficit of the hospital. Revenue generated from the long term lease of public hospital land is crucial to gradually eliminate hospital deficit. The Ministry of Health should encourage similar forms of Public Private Partnerships in order to ensure the sustainability of public (mental) hospitals.

Does providing more services increase the primary hospitals' revenue? An assessment of national essential medicine policy based on 2,675 counties in China.

Directory of Open Access Journals (Sweden)

Fei Chen

Full Text Available To understand whether the increased outpatient service provision (OSP brings in enough additional income (excluding income from essential medicine for primary hospitals (INCOME to compensate for reduced costs of medicine.The two outcomes, annual OSP and INCOME for the period of 2008-2012, were collected from 34,506 primary hospitals in 2,675 counties in 31 provinces in China by the national surveillance system. The data had a four-level hierarchical structure; time points were nested within primary hospital, hospitals within county, and counties within province. We fitted bivariate five-level random effects regression models to examine correlations between OSP and INCOME in terms of their mean values and dose-response effects of the essential medicine policy (EMP. We adjusted for the effects of time period and selected hospital resources.The estimated correlation coefficients between the two outcomes' mean values were strongly positive among provinces (r = 0.910, moderately positive among counties (r = 0.380, and none among hospitals (r = 0.002 and time (r = 0.007. The correlation between their policy effects was weakly positive among provinces (r = 0.234, but none at the county and hospital levels. However, there were markedly negative correlation coefficients between the mean and policy effects at -0.328 for OSP and -0.541 for INCOME at the hospital level.There was no evidence to suggest an association between the two outcomes in terms of their mean values and dose-response effects of EMP at the hospital level. This indicated that increased OSP did not bring enough additional INCOME. Sustainable mechanisms to compensate primary hospitals are needed.

Lessons Learned From the Environmental Public Health Tracking Sub-County Data Pilot Project.

Science.gov (United States)

Werner, Angela K; Strosnider, Heather; Kassinger, Craig; Shin, Mikyong

2017-12-07

Small area data are key to better understanding the complex relationships between environmental health, health outcomes, and risk factors at a local level. In 2014, the Centers for Disease Control and Prevention's National Environmental Public Health Tracking Program (Tracking Program) conducted the Sub-County Data Pilot Project with grantees to consider integration of sub-county data into the National Environmental Public Health Tracking Network (Tracking Network). The Tracking Program and grantees developed sub-county-level data for several data sets during this pilot project, working to standardize processes for submitting data and creating required geographies. Grantees documented challenges they encountered during the pilot project and documented decisions. This article covers the challenges revealed during the project. It includes insights into geocoding, aggregation, population estimates, and data stability and provides recommendations for moving forward. National standards for generating, analyzing, and sharing sub-county data should be established to build a system of sub-county data that allow for comparison of outcomes, geographies, and time. Increasing the availability and accessibility of small area data will not only enhance the Tracking Network's capabilities but also contribute to an improved understanding of environmental health and informed decision making at a local level.

Additional funding mechanisms for Public Hospitals in Greece: the case of Chania Mental Health Hospital

Directory of Open Access Journals (Sweden)

Golna Christina

2010-11-01

Full Text Available Abstract Objectives To investigate whether the long term lease of public hospital owned land could be an additional financing mechanism for Greek public (mental health hospitals. Methods We performed a financial analysis of the official 2008 data of a case - study hospital (Mental Health Hospital of Chania. We used a capital budgeting approach to investigate whether value is created for the public hospital by engaging its assets in a project for the development of a private renal dialysis Unit. Results The development of the private unit in hospital owned land is a good investment decision, as it generates high project Net Present Value and Internal Rate of Return. When the project commences generating operating cash flows, nearly €400.000 will be paid annually to the Mental Health Hospital of Chania as rent, thereby gradually decreasing the annual deficit of the hospital. Conclusions Revenue generated from the long term lease of public hospital land is crucial to gradually eliminate hospital deficit. The Ministry of Health should encourage similar forms of Public Private Partnerships in order to ensure the sustainability of public (mental hospitals.

Kenya Hospices and Palliative Care Association: integrating palliative care in public hospitals in Kenya.

Science.gov (United States)

Ali, Zipporah

2016-01-01

In Kenya, cancers as a disease group rank third as a cause of death after infectious and cardiovascular diseases. It is estimated that the annual incidence of cancer is about 37,000 new cases with an annual mortality of 28,000 cases (Kenya National Cancer Control Strategy 2010). The incidence of non-communicable diseases accounts for more than 50% of total hospital admissions and over 55% of hospital deaths (Kenya National Strategy for the Prevention and Control of Non Communicable Diseases 2015-2020). The prevalence of HIV is 6.8 (KIAS 2014). Most of these patients will benefit from palliative care services, hence the need to integrate palliative care services in the public healthcare system. The process of integrating palliative care in public hospitals involved advocacy both at the national level and at the institutional level, training of healthcare professionals, and setting up services within the hospitals that we worked with. Technical support was provided to each individual institution as needed. Eleven provincial hospitals across the country have now integrated palliative care services (Palliative Care Units) and are now centres of excellence. Over 220 healthcare providers have been trained, and approximately, over 30,000 patients have benefited from these services. Oral morphine is now available in the hospital palliative care units. As a success of the pilot project, Kenya Hospices and Palliative Care Association (KEHPCA) is now working with the Ministry of Health Kenya to integrate palliative care services in 30 other county hospitals across the country, thus ensuring more availability and access to more patients. Other developing countries can learn from Kenya's successful experience.

76 FR 12753 - Notice of Temporary Closures on Public Lands in Ada and Elmore Counties, ID

Science.gov (United States)

2011-03-08

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLIDB00200 LF20000ES.JS0000 LFESFTF60000] Notice of Temporary Closures on Public Lands in Ada and Elmore Counties, ID AGENCY: Bureau of Land... business hours. SUPPLEMENTARY INFORMATION: The Big Fire closure affects public lands located in Ada County...

Association between community health center and rural health clinic presence and county-level hospitalization rates for ambulatory care sensitive conditions: an analysis across eight US states.

Science.gov (United States)

Probst, Janice C; Laditka, James N; Laditka, Sarah B

2009-07-31

Federally qualified community health centers (CHCs) and rural health clinics (RHCs) are intended to provide access to care for vulnerable populations. While some research has explored the effects of CHCs on population health, little information exists regarding RHC effects. We sought to clarify the contribution that CHCs and RHCs may make to the accessibility of primary health care, as measured by county-level rates of hospitalization for ambulatory care sensitive (ACS) conditions. We conducted an ecologic analysis of the relationship between facility presence and county-level hospitalization rates, using 2002 discharge data from eight states within the US (579 counties). Counties were categorized by facility availability: CHC(s) only, RHC(s) only, both (CHC and RHC), and neither. US Agency for Healthcare Research and Quality definitions were used to identify ACS diagnoses. Discharge rates were based on the individual's county of residence and were obtained by dividing ACS hospitalizations by the relevant county population. We calculated ACS rates separately for children, working age adults, and older individuals, and for uninsured children and working age adults. To ensure stable rates, we excluded counties having fewer than 1,000 residents in the child or working age adult categories, or 500 residents among those 65 and older. Multivariate Poisson analysis was used to calculate adjusted rate ratios. Among working age adults, rate ratio (RR) comparing ACS hospitalization rates for CHC-only counties to those of counties with neither facility was 0.86 (95% Confidence Interval, CI, 0.78-0.95). Among older adults, the rate ratio for CHC-only counties compared to counties with neither facility was 0.84 (CI 0.81-0.87); for counties with both CHC and RHC present, the RR was 0.88 (CI 0.84-0.92). No CHC/RHC effects were found for children. No effects were found on estimated hospitalization rates among uninsured populations. Our results suggest that CHCs and RHCs may play a

Association between community health center and rural health clinic presence and county-level hospitalization rates for ambulatory care sensitive conditions: an analysis across eight US states

Directory of Open Access Journals (Sweden)

Laditka Sarah B

2009-07-01

Full Text Available Abstract Background Federally qualified community health centers (CHCs and rural health clinics (RHCs are intended to provide access to care for vulnerable populations. While some research has explored the effects of CHCs on population health, little information exists regarding RHC effects. We sought to clarify the contribution that CHCs and RHCs may make to the accessibility of primary health care, as measured by county-level rates of hospitalization for ambulatory care sensitive (ACS conditions. Methods We conducted an ecologic analysis of the relationship between facility presence and county-level hospitalization rates, using 2002 discharge data from eight states within the US (579 counties. Counties were categorized by facility availability: CHC(s only, RHC(s only, both (CHC and RHC, and neither. US Agency for Healthcare Research and Quality definitions were used to identify ACS diagnoses. Discharge rates were based on the individual's county of residence and were obtained by dividing ACS hospitalizations by the relevant county population. We calculated ACS rates separately for children, working age adults, and older individuals, and for uninsured children and working age adults. To ensure stable rates, we excluded counties having fewer than 1,000 residents in the child or working age adult categories, or 500 residents among those 65 and older. Multivariate Poisson analysis was used to calculate adjusted rate ratios. Results Among working age adults, rate ratio (RR comparing ACS hospitalization rates for CHC-only counties to those of counties with neither facility was 0.86 (95% Confidence Interval, CI, 0.78–0.95. Among older adults, the rate ratio for CHC-only counties compared to counties with neither facility was 0.84 (CI 0.81–0.87; for counties with both CHC and RHC present, the RR was 0.88 (CI 0.84–0.92. No CHC/RHC effects were found for children. No effects were found on estimated hospitalization rates among uninsured populations

Driven to Support: Individual- and County-Level Factors Associated With Public Support for Active Transportation Policies.

Science.gov (United States)

Cradock, Angie L; Barrett, Jessica L; Chriqui, Jamie F; Evenson, Kelly R; Goins, Karin Valentine; Gustat, Jeanette; Heinrich, Katie M; Perry, Cynthia K; Scanze, Michele; Schmid, Thomas L; Tabak, Rachel G; Umstattd Meyer, M Renee; Valko, Cheryl

2018-03-01

To assess predictors of stated support for policies promoting physically active transportation. Cross-sectional. US counties selected on county-level physical activity and obesity health status. Participants completing random-digit dialed telephone survey (n = 906). Survey measures assessed stated support for 5 policies to promote physically active transportation, access to active transportation facilities, and time spent in a car. County-level estimates included household car dependence and funding for bicycle-pedestrian projects. Multivariable generalized linear mixed models using binary distribution and logit link, accounting for clustering within county. Respondents supported policies for accommodating bicyclists and pedestrians through street improvements (89%), school active transportation programs (75%), employer-funded active commuting incentives (67%), and allocation of public funding (68%) and tax support (56%) for building and maintaining public transit. Residents spending >2 h/d (vs public transit (OR: 1.85; CI: 1.24-2.77) improvements. Residents in counties investing >$1.6 million in bicycle and pedestrian improvements expressed greater support for funding (OR: 1.71; CI: 1.04-2.83) and tax increases (OR: 1.73; CI: 1.08-2.75) for transit improvements compared to those with lower prior investments (transportation is higher where relevant investments in active transportation infrastructure are large (>$1.6 M), public transit is nearby, and respondents drive >2 h/d.

Re-thinking barriers to organizational change in public hospitals.

Science.gov (United States)

Edwards, Nigel; Saltman, Richard B

2017-01-01

Public hospitals are well known to be difficult to reform. This paper provides a comprehensive six-part analytic framework that can help policymakers and managers better shape their organizational and institutional behavior. The paper first describes three separate structural characteristics which, together, inhibit effective problem description and policy design for public hospitals. These three structural constraints are i) the dysfunctional characteristics found in most organizations, ii) the particular dysfunctions of professional health sector organizations, and iii) the additional dysfunctional dimensions of politically managed organizations. While the problems in each of these three dimensions of public hospital organization are well-known, and the first two dimensions clearly affect private as well as publicly run hospitals, insufficient attention has been paid to the combined impact of all three factors in making public hospitals particularly difficult to manage and steer. Further, these three structural dimensions interact in an institutional environment defined by three restrictive context limitations, again two of which also affect private hospitals but all three of which compound the management dilemmas in public hospitals. The first contextual limitation is the inherent complexity of delivering high quality, safe, and affordable modern inpatient care in a hospital setting. The second contextual limitation is a set of specific market failures in public hospitals, which limit the scope of the standard financial incentives and reform measures. The third and last contextual limitation is the unique problem of generalized and localized anxiety , which accompanies the delivery of medical services, and which suffuses decision-making on the part of patients, medical staff, hospital management, and political actors alike. This combination of six institutional characteristics - three structural dimensions and three contextual dimensions - can help explain why

Increased hospital admissions associated with extreme-heat exposure in King County, Washington, 1990-2010.

Science.gov (United States)

Isaksen, Tania Busch; Yost, Michael G; Hom, Elizabeth K; Ren, You; Lyons, Hilary; Fenske, Richard A

2015-01-01

Increased morbidity and mortality have been associated with extreme heat events, particularly in temperate climates. Few epidemiologic studies have considered the impact of extreme heat events on hospitalization rates in the Pacific Northwest region. This study quantifies the historic (May to September 1990-2010) heat-morbidity relationship in the most populous Pacific Northwest County, King County, Washington. A relative risk (RR) analysis was used to explore the association between heat and all non-traumatic hospitalizations on 99th percentile heat days, whereas a time series analysis using a piecewise linear model approximation was used to estimate the effect of heat intensity on hospitalizations, adjusted for temporal trends and day of the week. A non-statistically significant 2% [95% CI: 1.02 (0.98, 1.05)] increase in hospitalization risk, on a heat day vs. a non-heat day, was noted for all-ages and all non-traumatic causes. When considering the effect of heat intensity on admissions, we found a statistically significant 1.59% (95% CI: 0.9%, 2.29%) increase in admissions per degree increase in humidex above 37.4°C. Admissions stratified by cause and age produced statistically significant results with both relative risk and time series analyses for nephritis and nephrotic syndromes, acute renal failure, and natural heat exposure hospitalizations. This study demonstrates that heat, expressed as humidex, is associated with increased hospital admissions. When stratified by age and cause of admission, the non-elderly age groups (<85 years) experience significant risk for nephritis and nephrotic syndromes, acute renal failure, natural heat exposure, chronic obstructive pulmonary disease, and asthma hospitalizations.

Public hospital autonomy in China in an international context.

Science.gov (United States)

Allen, Pauline; Cao, Qi; Wang, Hufeng

2014-01-01

Following decades of change in health care structures and modes of funding, China has recently been making pilot reforms to the governance of its public hospitals, primarily by increasing the autonomy of public hospitals and redefining the roles of the health authorities. In this paper, we analyse the historical evolution and current situation of public hospital governance in China, focussing the range of governance models being tried out in pilot cities across China. We then draw on the experiences of public hospital governance reform in a wide range of other countries to consider the nature of the Chinese pilots. We find that the key difference in China is that the public hospitals in the pilot schemes do not receive sufficient funding from government and are able to distribute profits to staff. This creates incentives to charge patients for excessive treatment. This situation has undermined public service orientation in Chinese public hospitals. We conclude that the pilot reforms of governance will not be sufficient to remedy all the problems facing these hospitals, although they are a step in the right direction. Copyright © 2013 John Wiley & Sons, Ltd.

Bedfordshire County Structure Plan. Proposed alterations. Results of public consultation. Policy 97: Nuclear waste

International Nuclear Information System (INIS)

1984-01-01

The document refers to Alterations to the County Structure Plan, proposed by Bedfordshire County Council and submitted to the Secretary of State for the Environment. An additional Alteration initiated at the County Council's meeting, dealing with nuclear waste, had not been the subject of prior public consultation. Consultation had since been arranged, and the present document summarises the responses that have been received, and describes the next action to be taken. (U.K.)

Taxation as metaphor. The hospital and public responsibility.

Science.gov (United States)

Friedman, E

1992-01-01

In the debate over the tax status of voluntary hospitals, most hospital executives and trustees do not seem to comprehend--or want to comprehend--the underlying issues. First, the terror of being associated with a tax hike has led many politicians to seek other "revenue enhancements" that are more ingenious than they are honest. On the other hand, many of these governments have legitimate financial problems and are seeking new sources of revenue. A second, related issue is uncertainty over what should be done about the uninsured and Medicaid populations. In the absence of an acceptable solution, we will continue to provide direct public support to public hospitals and indirect public support to private providers--including charitable tax exemptions. The third underlying issue is hospitals' curiously narrow view of their private-sector status. Most of the functions hospitals provide are not only publicly funded; they are, in fact, public functions. Finally, hospitals believe they are inherently moral organizations because they provide an inherently moral service. But hospitals grew to their present role in society almost by accident; their services are neither unique nor ethically superior. It is in how hospitals provide care that their morality can be measured, not in the fact that they provide some kind of care to somebody. An honest appraisal of these issues will help each hospital answer the basic question: As an ethical and moral matter, should this organization be paying taxes? But is this fight really about taxes? I believe society and government are using taxation as a metaphor for trust in hospitals.

Bedfordshire County Structure Plan. Proposed alterations -Public participation statement. Policy 97: Nuclear waste

International Nuclear Information System (INIS)

1984-01-01

The document describes steps taken, in accord with the Town and Country Planning Act 1971, by Bedfordshire County Council, submitting proposed Alterations to the County Structure Plan to the Secretary of State for the Environment. When approving the submission the Council decided to add an additional Alteration dealing with nuclear waste: as this had not been the subject of public consultation the Council decided to seek the public's views on the proposal before submitting the Alteration. The arrangements for consultation and a list of persons and organizations consulted are given, together with the arrangements for considering comments. (U.K.)

THE FACTORS AFFECTING SATISFACTION LEVELS IN HOSPITALIZED PATIENTS: AN APPLICATION IN PUBLIC HOSPITAL

Directory of Open Access Journals (Sweden)

Neşe ACAR

2017-09-01

Full Text Available This study was conducted to determine the factors that affect the level of satisfaction of services provided by public hospitals. Patients' satisfaction levels were measured by interviewing 156 patients in a public hospital. Factor analysis of the data obtained from the research resulted in five factors called nurses 'behaviors, physical conditions, doctors' behavior, technical staff behaviors, food and beverage. MANOVA analysis was conducted to determine the differences in the perception of factors with respect to the demographic characteristics of the patients and differences were found in terms of profession. It has been seen that it is important that public hospitals have specialist doctors and modern equipment and that they have qualities such as the quality of the health personnel in preferring patients to public hospitals.

Hospital information system institutionalization processes in indonesian public, government-owned and privately owned hospitals.

Science.gov (United States)

Handayani, P W; Hidayanto, A N; Ayuningtyas, Dumilah; Budi, Indra

2016-11-01

The Hospital Information System (HIS) could help hospitals as a public entity to provide optimal health services. One of the main challenges of HIS implementation is an institutional change. Using institutional theory as the analytical lens, this study aims to explain the institutionalization of HIS as an instance of e-health initiatives in Indonesia. Furthermore, this paper aims for hospital management and researchers to improve the understanding of the social forces that influence hospital personnel's HIS acceptance within an organizational context. We use case studies from four public, government-owned hospitals and four privately owned (public and specialty) hospitals to explain the HIS institutionalization process by exploring the three concepts of institutional theory: institutional isomorphism, institutional logic, and institutional entrepreneurship. This study reveals that differences exist between public, government-owned and private hospitals with regard to the institutionalization process: public, government-owned hospitals' management is more motivated to implement HIS to comply with the regulations, while private hospitals' management views HIS as an urgent requirement that must be achieved. The study findings also reveal that various institutional isomorphism mechanisms and forms of institutional logic emerge during the process. Finally, three factors-self-efficacy, social influence, and management support-have a significant influence on the individual acceptance of HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Management challenges at the intersection of public policy environments and strategic decision making in public hospitals.

Science.gov (United States)

Longest, Beaufort B

2012-01-01

Hospitals in the United States are heavily impacted by public policies that affect them. For example, Medicare and Medicaid programs account for more than half the revenue in most of the nation's almost 5,000 community hospitals, including the almost 1,100 public hospitals controlled by state and local governments (American Hospital Association, 2012). The public hospitals are especially closely aligned with and controlled by governmental entities compared with hospitals with other kinds of sponsorship. This article addresses the management challenges at the intersection of the strategic management of public hospitals and their public policy environments. Public hospitals are complicated entities designed not only to provide health services but also in many cases to play key roles in health-related research and education and to play important general economic development roles in their communities. The multi-faceted strategic decision making in these organizations is as heavily affected by their public policy environments as by their business, demographic, technological or other external environments. Effectively managing the intersection of their public policy environments and their strategic management is indeed vital for contemporary public hospitals. This article is intended to clarify certain aspects of this intersection through a description and model of the strategic activity in public hospitals and the connection between this activity and their external environments. Specific attention is focused on the concept of public policy environments and their features. Attention is also given to how managers can assess public policy environments and incorporate the results into strategic activities.

Relationship between hospital financial performance and publicly reported outcomes.

Science.gov (United States)

Nguyen, Oanh Kieu; Halm, Ethan A; Makam, Anil N

2016-07-01

Hospitals that have robust financial performance may have improved publicly reported outcomes. To assess the relationship between hospital financial performance and publicly reported outcomes of care, and to assess whether improved outcome metrics affect subsequent hospital financial performance. Observational cohort study. Hospital financial data from the Office of Statewide Health Planning and Development in California in 2008 and 2012 were linked to data from the Centers for Medicare and Medicaid Services Hospital Compare website. Hospital financial performance was measured by net revenue by operations, operating margin, and total margin. Outcomes were 30-day risk-standardized mortality and readmission rates for acute myocardial infarction (AMI), congestive heart failure (CHF), and pneumonia (PNA). Among 279 hospitals, there was no consistent relationship between measures of financial performance in 2008 and publicly reported outcomes from 2008 to 2011 for AMI and PNA. However, improved hospital financial performance (by any of the 3 measures) was associated with a modest increase in CHF mortality rates (ie, 0.26% increase in CHF mortality rate for every 10% increase in operating margin [95% confidence interval: 0.07%-0.45%]). Conversely, there were no significant associations between outcomes from 2008 to 2011 and subsequent financial performance in 2012 (P > 0.05 for all). Robust financial performance is not associated with improved publicly reported outcomes for AMI, CHF, and PNA. Financial incentives in addition to public reporting, such as readmissions penalties, may help motivate hospitals with robust financial performance to further improve publicly reported outcomes. Reassuringly, improved mortality and readmission rates do not necessarily lead to loss of revenue. Journal of Hospital Medicine 2016;11:481-488. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

Radon in Public Waterworks at the Cities of Osijek-Baranja County

International Nuclear Information System (INIS)

Radolic, V.; Simatovic, V.; Miklavcic, I.

2008-01-01

At the end of year 2007, there was a sampling campaign of water samples from the public waterworks at the cities and municipalities of Osijek-Baranja County. Number of measuring locations was defined by the number of inhabitants in each city or municipality with criterion of 1 location per 3000 inhabitants. Samples were taken from private wells as well, at those municipalities without public waterworks infrastructure. In total, there were performed 130 measurements (19 from private wells). Radon measurements in water samples were performed by Alpha GUARD measuring system using standard procedure for quick measurements. The obtained values in public water-supplies were in range of 0.6 to 15.9 Bq l -1 with arithmetic mean of 4.6 Bq l -1 and standard deviation of 3.6 Bq l -1 . In private wells, the radon values were in range of 4.0 to 17.4 Bq l -1 with arithmetic mean of 9.5 Bq l -1 and standard deviation of 3.3 Bq l -1 . These values are significantly lower than reference level of 100 Bq l -1 recommended by the European Commission; a concentration above this level warrants consideration of possible remedial action. Statistical t-test pointed out there is significant difference between average radon concentrations in water sampled from public water-supplies and those from private wells. The estimated annual effective dose received by an inhabitant of Osijek-Baranja County from ingestion of 2 l water per day from public water-supplies containing averaged 4.6 Bq l -1 of radon is 11.6 μSv/year and 24.2 μSv/year for the consummation of the same amount of water from private wells. In addition, the annual effective dose due to inhalation of radon and its short lived daughters for the population of Osijek-Baranja County is around 175 times greater (2.0 mSv/year) so as the risk for public health.(author)

Public hospitals in financial distress: Is privatization a strategic choice?

Science.gov (United States)

Ramamonjiarivelo, Zo; Weech-Maldonado, Robert; Hearld, Larry; Menachemi, Nir; Epané, Josué Patien; O'Connor, Stephen

2015-01-01

As safety net providers, public hospitals operate in more challenging environments than private hospitals. Such environments put public hospitals at greater risk of financial distress, which may result in privatization and deterioration of the safety net. The purpose of this study was to investigate whether financial distress is associated with privatization among public hospitals. We used panel data merged from the American Hospital Association Annual Survey, Medicare Cost Reports, Area Resource File, and Local Area Unemployment Statistics. Our study population consisted of all U.S. nonfederal acute care public hospitals in 1997 tracked through 2009, resulting in 6,426 hospital-year observations. The dependent variable "privatization" was defined as conversion from public status to either private not-for-profit or private for-profit status. The main independent variable, "financial distress," was based on the Altman Z-score methodology. Control variables included market and organizational factors. Two random-effects logistic regression models with state and year fixed-effects were constructed. The independent and control variables were lagged by 1 year and 2 years for Models 1 and 2, respectively. Public hospitals in financial distress had greater odds of being privatized than public hospitals not in financial distress: (OR = 4.53, p resources and may provide financial relief to government entities from the burden of continuously funding a hospital operating at a loss, which in turn may help keep the hospital open and preserve access to care for the community. Privatizing a financially distressed public hospital may be a better strategic alternative than closure. The Altman Z-score could be used as a managerial tool to monitor hospitals' financial condition and take corrective actions.

The role of public relations activities in hospital choice.

Science.gov (United States)

Tengilimoglu, Dilaver; Yesiltas, Mehmet; Kisa, Adnan; Dziegielewski, Sophia F

2007-01-01

Public relations activities for all organizations can have an important effect on consumer decision-making when buying goods or services. This study examines the effect that public relations activities can have regarding consumer decisions and choice. To explore exemplify this relationship a questionnaire was given to 971 patients within public, university and private hospitals in Ankara, Turkey. Study results show that public relations activities were a crucial factor in determining consumer hospital choice. The majority of respondents reported that the behaviors and attitude of personnel as public relations activities that support the hospital's reputation within the public were the primary variables in hospital choice. Health care managers can use these findings to further understand how patients make informed choices related to usage of a health care facility and to develop and/or improve public relations activities.

Nursing organizational climates in public and private hospitals.

Science.gov (United States)

García, I García; Castillo, R F; Santa-Bárbara, E S

2014-06-01

Researchers study climate to gain an understanding of the psychological environment of organizations, especially in healthcare institutions. Climate is considered to be the set of recurring patterns of individual and group behaviour in an organization. There is evidence confirming a relationship between ethical climate within organizations and job satisfaction. The aim of this study is to describe organizational climate for nursing personnel in public and private hospitals and to confirm the relationships among the climate variables of such hospitals. A correlational study was carried out to measure the organizational climate of one public hospital and two private hospitals in Granada. The Work Environment Scale was used for data collection. The Work Environment Scale includes 10 scales, ranging from 0 to 9, which were used to evaluate social, demographic and organizational climate variables. In this study, 386 subjects were surveyed in three hospitals. A total of 87% of the participants were female and 16% were male. Most participants were nurses (65.6%), followed by nursing aides (20%), and technicians (14.4%). The results obtained reflected different patterns of organizational climate formation, based on hospital type (i.e. public or private) within the Spanish context. Most of the dimensions were below the midpoint of the scale. In conclusion, in public hospitals, there is a greater specialization and the organizational climate is more salient than in the private hospitals. In addition, in the public hospitals, the characteristics of the human resources and their management can have a significant impact on the perception of the climate, which gives greater importance to the organizational climate as decisive of the ethical climate. © The Author(s) 2013.

Accreditation in a public hospital: perceptions of a multidisciplinary team.

Science.gov (United States)

Camillo, Nadia Raquel Suzini; Oliveira, João Lucas Campos de; Bellucci Junior, José Aparecido; Cervilheri, Andressa Hirata; Haddad, Maria do Carmo Fernandez Lourenço; Matsuda, Laura Misue

2016-06-01

to analyze the perceptions of the multidisciplinary team on Accreditation in a public hospital. descriptive, exploratory, qualitative research, performed in May 2014, using recorded individual interviews. In total, 28 employees of a public hospital, Accredited with Excellence, answered the guiding question: "Tell me about the Accreditation system used in this hospital". The interviews were transcribed and subjected to content analysis. of the speeches, three categories emerged: Advantages offered by the Accreditation; Accredited public hospital resembling a private hospital; Pride/satisfaction for acting in an accredited public hospital. participants perceived Accreditation as a favorable system for a quality management in the public service because it promotes the development of professional skills and improves cost management, organizational structure, management of assistance and perception of job pride/satisfaction.

Practices regarding hospital waste management at public and private sector hospitals of Lahore

International Nuclear Information System (INIS)

Mahmood, S.; Din, N.U.; Mohsin, J.

2011-01-01

Health care (Biomedical) waste is a term used for all waste arising from health care establishments. In most of health care centers of Pakistan, including Lahore, hospital wastes are simply mixed with the municipal waste in collecting bins at road-sides and disposed off similarly. Proper Management of biomedical waste, especially the hazardous one, being produced in hospital settings is important in terms of their ability to cause harm to the related per-sons and the environment as well. To Observe and compare the practices regarding Hospital Waste management of the public sector hospital with private sector hospital. Descriptive, Cross sectional. Methodology: Standardized checklist was used to assess the practices of nursing and sanitary staff. Practices regarding waste segregation were same at both hospitals. While practices regarding waste collection and transportation were better at The Children's Hospital. Public sector hospital has, paradoxically, better practices regarding hospital waste management in comparison to private sector hospital. (author)

75 FR 81264 - Public Utility District No. 1 of Douglas County; Notice of Intent To Prepare an Environmental...

Science.gov (United States)

2010-12-27

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 2149-152] Public Utility District No. 1 of Douglas County; Notice of Intent To Prepare an Environmental Impact Statement December 16, 2010. On May 27, 2010, Public Utility District No. 1 of Douglas County filed an application for the...

75 FR 40821 - Public Utility District No. 1 of Douglas County; Notice of Settlement Agreement and Soliciting...

Science.gov (United States)

2010-07-14

... District No. 1 of Douglas County; Notice of Settlement Agreement and Soliciting Comments July 7, 2010. Take...: Public Utility District No. 1 of Douglas County, Washington. e. Location: The existing project is located at river mile 515.6 on the Columbia River in Chelan, Douglas, and Okanogan Counties in central...

Hospital Adoption of Health Information Technology to Support Public Health Infrastructure.

Science.gov (United States)

Walker, Daniel M; Diana, Mark L

2016-01-01

Health information technology (IT) has the potential to improve the nation's public health infrastructure. In support of this belief, meaningful use incentives include criteria for hospitals to electronically report to immunization registries, as well as to public health agencies for reportable laboratory results and syndromic surveillance. Electronic reporting can facilitate faster and more appropriate public health response. However, it remains unclear the extent that hospitals have adopted IT for public health efforts. To examine hospital adoption of IT for public health and to compare hospitals capable of using and not using public health IT. Cross-sectional design with data from the 2012 American Hospital Association annual survey matched with data from the 2013 American Hospital Association Information Technology Supplement. Multivariate logistic regression was used to compare hospital characteristics. Inverse probability weights were applied to adjust for selection bias because of survey nonresponse. All acute care general hospitals in the United States that matched across the surveys and had complete data available were included in the analytic sample. Three separate outcome measures were used: whether the hospital could electronically report to immunization registries, whether the hospital could send electronic laboratory results, and whether the hospital can participate in syndromic surveillance. A total of 2841 hospitals met the inclusion criteria. Weighted results show that of these hospitals, 62.7% can electronically submit to immunization registries, 56.6% can electronically report laboratory results, and 54.4% can electronically report syndromic surveillance. Adjusted and weighted results from the multivariate analyses show that small, rural hospitals and hospitals without electronic health record systems lag in the adoption of public health IT capabilities. While a majority of hospitals are using public health IT, the infrastructure still has

Blood Transfusion Delay and Outcome in County Hospitals in Kenya.

Science.gov (United States)

Thomas, Julius; Ayieko, Philip; Ogero, Morris; Gachau, Susan; Makone, Boniface; Nyachiro, Wycliffe; Mbevi, George; Chepkirui, Mercy; Malla, Lucas; Oliwa, Jacquie; Irimu, Grace; English, Mike

2017-02-08

Severe anemia is a leading indication for blood transfusion and a major cause of hospital admission and mortality in African children. Failure to initiate blood transfusion rapidly enough contributes to anemia deaths in sub-Saharan Africa. This article examines delays in accessing blood and outcomes in transfused children in Kenyan hospitals. Children admitted with nonsurgical conditions in 10 Kenyan county hospitals participating in the Clinical Information Network who had blood transfusion ordered from September 2013 to March 2016 were studied. The delay in blood transfusion was calculated from the date when blood transfusion was prescribed to date of actual transfusion. Five percent (2,875/53,174) of admissions had blood transfusion ordered. Approximately half (45%, 1,295/2,875) of children who had blood transfusion ordered at admission had a documented hemoglobin transfusions, 82% were administered and documented in clinical records, and three-quarters of these (75%, 1,760/2,352) were given on the same day as ordered but these proportions varied from 71% to 100% across the 10 hospitals. Children who had a transfusion ordered but did not receive the prescribed transfusion had a mortality of 20%, compared with 12% among those transfused. Malaria-associated anemia remains the leading indication for blood transfusion in acute childhood illness admissions. Delays in transfusion are common and associated with poor outcomes. Variance in delay across hospitals may be a useful indicator of health system performance. © The American Society of Tropical Medicine and Hygiene.

Errors in drug administration by anaesthetists in public hospitals in ...

African Journals Online (AJOL)

Objective. To investigate errors in administering drugs by anaesthetists working in public hospitals in the Free State province. Methods. Anonymous questionnaires were distributed to doctors performing anaesthesia in public hospitals in the Free State, i.e. 188 doctors at 22 public sector hospitals. Outcomes included ...

2014-2015 Student/Parent Handbook. Wake County Public School System

Science.gov (United States)

Wake County Public School System, 2015

2015-01-01

This handbook was produced as a resource for students and parents to explain the policies, rules, and regulations governing all students in the Wake County Public School System. Numbers that appear in some portions of the handbook refer to specific Board of Education policies. In some instances the entire policy is cited; at other times, only the…

Patient awareness of breast density and interest in supplemental screening tests: comparison of an academic facility and a county hospital.

Science.gov (United States)

Trinh, Long; Ikeda, Debra M; Miyake, Kanae K; Trinh, Jennifer; Lee, Kevin K; Dave, Haatal; Hanafusa, Kei; Lipson, Jafi

2015-03-01

The aim of this study was to measure women's knowledge of breast density and their attitudes toward supplemental screening tests in the setting of the California Breast Density Notification Law at an academic facility and a county hospital, serving women with higher and lower socioeconomic status, respectively. Institutional review board exemptions were obtained. A survey was administered during screening mammography at two facilities, assessing women's awareness of and interest in knowing their breast density and interest in and willingness to pay for supplemental whole breast ultrasound and contrast-enhanced spectral mammography (CEMG). The results were compared by using Fisher exact tests between groups. A total of 105 of 130 and 132 of 153 women responded to the survey at the academic and county facilities, respectively. Among respondents at the academic and county facilities, 23% and 5% were aware of their breast density, and 94% and 79% wanted to know their density. A majority were interested in supplemental ultrasonography and CEMG at both sites; however, fewer women had a willingness to pay for the supplemental tests at the county hospital compared with those at the academic facility (22% and 70%, respectively, for ultrasound, P women were interested in knowing their breast density and in supplemental screening tests. However, women at the county hospital were less willing to incur out-of-pocket expenses, suggesting a potential for a disparity in health care access for women of lower socioeconomic status after the enactment of breast density notification legislation. Published by Elsevier Inc.

75 FR 51257 - Public Utility District No. 1 of Douglas County (Douglas PUD); Notice of Application Ready for...

Science.gov (United States)

2010-08-19

... District No. 1 of Douglas County (Douglas PUD); Notice of Application Ready for Environmental Analysis and...: May 27, 2010. d. Applicant: Public Utility District No. 1 of Douglas County (Douglas PUD). e. Name of... in Douglas, Okanogan, and Chelan Counties, Washington. The project currently occupies 15.15 acres of...

Local socioeconomic changes and public fiscal implications of coal development in Wayne County, West Virginia

Energy Technology Data Exchange (ETDEWEB)

Metzger, J. E.; Mosena, P. W.; Stenehjem, E. J.

1978-09-01

This report attempts to characterize the economic and societal effects likely to accompany increased coal mining in and around Wayne County, West Virginia. The study concludes that population growth and increased demands for public services, with the exceptions of requirements for new roads, water, and sewer services, will be minimal as a result of the two new 2-million-tons-per-year deep mines planned for the area. The study estimates that both the County and the school district will experience positive new fiscal balances; i.e., more incremental annual revenue than additional mine-related annual expenditures. However, the town of Wayne is expected to experience a negative fiscal balance throughout the period of mine production. The study and its findings are each unique in several ways. First, the findings are somewhat unique in that major impacts (rapid population in-migration, shortages in housing and public services, and fiscal imbalances) are not projected to occur. In the heart of the coal mining district of Southern West Virginia similar levels of new mining may well have much different results. In areas, for example, where there are greater shortages of developable land, less adequate public and private infrastructure, and/or fewer available trained workers, the coal-related impacts would be dramatically different than those found for Wayne County. A second unique feature of this study concerns the manner in which it was originated and conducted. This study presents estimates of impacts for Wayne County and its associated jurisdictions which represent the combined knowledge and expertise of all parties involved: the citizens ofWayne County, the County Commission, the Advisory Board, the representatives from the Governor's Office, and the Argonne staff.

Prioritizing Public- Private Partnership Models for Public Hospitals of Iran Based on Performance Indicators

Directory of Open Access Journals (Sweden)

Mohammad Asghari Jaafarabadi

2012-12-01

Full Text Available Background: The present study was conducted to scrutinize Public- Private Partnership (PPP models in public hospitals of different countries based on performance indicators in order to se-lect appropriated models for Iran hospitals.Methods: In this mixed (quantitative-qualitative study, systematic review and expert panel hasbeen done to identify varied models of PPP as well as performance indicators. In the second stepwe prioritized performance indicator and PPP models based on selected performance indicatorsby Analytical Hierarchy process (AHP technique. The data were analyzed by Excel 2007 andExpert Choice11 software’s.Results: In quality – effectiveness area, indicators like the rate of hospital infections(100%, hospital accidents prevalence rate (73%, pure rate of hospital mortality (63%, patientsatisfaction percentage (53%, in accessibility equity area indicators such as average inpatientwaiting time (100% and average outpatient waiting time (74%, and in financial – efficiency area,indicators including average length of stay (100%, bed occupation ratio (99%, specific incometo total cost ratio (97% have been chosen to be the most key performance indicators. In the prioritizationof the PPP models clinical outsourcing, management, privatization, BOO (build, own,operate and non-clinical outsourcing models, achieved high priority for various performance indicatorareas.Conclusion: This study had been provided the most common PPP options in the field of public hospitals and had gathered suitable evidences from experts for choosing appropriate PPP option for public hospitals. Effect of private sector presence in public hospital performance, based on which PPP options undertaken, will be different.

Prioritizing public- private partnership models for public hospitals of iran based on performance indicators.

Science.gov (United States)

Gholamzadeh Nikjoo, Raana; Jabbari Beyrami, Hossein; Jannati, Ali; Asghari Jaafarabadi, Mohammad

2012-01-01

The present study was conducted to scrutinize Public- Private Partnership (PPP) models in public hospitals of different countries based on performance indicators in order to se-lect appropriated models for Iran hospitals. In this mixed (quantitative-qualitative) study, systematic review and expert panel has been done to identify varied models of PPP as well as performance indicators. In the second step we prioritized performance indicator and PPP models based on selected performance indicators by Analytical Hierarchy process (AHP) technique. The data were analyzed by Excel 2007 and Expert Choice11 software's. In quality - effectiveness area, indicators like the rate of hospital infections (100%), hospital accidents prevalence rate (73%), pure rate of hospital mortality (63%), patient satisfaction percentage (53%), in accessibility equity area indicators such as average inpatient waiting time (100%) and average outpatient waiting time (74%), and in financial - efficiency area, indicators including average length of stay (100%), bed occupation ratio (99%), specific income to total cost ratio (97%) have been chosen to be the most key performance indicators. In the pri¬oritization of the PPP models clinical outsourcing, management, privatization, BOO (build, own, operate) and non-clinical outsourcing models, achieved high priority for various performance in¬dicator areas. This study had been provided the most common PPP options in the field of public hospitals and had gathered suitable evidences from experts for choosing appropriate PPP option for public hospitals. Effect of private sector presence in public hospital performance, based on which PPP options undertaken, will be different.

The challenge of corporatisation: the experience of Portuguese public hospitals.

Science.gov (United States)

Rego, Guilhermina; Nunes, Rui; Costa, José

2010-08-01

The inability of traditional state organisations to respond to new economic, technological and social challenges and the associated emerging problems has made it necessary to adopt new methods of health management. As a result, new directions have emerged in the reform of Public Administration together with the introduction of innovative models. The aim is to achieve a type of management that focuses on results as well as on effort and efficiency. We intend to analyse to what extent the adoption of business management models by hospital healthcare units can improve their performance, mainly in terms of standards of efficiency. Data envelopment analysis (DEA) was used to investigate the efficiency of a set of public Portuguese hospitals. The aim was to evaluate the impact of business management in Portuguese public hospitals with regards to efficiency, specifically taking into account the fact that lack of resources and increased health care needs are a present and future reality. From a total of 83 public hospitals, a sample of 59 hospitals was chosen, of which 21 are state-owned hospital enterprises (SA) and 38 are traditional public administration sector hospitals (SPA). This study evaluates hospital performance by calculating two efficiency measures associated with two categories of inputs. The first efficiency measures the costs associated with hospital production lines and the number of beds (representing fixed capacity) as inputs. The annual costs generated by the hospitals in the consumption of capital and work (direct and indirect costs) are used. A second measure of efficiency is calculated separately. This measure includes in the inputs the number of beds as well as the human resources available (number of doctors, number of nurses and other personnel) in each hospital. With regard to output, the variables that best reflect the hospital services rendered were considered: number of inpatient days, patients discharged, outpatient visits, emergencies

Obstacles, Realities and Opportunities in Human Resources Management in Public Administration Institutions From Bihor County (Romania and Hajdú-Bihar County (Hungary

Directory of Open Access Journals (Sweden)

Maria-Madela ABRUDAN

2015-06-01

Full Text Available The aim of this paper is to analyze the par-ticularities of human resources management in the public institutions from Bihor County (Ro-mania and Hajdu-Bihar County (Hungary. The comparative dimension of our study is framed in Hofstede’s categories of cultural differences in organizational culture. The data presented is derived from a broader study conducted on the implementation of New Public Management at local public administration institutions in Ro-mania and Hungary. The project entitled ‘Es-tablishment of R&D programmes in the f eld of new public management between economic faculties of higher education in Hajdu-Bihar and Bihor Counties’ (HURO/0901/277/2.2.2 was developed in partnership between Faculties of Economics from the Universities of Oradea and Debrecen. Our results on public human resour-ces provide relevant insight in the processes re-garding personnel in the public institutions in this region and propose solutions for improvement of the observed weaknesses. The employees of the 60 public institutions included in this research consider themselves participants in the decision-al process, yet the evaluation process needs to be reshaped in order to provide a better balance between performances and the rewards system.

78 FR 23952 - Notice of Temporary Closure on Public Lands in Elmore County, ID

Science.gov (United States)

2013-04-23

...] Notice of Temporary Closure on Public Lands in Elmore County, ID AGENCY: Bureau of Land Management, Interior. ACTION: Notice of temporary closure. SUMMARY: Notice is hereby given that the Stout Fire closure to motorized vehicle use is in effect on public lands administered by the Four Rivers Field Office...

Public mental hospital work: pros and cons for psychiatrists.

Science.gov (United States)

Miller, R D

1984-09-01

The extensive literature concerning public mental hospitals has largely been written from the perspective of administrators and systems analysts; most of the reports emphasize the frustrations and problems of working in public mental hospitals and the continued exodus of psychiatrists from these facilities. The author addresses the pros and cons of such a career choice from the viewpoint of one who has been an "Indian" rather than a "chief" for a decade. He suggests that the current financial situation in both private practice and academia makes work in public mental hospitals increasingly attractive.

Tracks FAQs: How Do Heart Attack Hospitalization Rates In My Community Compare With Other Counties Or States?

Centers for Disease Control (CDC) Podcasts

In this podcast, CDC Tracking experts discuss how to compare heart attack hospitalization rates in your community with other counties or states. Do you have a question for our Tracking experts? Please e-mail questions to trackingsupport@cdc.gov.

Online Opportunist: Mary Ellen Icaza--Montgomery County Public Libraries, Rockville, MD

Science.gov (United States)

Library Journal, 2004

2004-01-01

When Mary Ellen Icaza became Electronic Services Librarian at Montgomery County Public Libraries, she noticed that the readers' services information on the library web site was invisible, even to librarians. "And if staff can't find it," she says, "customers can't." She set out to help people find that material-and to turn a…

78 FR 20135 - Notice of Temporary Closure on Public Lands in Boise County, ID

Science.gov (United States)

2013-04-03

...] Notice of Temporary Closure on Public Lands in Boise County, ID AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Temporary Closure SUMMARY: Notice is hereby given that the Springs Fire closure to all human use is in effect on public lands administered by the Four Rivers Field Office, Bureau of...

An evaluation of public school district tobacco policies in St. Louis County, Missouri.

Science.gov (United States)

Barbero, Colleen; Moreland-Russell, Sarah; Bach, Laura E; Cyr, Julianne

2013-08-01

One way to address tobacco use by youth is for primary and secondary schools to adopt and implement comprehensive tobacco policies. The purpose of this study was to evaluate the comprehensiveness of tobacco policies in St. Louis County, Missouri public school districts. We evaluated the strength of tobacco policies from all 23 public school districts located in the county using the Center for Tobacco Policy Research's School Tobacco Policy Index, a standardized tool for rating school tobacco policies. The districts averaged a score of 24.4 of 40 possible points on the Index. Policies scored highest on the Tobacco-Free Environment domain and lowest on the Enforcement domain. Policies averaged about half of the total possible points for the Prevention and Treatment Services and Policy Organization domains. Despite more than a decade of efforts by the Centers for Disease Control and Prevention to improve school tobacco policies, this study shows that policies in St. Louis County districts have yet to meet the standard of comprehensiveness. It is recommended that schools adopt policies that are comprehensive and that address all domains of the School Tobacco Policy Index. © 2013, American School Health Association.

Patient satisfaction in Turkey: differences between public and private hospitals.

Science.gov (United States)

Tengilimoglu, D; Kisa, A; Dziegielewski, S F

1999-02-01

This article reports the results of a patient-satisfaction survey administered by interview to 2045 adults discharged from several major public and private hospitals in Turkey. The direct measurement of patient-satisfaction is a new phenomenon for this country. An instrument was designed similar to those available in the United States and administered during exit interviews. Two primary areas of analyses were determined in comparing services provided by these public and private hospitals: demographic factors with regard to accessibility and consumer perceptions of the quality of service provided. Relationships and percentages within and among the five public and two private hospitals are reported. Several statistically significant differences were found between the hospitals, with the private hospitals achieving the greatest satisfaction on most of the quality of services issues examined. Future recommendations outline the need to take into account the public's perception of these hospitals and enhancing customer satisfaction as a means of increasing service utilization.

Incidence and risk factors for neonatal tetanus in admissions to Kilifi County Hospital, Kenya.

Directory of Open Access Journals (Sweden)

Fredrick Ibinda

Full Text Available Neonatal Tetanus (NT is a preventable cause of mortality and neurological sequelae that occurs at higher incidence in resource-poor countries, presumably because of low maternal immunisation rates and unhygienic cord care practices. We aimed to determine changes in the incidence of NT, characterize and investigate the associated risk factors and mortality in a prospective cohort study including all admissions over a 15-year period at a County hospital on the Kenyan coast, a region with relatively high historical NT rates within Kenya.We assessed all neonatal admissions to Kilifi County Hospital in Kenya (1999-2013 and identified cases of NT (standard clinical case definition admitted during this time. Poisson regression was used to examine change in incidence of NT using accurate denominator data from an area of active demographic surveillance. Logistic regression was used to investigate the risk factors for NT and factors associated with mortality in NT amongst neonatal admissions. A subset of sera from mothers (n = 61 and neonates (n = 47 were tested for anti-tetanus antibodies.There were 191 NT admissions, of whom 187 (98% were home deliveries. Incidence of NT declined significantly (Incidence Rate Ratio: 0.85 (95% Confidence interval 0.81-0.89, P<0.001 but the case fatality (62% did not change over the study period (P = 0.536. Younger infant age at admission (P = 0.001 was the only independent predictor of mortality. Compared to neonatal hospital admittee controls, the proportion of home births was higher among the cases. Sera tested for antitetanus antibodies showed most mothers (50/61, 82% had undetectable levels of antitetanus antibodies, and most (8/9, 89% mothers with detectable antibodies had a neonate without protective levels.Incidence of NT in Kilifi County has significantly reduced, with reductions following immunisation campaigns. Our results suggest immunisation efforts are effective if sustained and efforts should continue to

77 FR 34033 - Public Utility District No. 1 of Douglas County; Notice of Authorization for Continued Project...

Science.gov (United States)

2012-06-08

... District No. 1 of Douglas County; Notice of Authorization for Continued Project Operation On May 27, 2010, the Public Utility District No. 1 of Douglas County, licensee for the Wells Hydroelectric Project... regulations thereunder. The Wells Hydroelectric Project is located on the Columbia River in Douglas, Okanogan...

Acceptance, Benefits, and Challenges of Public Health-Oriented Pet Business Regulations in King County, Washington.

Science.gov (United States)

Wierenga, Janelle; Thiede, Hanne; Helms, Leah; Hopkins, Sharon

2016-01-01

New regulations were implemented in King County, Washington, in 2010 requiring pet businesses to obtain a permit from Public Health-Seattle & King County (Public Health) and undergo annual inspections to provide education and ensure compliance with regulatory standards. The regulations were developed as a tool for zoonotic disease control and prevention education for businesses and their customers, as well as for environmental protection. To assess the acceptance, benefits, and challenges of the new regulations and identify ways for Public Health to improve educational efforts and assist businesses with compliance. Cross-sectional survey. King County, Washington. Pet businesses with Public Health permits in 2013. Self-administered survey responses. The response rate was 40.5%. The majority of respondents provided grooming, pet day care, and kennel/boarding services from small, independent businesses. Sixty-one percent reported Public Health inspections as beneficial, especially concerning disinfection procedures and using an infection control plan. Almost three-fourths of respondents used the Public Health template to develop the infection control plan. Forty-four percent reported using the educational materials provided by Public Health, and 62% used educational materials from other sources. Most respondents reported that they gained benefits from the pet business permit, although fewer agreed that they obtained a good value from the permit and fee. The most common benefits reported were protection of animal and human health and establishing the credibility of the pet business. Major challenges with the implementation of the pet business regulations were not generally reported by respondents. Most respondents reported a collaborative relationship between Public Health and the pet businesses. Improvements in infection control practices and positive responses to the inspections were reported by pet businesses. Survey results were used to improve infection control

76 FR 5201 - Notice of Realty Action: Competitive Sale of Public Lands in Monterey County, CA

Science.gov (United States)

2011-01-28

... interested bidders must submit written sealed bids equal to, or greater than, the appraised fair market value... County. Parcel one is proposed for sale at the appraised fair market value of $68,200. Parcel Two T. 24S... County. Parcel two is proposed for sale at the appraised fair market value of $68,200. The public lands...

78 FR 39767 - Notice of Realty Action: Direct Sale of Public Land in Blaine County, ID

Science.gov (United States)

2013-07-02

... Field Office, proposes to sell a parcel of public land totaling 3.39 acres in Blaine County, Idaho, to... described contains 3.39 acres, more or less. The public land is identified as suitable for disposal in the...

Clinical impact of endoscopic ultrasonography at a county hospital

DEFF Research Database (Denmark)

Ainsworth, A P; Mortensen, M B; Durup, J

2002-01-01

BACKGROUND AND STUDY AIMS: Although endoscopic ultrasonography (EUS) is a well-described examination method, there have been few reports concerning its clinical impact. The aim of this study was to describe EUS as it is performed at a county hospital, with an emphasis on the indications...... and clinical outcome. PATIENTS AND METHODS: Patients examined using EUS between December 1997 and November 2000 were recorded prospectively. Follow-up was conducted by examining each patient's medical records at least 3 months after the investigation. The EUS findings were compared with the patient's final...... management strategy in 80 patients (24 %). CONCLUSIONS: EUS has a high level of accuracy and a substantial clinical impact when performed in an unselected population. The estimated numbers of investigations needed appear to justify setting up an EUS center at institutions with a catchment population of 350...

75 FR 28650 - Notice of Realty Action: Proposed Direct Sale of Public Lands in Riverside County, CA

Science.gov (United States)

2010-05-21

... in Riverside County, California to Cocopah Nurseries, Inc. for the appraised fair market value of $77...), as amended (43 U.S.C. 1713), at not less than the appraised fair market value: San Bernardino... County. The appraised fair market value is $77,000. The public land is identified as suitable for...

Impact of Discipline on Academic Performance of Pupils in Public Primary Schools in Muhoroni Sub-County, Kenya

Science.gov (United States)

Simba, Nicholas Odoyo; Agak, John Odwar; Kabuka, Eric K.

2016-01-01

In Muhoroni Sub-County, Kenya, pupils' academic performance has received little attention in relation to discipline. The objectives of this study were to determine the level of discipline and extent of impact of discipline on academic performance among class eight pupils in the sub-county's public primary schools. The study adopted descriptive…

75 FR 20598 - Public Buildings Service; Prospect Island, Sacramento Delta, Solano County, CA; Transfer of Property

Science.gov (United States)

2010-04-20

... GENERAL SERVICES ADMINISTRATION [Wildlife Order 188; 9-I-CA-1674] Public Buildings Service; Prospect Island, Sacramento Delta, Solano County, CA; Transfer of Property Pursuant to section 2 of Public... General Services Administration transferred 1253 acres of land identified as Prospect Island, Sacramento...

A Cost Analysis of Hospitalizations for Infections Related to Injection Drug Use at a County Safety-Net Hospital in Miami, Florida

OpenAIRE

Tookes, Hansel; Diaz, Chanelle; Li, Hua; Khalid, Rafi; Doblecki-Lewis, Susanne

2015-01-01

Background Infections related to injection drug use are common. Harm reduction strategies such as syringe exchange programs and skin care clinics aim to prevent these infections in injection drug users (IDUs). Syringe exchange programs are currently prohibited by law in Florida. The goal of this study was to estimate the mortality and cost of injection drug use-related bacterial infections over a 12-month period to the county safety-net hospital in Miami, Florida. Additionally, the prevalence...

ACT Participation and Performance for Montgomery County Public Schools Students [2014]. Memorandum

Science.gov (United States)

Sanderson, Geoffrey T.

2014-01-01

The Montgomery County (Maryland) Public Schools (MCPS) Class of 2014 consistently outperformed graduates across Maryland and the nation on all sections of the ACT, according to the ACT, Inc. annual report that was released Wednesday, August 20, 2014. Thirty percent of the graduates in the MCPS Class of 2014 took the ACT exam. According to the ACT,…

Seres Vivos. Nivel I. Basado en el curso de estudios de Ciencia de Montgomery County Public Schools. (Living Beings. Level 1. Based on the Montgomery County Public Schools Science Studies Program).

Science.gov (United States)

Senger, Graciela

This curriculum unit, developed by the Montgomery County Public Schools, Maryland, was designed for use in the elementary level foreign language immersion program. It is geared toward the first grade science classroom. The unit includes instructional and performance objectives, necessary vocabulary lists, optional language structure sections,…

[Technical efficiency of traditional hospitals and public enterprises in Andalusia (Spain)].

Science.gov (United States)

Herrero Tabanera, Luis; Martín Martín, José Jesús; López del Amo González, Ma del Puerto

2015-01-01

To assess the technical efficiency of traditional public hospitals without their own legal identity and subject to administrative law, and that of public enterprise hospitals, with their own legal identities and partly governed by private law, all of them belonging to the taxypayer-funded health system of Andalusia during the period 2005 -2008. The study included the 32 publicly-owned hospitals in Andalusia during the period 2005-2008. The method consisted of two stages. In the first stage, the indices of technical efficiency of the hospitals were calculated using Data Envelopment Analysis, and the change in total factor productivity was estimated using the Malmquist index. The results were compared according to perceived quality, and a sensitivity analysis was conducted through an auxiliary model and bootstrapping. In the second stage, a bivariate analysis was performed between hospital efficiency and organization type. Public enterprises were more efficient than traditional hospitals (on average by over 10%) in each of the study years. Nevertheless, a process of convergence was observed between the two types of organizations because, while the efficiency of traditional hospitals increased slightly (by 0.50%) over the study period, the performance of public enterprises declined by over 2%. The possible reasons for the greater efficiency of public enterprises include their greater budgetary and employment flexibility. However, the convergence process observed points to a process of mutual learning that is not necessarily efficient. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

[Decentralization and how to conduct it as a revolution or an evolution? County public health and management capacity building as a prerequisite for successful decentralization in the Republic of Croatia].

Science.gov (United States)

Sogorić, Selma; Dzakula, Aleksandar; Polasek, Ozren; Grozić-Zivolić, Sonja; Lang, Slobodan

2010-12-01

Based on the results of the first phase of the County Public Health Capacity Building Program named Health-Plan for It, implemented in the Republic of Croatia during the 2002-2008 period, this article analyzes the relationship between training of the county teams and their ability to develop health policy. Our hypothesis was that decentralized model of health planning and management would not occur just by changing legislation alone. Counties in Croatia needed educational support (learning-by-doing training) in order to improve public health practices at the county level. During the 2002-2005 period, the first 15 county teams (so-called first cycle counties) completed their training. The teams consisted of 12 to 15 members, representatives of political and executive component, technical component (public health professionals, representatives of health and social welfare institutions) and community members (non-government sector and media). Teams were trained in cohorts. Three counties passed together through the six-month process of modular training (four education modules, with four days of intensive training and "homework" between modules) at the time. The remaining 5 counties (second-cycle counties) completed the same kind of training in 2007-2008. The Public Health Performance Matrix (the Local Public Health Practice Performance Measures instrument developed by the US CDC Public Health Practice Program Office) was used as an evaluation instrument. Each county team had to fill it out at the beginning of education. Comparison of the Public Health Performance Matrices of first cycle counties (training in 2002-2005) with those of the second cycle counties (trained several years later) yielded no differences. Although training materials were publicly available (accessible through the Croatian Healthy Cities web pages) for years, the second cycle counties did not spontaneously (without training) increase their county-level capacities for participative health needs

Selecting public relations personnel of hospitals by analytic network process.

Science.gov (United States)

Liao, Sen-Kuei; Chang, Kuei-Lun

2009-01-01

This study describes the use of analytic network process (ANP) in the Taiwanese hospital public relations personnel selection process. Starting with interviewing 48 practitioners and executives in north Taiwan, we collected selection criteria. Then, we retained the 12 critical criteria that were mentioned above 40 times by theses respondents, including: interpersonal skill, experience, negotiation, language, ability to follow orders, cognitive ability, adaptation to environment, adaptation to company, emotion, loyalty, attitude, and Response. Finally, we discussed with the 20 executives to take these important criteria into three perspectives to structure the hierarchy for hospital public relations personnel selection. After discussing with practitioners and executives, we find that selecting criteria are interrelated. The ANP, which incorporates interdependence relationships, is a new approach for multi-criteria decision-making. Thus, we apply ANP to select the most optimal public relations personnel of hospitals. An empirical study of public relations personnel selection problems in Taiwan hospitals is conducted to illustrate how the selection procedure works.

How Does Patient Safety Culture in the Surgical Departments Compare to the Rest of the County Hospitals in Xiaogan City of China?

Science.gov (United States)

Wang, Manli; Tao, Hongbing

2017-09-26

Objectives : Patient safety culture affects patient safety and the performance of hospitals. The Hospital Survey on Patient Safety Culture (HSOPSC) is generally used to assess the safety culture in hospitals and unit levels. However, only a few studies in China have measured surgical settings compared with other units in county hospitals using the HSOPSC. This study aims to assess the strengths and weaknesses of surgical departments compared with all other departments in county hospitals in China with HSOPSC. Design : This research is a cross-sectional study. Methods : In 2015, a Chinese translation of HSOPSC was administered to 1379 staff from sampled departments from 19 county hospitals in Xiaogan City (Hubei Province, China) using a simple random and cluster sampling method. Outcome Measures : The HSOPSC was completed by 1379 participants. The percent positive ratings (PPRs) of 12 dimensions (i.e., teamwork within units, organizational learning and continuous improvement, staffing, non-punitive response to errors, supervisor/ manager expectations and actions promoting patient safety, feedback and communication about errors, communication openness, hospital handoffs and transitions, teamwork across hospital units, hospital management support for patient safety, overall perception of safety, as well as frequency of events reported) and the positive proportion of outcome variables (patient safety grade and number of events reported) between surgical departments and other departments were compared with t -tests and X² tests, respectively. A multiple regression analysis was conducted, with the outcome dimensions serving as dependent variables and basic characteristics and other dimensions serving as independent variables. Similarly, ordinal logistic regression was used to explore the influencing factors of two categorical outcomes. Results : A total of 56.49% of respondents were from surgical departments. The PPRs for "teamwork within units" and "organizational

California Library Statistics, 2009: Fiscal Year 2007-2008 from Public, Academic, Special and County Law Libraries

Science.gov (United States)

Bray, Ira, Ed.

2009-01-01

Each year the State Library sends annual report forms to California's public, academic, special, state agency, and county law libraries. Statistical data from those reports are tabulated in this publication, with directory listings published in the companion volume, "California Library Directory." For this fiscal year, 389 libraries of…

California Library Statistics, 2005: Fiscal Year 2003-2004 from Public, Academic, Special and County Law Libraries

Science.gov (United States)

Bray, Ira, Ed.

2005-01-01

Each year the State Library sends annual report forms to California's academic, public, special, state agency, and county law libraries. Statistical data from those reports are tabulated in this publication, with directory listings published in the companion volume, California Library Directory. For this fiscal year four hundred and eight…

A comparison between antenatal care quality in public and private sector in rural Hebei, China.

Science.gov (United States)

Chen, Li; Dai, Yaohua; Zhang, Yanfeng; Wu, Qiong; Rudan, Diana; Saftić, Vanja; van Velthoven, Michelle H M M T; Su, Jianqiang; Tan, Zangwen; Scherpbier, Robert W

2013-04-01

To evaluate the quality of antenatal care (ANC) in Hebei Province and compare it between the public and private sector and within the public sector. We conducted a Maternal, Newborn and Child Health Household Survey in 2010 using a two-stage sampling procedure and included 1079 mothers. The quality of ANC was assessed on the basis of the number of ANC visits, the time of the first ANC visit, 16 different ANC procedures, owning a maternal health care booklet, and the type of service provider. Almost all women (98%) received ANC services at least once, 80% at least four times, and 54% at least five times. About half of the women (46%) visited ANC facility within their first trimester. Neither public nor private sector provided all 16 standardized services, but significantly more women in public sector received ANC procedures. Most women received ANC in county or higher-level hospitals (75%) and very few in township hospitals (8%). Significantly fewer women were weighed and tested for HIV/AIDS in township than in county or higher-level hospitals. The quality of ANC in Hebei was poorer than required by China's national and World Health Organization norms. Although the public sector performed better than the private sector, the utilization and quality of care of ANC services in this sector varied and women generally visited county or higher-level health facilities.

Attempt to promote hospital management by IM Public Platform

Directory of Open Access Journals (Sweden)

Hui CHEN

2014-06-01

Full Text Available Thisarticle has analyzed the contribution of modern IT to hospital management: using public platform of IM (instant message/communication will make it more convenient and efficient to conduct communication with (prior to the treatment, conduct treatment, and provide post-treatment service for patients and their family; withthe set-up of a smooth and efficient information channel set up, the relationship between patients and doctors will be greatly improved ,thus reputation and credibility of the hospital and its doctors will be promoted; when the public has better received the hospital and its doctors, social harmony will be achieved. 

Allegheny County Primary Care Access

Data.gov (United States)

Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The data on health care facilities includes the name and location of all the hospitals and primary care facilities in Allegheny County. The current listing of...

Change Management And Performance Of Public Secondary Schools In Siaya Sub County

Directory of Open Access Journals (Sweden)

Okiiya Andrew Sande

2015-04-01

Full Text Available ABSTRACT The current focus on change management practices in the Public sector has been significantly induced by new public management paradigm shift that places heavy emphasis on managing for results. This is an emerging issue particularly in public secondary schools. The purpose of this study was to relate public secondary schools with the practice of generally established change management best practices. The specific objectives of the study were to establish change management practices adopted by Public Secondary Schools in Siaya Sub County. The study population consisted of all the 38 Public Secondary Schools in Siaya Sub County which necessitated the adoption of a descriptive cross-sectional survey design and the school managers were to respond to questionnaire items designed to address aspects of best change management practices. The researcher wanted to find out the extent to which the schools practiced these virtues. The school managers stated that they moderately practiced aspects of planning committed leadership workforce alignment stakeholder involvement and had defined governance structures in their institutions. However the extents were varying from one school to the next. Multiple regressions were run using the change management practices dimensions established against performance dimensions of student enrolment participation in co-curricular activities KCSE achievement financial management and provision of teaching and learning resources and development of school infrastructure. The study found out that change management practices adopted by the institutions significantly influenced performance. The study recommends that there is need to break from status quo and bureaucratic inefficiency associated with public institutions and be ready to implement comprehensive change management practices to maximize on resource utilization our public educational institutions. The study would contribute towards broadening the knowledge base of

"PCI Reading Program": The Final Report of a Three Year Experimental Study in Brevard Public Schools and Miami-Dade County Public Schools. Research Report

Science.gov (United States)

Toby, Megan; Jaciw, Andrew; Ma, Boya; Lipton, Akiko

2011-01-01

PCI Education conducted a three-year longitudinal study to determine the comparative effectiveness of the "PCI Reading Program" ("PCI") for students with severe disabilities as implemented in Florida's Brevard Public Schools and Miami-Dade County Public Schools. The primary question addressed by the study is whether students…

77 FR 14417 - Notice of Temporary Closure on Public Lands in Gooding and Elmore Counties, ID

Science.gov (United States)

2012-03-09

...] Notice of Temporary Closure on Public Lands in Gooding and Elmore Counties, ID AGENCY: Bureau of Land Management, Interior. ACTION: Notice of temporary closure. SUMMARY: Notice is hereby given that the Blair Fire closure to motorized vehicle use is in effect on public lands administered by the Four Rivers and...

"What is meant by public?": Stakeholder views on strengthening impacts of public reporting of hospital performance data.

Science.gov (United States)

Canaway, Rachel; Bismark, Marie; Dunt, David; Prang, Khic-Houy; Kelaher, Margaret

2018-04-01

Public reporting of hospital performance data is a developing area that is gaining increased attention. This is the first study to explore a range of stakeholder opinions on how such public reporting could be strengthened in Australia. Thirty-four semi-structured interviews were conducted with a purposive sample of expert healthcare consumer, provider and purchaser informants who worked in a variety of senior roles and had knowledge of or involvement in public reporting of hospital data within the public or private healthcare sectors. Informants from all Australian states, territory and national jurisdictions participated. Thematic analysis was used to gain an overview of experts' opinions to inform policy and systems-development for strengthening foundational frameworks for public reporting of health services performance. Themes arising were synthesised to generate explanatory figures to highlight key areas for strengthening public reporting. Our findings suggest that in Australia there is a lack of agreement on what the objectives and who the audience are for public reporting of hospital performance data. Without this shared understanding it is difficult to strengthen frameworks and impacts of public reporting. When developing frameworks for public reporting of hospital data in Australia, more explicit definition of what or who are the 'public' is needed along with identification of barriers, desired impacts, data needs, and data collection/reporting/feedback mechanisms. All relevant stakeholders should be involved in design of public reporting frameworks. Offering multiple systems of public reporting, each tailored to particular audiences, might enable greater impact of reporting towards improved hospital quality and safety, and consumer knowledge to inform treatment decisions. This study provides an overview of perspectives, but further research is warranted to develop PR frameworks that can generate greatest impacts for the needs of various audiences

Road Bridges and Culverts, Bridge dataset only includes bridges maintained by Johnson County Public Works in the unincorporated areas, Published in Not Provided, Johnson County Government.

Data.gov (United States)

NSGIC Local Govt | GIS Inventory — Road Bridges and Culverts dataset current as of unknown. Bridge dataset only includes bridges maintained by Johnson County Public Works in the unincorporated areas.

What Impact Does Behavior of Doctors and Patients on Service Integration of Multi-institutional Readmission cross Township—county Hospitals in Rural China

OpenAIRE

Zhang, Yan; Tang, Wenxi; Zhang, Liang

2017-01-01

Background: With the change of rural residents’ disease spectrum and patients with chronic diseases boom, multi-institutional health service utilization of rural residents and the continuous service demands are growing sharply in rural China.Objective: Evaluate the service integration of multi-institutional readmission cross township—county hospitals (MRCTCH) in rural China, and figure out determines of service integration.Methods: This study featured 7 sample counties in rural China. Based o...

Molecular epidemiology of Klebsiella pneumoniae invasive infections over a decade at Kilifi County Hospital in Kenya.

Science.gov (United States)

Henson, Sonal P; Boinett, Christine J; Ellington, Matthew J; Kagia, Ngure; Mwarumba, Salim; Nyongesa, Sammy; Mturi, Neema; Kariuki, Samuel; Scott, J Anthony G; Thomson, Nicholas R; Morpeth, Susan C

2017-10-01

Multidrug resistant (MDR) Klebsiella pneumoniae is a common cause of nosocomial infections worldwide. Recent years have seen an explosion of resistance to extended-spectrum β-lactamases (ESBLs) and emergence of carbapenem resistance. Here, we examine 198 invasive K. pneumoniae isolates collected from over a decade in Kilifi County Hospital (KCH) in Kenya. We observe a significant increase in MDR K. pneumoniae isolates, particularly to third generation cephalosporins conferred by ESBLs. Using whole-genome sequences, we describe the population structure and the distribution of antimicrobial resistance genes within it. More than half of the isolates examined in this study were ESBL-positive, encoding CTX-M-15, SHV-2, SHV-12 and SHV-27, and 79% were MDR conferring resistance to at least three antimicrobial classes. Although no isolates in our dataset were found to be resistant to carbapenems we did find a plasmid with the genetic architecture of a known New Delhi metallo-β-lactamase-1 (NDM)-carrying plasmid in 25 isolates. In the absence of carbapenem use in KCH and because of the instability of the NDM-1 gene in the plasmid, the NDM-1 gene has been lost in these isolates. Our data suggests that isolates that encode NDM-1 could be present in the population; should carbapenems be introduced as treatment in public hospitals in Kenya, resistance is likely to ensue rapidly. Copyright © 2017 The Authors. Published by Elsevier GmbH.. All rights reserved.

Greening Australia's public health system: the role of public hospitals in responding to climate change.

Science.gov (United States)

Primozic, Lauren

2010-05-01

Climate change is one of the most important social, economic, ecological and ethical issues of the 21st century. The effects of climate change on human health are now widely accepted as a genuine threat and the Australian Government has initiated policy and legislative responses. In addition, in the 2009-2010 budget the Australian Government has committed A$64 billion to public health and hospital reform. But will this Commonwealth funding support--and should it support--the government's high-profile climate change policy? Does Commonwealth funding translate to an obligation to support Commonwealth policies? This article explores the role of public hospitals as champions and role models of the Australian Government's climate change policy and how this might be done without detracting from the primary purpose of public hospital funding: improving patient care.

Productivity of public hospitals in Nepal: a data envelopment analysis.

Science.gov (United States)

Silwal, Pushkar Raj; Ashton, Toni

2017-07-20

Public hospitals in Nepal account for a major share of the total health budget. Therefore, questions are often asked about the performance of these hospitals. Existing measures of performance are limited to historical ratio analyses without any benchmarks. The objective of this study is to explore the trends in inputs, outputs and productivity changes in Nepalese public hospitals from 2011-2012 to 2013-2014. The study was conducted among 32 Nepalese public hospitals (23 district level and 9 higher level) for the three fiscal years from 2011-2012 to 2013-2014. First, basic ratio analyses were conducted for the input and output measures over the study years. Then, Malmquist productivity change scores were obtained using data envelopment analysis. Aggregated as well as separate analyses were conducted for district level and higher level hospitals. Real expenditures of the sampled hospitals declined over the 3-year period from an average of US$ 371 000 in year 1 to US$ 368 730 in year 2 and US$ 328680 in year 3. The average aggregated hospital outputs increased marginally from 8276 in 2011-2012 to 8613 in 2013-2014. The total factor productivity of the study hospitals declined by 6.9% annually from 2011-2012 to 2013-2014. Of the total 32 hospitals, productivity increased in only 12 (37.5%) hospitals and declined in the remaining 20 hospitals. The total factor productivity loss was influenced by a decline in technology change, despite an increase in efficiency. In general, productivity of the study hospitals declined over the study period. Availability and accessibility of accurate, detailed and consistent measures of hospital inputs and outputs is a major challenge for this type of analysis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Productivity of public hospitals in Nepal: a data envelopment analysis

Science.gov (United States)

Ashton, Toni

2017-01-01

Objectives Public hospitals in Nepal account for a major share of the total health budget. Therefore, questions are often asked about the performance of these hospitals. Existing measures of performance are limited to historical ratio analyses without any benchmarks. The objective of this study is to explore the trends in inputs, outputs and productivity changes in Nepalese public hospitals from 2011–2012 to 2013–2014. Setting and participants The study was conducted among 32 Nepalese public hospitals (23 district level and 9 higher level) for the three fiscal years from 2011–2012 to 2013–2014. Outcome measures First, basic ratio analyses were conducted for the input and output measures over the study years. Then, Malmquist productivity change scores were obtained using data envelopment analysis. Aggregated as well as separate analyses were conducted for district level and higher level hospitals. Results Real expenditures of the sampled hospitals declined over the 3-year period from an average of US$ 371 000 in year 1 to US$ 368 730 in year 2 and US$ 328680 in year 3. The average aggregated hospital outputs increased marginally from 8276 in 2011–2012 to 8613 in 2013–2014. The total factor productivity of the study hospitals declined by 6.9% annually from 2011–2012 to 2013–2014. Of the total 32 hospitals, productivity increased in only 12 (37.5%) hospitals and declined in the remaining 20 hospitals. The total factor productivity loss was influenced by a decline in technology change, despite an increase in efficiency. Conclusions In general, productivity of the study hospitals declined over the study period. Availability and accessibility of accurate, detailed and consistent measures of hospital inputs and outputs is a major challenge for this type of analysis. PMID:28729314

An Evaluation of the Employee Assistance Program in the Montgomery County Public School System.

Science.gov (United States)

Goldberg, Jo Ann

The Montgomery County public school system presently provides assistance through the Employee Assistance Program (EAP) to troubled employees with problems which affect work performance. EAP's mandate is to provide crisis intervention, prereferral evaluation, information, referral, and follow-up services. From its inception to March, 1981, EAP…

Hospital marketers sold on value of custom publications.

Science.gov (United States)

Rees, T

1998-01-01

More and more hospital marketing and public relations executives are recognizing that publications, such as newsletters and magazines, are a very important part of their arsenal of marketing tools. They're also finding that custom publishers are valuable allies when it comes to target market opportunities.

Governmental costs and revenues associated with geothermal energy development in Imperial County. Special Publication 3241

Energy Technology Data Exchange (ETDEWEB)

Goldman, G.; Strong, D.

1977-10-01

This study estimates the cost and revenue impacts to local governments of three geothermal energy growth scenarios in Imperial County. The level of geothermal energy potential for the three development scenarios tested is 2,000, 4,000 and 8,000 MW--enough power to serve 270,000 to 1,000,000 people. The government agencies involved do not expect any substantial additional capital costs due to geothermal energy development; therefore, average costing techniques have been used for projecting public service costs and government revenues. The analysis of the three growth scenarios tested indicates that county population would increase by 3, 7 and 19 percent and assessed values would increase by 20, 60, and 165 percent for Alternatives No. 1, No. 2 and No. 3 respectively. Direct and indirect effects would increase new jobs in the county by 1,000, 3,000 and 8,000. Government revenues would tend to exceed public service costs for county and school districts, while city costs would tend to exceed revenues. In each of the alternatives, if county, cities and school districts are grouped together, the revenues exceed costs by an estimated $1,600 per additional person either directly or indirectly related to geothermal energy development in the operational stages. In the tenth year of development, while facilities are still being explored, developed and constructed, the revenues would exceed costs by an approximate $1,000 per additional person for each alternative. School districts with geothermal plants in their boundaries would be required by legislation SB 90 to reduce their tax rates by 15 to 87 percent, depending on the level of energy development. Revenue limits and school taxing methods will be affected by the Serrano-Priest decision and by new school legislation in process.

Official Reports of Enrollment as of September 30, 2013. Montgomery County Public Schools

Science.gov (United States)

Erickson, Marianne

2013-01-01

This document is a combination of two reports produced for Montgomery County Public Schools (MCPS) by the Department of Policy, Records, and Reporting: (1) Official Race/Ethnic Membership of Students as of September 30, 2013; and (2) Official Report of Enrollment by Grade and School as of September 30, 2013. Both reports provide student data for…

75 FR 13303 - Notice of Realty Action: Direct Sale of Public Lands in Riverside County, CA

Science.gov (United States)

2010-03-19

....37 acres in Riverside County. The appraised fair market value is $2,102,000. The public land is... market value of $2,102,000. DATES: Comments regarding the proposed sale must be received by the BLM on or... market value: San Bernardino Meridian T. 3 S., R. 4 E., Sec. 34, those remaining public lands in the N...

A comparison between antenatal care quality in public and private sector in rural Hebei, China

Science.gov (United States)

Chen, Li; Dai, Yaohua; Zhang, Yanfeng; Wu, Qiong; Rudan, Diana; Saftić, Vanja; van Velthoven, Michelle H.M.M.T.; Su, Jianqiang; Tan, Zangwen; Scherpbier, Robert W.

2013-01-01

Aim To evaluate the quality of antenatal care (ANC) in Hebei Province and compare it between the public and private sector and within the public sector. Methods We conducted a Maternal, Newborn and Child Health Household Survey in 2010 using a two-stage sampling procedure and included 1079 mothers. The quality of ANC was assessed on the basis of the number of ANC visits, the time of the first ANC visit, 16 different ANC procedures, owning a maternal health care booklet, and the type of service provider. Results Almost all women (98%) received ANC services at least once, 80% at least four times, and 54% at least five times. About half of the women (46%) visited ANC facility within their first trimester. Neither public nor private sector provided all 16 standardized services, but significantly more women in public sector received ANC procedures. Most women received ANC in county or higher-level hospitals (75%) and very few in township hospitals (8%). Significantly fewer women were weighed and tested for HIV/AIDS in township than in county or higher-level hospitals. Conclusion The quality of ANC in Hebei was poorer than required by China’s national and World Health Organization norms. Although the public sector performed better than the private sector, the utilization and quality of care of ANC services in this sector varied and women generally visited county or higher-level health facilities. PMID:23630142

[Scientific production from public hospitals of the City of Buenos Aires, 2017].

Science.gov (United States)

Ibarra, Mariano; Torrents, Milagros; Ossorio, María Fabiana; Ferrero, Fernando

2018-01-01

The number of publications in the scientific literature coming from an institution is an indicator of its scientific production. The scientific production of the hospitals of the Government of the City of Buenos Aires (GCBA) has been evaluated previously, but without discriminating how much of that production corresponded to other academic institutions settled there (University of Buenos Aires, UBA, National Council of Scientific Research and Techniques, CONICET). Our objective was to evaluate the publications included in PubMed that correspond to hospitals of the GCBA, describe their main characteristics, and discriminate the contribution of other academic institutions (UBA and CONICET). It is a cross-sectional study based on a PubMed search, using the name of each of the 34 GCBA hospitals, CONICET and UBA in the "affiliation" field. In total, 2727 publications from GCBA hospitals were identified (4.6% of Argentine publications); 73.9% in English, 78.9% in relation to humans, 37.2% in the last 5 years; 6.4% with high level of evidence (clinical trials and meta-analysis), and 28.4% including children. Compared to the national total, the GCBA publications include fewer works in English, more research in humans, more clinical trials and more research in children. Of the publications corresponding to hospitals of the GCBA, 90.4% did not share the affiliation with CONICET or with UBA. In conclusion, the GCBA hospitals generated 4.6% of the total Argentine publications in PubMed; and 90% of these was not shared with UBA or CONICET. Publications from GCBA institutions include more clinical trials and research in children.

The financial impact of the 'zero-markup policy for essential drugs' on patients in county hospitals in western rural China.

Science.gov (United States)

Zhou, Zhongliang; Su, Yanfang; Campbell, Benjamin; Zhou, Zhiying; Gao, Jianmin; Yu, Qiang; Chen, Jiuhao; Pan, Yishan

2015-01-01

With a quasi-experimental design, this study aims to assess whether the Zero-markup Policy for Essential Drugs (ZPED) reduces the medical expense for patients at county hospitals, the major healthcare provider in rural China. Data from Ningshan county hospital and Zhenping county hospital, China, include 2014 outpatient records and 9239 inpatient records. Quantitative methods are employed to evaluate ZPED. Both hospital-data difference-in-differences and individual-data regressions are applied to analyze the data from inpatient and outpatient departments. In absolute terms, the total expense per visit reduced by 19.02 CNY (3.12 USD) for outpatient services and 399.6 CNY (65.60 USD) for inpatient services. In relative terms, the expense per visit was reduced by 11% for both outpatient and inpatient services. Due to the reduction of inpatient expense, the estimated reduction of outpatient visits is 2% among the general population and 3.39% among users of outpatient services. The drug expense per visit dropped by 27.20 CNY (4.47 USD) for outpatient services and 278.7 CNY (45.75 USD) for inpatient services. The proportion of drug expense out of total expense per visit dropped by 11.73 percentage points in outpatient visits and by 3.92 percentage points in inpatient visits. Implementation of ZPED is a benefit for patients in both absolute and relative terms. The absolute monetary reduction of the per-visit inpatient expense is 20 times of that in outpatient care. According to cross-price elasticity, the substitution between inpatient and outpatient due to the change in inpatient price is small. Furthermore, given that the relative reductions are the same for outpatient and inpatient visits, according to relative thinking theory, the incentive to utilize outpatient or inpatient care attributed to ZPED is equivalent, regardless of the 20-times price difference in absolute terms.

The financial impact of the 'zero-markup policy for essential drugs' on patients in county hospitals in western rural China.

Directory of Open Access Journals (Sweden)

Zhongliang Zhou

Full Text Available With a quasi-experimental design, this study aims to assess whether the Zero-markup Policy for Essential Drugs (ZPED reduces the medical expense for patients at county hospitals, the major healthcare provider in rural China.Data from Ningshan county hospital and Zhenping county hospital, China, include 2014 outpatient records and 9239 inpatient records. Quantitative methods are employed to evaluate ZPED. Both hospital-data difference-in-differences and individual-data regressions are applied to analyze the data from inpatient and outpatient departments.In absolute terms, the total expense per visit reduced by 19.02 CNY (3.12 USD for outpatient services and 399.6 CNY (65.60 USD for inpatient services. In relative terms, the expense per visit was reduced by 11% for both outpatient and inpatient services. Due to the reduction of inpatient expense, the estimated reduction of outpatient visits is 2% among the general population and 3.39% among users of outpatient services. The drug expense per visit dropped by 27.20 CNY (4.47 USD for outpatient services and 278.7 CNY (45.75 USD for inpatient services. The proportion of drug expense out of total expense per visit dropped by 11.73 percentage points in outpatient visits and by 3.92 percentage points in inpatient visits.Implementation of ZPED is a benefit for patients in both absolute and relative terms. The absolute monetary reduction of the per-visit inpatient expense is 20 times of that in outpatient care. According to cross-price elasticity, the substitution between inpatient and outpatient due to the change in inpatient price is small. Furthermore, given that the relative reductions are the same for outpatient and inpatient visits, according to relative thinking theory, the incentive to utilize outpatient or inpatient care attributed to ZPED is equivalent, regardless of the 20-times price difference in absolute terms.

76 FR 68784 - Notice of Realty Action: Direct Sale of Public Land in Santa Clara County, CA

Science.gov (United States)

2011-11-07

... California Limited Liability Company, for the appraised fair market value of $16,000. DATES: Written comments...] Notice of Realty Action: Direct Sale of Public Land in Santa Clara County, CA AGENCY: Bureau of Land...), Hollister Field Office, proposes to sell a parcel of public land consisting of approximately 15.97 acres...

Non-Public Schools in Durham County by Type

Data.gov (United States)

City and County of Durham, North Carolina — A list and the locations along with contact phone numbers of private schools within Durham County. The School Type field is either "religious" or independant....

Comparative Study on Male Vs Feminine Leadership in Public Administration in Maramures County, Romania

OpenAIRE

Gavrilescu Liviu

2011-01-01

Leadership in the Romanian public administration is an exciting research area and also of current interest, while the success of public organizations depends now more on the human factor than on the funds becoming less accessible. Another item of interest is given by the low representation of women in managerial positions in administration. This paper presents a study on two mayors, a woman and a man of Maramures County, Romania, in order to identify and compare the leadership styles practice...

75 FR 80841 - Notice of Realty Action: Direct Sale of Public Land in Kern County, CA

Science.gov (United States)

2010-12-23

... County wishes to secure the land for a buffer zone for their existing landfill. In accordance with 43 CFR... an integral part of a project of public importance and speculative bidding would jeopardize a timely...

An evaluation of systemic reforms of public hospitals: the Sanming model in China.

Science.gov (United States)

Fu, Hongqiao; Li, Ling; Li, Mingqiang; Yang, Chunyu; Hsiao, William

2017-10-01

Low- and middle-income countries (LMICs) have been searching for effective strategies to reform their inefficient and wasteful public hospitals. Recently, China developed a model of systemic reforms called the Sanming model to address the inefficiency and waste at public hospitals. In this article, we explain and evaluate how the Sanming model reformed its 22 public hospitals in 2013 by simultaneously restructuring the hospital governance structure, altering the payment system to hospitals, and realigning physicians' incentives. By employing the difference-in-difference (DID) method and using the hospital-level data from 187 public hospitals in Fujian province, we find that the Sanming model has reduced medical costs significantly without measurably sacrificing clinical quality and productive efficiency. The systemic reform, on average, has reduced the medical care cost per outpatient visit and per inpatient admission by 6.1% (P-value = 0.0445) and 15.4% (P-value transformation of public hospitals, where the governance structure, payment system and physician compensation methods are aligned, are crucial to improving their performance; it holds critical lessons for China and other LMICs. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Scientific production from public hospitals of the City of Buenos Aires, 2017

Directory of Open Access Journals (Sweden)

Mariano Ibarra

2018-01-01

Full Text Available The number of publications in the scientific literature coming from an institution is an indicator of its scientific production. The scientific production of the hospitals of the Government of the City of Buenos Aires (GCBA has been evaluated previously, but without discriminating how much of that production corresponded to other academic institutions settled there (University of Buenos Aires, UBA, National Council of Scientific Research and Techniques, CONICET. Our objective was to evaluate the publications included in PubMed that correspond to hospitals of the GCBA, describe their main characteristics, and discriminate the contribution of other academic institutions (UBA and CONICET. It is a cross-sectional study based on a PubMed search, using the name of each of the 34 GCBA hospitals, CONICET and UBA in the "affiliation" field. In total, 2727 publications from GCBA hospitals were identified (4.6% of Argentine publications; 73.9% in English, 78.9% in relation to humans, 37.2% in the last 5 years; 6.4% with high level of evidence (clinical trials and meta-analysis, and 28.4% including children. Compared to the national total, the GCBA publications include fewer works in English, more research in humans, more clinical trials and more research in children. Of the publications corresponding to hospitals of the GCBA, 90.4% did not share the affiliation with CONICET or with UBA. In conclusion, the GCBA hospitals generated 4.6% of the total Argentine publications in PubMed; and 90% of these was not shared with UBA or CONICET. Publications from GCBA institutions include more clinical trials and research in children.

Epidemiology of 411 140 cataract operations performed in public hospitals and private hospitals/clinics in Denmark between 2004 and 2012

DEFF Research Database (Denmark)

Solborg Bjerrum, Søren; Mikkelsen, Kim Lyngby; la Cour, Morten

2015-01-01

PURPOSE: To study the epidemiology and mortality in patients who had cataract surgery in public hospitals and private hospitals/clinics in Denmark between 2004 and 2012 and to assess the validity of the Danish cataract registries. METHODS: Register- and chart-based study. RESULTS: A total of 411...... 140 cataract operations were performed in 243 856 patients. Patients who had cataract surgery in public hospitals had an overall statistically significantly 62% higher mortality compared to patients who had cataract surgery in private hospitals/clinics. The decrease in mean age at first eye cataract...... surgery in private hospitals/clinics was statistically significantly greater compared to the decrease in mean age at first eye cataract surgery in public hospitals (p

Identifying county characteristics associated with resident well-being: A population based study.

Science.gov (United States)

Roy, Brita; Riley, Carley; Herrin, Jeph; Spatz, Erica S; Arora, Anita; Kell, Kenneth P; Welsh, John; Rula, Elizabeth Y; Krumholz, Harlan M

2018-01-01

Well-being is a positively-framed, holistic assessment of health and quality of life that is associated with longevity and better health outcomes. We aimed to identify county attributes that are independently associated with a comprehensive, multi-dimensional assessment of individual well-being. We performed a cross-sectional study examining associations between 77 pre-specified county attributes and a multi-dimensional assessment of individual US residents' well-being, captured by the Gallup-Sharecare Well-Being Index. Our cohort included 338,846 survey participants, randomly sampled from 3,118 US counties or county equivalents. We identified twelve county-level factors that were independently associated with individual well-being scores. Together, these twelve factors explained 91% of the variance in individual well-being scores, and they represent four conceptually distinct categories: demographic (% black); social and economic (child poverty, education level [divorced); clinical care (% eligible women obtaining mammography, preventable hospital stays per 100,000, number of federally qualified health centers); and physical environment (% commuting by bicycle and by public transit). Twelve factors across social and economic, clinical care, and physical environmental county-level factors explained the majority of variation in resident well-being.

Cycle-Based Budgeting and Continuous Improvement at Jefferson County Public Schools: Year 1 Report

Science.gov (United States)

Yan, Bo

2016-01-01

This report documents the first-year of implementing Cycle-based Budgeting at Jefferson County Public Schools (Louisville, KY). To address the limitations of incremental budgeting and zero-based budgeting, a Cycle-based Budgeting model was developed and implemented in JCPS. Specifically, each new program needs to submit an on-line budget request…

Notes from the field: identification of a Taenia tapeworm carrier - Los Angeles County, 2014.

Science.gov (United States)

Croker, Curtis; Soriano, Jan; Civen, Rachel; Larsen, Robert A; Schwartz, Benjamin

2015-01-30

Carriers of the pork tapeworm, Taenia solium, are the sole source of cysticercosis, a parasitic tissue infection. When tapeworm eggs excreted by the carrier are ingested, tapeworm larvae can form cysts. When cysts form in the brain, the condition is called neurocysticercosis and can be especially severe. In Los Angeles County an average of 136 county residents are hospitalized with neurocysticercosis each year. The prevalence of Taenia solium carriage is largely unknown because carriage is asymptomatic, making detection difficult. The identification and treatment of tapeworm carriers is an important public health measure that can prevent additional neurocysticercosis cases.

Identifying maternity services in public hospitals in rural and remote Australia.

Science.gov (United States)

Longman, Jo; Pilcher, Jennifer M; Donoghue, Deborah A; Rolfe, Margaret; Kildea, Sue V; Kruske, Sue; Oats, Jeremy J N; Morgan, Geoffrey G; Barclay, Lesley M

2014-06-01

This paper articulates the importance of accurately identifying maternity services. It describes the process and challenges of identifying the number, level and networks of rural and remote maternity services in public hospitals serving communities of between 1000 and 25000 people across Australia, and presents the findings of this process. Health departments and the national government's websites, along with lists of public hospitals, were used to identify all rural and remote Australian public hospitals offering maternity services in small towns. State perinatal reports were reviewed to establish numbers of births by hospital. The level of maternity services and networks of hospitals within which services functioned were determined via discussion with senior jurisdictional representatives. In all, 198 rural and remote public hospitals offering maternity services were identified. There were challenges in sourcing information on maternity services to generate an accurate national picture. The nature of information about maternity services held centrally by jurisdictions varied, and different frameworks were used to describe minimum requirements for service levels. Service networks appeared to be based on a combination of individual links, geography and transport infrastructure. The lack of readily available centralised and comparable information on rural and remote maternity services has implications for policy review and development, equity, safety and quality, network development and planning. Accountability for services and capacity to identify problems is also compromised.

Binational Dengue Outbreak Along the United States-Mexico Border - Yuma County, Arizona, and Sonora, Mexico, 2014.

Science.gov (United States)

Jones, Jefferson M; Lopez, Benito; Adams, Laura; Gálvez, Francisco Javier Navarro; Núñez, Alfredo Sánchez; Santillán, Nubia Astrid Hernández; Plante, Lydia; Hemme, Ryan R; Casal, Mariana; Hunsperger, Elizabeth A; Muñoz-Jordan, Jorge; Acevedo, Veronica; Ernst, Kacey; Hayden, Mary; Waterman, Steve; Gomez, Diana; Sharp, Tyler M; Komatsu, Kenneth K

2016-05-20

Dengue is an acute febrile illness caused by any of four dengue virus types (DENV-1-4). DENVs are transmitted by mosquitos of the genus Aedes (1) and are endemic throughout the tropics (2). In 2010, an estimated 390 million DENV infections occurred worldwide (2). During 2007-2013, a total of three to 10 dengue cases were reported annually in Arizona and all were travel-associated. During September-December 2014, coincident with a dengue outbreak in Sonora, Mexico, 93 travel-associated dengue cases were reported in Arizona residents; 70 (75%) cases were among residents of Yuma County, which borders San Luis Río Colorado, Sonora, Mexico. San Luis Río Colorado reported its first case of locally acquired dengue in September 2014. To investigate the temporal relationship of the dengue outbreaks in Yuma County and San Luis Río Colorado and compare patient characteristics and signs and symptoms, passive surveillance data from both locations were analyzed. In addition, household-based cluster investigations were conducted near the residences of reported dengue cases in Yuma County to identify unreported cases and assess risk for local transmission. Surveillance data identified 52 locally acquired cases (21% hospitalized) in San Luis Río Colorado and 70 travel-associated cases (66% hospitalized) in Yuma County with illness onset during September-December 2014. Among 194 persons who participated in the cluster investigations in Yuma County, 152 (78%) traveled to Mexico at least monthly during the preceding 3 months. Four (2%) of 161 Yuma County residents who provided serum samples for diagnostic testing during cluster investigations had detectable DENV immunoglobulin M (IgM); one reported a recent febrile illness, and all four had traveled to Mexico during the preceding 3 months. Entomologic assessments among 105 households revealed 24 water containers per 100 houses colonized by Ae. aegypti. Frequent travel to Mexico and Ae. aegypti colonization indicate risk for local

Public hospital bed crisis: too few or too misused?

Science.gov (United States)

Scott, Ian A

2010-08-01

* Increasing demand on public hospital beds has led to what many see as a hospital bed crisis requiring substantial increases in bed numbers. By 2050, if current bed use trends persist and as the numbers of frail older patients rise exponentially, a 62% increase in hospital beds will be required to meet expected demand, at a cost almost equal to the entire current Australian healthcare budget. * This article provides an overview of the effectiveness of different strategies for reducing hospital demand that may be viewed as primarily (although not exclusively) targeting the hospital sector - increasing capacity and throughput and reducing readmissions - or the non-hospital sector - facilitating early discharge or reducing presentations and admissions to hospital. Evidence of effectiveness was retrieved from a literature search of randomised trials and observational studies using broad search terms. * The principal findings were as follows: (1) within the hospital sector, throughput could be substantially improved by outsourcing public hospital clinical services to the private sector, undertaking whole-of-hospital reform of care processes and patient flow that address both access and exit block, separating acute from elective beds and services, increasing rates of day-only or short stay admissions, and curtailing ineffective or marginally effective clinical interventions; (2) in regards to the non-hospital sector, potentially the biggest gains in reducing hospital demand will come from improved access to residential care, rehabilitation services, and domiciliary support as patients awaiting such services currently account for 70% of acute hospital bed-days. More widespread use of acute care and advance care planning within residential care facilities and population-based chronic disease management programs can also assist. * This overview concludes that, in reducing hospital bed demand, clinical process redesign within hospitals and capacity enhancement of non-hospital

Surgery cancellations at a public hospital

Directory of Open Access Journals (Sweden)

Erika Pittelkow

2008-12-01

Full Text Available Objective: To determine the frequency of cancellation of scheduledsurgeries at a public hospital in the city of São Paulo, and to identifythe reasons of cancellation. Methods: A descriptive, exploratory,retrospective study, with quantitative analysis, of records ofprocedures cancelled and medical charts of patients whose surgerieswere cancelled, between January 2006 and July 2007. Results: Ofthe 6,149 (100% surgeries scheduled for the period surveyed, 701(11.4% were canceled and 5,448 (88.6% conducted; among thesurgeries cancelled, most were general surgeries (237/33.8% andorthopedic surgery (200/28.5%; surgeons or assistant surgeons(518/73.9% and anesthesiologists (183/26.1% were responsible forcancellations. The primary reasons for cancellation were unfavorableclinical status of patients (225/32.1%, no show up of patients(119/17.0%, change in medical management (79/11.3%, patientnot appropriately prepared (53/7.5% and lack of material (52/7.4%.Conclusions: This study enabled identifying the frequency and causesof surgical cancellations at a public hospital, so as to contribute toimproving professional performance in this area.

Environmental management in public hospitals: Environmental management in Colombia

OpenAIRE

Juan Pablo Rodríguez-Miranda; César Augusto García-Ubaque; María Camila García-Vaca

2016-01-01

Introduction: Activities in hospitals have environmental impacts which may pose risks to human and environmental health if they are not managed correctly. For this reason, it is necessary to implement an environmental management plan in hospitals that not only focuses on solid waste management but includes all aspects associated with health within institutions. Objective: To review environmental management aspects related to public hospitals in order to identify environmental management a...

Quality of Public Hospitals Websites: A Cross-Sectional Analytical Study in Iran.

Science.gov (United States)

Salarvand, Shahin; Samadbeik, Mahnaz; Tarrahi, Mohammad Javad; Salarvand, Hamed

2016-04-01

Nowadays, hospitals have turned increasingly towards the Internet and develop their own web presence. Hospital Websites could be operating as effective web resources of information and interactive communication mediums to enhance hospital services to the public. Therefore, the aim of this study was to assess the quality of websites in Tehran's public hospitals. This cross-sectional analysis involved all public hospitals in Iran's capital city, Tehran, with a working website or subsites between April and June, 2014 (N=59). The websites were evaluated using three validated instruments: a localized checklist, Google page rank, and the Alexa traffic ranking. The mentioned checklist consisted of 112 items divided into five sections: technical characteristics, hospital information and facilities, medical services, interactive on-line services and external activities. Data were analyzed using descriptive and analytical statistics. The mean website evaluation score was 45.7 out of 224 for selected public hospitals. All the studied websites were in the weak category based on the earned quality scores. There was no statistically significant association between the website evaluation score with Google page rank (P=0.092), Alexa global traffic rank and Alexa traffic rank in Iran (P>0.05). The hospital websites had a lower quality score in the interactive online services and external activities criteria in comparing to other criteria. Due to the low quality level of the studied websites and the importance of hospital portals in providing information and services on the Internet, the authorities should do precise planning for the appreciable improvement in the quality of hospital websites.

Labor law violations in Japanese public hospitals from March 2002 to March 2011.

Science.gov (United States)

Ehara, Akira

2013-02-01

According to the Japan Pediatric Society, the mean extra work hours of hospital pediatricians in 2010 was approximately 80 h per month, which is the certification criterion for Karoshi (death from overwork), but there is no precise picture of personnel management at hospitals because the labor authorities do not disclose detailed statistics concerning labor law violations to the public. Most local governments have a disclosure system, and the local governments that operate public hospitals were requested to disclose warning documents issued by the labor authorities from March 2002 to March 2011. A total of 208/369 public hospitals (56.4%) with ≥200 beds in Japan were warned of labor law violations. Offenses included exceeding the limit of working hours (177 hospitals) and non-payment of increased wages for night and holiday work (98 hospitals). Many public hospitals in Japan did not always pay workers including physicians for increased workload because they do not regard night and holiday duties as work hours. © 2012 The Author. Pediatrics International © 2012 Japan Pediatric Society.

76 FR 5398 - Notice of Temporary Closure of Selected Public Lands in La Paz County, AZ

Science.gov (United States)

2011-01-31

... closure of selected public lands under its administration in La Paz County, Arizona. This action is being... free of trash and litter. 14. Allowing any pet or other animal to be restrained by a leash of more than...

How a new 'public plan' could affect hospitals' finances and private insurance premiums.

Science.gov (United States)

Dobson, Allen; DaVanzo, Joan E; El-Gamil, Audrey M; Berger, Gregory

2009-01-01

Two key health reform bills in the House of Representatives and Senate include the option of a "public plan" as an additional source of health coverage. At least initially, the plan would primarily be structured to cover many of the uninsured and those who now have individual coverage. Because it is possible, and perhaps even likely, that this new public payer would pay less than private payers for the same services, such a plan could negatively affect hospital margins. Hospitals may attempt to recoup losses by shifting costs to private payers. We outline the financial pressures that hospitals and private payers could experience under various assumptions. High uninsured enrollment in a public plan would bolster hospital margins; however, this effect is reversed if the privately insured enter a public plan in large proportions, potentially stressing the hospital industry and increasing private insurance premiums.

The Financial Impact of the ‘Zero-Markup Policy for Essential Drugs’ on Patients in County Hospitals in Western Rural China

Science.gov (United States)

Zhou, Zhongliang; Su, Yanfang; Campbell, Benjamin; Zhou, Zhiying; Gao, Jianmin; Yu, Qiang; Chen, Jiuhao; Pan, Yishan

2015-01-01

Objective With a quasi-experimental design, this study aims to assess whether the Zero-markup Policy for Essential Drugs (ZPED) reduces the medical expense for patients at county hospitals, the major healthcare provider in rural China. Methods Data from Ningshan county hospital and Zhenping county hospital, China, include 2014 outpatient records and 9239 inpatient records. Quantitative methods are employed to evaluate ZPED. Both hospital-data difference-in-differences and individual-data regressions are applied to analyze the data from inpatient and outpatient departments. Results In absolute terms, the total expense per visit reduced by 19.02 CNY (3.12 USD) for outpatient services and 399.6 CNY (65.60 USD) for inpatient services. In relative terms, the expense per visit was reduced by 11% for both outpatient and inpatient services. Due to the reduction of inpatient expense, the estimated reduction of outpatient visits is 2% among the general population and 3.39% among users of outpatient services. The drug expense per visit dropped by 27.20 CNY (4.47 USD) for outpatient services and 278.7 CNY (45.75 USD) for inpatient services. The proportion of drug expense out of total expense per visit dropped by 11.73 percentage points in outpatient visits and by 3.92 percentage points in inpatient visits. Conclusion Implementation of ZPED is a benefit for patients in both absolute and relative terms. The absolute monetary reduction of the per-visit inpatient expense is 20 times of that in outpatient care. According to cross-price elasticity, the substitution between inpatient and outpatient due to the change in inpatient price is small. Furthermore, given that the relative reductions are the same for outpatient and inpatient visits, according to relative thinking theory, the incentive to utilize outpatient or inpatient care attributed to ZPED is equivalent, regardless of the 20-times price difference in absolute terms. PMID:25790443

Tracks FAQs: How Do Heart Attack Hospitalization Rates In My Community Compare With Other Counties Or States?

Centers for Disease Control (CDC) Podcasts

2011-09-01

In this podcast, CDC Tracking experts discuss how to compare heart attack hospitalization rates in your community with other counties or states. Do you have a question for our Tracking experts? Please e-mail questions to trackingsupport@cdc.gov.  Created: 9/1/2011 by National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Environmental Health Tracking Branch.   Date Released: 9/1/2011.

Payments and quality of care in private for-profit and public hospitals in Greece.

Science.gov (United States)

Kondilis, Elias; Gavana, Magda; Giannakopoulos, Stathis; Smyrnakis, Emmanouil; Dombros, Nikolaos; Benos, Alexis

2011-09-23

Empirical evidence on how ownership type affects the quality and cost of medical care is growing, and debate on these topics is ongoing. Despite the fact that the private sector is a major provider of hospital services in Greece, little comparative information on private versus public sector hospitals is available. The aim of the present study was to describe and compare the operation and performance of private for-profit (PFP) and public hospitals in Greece, focusing on differences in nurse staffing rates, average lengths of stay (ALoS), and Social Health Insurance (SHI) payments for hospital care per patient discharged. Five different datasets were prepared and analyzed, two of which were derived from information provided by the National Statistical Service (NSS) of Greece and the other three from data held by the three largest SHI schemes in the country. All data referred to the 3-year period from 2001 to 2003. PFP hospitals in Greece are smaller than public hospitals, with lower patient occupancy, and have lower staffing rates of all types of nurses and highly qualified nurses compared with public hospitals. Calculation of ALoS using NSS data yielded mixed results, whereas calculations of ALoS and SHI payments using SHI data gave results clearly favoring the public hospital sector in terms of cost-efficiency; in all years examined, over all specialties and all SHI schemes included in our study, unweighted ALoS and SHI payments for hospital care per discharge were higher for PFP facilities. In a mixed healthcare system, such as that in Greece, significant performance differences were observed between PFP and public hospitals. Close monitoring of healthcare provision by hospital ownership type will be essential to permit evidence-based decisions on the future of the public/private mix in terms of healthcare provision.

Innovations in health service delivery: the corporatization of public hospitals

National Research Council Canada - National Science Library

Harding, April; Preker, Alexander S

2003-01-01

... hospitals play a critical role in ensuring delivery of health services, less is known about how to improve the efficiency and quality of care provided. Much can be learned in this respect from the experiences of hospital reforms initiated during the 1990s. Innovations in Health Service Delivery: The Corporatization of Public Hospitals is an a...

Organizational climate: Comparing private and public hospitals within professional roles

Directory of Open Access Journals (Sweden)

Diana Rojas

2014-11-01

Full Text Available This study compares the organizational climate differences within professional roles in private and public hospitals. We focused on how physicians, administrative, healthcare and non-healthcare staff either in the public or in the private perceived their work environment and each organizational climate dimension. Data came from organizational-climate questionnaires administered in 2010 and 2012 to 19616 and 1276 health employees in public and private hospitals in the Tuscany Region respectively. We applied exploratory factoranalysis to verify the validity and internal consistency between items in the questionnaire and t-test, one-way analysis of variance to compare mean perceptions regarding to the dimensions across different groups of respondents. We measured four dimensions: “training opportunities”, “managerial tools”, “organization” and “management & leadership style” and overall job satisfaction. Hospital status in the professional roles was found significant in the staff's perceptions (p≤0.05.

Public views of reclaiming an abandoned coal mine: the Macoupin County project

Energy Technology Data Exchange (ETDEWEB)

Bernard, J. R.

1980-07-01

An abandoned underground coal mine waste area in Macoupin County, Illinois, has been reclaimed for demonstration and research purposes near the city of Staunton. According to federal law, end uses of reclaimed coal mines must be determined in part by local concerns. This study examined local residents' preferences for land uses and their social and economic evaluations of reclamation at the Macoupin County site. Personal interviews with 119 residents revealed preferences for recreational use of the demonstration area; however, responses were probably influenced by prior awareness of land-use intentions. Generally, very positive evaluations of the reclamation were received. Willingness to pay for reclamation appears to be linked to fulfillment of desired recreational uses on the site and socioeconomic status of the respondent. In general, the research results provide further evidence that the value of abatement of environmental damage from mining is recognized and supported in economic terms at the public level.

Stakeholder influence in public sector information systems strategy implementation-The case of public hospitals in South Africa.

Science.gov (United States)

Hwabamungu, Boroto; Brown, Irwin; Williams, Quentin

2018-01-01

Recent literature on organisational strategy has called for greater emphasis on individuals (stakeholders) and what they do in the process of strategizing. Public sector organisations have to engage with an array of heterogeneous stakeholders in fulfilling their mandate. The public health sector in particular needs to engage with a diversity of stakeholders at local, regional and national levels when strategising. The purpose of this study is to investigate the influence of stakeholder relations on the implementation of Information Systems (IS) strategy in public hospitals in South Africa. An interpretive approach using two provinces was employed. The Activity Analysis and Development (ActAD) framework, an enhanced form of activity theory, was used as the theoretical framework. Data was collected using semi-structured interviews, meetings, documents analysis, physical artefacts and observation. The collected data was analysed using thematic analysis. Findings reveal that IS strategy implementation in public hospitals involves a large and complex network of stakeholder groups at different levels, and over different time periods. These stakeholder groups act in accordance with formal and informal roles, rules and modalities. Various contextual conditions together with the actions of, and interactions between stakeholder groups give rise to the situationality of stakeholder relations dynamics and strategy implementation. The multiple actions and interactions over time lead to the realisation of some aspects of the IS strategy in public hospitals. Given the complexity and dynamism of the context there are also certain unplanned implementations as well. These relationships are captured in a Stakeholder Relations Influence (SRI) framework. The SRI framework can be assistive in the assessment and mapping of stakeholders and stakeholder relations, and the assessment of the implications of these relations for effective IS strategy implementation in public hospitals. The

Doctors' service orientation in public, private, and foreign hospitals.

Science.gov (United States)

Andaleeb, Syed Saad; Siddiqui, Nazlee; Khandakar, Shahjahan

2007-01-01

The purpose of this study is to propose a doctors' service orientation (DSO) scale and uses it to compare the services received in public, private and foreign hospitals in a developing country from the patient's perspective. The scale was derived from the service quality literature and qualitative research. A questionnaire was designed next. Data were collected from patients who had used the services of doctors in a hospital. The scale demonstrated appropriate psychometric properties. Two clear patterns emerge from the study results: on 10 out of 12 measures of doctors' service orientation, there was no significant difference in their perceived behaviors between public and private hospitals and foreign doctors were "always" rated significantly higher. This study focused on one major city because of time and resource constraints. The findings are thus not generalizable to hospitals across the country. Also, because of translation and retranslation issues, the scale ought to be further tested for wider use. The scale may be used periodically in a comprehensive quality assurance program to exhort doctors to become more service oriented and to improve their performance over time.

Bioethics and University: The University Hospital, Private or Public Institution?

Directory of Open Access Journals (Sweden)

José Nel Carreño R., MD, esp.

2007-12-01

Full Text Available In order to acquire a real and useful knowledgeof medicine, the practice in the hospital setting is indispensable. Public, former charity hospitals have been the scenary for student practice. In a paternalistic model of medicine this was understandable.Nevertheless now that the model has changed to a more respectful of autonomy and justice this discrimination appears as unethical. There are no real reasons to discriminate educationin such a way. Medical education should happen in both the public and private sector.

Electronic prescribing reduces prescribing error in public hospitals.

Science.gov (United States)

Shawahna, Ramzi; Rahman, Nisar-Ur; Ahmad, Mahmood; Debray, Marcel; Yliperttula, Marjo; Declèves, Xavier

2011-11-01

To examine the incidence of prescribing errors in a main public hospital in Pakistan and to assess the impact of introducing electronic prescribing system on the reduction of their incidence. Medication errors are persistent in today's healthcare system. The impact of electronic prescribing on reducing errors has not been tested in developing world. Prospective review of medication and discharge medication charts before and after the introduction of an electronic inpatient record and prescribing system. Inpatient records (n = 3300) and 1100 discharge medication sheets were reviewed for prescribing errors before and after the installation of electronic prescribing system in 11 wards. Medications (13,328 and 14,064) were prescribed for inpatients, among which 3008 and 1147 prescribing errors were identified, giving an overall error rate of 22·6% and 8·2% throughout paper-based and electronic prescribing, respectively. Medications (2480 and 2790) were prescribed for discharge patients, among which 418 and 123 errors were detected, giving an overall error rate of 16·9% and 4·4% during paper-based and electronic prescribing, respectively. Electronic prescribing has a significant effect on the reduction of prescribing errors. Prescribing errors are commonplace in Pakistan public hospitals. The study evaluated the impact of introducing electronic inpatient records and electronic prescribing in the reduction of prescribing errors in a public hospital in Pakistan. © 2011 Blackwell Publishing Ltd.

75 FR 45661 - Notice of Permanent Closure on Public Lands in Ada County, ID

Science.gov (United States)

2010-08-03

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLIDB00100 L17110000.PH0000 241A 4500013040] Notice of Permanent Closure on Public Lands in Ada County, ID AGENCY: Bureau of Land Management, Interior.../2\\NW\\1/4\\ NW\\1/4\\ and N\\1/2\\SW\\1/4\\ NW\\1/4\\ of Section 32, T.1 S., R.3 E., Boise Meridian, Ada...

Explaining turnover intention in Korean public community hospitals: occupational differences.

Science.gov (United States)

Hwang, Jee-In; Chang, Hyejung

2008-01-01

Personnel in public hospitals had relatively low job satisfaction despite of tenure employment. High turnover rates degrade hospital image and incur additional costs related to recruitment and training. The purposes of this study were to describe the occupational differences and to identify factors affecting turnover intention among public hospital personnel. A questionnaire survey was conducted as part of Administrative Services Quality Evaluation Program by Seoul metropolitan municipality from 1 November to 1 December in 2003. The subjects were 1251 entire hospital personnel in four hospitals. The questionnaire was designed to measure job satisfaction, organizational commitment, turnover intention, and demographic characteristics. Logistic regression analysis was performed to determine factors influencing turnover intention. There were significant differences in job satisfaction, organizational commitment, and turnover intention according to the occupations. The turnover intention rates were highest among physicians, followed by paramedicals and nursing staffs and then administrators. The significant factors affecting turnover intention were involvement and loyalty among physicians, hospital type, satisfaction with systems and loyalty among nursing staffs, satisfaction with relationship and loyalty among administrators, and loyalty among paramedicals. There were different moderators that influence turnover intentions of hospital personnel. Loyalty had the most important effect upon turnover intention in all occupations. 2007 John Wiley & Sons, Ltd

Perioperative nursing in public university hospitals

DEFF Research Database (Denmark)

Sørensen, Erik Elgaard; Olsen, Ida Østrup; Tewes, Marianne

2014-01-01

BACKGROUND: In recent years, perioperative nursing has received ongoing attention as part of an interprofessional collaboration. Perioperative nursing is constantly faced with new challenges and opportunities that necessitate continual updates of nursing knowledge and technical skills. In light...... of the longstanding relationship between nursing and technology, it is interesting that few studies with this focus have been performed. Therefore, our research question was: What is the content of perioperative nursing and how do nurses facilitate the interaction between nursing care and technology in highly...... specialized operating rooms in public university hospitals? METHODS: An ethnography involving participant observations and interviews was conducted during a 9-month study period. The participants comprised 24 nurses from 9 different operating wards at 2 university hospitals in different regions of Denmark...

Identifying county characteristics associated with resident well-being: A population based study.

Directory of Open Access Journals (Sweden)

Brita Roy

Full Text Available Well-being is a positively-framed, holistic assessment of health and quality of life that is associated with longevity and better health outcomes. We aimed to identify county attributes that are independently associated with a comprehensive, multi-dimensional assessment of individual well-being.We performed a cross-sectional study examining associations between 77 pre-specified county attributes and a multi-dimensional assessment of individual US residents' well-being, captured by the Gallup-Sharecare Well-Being Index. Our cohort included 338,846 survey participants, randomly sampled from 3,118 US counties or county equivalents.We identified twelve county-level factors that were independently associated with individual well-being scores. Together, these twelve factors explained 91% of the variance in individual well-being scores, and they represent four conceptually distinct categories: demographic (% black; social and economic (child poverty, education level [hospital stays per 100,000, number of federally qualified health centers; and physical environment (% commuting by bicycle and by public transit.Twelve factors across social and economic, clinical care, and physical environmental county-level factors explained the majority of variation in resident well-being.

Cost Accounting as a Possible Solution for Financial Sustainability of Croatian Public Hospitals

Directory of Open Access Journals (Sweden)

Ivana Dražić Lutilsky

2016-12-01

Full Text Available The purpose of this paper is to present the current usage of cost accounting methodology in Croatian public hospitals through conducted empirical research and to provide opinions of accountants and financial officers regarding possible implementation of cost accounting methodology in public hospitals. In the paper, the authors analyze the accounting system in Croatian public hospitals, identifying the flaws of the current accounting system with regard to the recording and allocation of costs. National healthcare systems of different European countries provide a theoretical background for the usage of accrual accounting basis and cost accounting methodologies, showing better governance and financial sustainability of public hospitals which have introduced cost accounting methodology. The conducted empirical research shows that accountants and financial officers believe that the healthcare system in Croatia is ready for a change in the current accounting system based on the modified accrual basis through the implementation of accrual accounting basis and full costing approach to cost allocation. Full costing approach is also known as activity-based accounting method for cost allocation. The authors also recommend some initial steps for implementation of the new cost accounting system in Croatian public hospitals.

Risk Factors for Mortality among 2009 A/H1N1 Influenza Hospitalizations in Maricopa County, Arizona, April 2009 to March 2010

Directory of Open Access Journals (Sweden)

G. Chowell

2012-01-01

Full Text Available We analyzed individual-level data on pandemic influenza A/H1N1pdm hospitalizations from the enhanced surveillance system of the Maricopa County Department of Public Health, AZ, USA from April 1st, 2009 to March 31st, 2010. We also assessed the the risk of death among A/H1N1 hospitalizations using multivariate logistic regression. Hospitalization rates were significantly higher among Native Americans (risk ratio (RR  =  6.2; 95% CI: 6.15, 6.21, non-Hispanic Black (RR = 3.84; 95% CI: 3.8, 3.9, and Hispanics (RR = 2.0; 95% CI: 2.0, 2.01 compared to non-Hispanic Whites. Throughout the spring, 59.2% of hospitalized patients received antiviral treatment; the proportion of patients treated increased significantly during the fall to 74.4% (Chi-square test, P<0.0001. In our best-fit logistic model, the adjusted risk of death among A/H1N1 inpatients was significantly higher during the fall wave (August 16, 2009 to March 31, 2010, OR = 3.94; 95% CI: 1.72, 9.03 compared to the spring wave (April 1, 2009 to August 15, 2009. Moreover, chronic lung disease (OR = 3.5; 95% CI: 1.7, 7.4, cancer within the last 12 months (OR = 4.3; 95%CI: 1.3, 14.8, immuno-suppression (OR = 4.0; 95% CI: 1.84, 8.9, and admission delays (OR = 4.6; 95% CI: 2.2, 9.5 were significantly associated with an increased the risk of death among A/H1N1 inpatients.

75 FR 62137 - Notice of Intent To Collect Fees on Public Land in Fremont County, Idaho, Upper Snake Field...

Science.gov (United States)

2010-10-07

... Intent To Collect Fees on Public Land in Fremont County, Idaho, Upper Snake Field Office Under the.... SUMMARY: In accordance with the Federal Lands Recreation Enhancement Act (REA), the Upper Snake Field... months after the publication of this notice, the Upper Snake Field Office will initiate fee collection in...

Contracting between public agencies and private psychiatric inpatient facilities.

Science.gov (United States)

Fisher, W H; Dorwart, R A; Schlesinger, M; Davidson, H

1991-08-01

Purchasing human services through contracts with private providers has become an increasingly common practice over the past 20 years. Using data from a national survey of psychiatric inpatient facilities, this paper examines the extent to which psychiatric units in privately controlled general hospitals and private psychiatric specialty hospitals (N = 611) participate in contractual arrangements to provide services to governmental bodies. It also examines how the likelihood of such a practice is affected by hospital characteristics (general or specialty, for profit or nonprofit) and features of hospitals' environments, including the competitiveness of the market for psychiatric inpatient care and the population's need for services in the hospital's county. The findings indicate that nonprofit psychiatric specialty hospitals were more likely than other types of hospitals to enter into such contracts, and that forces such as local competition and need for services were not predictors of such involvement. Contracting was shown to have a significant impact on the level of referrals a hospital accepted, but these levels were also affected by competition and need. Among hospitals with public contracts, referral acceptance from public agencies was unaffected by these factors, but they did have a significant effect on referral acceptance by hospitals without public contracts. These data suggest that public agencies contracting for services with private hospitals may represent a means by which "public sector" patients may gain access to private providers. Further, this mechanism may impose sufficient structure and regulation on the acceptance of such patients that many concerns of hospital administrators regarding patients who are costly and difficult to treat and discharge can be allayed.

Comparing Academic Library Spending with Public Libraries, Public K-12 Schools, Higher Education Public Institutions, and Public Hospitals between 1998-2008

Science.gov (United States)

Regazzi, John J.

2012-01-01

This study compares the overall spending trends and patterns of growth of Academic Libraries with Public Libraries, K-12 schools, higher education institutions, and hospitals in the period of 1998 to 2008. Academic Libraries, while showing a growth of 13% over inflation for the period, far underperformed the growth of the other public institutions…

77 FR 61023 - Notice of Realty Action: Direct Sale of Public Land in Shasta County, CA

Science.gov (United States)

2012-10-05

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLCA930000.L1430000.EU0000. CACA 053115] Notice of Realty Action: Direct Sale of Public Land in Shasta County, CA AGENCY: Bureau of Land Management, Interior. ACTION: Notice. SUMMARY: The Bureau of Land Management (BLM), Redding Field Office...

Measuring cost efficiency in the Nordic hospitals--a cross-sectional comparison of public hospitals in 2002

DEFF Research Database (Denmark)

Linna, Miika; Häkkinen, Unto; Peltola, Mikko

2010-01-01

The aim of this study was to compare the performance of hospital care in four Nordic countries: Norway, Finland, Sweden and Denmark. Using national discharge registries and cost data from hospitals, cost efficiency in the production of somatic hospital care was calculated for public hospitals. Data......, average efficiency was markedly higher in Finland compared to Norway and Sweden. This study found differences in cost efficiency that cannot be explained by input prices or differences in coding practices. More analysis is needed to reveal the causes of large efficiency disparities between Nordic...

Job satisfaction among nurses in a public hospital in Gauteng

Directory of Open Access Journals (Sweden)

C. Selebi

2007-09-01

Full Text Available Introduction: The nursing profession in South Africa has lost skilled nurses due to intense international recruitment drives. The public hospital in this study has also failed to recruit and retain skilled nurses. The shortage of skilled nurses has led to deterioration in patient nursing care. The aim of this study: The aim of this study was to describe the level of job satisfaction among nurses in a public hospital. The methodology: A quantitative, descriptive survey was conducted. The data were collected using the Minnesota Satisfaction Questionnaire. The sample included nurses working in a specific public hospital. Results: Generally all the nurses experienced low satisfaction (42% with the motivational aspects of their job, such as motivation, responsibility, opportunity for creativity and innovation, independence, and recognition. Nurses also experienced very low levels of satisfaction (22% with the hygiene aspects of their job, namely, relationships in the workplace, supervisors’ decision-making skills, supervision, working conditions, policies, job security, and salaries. Conclusions: Health services need to be made aware of the high level of dissatisfaction of nurses. The hospital struggles to keep nurses in their posts, and could benefit from taking note of the results of this study. The findings indicate some of the aspects which need to be considered in a human resource planning strategy for nurses. The hospital and nursing management needs to rethink nurses’ salaries, supervision methods and relationships, and also how the Department of Health policies are implemented.

Dementia in older people admitted to hospital: a regional multi-hospital observational study of prevalence, associations and case recognition

Science.gov (United States)

Timmons, Suzanne; Manning, Edmund; Barrett, Aoife; Brady, Noeleen M.; Browne, Vanessa; O’Shea, Emma; Molloy, David William; O'Regan, Niamh A.; Trawley, Steven; Cahill, Suzanne; O'Sullivan, Kathleen; Woods, Noel; Meagher, David; Ni Chorcorain, Aoife M.; Linehan, John G.

2015-01-01

Background: previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single London teaching hospital, and 21% in four Queensland hospitals. However, there is a lack of published data from any European country on the prevalence of dementia across hospitals and between patient groups. Objective: to determine the prevalence and associations of dementia in older patients admitted to acute hospitals in Ireland. Methods: six hundred and six patients aged ≥70 years were recruited on admission to six hospitals in Cork County. Screening consisted of Standardised Mini-Mental State Examination (SMMSE); patients with scores dementia; with 29% in public hospitals. Prevalence varied between hospitals (P dementia had a previous diagnosis. Patients with dementia were older and frailer, with higher co-morbidity, malnutrition and lower functional status (P dementia (57%) on admission. Conclusion: dementia is common in older people admitted to acute hospitals, particularly in acute medical admissions, and rural hospitals, where services may be less available. Most dementia is not previously diagnosed, emphasising the necessity for cognitive assessment in older people on presentation to hospital. PMID:26420638

The health of hospitals and lessons from history: public health and sanitary reform in the Dublin hospitals, 1858-1898.

Science.gov (United States)

Fealy, Gerard M; McNamara, Martin S; Geraghty, Ruth

2010-12-01

The aim was to examine, critically, 19th century hospital sanitary reform with reference to theories about infection and contagion. In the nineteenth century, measures to control epidemic diseases focused on providing clean water, removing waste and isolating infected cases. These measures were informed by the ideas of sanitary reformers like Chadwick and Nightingale, and hospitals were an important element of sanitary reform. Informed by the paradigmatic tradition of social history, the study design was a historical analysis of public health policy. Using the methods of historical research, documentary primary sources, including official reports and selected hospital archives and related secondary sources, were consulted. Emerging theories about infection were informing official bodies like the Board of Superintendence of Dublin Hospitals in their efforts to improve hospital sanitation. The Board secured important reforms in hospital sanitation, including the provision of technically efficient sanitary infrastructure. Public health measures to control epidemic infections are only as effective as the state of knowledge of infection and contagion and the infrastructure to support sanitary measures. Today, public mistrust about the safety of hospitals is reminiscent of that of 150 years ago, although the reasons are different and relate to a fear of contracting antimicrobial-resistant infections. A powerful historical lesson from this study is that resistance to new ideas can delay progress and improved sanitary standards can allay public mistrust. In reforming hospital sanitation, policies and regulations were established--including an inspection body to monitor and enforce standards--the benefits of which provide lessons that resonate today. Such practices, especially effective independent inspection, could be adapted for present-day contexts and re-instigated where they do not exist. History has much to offer contemporary policy development and practice reform and

76 FR 47237 - Notice of Realty Action: Direct Sale of Public Land in Monterey County, CA

Science.gov (United States)

2011-08-04

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLCA9300000 L58790000 EU0000; CACA 50168-14] Notice of Realty Action: Direct Sale of Public Land in Monterey County, CA AGENCY: Bureau of Land Management, Interior. ACTION: Notice of realty action. SUMMARY: The Bureau of Land Management (BLM...

Comparing public and private hospitals in China: evidence from Guangdong.

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Eggleston, Karen; Lu, Mingshan; Li, Congdong; Wang, Jian; Yang, Zhe; Zhang, Jing; Quan, Hude

2010-03-23

The literature comparing private not-for-profit, for-profit, and government providers mostly relies on empirical evidence from high-income and established market economies. Studies from developing and transitional economies remain scarce, especially regarding patient case-mix and quality of care in public and private hospitals, even though countries such as China have expanded a mixed-ownership approach to service delivery. The purpose of this study is to compare the operations and performance of public and private hospitals in Guangdong Province, China, focusing on differences in patient case-mix and quality of care. We analyze survey data collected from 362 government-owned and private hospitals in Guangdong Province in 2005, combining mandatorily reported administrative data with a survey instrument designed for this study. We use univariate and multi-variate regression analyses to compare hospital characteristics and to identify factors associated with simple measures of structural quality and patient outcomes. Compared to private hospitals, government hospitals have a higher average value of total assets, more pieces of expensive medical equipment, more employees, and more physicians (controlling for hospital beds, urban location, insurance network, and university affiliation). Government and for-profit private hospitals do not statistically differ in total staffing, although for-profits have proportionally more support staff and fewer medical professionals. Mortality rates for non-government non-profit and for-profit hospitals do not statistically differ from those of government hospitals of similar size, accreditation level, and patient mix. In combination with other evidence on health service delivery in China, our results suggest that changes in ownership type alone are unlikely to dramatically improve or harm overall quality. System incentives need to be designed to reward desired hospital performance and protect vulnerable patients, regardless of

Comparing public and private hospitals in China: Evidence from Guangdong

Directory of Open Access Journals (Sweden)

Yang Zhe

2010-03-01

Full Text Available Abstract Background The literature comparing private not-for-profit, for-profit, and government providers mostly relies on empirical evidence from high-income and established market economies. Studies from developing and transitional economies remain scarce, especially regarding patient case-mix and quality of care in public and private hospitals, even though countries such as China have expanded a mixed-ownership approach to service delivery. The purpose of this study is to compare the operations and performance of public and private hospitals in Guangdong Province, China, focusing on differences in patient case-mix and quality of care. Methods We analyze survey data collected from 362 government-owned and private hospitals in Guangdong Province in 2005, combining mandatorily reported administrative data with a survey instrument designed for this study. We use univariate and multi-variate regression analyses to compare hospital characteristics and to identify factors associated with simple measures of structural quality and patient outcomes. Results Compared to private hospitals, government hospitals have a higher average value of total assets, more pieces of expensive medical equipment, more employees, and more physicians (controlling for hospital beds, urban location, insurance network, and university affiliation. Government and for-profit private hospitals do not statistically differ in total staffing, although for-profits have proportionally more support staff and fewer medical professionals. Mortality rates for non-government non-profit and for-profit hospitals do not statistically differ from those of government hospitals of similar size, accreditation level, and patient mix. Conclusions In combination with other evidence on health service delivery in China, our results suggest that changes in ownership type alone are unlikely to dramatically improve or harm overall quality. System incentives need to be designed to reward desired hospital

Struggle against privatization: a case history in the use of comparative performance evaluation of public hospitals.

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Oh, Juhwan; Lee, Jin-Seok; Choi, Yong-Jun; Park, Hyeung-Keun; Do, Young Kyung; Eun, Sang-Jun

2011-01-01

After the 1997 economic crisis, the South Korean government implemented neoliberal policies in many sectors. In health care, the government attempted to privatize nine public hospitals, framing the initiative as "better management." In this discourse, public hospital workers were stereotyped as lazy and incompetent, while public hospitals were portrayed as poorly managed and of low quality. However, the government did not present any relevant evidence of improvement in already privatized hospitals, even though three hospitals had been semi-privatized at that time. In this study, the authors evaluated the effects of the semi-privatization, comparing the performance of the semi-privatized hospitals with that of the nine other hospitals targeted for privatization. The study found adverse effects on performance, unlike the claims made by the government. Semi-privatization intensified the workloads of hospital workers and the instability of employment, froze or decreased real wages, and drastically increased hospital revenue per patient stay. The changes may have resulted from redefining profit as the goal of the hospitals, as opposed to the previous focus on decision-making on public health. These research findings played a decisive role in the struggle to keep the targeted public hospitals free of privatization, especially in two of the nine hospitals targeted for privatization in 2001.

Investigating the health care delivery system in Japan and reviewing the local public hospital reform

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Zhang X

2016-03-01

Full Text Available Xing Zhang, Tatsuo Oyama National Graduate Institute for Policy Studies, Tokyo, Japan Abstract: Japan's health care system is considered one of the best health care systems in the world. Hospitals are one of the most important health care resources in Japan. As such, we investigate Japanese hospitals from various viewpoints, including their roles, ownership, regional distribution, and characteristics with respect to the number of beds, staff, doctors, and financial performance. Applying a multivariate analysis and regression model techniques, we show the functional differences between urban populated prefectures and remote ones; the equality gap among all prefectures with respect to the distribution of the number of beds, staff, and doctors; and managerial differences between private and public hospitals. We also review and evaluate the local public hospital reform executed in 2007 from various financial aspects related to the expenditure and revenue structure by comparing public and private hospitals. We show that the 2007 reform contributed to improving the financial situation of local public hospitals. Strategic differences between public and private hospitals with respect to their management and strategy to improve their financial situation are also quantitatively analyzed in detail. Finally, the remaining problems and the future strategy to further improve the Japanese health care system are described. Keywords: health care system, health care resource, public hospital, multivariate regression model, financial performance

'Waiting for' and 'waiting in' public and private hospitals: a qualitative study of patient trust in South Australia.

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Ward, Paul R; Rokkas, Philippa; Cenko, Clinton; Pulvirenti, Mariastella; Dean, Nicola; Carney, A Simon; Meyer, Samantha

2017-05-05

Waiting times for hospital appointments, treatment and/or surgery have become a major political and health service problem, leading to national maximum waiting times and policies to reduce waiting times. Quantitative studies have documented waiting times for various types of surgery and longer waiting times in public vs private hospitals. However, very little qualitative research has explored patient experiences of waiting, how this compares between public and private hospitals, and the implications for trust in hospitals and healthcare professionals. The aim of this paper is to provide a deep understanding of the impact of waiting times on patient trust in public and private hospitals. A qualitative study in South Australia, including 36 in-depth interviews (18 from public and 18 from private hospitals). Data collection occurred in 2012-13, and data were analysed using pre-coding, followed by conceptual and theoretical categorisation. Participants differentiated between experiences of 'waiting for' (e.g. for specialist appointments and surgery) and 'waiting in' (e.g. in emergency departments and outpatient clinics) public and private hospitals. Whilst 'waiting for' public hospitals was longer than private hospitals, this was often justified and accepted by public patients (e.g. due to reduced government funding), therefore it did not lead to distrust of public hospitals. Private patients had shorter 'waiting for' hospital services, increasing their trust in private hospitals and distrust of public hospitals. Public patients also recounted many experiences of longer 'waiting in' public hospitals, leading to frustration and anxiety, although they rarely blamed or distrusted the doctors or nurses, instead blaming an underfunded system and over-worked staff. Doctors and nurses were seen to be doing their best, and therefore trustworthy. Although public patients experienced longer 'waiting for' and 'waiting in' public hospitals, it did not lead to widespread distrust

Measuring and Benchmarking Technical Efficiency of Public Hospitals in Tianjin, China

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Li, Hao; Dong, Siping

2015-01-01

China has long been stuck in applying traditional data envelopment analysis (DEA) models to measure technical efficiency of public hospitals without bias correction of efficiency scores. In this article, we have introduced the Bootstrap-DEA approach from the international literature to analyze the technical efficiency of public hospitals in Tianjin (China) and tried to improve the application of this method for benchmarking and inter-organizational learning. It is found that the bias corrected efficiency scores of Bootstrap-DEA differ significantly from those of the traditional Banker, Charnes, and Cooper (BCC) model, which means that Chinese researchers need to update their DEA models for more scientific calculation of hospital efficiency scores. Our research has helped shorten the gap between China and the international world in relative efficiency measurement and improvement of hospitals. It is suggested that Bootstrap-DEA be widely applied into afterward research to measure relative efficiency and productivity of Chinese hospitals so as to better serve for efficiency improvement and related decision making. PMID:26396090

2013 Advanced Placement Exam Participation and Performance for Students in Montgomery County Public Schools and Public School Students in the State of Maryland and the Nation. Memorandum

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Sanderson, Geoffrey T.

2013-01-01

This memorandum provides data on the participation and performance of Advanced Placement (AP) exams taken by students in the Montgomery County (Maryland) Public Schools (MCPS) in the 2012-2013 school year as compared with those by public school students in Maryland and the nation. Generally, the number of AP exams taken by MCPS students in 2013…

Do private hospitals outperform public hospitals regarding efficiency, accessibility, and quality of care in the European Union? A literature review.

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Kruse, Florien M; Stadhouders, Niek W; Adang, Eddy M; Groenewoud, Stef; Jeurissen, Patrick P T

2018-03-02

European countries have enhanced the scope of private provision within their health care systems. Privatizing services have been suggested as a means to improve access, quality, and efficiency in health care. This raises questions about the relative performance of private hospitals compared with public hospitals. Most systematic reviews that scrutinize the performance of the private hospitals originate from the United States. A systematic overview for Europe is nonexisting. We fill this gap with a systematic realist review comparing the performance of public hospitals to private hospitals on efficiency, accessibility, and quality of care in the European Union. This review synthesizes evidence from Italy, Germany, the United Kingdom, France, Greece, Austria, Spain, and Portugal. Most evidence suggests that public hospitals are at least as efficient as or are more efficient than private hospitals. Accessibility to broader populations is often a matter of concern in private provision: Patients with higher social-economic backgrounds hold better access to private hospital provision, especially in private parallel systems such as the United Kingdom and Greece. The existing evidence on quality of care is often too diverse to make a conclusive statement. In conclusion, the growth in private hospital provision seems not related to improvements in performance in Europe. Our evidence further suggests that the private (for-profit) hospital sector seems to react more strongly to (financial) incentives than other provider types. In such cases, policymakers either should very carefully develop adequate incentive structures or be hesitant to accommodate the growth of the private hospital sector. Copyright © 2018 John Wiley & Sons, Ltd.

The paradox of public holidays: Hospital-treated self-harm and associated factors.

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Griffin, Eve; Dillon, Christina B; O'Regan, Grace; Corcoran, Paul; Perry, Ivan J; Arensman, Ella

2017-08-15

Recent research on the patterns of self-harm around public holidays is lacking. This study used national data to examine the patterns of hospital-treated self-harm during public holidays, and to examine associated factors. Data on self-harm presentations to all emergency departments were obtained from the National Self-Harm Registry Ireland. The association between self-harm presentations and public holidays was examined using univariate and multivariate Poisson regression analyses. A total of 104,371 presentations of self-harm were recorded between 2007 and 2015. The mean number of self-harm presentations was 32 on public holidays. St. Patrick's Day had the highest number of presentations compared to all other public holidays, with a daily mean of 44 presentations. Across all years, self-harm presentations during public holidays had a 24% increased risk of involving alcohol consumption compared to all other days and this effect was most pronounced during the Christmas period. The association with alcohol remained significant at a multivariate level. Presentations on public holidays were more likely to attend out of normal working hours. An increase in male presentations involving self-cutting was observed on public holidays and there was an over-representation of males presenting for the first time. It is likely that extent of alcohol involvement in self-harm presentations reported here is an underestimate, as it was dependent on the information being recorded by the attending clinician. Public holidays are associated with an elevated number of self-harm presentations to hospital, with presentations to hospital involving alcohol significantly increased on these days. Hospital resources should be targeted to address increases during public holidays, including during out-of-hours. Involvement of alcohol may delay delivery of care to these patients in emergency settings. Copyright © 2017 Elsevier B.V. All rights reserved.

Cities, Towns and Villages, We have the county boundaries including Hephzibah, and Blyth, with roads, parcels, schools, hospitals, fire stations, historic areas.points of interest, etc., Published in 2007, 1:1200 (1in=100ft) scale, Augusta-Richmond County Government.

Data.gov (United States)

NSGIC Local Govt | GIS Inventory — Cities, Towns and Villages dataset current as of 2007. We have the county boundaries including Hephzibah, and Blyth, with roads, parcels, schools, hospitals, fire...

Prevalence for Private Tuition among Parents, Teachers and Pupils in Public Primary Schools in Machakos County

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Kirigwi, Lucy Wambui; Maithya, Redempta

2016-01-01

Private tuition refers to tutoring offered outside mainstream teaching. The study sought to establish the difference in prevalence for private tuition among parents, teachers and pupils in public primary schools in Machakos County. The study employed descriptive survey design. The target populations were all teachers, parents and pupils of public…

76 FR 72971 - Notice of Intent to Collect Fees on Public Land in Alamosa County, CO

Science.gov (United States)

2011-11-28

... Collect Fees on Public Land in Alamosa County, CO AGENCY: Bureau of Land Management, Interior. ACTION... Act (REA), the Bureau of Land Management (BLM) La Jara Field Office is proposing to collect fees at... ``Expanded Amenity Recreation Fee'' authorized under section 3(g). In accordance with the REA, and the BLM's...

Efficiency indicators versus forntier methods: an empirical investigation of italian public hospitals

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Lorenzo Clementi

2013-05-01

Full Text Available Efficiency has a key-role in the measurement of the impact of the National Health Service (NHS reforms. We investigate the issue of inefficiency in health sector and provide empirical evidence derived from Italian public hospitals. Despite the importance of efficiency measurement in health care services, only recently advanced econometric methods have been applied to hospital data. We provide a synoptic survey of few empirical analyses of efficiency measurement in health care services. An estimate of the cost efficiency level in Italian public hospitals during 2001-2003 is obtained through a sample. We propose an efficiency indicator and provide cost frontiers for such hospitals, using stochastic frontier analysis (SFA for longitudinal data.

Northeast Florida Regional Sediment Management: Implementation Strategies and Recommendations for Nassau County and Duval County, Florida

Science.gov (United States)

2016-03-01

management strategies and alternatives are actively coordinated. DISCLAIMER: The contents of this report are not to be used for advertising , publication... Strategies and Recommendations for Nassau County and Duval County, Florida Co as ta l a nd H yd ra ul ic s La bo ra to ry Kevin C. Hodgens, Michael...Sediment Management Implementation Strategies and Recommendations for Nassau County and Duval County, Florida Kevin C. Hodgens and Michael P

A cost management model for hospital food and nutrition in a public hospital.

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Neriz, Liliana; Núñez, Alicia; Ramis, Francisco

2014-11-13

In Chile, the use of costing systems in the public sector is limited. The Ministry of Health requires hospitals to manage themselves with the aim of decentralizing health care services and increasing their quality. However, self-management with a lack of accounting information is almost impossible. On the other hand, nutrition department costs have barely been studied before, and there are no studies specifically for activity based costing (ABC) systems. ABC focuses on the process and traces health care activities to gain a more accurate measurement of the object costs and the financial performance of an organization. This paper uses ABC in a nutrition unit of a public hospital of high complexity to determine costs associated with the different meals for inpatients. The paper also provides an activity based management (ABM) analysis for this unit. The results show positive effects on the reduction of costs for the nutrition department after implementing ABC/ABM. Therefore, there are opportunities to improve the profitability of the area and the results could also be replicated to other areas in the hospital. ABC shed light on the amount of nutritionist time devoted to completing paperwork, and as a result, system changes were introduced to reduce this burden and allow them to focus on more relevant activities. Additional efficiencies were achieved through the elimination of non-value adding activities and automation of reports. ABC reduced the cost of the nutrition department and could produce similar results in other areas of the hospital. This is a practical application of a financial management tool, ABC, which would be useful for hospital managers to reduce costs and improve the management of the unit. This paper takes ABC and examines its use in an area, which has had little exposure to the benefits of this tool.

Measuring cost efficiency in the Nordic hospitals--a cross-sectional comparison of public hospitals in 2002.

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Linna, Miika; Häkkinen, Unto; Peltola, Mikko; Magnussen, Jon; Anthun, Kjartan S; Kittelsen, Sverre; Roed, Annette; Olsen, Kim; Medin, Emma; Rehnberg, Clas

2010-12-01

The aim of this study was to compare the performance of hospital care in four Nordic countries: Norway, Finland, Sweden and Denmark. Using national discharge registries and cost data from hospitals, cost efficiency in the production of somatic hospital care was calculated for public hospitals. Data were collected using harmonized definitions of inputs and outputs for 184 hospitals and data envelopment analysis was used to calculate Farrell efficiency estimates for the year 2002. Results suggest that there were marked differences in the average hospital efficiency between Nordic countries. In 2002, average efficiency was markedly higher in Finland compared to Norway and Sweden. This study found differences in cost efficiency that cannot be explained by input prices or differences in coding practices. More analysis is needed to reveal the causes of large efficiency disparities between Nordic hospitals.

Closure of a local public hospital in Korea: focusing on the organizational life cycle

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Yeo YH

2016-11-01

Full Text Available Young Hyun Yeo,1 Keon-Hyung Lee,2 Hye Jeong Kim3 1Department of Public Administration, Sunmoon University, Asan, ChungNam, South Korea; 2Askew School of Public Administration and Policy, Florida State University, Tallahassee, FL, USA; 3Department of Public Administration, Sunmoon University, Asan, ChungNam, South Korea Abstract: Just as living organisms have a creation-maintenance-extinction life cycle, organizations also have a life cycle. Private organizations will not survive if they fail to acquire necessary resources through market competition. Public organizations, however, continue to survive because the government has provided financial support in order to enhance public interest. Only a few public organizations in Korea have closed. With the introduction of new public management since the economic crisis in 1997, however, public organizations have had to compete with private organizations. Public hospitals are not free to open or close their business. They are also controlled by the government in terms of their prices, management, budgets, and operations. As they pursue public interest by fulfilling the government’s order such as providing free or lower-priced care to the vulnerable population, they tend to provide a lower quality of care and suffer a financial burden. Employing a case study analysis, this study attempts to understand the external environment that local public hospitals face. The fundamental problem of local public hospitals in Korea is the value conflict between public interest and profitability. Local public hospitals are required to pursue public interest by assignment of a public mission including building a medical safety net for low-income patients and managing nonprofitable medical facilities and emergent health care situations. At the same time, they are required to pursue profitability by achieving high-quality care through competition and the operation of an independent, self-supporting system according to

How patients think about social responsibility of public hospitals in China?

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Liu, Wenbin; Shi, Lizheng; Pong, Raymond W; Chen, Yingyao

2016-08-11

Hospital social responsibility is receiving increasing attention, especially in China where major changes to the healthcare system have taken place. This study examines how patients viewed hospital social responsibility in China and explore the factors that influenced patients' perception of hospital social responsibility. A cross-sectional survey was conducted, using a structured questionnaire, on a sample of 5385 patients from 48 public hospitals in three regions of China: Shanghai, Hainan, and Shaanxi. A multilevel regression model was employed to examine factors influencing patients' assessments of hospital social responsibility. Intra-class correlation coefficients (ICCs) were calculated to estimate the proportion of variance in the dependent variables determined at the hospital level. The scores for service quality, appropriateness, accessibility and professional ethics were positively associated with patients' assessments of hospital social responsibility. Older outpatients tended to give lower assessments, while inpatients in larger hospitals scored higher. After adjusted for the independent variables, the ICC rose from 0.182 to 0.313 for inpatients and from 0.162 to 0.263 for outpatients. The variance at the patient level was reduced by 51.5 and 48.6 %, respectively, for inpatients and outpatients. And the variance at the hospital level was reduced by 16.7 % for both groups. Some hospital and patient characteristics and their perceptions of service quality, appropriateness, accessibility and professional ethics were associated with their assessments of public hospital social responsibility. The differences were mainly determined at the patient level. More attention to law-abiding behaviors, cost-effective health services, and charitable works could improve perceptions of hospitals' adherence to social responsibility.

The effects of hospital reforms on the management of public hospitals in Tanzania: Challenges and lessons learnt.

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Shwekerela, Byera

2014-01-01

Although hospital reforms are being advocated internationally as part of a solution to hospital management problems in developing countries, studies have shown that they do give rise to some challenges. A study was undertaken that used in-depth interviews, focus group discussion and document review to examine hospital reforms. The article examines the effects of reforms on the management of Level II public hospitals in Tanzania and documents the related challenges and lessons Learnt. It is shown that hospital reforms have mixed effects in resource-strained hospitals, and that hospital reform actions may have replaced the bureaucratic inefficiencies associated with hospitals being managed from the central level (MoHSW) with the equally bureaucratic inefficiencies that characterize the management of these hospitals from a supposedly local level, the office of the Regional Administrative Secretary (RAS). Managing hospitals from this level seems to cause many hospital management problems to be left unattended.

Hospitalized Patients' Awareness Of Their Rights-A Cross Sectional Survey In A Public And Private Tertiary Care Hospitals Of Punjab, Pakistan.

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Tabassum, Tahirah; Ashraf, Mariam; Thaver, Inayat

2016-01-01

The awareness of patient's rights is negligible in developing countries where no legal framework is present to protect these rights and Pakistan is no exception. Not only is there an absence of legal structure for protection of patients' rights, but the enforcement and implementation for existing law is also questionable. Pakistan has an Islamic Charter of Medical and Health Ethics which includes the medical behaviour and physician's rights and duties towards the patients. Despite all these charters on patients' rights, there is little to no awareness regarding these rights and their practice remains low in healthcare system of Pakistan. This assessment of awareness among patients about their rights will guide in formulating recommendations to improve the existing system of healthcare delivery in the country. This descriptive cross-sectional comparative study was conducted in two hospitals in Lahore, each belonging to public and private sector. A structured questionnaire was used to collect data from patients. A total of 220 patients were selected to participate in the study, 110 belonging to each private and public hospital. The findings indicate that most of the patients (64%) were not aware of their rights. The awareness level was better in patients seeking care from private hospital than those from public hospital. Education, monthly income and type of hospital utilized were found to be positively associated with the level of awareness. Most of the patients were not satisfied with the practices of their rights, especially in public hospitals. The lack of awareness regarding the rights of a patient was more common in patients of public/government hospitals compared to private hospitals. A nation-wide healthcare education program is needed to increase awareness and practice of patients' rights in the country.

76 FR 62831 - Notice of Realty Action: Direct Sale of Public Land in Shasta County, CA

Science.gov (United States)

2011-10-11

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLCA930000.L58790000.EU0000; CACA 48506] Notice of Realty Action: Direct Sale of Public Land in Shasta County, CA AGENCY: Bureau of Land... serial number CACA 24929 and a ROW for a telephone line issued under serial number CACA 26611. 4. A...

Spatial distribution for diarrhea hospitalization in São Paulo State

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Fernanda Pires Cecchetti Vaz

Full Text Available Abstract Objectives: to identify spatial pattern on hospitalization rates of children with diarrhea in the counties in São Paulo State. Methods: ecological and exploratory study on hospitalized data of children with diarrhea under the age of four in 2008 and 2012, the IDH mothers with low schooling level and children living with a low income less than half minimum wage were obtained from Datasus and inserted into digital map of the counties in São Paulo State. Moran's global index (I and Pearson's coefficients correlation and thematic maps of hospitalization rates of 1,000 children, Moran maps and kernel map were calculated. Results: there were 34, 802 hospital admissions, with an average rate of 4.7 hospitalizations / 1,000 children (SD=7.2. Hospitalization rates were correlated only with schooling (r= 0.09, p<0.05. Moran's index for hospitalization rate was I=0.31(p<0.01. The thematic map of the hospital admission rates showed a cluster of counties in the west of the State; the kernel map showed a higher density of hospitalization in this region and the Moran map identified 57 counties which deserve attention. Conclusions: the results provide subsidies for the counties and regional managers to implement measurements aiming to reduce these rates.

Determinants of the direct cost of heart failure hospitalization in a public tertiary hospital.

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Parissis, John; Athanasakis, Kostas; Farmakis, Dimitrios; Boubouchairopoulou, Nadia; Mareti, Christina; Bistola, Vasiliki; Ikonomidis, Ignatios; Kyriopoulos, John; Filippatos, Gerasimos; Lekakis, John

2015-02-01

Heart failure (HF) is the first reason for hospital admission in the elderly and represents a major financial burden, the greatest part of which results from hospitalization costs. We sought to analyze current HF hospitalization-related expenditure and identify predictors of cost in a public tertiary hospital in Europe. We performed a retrospective chart review of 197 consecutive patients, aged 56±16years, 80% male, with left ventricular ejection fraction (LVEF) of 30±10%, hospitalized for HF in a major university hospital in Athens, Greece. The survey involved the number of hospitalization days, laboratory investigations and medical therapies. Patients who were hospitalized in CCU/ICU or underwent interventional procedures or device implantations were excluded from analysis. Costs were estimated based on the Greek healthcare system perspective in 2013. Patients were hospitalized for a median of 7 days with a total direct cost of €3198±3260/patient. The largest part of the expenses (79%) was attributed to hospitalization (ward), while laboratory investigations and medical treatment accounted for 17% and 4%, respectively. In multivariate analysis, pre-admission New York Heart Association NYHA class (p=0.001), serum creatinine (p=0.003) and NT-proBNP (p=0.004) were significant independent predictors of hospitalization cost. Direct cost of HF hospitalization is high particularly in patients with more severe symptoms, profound neurohormonal activation and renal dysfunction. Strategies to lower hospitalization rates are warranted in the current setting of financial constraints faced by many European countries. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Orange County Photovoltaic Project & Educational COmponent

Energy Technology Data Exchange (ETDEWEB)

Parker, Renee [Orange County Government, FL (United States)

2016-02-12

The purpose of this report is to discuss the projects implemented, utilizing Department of Energy grant funds, to support the use and understanding of renewable energy in Orange County, Florida and the Greater Orlando Area. Orange County is located in the State of Florida and is most popularly referred to as Orlando. The greater Orlando area’s current population is 1,225,267 and in 2015 was the first destination to surpass 60 million visitors. Orange County utilized grant funds to add to the growing demand for access to charging stations by installing one level 2 dual NovaCharge CT4021 electric vehicle charging station at the Orange County/University of Florida Cooperative Extension Center. The charging station is considered a “smart” charger connected to a central network operated by a third party. Data collected includes the number of charging sessions, session start and end times, the electricity usage, greenhouse gases saved and other pertinent data used for reporting purposes. Orange County continues to support the use of electric vehicles in Metro Orlando and this project continues to bring awareness to our public regarding using alternative vehicles. Additionally, we offer all visitors to the Orange County/University of Florida Cooperative Extension Center free charges for their electric vehicles 24 hours a day. Since the operation of the charging station there have been 52 unique driver users, a total of 532.2258 kg of greenhouse gas savings and 159.03 gallons of gasoline savings. The installation of the additional electric vehicle charging station is part of a county-wide goal of promoting implementation of renewable energy technologies as well as supporting the use of electric vehicles including the Drive Electric Orlando & Florida programs. http://driveelectricorlando.com/ & ; http://www.driveelectricflorida.org/ . Grant funds were also used for Outreach and Educational efforts. Educational efforts about renewable energy were accomplished through

Appropriate Utilization and Stocking of Antidotes in Qatar Public Hospitals

Directory of Open Access Journals (Sweden)

Rawan Salameh

2017-09-01

Full Text Available Background: There are a few studies that evaluate preparedness and availability of antidotes in the emergency setting and none have been conducted in Qatar. Published studies show that timely availability of antidotes in the emergency department setting is a common issue. To address this, we conducted a study to evaluate antidote stocking and utilization in Qatar hospital pharmacies and emergency departments. Methods: In order to evaluate the appropriate use and timely administration of antidotes, research assistants prospectively collected data on ED patients. All ED patients who received any key antidote over the 6-month study period were identified through both ED and pharmacy records. In order to evaluate the stocking of the 31 most important antidotes in our main public hospitals, a survey assessing the stocking of these key antidotes was sent to the four general hospitals in Qatar, to determine their availability and whether they are stocked in the ED or only in the main pharmacy. Results: Poison exposure was evaluated in 471 cases. Antidotes were given within 30 minutes in 73% of cases, which included atropine, calcium, dextrose, flumazenil, naloxone, pralidoxime, sodium bicarbonate, thiamine, vitamin K and scorpion and snake antivenoms. Administration occurred later than 60 minutes in 2% of cases, exclusively with N-acetylcysteine and activated charcoal. Atropine, calcium, dextrose, naloxone, pralidoxime (2-PAM, sodium bicarbonate, and anti-venoms were clinically indicated 92% of the times they were ordered. N-acetylcysteine was indicated in only 51.5% of administrations. Significant variation in antidote stocking existed between hospitals, and there was no stocked hydroxocobalamin as antidotes for cyanide poisoning or fomepizole for toxic alcohol poisoning. Conclusion: Antidote stocking varied significantly between hospitals, and antidotes necessary for cyanide and toxic alcohol poisoning were deficient in all public hospitals. The

Public vs private administration of rural health insurance schemes: a comparative study in Zhejiang of China.

Science.gov (United States)

Zhou, Xiaoyuan; Mao, Zhengzhong; Rechel, Bernd; Liu, Chaojie; Jiang, Jialin; Zhang, Yinying

2013-07-01

Since 2003, China has experimented in some of the country's counties with the private administration of the New Cooperative Medical Scheme (NCMS), a publicly subsidized health insurance scheme for rural populations. Our study compared the effectiveness and efficiency of private vs public administration in four counties in one of China's most affluent provinces in the initial stage of the NCMS's implementation. The study was undertaken in Ningbo city of Zhejiang province. Out of 10 counties in Ningbo, two counties with private administration for the NCMS (Beilun and Ninghai) were compared with two others counties with public administration (Zhenhai and Fenghua), using the following indicators: (1) proportion of enrollees who were compensated for inpatient care; (2) average reimbursement-expense ratio per episode of inpatient care; (3) overall administration cost; (4) enrollee satisfaction. Data from 2004 to 2006 were collected from the local health authorities, hospitals and the contracted insurance companies, supplemented by a randomized household questionnaire survey covering 176 households and 479 household members. In our sample counties, private administration of the NCMS neither reduced transaction costs, nor improved the benefits of enrollees. Enrollees covered by the publicly administered NCMS were more likely to be satisfied with the insurance scheme than those covered by the privately administered NCMS. Experience in the selected counties suggests that private administration of the NCMS did not deliver the hoped-for results. We conclude that caution needs to be exercised in extending private administration of the NCMS.

Prioritizing lean management practices in public and private hospitals.

Science.gov (United States)

Hussain, Matloub; Malik, Mohsin

2016-05-16

Purpose - The purpose of this paper is to prioritize 21 healthcare wastes in public and private hospitals of United Arab Emirates (UAE). Design/methodology/approach - Seven healthcare wastes linked with lean management are further decomposed in to sub-criteria and to deal with this complexity of multi criteria decision-making process, analytical hierarchical process (AHP) method is used in this research. Findings - AHP framework for this study resulted in a ranking of 21 healthcare wastes in public and private hospitals of UAE. It has been found that management in private healthcare systems of UAE is putting more emphasis on the inventory waste. On the other hand, over processing waste has got highest weight in public hospitals of UAE. Research limitations/implications - The future directions of this research would be to apply a lean set of tools for the value stream optimization of the prioritized key improvement areas. Practical implications - This is a contribution to the continuing research into lean management, giving practitioners and designers a practical way for measuring and implementing lean practices across health organizations. Originality/value - The contribution of this research, through successive stages of data collection, measurement analysis and refinement, is a set of reliable and valid framework that can be subsequently used in conceptualization, prioritization of the waste reduction strategies in healthcare management.

Providing engineering services to counties.

Science.gov (United States)

2008-09-01

An engineer is required by law to safeguard the health, safety and welfare of the public. The current Kansas : statute state, The Board of County Commissioners of each county shall appoint a licensed professional : engineer, whose title shall be c...

[Public music concerts in a psychiatric hospital: effects on public opinion and as therapy for patients].

Science.gov (United States)

Takasaka, Y; Yokota, O; Tanioka, T; Nagata, K; Yasuoka, K; Toda, H

2001-01-01

We investigate the effects of music therapy concerts, which were held 60 times over a four year period, 1992 to 1996, in Geiyo Psychiatric Hospital, Kochi Prefecture and found that; 1) Musicians who performed at the concerts were not only from Kochi prefecture but also from other prefectures (10 times) and from four foreign countries (7 times). 2) Live concerts in a small hall had a positive influence on patients and drew the patient's attention and interest away from their hallucinations and delusions to the real world. Moreover, the concerts provided the patients with chances to acquire social graces such as being well-groomed. 3) Explanations by the musicians, interviews with the musicians and the seasonal choruses accompanied by the musicians were helpful to give the patients motives for recovering communication skills and to interact with society. 4) Inquiries to the patients about the concerts indicated discrepancies between the poor observed estimations during the concerts (83.3%) and the good subjective impressions expressed by the patients (82.0%), suggesting that the patients were not good at expressing their internal emotions through facial expressions or attitudes. 5) Many citizens including children came to the concerts and/or gave aid to the hospital because the concerts were open to the public and we suggest that this contributed to improving the general publics' image of psychiatric hospitals. Questionnaires revealed that 90% of people in a control group had a bad image of psychiatric hospitals in Japan, but only 32% of the members of the general public who attended our concerts had a bad image of psychiatric hospitals. In addition, the revolving ratio of the hospital beds rose from 0.4 to 1.2 over the four years, which also suggests a beneficial effect on the patients.

Variations in pediatric asthma hospitalization rates and costs between and within Nordic countries

DEFF Research Database (Denmark)

Kocevar, Vasilisa Sazonov; Bisgaard, Hans; Jönsson, Linus

2004-01-01

BACKGROUND: We assessed variations in hospitalization parameters and costs among asthmatic children in four Nordic countries by geographic location and age groups. METHODS: Cross-sectional, county-level aggregate data on asthma-related hospitalizations in 1999, obtained from public national...... not differ significantly from Sweden. CONCLUSIONS: Large variations in all parameters were observed between and within countries. Given the similarities among the four countries studied, these results may, among other reasons, indicate different efficiencies of the various asthma management plans between...

Closure of a local public hospital in Korea: focusing on the organizational life cycle.

Science.gov (United States)

Yeo, Young Hyun; Lee, Keon-Hyung; Kim, Hye Jeong

2016-01-01

Just as living organisms have a creation-maintenance-extinction life cycle, organizations also have a life cycle. Private organizations will not survive if they fail to acquire necessary resources through market competition. Public organizations, however, continue to survive because the government has provided financial support in order to enhance public interest. Only a few public organizations in Korea have closed. With the introduction of new public management since the economic crisis in 1997, however, public organizations have had to compete with private organizations. Public hospitals are not free to open or close their business. They are also controlled by the government in terms of their prices, management, budgets, and operations. As they pursue public interest by fulfilling the government's order such as providing free or lower-priced care to the vulnerable population, they tend to provide a lower quality of care and suffer a financial burden. Employing a case study analysis, this study attempts to understand the external environment that local public hospitals face. The fundamental problem of local public hospitals in Korea is the value conflict between public interest and profitability. Local public hospitals are required to pursue public interest by assignment of a public mission including building a medical safety net for low-income patients and managing nonprofitable medical facilities and emergent health care situations. At the same time, they are required to pursue profitability by achieving high-quality care through competition and the operation of an independent, self-supporting system according to private business logic. Under such paradoxical situations, a political decision may cause an unexpected result.

76 FR 50492 - Notice of Realty Action: Direct Sale of Public Land in San Benito County, CA

Science.gov (United States)

2011-08-15

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLCA930000.L58790000.EU0000; CACA 50168 13] Notice of Realty Action: Direct Sale of Public Land in San Benito County, CA AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Realty Action. SUMMARY: The Bureau of Land Management (BLM...

Comparison of organizational learning capabilities of the personnel in public and private sector hospitals of Kermanshah

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Homayoun Abbasi

2014-03-01

Full Text Available Background: Hospitals are among the most interactive organizations in which the rate of knowledge transfer and learning is considerably high. The investigation of the level of organizational learning between public and private sector hospitals can be useful for managers to select proper organizational learning strategies aiming at improving service delivery and organizational behaviour (1. This study was carried out to compare the organizational learning capabilities of the personnel in public and private sector hospitals of Kermanshah. Methods: This descriptive survey was performed on the personnel in public and private sector hospitals of Kermanshah. According to Krejcie and Morgan’s table, 175 employees were selected via stratified random sampling from 6 public and 2 private hospitals. The instrument for gathering data was Organizational Learning Capability Questionnaire (OLCQ by Gomez et al. (2005 (2. Data were analysed by inferential statistics (K-S test, Levene’s test, t-test, one-way ANOVA using SPSS software (version 20.00. Results: The level of organizational learning capabilities of personnel was higher in the private hospitals than in public hospitals, indicating a statistically significant difference between them (T (26= 11.779, P0.01، F (3, 68 = 1.859. Conclusion: With regard to the higher average of knowledge transfer and integration than the other capabilities in public and private hospitals, it seems that the managers of hospitals should make use of this component to promote the organizational knowledge of the personnel and improve other organizational learning capabilities too.

75 FR 35083 - Notice of Realty Action; Direct Sale of Public Lands in Lincoln County, ID

Science.gov (United States)

2010-06-21

... of the surrounding private land for the appraised fair market value of $14,000. The private land... fair market value: Boise Meridian T. 6 S., R. 22 E, Sec. 29, SW\\1/4\\SW\\1/4\\. The area described contains 40 acres in Lincoln County. The appraised fair market value is $14,000. The public land is...

76 FR 29784 - Notice of Realty Action; Direct Sale of Public Lands in Jerome County, ID

Science.gov (United States)

2011-05-23

... adjacent private land, Todd and Bridget Buschhorn, for the appraised fair market value of $5,600. DATES... fair market value: Boise Meridian T. 10 S., R. 19 E., sec. 25, lot 10. The area described contains 7.45 acres in Jerome County. The appraised fair market value is $5,600. The public land is identified as...

Containing costs in public sector hospitals - a strategy for the future ...

African Journals Online (AJOL)

Containing costs in public sector hospitals - a strategy for the future. ... is increasing concern about expenditure in the public and the private health care sectors. ... at the micro-level comparison of expenditure over a 14-year period in one major ...

Hospitalization flow in the public and private systems in the state of Sao Paulo, Brazil.

Science.gov (United States)

Rocha, Juan Stuardo Yazlle; Monteiro, Rosane Aparecida; Moreira, Marizélia Leão

2015-01-01

OBJECTIVE To describe the migration flows of demand for public and private hospital care among the health regions of the state of Sao Paulo, Brazil.METHODS Study based on a database of hospitalizations in the public and private systems of the state of Sao Paulo, Southeastern Brazil, in 2006. We analyzed data from 17 health regions of the state, considering people hospitalized in their own health region and those who migrated outwards (emigration) or came from other regions (immigration). The index of migration effectiveness of patients from both systems was estimated. The coverage (hospitalization coefficient) was analyzed in relation to the number of inpatient beds per population and the indexes of migration effectiveness.RESULTS The index of migration effectiveness applied to the hospital care demand flow allowed characterizing health regions with flow balance, with high emigration of public and private patients, and with high attraction of public and private patients.CONCLUSIONS There are differences in hospital care access and opportunities among health regions in the state of Sao Paulo, Brazil.

Acute Stroke Through the Perspective of a County Hospital: Problems and Opportunities

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Atay Vural

2016-04-01

Full Text Available Objective: Stroke is one of the most important public health issues worldwide, and ranks as the second highest cause of mortality in our country. Regular follow-up of stroke statistics and taking necessary precautions upon determining deficits by countries themselves constitute the most important way of improving prognosis and survival after stroke incidents. To achieve this goal, statistical studies should be performed at various levels of healthcare services. Tertiary care hospitals are the most suitable centers to perform these studies. However, the majority of the population receives service at secondary care centers where the actual statistics remain unknown. The objective of this study was to examine all patients with acute stroke who presented to a county hospital over a one-year period and obtain related data, discuss deficits, and provide solutionbased recommendations. Materials and Methods: All patients diagnosed as having acute stroke between July 2013-July 2014 were included in the study. Demographic, clinical, and radiologic data, in addition to the timing of presentation and baseline National Institutes of Health Stroke Scale (NIHSS scores were recorded retrospectively, and patients were classified by the type of stroke. All patients were followed up for at least one year after the stroke incident and cumulative survival scores were calculated using Kaplan-Meier analysis. Results: Hemorrhagic stroke was determined in four out of 49 patients with acute stroke; the 45 patients diagnosed as having ischemic stroke were included in the study. Among these, 44.4% (n=20 of the patients presented within the first three hours of onset of clinical symptoms, 4.4% (n=2 presented at 3.-4.5 hours. Baseline NIHSS was 1-4 (mild stroke in 50% (n=10 of patients who presented in the first three hours, and >5 (moderate or severe stroke in 50% (n=10 of the remaining patients. The etiologic cause was embolic in 37.1% (n=13, large artery atherosclerosis

Public Opinion on Nutrition-Related Policies to Combat Child Obesity, Los Angeles County, 2011

OpenAIRE

Simon, Paul A.; Chiang, Choiyuk; Lightstone, Amy S.; Shih, Margaret

2014-01-01

We assessed public opinion on nutrition-related policies to address child obesity: a soda tax, restrictions on advertising unhealthy foods and beverages to children, and restrictions on siting fast food restaurants and convenience stores near schools. We analyzed data from 998 adults (aged ≥18 years) in the 2011 Los Angeles County Health Survey. Support was highest for advertising restrictions (74%), intermediate for a soda tax (60%), and lowest for siting restrictions on fast food restaurant...

Free Primary Education Policy: Coping Strategies in Public Primary Schools in Kakamega South District, Kakamega County, Kenya

Science.gov (United States)

Mulinya, Lidoro Charles; Orodho, John Aluko

2015-01-01

This study examined the challenges of implementing free primary education and copping strategies in public primary schools in Kakamega South District, Kakamega County, Kenya. The study was premised on the demand and supply theory. A descriptive survey research design was adopted. The sample comprised 23 headteachers, 92 teachers and one Ministry…

76 FR 72972 - Notice of Realty Action: Competitive Sale of Public Land in Santa Clara County, CA

Science.gov (United States)

2011-11-28

... appraised fair market value. The appraised value of the public land is $135,000. DATES: Comments regarding... described contains 23.42 acres, more or less, in Santa Clara County, California. Appraised fair market value... no known mineral values in the land proposed for sale. The BLM proposes that conveyance of the...

[Project financing in public hospital trusts].

Science.gov (United States)

Contarino, F; Grosso, G; Mistretta, A

2009-01-01

The growing debate in recent years over how to finance public works through private capital has progressively highlighted the role of project finance (PF) and publicprivate partnerships (PPP) in general. More and more European countries are turning to PF to finance their public infrastructure development. The UK, which pioneered the adoption of project finance in this field, has been followed by Italy, Spain, France, Portugal and Germany and more recently by Greece, Czech Republic and Poland. Beginning in the late 1990's, Italy has steadily amplified its use of PF and PPPs in key sectors such as healthcare as an alternative way of funding the modernisation of its health facilities and hospitals. The trend reveal an average annual growth of 10.9% since 2002 with peaks of varying intensity over the five year period. Project finance and PPPs represent an effective response to the country's infrastructure gap and support the competitiveness of local systems and the quality of public services. None of this will transpire, however without energetic new planning efforts and adequate policy at the centre.

ON THE DEGREE OF FINANCIAL MANAGEMENT TRANSPARENCY IN THE PUBLIC HOSPITALS OF THE REPUBLIC OF MOLDOVA

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Andrei PETROIA

2017-04-01

Full Text Available During the last ten years, the hospitals from the Republic of Moldova have received at least MDL 20 billion from the funds of CHI. Even if the amount of money allocated to hospitals is increasing the level of transparency of public money usage will decrease. Moldovan hospitals, either republican or district, have got used to managing money without reporting what they are doing, even if they are speaking about public money. According to the analysis of Sănătate INFO, no republican hospital did publish full financial reports, by which we can observe how public money managed and its aim. If private hospitals should report on the resources, they receive through the contact with NHIC, then all public institutions should present detailed information about the sources of revenues, which they manage.

Financial analysis of diabetic patients hospitalizations submitted to lower limb amputation in a public hospital

Directory of Open Access Journals (Sweden)

Renata Santos Silva

2015-03-01

Full Text Available This study is a documental descriptive analysis which aimed to verify the cost established in 2006, in relation to the hospitalization of 21 diabetic patients submitted to the lower limb amputation in a public hospital and the value transferred by the Unified Health System (SUS regarding this procedure. Among the studied patients, 57.14% were female and 42.86% male, aged 40 to 90 years. The time of diagnosis varied from 5 to 25 years. The average of hospitalization was 14 days per patient. The cost to the hospital was R$ 99,455.74, average cost per patient was R$ 4,735.98. The total amount transferred by SUS to the hospital was R$ 27,740.15, a cost 3.6 times lower than the hospital costs. The SUS transferring is in accordance with the predetermined values for its table of procedure. Prevention is the only alternative to reduce the rate of amputation and improve survival of diabetes patients. It is necessary an early diagnosis and better control of diabetes mellitus with appropriate government and institutional policies.

Hospitals need to customise care according to patients' differing information-seeking behaviour

DEFF Research Database (Denmark)

Riiskjær, Erik; Ammentorp, Jette; Nielsen, Jørn Flohr

2014-01-01

INTRODUCTION: The aim of the study was to describe how often patients seek information about their disease in connection with contact to a hospital and to elucidate how information-seeking behaviour is related to the patients' perception of this contact. MATERIAL AND METHODS: The study was based...... on patient surveys from the Danish county of Aarhus from 1999 to 2006 including eight public hospitals. The patients' information-seeking behaviour was related to patient characteristics, organisational context and patient perceptions. RESULTS: Among the 75,769 patients who responded, 33.4% had actively...

Post-abortion and induced abortion services in two public hospitals in Colombia.

Science.gov (United States)

Darney, Blair G; Simancas-Mendoza, Willis; Edelman, Alison B; Guerra-Palacio, Camilo; Tolosa, Jorge E; Rodriguez, Maria I

2014-07-01

Until 2006, legal induced abortion was completely banned in Colombia. Few facilities are equipped or willing to offer abortion services; often adolescents experience even greater barriers of access in this context. We examined post abortion care (PAC) and legal induced abortion in two large public hospitals. We tested the association of hospital site, procedure type (manual vacuum aspiration vs. sharp curettage), and age (adolescents vs. women 20 years and over) with service type (PAC or legal induced abortion). Retrospective cohort study using 2010 billing data routinely collected for reimbursement (N=1353 procedures). We utilized descriptive statistics, multivariable logistic regression and predicted probabilities. Adolescents made up 22% of the overall sample (300/1353). Manual vacuum aspiration was used in one-third of cases (vs. sharp curettage). Adolescents had lower odds of documented PAC (vs. induced abortion) compared with women over age 20 (OR=0.42; 95% CI=0.21-0.86). The absolute difference of service type by age, however, is very small, controlling for hospital site and procedure type (.97 probability of PAC for adolescents compared with .99 for women 20 and over). Regardless of age, PAC via sharp curettage is the current standard in these two public hospitals. Both adolescents and women over 20 are in need of access to legal abortion services utilizing modern technologies in the public sector in Colombia. Documentation of abortion care is an essential first step to determining barriers to access and opportunities for quality improvement and better health outcomes for women. Following partial decriminalization of abortion in Colombia, in public hospitals nearly all abortion services are post-abortion care, not induced abortion. Sharp curettage is the dominant treatment for both adolescents and women over 20. Women seek care in the public sector for abortion, and must have access to safe, quality services. Copyright © 2014. Published by Elsevier Inc.

Strengthening Public Financial Management at the County ...

International Development Research Centre (IDRC) Digital Library (Canada)

Counties suffer from weak financial management and accountability, human capacity ... The project team will prepare a report of its findings and recommendations, ... them consolidate their role as credible development actors in their countries, ...

Does hospital ownership affect patient experience? An investigation into public-private sector differences in England.

Science.gov (United States)

Pérotin, Virginie; Zamora, Bernarda; Reeves, Rachel; Bartlett, Will; Allen, Pauline

2013-05-01

Using patient experience survey data, the paper investigates whether hospital ownership affects the level of quality reported by patients whose care is funded by the National Health Service in areas other than clinical quality. We estimate a switching regression model that accounts for (i) some observable characteristics of the patient and the hospital episode; (ii) selection into private hospitals; and (iii) unmeasured hospital characteristics captured by hospital fixed effects. We find that the experience reported by patients in public and private hospitals is different, i.e. most dimensions of quality are delivered differently by the two types of hospitals, with each sector offering greater quality in certain specialties or to certain groups of patients. However, the sum of all ownership effects is not statistically different from zero at sample means. In other words, hospital ownership in and of itself does not affect the level of quality of the average patient's reported experience. Differences in mean reported quality levels between the private and public sectors are entirely attributable to patient characteristics, the selection of patients into public or private hospitals and unobserved characteristics specific to individual hospitals, rather than to hospital ownership. Copyright © 2013 Elsevier B.V. All rights reserved.

Rural hospital wages

Science.gov (United States)

Hendricks, Ann M.

1989-01-01

Average fiscal year 1982 wages from 2,302 rural American hospitals were used to test for a gradient descending from hospitals in counties adjacent to metropolitan areas to those not adjacent. Considerable variation in the ratios of adjacent to nonadjacent averages existed. No statistically significant difference was found, however. Of greater importance in explaining relative wages within States were occupational mix, mix of part-time and full-time workers, case mix, presence of medical residencies, and location in a high-rent county within the State. Medicare already adjusts payments for only two of these variables. PMID:10313454

Frequency of Hospital Use Before and After Home-Delivery Meal by Meals On Wheels, of Tarrant County, Texas.

Science.gov (United States)

Cho, J; Thorud, J L; Marishak-Simon, S; Hammack, L; Stevens, A B

2018-01-01

Patients recently discharged from the hospital are vulnerable and are at high risk for readmission. Home-delivered meals may be beneficial in improving their health and facilitating independent living in the community. The purpose of this study was to identify the association between home-delivered meals and use of hospital services. This study includes 120 clients recently discharged from an inpatient hospital stay or from an emergency department (ED) visit who received meal services from Meals On Wheels, Inc., of Tarrant County. Healthcare utilization data was extracted from the Dallas-Fort Worth Hospital Council Foundation, a regional all claims database used by over 90% of hospitals in Dallas-Fort Worth area. Signed tests and generalized linear models (GLM) were performed. A total of 16,959 meals were delivered from March 2013 through March 2014. Each client received an average of 6.19 meals per week. The average number of ED visits decreased from 5.03 before receipt of meals to 1.45 after receipt of meals, z = -5.23, p meals were less likely to experience ED visits and hospitalizations after controlling for demographic characteristics and levels of physical functioning. The findings of this study indicate that home-delivered meals services may contribute to a reduction in hospital based care services among frail and vulnerable adults. Additional studies should consider the short and long-term effects of home-delivered meals services on healthcare utilization and the potential to decrease healthcare costs.

The Efficacy of PCI's Reading Program--Level One: A Report of a Randomized Experiment in Brevard Public Schools and Miami-Dade County Public Schools. Research Summary

Science.gov (United States)

Empirical Education Inc., 2008

2008-01-01

PCI Education sought scientifically based evidence on the effectiveness of the "PCI Reading Program--Level One" for students with severe disabilities. During the 2007-2008 academic year. Empirical Education conducted a randomized control trial (RCT) in two Florida districts, Brevard and Miami-Dade County Public Schools. For this…

The Efficacy of PCI's "Reading Program--Level One": A Report of a Randomized Experiment in Brevard Public Schools and Miami-Dade County Public Schools. Research Report

Science.gov (United States)

Toby, Megan; Ma, Boya; Jaciw, Andrew; Cabalo, Jessica

2008-01-01

PCI Education sought scientifically based evidence on the effectiveness of the "PCI Reading Program--Level One" for students with severe disabilities. During the 2007-2008 academic year. Empirical Education conducted a randomized control trial (RCT) in two Florida districts, Brevard and Miami-Dade County Public Schools. For this…

Douglas County Historical Rectified Aerial Photos 1937

Data.gov (United States)

Kansas Data Access and Support Center — This raster dataset consists of approximately 200 aerial photographs taken in 1937 in Douglas county, Kansas, United States. The Douglas County Public Works...

Douglas County Historical Rectified Aerial Photos 1954

Data.gov (United States)

Kansas Data Access and Support Center — This raster dataset consists of approximately 200 aerial photographs taken in 1954 in Douglas county, Kansas, United States. The Douglas County Public Works...

Rebel with a Cause: A School Board Member Calls for Reform in Miami-Dade County Public Schools

Science.gov (United States)

Manning, Tom

2011-01-01

This case describes the experience of a new school board member in Miami-Dade County Public Schools, Marta Perez, as she discovers a wide range of ethical and management problems in the school district and attempts to deal with them. Layered throughout the case are challenges pertaining to the school board's roles and responsibilities,…

The reforms of the Chinese health care system: county level changes: the Jiangxi Study.

Science.gov (United States)

Zheng, X; Hillier, S

1995-10-01

A survey of the economic performance of county hospitals in middle income counties in Jiangxi province was undertaken in 1989. The survey considered the impact of health policy changes in the P.R.C., especially cost recovery, decentralization, managerial changes and the promotion of traditional medicine. The financial records of county level hospitals and traditional medicine hospitals for the period 1980-89 were examined, as were patient expenditures. Opinions of those responsible for policy execution were surveyed. The data showed that hospitals from which state subsidy had been removed had become dependent on medicine sales and increasing itemization of treatment to recover costs. The insurance status of patients influenced the length of stay and levels of payment. Uninsured peasants had a shorter stay and were charged more for items of treatment. Traditional Medicine hospitals saw more outpatients than County hospitals, but were more likely to have a deficit. They were also very dependent on medicine sales for income. Most officials questioned felt that the changing system caused problems, but at the same time were eager to invest in equipment as a source of revenue.

Can Architects Help Transform Public Education? What the Sarasota County Civic School Building Program (1955-1960) Teaches Us

Science.gov (United States)

Paley, Nicholas B.

2013-01-01

The Sarasota County School Building Program 1955-1960 is revisited through a detailed examination of how architects and educators collaborated to design an innovative group of public schools that provided opportunities for the transformation of learning space. This multi-dimensioned examination is grounded in an historical contextualization of the…

Does autonomy for public hospitals in developing countries increase performance? Evidence-based case studies.

Science.gov (United States)

De Geyndt, Willy

2017-04-01

Governments in middle and low income countries have sought ways for the past decades to make their public hospitals more performing. The objectives of this assessment are to: (a) synthesize the experience of eleven countries at granting autonomy to their public hospitals and the obstacles encountered; (b) deduce which autonomy policies have or have not been effective documenting successes and failures; and (c) propose evidence-based recommendations to policy makers. Data for five countries are derived from the author's participation in the autonomy process augmented by current updates provided by national colleagues. Data for the other six countries are derived from publications available in the literature. Policies granting autonomy to public hospitals have had limited success. In all cases Boards of Directors have been created. Governance of autonomized hospitals by Boards however is obstructed by the resistance of central level entities to have their authority diminished. The Ministry of Finance tends to maintain control over revenues and expenditures. The Public Service Commission resists abdicating its role to hire, promote, transfer and dismiss government employees. The Ministry of Health attempts to keep its authority to appoint hospital staff, procure medical supplies and equipment; it may do so directly or indirectly by selecting and appointing Board members. Management information systems continue to collect activity measures to be aggregated at the national level for statistical purposes and do not provide financial and clinical data useful for decision making by the Boards and by senior management. Decentralizing decision making to the operational level has had limited success. Stakeholders at the central level devise strategies to maintain their power. Two main obstacles are delegating authority over human resources and finances that are sine qua non conditions for governing and increasing the performance of public hospitals. Copyright © 2017 Elsevier

Adverse events in surgical inpatients: A comparative analysis of public hospitals in Victoria

OpenAIRE

Katharina Hauck; Xueyan Zhao; Terri Jackson

2010-01-01

We compare adverse event rates for surgical inpatients across 36 public hospitals in the state of Victoria, Australia, conditioning on differences in patient complexity across hospitals. We estimate separate models for elective and emergency patients which stay at least one night in hospitals, using fixed effects complementary log-log models to estimate AEs as a function of patient and episode characteristics, and hospital effects. We use 4 years of patient level administrative hospital data ...

Perceptions of patient-centred care at public hospitals in Nelson Mandela Bay

Directory of Open Access Journals (Sweden)

Sihaam Jardien-Baboo

2016-10-01

Full Text Available In South Africa, the quality of health care is directly related to the concept of patient-centred care and the enactment of the Batho Pele Principles and the Patients' Rights Charter. Reports in the media indicate that public hospitals in the Eastern Cape Province are on the brink of collapse, with many patients being treated in condemned hospitals which lacked piped water, electricity and essential medical equipment. Receiving quality care, and principally patient-centred care, in the face of such challenges is unlikely and consequently leads to the following question: “Are patients receiving patient-centred care in public hospitals?” A qualitative, explorative, descriptive and contextual study was conducted to explore and describe the perceptions of professional nurses regarding patient-centred care in public hospitals in Nelson Mandela Bay. Semi-structured interviews were conducted with a total of 40 purposively selected professional nurses working in public hospitals in Nelson Mandela Bay, Eastern Cape Province. Interviews were analysed according to the method described by Tesch in Creswell (2009:192. Professional nurses perceive patient-centred care as an awareness of the importance of the patient's culture, involving the patient's family, incorporating values of love and respect, optimal communication in all facets of patient care and accountability to the patient. Factors which enable patient-centred care were a positive work environment for staff, nursing manager's demonstrating exemplary professional leadership, continuous in service education for staff and collaborative teamwork within the interdisciplinary team. Barriers to patient-centred care were a lack of adequate resources, increased administrative work due to fear of litigation and unprofessional behaviour of nursing staff.

Diabetes control and complications in public hospitals in Malaysia.

Science.gov (United States)

Mafauzy, M

2006-10-01

The Diabcare-Asia project was initiated to study the status of diabetes care and prevalence of diabetic complications in Asia and this study was done to evaluate the above in public hospitals in Malaysia and compare to a similar study done in 1998. A total of 19 public hospitals participated in this study from which a total of 1099 patients were included and analysed. The majority of patients (94.8%) had type 2 diabetes mellitus and 66.5% were overweight or obese. As for glycaemic control only 41.0% of the patients had HbA1c 1.1 mmol/L and 51.1% had triglycerides diet regularly and 38.9% exercised regularly. As for glucose monitoring, only 26.8% of the patients did home blood glucose monitoring and 1.8% did home urine glucose testing. There was also a high complication rate with the commonest being neuropathy (19.0%) followed by albuminuria (15.7%), background retinopathy (11.1%) and microalbuminuria (6.6%). Compared to the 1998 study, there was some improvement in the percentage of patients achieving target levels and a reduction in the prevalence of complications. In conclusion, the majority of diabetic patients treated at the public hospitals were still not satisfactorily controlled and this was still associated with a high prevalence of complications. There is still an urgent need to educate both patients and health care personnel on the importance of achieving the clinical targets and greater effort must be made to achieve these targets.

Hurricane exposure and county fetal death rates, utilization of a county environmental quality index for confounding control.

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The effects of natural disasters on public health are a rising concern, with increasing severity of disaster events. Many disaster studies utilize county-level analysis, however most do not control for county level environmental factors. Hurricane exposure during pregnancy could ...

[Supply prescription filling and out-of-pocket expenditures on medicines in public hospitals in Mexico in 2009].

Science.gov (United States)

Sesma-Vázquez, Sergio; Gómez-Dantés, Octavio; Wirtz, Veronika J; Castro-Tinoco, Manuel

2011-01-01

To analyze the availability of drugs in public hospitals, the prescription-filling patterns for in-patients when they are discharged and their out-of-pocket expenditure during their hospitalization. Using the National Satisfaction and Responsiveness Survey (ENSATA) 2009, which includes a representative sample of public hospitals in Mexico in 2009, the availability of 83 essential medicines in the hospital pharmacies at the day of visit, the proportion of prescriptions completely filled for patients when they are discharged and their out-of-pocket expenditure during their hospitalization were analyzed. A total of 26 271 patients in 160 public hospitals were interviewed. The mean availability of drugs was 82% for all hospitals, with the lowest availability for the Ministry of Health (SESA) hospitals (77%, with a range of 30 to 96%). Patients discharged at social security hospitals received in 97% of cases a complete prescription filling, while in SESA hospitals the average was only 56.2%, with a large variance among states (13 to 94%). The median inpatient spending was 150 pesos in national currency (1% spent over 10 000 pesos). The lack of medicines in public hospitals may increase in-patient morbidity and mortality and has an economic impact on household spending, particularly in those with scarce resources.

Ground-water resources data for Baldwin County, Alabama

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Robinson, James L.; Moreland, Richard S.; Clark, Amy E.

1996-01-01

Geologic and hydrologic data for 237 wells were collected, and water-levels in 223 wells in Baldwin and Escambia Counties were measured. Long-term water water-level data, available for many wells, indicate that ground-water levels in most of Baldwin County show no significant trends for the period of record. However, ground-water levels have declined in the general vicinity of Spanish Fort and Daphne, and ground-water levels in the Gulf Shores and Orange Beach areas are less than 5 feet above sea level in places. The quality of ground water generally is good, but problems with iron, sulfur, turbidity, and color occur. The water from most private wells in Baldwin County is used without treatment or filtration. Alabama public- health law requires that water from public-supply wells be chlorinated. Beyond that, the most common treatment of ground water by public-water suppliers in Baldwin County consists of pH adjustment, iron removal, and aeration. The transmissivity of the Miocene-Pliocene aquifer was determined at 10 locations in Baldwin County. Estimates of transmissivity ranged from 700 to 5,400 feet squared per day. In general, aquifer transmissivity was greatest in the southeastern part of the county, and least in the western part of the county near Mobile Bay. A storage coefficient of 1.5 x 10-3 was determined for the Miocene-Pliocene aquifer near Loxley.

Gearing service quality into public and private hospitals in small islands: empirical evidence from Cyprus.

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Arasli, Huseyin; Ekiz, Erdogan Haktan; Katircioglu, Salih Turan

2008-01-01

The purpose of this research is to develop and compare some determinants of service quality in both the public and private hospitals of Northern Cyprus. There is considerable lack of literature with respect to service quality in public and private hospitals. Randomly, 454 respondents, who have recently benefited from hospital services in Famagusta, were selected to answer a modified version of the SERVQUAL Instrument. The instrument contained both service expectations and perceptions questions. This study identifies six factors regarding the service quality as perceived in both public and private Northern Cyprus hospitals. These are: empathy, giving priority to the inpatients needs, relationships between staff and patients, professionalism of staff, food and the physical environment. Research results revealed that the various expectations of inpatients have not been met in either the public or the private hospitals At the micro level, the lack of management commitment to service quality in both hospital settings leads doctors and nurses to expend less effort increasing or improving inpatient satisfaction. Hospital managers should also satisfy their employees, since job satisfaction leads to customer satisfaction and loyalty. Additionally, hospital administrations need to gather systematic feedback from their inpatients, establish visible and transparent complaint procedures so that inpatients' complaints can be addressed effectively and efficiently. The hospitals need to organize training sessions based on the critical importance of service quality and the crucial role of inpatient satisfaction in the health care industry. Future studies should include the remaining regions in Cyprus in order to increase research findings' generalizability. Additionally, including other dimensions such as hospital processes and discharge management and co-ordination may provide further insights into understanding inpatients' perceptions and intentions.

Organizational climate in a public hospital from Quindio Colombia

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Rubén Darío Agudelo Loaiza

2017-09-01

Full Text Available Objective: To characterize the organizational climate perceived by the assistance and administrative staff members at a public hospital in Quindio-Colombia 2015. Method: A quantitative correlational study, which measures the organizational climate of a low complexity hospital through the characterization of twelve dimensions. The population being studied was conformed by 114 assistance and administrative staff members who belong to a public hospital in Quindío-Colombia. Results: The measurement of the organizational climate provided a result of a global average of 69.81 with a score of 3.9 being classified as a medium level for the organizational climate. There was evidence of a highly meaningful positive bond between the organizational climate and the dimension of interpersonal relationships and between this one with the external coordination. Conclusion: There is evidence of the importance given by the staff members to the “friendly interaction” that is interpreted as a respectful and effective relationship with their co-workers, which is, in turn, necessary for the generation of a teamwork environment. Additionally, it was found that a high degree of importance regarding interpersonal relationships with the external coordination is given; fact that can be understood as the value staff members confere to the participative leadership within their perception of organizational climate.

Comparing public and private providers: a scoping review of hospital services in Europe.

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Tynkkynen, Liina-Kaisa; Vrangbæk, Karsten

2018-02-27

What is common to many healthcare systems is a discussion about the optimal balance between public and private provision. This paper provides a scoping review of research comparing the performance of public and private hospitals in Europe. The purpose is to summarize and compare research findings and to generate questions for further studies. The review was based on a methodological approach inspired by the British EPPI-Centre's methodology. This review was broader than review methodologies used by Cochrane and Campbell and included a wider range of methodological designs. The literature search was performed using PubMed, EconLit and Web of Science databases. The search was limited to papers published from 2006 to 2016. The initial searches resulted in 480 studies. The final sample was 24 papers. Of those, 17 discussed economic effects, and seven studies addressed quality. Our review of the 17 studies representing more than 5500 hospitals across Europe showed that public hospitals are most frequently reported as having the best economic performance compared to private not-for-profit (PNFP) and private for-profit (PFP) hospitals. PNFP hospitals are second, while PFP hospitals are least frequently reported as superior. However, a sizeable number of studies did not find significant differences. In terms of quality, the results are mixed, and it is not possible to draw clear conclusions about the superiority of an ownership type. A few studies analyzed patient selection. They indicated that public hospitals tend to treat patients who are slightly older and have lower socioeconomic status, riskier lifestyles and higher levels of co-morbidity and complications than patients treated in private hospitals. The paper points to shortcomings in the available studies and argues that future studies are needed to investigate the relationship between contextual circumstances and performance. A big weakness in many studies addressing economic effects is the failure to control for

Trouble Brewing in Orange County. Policy Brief

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Buck, Stuart

2010-01-01

Orange County will soon face enormous budgetary pressures from the growing deficits in public pensions, both at a state and local level. In this policy brief, the author estimates that Orange County faces a total $41.2 billion liability for retiree benefits that are underfunded--including $9.4 billion for the county pension system and an estimated…

Prevalence of Pressure Injury of Bedridden Patients, Hospitalized in a Public Hospital

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Sandra Marina Gonçalves Bezerra

2017-03-01

Full Text Available Objective: To analyze the prevalence of pressure injury in bedridden patients, hospitalized in a public hospital. Methodology: This is a cross-sectional study conducted in the city of Teresina, state of Piauí. The sample consisted of 27 bedridden patients, with pressure injuries. Results: The injury prevalence was 31,4%. From the 27 patients studied, 59.3% were elderly, 77.8% were male, 48.1% had circulatory system diseases, 22.2% had respiratory system diseases and 59.3% of the pressure injuries were located in the sacral region. Conclusion: The prevalence of pressure injury was high among bedridden patients, which shows the need of preventive measures, such as protocol implantation, use of scale of risk assessment, appropriate supporting surface, repositioning in bed, adequacy of dressings and instructions for patient discharge. Keywords: Pressure ulcer. Prevalence. Nursing.

Theoretical and perceived balance of power inside Spanish public hospitals.

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Salvadores, P; Schneider, J; Zubero, I

2001-01-01

The hierarchical pyramid inside Spanish public hospitals was radically changed by the Health Reform Law promulgated in 1986. According to it, the manpower of the hospitals was divided into three divisions (Medical, Nursing, General Services/Administration), which from then on occupied the same level, only subject to the general manager. Ten years after the implementation of the law, the present study was designed in order to investigate if the legal changes had indeed produced a real change in the balance of power inside the hospitals, as perceived by the different workers within them. A questionnaire was administered to 1,027 workers from four different public hospitals (two university-based and two district hospitals). The participants belonged to all divisions, and to all three operative levels (staff, supervisory and managerial) within them. The questionnaire inquired about the perceived power inside each division and hierarchical level, as well as about that of the other divisions and hierarchical levels. Every division attributed the least power to itself. The Nursing and the Administrative division attributed the highest power to the physicians, and these attributed the highest power to the General Services/Administrative division. All hierarchical levels (including the formal top of the pyramid) attributed significantly more power to the other than to them. More than ten years after the implementation of the new law, the majority of workers still perceive that the real power within the hospitals is held by the physicians (whereas these feel that it has shifted to the administrators). No division or hierarchical level believes it holds any significant degree of power, and this carries with it the danger of also not accepting any responsibility.

Screening of HBsAg and anti HCV from tertiary care, private and public sector hospitals

International Nuclear Information System (INIS)

Khan, R.A.W.; Ahmed, W.; Alam, S.E.; Arif, A

2011-01-01

Objectives: To find out the frequency of hepatitis B surface antigen and hepatitis C antibodies in patients referred from a tertiary care public sector hospital, other public sector and private hospitals of Karachi. Settings and duration: Pakistan Medical Research Council's Specialized Research Centre for Gastroenterology and Hepatology, at Jinnah Postgraduate Medical Centre Karachi from January to December 2009. Patients and Methods: A cross sectional study was conducted where patients were referred from different departments of Jinnah Postgraduate Medical Centre (tertiary care public sector hospital), other public sector hospitals, private hospitals and clinics for the screening of hepatitis B and C virus infection. Three ml blood was collected from each patient, serum separated and tested for HBsAg and Anti HCV using Abbott Murex fourth Generation ELISA kits. Results: A total of 2965 cases were referred in a year. Overall sero prevalence of HBsAg and Anti-HCV was 5.9% and 12.8% respectively. HBsAg positivity in patient referred from public sector hospitals was 5.8%, those from private hospitals/clinics were 7.2%, and self-referred patients was 5.6%. Anti HCV positivity rates amongst these cases were 12.5%, 16.7% and 8.5% respectively. Co-infection of hepatitis B virus and hepatitis C virus was seen in 0.9, 2.5 and 1.4% cases respectively. Breakdown of viral positivity within different departments of Jinnah Postgraduate Medical Centre Karachi showed HBsAg positivity of 7.1% in Medical department, 5.2% in Surgical department, 5.0% in Gynaecology department, 6.6% in other departments of Jinnah Postgraduate Medical Centre while, only 1.7% were positive from Pakistan Railway, hospital Anti HCV positivity was maximally (20.3%) seen in medical department followed by 14% in other departments, 10.9% in surgical department, 7.9% in gynaecology and 5.1% in railway hospital. Co-infection of HBV and HCV was seen in 2% cases referred from medical department, while rest of the

Management of incomplete abortion in South African public hospitals.

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Brown, H C; Jewkes, R; Levin, J; Dickson-Tetteh, K; Rees, H

2003-04-01

To describe the current management of incomplete abortion in South African public hospitals and to discuss the extent to which management is clinically appropriate. A multicentre, prospective descriptive study. South African public hospitals that manage gynaecological emergencies. Hospitals were selected using a stratified random sampling method. All women who presented to the above sampled hospitals with incomplete abortion during the three week data collection period in 2000 were included. A data collection sheet was completed at the time of discharge for each woman admitted with a diagnosis of incomplete, complete, missed or inevitable abortion during the study period. Information gathered included demographic data, clinical signs and symptoms at admission, medical management, surgical management, anaestetic management, use of blood products and antibiotics and complications. Three clinical severity categories were used for the purpose of data analysis and interpretation. Detail of medical management, detail of surgical management, use of blood products and antibiotics, methods of analgesia and anaesthesia used, and use of abortifacients. There is a trend towards low cost technology such as the use of manual vacuum aspiration and sedation anaesthesia; however, this is mainly limited to the better resourced tertiary hospitals linked to academic units. The use of antibiotics and blood products has decreased but much of the use is inappropriate. The use of abortifacients does include some use of misoprostol but merely as an adjunct to surgical evacuation. The management of incomplete abortion remains a problem in South Africa, a low income country that is still managing a common clinical problem with costly interventions. The evidence of a trend towards low cost technology is promising, albeit limited to tertiary centres. This study has given us information as how to best address this problem. More training in low cost methods is needed, targeting in particular the

An empirical analysis of the public's attitudes toward advertising hospital services: a comparative cross-sectional study.

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Moser, H Ronald; Freeman, Gordon L

2014-01-01

This study investigates current opinions about hospital advertising and compares them to the attitudes expressed 25 years ago. It replicates a survey done in 1985, using the same questionnaire and population to compare responses longitudinally. The study indicates some changes in the public's opinions of hospital advertising. Although the image of hospitals remains positive, most of the 2010 respondents' opinions were rather mixed regarding whether it is proper for hospitals to advertise. The study also confirmed that the quality of service and reputation of hospitals remain more important to the public than price.

Wasteful use of financial resources in public hospitals in Turkey: a trend analysis.

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Ozgulbas, Nermin; Kisa, Adnan

2006-01-01

The Turkish health system is mainly financed by public sources such as taxes and premiums collected from workers. According to 2003 data, total health expenditures were 4.5% of the country's Gross Domestic Product. Currently, 56% of the system is financed by the Ministry of Health, and services are also provided by the Ministry. The main sources of finance among the Ministry of Health hospitals are general budget contributions made by the Ministry and revolving funds. The purpose of this study is to evaluate the financial conditions of those Ministry of Health hospitals that have revolving funds. The financial trends of 2514 hospitals were followed from 1996 to 2000, and financial statement analyses were conducted. The results of the study show that the Ministry of Health hospitals are not professionally administered for their financial situation and also that their financial resources are not used effectively. The hospitals had difficulty in collecting debts and had problems in cash returns. At the end of the study, policy suggestions are made for health care managers toward improving financial conditions in these public hospitals.

[State of food and nutritional care in public hospitals of Ecuador].

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Gallegos Espinosa, Sylvia; Nicolalde Cifuentes, Marcelo; Santana Porbén, Sergio

2014-10-03

The ELAN Ecuadorian Study of Hospital Malnutrition returned a malnutrition rate of 37.1% in public hospitals of Ecuador [Gallegos Espinosa S, Nicolalde Cifuentes M, Santana Porbén S; para el Grupo Ecuatoriano de Estudio de la Desnutrición Hospitalaria. State of malnutrition in hospitals of Ecuador. Nutr Hosp (España) 2014;30:425-35]. Hospital malnutrition could be the result of institutional cultural practices affecting the patient's nutritional status. To present the current state of food and nutritional care provided to patients assisted in public hospitals of Ecuador. The state of food and nutritional care provided to 5,355 patients assisted in 36 hospitals of 23 provinces of the country was documented by means of the Hospital Nutrition Survey (HNS), conducted as part of the ELAN Study. HNS recorded the completion of nutritional assessment exercises, the use of food-bymouth, fasting, use of oral nutritional supplements, and implementation and conduction of Artificial nutritional schemes (Enteral/Parenteral); respectively. Less than 0.1% of clinical charts had a diagnosis of malnutrition included in the list of the patient's health problems. Less than half of the patients had been measured and weighted on admission. Serum Albumin values and Total Lymphocytes Counts were annotated on admission in only 13.5% and 59.2% of the instances, respectively. Current weight value was registered in only 59.4% of the patients with length of stay ³ 15 days. An oral nutritional supplement was prescribed in just 3.5% of non-malnourished patients in which significant metabolic stress and/or reduced food intakes concurred. Although up to 10 different indications for use of Artificial nutrition were identified in the sample study, any of these techniques was administered to just 2.5% (median of observed percentages; range: 1.3 - 11.9%) of surveyed patients. Currently, nutritional status of hospitalized patient is not included within therapeutic goals, nutritional assessment

7 CFR 7.10 - Conduct of county convention.

Science.gov (United States)

2010-01-01

... 7 Agriculture 1 2010-01-01 2010-01-01 false Conduct of county convention. 7.10 Section 7.10 Agriculture Office of the Secretary of Agriculture SELECTION AND FUNCTIONS OF AGRICULTURAL STABILIZATION AND... other purpose. (e) The county committee shall give advance public notice of the county convention which...

Patient's perceptions about the service quality of public hospitals located at District Kohat.

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Aman, Bakhtiar; Abbas, Faisal

2016-01-01

To determine patients' perception regarding service and quality of healthcare at public-sector institutions. The descriptive quantitative study was conducted in Kohat district, Pakistan, between July and December 2014, and focussed on 30 variables to assess the participants' perceptions of the actual healthcare service quality delivered. SERVQUAL instrument was used to measure the reliability and cronbach alpha was calculated to measure the reliability and validity of the instrument. A total of 200 questionnaires were distributed and 157(78.5%) were received back fully filled. Of them, 105(67%) were men and 52(33%) were women.The mean value of Assurance parameter was 3.05±0.88, indicating trust in public hospitals was high as they had experienced and capable doctors. On the other hand, the lowest mean value of 2.61±0.84 was for Empathy, highlighting the fact that public hospitals lacked the ability to handle patients' problem properly, services were not offered in time and they were short of staff. Public hospitals were largely seen as failing to deliver quality service.

Just the Right Mix: Identifying Potential Dropouts in Montgomery County Public Schools Using an Early Warning Indicators Approach

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West, Thomas C.

2013-01-01

Each school year, roughly a thousand students drop out of Montgomery County (Maryland) Public Schools (MCPS). However, unlike other large, urban school districts where students who drop out skip school and are suspended often (Balfanz & Byrnes, 2010), students who drop out of MCPS are present in school; they just are not doing well…

Utilization of European Funds in the Public Administration. Study case - Galati County Council

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Manuela Panaitescu

2014-05-01

Full Text Available The main objectives of this paper are to reveal some aspects regarding European funds‟ utilization, starting with the comprehension of EU philosophy regarding cohesion policy and emphasizing the important role played by Structural and Cohesion Funds for public administration, especially in times of economic downturn when the financial resources are difficult to access. Prior Work: this work continues prior research carried out for the “European Programs and Projects Management” MA thesis. Approach: The main methods employed for capturing the research evidence consists in management strategies analysis in the public administration, especially in studying the capacity of absorption of European funds in the case Galati County Council. The main results of this paper show that the risks of absorption capacity decrease of EU funds are linked to a number of factors, such as financial problems, poor information, lack of managerial experience, etc.

Public hospital care: equal for all or equal for some? Evidence from the Philippines.

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James, Chris D; Peabody, John; Hanson, Kara; Solon, Orville

2015-03-01

In low- and middle-income countries, government budgets are rarely sufficient to cover a public hospital's operating costs. Shortfalls are typically financed through a combination of health insurance contributions and user charges. The mixed nature of this financing arrangement potentially creates financial incentives to treat patients with equal health need unequally. Using data from the Philippines, the authors analyzed whether doctors respond to such incentives. After controlling for a patient's condition, they found that patients using insurance, paying more for hospital accommodation, and being treated in externally monitored hospitals were likely to receive more care. This highlights the worrying possibility that public hospital patients with equal health needs are not always equally treated. © 2011 APJPH.

[Public hospital utilization by the foreign population in Aragon, Spain (2004-2007)].

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Ben Cheikh, Wafa; Abad, José María; Arribas, Federico; Andrés, Eva; Rabanaque, María José

2011-01-01

To describe hospitalization rates and hospital morbidity among the foreign population residing in Aragon (Spain) by country of birth, between 2004 and 2007, and to compare these rates with those in the autochthonous population. A retrospective longitudinal study was carried out of hospital discharges of the foreign population in public hospitals in Aragon. Utilization rates were estimated by sex, age, country of birth and main diagnosis. Poisson regression was used to estimate the utilization rate ratios and their 95% confidence intervals. Hospitalization rates were lower in the foreign population (adjusted RR: 0.52; 95% CI: 0.51-0.56), except in women aged between 15 and 24 years (RR: 2.9; 95% CI: 2.8-3.0) and among those born in the Maghreb (RR: 1.8; 95% CI: 1.7; 1.9), sub-Saharan Africa (RR: 2.0; 95% CI: 1.9-2.1) and Asia (RR=1.4; 95% CI: 1.3-1.6). When hospital discharges related to obstetrics and gynecology were excluded, only women born in sub-Saharan Africa continued to have adjusted RR greater than 1. These women had higher hospitalization rates in groups of infectious and parasitic diseases (RR: 2.5) and blood and blood-forming organs (RR: 2.8). In Aragon (Spain), public hospital utilization is lower in foreigners than in the autochthonous population. The diseases treated varied by country of birth. The diseases prevalent in these countries, together with hereditary diseases, can increase hospital utilization rates. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

Public awareness of and support for infrastructure changes designed to increase walking and biking in Los Angeles County.

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Gase, Lauren N; Barragan, Noel C; Simon, Paul A; Jackson, Richard J; Kuo, Tony

2015-03-01

Policies to promote active transportation are emerging as a best practice to increase physical activity, yet relatively little is known about public opinion on utilizing transportation funds for such investments. This study sought to assess public awareness of and support for investments in walking and biking infrastructure in Los Angeles County. In the fall of 2013, the Los Angeles County Department of Public Health conducted a telephone survey with a random sample of registered voters in the region. The survey asked respondents to report on the presence and importance of walking and biking infrastructure in their community, travel behaviors and preferences, and demographics. One thousand and five interviews were completed (response rate 20%, cooperation rate 54%). The majority of participants reported walking, biking, and bus/rail transportation investments as being important. In addition, participants reported a high level of support for redirecting transportation funds to active transportation investment - the population average was 3.28 (between 'strongly' and 'somewhat' support) on a 4 point Likert scale. Voters see active transportation infrastructure as being very important and support redirecting funding to improve the infrastructure. These findings can inform policy-decisions and planning efforts in the jurisdiction. Copyright © 2015 Elsevier Inc. All rights reserved.

The organizational commitment of emergency physicians in Spanish public hospitals

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Noval de la Torre, A; Bulchand Gidumal, J; Melián González, S

2016-12-30

Background. There are not too many studies that deal with the organizational commitment of emergency physicians. This commitment has been shown to impact organizational performance. The aim of this paper is to analyse the degree of commitment of the emergency physicians in Spanish public hospitals and the factors that may influence it. Method. Online survey using SurveyMonkey to emergency physicians in Spanish public hospitals. Results. Two hundred and five questionnaires were received, 162 from physicians and 43 from heads of the emergency service. Results show an intermediate level of commitment, with affective commitment showing the lowest level and continuance commitment showing the highest level. The capabilities of the physician have an influence on their affective commitment; specific training in emergency procedures and seniority has an influence on their continuance commitment; and the opinion they hold about the organization of their service influences affective commitment. Conclusions. Emergency physicians show an average involvement in the hospital in which they work (average 3.8 on a range of 1 to 5), feel an average affection for it (3.4), and have a high intention to keep working there (4.0). The resources the hospital has due to its level do not have an influence on this commitment, while the training and perceptions of the service do have an influence.

Is there an association of circulatory hospitalizations independent of mining employment in coal-mining and non-coal-mining counties in west virginia?

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Talbott, Evelyn O; Sharma, Ravi K; Buchanich, Jeanine; Stacy, Shaina L

2015-04-01

Exposures associated with coal mining activities, including diesel fuel exhaust, products used in coal processing, and heavy metals and other forms of particulate matter, may impact the health of nearby residents. We investigated the relationships between county-level circulatory hospitalization rates (CHRs) in coal and non-coal-mining communities of West Virginia, coal production, coal employment, and sociodemographic factors. Direct age-adjusted CHRs were calculated using West Virginia hospitalizations from 2005 to 2009. Spatial regressions were conducted to explore associations between CHR and total, underground, and surface coal production. After adjustment, neither total, nor surface, nor underground coal production was significantly related to rate of hospitalization for circulatory disease. Our findings underscore the significant role sociodemographic and behavioral factors play in the health and well-being of coal mining communities.

Quality of Care at Hospitals Identified as Outliers in Publicly Reported Mortality Statistics for Percutaneous Coronary Intervention.

Science.gov (United States)

Waldo, Stephen W; McCabe, James M; Kennedy, Kevin F; Zigler, Corwin M; Pinto, Duane S; Yeh, Robert W

2017-05-16

Public reporting of percutaneous coronary intervention (PCI) outcomes may create disincentives for physicians to provide care for critically ill patients, particularly at institutions with worse clinical outcomes. We thus sought to evaluate the procedural management and in-hospital outcomes of patients treated for acute myocardial infarction before and after a hospital had been publicly identified as a negative outlier. Using state reports, we identified hospitals that were recognized as negative PCI outliers in 2 states (Massachusetts and New York) from 2002 to 2012. State hospitalization files were used to identify all patients with an acute myocardial infarction within these states. Procedural management and in-hospital outcomes were compared among patients treated at outlier hospitals before and after public report of outlier status. Patients at nonoutlier institutions were used to control for temporal trends. Among 86 hospitals, 31 were reported as outliers for excess mortality. Outlier facilities were larger, treating more patients with acute myocardial infarction and performing more PCIs than nonoutlier hospitals ( P fashion (interaction P =0.50) after public report of outlier status. The likelihood of in-hospital mortality decreased at outlier institutions (RR, 0.83; 95% CI, 0.81-0.85) after public report, and to a lesser degree at nonoutlier institutions (RR, 0.90; 95% CI, 0.87-0.92; interaction P <0.001). Among patients that underwent PCI, in-hospital mortality decreased at outlier institutions after public recognition of outlier status in comparison with prior (RR, 0.72; 9% CI, 0.66-0.79), a decline that exceeded the reduction at nonoutlier institutions (RR, 0.87; 95% CI, 0.80-0.96; interaction P <0.001). Large hospitals with higher clinical volume are more likely to be designated as negative outliers. The rates of percutaneous revascularization increased similarly at outlier and nonoutlier institutions after report of outlier status. After outlier

Sense of place, organizational context and the strategic management of publicly funded hospitals.

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Hanlon, N T

2001-11-01

An era of managerialism in health care delivery systems is now well ensconced throughout the nations of the OECD. This development has occurred, in large part, as a response to funding pressures in institutionally based health care delivery imposed by principal third party insurers. In the case of publicly funded hospitals, the more traditional concerns for stewardship and appeasement of professional groups is being replaced by a greater emphasis on cost consciousness and corporate-style leadership as these organizations seek to reposition themselves in new funding and regulatory environments. While institutional theory and strategic management perspectives help illuminate these issues, this paper argues that a place-based perspective is also needed to understand the changes currently underway in health care delivery and publicly funded human services more generally. This is illustrated with reference to developments in the strategic management of public hospitals in the province of Ontario. Evidence from a survey of senior administrators of public hospitals, distributed at the height of these policy reform initiatives, is examined to shed light on local level management responses to changing policy and fiscal pressures. The data suggest that the latest policy directions in the province of Ontario will 'encourage' hospital executives in particular community settings to steer their organizations in very unfamiliar directions. The findings suggest a need for greater attention to context and setting in health services research and policy.

Communication with the public in the health-care system: a descriptive study of the use of social media in local health authorities and public hospitals in Italy.

Science.gov (United States)

Vanzetta, Marina; Vellone, Ercole; Dal Molin, Alberto; Rocco, Gennaro; De Marinis, Maria Grazia; Rosaria, Alvaro

2014-01-01

In 2010 the Italian Ministry of Health set out recommendations for the use of social technology and Web 2.0, inviting organisations within the Italian national health service (Servizio Sanitario Nazionale, SSN) to equip themselves with instruments. 1. to ascertain how many local health authorities (Aziende Sanitarie Locali, ASL) and public hospitals have a presence on the most widely used social media websites in Italy: Facebook, Twitter and YouTube; 2. to find out how well the Facebook, Twitter and YouTube pages of ASLs and public hospitals are known among the general population; 3. to find out how ASLs and public hospitals engage with the general public on social media sites. The websites of all ASLs and public hospitals across the country were visited to look for the icons of the social media sites under examination. The data considered were publicly available upon access. A total of 245 websites were analysed. 7.34% ASLs and hospitals had social media accounts. 8 organisations had an account on all three of the social media sites considered in the study. The results show a low presence of ASLs and hospitals on social media. Other studies are needed in this field.

Clinical indications and determinants of the rise of cesarean section in three hospitals in rural China.

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Qin, Cheng; Zhou, Min; Callaghan, William M; Posner, Samuel F; Zhang, Jun; Berg, Cynthia J; Zhao, Gengli

2012-10-01

This study investigated changes in cesarean delivery rate and cesarean indications in 3 county-level hospitals in rural China. Hospital delivery records in 1997 and 2003 were used to examine the reasons behind the changes. In Chengde County Hospital, the cesarean delivery rate increased from 28% in 1997 to 54% in 2003. The rate increased from 43% in 1997 to 65% in 2003 in Anxian County Hospital and Anxian Maternal and Child Health Hospital. The dramatic increase in cesarean delivery in the study hospitals was associated with a shift from more severe to mild or no clinical indications. The ratio of mild to moderate to severe hypertension increased substantially. More than half of the cephalopelvic disproportion cases were diagnosed prior to labor. The majority of nuchal cord cases were diagnosed without fetal distress. Maternal/family request was the number one cesarean indication in Anxian County Hospital and Anxian MCH Hospital in 2003. Ultrasound evidence of nuchal cord moved from the ninth ranked indication in 1997 to the second in 2003 in Chengde County Hospital.

Funding Victoria's public hospitals: the casemix policy of 2000-2001.

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McNair, Peter; Duckett, Stephen

2002-01-01

On 1 July 1993 Victoria became the first Australian state to use casemix information to set budgets for its public hospitals commencing with casemix funding for inpatient services. Victoria's casemix funding approach now embraces inpatient, outpatient and rehabilitation services.

Variation in Surgical Quality Measure Adherence within Hospital Referral Regions: Do Publicly Reported Surgical Quality Measures Distinguish among Hospitals That Patients Are Likely to Compare?

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Safavi, Kyan C; Dai, Feng; Gilbertsen, Todd A; Schonberger, Robert B

2014-01-01

Objective To determine whether surgical quality measures that Medicare publicly reports provide a basis for patients to choose a hospital from within their geographic region. Data Source The Department of Health and Human Services' public reporting website, Medicare Claims Processing Manual Baltimore, MD CMS http://www.medicare.gov/hospitalcompare. Study Design We identified hospitals (n = 2,953) reporting adherence rates to the quality measures intended to reduce surgical site infections (Surgical Care Improvement Project, 1–3) in 2012. We defined regions within which patients were likely to compare hospitals using the hospital referral regions (HRRs) from the Dartmouth Atlas of Health Care Project. We described distributions of reported SCIP adherence within each HRR, including medians, interquartile ranges (IQRs), skewness, and outliers. Principal Findings Ninety-seven percent of HRRs had median SCIP-1 scores ≥95 percent. In 93 percent of HRRs, half of the hospitals in the HRR were within 5 percent of the median hospital's score. In 62 percent of HRRs, hospitals were skewed toward the higher rates (negative skewness). Seven percent of HRRs demonstrated positive skewness. Only 1 percent had a positive outlier. SCIP-2 and SCIP-3 demonstrated similar distributions. Conclusions Publicly reported quality measures for surgical site infection prevention do not distinguish the majority of hospitals that patients are likely to choose from when selecting a surgical provider. More studies are needed to improve public reporting's ability to positively impact patient decision making. PMID:24611578

Studying the Factors for Selecting Public or Private Hospitals by Non Emergent Patients of Ardabil District in 2012

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Saadat Jalili

2014-12-01

Full Text Available Background & objectives: At the present time, health care services have been increasingly transformed to a competitive issue and many factors influence usage of hospital services and selection of a hospital by the patients. This study has been performed for surveying effective factors on selecting a public or private hospital among non-emergent patients of Ardabil hospitals in 2012.   Method: This research was a cross-sectional descriptive-correlational study and the statistical population was non emergent patients of four public and two private hospitals of Ardabil in 2012. The samples (598 patients were collected by stratified random sampling method. Data-gathering tool was a researcher-made questionnaire and data were analyzed by descriptive statistics, frequency [distribution] tables, and logistic regression analysis.   Results: The results depicted a direct interdependence between selecting a hospital (public or private and the three factors of social elements, hospital services, and hospital facilities with a confidence coefficient of 92%. Based on logistic regression analysis and Exp(B coefficient, the patients’ priorities for hospital choosing were hospital services, social elements, and hospital facilities with Exp(B of 1.932, 1.332, and 0.338, respectively.   Conclusion: The most important factor for choosing public hospitals was lower cost of services and for private hospitals was physician’s recommendation. The strong effects of these two factors have overshadowed other variables.

Workplace Stressors and Coping Strategies Among Public Hospital Nurses in Medan, Indonesia

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Achmad Fathi

2012-08-01

Full Text Available Background: Nursing is considered as a stressful job when compared with other jobs. Prolonged stress without effective coping strategies affects not only nurses’ occupational life but also their nursing competencies. Medan is the biggest city in Sumatera Island of Indonesia. Two tertiary public hospital nurses in this city hold the responsibility in providing excellent care to their patients. Objective: To investigate the relationships between the nurse’s workplace stressors and the coping strategies used. Method: The descriptive correlational study was conducted to examine the relationships between workplace stressors and the coping strategies used in nurses of two public hospitals in Medan. The sample size of 126 nurses was drawn from selected in-patient units. Data were collected by using self-report questionnaires and focus group interview. The majority of subjects experienced low workplace stressors, where death/dying was the most commonly reported workplace stressor followed by workload. Religion was the most commonly used coping strategy. Result: Significant correlations were found between subscales of workplace stressors and coping strategies. Most of subjects used emotion-focused and dysfunctional coping strategies rather than problem-focused coping strategies. Conclusion: The nurse administrators in the hospitals need to advocate their in order to use problem-focused coping strategies more frequent than emotion-focused and dysfunctional coping strategies when dealing with workplace stressors. Keywords: workplace stressor, coping strategy, public hospital nurses

Students and Teachers Accessing Tomorrow (STAT): Baltimore County Public School's One-to-One Digital Conversion Case in Practice

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Imbriale, Ryan; Schiner, Nicholas; Elmendorf, Douglas

2017-01-01

Baltimore County Public Schools is in the midst of a transformation of teaching and learning; the goal being the creation of student-centered classrooms supported by a one-to-one computer for every student. This transformation, known as Students and Teachers Accessing Tomorrow, began in 2014 and is now in its third academic year. We present this…

Corporate political strategy: incorporating the management of public policy issues into hospital strategy.

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Bigelow, B; Arndt, M; Stone, M M

1997-01-01

Hospitals engage in a variety of strategies designed to anticipate, shape, and respond to public policy issues. This article describes corporate political strategy and argues for its need throughout a public policy issue's life cycle.

Sewerage Pumping Stations, City_ssLiftstations, Public and Privately owned sanitary lift stations located in Glynn County and the City of Brunswick., Published in Not Provided, 1:2400 (1in=200ft) scale, Glynn County Government.

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NSGIC Local Govt | GIS Inventory — Sewerage Pumping Stations dataset current as of unknown. City_ssLiftstations, Public and Privately owned sanitary lift stations located in Glynn County and the City...

Factors predicting health practitioners' awareness of UNHS program in Malaysian non-public hospitals.

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Ismail, Abdussalaam Iyanda; Abdul Majid, Abdul Halim; Zakaria, Mohd Normani; Abdullah, Nor Azimah Chew; Hamzah, Sulaiman; Mukari, Siti Zamratol-Mai Sarah

2018-06-01

The current study aims to examine the effects of human resource (measured with the perception of health workers' perception towards UNHS), screening equipment, program layout and screening techniques on healthcare practitioners' awareness (measured with knowledge) of universal newborn hearing screening (UNHS) in Malaysian non-public hospitals. Via cross sectional approach, the current study collected data using a validated questionnaire to obtain information on the awareness of UNHS program among the health practitioners and to test the formulated hypotheses. 51, representing 81% response rate, out of 63 questionnaires distributed to the health professionals were returned and usable for statistical analysis. The survey instruments involving healthcare practitioners' awareness, human resource, program layout, screening instrument, and screening techniques instruments were adapted and scaled with 7-point Likert scale ranging from 1 (little) to 7 (many). Partial Least Squares (PLS) algorithm and bootstrapping techniques were employed to test the hypotheses of the study. With the result involving beta values, t-values and p-values (i.e. β=0.478, t=1.904, phealth practitioners. Likewise, program layout, human resource, screening technique and screening instrument explain 71% variance in health practitioners' awareness. Health practitioners' awareness is explained by program layout, human resource, and screening instrument with effect size (f2) of 0.065, 0.621, and 0.211 respectively, indicating that program layout, human resource, and screening instrument have small, large and medium effect size on health practitioners' awareness respectively. However, screening technique has zero effect on health practitioners' awareness, indicating the reason why T-statistics is not significant. Having started the UNHS program in 2003, non-public hospitals have more experienced and well-trained employees dealing with the screening tools and instrument, and the program layout is well

Use of drug-eluting stents in Victorian public hospitals.

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Yan, Bryan P; Ajani, Andrew E; Duffy, Stephen J; New, Gishel; Horrigan, Mark; Szto, Gregory; Walton, Antony; Eccleston, David; Lefkovits, Jeffery; Black, Alexander; Sebastian, Martin; Brennan, Angela L; Reid, Christopher M; Clark, David J

2006-10-02

We aimed to assess the pattern of use of drug-eluting stents (DESs) in patients undergoing percutaneous coronary interventions (PCIs) in Victorian public hospitals. Prospective study comparing the use of one or more DESs versus bare-metal stents (BMSs) only, in consecutive patients undergoing 2428 PCIs with stent implantation from 1 April 2004 to 31 December 2005 at seven Victorian public hospitals. Adherence to current Victorian Department of Human Services guidelines which recommend DES use in patients with high-risk features for restenosis (diabetes, small vessels, long lesions, in-stent restenotic lesions, chronic total occlusions and bifurcation lesions). Of the 2428 PCIs performed, at least one DES was implanted in 1101 (45.3%) and BMSs only were implanted in 1327 (54.7%). In 87.7% (966/1101) of PCI with DESs, there was at least one criterion for high risk of restenosis. DESs were more likely to be used in patients with diabetes (risk ratio [RR], 2.45; 95% CI, 2.02-2.97), small vessels (RR, 3.35; 95%CI, 2.35-4.76), long lesions (RR, 3.87; 95% CI, 3.23-4.65), in-stent restenotic lesions (RR, 3.98; 95%CI, 2.67-6.06), chronic total occlusions (RR, 1.30; 95% CI, 0.51-2.88) and bifurcation lesions (RR, 2.23; 95%CI, 1.57-3.17). However, 66.2% (1608/2428) of all PCIs were in patients eligible for DESs according to Victorian guidelines, and in 39.9% (642/1608) of these PCIs, a BMS was used. In Victorian public hospitals, DESs have been largely reserved for patients at high risk of restenosis in accordance with Department of Human Services guidelines. However, many patients with high-risk criteria for restenosis did not receive DESs. Greater use of DESs in these patients may improve outcomes by reducing the need for repeat revascularisation.

[Evaluation of the efficiency and quality of hospitals publicly owned with private management and hospitals of the public sector].

Science.gov (United States)

Giraldes, Maria Do Rosário

2007-01-01

, and by the Garcia de Orta Hospital, which are the less efficient hospitals. In Group V, with central hospitals and hospitals with functions of central hospital, it is the Hospital of Vila Real/Régua, EPE, to present the best situation of the Composite Efficiency Indicator, followed by the Santo António Hospital, EPE, the Santa Maria Hospital, EPE, and the HUC, while the hospitals with a worst situation of the Composite Efficiency Indicator are the Hospitals of Faro, Evora and S. José. In Group VI hospitals with a better Composite Efficiency Indicator are the hospitals of Santa Marta, Gama Pinto Institute and Orthopedic Hospital of Outão, while the Estefânia Hospital is the most inefficient. Tondela, Valongo and Peniche Hospitals (Group I), have a good value of the Composite Efficiency and Quality Indicator, while Barcelos, Oliveira de Azeméis and Póvoa de Varzim/Vila do Conde Hospitals (Group II) present also good values of this indicator. The Hospitals of Vila Franca de Xira, Bragança and Setúbal (Group III), the Hospitals of Santarém, Garcia de Orta, and Curry Cabral (Group IV), the Hospital of Vila Real/Régua, the Egas Moniz Hospital and the Santa Maria Hospital (Group V), and the Gama Pinto Institute, the Orthopedic Hospital of Outão, and the Santa Cruz Hospital (Group VI) are the best classified in their groups. EPE Hospitals (Hospitals publicly owned with private management) are the best classified in their groups in what efficiency is concerned, what is a better result tan the one shown in 2003. The lower inequality in relation to management indicators, in all hospital groups, exists in the areas of expenditure with inpatient care by user, what shows the existence of a norm of proceeding, in this traditional hospital area. The higher inequalities are those of day hospital, drugs in day hospital, drugs in outpatient care and rehabilitation by user. In what management indicators are concerned incentives must be created. The most efficient hospitals

Hospitalization patterns associated with Appalachian coal mining.

Science.gov (United States)

Hendryx, Michael; Ahern, Melissa M; Nurkiewicz, Timothy R

2007-12-01

The goal of this study was to test whether the volume of coal mining was related to population hospitalization risk for diseases postulated to be sensitive or insensitive to coal mining by-products. The study was a retrospective analysis of 2001 adult hospitalization data (n = 93,952) for West Virginia, Kentucky, and Pennsylvania, merged with county-level coal production figures. Hospitalization data were obtained from the Health Care Utilization Project National Inpatient Sample. Diagnoses postulated to be sensitive to coal mining by-product exposure were contrasted with diagnoses postulated to be insensitive to exposure. Data were analyzed using hierarchical nonlinear models, controlling for patient age, gender, insurance, comorbidities, hospital teaching status, county poverty, and county social capital. Controlling for covariates, the volume of coal mining was significantly related to hospitalization risk for two conditions postulated to be sensitive to exposure: hypertension and chronic obstructive pulmonary disease (COPD). The odds for a COPD hospitalization increased 1% for each 1462 tons of coal, and the odds for a hypertension hospitalization increased 1% for each 1873 tons of coal. Other conditions were not related to mining volume. Exposure to particulates or other pollutants generated by coal mining activities may be linked to increased risk of COPD and hypertension hospitalizations. Limitations in the data likely result in an underestimate of associations.

Work ability among nursing personnel in public hospitals and health centers in Campinas--Brazil.

Science.gov (United States)

Monteiro, Inês; Chillida, Manuela de Santana Pi; Moreno, Luciana Contrera

2012-01-01

Nursing personnel is essential in hospital, health centers and enterprises and is the large work force in health system. A cross-sectional study was conducted in a large city in two public hospitals and five health centre with the objective of to evaluate the work ability and health aspects of nursing staff. The sample was composed by 570 workers. The Work Ability Index - WAI and a questionnaire with socio-demographic, health and life style data was applied. The majority of workers was women (83%), married (50.4%), and was working in night shift work (65.6%); 61.4% was auxiliary nursing, 22.3% was registered nurses (RN). The average age was 38.9 years (SD 7.8) and the Body Mass Index mean was 25.8 (SD 5.3). Only 17.2% referred to practice at least 150 minutes of physical exercise five times per week or more. 26.8% had a second job. The work ability mean was 39.3 (SD 5.3) points. Age had a negative correlation with WAI (p=0.0052). Public hospital and health centre workers had poor work ability score when compared with workers from another branches. Public policies related to workplace health promotion need to be implemented in public hospital and health centre to improve the work ability.

Author! author!: creating a digital archive of publications in a hospital library setting.

Science.gov (United States)

Rourke, Diane; Samsundar, Devica Ramjit; Shalini, Channapatna

2005-01-01

Baptist Hospital of Miami has been honoring its staff authors annually during National Library Week since 1979, at the time the library was relocated. Upon "doing the math" and realizing that twenty-five years had passed, a special event was planned to celebrate the occasion in 2004. A merger of four hospitals in 1995 to form Baptist Health South Florida, and an addition of a fifth hospital in 2003 added into the complexity of these publications. Organizing the event led to the conclusion that there had to be a "better way" to manage the publication archive. This paper will include a look back at the event's past, present efforts to develop an archival database, and future plans to make articles available electronically to users, copyright permitting.

The impact of New Public Management on efficiency: an analysis of Madrid's hospitals.

Science.gov (United States)

Alonso, José M; Clifton, Judith; Díaz-Fuentes, Daniel

2015-03-01

Madrid has recently become the site of one of the most controversial cases of public healthcare reform in the European Union. Despite the fact that the introduction of New Public Management (NPM) into Madrid hospitals has been vigorous, little scholarship has been done to test whether NPM actually led to technical efficiency. This paper is one of the first attempts to do so. We deploy a bootstrapped data envelopment analysis to compare efficiency scores in traditionally managed hospitals and those operating with new management formulas. We do not find evidence that NPM hospitals are more efficient than traditionally managed ones. Moreover, our results suggest that what actually matters may be the management itself, rather than the management model. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Economic effects of Ohio's smoke-free law on Kentucky and Ohio border counties.

Science.gov (United States)

Pyles, Mark K; Hahn, Ellen J

2011-01-01

To determine if the Ohio statewide smoke-free law is associated with economic activity in Ohio or Kentucky counties that lie on the border between the two states. In November 2006, Ohio implemented a comprehensive statewide smoke-free law for all indoor workplaces. A feasible generalised least squares (FLGS) time series design to estimate the impact of the Ohio smoke-free law on Kentucky and Ohio border counties. Six Kentucky and six Ohio counties that lie on the border between the two states. All reporting hospitality and accommodation establishments in all Kentucky and Ohio counties including but not limited to food and drinking establishments, hotels and casinos. Total number of employees, total wages paid and number of reported establishments in all hospitality and accommodation services, 6 years before Ohio's law and 1 year after. There is no evidence of a disproportionate change in economic activity in Ohio or Kentucky border counties relative to their non-border counterparts. There was no evidence of a relation between Ohio's smoke-free law and economic activity in Kentucky border counties. The law generated a positive influence on wages and number of establishments in Ohio border counties. The null result cannot be explained by low test power, as minimum changes necessary in the dependent variables to detect a significant influence are very reasonable in size. Our data add to the large body of evidence that smoke-free laws are neutral with respect to the hospitality business across jurisdictions with and without laws.

[The challenges and opportunities of implementing outsourcing in private and public hospitals in Israel].

Science.gov (United States)

Rahimi, Benny; Mizrahi, Ronit; Magnezi, Racheli

2011-01-01

Outsourcing is a method that enables an organization to focus on its expertise by transferring its other services to professionals who can fulfill them. In recent years, research has repeatedly shown that health services use a variety of outsourcing companies. To describe the experience acquired using outsourcing in public and private hospitals in Israel, and to present the factors, budgetary parameters, opportunities and problems affecting outsourcing. The questionnaire was sent to 36 hospitals in Israel, constituting 88.2% of all hospitals in Israel--private, public, H.M.O ("Clalit") and governmental. The response to the questionnaire reached 97.2% and revealed the following: 94% of the hospitals use outsourcing services in the following fields: security, cleaning, Laundry service, cafeterias, and I.T.; 42% of the hospitals assign 0-5% of their annual budget for outsourcing contracts. Private hospitals use more outsourcing services than public hospitals. The factors driving outsourcing are: cost restrictions (82.8%), operational flexibility (77%), and focus on the core business (74.2%). The potential advantages of outsourcing are: improvement in services 180.5%), customer satisfaction (72.2%), and cost reduction (69.4%). Difficulties affecting outsourcing are: dependence on external resources (83.3%] and internal organizational resistance (69.4%). The results of the outsourcing are lower costs, reduced number of personnel by 1-10% and high level of satisfaction. It seems that in recent years outsourcing is being used in hospitals and is central to the areas of infrastructure and logistics, as well as legal and medical services. Using outsourcing in hospitals provides opportunities for improved customer satisfaction, better focus for the hospital on its core activities and cost reduction. HospitaLs that succeed in synergetically integrating the external and the internal service providers will flourish. INNOVATION/VALUE: This research exposes, for the first time

Control costs, enhance quality, and increase revenue in three top general public hospitals in Beijing, China.

Science.gov (United States)

Zhao, Lue-Ping; Yu, Guo-Pei; Liu, Hui; Ma, Xie-Min; Wang, Jing; Kong, Gui-Lan; Li, Yi; Ma, Wen; Cui, Yong; Xu, Beibei; Yu, Na; Bao, Xiao-Yuan; Guo, Yu; Wang, Fei; Zhang, Jun; Li, Yan; Xie, Xue-Qin; Jiang, Bao-Guo; Ke, Yang

2013-01-01

With market-oriented economic and health-care reform, public hospitals in China have received unprecedented pressures from governmental regulations, public opinions, and financial demands. To adapt the changing environment and keep pace of modernizing healthcare delivery system, public hospitals in China are expanding clinical services and improving delivery efficiency, while controlling costs. Recent experiences are valuable lessons for guiding future healthcare reform. Here we carefully study three teaching hospitals, to exemplify their experiences during this period. We performed a systematic analysis on hospitalization costs, health-care quality and delivery efficiencies from 2006 to 2010 in three teaching hospitals in Beijing, China. The analysis measured temporal changes of inpatient cost per stay (CPS), cost per day (CPD), inpatient mortality rate (IMR), and length of stay (LOS), using a generalized additive model. There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (Phospitalizations with higher costs, along with an overall stable CPS, reduced IMR, and shorter LOS, appear to be the major characteristics of these three hospitals at present. These three teaching hospitals have gained some success in controlling costs, improving cares, adopting modern medical technologies, and increasing hospital revenues. Effective hospital governance and physicians' professional capacity plus government regulations and supervisions may have played a role. However, purely market-oriented health-care reform could also misguide future healthcare reform.

Downsizing in the public sector: Metro-Toronto's hospitals.

Science.gov (United States)

Flint, Douglas H

2003-01-01

This study has two objectives. First, to predict the outcomes of a public sector downsizing; second to measure effects of downsizing at organizational and inter-organizational levels. Primary data to assess the organizational level effects was collected through interviews with senior executives at two of Metro-Toronto's hospitals. Secondary data, to assess the inter-organizational effects, was collected from government documents and media reports. Due to the exploratory nature of the study's objectives a case study method was employed. Most institutional downsizing practices aligned with successful outcomes. Procedures involved at the inter-organizational level aligned with unsuccessful outcomes and negated organizational initiatives. This resulted in an overall alignment with unsuccessful procedures. The implication, based on private sector downsizings, is that the post-downsized hospital system was more costly and less effective.

Communication with the public in the health-care system: a descriptive study of the use of social media in Local Health Authorities and public hospitals in Italy

Directory of Open Access Journals (Sweden)

Marina Vanzetta

2014-06-01

Full Text Available INTRODUCTION. In 2010 the Italian Ministry of Health set out recommendations for the use of social technology and Web 2.0, inviting organisations within the Italian national health service (Servizio Sanitario Nazionale, SSN to equip themselves with instruments. Objectives. 1. to ascertain how many local health authorities (Aziende Sanitarie Locali, ASL and public hospitals have a presence on the most widely used social media websites in Italy: Facebook, Twitter and YouTube; 2. to find out how well the Facebook, Twitter and YouTube pages of ASLs and public hospitals are known among the general population; 3. to find out how ASLs and public hospitals engage with the general public on social media sites. MATERIALS AND METHODS. The websites of all ASLs and public hospitals across the country were visited to look for the icons of the social media sites under examination. The data considered were publicly available upon access. RESULTS. A total of 245 websites were analysed. 7.34% ASLs and hospitals had social media accounts. 8 organisations had an account on all three of the social media sites considered in the study. CONCLUSIONS. The results show a low presence of ASLs and hospitals on social media. Other studies are needed in this field.

Middle School Math Acceleration and Equitable Access to Eighth-Grade Algebra: Evidence from the Wake County Public School System

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Dougherty, Shaun M.; Goodman, Joshua S.; Hill, Darryl V.; Litke, Erica G.; Page, Lindsay C.

2015-01-01

Taking algebra by eighth grade is considered an important milestone on the pathway to college readiness. We highlight a collaboration to investigate one district's effort to increase middle school algebra course-taking. In 2010, the Wake County Public Schools began assigning middle school students to accelerated math and eighth-grade algebra based…

A Public-Private Partnership Improves Clinical Performance In A Hospital Network In Lesotho.

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McIntosh, Nathalie; Grabowski, Aria; Jack, Brian; Nkabane-Nkholongo, Elizabeth Limakatso; Vian, Taryn

2015-06-01

Health care public-private partnerships (PPPs) between a government and the private sector are based on a business model that aims to leverage private-sector expertise to improve clinical performance in hospitals and other health facilities. Although the financial implications of such partnerships have been analyzed, few studies have examined the partnerships' impact on clinical performance outcomes. Using quantitative measures that reflected capacity, utilization, clinical quality, and patient outcomes, we compared a government-managed hospital network in Lesotho, Africa, and the new PPP-managed hospital network that replaced it. In addition, we used key informant interviews to help explain differences in performance. We found that the PPP-managed network delivered more and higher-quality services and achieved significant gains in clinical outcomes, compared to the government-managed network. We conclude that health care public-private partnerships may improve hospital performance in developing countries and that changes in management and leadership practices might account for differences in clinical outcomes. Project HOPE—The People-to-People Health Foundation, Inc.

Effect of air pollution control on mortality and hospital admissions in Ireland.

Science.gov (United States)

Dockery, Douglas W; Rich, David Q; Goodman, Patrick G; Clancy, Luke; Ohman-Strickland, Pamela; George, Prethibha; Kotlov, Tania

2013-07-01

During the 1980s the Republic of Ireland experienced repeated severe pollution episodes. Domestic coal burning was a major source of this pollution. In 1990 the Irish government introduced a ban on the marketing, sale, and distribution of coal in Dublin. The ban was extended to Cork in 1995 and to 10 other communities in 1998 and 2000. We previously reported decreases in particulate black smoke (BS*) and sulfur dioxide (SO2) concentrations, measured as total gaseous acidity, in Dublin after the 1990 coal ban (Clancy et al. 2002). In the current study we explored and compared the effectiveness of the sequential 1990, 1995, and 1998 bans in reducing community air pollution and in improving public health. We compiled records of daily BS, total gaseous acidity (SO2), and counts of cause-specific deaths from 1981 to 2004 for Dublin County Borough (1990 ban), county Cork (1995 ban), and counties Limerick, Louth, Wexford, and Wicklow (1998 ban). We also compiled daily counts of hospital admissions for cardiovascular, respiratory, and digestive diagnoses for Cork County Borough (1991 to 2004) and counties Limerick, Louth, Wexford, and Wicklow (1993 to 2004). We compared pre-ban and post-ban BS and SO2 concentrations for each city. Using interrupted time-series methods, we estimated the change in cause-specific, directly standardized mortality rates in each city or county after the corresponding local coal ban. We regressed weekly age- and sex-standardized mortality rates against an indicator of the post- versus pre-ban period, adjusting for influenza epidemics, weekly mean temperature, and a season smooth of the standardized mortality rates in Coastal counties presumably not affected by the bans. We compared these results with similar analyses in Midlands counties also presumably unaffected by the bans. We also estimated the change in cause-specific, directly standardized, weekly hospital admissions rates normalized for underreporting in each city or county after the 1995

76 FR 81526 - Notice of Realty Action: Recreation and Public Purposes Act Classification of Public Land...

Science.gov (United States)

2011-12-28

..., approximately 8.45 acres of public land in Comanche County, Oklahoma. The Town of Medicine Park proposes to use... County, Oklahoma AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Realty Action. SUMMARY...: The following described public land in Comanche County, Oklahoma, has been examined and found suitable...

Kemper County IGCC (tm) Project Preliminary Public Design Report

Energy Technology Data Exchange (ETDEWEB)

Nelson, Matt; Rush, Randall; Madden, Diane; Pinkston, Tim; Lunsford, Landon

2012-07-01

The Kemper County IGCC Project is an advanced coal technology project that is being developed by Mississippi Power Company (MPC). The project is a lignite-fueled 2-on-1 Integrated Gasification Combined-Cycle (IGCC) facility incorporating the air-blown Transport Integrated Gasification (TRIG™) technology jointly developed by Southern Company; Kellogg, Brown, and Root (KBR); and the United States Department of Energy (DOE) at the Power Systems Development Facility (PSDF) in Wilsonville, Alabama. The estimated nameplate capacity of the plant will be 830 MW with a peak net output capability of 582 MW. As a result of advanced emissions control equipment, the facility will produce marketable byproducts of ammonia, sulfuric acid, and carbon dioxide. 65 percent of the carbon dioxide (CO{sub 2}) will be captured and used for enhanced oil recovery (EOR), making the Kemper County facility’s carbon emissions comparable to those of a natural-gas-fired combined cycle power plant. The commercial operation date (COD) of the Kemper County IGCC plant will be May 2014. This report describes the basic design and function of the plant as determined at the end of the Front End Engineering Design (FEED) phase of the project.

Inadequate ventilation for nosocomial tuberculosis prevention in public hospitals in Central Thailand.

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Jiamjarasrangsi, W; Bualert, S; Chongthaleong, A; Chaindamporn, A; Udomsantisuk, N; Euasamarnjit, W

2009-04-01

Forty-two community and general hospitals in central Thailand. To examine the adequacy of indoor ventilation for nosocomial tuberculosis (TB) prevention in public hospitals in central Thailand. A cross-sectional survey was conducted among 323 patient care and ancillary areas in the target hospitals. Data on indoor ventilation rate were collected by the tracer gas method and reported as air changes per hour (ACH). The adequacy of the measured ventilation rates were then determined by comparison with the international recommended standard values. Indoor ventilation rates were inadequate in almost half of the studied areas (144/323, 44.6%). The inadequacy was particularly serious in the emergency rooms (ERs) and radiological areas, where 73.8% (31/42 each) of the rooms had ACH below the recommended standards. Detailed analysis showed that most of the rooms with natural ventilation had air exchange rates that exceeded the recommended standards, while the opposite was the case for rooms with air-conditioning, particularly the window or wall-mount type. Indoor ventilation in high-risk nosocomial TB areas in public hospitals in Thailand was inadequate due to the installation of air-conditioning systems in modern buildings.

An assessment of business intelligence in public hospitals

OpenAIRE

Rikke Gaardboe; Niels Sandalgaard; Tom Nyvang

2017-01-01

In this paper, DeLone and McLean's information systems success model is empirically tested on 12 public hospitals in Denmark. The study aims to investigate the factors that contribute to business intelligence (BI) success. 1,352 BI end-users answered the questionnaire. A partial least square structural equation model was used to empirically test the model. We find that system quality is positively and significantly associated with use and user satisfaction, and that information quality is pos...

U.S. History and Modern World History Courses for English Speakers of Other Languages in Montgomery County Public Schools

Science.gov (United States)

Zhao, Huafang; Wade, Julie

2014-01-01

The Office of Shared Accountability (OSA) in Montgomery County (Maryland) Public Schools (MCPS) examined academic performance of English for Speakers of Other Languages (ESOL) students in U.S. History and Modern World History courses, as well as the course sequence in ESOL U.S. History and Modern World History. In MCPS, students who are not ESOL…

Effect of Non Financial Incentives on Job Satisfaction of Teachers in Public Secondary Schools--Survey of Kisii Sub County

Science.gov (United States)

Sabina, Asiago Lenah; Okibo, Walter; Nyang'au, Andrew; Ondima, Cleophas

2015-01-01

Job satisfaction is a major challenge among employees in many organizations. The purpose of this research project is to assess the effect of non-financial incentives on job satisfaction of teachers in public secondary schools of Kisii Sub County in the Republic of Kenya. The specific objectives for the study include: to assess the effect of…

78 FR 53780 - Notice of Realty Action: Direct Sale of Public Land in Doña Ana County, NM

Science.gov (United States)

2013-08-30

... Do[ntilde]a Ana County, New Mexico. The public land would be sold to the Union Pacific Railroad for $11,000 which is more than the appraised fair market value. DATES: Written comments regarding the... as follows: New Mexico Principal Meridian, New Mexico T. 28 S., R. 2 E., Sec. 11, lot 2; Sec. 14, lot...

Monitoring Cataract Surgical Outcome in a Public Hospital in Orlu ...

African Journals Online (AJOL)

Objective: To determine the proportion and causes of poor visual outcome of cataract operations done in a public hospital in southeast Nigeria and propose actions to improve the cataract surgical outcome. Method: A prospective observational analysis of the initial hundred cases of cataract operations done in Imo State ...

Setting healthcare priorities: a description and evaluation of the budgeting and planning process in county hospitals in Kenya.

Science.gov (United States)

Barasa, Edwine W; Cleary, Susan; Molyneux, Sassy; English, Mike

2017-04-01

This paper describes and evaluates the budgeting and planning processes in public hospitals in Kenya. We used a qualitative case study approach to examine these processes in two hospitals in Kenya. We collected data by in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), a review of documents, and non-participant observations within the hospitals over a 7 month period. We applied an evaluative framework that considers both consequentialist and proceduralist conditions as important to the quality of priority-setting processes. The budgeting and planning process in the case study hospitals was characterized by lack of alignment, inadequate role clarity and the use of informal priority-setting criteria. With regard to consequentialist conditions, the hospitals incorporated economic criteria by considering the affordability of alternatives, but rarely considered the equity of allocative decisions. In the first hospital, stakeholders were aware of - and somewhat satisfied with - the budgeting and planning process, while in the second hospital they were not. Decision making in both hospitals did not result in reallocation of resources. With regard to proceduralist conditions, the budgeting and planning process in the first hospital was more inclusive and transparent, with the stakeholders more empowered compared to the second hospital. In both hospitals, decisions were not based on evidence, implementation of decisions was poor and the community was not included. There were no mechanisms for appeals or to ensure that the proceduralist conditions were met in both hospitals. Public hospitals in Kenya could improve their budgeting and planning processes by harmonizing these processes, improving role clarity, using explicit priority-setting criteria, and by incorporating both consequentialist (efficiency, equity, stakeholder satisfaction and understanding, shifted priorities

Inpatient satisfaction at different public sector hospitals of a metropolitan city in Pakistan: a comparative cross-sectional study.

Science.gov (United States)

Hussain, Mehwish; Rehman, Rehana; Ikramuddin, Zia; Asad, Nava; Farooq, Ayesha

2018-04-01

To observe inpatient satisfaction at different public sector hospitals of Karachi, Pakistan. A cross sectional study was carried out during 2010-2012 in four major public sector hospitals of Karachi. A total of 710 patients completed the study. Responses were gathered in a self-structured questionnaire that comprised of four dimensions of satisfaction with doctor, staff, administration and treatment. Average Score of each dimension was taken and compared using one way analysis of variance. Satisfaction with doctors, staff and administration of provincial and federal hospitals were comparatively similar (P > 0.05). However, satisfaction with treatment significantly differed in all four hospitals (P public sector hospitals showed satisfaction with healthcare personnel and related administration. However, treatment dimension needs to be improved to get more satisfaction.

Payment schemes and cost efficiency: evidence from Swiss public hospitals.

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Meyer, Stefan

2015-03-01

This paper aims at analysing the impact of prospective payment schemes on cost efficiency of acute care hospitals in Switzerland. We study a panel of 121 public hospitals subject to one of four payment schemes. While several hospitals are still reimbursed on a per diem basis for the treatment of patients, most face flat per-case rates-or mixed schemes, which combine both elements of reimbursement. Thus, unlike previous studies, we are able to simultaneously analyse and isolate the cost-efficiency effects of different payment schemes. By means of stochastic frontier analysis, we first estimate a hospital cost frontier. Using the two-stage approach proposed by Battese and Coelli (Empir Econ 20:325-332, 1995), we then analyse the impact of these payment schemes on the cost efficiency of hospitals. Controlling for hospital characteristics, local market conditions in the 26 Swiss states (cantons), and a time trend, we show that, compared to per diem, hospitals which are reimbursed by flat payment schemes perform better in terms of cost efficiency. Our results suggest that mixed schemes create incentives for cost containment as well, although to a lesser extent. In addition, our findings indicate that cost-efficient hospitals are primarily located in cantons with competitive markets, as measured by the Herfindahl-Hirschman index in inpatient care. Furthermore, our econometric model shows that we obtain biased estimates from frontier analysis if we do not account for heteroscedasticity in the inefficiency term.

The economic impact of vocal attrition in public school teachers in Miami-Dade County.

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Rosow, David E; Szczupak, Mikhaylo; Saint-Victor, Sandra; Gerhard, Julia D; DuPont, Carl; Lo, Kaming

2016-03-01

Teachers are a known at-risk population for voice disorders. The prevalence and risk factors for voice disorders have been well studied in this population, but little is known about the associated economic cost. The purpose of this study is to assess the economic impact of voice dysfunction in teachers and understand the difference between the cost of absenteeism and presenteeism as a direct result of voice dysfunction. Cross-sectional analysis via self-administered online questionnaire. A total of 14,256 public school teachers from Miami-Dade County, Florida, were asked to participate. Questions were formatted based on the previously validated Work Productivity and Activity Impairment: Specific Health Problem questionnaire adapted for hoarseness and voice disorders. Additional demographic questions were included in the questionnaire. A total of 961 questionnaire responses were received. The demographic characteristics of respondents closely matched known statistics for public school teachers in Miami-Dade County. Economic calculations were performed for each questionnaire respondent and summed for all respondents to avoid bias. Per week, absenteeism-related costs were $25,000, whereas presenteeism-related costs were approximately $300,000. These figures were used to extrapolate annual cost. Per year, absenteeism-related costs were $1 million, whereas presenteeism-related costs were approximately $12 million. The economic impact of voice dysfunction on the teaching profession is enormous. With the above calculations only including lost wages and decreased productivity, the actual figures may in fact be larger (cost of substitute teachers, impact on nonwork activities, etc.). Research investigating preventative measures for voice dysfunction in teachers is necessary to reduce this costly issue. 2C. Laryngoscope, 126:665-671, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Fire Hydrants, Both public and private fire hydrants in Johnson County. Spring Hill is hte only entity missing. Data is limited to CUE (Collaborative Utiity Exchange) Participants and subcontractors of them., Published in 2004, Johnson County Government.

Data.gov (United States)

NSGIC Local Govt | GIS Inventory — Fire Hydrants dataset current as of 2004. Both public and private fire hydrants in Johnson County. Spring Hill is hte only entity missing. Data is limited to CUE...

Park Land and Nature Preserves, This layer shows the geographic area of public lands along with their amenties in the County of Polk, Wisconsin., Published in 2007, 1:2400 (1in=200ft) scale, Polk County Government.

Data.gov (United States)

NSGIC Local Govt | GIS Inventory — Park Land and Nature Preserves dataset current as of 2007. This layer shows the geographic area of public lands along with their amenties in the County of Polk,...

[Cost of assisted reproduction technology in a public hospital].

Science.gov (United States)

Navarro Espigares, José Luis; Martínez Navarro, Luis; Castilla Alcalá, José Antonio; Hernández Torres, Elisa

2006-01-01

Most studies on the costs of assisted reproductive technologies (ART) identify the total cost of the procedure with the direct cost, without considering important items such as overhead or intermediate costs. The objective of this study was to determine the cost per ART procedure in a public hospital in 2003 and to compare the results with those in the same hospital in 1998. Data from the Human Reproduction Unit of the Virgen de las Nieves University Hospital in Granada (Spain) from 1998 and 2003 were analyzed. Since the total costs of the unit were known, the cost of the distinct ART procedures performed in the hospital was calculated by means of a methodology for cost distribution. Between 1998 and 2003, the activity and costs of the Human Reproduction Unit analyzed evolved differently. Analysis of activity showed that some techniques, such as intracytoplasmic sperm injection, were consolidated while others, such as stimulation without assisted reproduction or intracervical insemination were abandoned. In all procedures, unit costs per cycle and per delivery decreased in the period analyzed. Important changes took place in the structure of costs of ART in the Human Reproduction Unit of the Virgen de las Nieves University Hospital between 1998 and 2003. Some techniques were discontinued, while others gained importance. Technological advances and structural innovations, together with a "learning effect," modified the structure of ART-related costs.

Is the Colombian health system reform improving the performance of public hospitals in Bogotá?

Science.gov (United States)

McPake, Barbara; Yepes, Francisco Jose; Lake, Sally; Sanchez, Luz Helena

2003-06-01

Many countries are experimenting with public hospital reform - both increasing the managerial autonomy with which hospitals conduct their affairs, and separating 'purchaser' and 'provider' sides of the health system, thus increasing the degree of market pressure brought to bear on hospitals. Evidence suggesting that such reform will improve hospital performance is weak. From a theoretical perspective, it is not clear why public hospitals should be expected to behave like firms and seek to maximize profits as this model requires. Empirically, there is very slight evidence that such reforms may improve efficiency, and reason to be concerned about their equity implications. In Colombia, an ambitious reform programme includes among its measures the attempt to universalize a segmented health system, the creation of a purchaser-provider split and the transformation of public hospitals into 'autonomous state entities'. By design, the Colombian reform programme avoids the forces that produce equity losses in other developing countries. This paper reports the results of a study that has tried to track hospital performance in other dimensions in the post-reform period in Bogotá. Trends in hospital inputs, production and productivity, quality and patient satisfaction are presented, and qualitative data based on interviews with hospital workers are analyzed. The evidence we have been able to collect is capable of providing only a partial response to the study question. There is some evidence of increased activity and productivity and sustained quality despite declining staffing levels. Qualitative data suggest that hospital workers have noticed considerable changes, which include greater responsiveness to patients but also a heavier administrative burden. It is difficult to attribute specific causality to all of the changes measured and this reflects the inherent difficulty of judging the effects of large-scale reform programmes as well as weaknesses and gaps in the data

[A guide to successful public relations for hospitals and emergency medical services].

Science.gov (United States)

Ausserer, J; Schwamberger, J; Preloznik, R; Klimek, M; Paal, P; Wenzel, V

2014-04-01

Tragic accidents, e.g. involving celebrity patients or severe incidents in hospital occur suddenly without any advance warning, often produce substantial interest by the media and quickly overburden management personnel involved in both hospitals and emergency medical services. While doctors, hospitals and emergency medical services desire objective media reports, the media promote emotionalized and dramatized reports to ensure maximum attention and circulation. When briefing the media, the scales may quickly tilt from professional, well-deliberated information to unfortunate, often unintended disinformation. Such phenomena may result in continuing exaggerated reports in the tabloid press, which in the presence of aggressive lawyers and a competitive hospital environment can turn into image and legal problems. In this article, several aspects are discussed in order to achieve successful public relations.Interviews should be given only after consultation with the responsible press officer and the director of the respective department or hospital director. Requests for information by the media should always be answered as otherwise one-sided, unintentional publications can result that are extremely difficult to correct later. One should be available to be contacted easily by journalists, regular press conferences should be held and critics should be taken seriously and not be brushed off. Questions by journalists should be answered in a timely manner as journalists are continuously under time pressure and do not understand unnecessary delays. Information for the media should always be provided at the same time, no publication should be given preference and an absolutely current list of E-mail contacts is required. When facing big events a press conference is preferred as many questions can be answered at once. Always be well prepared for an interview or even for just a statement. Each interview should be regarded as an opportunity to put a story forward which you

Public hospital quality report awareness: evidence from National and Californian Internet searches and social media mentions, 2012.

Science.gov (United States)

Huesch, Marco D; Currid-Halkett, Elizabeth; Doctor, Jason N

2014-03-11

Publicly available hospital quality reports seek to inform consumers of important healthcare quality and affordability attributes, and may inform consumer decision-making. To understand how much consumers search for such information online on one Internet search engine, whether they mention such information in social media and how positively they view this information. A leading Internet search engine (Google) was the main focus of the study. Google Trends and Google Adwords keyword analyses were performed for national and Californian searches between 1 August 2012 and 31 July 2013 for keywords related to 'top hospital', best hospital', and 'hospital quality', as well as for six specific hospital quality reports. Separately, a proprietary social media monitoring tool was used to investigate blog, forum, social media and traditional media mentions of, and sentiment towards, major public reports of hospital quality in California in 2012. (1) Counts of searches for keywords performed on Google; (2) counts of and (3) sentiment of mentions of public reports on social media. National Google search volume for 75 hospital quality-related terms averaged 610 700 searches per month with strong variation by keyword and by state. A commercial report (Healthgrades) was more commonly searched for nationally on Google than the federal government's Hospital Compare, which otherwise dominated quality-related search terms. Social media references in California to quality reports were generally few, and commercially produced hospital quality reports were more widely mentioned than state (Office of Statewide Healthcare Planning and Development (OSHPD)), or non-profit (CalHospitalCompare) reports. Consumers are somewhat aware of hospital quality based on Internet search activity and social media disclosures. Public stakeholders may be able to broaden their quality dissemination initiatives by advertising on Google or Twitter and using social media interactively with consumers looking

Management Control Systems and Clinical Experience of Managers in Public Hospitals

Science.gov (United States)

Naranjo-Gil, David

2018-01-01

Healthcare authorities are encouraging managers in hospitals to acquire clinical experience and knowledge in order to better carry out and coordinate healthcare service delivery. The main objective of this paper is to analyse how the clinical experience of hospital managers is related to public health institutions’ performance. It is proposed that the effect of the clinical experience on operative and financial organizational performance is indirect through the mediating variables of perceived utility of management information and horizontal management control system. This paper analyses how these variables impact hospital performance through the data from a survey sent to 364 hospital managers in Brazil. The results show that managers’ clinical experience is related to higher perceived utility of historical, financial, short-term, and internal information, but not with horizontal control adoption in hospitals. Furthermore, our results show that, in hospitals, perceived utility of forecasted, non-financial, long-term, and external managerial information positively affects hospitals’ financial performance, while adoption of horizontal control management positively affects operational performance. Through showing evidence that clinical background could explain the differences not only in hospital service management but also in information capabilities and management control processes, this study offer meaningful implications for healthcare authorities and hospital managers involved in the development and implementation of strategies in the health sector. PMID:29673192

Community/hospital indicators in South African public sector mental health services.

Science.gov (United States)

Lund, Crick; Flisher, Alan J

2003-12-01

The need to balance resources between community and hospital-based mental health services in the post-deinstitutionalisation era has been well-documented. However, few indicators have been developed to monitor the relationship between community and hospital services, in either developed or developing countries. There is a particular need for such indicators in the South African context, with its history of inequitable services based in custodial institutions under apartheid, and a new policy that proposes the development of more equitable community-based care. Indicators are needed to measure the distribution of resources and the relative utilisation of community and hospital-based services during the reform process. These indicators are potentially useful for assessing the implementation of policy objectives over time. To develop and document community/hospital indicators in public sector mental health services in South Africa. A questionnaire was distributed to provincial mental health coordinators requesting numbers of full-time equivalent (FTE) staff who provide mental health care at all service levels, annual patient admissions to hospitals and annual patient attendances at ambulatory care facilities. The information was supplemented by consultations with mental health coordinators in each of the 9 provinces. Population data were obtained from preliminary findings of the 1996 census. The community/hospital indicator measuring staff distribution was defined as the ratio of staff employed in community settings to all staff, expressed as a percentage. The community/hospital indicator measuring patient service utilisation was defined as the ratio of the annual ambulatory care attendance rate per 100,000 population to the sum of this rate and the annual hospital admission rate per 100,000 population, expressed as a percentage. Of psychiatric public sector staff, 25% are located in community settings in South Africa (provincial range: 11-70%). If hospital outpatient

Use of a geographic information system to identify differences in automated external defibrillator installation in urban areas with similar incidence of public out-of-hospital cardiac arrest: a retrospective registry-based study.

Science.gov (United States)

Fredman, David; Haas, Jan; Ban, Yifang; Jonsson, Martin; Svensson, Leif; Djarv, Therese; Hollenberg, Jacob; Nordberg, Per; Ringh, Mattias; Claesson, Andreas

2017-06-02

Early defibrillation in out-of-hospital cardiac arrest (OHCA) is of importance to improve survival. In many countries the number of automated external defibrillators (AEDs) is increasing, but the use is low. Guidelines suggest that AEDs should be installed in densely populated areas and in locations with many visitors. Attempts have been made to identify optimal AED locations based on the incidence of OHCA using geographical information systems (GIS), but often on small datasets and the studies are seldom reproduced. The aim of this paper is to investigate if the distribution of public AEDs follows the incident locations of public OHCAs in urban areas of Stockholm County, Sweden. OHCA data were obtained from the Swedish Register for Cardiopulmonary Resuscitation and AED data were obtained from the Swedish AED Register. Urban areas in Stockholm County were objectively classified according to the pan-European digital mapping tool, Urban Atlas (UA). Furthermore, we reclassified and divided the UA land cover data into three classes (residential, non-residential and other areas). GIS software was used to spatially join and relate public AED and OHCA data and perform computations on relations and distance. Between 1 January 2012 and 31 December 2014 a total of 804 OHCAs occurred in public locations in Stockholm County and by December 2013 there were 1828 AEDs available. The incidence of public OHCAs was similar in residential (47.3%) and non-residential areas (43.4%). Fewer AEDs were present in residential areas than in non-residential areas (29.4% vs 68.8%). In residential areas the median distance between OHCAs and AEDs was significantly greater than in non-residential areas (288 m vs 188 m, p<0.001). The majority of public OHCAs occurred in areas classified in UA as 'residential areas' with limited AED accessibility. These areas need to be targeted for AED installation and international guidelines need to take geographical location into account when suggesting

Assessment of ebola virus disease, health care infrastructure, and preparedness - four counties,Southeastern Liberia, august 2014.

Science.gov (United States)

Forrester, Joseph D; Pillai, Satish K; Beer, Karlyn D; Neatherlin, John; Massaquoi, Moses; Nyenswah, Tolbert G; Montgomery, Joel M; De Cock, Kevin

2014-10-10

Ebola virus disease (Ebola) is a multisystem disease caused by a virus of the genus Ebolavirus. In late March 2014, Ebola cases were described in Liberia, with epicenters in Lofa County and later in Montserrado County. While information about case burden and health care infrastructure was available for the two epicenters, little information was available about remote counties in southeastern Liberia. Over 9 days, August 6-14, 2014, Ebola case burden, health care infrastructure, and emergency preparedness were assessed in collaboration with the Liberian Ministry of Health and Social Welfare in four counties in southeastern Liberia: Grand Gedeh, Grand Kru, River Gee, and Maryland. Data were collected by health care facility visits to three of the four county referral hospitals and by unstructured interviews with county and district health officials, hospital administrators, physicians, nurses, physician assistants, and health educators in all four counties. Local burial practices were discussed with county officials, but no direct observation of burial practices was conducted. Basic information about Ebola surveillance and epidemiology, case investigation, contact tracing, case management, and infection control was provided to local officials.

Establishing a general medical outpatient clinic for cancer survivors in a public city hospital setting.

Science.gov (United States)

Goytia, Elliott J; Lounsbury, David W; McCabe, Mary S; Weiss, Elisa; Newcomer, Meghan; Nelson, Deena J; Brennessel, Debra; Rapkin, Bruce D; Kemeny, M Margaret

2009-11-01

Many cancer centers and community hospitals are developing novel models of survivorship care. However, few are specifically focused on services for socio-economically disadvantaged cancer survivors. To describe a new model of survivorship care serving culturally diverse, urban adult cancer patients and to present findings from a feasibility evaluation. Adult cancer patients treated at a public city hospital cancer center. The clinic provides comprehensive medical and psychosocial services for patients within a public hospital cancer center where they receive their oncology care. Longitudinal data collected over a 3-year period were used to describe patient demographics, patient needs, and services delivered. Since inception, 410 cancer patients have been served. Demand for services has grown steadily. Hypertension was the most frequent comorbid condition treated. Pain, depression, cardiovascular disease, hyperlipidemia, and bowel dysfunction were the most common post-treatment problems experienced by the patients. Financial counseling was an important patient resource. This new clinical service has been well-integrated into its public urban hospital setting and constitutes an innovative model of health-care delivery for socio-economically challenged, culturally diverse adult cancer survivors.

The development of hospitalbased palliative care services in public hospitals in the Western Cape South Africa

Directory of Open Access Journals (Sweden)

L Gwyther

2018-02-01

Full Text Available With the recent approval of a South African (SA National Policy Framework and Strategy for Palliative Care by the National Health Council, it is pertinent to reflect on initiatives to develop palliative care services in public hospitals. This article reviews the development of hospital-based palliative care services in the Western Cape, SA. Palliative care services in SA started in the non-governmental sector in the 1980s. The first SA hospital-based palliative care team was established in Charlotte Maxeke Johannesburg Academic Hospital in 2001. The awareness of the benefit of palliative care in the hospital setting led to the development of isolated pockets of excellence providing palliative care in the public health sector in SA. This article describes models for palliative care at tertiary, provincial and district hospital level, which could inform development of hospital-based palliative care as the national policy for palliative care is implemented in SA.

Impact of Disease Prevalence Adjustment on Hospitalization Rates for Chronic Ambulatory Care-Sensitive Conditions in Germany.

Science.gov (United States)

Pollmanns, Johannes; Romano, Patrick S; Weyermann, Maria; Geraedts, Max; Drösler, Saskia E

2018-04-01

To explore effects of disease prevalence adjustment on ambulatory care-sensitive hospitalization (ACSH) rates used for quality comparisons. County-level hospital administrative data on adults discharged from German hospitals in 2011 and prevalence estimates based on administrative ambulatory diagnosis data were used. A retrospective cross-sectional study using in- and outpatient secondary data was performed. Hospitalization data for hypertension, diabetes, heart failure, chronic obstructive pulmonary disease, and asthma were obtained from the German Diagnosis Related Groups (DRG) database. Prevalence estimates were obtained from the German Central Research Institute of Ambulatory Health Care. Crude hospitalization rates varied substantially across counties (coefficients of variation [CV] 28-37 percent across conditions); this variation was reduced by prevalence adjustment (CV 21-28 percent). Prevalence explained 40-50 percent of the observed variation (r = 0.65-0.70) in ACSH rates for all conditions except asthma (r = 0.07). Between 30 percent and 38 percent of areas moved into or outside condition-specific control limits with prevalence adjustment. Unadjusted ACSH rates should be used with caution for high-stakes public reporting as differences in prevalence may have a marked impact. Prevalence adjustment should be considered in models analyzing ACSH. © Health Research and Educational Trust.

[Study of public and private hospital care on a population basis, 1986-1996].

Science.gov (United States)

Rocha, J S; Simões, B J

1999-02-01

The last decade saw the creation and implementation of the Brazilian National Health System (NHS)--public, universal and equalitarian--with the objective of offering wide coverage to meet the population's health needs. The objective of the study was the assessment of the evolution of public and private hospital care on a populational basis during the period of the implementation of the NHS. The 984,142 inpatients of the general hospitals of Ribeirão Preto, Brazil, during the period 1986 to 1996 were studied and those of them living in their own municipal district were selected. The inpatients are classified according to the financing system as private, pre-payment and NHS; the social situation of the patients and the profile of hospital morbidity are analysed. In the period studied a continuous growth in the number of hospitalizations is observed, both in absolute numbers and in coefficient per thousand inhabitants, increasing from 43,773 to 55,844 inpatients per year. Though when the categories of the hospitalizations are studied, it is seen that private inpatients present a reduction both in absolute numbers and as a coefficient from 3,181 (7.3%) to 2,215 (3.9%); the NHS inpatients decrease in absolute numbers and in a percentage by a third at the end of the period--falling from 33,254 (76.0%) to 29,373 (51.7%). On the other hand the pre-payment inpatient system triplicates in absolute numbers and duplicates by rate for inhabitant--from 7,338 (16.8%) to 25,256 (44.4%). The NHS hospital care attends mainly unskilled and semi-skilled manual workers; the professionals, technicians, non manual and skilled manual workers being assisted by the private services. The hospital morbidity of NHS inpatients is different from that of the private inpatient systems. The health policy in that period, limiting NHS financing, repressing demand and discouraging the private providers to work with NHS inpatients led to negative selectivity. The result was an increase in difference

Physicians’ engagement in dual practices and the effects on labor supply in public hospitals: results from a register-based study

Science.gov (United States)

2014-01-01

Background Physician dual practice, a combination of public and private practice, has attracted attention due to fear of reduced work supply and a lack of key personnel in the public system, increase in low priority treatments, and conflicts of interest for physicians who may be competing for their own patients when working for private suppliers. In this article, we analyze both choice of dual practice among hospital physicians and the dual practices’ effect on work supply in public hospitals. Methods The sample consisted of 12,399 Norwegian hospital physicians working in public hospitals between 2001 and 2009. We linked hospital registry data on salaries and hospital working hours with data from national income and other registries covering non-hospital income, including income from dual work, cohabiting status, childbirths and socioeconomic characteristics. Our dataset also included hospital variables describing i.e. workload. We estimated odds ratio for choosing dual practice and the effects of dual practice on public working hours using different versions of mixed models. Results The percentage of physicians engaged in dual practice fell from 35.1% for men and 17.6% for women in 2001 to 25.0% and 14.2%, respectively, in 2009. For both genders, financial debt and interest payments were positively correlated and having a newborn baby was negatively correlated with engaging in dual practice. Larger family size and being cohabitating increased the odds ratio of dual practice among men but reduced it for women. The most significant internal hospital factor for choosing dual practice was high wages for extended working hours, which significantly reduced the odds ratio for dual practice. The total working hours in public hospitals were similar for both those who did and did not engage in dual practice; however, dual practice reduced public working hours in some specialties. Conclusion Economic factors followed by family variables are significant elements influencing

Using data from a multi-hospital clinical network to explore prevalence of pediatric rickets in Kenya

Science.gov (United States)

Karuri, Stella W.; Murithi, Maureen K.; Irimu, Grace; English, Mike

2017-01-01

Background: Nutritional rickets is a public health concern in developing countries despite tropical climates and a re-emerging issue in developed countries. In this study, we reviewed pediatric admission data from the Clinical Information Network (CIN) to help determine hospital and region based prevalence of rickets in three regions of Kenya (Central Kenya, Western Kenya and Nairobi County). We also examine the association of rickets with other diagnosis, such as malnutrition and pneumonia, and study the effect of rickets on regional hospital stays. Methods: We analyzed discharge records for children aged 1 month to 5 years from county (formerly district) hospitals in the CIN, with admissions from February 1 st 2014 to February 28 th 2015. The strength of the association between rickets and key demographic factors, as well as with malnutrition and pneumonia, was assessed using odds ratios. The Fisher exact test was used to test the significance of the estimated odd ratios. Kaplan-Meier curves were used to analyze length of hospital stays. Results: There was a marked difference in prevalence across the three regions, with Nairobi having the highest number of cases of rickets at a proportion of 4.01%, followed by Central Region at 0.92%. Out of 9756 admissions in the Western Region, there was only one diagnosis of rickets. Malnutrition was associated with rickets; this association varied regionally. Pneumonia was found to be associated with rickets in Central Kenya. Children diagnosed with rickets had longer hospital stays, even when cases of malnutrition and pneumonia were excluded in the analysis. Conclusion: There was marked regional variation in hospital based prevalence of rickets, but in some regions it is a common clinical diagnosis suggesting the need for targeted public health interventions. Factors such as maternal and child nutrition, urbanization and cultural practices might explain these differences. PMID:29062911

A nurse-led model at public academic hospitals maintains high adherence to colorectal cancer surveillance guidelines.

Science.gov (United States)

Symonds, Erin L; Simpson, Kalindra; Coats, Michelle; Chaplin, Angela; Saxty, Karen; Sandford, Jayne; Young Am, Graeme P; Cock, Charles; Fraser, Robert; Bampton, Peter A

2018-06-18

To examine the compliance of colorectal cancer surveillance decisions for individuals at greater risk with current evidence-based guidelines and to determine whether compliance differs between surveillance models. Prospective auditing of compliance of surveillance decisions with evidence-based guidelines (NHMRC) in two decision-making models: nurse coordinator-led decision making in public academic hospitals and physician-led decision making in private non-academic hospitals. Selected South Australian hospitals participating in the Southern Co-operative Program for the Prevention of Colorectal Cancer (SCOOP). Proportions of recall recommendations that matched NHMRC guideline recommendations (March-May 2015); numbers of surveillance colonoscopies undertaken more than 6 months ahead of schedule (January-December 2015); proportions of significant neoplasia findings during the 15 years of SCOOP operation (2000-2015). For the nurse-led/public academic hospital model, the recall interval recommendation following 398 of 410 colonoscopies (97%) with findings covered by NHMRC guidelines corresponded to the guideline recommendations; for the physician-led/private non-academic hospital model, this applied to 257 of 310 colonoscopies (83%) (P < 0.001). During 2015, 27% of colonoscopies in public academic hospitals (mean, 27 months; SD, 13 months) and 20% of those in private non-academic hospitals (mean, 23 months; SD, 12 months) were performed more than 6 months earlier than scheduled, in most cases because of patient-related factors (symptoms, faecal occult blood test results). The ratio of the numbers of high risk adenomas to cancers increased from 6.6:1 during 2001-2005 to 16:1 during 2011-2015. The nurse-led/public academic hospital model for decisions about colorectal cancer surveillance intervals achieves a high degree of compliance with guideline recommendations, which should relieve burdening of colonoscopy resources.

The Los Angeles County Community Disaster Resilience Project — A Community-Level, Public Health Initiative to Build Community Disaster Resilience

Directory of Open Access Journals (Sweden)

David Eisenman

2014-08-01

Full Text Available Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel evaluation of the Los Angeles County Community Disaster Resilience Project (LACCDR, a public health program for increasing community disaster resilience. The LACCDR Project utilizes a pretest–posttest method with control group design. Sixteen communities in Los Angeles County were selected and randomly assigned to the experimental community resilience group or the comparison group. Community coalitions in the experimental group receive training from a public health nurse trained in community resilience in a toolkit developed for the project. The toolkit is grounded in theory and uses multiple components to address education, community engagement, community and individual self-sufficiency, and partnerships among community organizations and governmental agencies. The comparison communities receive training in traditional disaster preparedness topics of disaster supplies and emergency communication plans. Outcome indicators include longitudinal changes in inter-organizational linkages among community organizations, community member responses in table-top exercises, and changes in household level community resilience behaviors and attitudes. The LACCDR Project is a significant opportunity and effort to operationalize and meaningfully measure factors and strategies to increase community resilience. This paper is intended to provide public health and academic researchers with new tools to conduct their community resilience programs and evaluation research. Results are not yet available and will be presented in future reports.

Effects of automated speed enforcement in Montgomery County, Maryland, on vehicle speeds, public opinion, and crashes.

Science.gov (United States)

Hu, Wen; McCartt, Anne T

2016-09-01

In May 2007, Montgomery County, Maryland, implemented an automated speed enforcement program, with cameras allowed on residential streets with speed limits of 35 mph or lower and in school zones. In 2009, the state speed camera law increased the enforcement threshold from 11 to 12 mph over the speed limit and restricted school zone enforcement hours. In 2012, the county began using a corridor approach, in which cameras were periodically moved along the length of a roadway segment. The long-term effects of the speed camera program on travel speeds, public attitudes, and crashes were evaluated. Changes in travel speeds at camera sites from 6 months before the program began to 7½ years after were compared with changes in speeds at control sites in the nearby Virginia counties of Fairfax and Arlington. A telephone survey of Montgomery County drivers was conducted in Fall 2014 to examine attitudes and experiences related to automated speed enforcement. Using data on crashes during 2004-2013, logistic regression models examined the program's effects on the likelihood that a crash involved an incapacitating or fatal injury on camera-eligible roads and on potential spillover roads in Montgomery County, using crashes in Fairfax County on similar roads as controls. About 7½ years after the program began, speed cameras were associated with a 10% reduction in mean speeds and a 62% reduction in the likelihood that a vehicle was traveling more than 10 mph above the speed limit at camera sites. When interviewed in Fall 2014, 95% of drivers were aware of the camera program, 62% favored it, and most had received a camera ticket or knew someone else who had. The overall effect of the camera program in its modified form, including both the law change and the corridor approach, was a 39% reduction in the likelihood that a crash resulted in an incapacitating or fatal injury. Speed cameras alone were associated with a 19% reduction in the likelihood that a crash resulted in an

The future of public hospitals in a globalized world: corporate governance, corporatization or privatization?

Science.gov (United States)

Mordelet, Patrick

2008-01-01

This paper contributes to research in health systems and hospitals governance by examining the reasons and expected outcomes of the generalization of corporate governance rules in both public and private non-profit hospitals, all over the world, in order to achieve its clinical, quality and financial objectives.

Hipocrates (2014. Real life of a resident at a public hospital

Directory of Open Access Journals (Sweden)

Emilio PINTOR HOLGUIN

2017-12-01

Full Text Available It describes Benjamin´s first weeks of work as a new resident of Internal Medicine in a public hospital in Paris. Next to him, an experienced Algerian physician; Abdel, performs his practices of validation. Main problems with these two doctors are described: doubts, decision making, camaraderie, bioethical and liability problems as well as problems derived from public health system budgets. All mixed with short ironic and comic scenes that sometimes reach surrealism.

Right care, right place, right time: improving the timeliness of health care in New South Wales through a public-private hospital partnership.

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Saunders, Carla; Carter, David J

2017-10-01

Objective The overall aim of the study was to investigate and assess the feasibility of improving the timeliness of public hospital care through a New South Wales (NSW)-wide public-private hospital partnership. Methods The study reviewed the academic and professional grey literature, and undertook exploratory analyses of secondary data acquired from two national health data repositories informing in-patient access and utilisation across NSW public and private hospitals. Results In 2014-15, the NSW public hospital system was unable to deliver care within the medically recommended time frame for over 27400 people who were awaiting elective surgery. Available information indicates that the annual commissioning of 15% of public in-patient rehabilitation bed days to the private hospital system would potentially free up enough capacity in the NSW public hospital system to enable elective surgery for all public patients within recommended time frames. Conclusions The findings of the study justify a strategic whole-of-health system approach to reducing public patient wait times in NSW and highlight the need for research efforts aimed at securing a better understanding of available hospital capacity across the public and private hospital systems, and identifying and testing workable models that improve the timeliness of public hospital care. What is known about the topic? There are very few studies available to inform public-private hospital service partnerships and the opportunities available to improve timely health care access through such partnerships. What does this paper add? This paper has the potential to open and prompt timely discussion and debate, and generate further fundamental investigation, on public-private hospital service partnerships in Australia where opportunity is available to address elective surgery wait times in a reliable and effective manner. What are the implications for practitioners? The NSW Ministry of Health and its Local Health Districts

Representation of work stress in an Australian public hospital. A case study.

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Trubshaw, E A; Dollard, M F

2001-09-01

Content analysis of the view of occupational stress presented in the Annual Reports of an Australian public hospital revealed scant attention to occupational health and safety issues and less still to the issue of workplace stress. The hospital aimed to "provide for all employees a working environment with maximum job satisfaction and opportunities for personal growth," yet stepped up surveillance of "sick leave not absolutely necessary or related to medical conditions." Investigation of the hospital's employee assistance programs revealed a "band aid" approach of individually focused stress management techniques rather than preventative organizational procedures. The researchers concluded that management considered workplace stress to be a problem in the employee not in the workplace, evident also in an increase of almost 1,000% in the number of clients visiting the staff counseling center in a 10 year period. Although a shift to focus on prevention was noticed in most recent reports consistent with the World Health Organization's target of stress prevention, the holistic public safety of workers appears an unmet challenge in this health industry.

Key Performance Indicators for Maintenance Management Effectiveness of Public Hospital Building

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Farhana Omar Mardhiah

2017-01-01

Full Text Available Effectiveness of management in maintenance aspect holds the key element in influencing the performance of overall maintenance management. Similarly, public hospital building needs an effective maintenance management as this type of building in nature is one of the most complex issues in the field of maintenance. Improper building maintenance management adopted by the organization significantly will interrupt the overall operation of the building. Therefore, this paper is aim to identifying the key performance indicator (KPI of effectiveness of maintenance management for the public hospital building. A total of 32 set of questionnaires were distributed to the maintenance manager for each hospital in the northern region of peninsular Malaysia by using self-administration strategy. The survey answer was analyzed by performing descriptive analysis in SPSS. Overall, the result of descriptive analysis shows that all the ten factors of effectiveness of maintenance management are accepted as KPI since the mean value is at least 3.93 which classified as important and significant. The most significant factor of effectiveness of maintenance management is task planning and scheduling with the mean score of 4.35. While less significant factor is identify as maintenance approach with the value of mean score is 3.93. The both results indicates that the management need to have well-structured planning for the maintenance works and also need to embrace the exact strategy of maintenance approach in order to achieved better overall performance of maintenance management. This study may draw a standard practice for the government in assessing the performance of public facilities in terms of maintenance management.

Control costs, enhance quality, and increase revenue in three top general public hospitals in Beijing, China.

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Lue-Ping Zhao

Full Text Available BACKGROUND: With market-oriented economic and health-care reform, public hospitals in China have received unprecedented pressures from governmental regulations, public opinions, and financial demands. To adapt the changing environment and keep pace of modernizing healthcare delivery system, public hospitals in China are expanding clinical services and improving delivery efficiency, while controlling costs. Recent experiences are valuable lessons for guiding future healthcare reform. Here we carefully study three teaching hospitals, to exemplify their experiences during this period. METHODS: We performed a systematic analysis on hospitalization costs, health-care quality and delivery efficiencies from 2006 to 2010 in three teaching hospitals in Beijing, China. The analysis measured temporal changes of inpatient cost per stay (CPS, cost per day (CPD, inpatient mortality rate (IMR, and length of stay (LOS, using a generalized additive model. FINDINGS: There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (P<0.001, from CNY 1,531 in 2006 to CNY 2,169 in 2010. The increasing CPD seemed synchronous with the steady rising of the national annual income per capita. Surgical cost was the main contributor to the temporal change of CPD, while medicine and examination costs tended to be stable over time. From 2006 and 2010, IMR decreased by 36%, while LOS reduced by 25%. Increasing hospitalizations with higher costs, along with an overall stable CPS, reduced IMR, and shorter LOS, appear to be the major characteristics of these three hospitals at present. INTERPRETATIONS: These three teaching hospitals have gained some success in controlling costs, improving cares, adopting modern medical technologies, and increasing hospital revenues. Effective hospital governance and physicians' professional capacity plus government regulations and supervisions may have played a role

Implementing Sustainable Data Collection for a Cardiac Outcomes Registry in an Australian Public Hospital.

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Cox, Nicholas; Brennan, Angela; Dinh, Diem; Brien, Rita; Cowie, Kath; Stub, Dion; Reid, Christopher M; Lefkovits, Jeffrey

2018-04-01

Clinical outcome registries are an increasingly vital component of ensuring quality and safety of patient care. However, Australian hospitals rarely have additional resources or the capacity to fund the additional staff time to complete the task of data collection and entry. At the same time, registry funding models do not support staff for the collection of data at the site but are directed towards the central registry tasks of data reporting, managing and quality monitoring. The sustainability of a registry is contingent on building efficiencies into data management and collection. We describe the methods used in a large Victorian public hospital to develop a sustainable data collection system for the Victorian Cardiac Outcomes Registry (VCOR), using existing staff and resources common to many public hospitals. We describe the features of the registry and the hospital specific strategies that allowed us to do this as part of our routine business of providing good quality cardiac care. All clinical staff involved in patient care were given some data collection task with the entry of these data embedded into the staff's daily workflow. A senior cardiology registrar was empowered to allocate data entry tasks to colleagues when data were found to be incomplete. The task of 30-day follow-up proved the most onerous part of data collection. Cath-lab nursing staff were allocated this role. With hospital accreditation and funding models moving towards performance based quality indicators, collection of accurate and reliable information is crucial. Our experience demonstrates the successful implementation of clinical outcome registry data collection in a financially constrained public hospital environment utilising existing resources. Copyright © 2017. Published by Elsevier B.V.

Management Control Systems and Clinical Experience of Managers in Public Hospitals

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Rogério Joao Lunkes

2018-04-01

Full Text Available Healthcare authorities are encouraging managers in hospitals to acquire clinical experience and knowledge in order to better carry out and coordinate healthcare service delivery. The main objective of this paper is to analyse how the clinical experience of hospital managers is related to public health institutions’ performance. It is proposed that the effect of the clinical experience on operative and financial organizational performance is indirect through the mediating variables of perceived utility of management information and horizontal management control system. This paper analyses how these variables impact hospital performance through the data from a survey sent to 364 hospital managers in Brazil. The results show that managers’ clinical experience is related to higher perceived utility of historical, financial, short-term, and internal information, but not with horizontal control adoption in hospitals. Furthermore, our results show that, in hospitals, perceived utility of forecasted, non-financial, long-term, and external managerial information positively affects hospitals’ financial performance, while adoption of horizontal control management positively affects operational performance. Through showing evidence that clinical background could explain the differences not only in hospital service management but also in information capabilities and management control processes, this study offer meaningful implications for healthcare authorities and hospital managers involved in the development and implementation of strategies in the health sector.

[Hospital governance: between crisis management and implementation of public health policy].

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Bréchat, Pierre-Henri; Antoine, Leenhardt; Mathieu-Grenouilleau, Marie-Christine; Rymer, Roland; Matisse, François; Baraille, Denis; Beaufils, Philippe

2010-01-01

The implementation of the recent act to amend the law on hospitals, patient health and territories (HPST Law) completes the reform of the organization and governance of health facilities, which was announced in 2002 by the "Hospital 2007" plan. What kind of assessments and perspectives can be considered and envisaged for these Hospital Activity Poles? We compared our experience with a review of the professional and scientific literature in order to stimulate answers to these questions for advocacy purposes prior to the Act's implementation. The hospital's cluster of activities should reinforce--not call into question the core activities and the financial stability of the facility, while respecting the contract on agreed objectives and the necessary means and resources to meet the health needs of the catchment population as well as national priorities. Although significant, but limited, successes exist, five obstacles to hospital reorganization can be identified. These include, for example: lack of delegation of management and centralization of decisions, the heterogeneity of numerous Hospital Activity Poles or problems related to timing. These obstacles may cause strain, or put the Hospital Activity Poles and the health facilities in a difficult situation with respect to their dynamics. This may show that the State and social health insurance should steer and direct public health policy and that the delegation of management roles and responsibilities to the Hospital Activity Poles should be addressed.

Skin cancer has a large impact on our public hospitals but prevention programs continue to demonstrate strong economic credentials.

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Shih, Sophy T F; Carter, Rob; Heward, Sue; Sinclair, Craig

2017-08-01

While skin cancer is still the most common cancer in Australia, important information gaps remain. This paper addresses two gaps: i) the cost impact on public hospitals; and ii) an up-to-date assessment of economic credentials for prevention. A prevalence-based cost approach was undertaken in public hospitals in Victoria. Costs were estimated for inpatient admissions, using State service statistics, and outpatient services based on attendance at three hospitals in 2012-13. Cost-effectiveness for prevention was estimated from 'observed vs expected' analysis, together with program expenditure data. Combining inpatient and outpatient costs, total annual costs for Victoria were $48 million to $56 million. The SunSmart program is estimated to have prevented more than 43,000 skin cancers between 1988 and 2010, a net cost saving of $92 million. Skin cancer treatment in public hospitals ($9.20∼$10.39 per head/year) was 30-times current public funding in skin cancer prevention ($0.37 per head/year). At about $50 million per year for hospitals in Victoria alone, the cost burden of a largely preventable disease is substantial. Skin cancer prevention remains highly cost-effective, yet underfunded. Implications for public health: Increased funding for skin cancer prevention must be kept high on the public health agenda. Hospitals would also benefit from being able to redirect resources to non-preventable conditions. © 2017 The Authors.

Perceptions of patient-centred care at public hospitals in Nelson ...

African Journals Online (AJOL)

In South Africa, the quality of health care is directly related to the concept of patientcentred care and the enactment of the Batho Pele Principles and the Patients' Rights Charter. Reports in the media indicate that public hospitals in the Eastern Cape Province are on the brink of collapse, with many patients being treated in ...

Conflict management in public hospitals: the Cyprus case.

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Pavlakis, A; Kaitelidou, D; Theodorou, M; Galanis, P; Sourtzi, P; Siskou, O

2011-06-01

Conflict among health-care personnel has been identified as an issue within health-care settings around the world. To investigate the existence and management of conflict among health-care personnel in public hospitals in Cyprus; to assess the factors leading to conflict among staff members; to evaluate the consequences of conflict arising; and to consider the management strategies. A self-administered questionnaire was completed by a random sample of 1037 health-care professionals in all (seven) state-run hospitals in Cyprus in 2008. Mean age of respondents was 41 years, and 75% were female. Sixty-four per cent of respondents reported that they had never been informed about conflict management strategies, with physicians being the least informed as the relative percentage was 79.8% (χ(2) = 33, P conflict management for physicians, nurses and their managers may also be needed. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

Are residents of mountain-top mining counties more likely to have infants with birth defects? The West Virginia experience.

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Lamm, Steven H; Li, Ji; Robbins, Shayhan A; Dissen, Elisabeth; Chen, Rusan; Feinleib, Manning

2015-02-01

Pooled 1996 to 2003 birth certificate data for four central states in Appalachia indicated higher rates of infants with birth defects born to residents of counties with mountain-top mining (MTM) than born to residents of non-mining-counties (Ahern 2011). However, those analyses did not consider sources of uncertainty such as unbalanced distributions or quality of data. Quality issues have been a continuing problem with birth certificate analyses. We used 1990 to 2009 live birth certificate data for West Virginia to reassess this hypothesis. Forty-four hospitals contributed 98% of the MTM-county births and 95% of the non-mining-county births, of which six had more than 1000 births from both MTM and nonmining counties. Adjusted and stratified prevalence rate ratios (PRRs) were computed both by using Poisson regression and Mantel-Haenszel analysis. Unbalanced distribution of hospital births was observed by mining groups. The prevalence rate of infants with reported birth defects, higher in MTM-counties (0.021) than in non-mining-counties (0.015), yielded a significant crude PRR (cPRR = 1.43; 95% confidence interval [CI] = 1.36-1.52) but a nonsignificant hospital-adjusted PRR (adjPRR = 1.08; 95% CI = 0.97-1.20; p = 0.16) for the 44 hospitals. So did the six hospital data analysis ([cPRR = 2.39; 95% CI = 2.15-2.65] and [adjPRR = 1.01; 95% CI, 0.89-1.14; p = 0.87]). No increased risk of birth defects was observed for births from MTM-counties after adjustment for, or stratification by, hospital of birth. These results have consistently demonstrated that the reported association between birth defect rates and MTM coal mining was a consequence of data heterogeneity. The data do not demonstrate evidence of a "Mountain-top Mining" effect on the prevalence of infants with reported birth defects in WV. © 2014 Wiley Periodicals, Inc.

Associations Between County Wealth, Health and Social Services Spending, and Health Outcomes.

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McCullough, J Mac; Leider, Jonathon P

2017-11-01

Each year, the County Health Rankings rate the health outcomes of each county in the U.S. A common refrain is that poor counties perform worse than wealthier ones. This article examines that assumption and specifically analyzes characteristics of counties that have performed better in terms of health outcomes than their wealth alone would suggest. Data from the 2013 County Health Rankings were used, as were 2012 financial and demographic information collected by the U.S. Census Bureau. A logistic model was constructed to examine the odds of a county "overperforming" in the rankings relative to community wealth. Analyses were performed in 2016. Communities that were wealthier performed better on the rankings. However, more than 800 of 3,141 counties overperformed by ranking in a better health outcomes quartile than their county's wealth alone would suggest. Regression analyses found that for each additional percentage point of total public spending that was allocated toward community health care and public health, the odds of being an overperformer increased by 3.7%. Community wealth correlates with health, but not always. Population health outcomes in hundreds of counties overperform what would be expected given community wealth alone. These counties tend to invest more in community health care and public health spending and other social services. Although the level of a community's wealth is outside the control of practitioners, shifting the proportion of spending to certain social services may positively impact population health. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Tobacco industry manipulation of the hospitality industry to maintain smoking in public places

Science.gov (United States)

Dearlove, J; Bialous, S; Glantz, S

2002-01-01

Objective: To describe how the tobacco industry used the "accommodation" message to mount an aggressive and effective worldwide campaign to recruit hospitality associations, such as restaurant associations, to serve as the tobacco industry's surrogate in fighting against smoke-free environments. Methods: We analysed tobacco industry documents publicly available on the internet as a result of litigation in the USA. Documents were accessed between January and November 2001. Results: The tobacco industry, led by Philip Morris, made financial contributions to existing hospitality associations or, when it did not find an association willing to work for tobacco interests, created its own "association" in order to prevent the growth of smoke-free environments. The industry also used hospitality associations as a vehicle for programmes promoting "accommodation" of smokers and non-smokers, which ignore the health risks of second hand smoke for employees and patrons of hospitality venues. Conclusion: Through the myth of lost profits, the tobacco industry has fooled the hospitality industry into embracing expensive ventilation equipment, while in reality 100% smoke-free laws have been shown to have no effect on business revenues, or even to improve them. The tobacco industry has effectively turned the hospitality industry into its de facto lobbying arm on clean indoor air. Public health advocates need to understand that, with rare exceptions, when they talk to organised restaurant associations they are effectively talking to the tobacco industry and must act accordingly. PMID:12034999

Public hospital quality report awareness: evidence from National and Californian Internet searches and social media mentions, 2012

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Huesch, Marco D; Currid-Halkett, Elizabeth; Doctor, Jason N

2014-01-01

Objectives Publicly available hospital quality reports seek to inform consumers of important healthcare quality and affordability attributes, and may inform consumer decision-making. To understand how much consumers search for such information online on one Internet search engine, whether they mention such information in social media and how positively they view this information. Setting and design A leading Internet search engine (Google) was the main focus of the study. Google Trends and Google Adwords keyword analyses were performed for national and Californian searches between 1 August 2012 and 31 July 2013 for keywords related to ‘top hospital’, best hospital’, and ‘hospital quality’, as well as for six specific hospital quality reports. Separately, a proprietary social media monitoring tool was used to investigate blog, forum, social media and traditional media mentions of, and sentiment towards, major public reports of hospital quality in California in 2012. Primary outcome measures (1) Counts of searches for keywords performed on Google; (2) counts of and (3) sentiment of mentions of public reports on social media. Results National Google search volume for 75 hospital quality-related terms averaged 610 700 searches per month with strong variation by keyword and by state. A commercial report (Healthgrades) was more commonly searched for nationally on Google than the federal government's Hospital Compare, which otherwise dominated quality-related search terms. Social media references in California to quality reports were generally few, and commercially produced hospital quality reports were more widely mentioned than state (Office of Statewide Healthcare Planning and Development (OSHPD)), or non-profit (CalHospitalCompare) reports. Conclusions Consumers are somewhat aware of hospital quality based on Internet search activity and social media disclosures. Public stakeholders may be able to broaden their quality dissemination initiatives by

Measuring the efficiency of Palestinian public hospitals during 2010-2015: an application of a two-stage DEA method.

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Sultan, Wasim I M; Crispim, José

2018-05-29

While health needs and expenditure in the Occupied Palestinian Territories (OPT) are growing, the international donations are declining and the economic situation is worsening. The purpose of this paper is twofold, to evaluate the productive efficiency of public hospitals in West Bank and to study contextual factors contributing to efficiency differences. This study examined technical efficiency among 11 public hospitals in West Bank from 2010 through 2015 targeting a total of 66 observations. Nationally representative data were extracted from the official annual health reports. We applied input-oriented Data Envelopment Analysis (DEA) models to estimate efficiency scores. To elaborate further on performance, we used Tobit regression to identify contextual factors whose impact on inefficient performance is statistically significant. Despite the increase in efficiency mean scores by 4% from 2010 to 2015, findings show potential savings of 14.5% of resource consumption without reducing the volume of the provided services. The significant Tobit model showed four predictors explaining the inefficient performance of a hospital (p public hospitals in the OPT. Our work identified their efficiency levels for potential improvements and the determinants of efficient performance. Based on the measurement of efficiency, the generated information may guide hospitals' managers, policymakers, and international donors improving the performance of the main national healthcare provider. The scope of this study is limited to public hospitals in West Bank. For a better understanding of the Palestinian market, further research on private hospitals and hospitals in Gaza Strip will be useful.

Policy and Practice Model of Public-Private Partnership in Public Hospitals during the New Medical Reform Period.

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Zhang, Ju-Yang; Long, Ru-Yin; Yan, Hai; Yang, Qing; Yang, Bo

2016-01-01

Purpose: Since the beginning of the new health care reform in 2009, the state has illustrated the top design and health care improvement strategy of "encouraging social capital to participate in the reform of public hospitals", in accordance with the program's general objective. All areas have been explored on this matter and the results obtained are very interesting, not to mention the acquisition of significant experience. At present, the existing business models in China are mainly the following: Rebuild-Operate-Transfer (ROT), franchise business model, Build-Own-Operate-Transfer (BOOT) model, mixed ownership model and business insurance model. This paper introduces a variety of alternative models, and provides a simple analysis of the advantages and disadvantages. Moreover, for the reform of public hospitals, the government shares should go into franchise mode or mixed ownership, and all property rights should be transferred to the government to ensure the conservation and proliferation of state-owned assets.

Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting?

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Than, Thet Mon; Saw, Yu Mon; Khaing, Moe; Win, Ei Mon; Cho, Su Myat; Kariya, Tetsuyoshi; Yamamoto, Eiko; Hamajima, Nobuyuki

2017-09-19

Cost information is important for efficient allocation of healthcare expenditure, estimating future budget allocation, and setting user fees to start new financing systems. Myanmar is in political transition, and trying to achieve universal health coverage by 2030. This study assessed the unit cost of healthcare services at two public hospitals in the country from the provider perspective. The study also analyzed the cost structure of the hospitals to allocate and manage the budgets appropriately. A hospital-based cross-sectional study was conducted at 200-bed Magway Teaching Hospital (MTH) and Pyinmanar General Hospital (PMN GH), in Myanmar, for the financial year 2015-2016. The step-down costing method was applied to calculate unit cost per inpatient day and per outpatient visit. The costs were calculated by using Microsoft Excel 2010. The unit costs per inpatient day varied largely from unit to unit in both hospitals. At PMN GH, unit cost per inpatient day was 28,374 Kyats (27.60 USD) for pediatric unit and 1,961,806 Kyats (1908.37 USD) for ear, nose, and throat unit. At MTH, the unit costs per inpatient day were 19,704 Kyats (19.17 USD) for medicine unit and 168,835 Kyats (164.24 USD) for eye unit. The unit cost of outpatient visit was 14,882 Kyats (14.48 USD) at PMN GH, while 23,059 Kyats (22.43 USD) at MTH. Regarding cost structure, medicines and medical supplies was the largest component at MTH, and the equipment was the largest component at PMN GH. The surgery unit of MTH and the eye unit of PMN GH consumed most of the total cost of the hospitals. The unit costs were influenced by the utilization of hospital services by the patients, the efficiency of available resources, type of medical services provided, and medical practice of the physicians. The cost structures variation was also found between MTH and PMN GH. The findings provided the basic information regarding the healthcare cost of public hospitals which can apply the efficient utilization of the

Violence exposure among health care professionals in Saudi public hospitals. A preliminary investigation.

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Algwaiz, Waleed M; Alghanim, Saad A

2012-01-01

To identify the prevalence, causes, types, and sources of workplace violence among health professionals in public hospitals in the Kingdom of Saudi Arabia. This exploratory cross-sectional survey employed self-administered questionnaires to collect data on aspects of workplace violence against physicians and nurses in Saudi hospitals. The questionnaires were distributed randomly to 600 physicians and nurses, of which 383 (63.8%) completed the questionnaires at 2 public hospitals in Riyadh city between May and July 2011. More than two-thirds (67.4%) of respondents reported they were victims of violence in the previous 12 months. Nurses were more likely to be exposed to violent incidents than physicians (pviolence. Verbal abuse was the most common type encountered. The assailants were mostly the patients' relatives or friends, followed by the patients themselves. Reasons for not reporting violent events included: feel it is a part of the job, previous experience of no action, and fear of consequences. Physicians and nurses are at high risk of violent incidents. Health decision makers need to be aware of the potential consequences of such events. Appropriate preventive measures are needed to make hospitals safer environments.

Public Hospital Spending in England: Evidence from National Health Service Administrative Records

OpenAIRE

Kelly, E.; Stoye, G.; Vera-Hernández, M.

2016-01-01

© 2016 The Authors. Fiscal Studies published by John Wiley & Sons Ltd. on behalf of Institute for Fiscal StudiesHealth spending per capita in England has almost doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the life cycle, and the concentration of spendi...

Public hospital spending in England: Evidence from National Health Service administrative records

OpenAIRE

Kelly, Elaine; Stoye, George; Vera-Hernández, Marcos

2015-01-01

Health spending per capita in England has more than doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the lifecycle, and the concentration of spending among people and over time. We find that costs per person start to increase after age 50 and escalate after...

Power and trust in organizational relations: an empirical study in Turkish public hospitals.

Science.gov (United States)

Bozaykut, Tuba; Gurbuz, F Gulruh

2015-01-01

Given the salience of the interplay between trust and power relations in organizational settings, this paper examines the perceptions of social power and its effects on trust in supervisors within the context of public hospitals. Following the theoretical background from which the study model is developed, the recent situation of hospitals within Turkish healthcare system is discussed to further elucidate the working conditions of physicians. Sample data were collected employing a structured questionnaire that was distributed to physicians working at seven different public hospitals. The statistical analyses indicate that perceptions of supervisors' social power affect subordinates' trust in supervisors. Although coercive power is found to have the greatest impact on trust in supervisors, the influence of the power base is weak. In addition, the results show that perceptions of social power differ between genders. However, the results do not support any of the hypotheses regarding the relations between trust in supervisors and the examined demographic variables. Copyright © 2014 John Wiley & Sons, Ltd.

Physicians' job satisfaction and motivation in a public academic hospital.

Science.gov (United States)

de Oliveira Vasconcelos Filho, Paulo; de Souza, Miriam Regina; Elias, Paulo Eduardo Mangeon; D'Ávila Viana, Ana Luiza

2016-12-07

Physician shortage is a global issue that concerns Brazil's authorities. The organizational structure and the environment of a medical institution can hide a low-quality life of a physician. This study examines the relationship between the hospital work environment and physicians' job satisfaction and motivation when working in a large public academic hospital. The study was restricted to one large, multispecialty Brazil's hospital. Six hundred hospital physicians were invited to participate by e-mail. A short version of the Physician Worklife Survey (PWS) was used to measure working satisfaction. Physicians were also asked for socio-demographic information, medical specialty, and the intention to continue working in the hospital. Data from 141 questionnaires were included in the analyses. Forty-five physicians graduated from the hospital's university, and they did not intend to leave the hospital under any circumstance (affective bond). The motivating factor for beginning the career at the hospital and to continue working there were the connection to the medical school and the hospital status as a "prestigious academic hospital"; the physicians were more satisfied with the career than the specialty. Only 30% completely agreed with the statement "If I had to start my career over again, I would choose my current specialty," while 45% completely agreed with the statement "I am not well compensated given my training and experience." The greater point of satisfaction was the relationship with physician colleagues. They are annoyed about the amount of calls they are requested to take and about how work encroaches on their personal time. No significant differences between medical specialties were found in the analysis. The participants were satisfied with their profession. The fact that they remained at the hospital was related to the academic environment, the relationship with colleagues, and the high prestige in which society holds the institution. The points of

[Costs of chronic dialysis in a public hospital: myths and realities].

Science.gov (United States)

Lamas, J; Alonso, M; Saavedra, J; García-Trío, G; Rionda, M; Ameijeiras, M

2001-01-01

In this study regular dialysis treatment costs during 1998 and 1999 in a public hospital, which is responsible for a population of 178,000, has been analysed. Hemodialysis (HD) and peritoneal dialysis (PD) costs have been differentiated and compared with those of external providers. The best technical and productive efficiency of both treatments have been estimated by analyzing the "treatment cost/human resources of the community utilized" relationship. The HD treatment costs per patient per year were 20,343 and 18,871 euros in 1988 and 1,999, respectively, lower than the costs reported in other studies. In 1999 these costs were similar to those of external providers and lower than the PD treatment costs (23,295 euros). HD retains its advantage even after costs of erythropoietin, hospital admissions and transport are included. In the hospital studied, the best technical efficiency in HD would be reached with 64 patients on treatment (17,851 euros per patient per year) and in PD with 48 patients (21,167 euros per patient per year). If we take into account our population characteristics and consider a patient distribution of 70% on HD and 30% on PD, the best productive efficiency would be reached with 56 patients on HD (17,916 euros per patient per year) and 24 patients on PD (21,813 euros per patient per year). HD confers the greatest economic and social benefits on the population supplied by the hospital since it provides the community with more jobs than PD in relation to treatment costs while the two yield the same clinical results. In conclusion, HD in a public hospital, at least in our environment, may be efficient and competitive with HD from external providers and it may be more efficient and provide a bigger economic and social profit for the population serviced by the hospital than PD, at least while the current supply systems for this treatment in our country are maintained.

The Journey to Meet Emerging Community Benefit Requirements in a Rural Hospital: A Case Study

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Sabin, Allison V; Levin, Pamela F

2015-10-22

The Affordable Care Act requires nonprofit hospitals to collaborate with public health agencies and community stakeholders to identify and address community health needs. As a rural organization, Wabash County (Indiana) Hospital pursued new approaches to achieve these revised requirements of the community benefit mandate. Using a case study approach, the authors provide a historical review of governmental relationships with nonprofit community hospitals, offer a case study application for implementing legislative mandates and community benefit requirements, share the insights they garnered on their journey to meet the mandates, and conclude that drawing upon the existing resources in the community and using current community assets in novel ways can help conserve time, and also financial, material, and human resources in meeting legislative mandates.

Workplace Bullying Among the Nursing Staff of Greek Public Hospitals.

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Karatza, Christine; Zyga, Sofia; Tziaferi, Styliani; Prezerakos, Panagiotis

2017-02-01

In this quantitative, cross-sectional study, the authors identified the impact of workplace bullying on nursing staff employed at select Greek public hospitals. They conducted the study using the Negative Acts Questionnaire with a convenience sample of 841 participants employed by five Greek hospitals in the 1st Regional Health Authority of Attica. One third of the respondents reported having been psychologically harassed at work in the past 6 months. According to the results, the impact workplace bullying has on nursing staff varies depending on the existence of a supportive familial or friend environment and if nurses parent children. These findings demonstrate the value of family and friend support when coping with workplace bullying.

Defining the activities of publicness for Korea's public community hospitals using the Delphi method.

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Lee, Kunsei; Kim, Hyun Joo; You, Myoungsoon; Lee, Jin-Seok; Eun, Sang Jun; Jeong, Hyoseon; Ahn, Hye Mi; Lee, Jin Yong

2017-03-01

This study aims to identify which activities of a public community hospital (PHC) should be included in their definition of publicness and tries to achieve a consensus among experts using the Delphi method. We conduct 2 rounds of the Delphi process with 17 panel members using a developed draft of tentative activities for publicness including 5 main categories covering 27 items. The questions remain the same in both rounds and the applicability of each of the 27 items to publicness is measured on a 9-point scale. If the participants believe government funding is needed, we ask how much they think the government should support each item on a 0% to 100% scale. After conducting 2 rounds of the Delphi process, 22 out of the 27 items reached a consensus as activities defining the publicness of the PHCs. Among the 5 major categories, in category C, activities preventing market failure, all 10 items were considered activities of publicness. Nine of these were evaluated as items that should be compensated at 100% of total financial loss by the Korean government. Throughout results, we were able to define the activities of the PCH that encompassed its publicness and confirm that there are "good deficits" in the context of the PCHs. Thus, some PCH deficits are unavoidable and not wasted as these monies support a necessary role and function in providing public health. The Korean government should therefore consider taking actions such as exempting such "good deficits" or providing additional financial aid to reimburse the PHCs for "good deficits."

A Generic Discrete-Event Simulation Model for Outpatient Clinics in a Large Public Hospital

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Waressara Weerawat

2013-01-01

Full Text Available The orthopedic outpatient department (OPD ward in a large Thai public hospital is modeled using Discrete-Event Stochastic (DES simulation. Key Performance Indicators (KPIs are used to measure effects across various clinical operations during different shifts throughout the day. By considering various KPIs such as wait times to see doctors, percentage of patients who can see a doctor within a target time frame, and the time that the last patient completes their doctor consultation, bottlenecks are identified and resource-critical clinics can be prioritized. The simulation model quantifies the chronic, high patient congestion that is prevalent amongst Thai public hospitals with very high patient-to-doctor ratios. Our model can be applied across five different OPD wards by modifying the model parameters. Throughout this work, we show how DES models can be used as decision-support tools for hospital management.

Motivation of health workers and associated factors in public hospitals of West Amhara, Northwest Ethiopia

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Weldegebriel Z

2016-02-01

Full Text Available Zemichael Weldegebriel,1 Yohannes Ejigu,2 Fitsum Weldegebreal,3 Mirkuzie Woldie2 1Public Planning Department, Debark Hospital, Debark, North Gondar, Amhara Region, 2Department of Health Services Management, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia; 3Department of Medical Laboratory Science, College of Health and Medical Science, Haramaya University, Harar, Ethiopia Background: Health professionals’ motivation reflects the interaction between health professionals and their work environment. It can potentially affect the provision of health services; however, this important attribute of the workplace climate in public hospitals is not usually given serious attention to the desired level. For this reason, the authors of this study have assessed the level of motivation of health professionals and associated factors in public hospitals of West Amhara, Northwest Ethiopia.  Methods: A facility based cross-sectional study was conducted in eight public hospitals of West Amhara from June 1 to July 30, 2013. A total of 304 health professionals were included in this study. The collected data were analyzed using SPSS software version 20. The reliability of the instrument was assessed through Cronbach’s α. Factor scores were generated for the items found to represent the scales (eigenvalue greater than one in varimax rotation used in the measurement of the variables. The scores were further analyzed using one-way analysis of variance, t-tests, Pearson’s correlation, and hierarchical multiple linear regression analyses. The cut-off point for the regression analysis to determine significance was set at β (95% confidence interval, P<0.05.  Results: Mean motivation scores (as the percentage of maximum scale scores were 58.6% for the overall motivation score, 71.0% for the conscientiousness scale, 52.8% for the organizational commitment scale, 58.3% for the intrinsic motivation scale, and 64.0% for organizational

Opportunities for the improvement of cost accounting systems in public hospitals in Italy and Croatia: A case study

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Michele Bertoni

2017-01-01

Full Text Available The purpose of this paper is to highlight similarities and differences between one Croatian and one Italian public hospital regarding the implementation of cost accounting and full costing method in their accounting systems. Moving from the theoretical background, it is evident that cost accounting methods introduced in healthcare sector bring benefits to the whole society through an increased efficiency of the healthcare services provided. It primarily ensures better governing of hospital’s resources allowing more transparency in spending public funds. The main topic is that with the introduction of cost accounting system for internal purposes in public hospitals, the management would be able to govern them in a more efficient and effective way while reducing costs. The research for this paper was conducted through the interview of accounting officers in one Croatian and one Italian public hospital. The main results show that there are differences in legislation background regarding how they record costs, but also how they allocate costs to the cost objects and in how they use cost information in their decision-making process. In order to successfully manage public hospitals, it is crucial that true, timely and valid information are obtained as a base for the decision-making process. The cost accounting methodology is therefore essential to the management of public hospitals. It must provide information on the type and amount of resources spent, and thus enable the preconditions for control, management and potential reduction of costs.

Problematising public and private work spaces: midwives' work in hospitals and in homes.

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Bourgeault, Ivy Lynn; Sutherns, Rebecca; Macdonald, Margaret; Luce, Jacquelyne

2012-10-01

as the boundaries between public and private spaces become increasingly fluid, interest is growing in exploring how those spaces are used as work environments, how professionals both construct and convey themselves in those spaces, and how the lines dividing spaces traditionally along public and private lines are blurred. This paper draws on literature from critical geography, organisational studies, and feminist sociology to interpret the work experiences of midwives in Ontario, Canada who provide maternity care both in hospitals and in clients' homes. qualitative design involving in-depth semi-structured interviews content coded thematically. Ontario, Canada. community midwives who practice at home and in hospital. the accounts of practicing midwives illustrate the ways in which hospital and home work spaces are sites of both compromise and resistance. With the intention of making birthing women feel more `at home', midwives describe how they attempt to recreate the woman's home in the hospital. Similarly, midwives also reorient women's homes to a certain degree into a more standardised work space for home birth attendance. Many midwives also described how they like `guests' in both settings. there seems to be a conscious or unconscious convergence of midwifery work spaces to accommodate Ontario midwives' unique model of practice. we link these findings of midwives' place of work on their experiences as workers to professional work experiences in both public and private spaces and offer suggestions for further exploration of the concept of professionals as guests in their places of work. Copyright © 2012. Published by Elsevier Ltd.

Assessing Performance of Botswana’s Public Hospital System: The Use of the World Health Organization Health System Performance Assessment Framework

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Onalenna Seitio-Kgokgwe

2014-09-01

Full Text Available Background Very few studies have assessed performance of Botswana public hospitals. We draw from a large research study assessing performance of the Botswana Ministry of Health (MoH to evaluate the performance of public hospital system using the World Health Organization Health Systems Performance Assessment Framework (WHO HSPAF. We aimed to evaluate performance of Botswana public hospital system; relate findings of the assessment to the potential for improvements in hospital performance; and determine the usefulness of the WHO HSPAF in assessing performance of hospital systems in a developing country. Methods This article is based on data collected from document analysis, 54 key informants comprising senior managers and staff of the MoH (N= 40 and senior officers from stakeholder organizations (N= 14, and surveys of 42 hospital managers and 389 health workers. Data from documents and transcripts were analyzed using content and thematic analysis while data analysis for surveys was descriptive determining proportions and percentages. Results The organizational structure of the Botswana’s public hospital system, authority and decision-making are highly centralized. Overall physical access to health services is high. However, challenges in the distribution of facilities and inpatient beds create inequities and inefficiencies. Capacity of the hospitals to deliver services is limited by inadequate resources. There are significant challenges with the quality of care. Conclusion While Botswana invested considerably in building hospitals around the country resulting in high physical access to services, the organization and governance of the hospital system, and inadequate resources limit service delivery. The ongoing efforts to decentralize management of hospitals to district level entities should be expedited. The WHO HSPAF enabled us to conduct a comprehensive assessment of the public hospital system. Though relatively new, this approach proved

Bacterial contamination on touch surfaces in the public transport system and in public areas of a hospital in London.

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Otter, J A; French, G L

2009-12-01

To investigate bacterial contamination on hand-touch surfaces in the public transport system and in public areas of a hospital in central London. Dipslides were used to sample 118 hand-touch surfaces in buses, trains, stations, hotels and public areas of a hospital in central London. Total aerobic counts were determined, and Staphylococcus aureus isolates were identified and characterized. Bacteria were cultured from 112 (95%) of sites at a median concentration of 12 CFU cm(-2). Methicillin-susceptible Staph. aureus (MSSA) was cultured from nine (8%) of sites; no sites grew methicillin-resistant Staph. aureus (MRSA). Hand-touch sites in London are frequently contaminated with bacteria and can harbour MSSA, but none of the sites tested were contaminated with MRSA. Hand-touch sites can become contaminated with staphylococci and may be fomites for the transmission of bacteria between humans. Such sites could provide a reservoir for community-associated MRSA (CA-MRSA) in high prevalence areas but were not present in London, a geographical area with a low incidence of CA-MRSA.

Public and private hospital services reform using data envelopment analysis to measure technical, scale, allocative, and cost efficiencies.

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Sheikhzadeh, Yaghoub; Roudsari, Abdul V; Vahidi, Reza Gholi; Emrouznejad, Ali; Dastgiri, Saeed

2012-01-01

The aim of this study was to suggest a suitable context to develop efficient hospital systems while maintaining the quality of care at minimum expenditures. This research aimed to present a model of efficiency for selected public and private hospitals of East Azerbaijani Province of Iran by making use of Data Envelopment Analysis approach in order to recognize and suggest the best practice standards. Among the six inefficient hospitals, 2 (33%) had a technical efficiency score of less than 50% (both private), 2 (33%) between 51 and 74% (one private and one public) and the rest (2, 33%) between 75 and 99% (one private and one public). In general, the public hospitals are relatively more efficient than private ones; it is recommended for inefficient hospitals to make use of the followings: transferring, selling, or renting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals or other health centers; pensioning off, early retirement clinic officers, technicians/technologists, and other technical staff. The saving obtained from the above approaches could be used to improve remuneration for remaining staff and quality of health care services of hospitals, rural and urban health centers, support communities to start or sustain systematic risk and resource pooling and cost sharing mechanisms for protecting beneficiaries against unexpected health care costs, compensate the capital depreciation, increasing investments, and improve diseases prevention services and facilities in the provincial level.

Communication satisfaction of professional nurses working in public hospitals.

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Wagner, J-D; Bezuidenhout, M C; Roos, J H

2015-11-01

This study aimed to establish and describe the level of communication satisfaction that professional nurses experience in selected public hospitals in the City of Johannesburg, South Africa. The success of any organisation depends on the effectiveness of its communication systems and the interaction between staff members. Data were collected by means of questionnaires, based on the Communication Satisfaction Questionnaire (CSQ), from a sample of 265 professional nurses from different categories, chosen using a disproportionate random stratified sampling method. The results indicated poor personal feedback between nurse managers (operational managers) and professional nurses, as well as dissatisfaction among nurse managers and professional nurses with regard to informal communication channels. A lack of information pertaining to policies, change, financial standing and achievements of hospitals was identified. Nurse managers should play a leadership role in bringing staff of different departments together by creating interactive communication forums for the sharing of ideas. The results emphasise the need for nurse managers to improve communication satisfaction at all levels of the hospital services in order to enhance staff satisfaction and create a positive working environment for staff members. © 2014 The Authors. Journal of Nursing Management Published by John wiley & Sons Ltd.

Characterization of hospitalizations due to external causes in the public health system, Brazil, 2011.

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Mascarenhas, Márcio Dênis Medeiros; Barros, Marilisa Berti de Azevedo

2015-01-01

The aim of this work is to describe the characteristics of hospital admissions owing to external causes in the public health system in Brazil in 2011. Data from the Hospital Information System of the Unified Health System (SIH/SUS) were analyzed to obtain the frequency, coefficient of hospitalization, and hospital morbidity indicators. Of the 973,015 admissions, falls (38.4%) predominated, followed by traffic accidents (15.8%). The estimated coefficient of hospitalization owing to external causes increased with the age, and it was higher in male patients and in the midwest region of the country. The average stay was higher in hospitalizations for traffic accidents (6.1 days) and assaults (6.0 days), while the hospital mortality rate reached higher values in hospitalizations for assaults (4.7%) and self-harms (4.0%). It is evident from the knowledge of the characteristics described the usefulness of hospital morbidity data for planning care actions and prevention of the external causes.

Value of Public Health Funding in Preventing Hospital Bloodstream Infections in the United States.

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Whittington, Melanie D; Bradley, Cathy J; Atherly, Adam J; Campbell, Jonathan D; Lindrooth, Richard C

2017-11-01

To estimate the association of 1 activity of the Prevention and Public Health Fund with hospital bloodstream infections and calculate the return on investment (ROI). The activity was funded for 1 year (2013). A difference-in-differences specification evaluated hospital standardized infection ratios (SIRs) before funding allocation (years 2011 and 2012) and after funding allocation (years 2013 and 2014) in the 15 US states that received the funding compared with hospital SIRs in states that did not receive the funding. We estimated the association of the funded public health activity with SIRs for bloodstream infections. We calculated the ROI by dividing cost offsets from infections averted by the amount invested. The funding was associated with a 33% (P < .05) reduction in SIRs and an ROI of $1.10 to $11.20 per $1 invested in the year of funding allocation (2013). In 2014, after the funding stopped, significant reductions were no longer evident. This activity was associated with a reduction in bloodstream infections large enough to recoup the investment. Public health funding of carefully targeted areas may improve health and reduce health care costs.

[Transparency in public sector acquisitions. The case of hospitals in the City of Buenos Aires].

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Rossi, T; Murillo Fort, C; Puente Karolys, J C

2002-01-01

This paper deals with corruption and the lack of transparency in public sector purchases as well as with the main instruments to obtain adequate results in purchase negotiation.Firstly, we discuss how corruption causes concern to national governments, international organizations, academic centers, non-governmental organizations and society in general. The consequences of corruption in Argentina and other Latin American countries are highlighted, especially the effect of corruption on economic growth and the way it creates economic inefficiency and inequality.Secondly, the database created by the Subsecretary of Strategic Management of the Autonomous Government of the City of Buenos Aires is analyzed. The central purpose of this study is to evaluate the impact of the Administrative Reform of 1998 on the prices of 24 products acquired by 13 general acute care hospitals from 1998-1999. The weighted prices, the number of units purchased and the total number of contracts given in this period, as well as the products with the greatest utilization rate, are analyzed. Multivariante analysis was used to identify hospitals with appropriate activity and efficient budget administration (activity and negotiation indicators). Price development was analyzed using the regression technique (ordinary least squares), which demonstrated an 8% reduction in prices for the year 1999. The contribution of each hospital to this variation is presented using dummy variables. Thus, six of the 13 hospitals significantly contributed to the decrease in prices. Of these six, three hospitals also contributed to reduction in price dispersion. The results obtained allow us to conclude that, if public hospitals have adequate purchase negotiation instruments and a uniform legal framework, they can achieve a good level of activity. Furthermore, public hospitals can contribute to reductions in price and price dispersion, at the same time as improving efficiency in the assignation and utilization of

Influence of Selected Factors on the Implementation of Information and Communication Technology Policy in Public Secondary Schools in Naivasha Sub-County, Kenya

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Francis, Njoroge Ngugi; Ngugi, Margaret; Kinzi, Joab

2017-01-01

The aim of this study was to examine the influence of selected factors on implementation of Information and Communication Technology in public secondary schools in Naivasha sub-county, Kenya. The study investigated whether the ICT infrastructural cost, schools' visions, and teachers' ICT skills hinder effective implementation of ICT policy in…

Breast and cervical cancer screening among women in metropolitan areas of the United States by county-level commuting time to work and use of public transportation, 2004 and 2006.

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Coughlin, Steven S; King, Jessica

2010-03-19

Commuting times and behaviors have been associated with a variety of chronic disease outcomes and health behaviors. We examined the relationships between ecologic measures of commuting time and use of public transportation in relation to breast and cervical cancer screening among women in U.S. metropolitan areas who participated in the 2004 and 2006 Behavioral Risk Factor Surveillance System (BRFSS) surveys. Self-reported county of residence was used to classify respondents as residents of metropolitan statistical areas (MSAs). Only BRFSS respondents who resided in the 39 MSAs with a population of > or = 1.5 million in 2007--representing a total of 337 counties--were included in this analysis. A total of 76,453 women aged > or = 40 years were included in analyses on mammography. Analyses on Pap testing were limited to women aged > or =18 years with no history of hysterectomy (n = 80,959). Area-based measures of socio-economic status (SES) were obtained by utilizing county-level information from the 2000 U.S. Census. With adjustment for age, no important associations were observed between receipt of a recent mammogram and either a county-level measure of commute time or residence in an area where more residents had access to a car. Similarly, women living in counties where at least four percent of the residents used public transportation were as likely to have had a recent mammogram or Pap test compared with women in areas where less than four percent of residents used public transportation. However, women living in counties where or = 3% of the residents had no access to a car (87.3% versus 84.5%; p-value for test for trend public transportation and having had a Pap test in the past 3 years, which was of borderline significance (adjusted OR 1.2, 95% CI 1.0-1.4, p = .05). In large U.S. metropolitan areas, transportation issues may play a role in whether a woman obtains cancer screening along with other factors (e.g., Hispanic ethnicity, low income, and no physician

Assessment of patient safety culture in private and public hospitals in Peru.

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Arrieta, Alejandro; Suárez, Gabriela; Hakim, Galed

2018-04-01

To assess the patient safety culture in Peruvian hospitals from the perspective of healthcare professionals, and to test for differences between the private and public healthcare sectors. Patient safety is defined as the avoidance and prevention of patient injuries or adverse events resulting from the processes of healthcare delivery. A non-random cross-sectional study conducted online. An online survey was administered from July to August 2016, in Peru. This study reports results from Lima and Callao, which are the capital and the port region of Peru. A total of 1679 healthcare professionals completed the survey. Participants were physicians, medical residents and nurses working in healthcare facilities from the private sector and public sector. Assessment of the degree of patient safety and 12 dimensions of patient safety culture in hospital units as perceived by healthcare professionals. Only 18% of healthcare professionals assess the degree of patient safety in their unit of work as excellent or very good. Significant differences are observed between the patient safety grades in the private sector (37%) compared to the public sub-sectors (13-15%). Moreover, in all patient safety culture dimensions, healthcare professionals from the private sector give more favorable responses for patient safety, than those from the public sub-systems. The most significant difference in support comes from patient safety administrators through communication and information about errors. Overall, the degree of patient safety in Peru is low, with significant gaps that exist between the private and the public sectors.

Childhood astrovirus-associated diarrhea in the ambulatory setting in a Public Hospital in Cordoba city, Argentina

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Giordano Miguel O.

2004-01-01

Full Text Available Human astroviruses have been increasingly identified as important agents of diarrheal disease in children. However, the disease burden of astrovirus infection is still incompletely assessed. This paper reports results on the epidemiological and clinical characteristics of astrovirus-associated diarrhea, as well as the impact of astrovirus infection on the ambulatory setting at a Public Hospital in Córdoba city, Argentina. From February 2001 through January 2002, 97 randomly selected outpatient visits for diarrhea among children 0.05. According to our estimation about one out of seventy-four children in this cohort would be assisted annually for an astroviral-diarrheal episode in the Public Hospital and one out of eight diarrheal cases could be attributed to astrovirus infection. Astrovirus is a common symptomatic infection in pediatric outpatient visits in the public hospital in the study area, contributing 12.37% of the overall morbidity from diarrhea.

Patient and public understanding and knowledge of antimicrobial resistance and stewardship in a UK hospital: should public campaigns change focus?

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Micallef, Christianne; Kildonaviciute, Kornelija; Castro-Sánchez, Enrique; Scibor-Stepien, Aleksandra; Santos, Reem; Aliyu, Sani H; Cooke, Fiona J; Pacey, Sarah; Holmes, Alison H; Enoch, David A

2017-01-01

The rising global tide of antimicrobial resistance is a well-described phenomenon. Employing effective and innovative antimicrobial stewardship strategies is an essential approach to combat this public health threat. Education of the public and patients is paramount to enable the success of such strategies. A panel of hospital multidisciplinary healthcare professionals was set up and a short quiz containing true/false statements around antimicrobial stewardship and resistance was designed and piloted. An educational leaflet with the correct replies and supporting information was also produced and disseminated. Participants were recruited on a single day (18 November 2015) from the hospital outpatient clinics and the hospital outpatient pharmacy waiting room. One hundred and forty-five completed quizzes were returned, providing a total of 1450 answers. Overall, 934 of 1450 (64%) statements were scored correctly whilst 481 (33%) were scored incorrectly; 35 (3%) statements were left unscored. We speculate that these results may demonstrate that respondents understood the statements, as only a small proportion of statements were left unanswered. The question dealing with the definition of antimicrobial resistance and the question dealing with the definition of antimicrobial stewardship obtained the most incorrect replies (85% and 72%, respectively). However, a specific factual recall question regarding only one microorganism (MRSA) received the most correct responses (99%). We describe a simple, innovative method of engagement with patients and the general public to help educate and disseminate important public health messages around antimicrobial resistance and stewardship. We also identified the need for public health campaigns to address the knowledge gaps found around this topic. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The Role of the Nobles-Philanthropists in the Activities of Hospitals in the Danube Region

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Nataliya Goncharova

2015-08-01

Full Text Available Reviews the legal and regulatory basis in the sphere of the guardianship treatment centres in the Russian Empire in the middle of the XIXth century, alleging the establishment of the public supervision over the activities of city, County and provincial hospitals. Contents of the powers of the Trustees, their objectives and main activities. Specific examples in the Danube region proved the thesis that among the Trustees were dominated by representatives of the nobility.

Session 1984-85. Radioactive waste. Minutes of evidence, Wednesday 26 June 1985. Association of Metropolitan Authorities; Association of County Councils; Bedford County Council

International Nuclear Information System (INIS)

1985-01-01

The Environment Select Committee of the House of Commons received a memorandum from the Association of Metropolitan Authorities on radioactive waste management, including: government policy; local authorities; administrative procedures; public opinion and public relations; planning; transport; NIREX; legal aspects; identification of specific disposal sites. Representatives of the Association were examined on the subject of the memorandum and the Minutes of Evidence are recorded. The Committee also received a memorandum from the Association of County Councils on planning, transportation and waste disposal considerations, including kinds and quantities of radioactive waste; safety and security; financial, administrative and political aspects; counties as planning authorities and waste disposal authorities. Representatives of the Association were examined on the subject of the memorandum. The Committee also received a memorandum from Bedford County Council on intermediate and low level radioactive waste management in the UK. Representatives of the County Council were examined on the subject of the memorandum. The Minutes of Evidence are recorded. (U.K.)

Limerick, City and County

OpenAIRE

2011-01-01

Postcard. Colour drawings of maps of Limerick city and county and Foynes - transatlantic air base flying boat, Dromore Castle, Glenstal Abbey, Ardagh Chalice, Askeaton; the Abbey, Gate Loge Adare Manor, Newcastlewest, King John's Castle, St. Mary's Cathedral (Church of Ireland), The Old Custom House, The Hunt Museum, The Old Mill and Bridge croom, The Coll (de Valera) Cottage Buree, Town Gate Kilmallock, Lough Gur Interpretive Centre, Hospital Ancient hostelry and The Treaty Stone. Copyright ...

Beyond NIMBYs and NOOMBYs: what can wind farm controversies teach us about public involvement in hospital closures?

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Stewart, Ellen; Aitken, Mhairi

2015-12-01

Many policymakers, researchers and commentators argue that hospital closures are necessary as health systems adapt to new technological and financial contexts, and as population health needs in developed countries shift. However closures are often unpopular with local communities. Previous research has characterised public opposition as an obstacle to change. Public opposition to the siting of wind farms, often described as NIMBYism (Not In My Back Yard), is a useful comparator issue to the perceived NOOMBYism (Not Out Of My Back Yard) of hospital closure protestors. The analysis of public attitudes to wind farms has moved from a fairly crude characterisation of the 'attitude-behaviour gap' between publics who support the idea of wind energy, but oppose local wind farms, to empirical, often qualitative, studies of public perspectives. These have emphasised the complexity of public attitudes, and revealed some of the 'rational' concerns which lie beneath protests. Research has also explored processes of community engagement within the wind farm decision-making process, and the crucial role of trust between communities, authorities, and developers. Drawing on what has been learnt from studies of opposition to wind farms, we suggest a range of questions and approaches to explore public perspectives on hospital closure more thoroughly. Understanding the range of public responses to service change is an important first step in resolving the practical dilemma of effecting health system transformation in a democratic fashion.

Costs of Dengue Control Activities and Hospitalizations in the Public Health Sector during an Epidemic Year in Urban Sri Lanka.

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Thalagala, Neil; Tissera, Hasitha; Palihawadana, Paba; Amarasinghe, Ananda; Ambagahawita, Anuradha; Wilder-Smith, Annelies; Shepard, Donald S; Tozan, Yeşim

2016-02-01

Reported as a public health problem since the 1960s in Sri Lanka, dengue has become a high priority disease for public health authorities. The Ministry of Health is responsible for controlling dengue and other disease outbreaks and associated health care. The involvement of large numbers of public health staff in dengue control activities year-round and the provision of free medical care to dengue patients at secondary care hospitals place a formidable financial burden on the public health sector. We estimated the public sector costs of dengue control activities and the direct costs of hospitalizations in Colombo, the most heavily urbanized district in Sri Lanka, during the epidemic year of 2012 from the Ministry of Health's perspective. The financial costs borne by public health agencies and hospitals are collected using cost extraction tools designed specifically for the study and analysed retrospectively using a combination of activity-based and gross costing approaches. The total cost of dengue control and reported hospitalizations was estimated at US$3.45 million (US$1.50 per capita) in Colombo district in 2012. Personnel costs accounted for the largest shares of the total costs of dengue control activities (79%) and hospitalizations (46%). The results indicated a per capita cost of US$0.42 for dengue control activities. The average costs per hospitalization ranged between US$216-609 for pediatric cases and between US$196-866 for adult cases according to disease severity and treatment setting. This analysis is a first attempt to assess the economic burden of dengue response in the public health sector in Sri Lanka. Country-specific evidence is needed for setting public health priorities and deciding about the deployment of existing or new technologies. Our results suggest that dengue poses a major economic burden on the public health sector in Sri Lanka.

Costs of Dengue Control Activities and Hospitalizations in the Public Health Sector during an Epidemic Year in Urban Sri Lanka

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Thalagala, Neil; Tissera, Hasitha; Palihawadana, Paba; Amarasinghe, Ananda; Ambagahawita, Anuradha; Wilder-Smith, Annelies; Shepard, Donald S.; Tozan, Yeşim

2016-01-01

Background Reported as a public health problem since the 1960s in Sri Lanka, dengue has become a high priority disease for public health authorities. The Ministry of Health is responsible for controlling dengue and other disease outbreaks and associated health care. The involvement of large numbers of public health staff in dengue control activities year-round and the provision of free medical care to dengue patients at secondary care hospitals place a formidable financial burden on the public health sector. Methods We estimated the public sector costs of dengue control activities and the direct costs of hospitalizations in Colombo, the most heavily urbanized district in Sri Lanka, during the epidemic year of 2012 from the Ministry of Health’s perspective. The financial costs borne by public health agencies and hospitals are collected using cost extraction tools designed specifically for the study and analysed retrospectively using a combination of activity-based and gross costing approaches. Results The total cost of dengue control and reported hospitalizations was estimated at US$3.45 million (US$1.50 per capita) in Colombo district in 2012. Personnel costs accounted for the largest shares of the total costs of dengue control activities (79%) and hospitalizations (46%). The results indicated a per capita cost of US$0.42 for dengue control activities. The average costs per hospitalization ranged between US$216–609 for pediatric cases and between US$196–866 for adult cases according to disease severity and treatment setting. Conclusions This analysis is a first attempt to assess the economic burden of dengue response in the public health sector in Sri Lanka. Country-specific evidence is needed for setting public health priorities and deciding about the deployment of existing or new technologies. Our results suggest that dengue poses a major economic burden on the public health sector in Sri Lanka. PMID:26910907

[Production chain supply management for public hospitals: a logistical approach to healthcare].

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Infante, Maria; dos Santos, Maria Angélica Borges

2007-01-01

Despite their importance for hospital operations, discussions of healthcare organization logistics and supply and materials management are notably lacking in Brazilian literature. This paper describes a methodology for organizing the supply of medical materials in public hospitals, based on an action-research approach. Interventions were based on the assumption that a significant portion of problems in Brazil's National Health System (SUS) facilities derive from the fact that their clinical and administrative departments do not see themselves as belonging to the same production chain - neither the hospital nor the supply department is aware of what the other produces. The development of the methodology and its main steps are presented and discussed, against a background of recent literature and total quality and supply chain management concepts.

Orthopedics nursing patients' profile of a public hospital in Salvador-Bahia.

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de Castro, Renata Reis Matutino; Ribeiro, Natália Fonseca; de Andrade, Aline Mendonça; Jaques, Bruno Dórea

2013-07-01

To describe the profile of patients treated in the trauma and orthopedics nursing of a trauma care referral public hospital of in the state of Bahia. Cross-sectional study in which data were collected from medical records of patients in the period from July to December 2008. The profile of the patients involved was formed by subjects mostly male young subjects, victims of trauma from accidents, especially those with motorcycles or car runover. On the other hand,the most frequent traumas associated with urban violence were perforations by gunshot and stab wounds. The primary injury presented by these individuals was exposed fracture of the femur and the most common treatment was external fixation. The most frequent in-hospital complication was wound infection, which required another surgical approach. Most inpatients were discharged and only one death was reported during this period. The results of this study corroborate those from other institutions in the country, which may contribute to elaborate public policies for accidents and violence prevention. Level of Evidence IV, Case Series.

Public health safety and environment in inadequate hospital and healthcare settings: a review.

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Baguma, D

2017-03-01

Public health safety and environmental management are concerns that pose challenges worldwide. This paper briefly assesses a selected impact of the environment on public health. The study used an assessment of environmental mechanism to analyse the underlying different pathways in which the health sector is affected in inadequate hospital and health care settings. We reviewed the limited available evidence of the association between the health sector and the environment, and the likely pathways through which the environment influences health. The paper also models the use of private health care as a function of costs and benefits relative to public care and no care. The need to enhancing policies to improve the administration of health services, strengthening interventions on environment using international agreements, like Rio Conventions, including measures to control hospital-related infection, planning for human resources and infrastructure construction development have linkage to improve environment care and public health. The present study findings partly also demonstrate the influence of demand for health on the environment. The list of possible interventions includes enhancing policies to improve the administration of health services, strengthening Rio Conventions implementation on environmental concerns, control of environmental hazards and public health. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Relative efficiency and productivity: a preliminary exploration of public hospitals in Beijing, China.

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Li, Hao; Dong, Siping; Liu, Tingfang

2014-04-06

Third-grade hospitals in Beijing have been rapidly developing in capacity and scale for many years. These hospitals receive a large number of patients, and ensuring their efficient operation is crucial in meeting people's healthcare needs. In this context, a study of their relative efficiency and productivity would be helpful to identify the driving factors and further improve their performance. After a review of literature, the current numbers of open beds and employees were selected as input variables. The number of outpatient and emergency visits and the number of discharged patients were selected as output variables. A total of 12 third-grade Class A general public hospitals in Beijing were selected for a preliminary study. The panel data from 2006-2009 were collected by the National Institute of Hospital Administration, Ministry of Health of P.R. China. Descriptive analysis and data envelopment analysis were used to analyze the data using Stata 10.0 and DEAP(V2.1) software. In the 2006-2009 period, descriptive results show that sample hospitals continuously expanded their capacity and scale, with growth rate of total revenue being the highest among all variables. The DEA results show that the average annual growth rate of productivity was 26.7%, and the rates were 47.3%, 21.3% and 13.8% respectively for two consecutive years. The average annual growth rate of technological change was 28.3%, and the rates were 49.4%, 21.5% and 16.4% respectively for two consecutive years. The average annual growth rate of technical efficiency change was -1.3%, and the rates were -1.4%, -0.02% and -2.2% respectively for two consecutive years. The sample hospitals in Beijing experienced substantial productivity growth, but annual growth rates were declining. Substantial technological change was the main contributor to the growth. Although some hospitals exhibited improvements in technical efficiency, there was a slight decline in general. To improve overall efficiency and

Relative efficiency and productivity: a preliminary exploration of public hospitals in Beijing, China

Science.gov (United States)

2014-01-01

Background Third-grade hospitals in Beijing have been rapidly developing in capacity and scale for many years. These hospitals receive a large number of patients, and ensuring their efficient operation is crucial in meeting people’s healthcare needs. In this context, a study of their relative efficiency and productivity would be helpful to identify the driving factors and further improve their performance. Methods After a review of literature, the current numbers of open beds and employees were selected as input variables. The number of outpatient and emergency visits and the number of discharged patients were selected as output variables. A total of 12 third-grade Class A general public hospitals in Beijing were selected for a preliminary study. The panel data from 2006–2009 were collected by the National Institute of Hospital Administration, Ministry of Health of P.R. China. Descriptive analysis and data envelopment analysis were used to analyze the data using Stata 10.0 and DEAP(V2.1) software. Results In the 2006–2009 period, descriptive results show that sample hospitals continuously expanded their capacity and scale, with growth rate of total revenue being the highest among all variables. The DEA results show that the average annual growth rate of productivity was 26.7%, and the rates were 47.3%, 21.3% and 13.8% respectively for two consecutive years. The average annual growth rate of technological change was 28.3%, and the rates were 49.4%, 21.5% and 16.4% respectively for two consecutive years. The average annual growth rate of technical efficiency change was -1.3%, and the rates were -1.4%, -0.02% and -2.2% respectively for two consecutive years. Conclusions The sample hospitals in Beijing experienced substantial productivity growth, but annual growth rates were declining. Substantial technological change was the main contributor to the growth. Although some hospitals exhibited improvements in technical efficiency, there was a slight decline in