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Sample records for public general hospital

  1. Alternate Level of Care Patients in Public General Hospital Psychiatry.

    Science.gov (United States)

    Marcos, Luis R.; Gil, Rosa M.

    1984-01-01

    Analyzes the interaction between psychiatric services in public general hospitals and in other institutional settings. A one-day census of patients in a New York general hospital showed the hospital was providing care to a large number of patients in need of other, less intensive institutional settings. (BH)

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

    Directory of Open Access Journals (Sweden)

    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

  3. Awareness and utilization of peer support programs in Singapore public general hospitals.

    Science.gov (United States)

    Chan, Angelina O M; Kee, Jass P C; Chan, Yiong Huak

    2012-01-01

    To address the effects of acute, chronic and cumulative stress in the healthcare environment in Singapore, the Ministry of Health provided funding to develop a comprehensive crisis response management system (peer support programs/PSPs) that increases mental health awareness, provides emotional support to affected staff during work-related critical incidents and assists hospital management to better understand the emotional needs of the employees. This paper reports the awareness and utilization of PSPs in Singapore public general hospitals about one year after they were set up.

  4. The Difference in the Online Medical Information Searching Behaviors of Hospital Patients and Their Relatives versus the General Public

    Science.gov (United States)

    Wang, Hung-Yuan; Liang, Jyh-Chong; Tsai, Chin-Chung

    2014-01-01

    The purpose of this study is two-fold: to explore the differences in online medical information searching behaviors, including evaluative standards and search strategies, of the general public (general group) and those of hospital patients and their relatives (hospital group); and to compare the predictive relationship between the evaluative…

  5. Using path analysis to examine causal relationships among balanced scorecard performance indicators for general hospitals: the case of a public hospital system in Taiwan.

    Science.gov (United States)

    Yang, Ming-Chin; Tung, Yu-Chi

    2006-01-01

    Examining whether the causal relationships among the performance indicators of the balanced scorecard (BSC) framework exist in hospitals is the aim of this article. Data were collected from all twenty-one general hospitals in a public hospital system and their supervising agency for the 3-year period, 2000-2002. The results of the path analyses identified significant causal relationships among four perspectives in the BSC model. We also verified the relationships among indicators within each perspective, some of which varied as time changed. We conclude that hospital administrators can use path analysis to help them identify and manage leading indicators when adopting the BSC model. However, they should also validate causal relationships between leading and lagging indicators periodically because the management environment changes constantly.

  6. Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital

    Science.gov (United States)

    2010-01-01

    Background The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. Methods A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co-workers and achievements) was used. Two categories of health care professionals, medical doctors and dentists (N = 67) and nurses (N = 219) participated and motivation and job satisfaction was compared across socio-demographic and occupational variables. Results The survey revealed that achievements was ranked first among the four main motivators, followed by remuneration, co-workers and job attributes. The factor remuneration revealed statistically significant differences according to gender, and hospital sector, with female doctors and nurses and accident and emergency (A+E) outpatient doctors reporting greater mean scores (p 55 years of age reported higher job satisfaction when compared to the other groups. Conclusions The results are in agreement with the literature which focuses attention to management approaches employing both monetary and non-monetary incentives to motivate health care professionals. Health care professionals tend to be motivated more by intrinsic factors, implying that this should be a target for effective employee motivation. Strategies based on the survey's results to enhance employee motivation are suggested. PMID:21080954

  7. Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital

    Directory of Open Access Journals (Sweden)

    Kontodimopoulos Nick

    2010-11-01

    Full Text Available Abstract Background The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. Methods A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co-workers and achievements was used. Two categories of health care professionals, medical doctors and dentists (N = 67 and nurses (N = 219 participated and motivation and job satisfaction was compared across socio-demographic and occupational variables. Results The survey revealed that achievements was ranked first among the four main motivators, followed by remuneration, co-workers and job attributes. The factor remuneration revealed statistically significant differences according to gender, and hospital sector, with female doctors and nurses and accident and emergency (A+E outpatient doctors reporting greater mean scores (p 55 years of age reported higher job satisfaction when compared to the other groups. Conclusions The results are in agreement with the literature which focuses attention to management approaches employing both monetary and non-monetary incentives to motivate health care professionals. Health care professionals tend to be motivated more by intrinsic factors, implying that this should be a target for effective employee motivation. Strategies based on the survey's results to enhance employee motivation are suggested.

  8. Attitudes and relationship between physicians and the pharmaceutical industry in a public general hospital in Lima, Peru.

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    Aldo De Ferrari

    Full Text Available BACKGROUND: The interaction between physicians and the pharmaceutical industry influences physicians' attitudes and prescribing behavior. Although largely studied in the US, this topic has not been well studied in resource-poor settings, where a close relationship between physicians and industry still exists. OBJECTIVE: To describe physician interactions with and attitudes towards the pharmaceutical industry in a public general hospital in Lima, Peru. DESIGN: Descriptive, cross-sectional study through an anonymous, self-filled questionnaire distributed among faculty and trainee physicians of five different clinical departments working in a Peruvian public general hospital. A transcultural validation of an existing Spanish questionnaire was performed. Exposure to marketing activities, motivations to contact pharmaceutical representatives and attitudes towards industry were studied. Collected data was analyzed by degree of training, clinical department, gender and teaching status. Attitudes were measured on a four-point LIKERT scale. RESULTS: 155 physicians completed the survey, of which 148 were included in the study sample. 94.5% of attending physicians reported ongoing encounters with pharmaceutical representatives. The most common industry-related activities were receiving medical samples (91.2%, promotional material (87.8% and attending meetings in restaurants (81.8%. Respondents considered medical samples and continuing medical education the most ethically acceptable benefits. We found significant differences between attendings and residents, and teaching and non-teaching attendings. An association between the amount of encounters with pharmaceutical representatives, and attitudes towards industry and acceptance of medical samples was found. CONCLUSIONS: A close physician-industry relationship exists in the population under study. The contact is established mainly through pharmaceutical representatives. Medical samples are the most received

  9. Attitudes and relationship between physicians and the pharmaceutical industry in a public general hospital in Lima, Peru.

    Science.gov (United States)

    De Ferrari, Aldo; Gentille, Cesar; Davalos, Long; Huayanay, Leandro; Malaga, German

    2014-01-01

    The interaction between physicians and the pharmaceutical industry influences physicians' attitudes and prescribing behavior. Although largely studied in the US, this topic has not been well studied in resource-poor settings, where a close relationship between physicians and industry still exists. To describe physician interactions with and attitudes towards the pharmaceutical industry in a public general hospital in Lima, Peru. Descriptive, cross-sectional study through an anonymous, self-filled questionnaire distributed among faculty and trainee physicians of five different clinical departments working in a Peruvian public general hospital. A transcultural validation of an existing Spanish questionnaire was performed. Exposure to marketing activities, motivations to contact pharmaceutical representatives and attitudes towards industry were studied. Collected data was analyzed by degree of training, clinical department, gender and teaching status. Attitudes were measured on a four-point LIKERT scale. 155 physicians completed the survey, of which 148 were included in the study sample. 94.5% of attending physicians reported ongoing encounters with pharmaceutical representatives. The most common industry-related activities were receiving medical samples (91.2%), promotional material (87.8%) and attending meetings in restaurants (81.8%). Respondents considered medical samples and continuing medical education the most ethically acceptable benefits. We found significant differences between attendings and residents, and teaching and non-teaching attendings. An association between the amount of encounters with pharmaceutical representatives, and attitudes towards industry and acceptance of medical samples was found. A close physician-industry relationship exists in the population under study. The contact is established mainly through pharmaceutical representatives. Medical samples are the most received and ethically accepted benefit. The attitudes of physicians on the

  10. Entrance surface dose and image quality: comparison of adult chest and abdominal X-ray examinations in general practitioner clinics, public and private hospitals in Malaysia.

    Science.gov (United States)

    Hambali, Ahmad Shariff; Ng, Kwan-Hoong; Abdullah, Basri Johan Jeet; Wang, Hwee-Beng; Jamal, Noriah; Spelic, David C; Suleiman, Orhan H

    2009-01-01

    This study was undertaken to compare the entrance surface dose (ESD) and image quality of adult chest and abdominal X-ray examinations conducted at general practitioner (GP) clinics, and public and private hospitals in Malaysia. The surveyed facilities were randomly selected within a given category (28 GP clinics, 20 public hospitals and 15 private hospitals). Only departmental X-ray units were involved in the survey. Chest examinations were done at all facilities, while only hospitals performed abdominal examinations. This study used the x-ray attenuation phantoms and protocols developed for the Nationwide Evaluation of X-ray Trends (NEXT) survey program in the United States. The ESD was calculated from measurements of exposure and clinical geometry. An image quality test tool was used to evaluate the low-contrast detectability and high-contrast detail performance under typical clinical conditions. The median ESD value for the adult chest X-ray examination was the highest (0.25 mGy) at GP clinics, followed by private hospitals (0.22 mGy) and public hospitals (0.17 mGy). The median ESD for the adult abdominal X-ray examination at public hospitals (3.35 mGy) was higher than that for private hospitals (2.81 mGy). Results of image quality assessment for the chest X-ray examination show that all facility types have a similar median spatial resolution and low-contrast detectability. For the abdominal X-ray examination, public hospitals have a similar median spatial resolution but larger low-contrast detectability compared with private hospitals. The results of this survey clearly show that there is room for further improvement in performing chest and abdominal X-ray examinations in Malaysia.

  11. QECH general hospital strike

    African Journals Online (AJOL)

    Malawi's only medical school and also hosts the Blantyre cam- pus for the ... 1993 when general civil disobedience in form of street demon- strations, riots and strikes ... However their own rights are limited by their responsibility to save life and ...

  12. Effort-reward and work-life imbalance, general stress and burnout among employees of a large public hospital in Switzerland

    National Research Council Canada - National Science Library

    Hämmig, Oliver; Brauchli, Rebecca; Bauer, Georg F

    2012-01-01

    .... The study was based on survey data collected in 2007 among the personnel of a large public hospital in the canton of Zurich covering a random sample of 502 employees of all professions and positions...

  13. Effort-reward and work-life imbalance, general stress and burnout among employees of a large public hospital in Switzerland.

    Science.gov (United States)

    Hämmig, Oliver; Brauchli, Rebecca; Bauer, Georg F

    2012-05-31

    Effort-reward imbalance (ERI) and work-life imbalance (WLI) are recognised risk factors for work stress and burnout but have not been investigated conjointly so far and compared with each other in this regard. The present cross-sectional study provides initial evidence by studying associations of ERI and WLI with general stress and burnout simultaneously. The study was based on survey data collected in 2007 among the personnel of a large public hospital in the canton of Zurich covering a random sample of 502 employees of all professions and positions. Prevalence rates, correlation coefficients, standardised regression coefficients and odds ratios were calculated as measures of association. Concerning the main research question and relating to the entire study sample, WLI was found to be more strongly associated with general stress and burnout than ERI. As stratified analyses with regard to burnout have shown, this applied especially to nursing, technical care and emergency staffs who account for more than three fifths of the study population. But for other professional categories like physicians, therapists and medical-technical personnel the opposite of a stronger association of ERI with burnout was found. Results also suggested that general stress plays a (rather minor) mediating role in the relationships between ERI and burnout and particularly between WLI and burnout. For the prevention of chronic stress and burnout one should consider both high efforts put into work as well as all job demands that are competing and interfering with family responsibilities or other private activities should be considered.

  14. Data on motivational factors of the medical and nursing staff of a Greek Public Regional General Hospital during the economic crisis

    Directory of Open Access Journals (Sweden)

    Marianna Charalambous

    2017-04-01

    Full Text Available In this article, we present the data related to motivational factors given by the medical (n=118 and nursing (n=217 staff, of a Greek Public General Hospital during a period of financial austerity. The data collection has been based on a structured self-administrable questionnaire which was used in a previous survey in Cyprus (Chatzicharalambous, 2015 [1]. The incentives-rewards included amount in a total to 11 (both financial and non-financial. The data contains 4 parts: (1 demographics, (2 assessment of the degree to which this hospital provided such incentives-rewards, (3 personal assessment of the participants about the significance of these incentive-rewards and (4 to what extent these incentives-rewards have increased or decreased over the last five years due to the economic crisis. The sample was analyzed as a whole on demographics and by a professional subgroup (doctors and nurses for the other three parts. The data include quantitative tables for all parts. Finally include three tables contain multilevel models.

  15. [Institutional support as a method of analysis-intervention in the context of public health policies: the experience in a general hospital].

    Science.gov (United States)

    Barros, Maria Elizabeth Barros de; Guedes, Carla Ribeiro; Roza, Monica Maria Raphael

    2011-12-01

    The article addresses the elaboration of a method for analysis/intervention in the sphere of public health policies. It describes the introduction of the National Humanization Policy of the Unified Health System (SUS) in a general hospital. It proposes institutional support expressed as a method for doing things that seeks the creation of group action, work process analysis and involves examining work management methods. It relies on promotion of health, which implies the production of subjects. The promotion of health is a networking process that involves individuals, work processes, knowledge and power. The challenge of supporting this network is to foster the exercise of the role of individuals and summon the inherent creative potential of life for the construction of new ways of work management that are not new forms of subjection. The study aims to show that by means of institutional support it is possible to bring to the fore the forces involved in the promotion of health and thereby summon the groups for an analysis of its implications. The effects produced indicate that this is a powerful strategy for the intervention of work processes within the scope of public health policies.

  16. 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.

  17. Private and public patients in public hospitals in Australia.

    Science.gov (United States)

    Shmueli, Amir; Savage, Elizabeth

    2014-04-01

    The nature of the private-public mix in health insurance and in health care is a major issue in most health systems. To compare the hospitalization characteristics of private and public patients hospitalized in public hospitals. We focused on planned, overnight and same-day admissions, discharged during 2004-2005 from the public New South Wales hospitals, and run fixed-effects regressions in order to identify the effect of accommodation status (private/public) on the hospitalization characteristics. Private patients have one third less waiting days than public patients, and they are assigned higher urgency of admission. Length of stay and length of visit are both unrelated to the accommodation status, however, private patients tend to have more hours in ICU and more procedures performed during the hospitalization. In-hospital mortality and the number of transfers (wards) are not affected by the accommodation status. Private patients are treated differently than public patients in public hospitals, reinforcing the private health insurance-related inequity in inpatient care identified by others. Two health policy issues emerge from the findings: the role of private health insurance in the Australian socialized medicine system, and in particular, in the public hospitals; and the way public hospitals are reimbursed for private patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. 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.

  19. 我国综合性公立医院价值观倾向的特征研究%Characteristic Analysis of Organizational Values of Public General Hospitals in China

    Institute of Scientific and Technical Information of China (English)

    白飞; 张俊超; 常继乐; 黄金星; 周萍; 薛迪

    2013-01-01

    通过对我国东、中、西3省(直辖市)9个地区的78所综合性公立医院的13组价值观的倾向性调查,试图了解目前我国综合性公立医院的价值观面貌的特征.研究显示,我国综合性公立医院价值观倾向有较大的趋同性.对不同战略定位类型的医院分析显示,B类医院价值观倾向普遍趋向弱势,值得关注.%The article made a characteriStic analysis on organizational values of public general hospitals based on the surveying data from 78 public general hospitals in 9 regions of 3 provinces locating in eastern,central,western areas in China.It was found that public general hospitals shared common orientation feature.It deserved attention that the hospitals with Strategic-Positioning-B universally had lower values.

  20. [Family and psychiatric hospitalization in a general hospital].

    Science.gov (United States)

    de Mello, Rita Mello; Schneider, Jacó Fernando

    2011-06-01

    This study aims to identify the reasons that lead relatives to hospitalize patients in a psychiatric unit of a general hospital. It is a qualitative study based on Alfred Schutz' phenomenological sociology. Fourteen relatives, each with one family member hospitalized, were interviewed from August to October 2009. The guiding question of the phenomenological interview was "What do you expect from psychiatric hospitalization in a general hospital?". Phenomenological sociology was used to understand and interpret the interviews. Statements showed three concrete categories, that lead to the reasons for: treatment guidelines and continuity; prospects for improvement; ideas about normality. This research shows the experiences of relatives, contributing with mental health professionals' reflection about their actions and about the involvement of families in a general hospital's psychiatric unit.

  1. 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

  2. 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.

  3. [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.

  4. 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.

  5. Research on a tool for organizational culture assessment of public general hospitals in China%公立医院组织文化测评量表研究

    Institute of Scientific and Technical Information of China (English)

    周萍; 常继乐; 黄金星; 李岚; 唐智柳; 黄葭燕; 伍蓉; 薛迪

    2011-01-01

    Objective A scientific evaluation of hospital culture with the Dimension organizational culture model, in view of features of China's general public hospitals.Methods Based on Denison model, according to the characteristics of the public general hospitals in China, the authors developed a tool for organizational culture assessment (TOCA) by using the survey data from 87 hospitals in three provinces from the East, Central, and West areas in China.Results This tool, an evaluation scale, comprises the four cultural characteristics of direction, consistency, participation, and adaptability, as well as 13 cultural dimensions of social responsibility and competitive consciousness. The tool is tested as having good internal reliability and validity.Conclusion The TOCA provides hospital administrators with a tool for hospital culture evaluation, diagnosis and improvement.%目的借鉴Denison组织文化模型,结合我国公立综合性医院特点,科学测评医院文化.方法 运用我国东、中、西3省/直辖市的87所医院的调查数据,研究设计了医院文化测评量表.结果 医院文化测评量表包括方向性、一致性、参与性、适应性4大文化特性以及社会责任、竞争意识在内的13个文化维度,经检验,量表具有良好的内部信度和效度.结论 医院文化测评量表为医院管理者进行医院文化测评、诊断和改善提供了测评工具.

  6. Study on the Types of Strategic Positioning of Public General Hospitals in China%我国公立综合性医院战略定位类型研究

    Institute of Scientific and Technical Information of China (English)

    周萍; 常继乐; 黄金星; 白飞; 王评; 唐智柳; 伍蓉; 黄葭燕; 薛迪

    2011-01-01

    借鉴经营战略相关理论,结合我国特点,从业务定位、市场定位和竞争态势定位对我国公立综合性医院的战略定位分类进行了研究.通过对我国东、中、西三省/直辖市公立综合性医院的抽样调查,课题组将其战略定位分为5类,并分析了5类战略定位在公立综合性医院中的分布.%Based on the relative theories for business strategy and the Chinese characteristics, the paper studied the types of strategic positioning of public general hospitals from business positioning, market positioning and competitive positioning, Five types of strategic positioning were classified and their distribution among public general hispitals in China were analyzed by the survey of public general hospitals in three provinces located in eastern, middle and western areas of China

  7. Mathematical Articles for the general public

    DEFF Research Database (Denmark)

    Hansen, Vagn Lundsgaard

    2003-01-01

    Report on an article competition for mathematical articles addressing the general public arranged by the European Mathematical Society.......Report on an article competition for mathematical articles addressing the general public arranged by the European Mathematical Society....

  8. Mathematical Articles for the general public

    DEFF Research Database (Denmark)

    Hansen, Vagn Lundsgaard

    2003-01-01

    Report on an article competition for mathematical articles addressing the general public arranged by the European Mathematical Society.......Report on an article competition for mathematical articles addressing the general public arranged by the European Mathematical Society....

  9. 上海市浦东新区公立综合性医院病人安全氛围评价%Evaluation on patient safety climate in public general hospitals in Pudong New Area of Shanghai

    Institute of Scientific and Technical Information of China (English)

    蔡美玉; 顾建钧; 贺晓燕; 俞步青; 孙昕; 周萍; 廖兴斌; 薛迪

    2015-01-01

    目的:评价上海市浦东新区区属公立综合性医院的病人安全氛围。方法:采用病人安全氛围测评量表,对浦东新区7家综合性医院1353位员工进行问卷调查。结果:员工对医院病人安全氛围总体评价良好,但对不害怕受羞辱、不害怕受责备、未见不良结果维度的评价较低,管理者和受过质控培训的员工评价较高。结论:医院应加强医院病人安全文化的建设,避免医疗差错重复发生。%Objective:The study aims to evaluate the patient safety climate in public general hospitals in Pudong New Area of Shanghai. Methods:Questionnaire survey of 1 353 employees in seven public general hospitals of Pudong New Area was conducted. An assessment tool for patient safety climate was used. Results:Overall,the perception of employees on patient safety climate was positive,but the perceptions of employees on“not fear of shame”,“not fear of blame”and“no adverse outcomes”dimensions were negative. In addition,the hospital managers and the employees who had got training on quality control had more positive perception on patient safety climate. Conclusion:Hospitals should construct patient safety culture to avoid repeated medical errors.

  10. [Crisis unit at the general hospital: Determinants of further hospitalization].

    Science.gov (United States)

    Norotte, C; Omnès, C; Crozier, C; Verlyck, C; Romanos, M

    2016-10-10

    The availability of short-stay beds for brief admission (less than 72hours) of crisis patients presenting to the emergency room is a model that has gained a growing interest because it allows time for developing alternatives to psychiatric hospitalization and favors a maintained functioning in the community. Still, the determinants influencing the disposition decision at discharge after crisis intervention remain largely unexplored. The primary objective of this study was to determine the factors predicting aftercare dispositions at crisis unit discharge: transfer for further hospitalization or return to the community. Secondary objectives included the description of clinical and socio-demographic characteristics of patients admitted to the crisis unit upon presentation to the emergency room. All patients (n=255) admitted to the short-stay unit of the emergency department of Rambouillet General Hospital during a one-year period were included in the study. Patient characteristics were collected in a retrospective manner from medical records: patterns of referral, acute stressors, presenting symptoms, initial patient demand, Diagnostic and Statistical Manual, 5th edition (DSM-5) disorders, psychiatric history, and socio-demographic characteristics were inferred. Logistic regression analysis was used to determine the factors associated with hospitalization decision upon crisis intervention at discharge. Following crisis intervention at the short-stay unit, 100 patients (39.2%) required further hospitalization and were transferred. Statistically significant factors associated with a higher probability of hospitalization (P<0.05) included the patient's initial wish to be hospitalized (OR=4.28), the presence of a comorbid disorder (OR=3.43), a referral by family or friends (OR=2.89), a history of psychiatric hospitalization (OR=2.71) and suicidal ideation on arrival in the emergency room (OR=2.26). Conversely, significant factors associated with a lower probability of

  11. Hospital Patients and Handicapped Readers Section and Round Table of Libraries for the Blind. Libraries Serving the General Public Division. Papers.

    Science.gov (United States)

    International Federation of Library Associations, The Hague (Netherlands).

    Papers on hospital and health libraries and library services to the blind and deaf which were presented at the 1982 International Federation of Library Associations conference include: (1) "Leisure Pursuits of the Blind" by Antun Lastric (Yugoslavia); (2) "Library Services for the Handicapped in Canada: An Overview" by…

  12. [Work as subsistence in Brazilian public hospitals].

    Science.gov (United States)

    Vaghetti, Helena Heidtmann; Padilha, Maria Itayra; da Silva, Rosimeri Carvalho; de Almeida Simões, Jorge Manuel Trigo

    2009-01-01

    That was a review study that aimed to analyze the interpretations that authors of dissertations and thesis about the meanings expressed by health workers, about the relations of subsistence with the job, in the organizational culture of public hospitals in Brazil. Data were extracted from from dissertations and theses in the period from 2002 to 2006. The theoretical methodological reference laid in the interpretive anthropology by Clifford Geertz. The results point that the subsistence relations conduct to alienation from work. The payment generates economic non satisfaction that pry the need to have other jobs. The work stability feeds the disengagement and actions that stimulates the transgression of standards and help the own governs in public hospitals in Brazil.

  13. Evaluation of Outpatient Antibiotic Use in Beijing General Hospitals in 2015

    Directory of Open Access Journals (Sweden)

    Chuan Yang

    2017-01-01

    Conclusions: Antibiotic use in Beijing general hospitals is generally low; however, inappropriate antibiotic use still exists. Inappropriately used antibiotics should be subject to rigorous control and management, and public policy initiatives are required to promote the judicious use of antibiotics.

  14. Profile of hospital care for external causes in public hospitals

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    Marlos Victor Fonsêca de Lima

    2012-04-01

    Full Text Available This study aimed to identify the profile of external causes in the emergency room of a public reference hospital in the state. Descriptive research document with a quantitative approach. The data analysis revealed that from January to December 2009 were made 4464 external causes. The higher frequency of injuries occurred in individuals aged 21 to 40 years (37.70%, males (68.6%. Regarding the causes, falls (29% was the biggest variable, followed by motorcycle accidents (17.98%, domestic accidents (16.53%, physical abuse (10.43% and bicycle accident (8, 84%. It was observed that 23.3% of the visits made to the emergency room were the people coming from surrounding municipalities. The study revealed the need to improve the quality of information about the grievances motivated by external causes, which are major causes of hospitalization and health care expenses.

  15. Informal payments in public hospitals in Greece.

    Science.gov (United States)

    Liaropoulos, Lycourgos; Siskou, Olga; Kaitelidou, Daphne; Theodorou, Mamas; Katostaras, Theofanis

    2008-07-01

    Informal payments are an ingrained social institution in Greece. In some cases, they are also part of corruption in the health area, which includes a variety of other forms. The objective of this paper is to measure and analyze the size and nature of informal payments in the Greek public hospitals, concentrating on payments made to health personnel to facilitate access to services and preferred providers. We used a randomized countrywide sample of 1616 households, amounting to 4738 individuals. The survey methodology was telephone interviews with a questionnaire supported by the software of Computer Assisted Telephone Interviewing. Out of the total number of those reporting treatment in public hospitals (N=336), 36% reported at least one informal payment to a doctor. Of these, 42% reported it was given because of the fear of receiving sub-standard care (if they did not pay) and another 20% claimed that the doctor demanded such a payment. None of the socio-economic characteristics of the family were related to the size of extra (informal) payments. The probability of extra payments is 72% higher for patients aiming to "jump the queue", compared to those admitted through normal procedures. Also, surgical cases had a 137% higher probability for extra payments compared to non-surgical patients. A very high percentage of informal payments are made in order to gain access to public hospitals and to receive a higher quality of services. Despite near universal coverage of the population by public health insurance, informal payments are widespread and a major source of inequity and inefficiency in the Greek health care system.

  16. Job satisfaction among nurses in a public hospital in Gauteng

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    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.

  17. Readmissions at a public safety net hospital.

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    Eri Shimizu

    Full Text Available OBJECTIVE: We aimed to determine factors related to avoidability of 30-day readmissions at our public, safety net hospital in the United States (US. METHODS: We prospectively reviewed medical records of adult internal medicine patients with scheduled and unscheduled 30-day readmissions. We also interviewed patients if they were available. An independent panel used pre-specified, objective criteria to adjudicate potential avoidability. RESULTS: Of 153 readmissions evaluated, 68% were unscheduled. Among these, 67% were unavoidable, primarily due to disease progression and development of new diagnoses. Scheduled readmissions accounted for 32% of readmissions and most (69% were clinically appropriate and unavoidable. The scheduled but avoidable readmissions (31% were attributed largely to limited resources in our healthcare system. CONCLUSIONS: Most readmissions at our public, safety net hospital were unavoidable, even among our unscheduled readmissions. Surprisingly, one-third of our overall readmissions were scheduled, the majority reflecting appropriate management strategies designed to reduce unnecessary hospital days. The scheduled but avoidable readmissions were due to constrained access to non-emergent, expensive procedures that are typically not reimbursed given our system's payor mix, a problem which likely plague other safety net systems. These findings suggest that readmissions do not necessarily reflect inadequate medical care, may reflect resource constraints that are unlikely to be addressable in systems caring for a large burden of uninsured patients, and merit individualized review.

  18. The General Hospital Colombo Rehabilitation Project.

    Science.gov (United States)

    Jayasuriya, L

    1992-12-01

    The General Hospital Colombo (GHC) Rehabilitation Project was to be implemented in 6 phases in about 25 years. The proposed funding was a grant of 100% from Finland for technical assistance and training, and 85% for investments. The development objective was to reinforce the status of the hospital as the apex of the medical care system. In Phase I (1985-1990) an 8 storeyed accident and orthopaedic services building with modern facilities has been commissioned. A water tower and a 'septic' operating theatre have been built. Infection control and maintenance organizations have been started. Phase I cost Rs.960 million. In the Bridging Phase, the existing six storeyed building is being renovated. Phase II has been drastically curtailed. It will concentrate on infrastructure development such as water supply, kitchen, stores and transport, and the construction of four new medical wards. The project will end in 1993.

  19. 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...

  20. Use of neuroleptics in a general hospital

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    Castellanos Virgilio

    2002-05-01

    Full Text Available Abstract Background This study investigates the clinical use of neuroleptics within a general hospital in acutely ill medical or surgical patients and its relation with dementia three months after admission compared with control subjects. Methods Cases were defined as every adult patient to whom a neuroleptic medication was prescribed during their hospitalization in our Hospital from February 1st, to June 30th, 1998. A control matched by age and sex was randomly selected among patients who had been admitted in the same period, in the same department, and had not received neuroleptics drugs (205 cases and 200 controls. Demographic, clinical and complementary data were compared between cases and controls. Crude odds ratios estimating the risk of dementia in non previously demented subjects compared with the risk in non-demented control subjects were calculated. Results 205 of 2665 patients (7.7% received a neuroleptic drug. The mean age was 80.0 ± 13.6 years and 52% were females. They were older and stayed longer than the rest of the population. Only 11% received a psychological evaluation before the prescription. Fifty two percent were agitated while 40% had no reason justifying the use of neuroleptic drug. Three months after neuroleptic use 27% of the surviving cases and 2.6% of the surviving controls who were judged non-demented at admission were identified as demented. Conclusions The most common reason for neuroleptic treatment was to manage agitation symptomatically in hospitalised patients. Organic mental syndromes were rarely investigated, and mental status exams were generally absent. Most of neuroleptic recipients had either recognised or unrecognised dementia.

  1. Brazil's Mixed Public and Private Hospital System.

    Science.gov (United States)

    Lewis, Maureen; Penteado, Evandro; Malik, Ana Maria

    2015-01-01

    Brazil's hospital sector is vibrant and growing. Under the 1988 Brazilian constitution all citizens have the right to health care, anticipating the global commitment to Universal Health Care. Brazil's public sector prides itself on having one of the world's largest single payer health care systems, but complementing that is a significant and larger private sector that is seeing big increase in investment, utilization and prices. This article outlines the structure of the hospital system and analyzes the nature and direction of private health sector expansion. Twenty-six percent of Brazilians have private health insurance and although coverage is concentrated in the urban areas of the Southeastern part of the country, it is growing across the nation. The disease burden shift to chronic diseases affects the nature of demand and the directly affects overall health care costs, which are rising rapidly outstripping national inflation by a factor of 3. Increasingly costs will have to be brought under control to maintain the viability of the private sector. Adaption of integrated care networks and strengthening of the public reimbursement system represent important areas for improvement.

  2. CONSUMER'S SATISFACTION MEASUREMENT IN PUBLIC HOSPITALS

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    Andreea Cipriana MUNTEAN

    2015-02-01

    Full Text Available Customer satisfaction is an important indicator in determining the future coordinates of any entrepreneurial activity, be it company, institution or non-governmental organization. Our research is performed in the public hospital units from Alba County. The purpose of this paper is to identify an instrument for measuring the satisfaction of consumers of health services respectively patients. The questionnaire has led to validate/invalidate the working hypotheses assumed at the start of the study. We also found data regarding the place of activities of the respondents to the questionnaire, in order to see further what extent the employment rebounds on achieving the service tasks and responsibilities and the involvement physicians in decision making. In other words, we observed specific influence of the working environment of those.

  3. Neuritic Patient at Sanglah General Hospital Denpasar

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    Ni Putu Dita-Rinjani

    2012-05-01

    Full Text Available Objective: Treatment of optic neuritic as recommended by the Optic Neuritic Treatment Trial (ONTT was intravenous methylprednisolon followed by oral prednisone. This study aims to describe  characteristics and response to intravenous methylprednisolon followed by oral prednisone treatment of optic neuritic patient in Sanglah General Hospital Denpasar. Method: This report is an analytical cross sectional study. Data were collected retrospectively from medical report of optic neuritic patient who came to Sanglah General Hospital during a period of January 1st 2010 until December 31st 2011. Patient characteristics were analyzed with descriptive analyses and presented as frequency, percentage, mean and standar deviation. Visual acuity and contrast sensitivity improvement after intravenous methylprednisolon followed by oral prednisone treatment were statistically analyzed with Wilcoxon test Results:  Optic neuritic were found in twenty-three patients (33 eyes, majority was in age group of 15-40 years (56.5% with female predominance (65.2% and unilateral involvement was 56.3%. Mean onset patient presented to the hospital was 21.7±2.21 days and the most common symptom was decreasing vision (87.9%.  The majority of patient presented with papillitis (54.5%, totally color blindness found in 39.4% eyes, and the type of visual field defect at presentation was central scotoma (18.2%. All cases show lesion of optic nerve from visual evoked potential (VEP examination and magnetic resonance imaging (MRI shows normal results (39.1% patient. The mean of pretreatment logMAR visual acuity and contrast sensitivity were significant improve after treatment from 1.59±0.47 to 0.59±0.62 (p=0.0001 and 0.31±0.56 to 1.25±0.56 (p=0.0001, respectively. All cases in this study were idiopathic. Recurrences were seen in 2 eyes and none of patient had clinical features suggestive of multiple sclerosis. Conclusions: Visual acuity and contrast sensitivity improvement

  4. Status of radiological services in Addis Ababa public hospitals.

    Science.gov (United States)

    Shimelis, Dagmawit; Tsige, Mesfin; Atnafu, Asfaw

    2011-07-01

    The availability and quality of radiological service in the developing countries are generally poor. Ethiopia is one of the countries where overall health service has been compromised by inadequate & poorly maintained infrastructure and scarcity of health professionals. Radiological service is a resource intensive unit in a hospital and most developing countries radiological service is expected to be poor or may not be available at all. However, there is no study conducted to assess the radiological service in Ethiopia. The aim of the study is to assess the status of radiological service in all public hospitals in Addis Ababa, capital of Ethiopia, and to render insight to the overall national service status. A cross sectional survey was conducted from Aug 2008 to Oct 2009 G C in all twelve public hospitals in Addis Ababa, including specialized and military hospitals. Self administered pre-tested questioners were used to collect data from key informants, chief radiographers and radiologist. In addition, departmental daily work record book was used to extract the type of radiological examination performed Data analysis was done manually. All hospitals in the study provide a basic level of radiological services. Plain x-ray and ultrasound is the type of service (100%) available, whereas services like mammography (9%), CT scan (18%) and MRI (0%) were found to be the least available. There are a total of 78 radiographers and 20 radiologists in Addis Ababa public hospitals with no radiologist in three. The average number of examinations performed in a year amounts to 113,204 and US and routine x-ray examinations account for nearly 98% of the service offered The study showed 25% of the radiological equipments are non-functional and no appropriately trained dark room technicians & no maintenance staffpresent in all hospitals This study verifies the poor radiological infrastructure, poor level of support and the basic nature of the radiological service in the capital. We

  5. Qualitative analysis of direction of public hospital reforms in China.

    Science.gov (United States)

    Zhao, Dahai; Zhang, Zhiruo

    2017-07-03

    Reforms in public hospitals are among the most important improvements in China's health care system over the last two decades. However, the reforms that should be implemented in public hospitals are unclear. Thus, a feasible direction of reforms in Chinese public hospitals is suggested and reliable policy suggestions are provided for the government to reform public hospitals. The data used in this study were mainly derived from a qualitative study. Focus group discussions and in-depth interviews were conducted in Shanghai, Guangdong, and Gansu between May and December 2014. Government funding accounted for approximately eight percent of the total annual revenue of public hospitals in China, and the insufficient government subsidy considerably affects the operation mechanism of public hospitals. However, solely increasing this subsidy cannot address the inappropriate incentives of public hospitals in China. The most crucial step in setting the direction of reforms in public hospitals in China is transforming inappropriate incentives by implementing a new evaluation index system for directors and physicians in public hospitals.

  6. Rising caesarean section rates in public hospitals in Malaysia 2006.

    Science.gov (United States)

    Ravindran, J

    2008-12-01

    The caesarean section rate in Malaysian public hospitals has increased to 15.7% from 10.5% in the year 2000. There are inter-state variations in the rate ranging from a high of 25.4% in Melaka to 10.9% in Sabah. The West Coast states generally had a higher caesarean section rate than the East Coast states as well as East Malaysia. It would be prudent for Malaysia to implement stringent caesarean audits to ensure that rising caesarean section rates are kept in check.

  7. [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.

  8. [Neuropediatric healthcare demand in a general hospital].

    Science.gov (United States)

    Herrera Martín M; Gracia Remiro R; Santana Rodríguez C; Jiménez Moya A; Ayala Curiel J; Cuadrado Bello P

    2000-08-01

    The few existing studies on the demand for neuropediatric care in Spain offer information of enormous value, contributing to our knowledge of this specialty and of the needs of specialists and their training, as well as to the correct planning and use of economic and human resources. To determine the real demand, predominant disorders and usefulness of complementary examinations with a view to determining the need for neuropediatric care in a general hospital. Descriptive, retrospective study of patients attending the neuropediatric department for the first time during a 7-year period and for follow-up visits during a 4-year period. The periods were randomly selected. During this period 1130 children, generating 5033 consultations, were assessed. The total number of visits amounted to 25% of all consultations in the Pediatric Department, involving 31% of the children under 14 years of age in the pediatric population of Segovia. The overall rate of reexaminations/new patients was 3.4. The most frequent diagnosis was headache (32%), followed by non-epileptic paroxysms, febrile convulsions and epilepsy. The disorders requiring the greatest number of follow-up consultations were epilepsy (20%), headache (9%) and febrile convulsions (5%). The rate of reexamination/new patients was significantly higher in pediatric cerebral palsy and epilepsy. Electroencephalogram was the most frequently requested complementary examination, followed by neuroradiological studies. Demand for neuropediatric care mainly involves headaches, epilepsy, convulsions, non-epileptic paroxysmal disorders, and neonatal neurology in the first years of life. Pressure on neuropediatric departments is great due to the number of patients attending consulting rooms because of functional or self-limiting disorders. This pressure could be reduced by appropriate neurological training of general pediatricians or family doctors.

  9. Public hospitals: the legal obstacles of entering into joint ventures.

    Science.gov (United States)

    Miller, J N

    1986-03-01

    Public hospitals, as public entities, are limited in many of their activities by state constitutions and statutes. One area where activity can be particularly limited is the joint venture. Constitutional and statutory limitations can influence several aspects of the joint venture: scope of activities, geographic boundaries, authority to enter into joint ventures, gift of public funds prohibition, and stock ownership. Therefore, public hospitals must be aware of possible legal obstacles and carefully consider their options.

  10. 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.

  11. BIOMEDICAL SOLID WASTE MANAGEMENT PRACTICES IN MAJOR PUBLIC HOSPITALS OF SHIMLA CITY

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    Saurabh

    2014-04-01

    Full Text Available BACKGROUND: The actual biomedical waste management situation in the democratic developing country like India is grim. Even though there are Rules stipulating the method of safe disposal of Bio-medical Waste (BMW, hospital waste generated by Government Hospitals is still largely being dumped in the open, waiting to be collected along with general waste. OBJECTIVES: To assess the waste handling and treatment system of hospital bio-medical solid waste METHODOLOGY: A Cross sectional study was conducted in the major public hospitals of Shimla city. The study comprised of cross sectional survey of the personnel handling and monitoring the biomedical waste and observational survey of the hospitals using INCLEN (International Clinical Epidemiology Network data collection tools. RESULTS: The results were described under quantification of waste, segregation and collection, transport, storage, offsite transport, final treatment and disposal, occupational safety. The mean hazardous biomedical waste generated by the major public hospitals was found to be 191.5 g/bed/day (SD 93.83. In 91(86.1% of the patient care areas of the hospitals segregation of the wastes was not observed. None of the patient care areas had designated waste route inside the hospital. All the hospitals except one public hospital had central waste storage facility. Only two of the hospitals (public hospitals had a central storage cum treatment facility. None of the cleaning workers were using complete personal protective measures in any of the public hospitals. CONCLUSION: All major public hospitals of Shimla city in the study area practice poor management of biomedical wastes. The practices for segregation, transportation, storage and treatment and disposal of wastes generated at the major hospitals need change and major improvements

  12. 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.

  13. [Treatment with tuberculostatic drugs: compliance at a general hospital].

    Science.gov (United States)

    Polo Friz, H; Kremer, L; Acosta, H; Abdala, O; Canova, S; Rojo, S; Roca, G; Daín, A

    1997-01-01

    The purpose of this study was to assess the compliance with tuberculostatic drugs treatment in a public hospital from Córdoba City and to establish the causes of noncompliance. All the patients to which treatment with tuberculostatic drugs was indicated from January 1991 up to December 1994 were included. 45 patients were included: 18 females (40%) and 29 males. Sixteen (35.6%) did not complete the time of treatment indicated. Nine (56.3%) abandoned the treatment 2 months after having initiated it. In the group that did not complete the treatment there was a higher percentage of female patients (62.5%) than in the group that did complete it (27.6%), p = 0.02. There were not statistically significant differences in age, percentages of pulmonar and extrapulmonar tuberculosis and months of treatment indicated between both groups. Thirty-six percent of the patients who abandoned the treatment referred having interrupted it due to their own negligency, knowing the risk of such behavior; 36% suffered side effects and did not come back to hospital; 21% referred having consulted another physician who indicated to interrupt the treatment without performing other tests; and 7% misunderstood the indications. It is concluded that in a general hospital from Córdoba City, the percentage of patients who abandoned tuberculostatic treatment is high. In most cases the cause was related to failures in the conduct of patients, physicians or both.

  14. Managing retrenchment in French public hospitals: philosophical and regulatory constraints.

    Science.gov (United States)

    Sobczak, P M; Fottler, M D; Chastagner, D

    1988-01-01

    The French hospital system is experiencing economic stresses similar to those experienced by US hospitals. Pressures for cost containment have occurred due to changes in health care funding. The public hospital system is facing unprecedented severe retrenchment. Innovative strategies for managing retrenchment have been restricted by regulatory and philosophical constraints. What is needed is to provide more autonomy for individual hospital managers together with greater accountability for achievement of results.

  15. Explaining the LHC to the general public

    CERN Multimedia

    2008-01-01

    We’re looking for volunteers for the "Big Science" exhibition, to be set up for a limited time at the Balexert shopping centre.To get even closer to the general public, CERN is moving its "Big Science" exhibition from the Globe of Science and Innovation to the Balexert shopping centre for a limited time only, from 19 to 31 May 2008. All members of the CERN personnel are warmly invited to enrol as volunteers to help welcome and guide members of the general public around the exhibition. From 11.30 a.m. to 6.30 p.m., Monday to Friday, and 10.00 a.m. to 6.00 p.m. on the Saturdays. For information and to sign up, please call +41 22 767 9288, or e-mail mailto:genevieve.choukroun@cern.ch

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

    Science.gov (United States)

    2010-01-01

    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. PMID:21067580

  17. 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.

  18. 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.

  19. Organizational Culture and Its Relationship with Hospital Performance in Public Hospitals in China

    Science.gov (United States)

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

    2011-01-01

    Objective To measure perceptions of organizational culture among employees of public hospitals in China and to determine whether perceptions are associated with hospital performance. Data Sources Hospital, employee, and patient surveys from 87 Chinese public hospitals conducted during 2009. Study Design 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. Principal Findings 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. Conclusions Managers in Chinese public hospitals should consider whether the culture of their organization will enable them to respond effectively to their changing environment. PMID:22092228

  20. Re-thinking barriers to organizational change in public hospitals

    National Research Council Canada - National Science Library

    Nigel Edwards; Richard B Saltman

    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...

  1. Comparing public and private hospital care service quality.

    Science.gov (United States)

    Camilleri, D; O'Callaghan, M

    1998-01-01

    The study applies the principles behind the SERVQUAL model and uses Donabedian's framework to compare and contrast Malta's public and private hospital care service quality. Through the identification of 16 service quality indicators and the use of a Likert-type scale, two questionnaires were developed. The first questionnaire measured patient pre-admission expectations for public and private hospital service quality (in respect of one another). It also determined the weighted importance given to the different service quality indicators. The second questionnaire measured patient perceptions of provided service quality. Results showed that private hospitals are expected to offer a higher quality service, particularly in the "hotel services", but it was the public sector that was exceeding its patients' expectations by the wider margin. A number of implications for public and private hospital management and policy makers were identified.

  2. 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.

  3. The role of public university hospitals in a globalized world.

    Science.gov (United States)

    Slama, Slim

    2012-01-01

    Globalization has increased interdependence between countries and highlighted the importance of international cooperation for improving global health outcomes. International hospital partnerships aimed at expanding education, research opportunities or improving services are increasingly being shaped by globalization processes. Focusing on public university hospitals, this article calls for a critical review of the motives, processes and impact of international hospital partnerships in a changing landscape characterized by economic uncertainty and a global power shift to emerging economies.

  4. Mixed strategy under generalized public goods games.

    Science.gov (United States)

    Zhang, Yanling; Wu, Te; Chen, Xiaojie; Xie, Guangming; Wang, Long

    2013-10-07

    The relationship between group's contribution and public goods produced often exhibits nonlinearity, which constitutes the generalized public goods game. Far less attention has been paid to how the mixed strategy evolves in such generalized games. Here, we study the effects of nonlinear production functions on the evolution of the mixed strategy in finite populations for the first time. When the group size and the population size are comparable, cooperation is doomed irrespective of the production function. Otherwise, nonlinear production functions may induce a convergent evolutionary stable strategy (CESS) or a repeller, but cannot yield the evolutionary branching. Moreover, we particularly consider three representative families of production functions, intriguingly which all display the hysteresis effect. For two families of production functions including concave and convex curves, a unique CESS or a unique repeller may occur even if the group size is two. Whereas for the third class encompassing symmetrically sigmoidal and inverse sigmoidal curves, the coexistence of a CESS and a repeller only occurs if group size is above two, and two saddle-node bifurcations appear. Our work includes some evidently different results by comparing with the evolution of continuous investment or binary strategy.

  5. The Provision of the Disabled Facilities in Public Hospitals

    Directory of Open Access Journals (Sweden)

    Talib Yuhainis Abdul

    2016-01-01

    Full Text Available The implementation of Person with Disabilities Act 2008 has become an eye opener towards the provision of disabled facilities in all public buildings especially regarding healthcare accessibility. The aim of this research is to analyse the provision of the disabled facilities provided in a public hospital in Perak, Malaysia. To support the research, it was supporting with two objectives that are to identify the designs and requirements of disabled facilities that need to be fulfilled according to Uniform Building By-Laws (UBBL and other standard regulations and to identify the level of awareness of public on disabled facilities in the public hospital. For the purpose of the research, the observation method has been done towards three (3 selected hospital in Perak and questionnaire survey have been distributed to 96 respondents among the staff and visitors of the hospitals. All the data collected from the questionnaire survey and the checklist using UBBL standard requirement, then analysed using the SPSS V.21. The outcome of the observation indicates that most of the hospitals were provided with the disabled facilities, but there are still some rooms for improvement regarding specifications and the provision itself. In a nutshell, this research helps the management of the hospital together with the public on the importance of the provision of the disabled facilities in public buildings.

  6. Reserve capacity of public and private hospitals in response to demand uncertainty.

    Science.gov (United States)

    Rodriguez-Alvarez, Ana; Roibás, David; Wall, Alan

    2012-07-01

    A feature of hospitals is that they face uncertain demand for the services they offer. To cover fluctuations in demand, they need to maintain reserve service capacity in the form of beds, equipment, personnel, etc. to minimize the probability of excess queuing or turning away patients, creating a trade-off between reserve service capacity and economic costs. Using a simple theoretical framework, we show how the reserve capacity established depends on institutional characteristics that can affect the objective of the hospital. In particular, we show that private and public hospitals may provide different levels of reserve capacity. In an empirical application using a panel data set of Spanish hospitals over the period 1996-2006, we model reserve service capacity using a distance frontier approach. Our results show that private hospitals generally react to a lesser extent to demand uncertainty than public hospitals.

  7. 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.

  8. Quantum physics reimagined for the general public

    Science.gov (United States)

    Bobroff, Julien

    2015-03-01

    Quantum Physics has always been a challenging issue for outreach. It is invisible, non-intuitive and written in sophisticated mathematics. In our ``Physics Reimagined'' research group, we explore new ways to present that field to the general public. Our approach is to develop close collaborations between physicists and designers or graphic artists. By developing this new kind of dialogue, we seek to find new ways to present complex phenomena and recent research topics to the public at large. For example, we created with web-illustrators a series of 3D animations about basic quantum laws and research topics (graphene, Bose-Einstein condensation, decoherence, pump-probe techniques, ARPES...). We collaborated with designers to develop original setups, from quantum wave animated models or foldings to a superconducting circus with levitating animals. With illustrators, we produced exhibits, comic strips or postcards displaying the physicists in their labs, either famous ones or even our own colleagues in their daily life as researchers. With artists, we recently made a stop-motion picture to explain in an esthetic way the process of discovery and scientific publication. We will discuss how these new types of outreach projects allowed us to engage the public with modern physics both on a scientific and cultural level and how the concepts and process can easily be replicated and expanded by other physicists. We are at the precise time when creative tools, interfaces, and ways of sharing and learning are rapidly evolving (wikipedia, MOOCs, smartphones...). If scientists don't step forward to employ these tools and develop new resources, other people will, and the integrity of the science and underlying character of research risks being compromised. All our productions are free to use and can be downloaded at www.PhysicsReimagined.com (for 3D quantum videos, specific link: www.QuantumMadeSimple.com) This work benefited from the support of the Chair ``Physics Reimagined

  9. 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.

  10. [Prevalence of pain in Andalusian public hospitals].

    Science.gov (United States)

    Echevarria Moreno, M; Ortega Garcia, J L; Herrera Silva, J; Galvez Mateo, R; Torres Morera, L M; de la Torre Liebanas, R

    2014-12-01

    To determine the prevalence of pain in medical and surgical patients admitted to reference hospitals in Andalusia, as well as their features and the most population groups most affected. A cross-sectional, multicenter epidemiological study was conducted simultaneously on the population admitted to 5 hospitals. Using a structured questionnaire the demographics, hospital area, presence of pain at the time of the interview, and pre- and post-variables related to the intensity of pain and its treatment at 24h were investigated. All patients over 18 years old were included, except those patients with difficulty in understanding the questionnaire, and psychiatric and obstetric patients. Pain intensity was assessed by simple verbal scale. Of the 1,236 patients included, 54.2% were male, with 51.1% of patients aged 65 years, and 69.17% were admitted to medical areas. Pain was observed in 52.9% of patients admitted to the surgical area compared to 29.4% in the medical area. Of the 19.4% who reported having had pain in the last 24h prior to the questionnaire, 57.7% of them were surgical patients and 32% were medical, PDolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. 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. 

  12. Is quality of cardiac hospital care a public or private good?

    Science.gov (United States)

    Chen, Hsueh-Fen; Bazzoli, Gloria J; Harless, David W; Clement, Jan P

    2010-11-01

    There are many studies examining the effects of financial pressure from different payment sources on hospital quality of care, but most have assumed that quality of care is a public good in that payment changes from one payer will affect all hospital patients rather than just those directly associated with the payer. Although quality of hospital care can be either a public or private good, few studies have tested which of these scenarios are more likely to hold. To examine whether the change in the magnitude of in-hospital mortality for Medicare and managed care patients is different based on financial pressure resulting from the Balanced Budget Act and growing managed care market penetration; and to examine what role hospital competition may play in affecting these changes. The unit of analysis for the study was the hospital. Multiple data sources were used including the Agency for Healthcare Research and Quality State Inpatient Databases, American Hospital Association Annual Surveys, Area Resource File, and health maintenance organization data from InterStudy. A difference-in-difference-in-difference model was applied for a 2-period panel design. In general, Balanced Budget Act financial pressure and managed care market share did not magnify the difference in in-hospital mortality rates between Medicare and managed care patients. The results suggest that quality of cardiac care in the hospital setting is more likely to be a public good; however, more investigation using other quality indicators and the role of hospital competition under different payment systems is recommended.

  13. Diagnosis and treatment of schizophrenia in a general hospital ...

    African Journals Online (AJOL)

    Diagnosis and treatment of schizophrenia in a general hospital based acute ... Conclusion: The study contributed by identifying these predictive indicators for the acute ... Key words: Acute management; Schizophrenia; Diagnosis; Treatment; ...

  14. 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.

  15. Public expectations for nonemergency hospital resources and services during disasters.

    Science.gov (United States)

    Charney, Rachel L; Rebmann, Terri; Esguerra, Cybill R; Lai, Charlene W; Dalawari, Preeti

    2013-04-01

    The public's expectations of hospital services during disasters may not reflect current hospital disaster plans. The objective of this study was to determine the public's expected hospital service utilization during a pandemic, earthquake, and terrorist bombing. A survey was distributed to adult patients or family members at 3 emergency departments (EDs). Participants identified resources and services they expect to need during 3 disaster scenarios. Linear regression was used to describe factors associated with higher expected utilization scores for each scenario. Of the 961 people who participated in the study, 66.9% were women, 47.5% were white, and 44.6% were black. Determinants of higher pandemic resource utilization included persons who were younger (P expectations of hospitals during disasters are high, and some expectations are inappropriate. Better community disaster planning and public risk communication are needed.

  16. Early readmission in a high complexity public hospital in cardiology

    Directory of Open Access Journals (Sweden)

    Herminia Ricci

    2016-01-01

    Full Text Available Objective: to evaluate the early readmission of patients in a high complexity public hospital in cardiology. Methods: this is a descriptive, documental and retrospective study, carried out in a public hospital. Results: in 2012, 729 of the 9,218 hospitalized patients were readmitted, 47.9% of them were readmitted within 30 days after discharge, 61% were men, with a mean age of 57 years old, with the main medical diagnosis of heart disease (heart failure, treatment of acute coronary syndrome, among others on admission (44.7% and readmission (45.8%. Most were readmitted for the same medical reason that led to their first hospitalization. Conclusion: considering the profile of the population admitted and readmitted to the institution, it is believed that the rate of readmission is mainly due to the profile of the patients, considering the high prevalence of non-communicable chronic diseases, and coronary artery disease considered unapproachable for percutaneous or surgical when hospitalized.

  17. DRUG MANAGEMENT REVIEWS IN DISTRICT DRUG MANAGEMENT UNIT AND GENERAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    Max Joseph Herman

    2009-12-01

    Full Text Available Drug is one of the essential elements in healthcare that should be effectively and efficiently managed. Following thedecentralization in 2001 in Indonesia, drug management has changed in district drug management units and also in District General Hospitals. Certainly this condition influences the sustainability of drug access in primary health care such as in Community Health Center and District General Hospital, especially in drug financing policy. A cross sectional descriptive study to obtain information on drug management in public healthcare in district had been carried out between July and December 2006 in 10 District Public Drug Management Units from 10 district health offices and 9 district general hospitals as samples. Data were collected by interviewing heads of Drug Section in District Health Offices and heads of Hospital Pharmacies using structured questionnaires and observing drug storage in District Drug Management Units, Community Health Centers, and Hospital Pharmacies. Results of the study show that drug planning in District Health Offices and General Hospitals did not meet the basic real need in some districts nor District Hospitals. The minimum health service standards had no been achieved yet. Furthermore, drug procurement, storage and recording as well as reporting was not good enough either, such as shown by the existence of expired drugs. Lead time for drug delivery to community health centers in some districts was longer than the average of lead time in the past 3 years.

  18. Linking public health agencies and hospitals for improved emergency preparedness: North Carolina's public health epidemiologist program.

    Science.gov (United States)

    Markiewicz, Milissa; Bevc, Christine A; Hegle, Jennifer; Horney, Jennifer A; Davies, Megan; MacDonald, Pia D M

    2012-02-23

    In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders. We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1) elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2) examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data. Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists. Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public health emergency preparedness and response system.

  19. Linking public health agencies and hospitals for improved emergency preparedness: North Carolina's public health epidemiologist program

    Directory of Open Access Journals (Sweden)

    Markiewicz Milissa

    2012-02-01

    Full Text Available Abstract Background In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders. Methods We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1 elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2 examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data. Results Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists. Conclusions Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public

  20. 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.

  1. LIGASURE (PRECISION HAEMORROIDECTOMY AT GOVT. GENERAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    Anand

    2015-09-01

    Full Text Available BACKGROUND : Haemorrhoids is a common problem throughout the world. Many procedures are available for management of grade II and grade III hemorrhoids. The main postoperative complications associated with any of these procedures are pain and bleeding per rectum and pro longed healing time. Liga Surel TM haemorroidectomy was evaluated in this study for post - operative complications and symptomatic relief. METHODS: We analyzed 50 patients of hemorrhoids of grade II, III and IV who underwent Ligasure Precise haemorroidectomy by a classical Milligan - Morgan technique. The outcome factors analyzed were total operative time, blood loss, post - operative pain on visual analogue scale, any other complication and days of hospital stay. RESULTS: Of all the 50 patients, the operative ti me was less than 10 minutes in 27 patients (54% and the blood loss, as was measured by number of soaked gauze pieces only one gauze piece was soaked in 31 patients (62%. The Average Post - operative pain score measured on Visual Analogue Scale (VAS at 12, 24 & 48 hours were 6.54, 4.52 and 3.12 respectively. In all patients postoperative period and follow up was uneventful except for one patient who developed transient flatus incontinence. With physiotherapy and dietary management this problem resolved ther eafter. CONCLUSIONS: Liga Sure Hemarrhoidectomy is a safe, Technically easy and fast modality of treatment for 2 nd , 3 rd & 4 th degree of hemorrhoids whether single or multiple, requiring very less operating ti me, with no major post - operative complications an d early return to day to day activities

  2. Performance evaluation of hospitals that provide care in the public health system, Brazil.

    Science.gov (United States)

    Ramos, Marcelo Cristiano de Azevedo; da Cruz, Lucila Pedroso; Kishima, Vanessa Chaer; Pollara, Wilson Modesto; de Lira, Antônio Carlos Onofre; Couttolenc, Bernard François

    2015-01-01

    OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System. METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities), 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA) and Bonferroni correction. RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed. CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals.

  3. Performance evaluation of hospitals that provide care in the public health system, Brazil

    Directory of Open Access Journals (Sweden)

    Marcelo Cristiano de Azevedo Ramos

    2015-01-01

    Full Text Available OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System.METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities, 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA and Bonferroni correction.RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed.CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals.

  4. 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.

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

    Science.gov (United States)

    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

  6. 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

  7. Perceived hospital managerial competency in Tehran, Iran: is there a difference between public and private hospitals?

    Science.gov (United States)

    Kalhor, Rohollah; Tajnesaei, Mahsa; Kakemam, Edris; Keykaleh, Mesam Safi; Kalhor, Leila

    2016-12-01

    Hospital managers should have enough managerial competencies to coordinate the complex environment. The underlying assumption is that there is a potential gap in management capacity between public and private hospitals in Iran. This study aims to evaluate competency level of hospital managers and to compare their competencies in public and private hospitals. This study was descriptive-analytic, carried out in 2015. A survey using a self-administered questionnaire was conducted among 127 public and private hospitals managers in Tehran Province, Iran. Respondents were asked to rate their competencies in a five-key subscale that included people-related skills, health delivery, self-management, task-related skills, and strategic planning and management. Ratings were based on a five-point Likert scale ranging from very low to excellent competency level. Self-assessment of competencies level showed that managers in all state hospitals evaluate their competency at a low level. Managers felt most competent in health-delivery skills (3.71), people-related skills (3.61), and strategic planning and management (3.57), relatively less competent in self-management (3.54) and task-related skills (3.49). While being the mean total competency levels were significantly higher among male managers, those who participated in the healthcare/hospital management training courses, and those whose primary formal qualification was management in healthcare/hospital management (Phospitals perceived themselves to be significantly more competent than their public hospitals colleagues in most of the management facets (Phospitals and the gap between public and private hospitals is small. There is widespread need for management training to be made available in Iran.

  8. Resource constraints and strategic change in a public hospital system.

    Science.gov (United States)

    Champagne, F; Langley, A; Denis, J L; Contandriopoulos, A P; Cazale, L; Rivard, M

    1997-08-01

    It has been suggested that strategic management in public services tends to be oriented towards preserving and perpetuating current patterns of service provision, rather than changing priorities. However, faced with severe resource constraints combined with growing demand and rapidly developing technology, public hospitals in Canada have come under increasing pressure. Based on an empirical study of strategic management and change in 32 Montreal hospitals, this paper examines the relationship between financial adversity and the extent and nature of strategic change in these organizations. Strategic change indicators considered in the study include overall product mix, product diversity, product complexity, market demographics, efficiency, and revenue diversification. Results suggest that resource constraints have indeed stimulated changes within these organizations. In particular, hospitals suffering more severe financial difficulties have reduced their size and focused on a narrower range of services. Moreover, there is evidence that greater complementarity has been achieved among the entire sample of hospitals.

  9. Provision of general paediatric surgical services in a regional hospital.

    LENUS (Irish Health Repository)

    Zgraj, O

    2012-01-31

    BACKGROUND: In Ireland, specialist paediatric surgery is carried out in paediatric hospitals in Dublin. General surgeons\\/consultants in other surgical specialities provide paediatric surgical care in regional centres. There has been a failure to train general surgeons with paediatric skills to replace these surgeons upon retirement. AIM: To assess paediatric surgical workload in one regional centre to focus the debate regarding the future provision of general paediatric surgery in Ireland. METHODS: Hospital in-patient enquiry (HIPE) system was used to identify total number of paediatric surgical admissions and procedures. Cases assessed requiring hospital transfer. RESULTS: Of 17,478 surgical patients treated, 2,584 (14.8%) were under 14 years. A total of 2,154 procedures were performed. CONCLUSION: Regional centres without dedicated paediatric surgeons deliver care to large numbers of paediatric patients. The demand for care highlights the need for formal paediatric services\\/appropriate surgical training for general surgical trainees.

  10. 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.

  11. Comparative Study of Three Commonly Used Methods for Hospital Efficiency Analysis in Beijing Tertiary Public Hospitals, China

    Institute of Scientific and Technical Information of China (English)

    Guo-Chao Xu; Jian Zheng; Zi-Jun Zhou; Chuan-Kun Zhou; Yang Zhao

    2015-01-01

    Background: Tertiary hospitals serve as the medical service center within the region and play an important role in the medical and health service system.They are also the key targets of public hospital reform in the new era in China.Through the reform of health system, the public hospital efficiency has changed remarkably.Therefore, this study aimed to provide some advice for efficiency assessment of public hospitals in China by comparing and analyzing the consistency of results obtained by three commonly used methods for examining hospital efficiency, that is, ratio analysis (RA), stochastic frontier analysis (SFA), and data envelopment analysis (DEA).Methods: The theoretical basis, operational processes, and the application status ofRA, SFA, and DEA were learned through literature analysis.Then, the empirical analysis was conducted based on measured data from 51 tertiary public hospitals in Beijing from 2009 to 2011.Results: The average values of hospital efficiency calculated by SFA with index screening and principal component analysis (PCA) results and those calculated by DEA with index screening results were relatively stable.The efficiency of specialized hospitals was higher than that of general hospitals and that of traditional Chinese medicine hospitals.The results obtained by SFA with index screening results and the results obtained by SFA with PCA results showed a relatively high correlation (r-value in 2009, 2010, and 2011 were 0.869, 0.753, and 0.842, respectively, P < 0.01).The correlation between results obtained by DEA with index screening results and PCA results and results obtained by other methods showed statistical significance, but the correlation between results obtained by DEA with index screening results and PCA results was lower than that between results obtained by SFA with index screening results and PCA results.Conclusions: RA is not suitable for multi-index evaluation of hospital efficiency.In the given conditions, SFA is a stable

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

    Science.gov (United States)

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

    2017-05-05

    in public hospitals or healthcare professionals. Private patients recounted largely positive stories of reduced 'waiting for' and 'waiting in' private hospitals, and generally distrusted public hospitals. The continuing trust by public patients in the face of negative experiences may be understood as a form of exchange trust norm, in which institutional trust is based on base-level expectations of consistency and minimum standards of care and safety. The institutional trust by private patients may be understood as a form of communal trust norm, whereby trust is based on the additional and higher-level expectations of flexibility, reduced waiting and more time with healthcare professionals.

  13. Data Envelopment Analysis on Evaluating the Efficiency of Public Hospitals in Tianjin, China

    Institute of Scientific and Technical Information of China (English)

    孙彬; 张连云; 杨文秀; 张竞超; 骆达; 韩超

    2016-01-01

    Public hospitals are the most important components of health systems and account for a large proportion of health resources in China. However, few researches on the efficiency assessment of public hospitals have been conducted in Tianjin, China. On the basis of the data of annual health service report in 2013 from the Ministry of Health, we measured the relative efficiency of the tertiary general public hospitals in Tianjin and estimated the mag-nitudes of output increase and/or input reduction by using data envelopment analysis to improve hospital efficiency. The main findings of this study indicate that more than half of the sample hospitals operate at a technical and scale efficiency, and the prevalent scale inefficiency is increasing returns to scale. Moreover, it is a prominent issue that health resource constraint and resource waste coexist. Health policy-makers and hospital administrators would need to address these problems by taking comprehensive measures such as optimizing the allocation of health resources, implementing hierarchical diagnosis and treatment, as well as innovating medical-service operating mechanism of public hospital to improve the people’s wellbeing.

  14. Improving the smoking patterns in a general hospital psychiatric unit

    OpenAIRE

    Celso Iglesias García; María José Alonso Villa; Juan Carlos Bernaldo de Quirós; Elena Bocanegra Suárez; Julia Cueta Gonzalo; Rosario García del Valle; José Manuel González González; Álvaro Miranda García; Ana Belén Palacio Bande

    2009-01-01

    Objectives: The purpose of the present paper is to evaluate the effects of a smoking ban in a general hospital psychiatric unit. Methods: We study the effects of smoking ban in 40 consecutive psychiatric inpatients. The staff registered socio-demographic and tobacco-related variables. We also registered any kind of behavioral effects of smoking ban.Results: The patients were willing to stop smoking during their hospital stay (with or without nicotine replacement) with two mild behavioural inc...

  15. Improving Midwifery Care in Ugandan Public Hospitals: The Midwives’ Perspective

    Science.gov (United States)

    Nabirye, Rose C.; Beinempaka, Florence; Okene, Cindrella; Groves, Sara

    2016-01-01

    Background A serious shortage of nurses and midwives in public hospitals has been reported in Uganda. In addition, over 80% of the nurses and midwives working in public hospitals have been found to have job stress and only 17% to be satisfied on the job. Stress and lack of job satisfaction affect quality of nursing and midwifery care and puts patients’ lives at risk. This is coupled with rampant public outcry about the deteriorating nursing and midwifery care in Ugandan public hospitals. Objective To explore factors that result in poor quality of midwifery care and strategies to improve this care from the perspective of the midwives. Method It was a qualitative exploratory design. Participants were midwives and their supervisors working in four Regional Referral hospitals in Uganda. Data was collected by FGDs and KIIs. Content analysis was used to analyze the transcribed data from the voice recordings. Results Four major themes emerged from the study. They were organizational (poor work environment and lack of materials/equipment), professional (midwives’ attitudes, lack of supervision), public/consumer issues (interference) and policy issues (remuneration, promotion and retirement). Conclusions and implications for Practice Midwives love their work but they need support to provide quality care. Continuous neglect of midwives’ serious concerns will lead to more shortages as more dissatisfied midwives leave service.

  16. General surgery at rural Tennessee hospitals: a survey of rural Tennessee hospital administrators.

    Science.gov (United States)

    Cofer, Joseph B; Petros, Tommy J; Burkholder, Hans C; Clarke, P Chris

    2011-07-01

    Rural communities face an impending surgical workforce crisis. The purpose of this study is to describe perceptions of rural Tennessee hospital administrators regarding the importance of surgical services to their hospitals. In collaboration with the Tennessee Hospital Association, we developed and administered a 13-item survey based on a recently published national survey to 80 rural Tennessee hospitals in August 2008. A total of 29 responses were received for an overall 36.3 per cent response rate. Over 44 per cent of rural surgeons were older than 50 years of age, and 27.6 per cent of hospitals reported they would lose at least one surgeon in the next 2 years. The responding hospitals reported losing 10.4 per cent of their surgical workforce in the preceding 2 years. Over 53 per cent were actively recruiting a general surgeon with an average time to recruit a surgeon of 11.8 months. Ninety-seven per cent stated that having a surgical program was very important to their financial viability with the mean and median reported revenue generated by a single general surgeon being $1.8 million and $1.4 million, respectively. Almost 11 per cent of the hospitals stated they would have to close if they lost surgical services. Although rural Tennessee hospitals face similar difficulties to national rural hospitals with regard to retaining and hiring surgeons, slightly more Tennessee hospitals (54 vs 36%) were actively attempting to recruit a general surgeon. The shortage of general surgeons is a threat to the accessibility of comprehensive hospital-based care for rural Tennesseans.

  17. Factors associated with readmission to a general hospital in Brazil Fatores associados às readmissões hospitalares em um hospital geral brasileiro

    OpenAIRE

    Mônica Silva Monteiro de Castro; Marilia Sá Carvalho; Cláudia Travassos

    2005-01-01

    The objective of this study was to compare different modeling strategies to identify individual and admissions characteristics associated with readmission to a general hospital. Routine data recorded in the Hospital Information System on all admissions to the Regional Public Hospital of Betim, Minas Gerais State, Brazil, from July 1996 to June 2000 were analyzed. Cox proportional hazards model and variants designed to deal with multiple-events data, like Andersen-Gill (AG), Prentice, Williams...

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

    Science.gov (United States)

    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.

  19. The organizational culture of a Brazilian public hospital

    Directory of Open Access Journals (Sweden)

    Fernanda Ludmilla Rossi Rocha

    2014-04-01

    Full Text Available The objective of this research was to analyze the organizational culture of a Brazilian public hospital. It is a descriptive study with quantitative approach of data, developed in a public hospital of São Paulo State, Brazil. The sample was composed by 52 nurses and 146 nursing technicians and auxiliaries. Data were collected from January to June 2011 using the Brazilian Instrument for Assessing Organizational Culture – IBACO. The analysis of the organizational values showed the existence of hierarchical rigidity and centralization of power within the institution, as well as individualism and competition, which hinders teamwork. The values concerning workers’ well-being, satisfaction and motivation were not highly valued. In regard to organizational practices, the promotion of interpersonal relationship, continuous education, and rewarding practices were not valued either. It becomes apparent that traditional models of work organization support work practices and determine the organizational culture of the hospital.

  20. [The organizational culture of a Brazilian public hospital].

    Science.gov (United States)

    Rocha, Fernanda Ludmilla Rossi; Marziale, Maria Helena Palucci; de Carvalho, Michele Cristina; Cardeal Id, Samira de Fátima; de Campos, Monica Chiodi Toscano

    2014-04-01

    The objective of this research was to analyze the organizational culture of a Brazilian public hospital. It is a descriptive study with quantitative approach of data, developed in a public hospital of São Paulo State, Brazil. The sample was composed by 52 nurses and 146 nursing technicians and auxiliaries. Data were collected from January to June 2011 using the Brazilian Instrument for Assessing Organizational Culture - IBACO. The analysis of the organizational values showed the existence of hierarchical rigidity and centralization of power within the institution, as well as individualism and competition, which hinders teamwork. The values concerning workers' well-being, satisfaction and motivation were not highly valued. In regard to organizational practices, the promotion of interpersonal relationship, continuous education, and rewarding practices were not valued either. It becomes apparent that traditional models of work organization support work practices and determine the organizational culture of the hospital.

  1. The dynamics of psychiatric bed use in general hospitals.

    Science.gov (United States)

    Slade, Eric P; Goldman, Howard H

    2015-03-01

    This study examines general hospitals' adjustments in psychiatric bed utilization practices in response to increases in psychiatric inpatient admissions. Using panel data from 439 hospitals, monthly observations (N = 7,831) between 2007 and 2010 on psychiatric admissions, psychiatric bed occupancy rates, and average length-of-stay were created for psychiatric inpatients. In fixed-effects regressions, an increase in psychiatric admissions was associated with an increase in the probability of psychiatric bed use exceeding 100 % occupancy and with a reduction of mean length-of-stay. These results were confirmed in instrumental variables models. General hospitals may dynamically adjust bed utilization practices in response to changing psychiatric bed needs. An implication of this dynamic adjustment model is that bed shortages are likely to be local, transitory events.

  2. The dynamics of psychiatric bed use in general hospitals

    Science.gov (United States)

    Slade, Eric P; Goldman, Howard H

    2014-01-01

    This study examines general hospitals' adjustments in psychiatric bed utilization practices in response to increases in psychiatric inpatient admissions. Using panel data from 439 hospitals, monthly observations (N=7831) between 2007 and 2010 on psychiatric admissions, psychiatric bed occupancy rates, and average length-of-stay were created for psychiatric inpatients. In fixed-effects regressions, an increase in psychiatric admissions was associated with an increase in the probability of psychiatric bed use exceeding 100% occupancy and with a reduction of mean length-of-stay. These results were confirmed in instrumental variables models. General hospitals may dynamically adjust bed utilization practices in response to changing psychiatric bed needs. An implication of this dynamic adjustment model is that bed shortages are likely to be local, transitory events. PMID:24756929

  3. Internal and External Perspectives on Quality of Healthcare Services at Sanglah General Hospital Denpasar

    Directory of Open Access Journals (Sweden)

    Made Nopy Diah Sundari

    2015-04-01

    Full Text Available Background and purpose: Customer satisfaction is a primary indicator of the quality of public healthcare services. This study investigated internal (hospital staff and external (hospital clients perspectives in order to gain insight into the quality of care at Sanglah General Hospital.Methods: The study used both qualitative and quantitative methodologies with 11 informants and 106 respondents. Qualitative data obtained through in-depth interviews with hospital staff were analyzed thematically. Quantitative data obtained through self-administered questionnaire were analyzed using univariate analysis.Results: Informants from the qualitative data collection stated that Sanglah General Hospital has a relatively high level of service and that existing structures to mitigate issues are in place, which act as reinforcing factors. Data from the quantitative survey indicated that clients were satisfied with the quality of service (ServQual, with an overall percentage of 83.82%.Conclusion: Further efforts could be made in order to improve healthcare provision at Sanglah Hospital, particularly from the perspective of hospital facilities, staff support and increased implementation of clinical governance.Keywords: quality of service, internal perspectives, external perspectives, Sanglah Hospital

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

    Science.gov (United States)

    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.

  5. [Evaluation of financial status of public hospitals considering the updated costs of their services].

    Science.gov (United States)

    Cid P, Camilo; Bastías S, Gabriel

    2014-02-01

    In 2011 the Chilean National Health Fund (FONASA) commissioned a study to assess the costs of the 120 most relevant hospital care services with an established fee, in a large sample of public hospitals. We herein report the cost evaluation results of such study, considering the financial condition of those hospitals in the year of the study. Based on the premise that the expenses derived from the provision of institutional and appraised hospital services should be identical to the billing of hospitals to FONASA, the prices are undervalued, since they cover only 56% of billing, generating a gap between expenses and invoicing. This gap shows an important limitation of tariffs, since their prices do not cover the real costs. However not all hospitals behave in the same way. While the provision of services of some hospitals is even higher than their billing, most hospitals do not completely justify their invoicing. These assumptions would imply that, generally speaking, hospital debts are justified by the costs incurred. However, hospitals have heterogeneous financial situations that need to be analyzed carefully. In particular, nothing can be said about their relative efficiency if cost estimations are not adjusted by the complexity of patients attended and comparison groups are not defined.

  6. Discharge against medical advice at a general hospital in Catalonia.

    Science.gov (United States)

    Duñó, Rosó; Pousa, Esther; Sans, Jordi; Tolosa, Carles; Ruiz, Ada

    2003-01-01

    Some studies on discharge against medical advice (AMA) in general hospitals report a prevalence between 0.7-7% with 11-42% of this population identified as psychiatric patients. To study the sociodemographic and psychopathological features of patients who leave AMA, we performed a retrospective case-control comparison study of length of hospitalization and presence of psychiatric disturbances on patients who left AMA from the University General Hospital in Catalan Spain over a two-year period. An analysis of the hospital epidemiological discharge register and retrospective chart review for presence of psychiatric disturbances found that AMA prevalence was 0.34%, the total discharge number in the 2-year period being 41,648. AMA rates by medical department were 0.44% for the internal medicine department; 0.24% for surgery; 0.26% for orthopedic surgery, 0.32% for obstetrics-gynecology and 0.93% for rehabilitation. The mean age for AMA patients was 38.63 years, with a higher number of men (59.9%). A total of 45.8% AMA discharges were from the internal medicine department. No significant differences were found in the average length of hospitalization between the AMA and control groups. The presence of psychiatric pathology was significantly higher among the AMA group (Phistory of psychiatric pathology, mainly narcotic dependence.

  7. General public and workers exposure to high-frequency electric fields in Spanish hospitals Exposición de trabajadores y usuarios a campos eléctricos de alta frecuencia en hospitales españoles

    Directory of Open Access Journals (Sweden)

    Alberto Caldés Casas

    2013-03-01

    Full Text Available Introduction: Electromagnetic fields (EMF are commonly used in hospitals to detect and treat certain diseases or ailments, exposing healthcare workers daily to such fields and casting doubts about workers and patients safety. Objectives: To quantify the actual exposure to high-frequency electric fields of workers and public hospitals users in the Balearic Islands (Spain and the compliance with the references levels established by the International Commission on Non-Ionizing Radiation Protection (ICNIRP. Material and Methods: High-frequency radiation exposure levels were measured in different areas and compared with ICNIRP levels and Spanish regulation, using a broadband field strength meter and a spectrum analyzer. Results: 1,290 measurements were performed obtaining a median electric field of 0.31 V/m (1st quartile: 0.16 V/m; 3rd quartile: 0.67 V/m. Users and workers are exposed to electric fields from 0.19 V/m to 0.25 V/m in all areas, but Rehabilitation and Radiology. In the former, the patients (not under microwave therapy are exposed to EMF between 1.87 V/m and 25.71 V/m. Discussion and conclusions: Although effective electric field values are lower than the reference levels, measures should be taken to reduce exposure of especially sensitive people (infants, children, pregnant women,... and ensure regular monitoring of the exposure.Introducción: Los campos electromagnéticos (CEM se utilizan con frecuencia en los hospitales para detectar y tratar ciertas enfermedades o dolencias, exponiendo diariamente a los trabajadores sanitarios a esos campos y sembrando dudas sobre la seguridad de trabajadores y pacientes. Objetivos: Cuantificar la exposición real de trabajadores y usuarios de los hospitales públicos de las Islas Baleares (España a campos eléctricos de alta frecuencia y el cumplimiento de los niveles de referencia establecidos por la Comisión Internacional de Protección contra la Radiación No Ionizante (ICNIRP. Material y m

  8. O apoio institucional como método de análise-intervenção no âmbito das políticas públicas de saúde: a experiência em um hospital geral Institutional support as a method of analysis-intervention in the context of public health policies: the experience in a general hospital

    Directory of Open Access Journals (Sweden)

    Maria Elizabeth Barros de Barros

    2011-12-01

    Full Text Available O artigo aborda a construção de um método de análise/intervenção no âmbito das políticas públicas de saúde, que se delineia de forma articulada aos princípios da Política Nacional de Humanização do SUS em um hospital geral. Apresenta o apoio institucional como um método que se expressa num modo de fazer que persegue a criação de grupalidade, a análise dos processos de trabalho e envolve a problematização dos modos de gestão. A Política Nacional de Humanização aposta na produção da saúde que implica em produção dos sujeitos. A produção da saúde é um processo em rede que envolve sujeitos, processos de trabalho, saberes e poderes. O desafio do apoio é fomentar nessa rede o exercício do protagonismo dos sujeitos e convocar o potencial criativo próprio da vida para a construção de novos modos de gerir o trabalho que não sejam novas formas de assujeitamento. O estudo pretende mostrar que por meio do apoio institucional é possível colocar em cena as forças implicadas na produção de saúde e com isso convocar os grupos a uma análise de suas implicações. Os efeitos produzidos indicam que esta é uma estratégia potente para a intervenção dos processos de trabalho no âmbito das políticas públicas de saúde.The article addresses the elaboration of a method for analysis/intervention in the sphere of public health policies. It describes the introduction of the National Humanization Policy of the Unified Health System (SUS in a general hospital. It proposes institutional support expressed as a method for doing things that seeks the creation of group action, work process analysis and involves examining work management methods. It relies on promotion of health, which implies the production of subjects. The promotion of health is a networking process that involves individuals, work processes, knowledge and power. The challenge of supporting this network is to foster the exercise of the role of individuals and

  9. Perfil del embarazo prolongado en pacientes de un hospital general

    OpenAIRE

    Chavarry Valencia, Flor de Maria; Cabrera Epiquen, Ronald Alfredo; Diaz Herrera, Jorge Antonio

    2012-01-01

    Objetivo: Determinar las características maternas y perinatales de las pacientes con diagnóstico de embarazo prolongado (EP) en un hospital general. Material y métodos: Estudio retrospectivo tipo serie de casos, realizado en el Hospital Nacional Cayetano Heredia del 1° de enero de 2000 al 31 de diciembre de 2004. Se incluyeron 341 pacientes con diagnóstico de EP (>42 semanas) basado en la fecha de último periodo menstrual o ecografía del primer trimestre. Resultados: El 76% de pacientes te...

  10. Martin Luther King, Jr., General Hospital and community involvement.

    Science.gov (United States)

    Humphrey, M M

    1973-07-01

    Community involvement is not just one facet of the new Martin Luther King, Jr., General Hospital's existence. It is the mainstream from which all other activities flow. In addition to meeting the conventional needs of a conventional hospital staff with the core collection of texts and journals, this library goes one step further. It acts as a resource for its community health workers, dietitians, and nurses in their various outreach programs. It serves as a stimulus for the high school or community college student who may be curious about a health career. It also finds time to provide reading material for its patients.

  11. 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.

  12. Neonatal outbreak of salmonella worthington in a general hospital

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    Muley V

    2004-01-01

    Full Text Available This is a report of an outbreak of Salmonella worthington in neonates at Sassoon General Hospitals, Pune, which occurred during August and September 2000. A total of 148 blood, 4 CSF and 6 stool specimens were received from neonates admitted to the hospital. Salmonella worthington could be isolated from 17 clinical specimens [15 blood (10.8%, 1 CSF (25% and 1 stool (16.6% sample]. Environmental swabs were also processed. An attempt was made to detect carriers in health care personnel. However, no source or carrier of Salmonella worthington in the hospital environment could be identified. Intensive cleaning measures and fumigation were undertaken. All these measures succeeded in aborting the outbreak.

  13. Clinical manifestation of HIV/AIDS patients: differences between public and private hospitals in Jakarta

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    Herdiman T. Pohan

    2004-12-01

    Full Text Available The aims of this study is to determine the demographic data, risk factors, clinical presentations, opportunistic/co-infections and its difference between public and private hospitals. A retrospective -descriptive study was conducted in Dr. Cipto Mangunkusumo National General Hospital (public hospital and Medistra Hospital (private hospital, Jakarta. The inclusion criteria were new HIV/AIDS cases admitted in year 2002-2003 and positive HIV serology (Elisa method. Secondary data were collected form medical record. Sixty-six subjects were enrolled in this study (public hospital 30 subjects and private hospital 36 subjects, consist of 59 male (89.4% and 7 female (10.6%. Thirty-seven percent subjects were defined as HIV and 62% AIDS. Risk factors obtained include drug user (59.1%, homosexual (13.6%, heterosexual (21.1%, transfusion (1.5% and maternal-child (perinatal (1.5%. The clinical symptoms mainly present as acute fever (56.2%, weight loss (39.4%, cough (38.8%, shortness of breath (27.2%, chronic diarrhea (22.8%, prolong fever (19.7%, loss of conciousness (15.3%, anorexia (15.3%. Significant differences between public and private hospitals were seen in fever and cough symptoms. Clinical presentation of HIV/AIDS patients during admission were : pneumonia (56%, oral trush (22.6%, anemia (56.5%, leucopenia (32.3%, lymphopenia (55.9%, elevated AST/ALT (66.1%, hypoalbuminemia (46.9%, limphadenopathy (10.6%, brain space occuping lesion (7.6%, encephalopathy (6.0%, pulmonary tb and pleural effusion (10.6%. The opportunistic and co-infections present were candidiasis (25.8%, chronic hepatitis C (24.2%, chronic hepatitis B and C (4.5%, pulmonary tb, lymphadenitis and miliary tb. Candidiasis and pulmonary tb were frequently found in public hospital. In conclusion from this study that clinical manifestation of HIV/AIDS were young man or woman, with one or more possible risk factor, had fever, respiratory complain, loss of body weight, chronic diarrhea

  14. The Adaptive Capabilities of Organizations. Case of Polish Public Hospitals

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    Mariola Ciszewska-Mlinaric

    2009-09-01

    Full Text Available Information gathering and analysis, reaction design and implementation, and activities correction and learning are three types of adaptive capabilities connected to three phases of organizational adaptation to the environment. The primary objective of this article is to present how adaptive capabilities of high and low performers differ. In the second part of the article the key factors influencing the adaptive capabilities of Polish public hospitals will be identified and examined.

  15. 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.

  16. 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

  17. [The practice of the mental health in the general hospital].

    Science.gov (United States)

    Kuroki, Nobuo

    2012-01-01

    On December 2, 2011 a new reform bill concerning the Labor Safety and Hygiene law was presented to parliament. The bill states that all companies and businesses regardless of size are obliged to have all employees take a stress test once a year in addition to the regular health check. In September 2010 the employees fo Toho University Sakura Hospital were given this new stress. The test included categories for occupation and the various departments in the hospital. There were 40 employees found to test high for stress and to have depressive tendencies. We interviewed about 16 of these employees. One employee started to receive medicine to help reduce the stress and 4 employees received counseling only. The other 11 employees did not need to receive counseling or medicine. From April 2005 to September 2011, we conducted another study. The subjects this time were 92 employees of the hospital who have received treatment at other facilities for mental problems from occupational physicians. We categorized the subjects by sex, age occupation, length of time employed at the hospital, department and period of time from the onset of symptoms to the time they sought treatment. In this paper I will present my findings and suggestions for improving mental health care for employees of general hospital throughout Japan.

  18. Investigation of conflict management among nurses in public hospitals

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    Borou A.

    2013-07-01

    Full Text Available Introduction: Conflict is inevitable in a dynamic organization, like hospital. What is important is not only to avoid conflict but to seek its resolution in a constructive manner. Conflicts have an adverse effect on efficiency and quality of hospital services. Aim: The aim of this study was to identify the conflict resolution styles used by a sample of Greek nurses in two different hospitals, General Hospital of Lamia and University Hospital of Larisa, in order to determine differences between them. The influence of demographic variables and employment level on conflict management was explored as well. Material and methods: 100 female nurses from two different hospitals filled in the Thomas –Kilman conflict mode instrument. Statistical significance level was set at p37 years old.[ 4.91±2.12 vs 5.91±2.05, respectively]. Competiting was positively correlated negatively and statistically significantly correlated with all other TKI subscales. Conclusions: Demographic variables and work characteristics may affect how to resolve the conflict. The compromise and avoidance methods as selected by the majority of nurses.

  19. The Factors Affecting Performance of Nurse at Paniai General Hospital

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    Elias Tatogo

    2017-02-01

    Full Text Available General hospital of Paniai regency health service institution under Local Government Paniai Regency with amount of nurse resource counted 69 one who have duty to remain to can improve more certifiable service and reached by society, so to be form degree of health which at the farthest, so that nurse performance of vital importance in giving of health service. The goal of research: To knowing of factors affecting performance of nurse at Paniai general hospital. Method: Type research is causal associative by using quantitative approach. Sample is all of nurse as much 69 nurse with date implemented in October 2016. Data obtained used questioner and analyzed by chi square test. Result of research is obtained that factor’s affecting of nurse performance in Paniai General Hospital is motivation (p-value = 0,001; RP = 3,000; CI95%= 1,607 - 5,601, [job/activity] discipline (p-value = 0,043; RP = 2,068; CI95%= 1,150 - 3,719, reward (p- value = 0,001; RP = 5,008; CI95%= 1,656 - 15,142, punishment (p- value = 0,000 ; RP= 16,839; CI95%= ( 4,310 - 65,784 and style leadership [of] director (p- value = 0,000; RP = 3,333; CI95%= 1,742 - 6,380. The factor’s not related of nurse performance at Paniai general hospital is age (p- value = 1,000 ; RP = 0,908; CI95%= 0,456 - 1,806, long working (p- value = 1,000; RP = 0,908; CI95%= 0,456 - 1,806 and job rotation (p- value = 0,843; RP = 1,190; CI95%= 0,603 – 2,348.

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

    Science.gov (United States)

    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.

  1. Hospital cost flexibility in the presence of many outputs: a public-private comparison.

    Science.gov (United States)

    Crémieux, Pierre-Yves; Ouellette, Pierre; Rimbaud, François; Vigeant, Stéphane

    2005-05-01

    This paper develops flexibility measures in the context of a multi-firm output based on a generalized average cost function. We then apply this methodology to assess and compare the relative flexibility of hospital services in Québec and California based on two very complete data sets. Results indicate that there is no clear distinction between private and public institutions and that there is no clear distinction between Québec and California hospitals. However, there are clear differences in flexibility among different outputs. This last result suggests that there are bottlenecks in the health care system and calls for a targeted approach on the part of hospital administrators, whether public or private, in Québec or California.

  2. [Use of antibiotics in a general hospital (author's transl)].

    Science.gov (United States)

    Escolar, A; Gómez, J; Andreo, J; García-Estany, J; Espi, F; Amorós, T

    1980-10-25

    The utilization of antibiotics at a general hospital has been assessed by retrospectively studying the clinical histories of all patients admitted during the month of April 1978 to the Residencia General de la Ciudad Sanitaria Virgen de la Arrixaca (Murcia, Spain). Medical records were reviewed according to a preestablished protocol. Out of 1.057 patients admitted antibiotics were used in 419 (46%), of whom 189 belonged to the medical services and 302 to the surgical ones. Overall, the surgical services utilized more antibiotics and had less bacteriologic data on their patients. Antibiotics more utilized were ampicillin, which use was generally correct, followed by gentamicin, the G-penicillins, and trimethoprim-sulfamethoxazol. Undesirable side-effects of antibiotic treatment were found in 13 cases (2,6%). Infectious disease of bacterial origin was correctly diagnosed in 40% of the cases, while the diagnosis was doubtful or incorrect in the remaining 60% of cases treated with antibiotics. Appropriate bacteriological data were obtained only in 164 cases (33,4%), with positive results in 75 (49,9%). Independent antibiotics were given in association in 157 cases (31,9%). From this study it can be concluded that the more frequent causes of improper antibiotic utilization were the incorrect clinical diagnosis of bacterial infectious disease, the prophylactic use of antibiotics and the scarcity of bacteriological data. It is therefore suggested that systems of supervision of in-hospital antibiotic prescription be updated and continuous education programs for hospital staff be instituted.

  3. Terapia ocupacional en un hospital general de pacientes agudos = Occupational therapy in a general hospital for acute pacients

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    Ocello, M. G

    2006-09-01

    Full Text Available RESUMEN Desde su creación, el Hospital Provincial “Dr. José María Cullen” posee la característica de ser un hospital de emergencias, sostenido por la Sociedad de Beneficencia y la Hermanas de la Caridad.Su funcionamiento responde a un Modelo Clínico-Asistencial, lo cual influye en la inserción de Terapia Ocupacional debiendo adaptar sus funciones a las características de la Institución.Los marcos de referencia teóricos y programas que se implementandeber ser acordes con las necesidades surgidas de un Hospital General de Agudos y de emergencias.En el Sector de Terapia Ocupacional se desarrolla la actividad docente cumpliendo con los requisitos reglamentados por el Ministerio de Salud de la Provincia de Santa Fe.ABSTRACT Ever since its start the Provincial Hospital “Dr. José María Cullen” is characterised for being an emergency hospital under the guidance of the Benfit Society of Hermanas de la Caridad.Its function responds to a Clinical Assistential Model, which influences the insertion of Occupational Therapy, adapting its functiones to the characteristics of the Institution as and when called for.The theoretical points of reference and programmes that are used must be in accordance with tehe necessities that appear in an Acute and Emergency General Hospital.In the Occupational Therapy Sector the teaching activity is developed as required by rules and regulations of the Ministry of Health for the Province of Santa Fe.

  4. 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.

  5. 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

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    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.

  6. [Neuropaediatric care in the Hospital General Universitario de Guadalajara].

    Science.gov (United States)

    Peña-Segura, J L; López-Pisón, J; Marco-Olloqui, M; Mateos-Hernández, J; Adrados-Razola, I; Jiménez-Bustos, J M

    Influenced by medical, scientific and social advances, the changes that have taken place in the needs of the population have given rise to a growing demand for health care in neuropaediatric pathology. The aim of this study was to determine the neuropaediatric health care requirements at the Hospital General Universitario de Guadalajara, a secondary care hospital that is a reference centre for the province of Guadalajara. We studied the children up to the age of 10 years with a neurological pathology attended at the Hospital General Universitario de Guadalajara over an 8-year period, since the Neuropaediatric unit was opened on 1 July 1992. In all 1,236 children were evaluated, which represents 8.45% of all the children below the age of 10 in the province of Guadalajara, with an average of 154.5 new patients per year. There was a predominance of males, 56.4%, and a high percentage of very young children: 26.05% under the age of 1 year and 50.56% under the age of 3. There has been a progressive increase in the number of Neuropaediatric outpatients, which in the year 2000 accounted for 20% of first visits and 16% of the total number (first and successive) of Paediatric outpatients. 12.94% of the patients in our series had also been examined in different tertiary care hospitals. There is a very high demand for neuropaediatric care in Guadalajara and it is growing in a significant and progressive manner. We suggest it would be advisable to have a tertiary reference hospital available to help cope with this situation.

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

    Science.gov (United States)

    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

  8. Hospital Bed Occupancy and HIV/AIDS in three Major Public Hospitals of Addis Ababa, Ethiopia.

    Science.gov (United States)

    Tamiru, Melesse; Haidar, Jemal

    2010-09-01

    In countries like Ethiopia where the spread of HIV infection is extensive, health services are faced with an increased demand for care. The most obvious reflection of this increased demand is through patient load, longer bed occupancy perhaps to the exclusion of patients with other ailments. The purpose of this study was to describe the bed occupancy rate and the average length of stay of HIV/AIDS inpatients of three major public hospitals. A Retrospective Cross-sectional study was conducted in three major hospitals of Addis Ababa namely Zewditu Memorial Hospital, Tikure Anbessa Hospital and Saint Paul's Hospital from February to March 2004. Of the total 453 sampled inpatients, 293 (65 %) were HIV positives. Over half (55.0%) were Males. The most affected age group was between 24 and 56 years. The majority (85.8%) were from Addis Ababa and over half (57.7%) was married. Housewives constituted about a quarter (26.3%) of all the admitted cases. The most common co-morbidities resulted in admission to the medical wards among the HIV-positive cases were Tuberculosis (73.0%) and jirovicii pneumonia (70.3%), and their occurrence was significantly higher among HIV+ than their counter parts (p=0.001). Although numbers of patients admitted in Tikur Anbesa hospital was more than Saint Paul's and Zewditu Memorial hospitals (ZMH), the proportion of HIV positive cases admitted to ZMH however was higher (49.0%) than Tikur Anbessa (14.0%) and Saint Paul's hospitals (18.0%). Likewise the number of inpatient days was also higher in ZMH (n=7765) than the other hospitals. The bed occupancy rate was however, higher in ZMH (53.0%) than Tikur Anbessa (12.0%) and Saint Paul's (12.0%) hospitals. One of the most obvious consequences of HIV/AIDS patients are the increased occupancy of hospitals beds suggesting that only 81.1 % of the beds are for all other afflictions in the hospitals. It appears that there is a lot of concern that patients with HIV are competing with the non-HIV infected

  9. Fraud Prevention A Study In Regional Public Service Agency BLUD For Hospital In Malang Regency Indonesia

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    Koenta Adji Koerniawan

    2015-08-01

    Full Text Available This study aims to understand the effect of management perceptions in Regional Public Service Agency BLUD for Hospital in Malang regency Indonesia on the role of the Independent Auditor and their understanding towards Good Governance the General Audit Engagement and its implications for the prevention of corruption. This research is quantitative which placed latent variables General Audit Engagements as intervening variables. Partial Least Square PLS is used to confirm the model created in order to explain the relationship between variables. The results show that the perception of BLUD hospital management on the role of independent auditors and their understanding of good governance to give effect to the implementation of the audit engagement and the implications for the prevention of fraud in BLUDs hospital. This is consistent with the theory of auditing and fraud prevention concepts. JEL Classification M420 K420

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

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    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.

  11. Performance Based Supplementary Payment Systems in Istanbul Public Hospitals

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    Ayşegül YILDIRIM KAPTANOĞLU

    2013-01-01

    Full Text Available Since 2003 new healthcare reforms have been implemented in Turkey. Although, the healthcare system has gone through modifications for the past several years; there is insufficient research to demonstrate the effects of these changes. This paper aims to address the issues in the supplementary payment systems, which are one of the recent changes of the healthcare system in the country. This study is mainly based on a review of the relevant professional literature, a research and interpretation of supplementary payment in the public hospitals. This is a research as well as an assessment work done in secondary and tertiary care hospitals. Performance based supplementary payment system in public hospitals aims to provide bonuses to health care employees like physicians, nurses, etc. The bonus is given to professionals, who produce the qualified health services based on records by the evaluation of the whole institution. Financing of supplementary payment system in Turkey is mainly based on social security premiums. Consequently, balance of income and expenditures at hospitals is needed to be followed sensitively. According to this study, physicians' productivity has increased but number of patients per physician has decreased. Also, the amount of performance paid to the physician for their specialty has decreased. Physicians like cardiologists can benefit more from the pay for performance system as their work contributions are paid more compared to internist work. Also secondary care hospital staffs were better paid compared to tertiary care hospitals because more critical cases are sent to tertiary care and treatment of such cases are of high cost. The reforms resulted satisfactory and very successful improvement in healthcare performance. The main health indicators are now better than at the beginning of the transition period. The sustainability of the reform processes will cause further improvement in the near future. The number of treatments per

  12. Hospital Anxiety and Depression Scale (HADS: validation in a Greek general hospital sample

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    Patapis Paulos

    2008-03-01

    Full Text Available Abstract Background The Hospital Anxiety and Depression Scale (HADS has been used in several languages to assess anxiety and depression in general hospital patients with good results. Methods The HADS was administered to 521 participants (275 controls and 246 inpatients and outpatients of the Internal Medicine and Surgical Departments in 'Attikon' General Hospital in Athens. The Beck Depression Inventory (BDI and the State-Trait Anxiety Inventory (STAI were used as 'gold standards' for depression and anxiety respectively. Results The HADS presented high internal consistency; Cronbach's α cofficient was 0.884 (0.829 for anxiety and 0.840 for depression and stability (test-retest intraclass correlation coefficient 0.944. Factor analysis showed a two-factor structure. The HADS showed high concurrent validity; the correlations of the scale and its subscales with the BDI and the STAI were high (0.722 – 0.749. Conclusion The Greek version of HADS showed good psychometric properties and could serve as a useful tool for clinicians to assess anxiety and depression in general hospital patients.

  13. [Nutritional status in hospitalized patients in a public hospital in Mexico City].

    Science.gov (United States)

    Fuchs, V; Mostkoff, D; Salmeán, G Gutiérrez; Amancio, O

    2008-01-01

    To determine the frequency of malnutrition among hospitalized patients and to relate nutrition status with body mass index, fasting time, adequacy intake of protein and energy during hospitalization and length of stay. METHODS (STUDY POPULATION, SUBJECTS, INTERVENTION): We evaluated weight loss in the last 6 months prior to admission, body mass index (BMI), ideal and usual body weight percentages, days of hospitalization, energy and protein intake adequacy, fasting days and cause in hospitalized patients at different wards at Hospital General de Mexico. Patients were divided into groups according to their nutritional status (at risk/with malnutrition or normal) and data was assessed descriptively and comparatively by t-tests to determine mean differences. We assessed 561 hospitalized patients. We found different frequencies of malnutrition according to various indicators: 21.17% according to BMI, 38.07% and 19.57% by percentages of habitual and ideal weights--respectively-- and a weight loss in 69.57% of the patients. Mean daily energy intake was found to be of 1,061+/-432.7 kcal, while mean protein intake was 42.1 + 22.7 g, representing only the 69.4% and 54.9% of the energy and protein requirements. We found statically significant differences among malnourished and normal patients in relation to BMI (p Malnutrition is common in hospitalized patients. An important factor in hospital malnutrition is the lack of compliance in the patient's requirements, preventing a fast recovery and increasing their length of stay. Thus, it is important to make changes and improvements in the institutional health system so that there is trained personnel in order to provide and adequate nutrition care attention to the critically ill patient, improving their condition and general prognosis.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

  16. Optimal administrative scale for planning public services: a social cost model applied to Flemish hospital care.

    Science.gov (United States)

    Blank, Jos L T; van Hulst, Bart

    2015-01-01

    In choosing the scale of public services, such as hospitals, both economic and public administrative considerations play important roles. The scale and the corresponding spatial distribution of public institutions have consequences for social costs, defined as the institutions' operating costs and the users' travel costs (which include the money and time costs). Insight into the relationship between scale and spatial distribution and social costs provides a practical guide for the best possible administrative planning level. This article presents a purely economic model that is suitable for deriving the optimal scale for public services. The model also reveals the corresponding optimal administrative planning level from an economic perspective. We applied this model to hospital care in Flanders for three different types of care. For its application, we examined the social costs of hospital services at different levels of administrative planning. The outcomes show that the social costs of rehabilitation in Flanders with planning at the urban level (38 areas) are 11% higher than those at the provincial level (five provinces). At the regional level (18 areas), the social costs of rehabilitation are virtually equal to those at the provincial level. For radiotherapy, there is a difference of 88% in the social costs between the urban and the provincial level. For general care, there are hardly any cost differences between the three administrative levels. Thus, purely from the perspective of social costs, rehabilitation should preferably be planned at the regional level, general services at the urban level and radiotherapy at the provincial level.

  17. Improving the smoking patterns in a general hospital psychiatric unit

    Directory of Open Access Journals (Sweden)

    Celso Iglesias García

    2009-01-01

    Full Text Available Objectives: The purpose of the present paper is to evaluate the effects of a smoking ban in a general hospital psychiatric unit. Methods: We study the effects of smoking ban in 40 consecutive psychiatric inpatients. The staff registered socio-demographic and tobacco-related variables. We also registered any kind of behavioral effects of smoking ban.Results: The patients were willing to stop smoking during their hospital stay (with or without nicotine replacement with two mild behavioural incidences registered throughout the study. Conclusions: The benefits of non-smoking policy in a psychiatric unit can be significant. The introduction of smoking bans in psychiatric inpatients settings is possible and safe.

  18. Workplace Bullying Among the Nursing Staff of Greek Public Hospitals.

    Science.gov (United States)

    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.

  19. Trabalho, saúde e subjetividade sob o olhar dos trabalhadores administrativo-operacionais de um hospital geral, público e universitário Work, health and subjectivity in the viewpoint of administrative and operational workers in a public general university hospital

    Directory of Open Access Journals (Sweden)

    Desiree Luzardo Cardozo Bianchessi

    2009-01-01

    investigation was to analyze the suffering of administrative and operational workers and the strategies of health production, due to the frequent occurrence of illnesses and absences from work. The conceptual field articulates the concepts of work, health and subjectivity, seeking the extension of the analysis of the focus in clinical diagnosis. The methodological strategies are based on the assumptions of intervention research, using the group device to operate in the field, combined with individual interviews, observations in the workplace and photographic intervention. The analyses show the configuration of the suffering of administrative and operational worker as related to the experience of invisibility, generated by collisions in labor relations in the organization of work at the hospital, where his place is associated with unworthiness and disqualification. Games of truth in the hospital show that the work recognized as having value is linked to medicine and to the prominent place medical knowledge historically occupies in the hospital. The workers studied suggest experiences of powerlessness in the face of demands of patients and families, considering the limitations imposed by public health policies. In view of the tensions generated in these experiences, they produce strategies linked to the production of health and coping with daily work in the hospital. The intervention research has provided multiple assemblages in the group, making it feasible to carry out the necessary changes in working relationships, bringing new meaning and seeking other modes of subjectivation.

  20. Dispositivos clínicos em hospital geral Clinical dispositives in the general hospital

    Directory of Open Access Journals (Sweden)

    Ana Cleide Guedes Moreira

    2006-01-01

    Full Text Available Este trabalho participa de investigação sobre a inserção da Psicanálise no campo institucional e hospitalar de saúde, objetivando formular contribuições, a partir da clínica da melancolia e dos estados depressivos, para a construção de dispositivos clínicos em hospital geral do Sistema Único de Saúde.This paper is a part of a research project that investigates the insertion of Psychoanalysis into the health institutional field and hospitals; the objective is to formulate contributions from the clinic of melancholic and depressive states to the construction of clinical dispositives in general hospital of the "Sistema Único de Saúde (Unified Health System.

  1. Quality of inpatient care in public and private hospitals in Sri Lanka.

    Science.gov (United States)

    Rannan-Eliya, Ravindra P; Wijemanne, Nilmini; Liyanage, Isurujith K; Dalpatadu, Shanti; de Alwis, Sanil; Amarasinghe, Sarasi; Shanthikumar, Shivanthan

    2015-03-01

    To compare the quality of inpatient clinical care in public and private hospitals in Sri Lanka. A retrospective, cross-sectional comparison was done of inpatient quality, in a sample of 11 public and 10 private hospitals in three of 25 districts. Data were collected for 55 quality indicators from medical records of 2523 public and 1815 private inpatient admissions. These covered treatment of asthma, acute myocardial infarction (AMI), childbirth and five other conditions, along with outcome indicators, and medicine prescribing indicators. Overall quality scores were better in the public sector than the private sector (77 vs 69%). Performance was similar for management of AMI and childbirth and somewhat better in the private sector for management of asthma. The public sector performed better in those indicators that are not constrained by resources (94 vs 81%), but worse in indicators that are highly resource intensive (10 vs 31%). Quality was comparable in assessment and investigation, but the public sector performed better in treatment and management (70 vs 62%) and drug prescribing (68 vs 60%), and modestly worse in terms of outcomes (92 vs 97%). For a range of indicators where comparisons were possible, quality of inpatient clinical care in Sri Lanka was comparable to levels reported from upper-middle income Asian countries, and often approaches that in developed countries, although the findings cannot be generalized. Quality in the public sector is better than in the private sector in many areas, despite spending being substantially less. Quality in public hospitals is resource constrained, and needs greater government investment for improvement, but when resource limitations are not critical, the public sector appears able to deliver equal or better quality than the private sector. Overall similarities in quality between the two sectors suggest the importance of physician training and other factors. Published by Oxford University Press in association with The

  2. Optimising neuroimaging effectiveness in a district general hospital.

    Science.gov (United States)

    McCarron, M O; Wade, C; McCarron, P

    2014-01-01

    Diagnostic accuracy in neurology frequently depends on clinical assessment and neuroimaging interpretation. We assessed neuroimaging discrepancy rates in reported findings between general radiologists and neuroradiologists among patients from a district general hospital (DGH). A neuroradiologist's report was sought on selected DGH patients over 28 months. Pre-planned outcomes included comparisons of primary findings (main diagnosis or abnormality), secondary findings (differential diagnoses and incidental findings) and advice from neuroradiologists for further investigations. A total of 233 patients (119 men and 114 women), mean age 47.2 (SD 17.8) years were studied: 43 had a computed tomography (CT) brain scan only, 37 had CT and magnetic resonance imaging (MRI) scans and 153 had only MRI scans. Discrepancies in the primary diagnosis/abnormality were identified in 33 patients (14.2%). This included 7 of 43 patients (16.3%) who had a CT brain scan as their only neuroimaging. Secondary outcomes differed in 50 patients (21.5%). Neuroradiologists recommended further neuroimaging for 29 patients (12.4%). The most common discrepancies in the primary diagnosis/abnormality were misinterpreting normal for hippocampal sclerosis and missed posterior fossa lesions. There was no evidence of temporal changes in discrepancy rates. Selecting CT and MR neuroimaging studies from general hospitals for reviewing by neuroradiologists is an important and effective way of optimising management of neurological patients.

  3. A general model of the public goods dilemma.

    Science.gov (United States)

    Frank, Steven A

    2010-06-01

    An individually costly act that benefits all group members is a public good. Natural selection favours individual contribution to public good [corrected] only when some benefit to the individual offsets the cost of contribution. Problems of sex ratio, parasite virulence, microbial metabolism, punishment of noncooperators, and nearly all aspects of sociality have been analysed as public goods shaped by kin and group selection. Here, I develop two general aspects of the public goods problem that have received relatively little attention. First, variation in individual resources favours selfish individuals to vary their allocation to public goods. Those individuals better endowed contribute their excess resources to public benefit, whereas those individuals with fewer resources contribute less to the public good. Thus, purely selfish behaviour causes individuals to stratify into upper classes that contribute greatly to public benefit and social cohesion and to lower classes that contribute little to the public good. Second, if group success absolutely requires production of the public good, then the pressure favouring production is relatively high. By contrast, if group success depends weakly on the public good, then the pressure favouring production is relatively weak. Stated in this way, it is obvious that the role of baseline success is important. However, discussions of public goods problems sometimes fail to emphasize this point sufficiently. The models here suggest simple tests for the roles of resource variation and baseline success. Given the widespread importance of public goods, better models and tests would greatly deepen our understanding of many processes in biology and sociality.

  4. Pharmacy services at admission and discharge in adult, acute, public hospitals in Ireland.

    LENUS (Irish Health Repository)

    Grimes, Tamasine

    2012-02-01

    OBJECTIVES: to describe hospital pharmacy involvement in medication management in Ireland, both generally and at points of transfer of care, and to gain a broad perspective of the hospital pharmacy workforce. METHODS: a survey of all adult, acute, public hospitals with an accident and emergency (A&E) department (n = 36), using a semi-structured telephone interview. KEY FINDINGS: there was a 97% (n = 35) response rate. The majority (n = 25, 71.4%) of hospitals reported delivery of a clinical pharmacy service. On admission, pharmacists were involved in taking or verifying medication histories in a minority (n = 15, 42.9%) of hospitals, while few (n = 6,17.1%) deployed staff to the A&E\\/acute medical admissions unit. On discharge, the majority (n = 30,85.7%) did not supply any take-out medication, a minority (n =5,14.3%) checked the discharge prescription, 51.4% (n = 18) counselled patients, 42.9% (n = 15) provided medication compliance charts and one hospital (2.9%) communicated with the patient\\'s community pharmacy. The number of staff employed in the pharmacy department in each hospital was not proportionate to the number of inpatient beds, nor the volume of admissions from A&E. There were differences identified in service delivery between hospitals of different type: urban hospitals with a high volume of admissions from A&E were more likely to deliver clinical pharmacy. CONCLUSIONS: the frequency and consistency of delivering pharmacy services to facilitate medication reconciliation at admission and discharge could be improved. Workforce constraints may inhibit service expansion. Development of national standards of practice may help to eliminate variation between hospitals and support service development.

  5. General medications utilization and cost patterns in hospitalized children

    Directory of Open Access Journals (Sweden)

    Kassis I

    2009-03-01

    Full Text Available Drug utilization in the in-patient setting can provide mechanisms to assess drug prescribing trends, efficiency and cost-effectiveness of hospital formularies and examine sub-populations such as children for which prescribing habits are different from adults. Objectives: The aim of this descriptive study was to analyze general medication utilization patterns and costs excluding antimicrobials prescriptions and to compare two pediatric admission units in a tertiary care university hospital. Methods: The total number of admitted children was 1,521 and 1,467 for the A and B admission units, respectively. The electronic data from 252 and 253 hospitalized children in the A and B admission unit were prospectively screened for general medication prescriptions, children on antimicrobials were excluded from the analysis. Their electronic charts were viewed once weekly from October 15, 2007 up to April 7, 2008 using the prescription-point prevalence method. One medication was considered to be one prescription. Results: The general medications prescription number was 790 for 94 children (8.4 prescription/patient in A and 959 for 88 children (10.9 prescription/patient in B (p=0.02. The general medications defined daily dose (DDD and drug utilization 90% (DU90% index were 2,509.63, 2,259 for A; and 6,110.35, 5,499 for B, respectively. The DU90% index placed salbutamol inhalation with 835 DDD and sodium heparin with 2,102 DDD in the first place for the A and B admission units, respectively. A net increment in medication cost was registered according to the calculated cost from the depicted DU90% when the A (20,263 NIS and B (6,269 NIS admission units were compared (p=0.04. Conclusions: A significant difference in the prescription utilization of general medications was shown between the A and B admission units. The A admission unit had lower prescriptions measured by the DU90% index with higher medication cost. Potential drug-drug interactions were depicted in

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  8. Alcohol misuse in the general hospital: some hard facts.

    LENUS (Irish Health Repository)

    Bradshaw, P

    2012-02-03

    AIMS: To examine (1) the prevalence of alcohol use disorders in adult general hospital inpatients; (2) the accuracy of documentation in relation to alcohol use. METHODS: A total of 210 random patients were interviewed out of 1,448 consecutive new admissions to CUH over 7 days. Case notes were reviewed for 206 (98%). Alcohol consumption was assessed using the Fast Alcohol Screening Test (FAST) and weekly drinking diary. FAST-positive (and a random sample of FAST-negative) patients then had a standardized interview. RESULTS: A total of 82% admitted for drinking alcohol. Among them 22% were drinking in excess of guidelines, 9% had DSM-IV Alcohol Abuse and 7% dependence. The sensitivity and specificity of the FAST for detecting those drinking above guidelines were 89 and 94% and for detecting a DSM-IV diagnosis was 100 and 73%. The majority of case notes contained inadequate information about alcohol intake. CONCLUSION: Alcohol use disorders are common and often undetected in the general hospital setting.

  9. Recurrence of inguinal hernias repaired in a large hernia surgical specialty hospital and general hospitals in Ontario, Canada.

    Science.gov (United States)

    Malik, Atiqa; Bell, Chaim M; Stukel, Thérèse A; Urbach, David R

    2016-02-01

    The effect of hospital specialization on the risk of hernia recurrence after inguinal hernia repair is not well described. We studied Ontario residents who had primary elective inguinal hernia repair at an Ontario hospital between 1993 and 2007 using population-based, administrative health data. We compared patients from a large hernia specialty hospital (Shouldice Hospital) with those from general hospitals to determine the risk of recurrence. We studied 235 192 patients, 27.7% of whom had surgery at Shouldice hospital. The age-standardized proportion of patients who had a recurrence ranged from 5.21% (95% confidence interval [CI] 4.94%-5.49%) among patients who had surgery at the lowest volume general hospitals to 4.79% (95% CI 4.54%-5.04%) who had surgery at the highest volume general hospitals. In contrast, patients who had surgery at the Shouldice Hospital had an age-standardized recurrence risk of 1.15% (95% CI 1.05%-1.25%). Compared with patients who had surgery at the lowest volume hospitals, hernia recurrence among those treated at the Shouldice Hospital was significantly lower after adjustment for the effects of age, sex, comorbidity and income level (adjusted hazard ratio 0.21, 95% CI 0.19-0.23, p hernia repair at Shouldice Hospital was associated with a significantly lower risk of subsequent surgery for recurrence than repair at a general hospital. While specialty hospitals may have better outcomes for treatment of common surgical conditions than general hospitals, these benefits must be weighed against potential negative impacts on clinical care and the financial sustainability of general hospitals.

  10. Integration of a psychoanalytic liaison department at a public hospital.

    Science.gov (United States)

    Neuburger, R P

    2000-08-01

    A general overview of liaison-psychoanalysis in a general hospital is presented. The team's trajectory is revisited, as generating a presence in the inpatient units: a demand which changes from a purely psychiatric, scarcely operative level to an acknowledgment of subjectivity. Generally, this appears disruptively in medical proceedings. Two case histories are presented: (i) 'the tenant' and (ii) 'the nail-polishing file'. With regard to the first case history, the transference in its double aspect, with the patient as well as with the unit's staff, is examined. The analyst's intervention seeks to untangle the impasse, which prevents the physicians from helping the patient. With regard to the second case history, in which the de-mystification aspects of liaison work are shown, the horror that the so-called 'mental illness' can produce in the medical institution is explored. The aim of narrating this experience is to preserve a psy-space in the hospital where the overwhelming technological developments menace with its disappearance.

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

    Science.gov (United States)

    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."

  12. Sustained public preferences on hospital performance across Canadian provinces.

    Science.gov (United States)

    Sandoval, Guillermo A; Barnsley, Jan; Berta, Whitney; Murray, Michael; Brown, Adalsteinn D

    2007-10-01

    To compare the Canadian public's view of various components of hospital performance at two points in time, and to investigate differences across provinces. Random telephone interviews were conducted across Canada in 2001 and again in 2004. Respondents were asked to rate the importance of 10 aspects of hospital performance including coordination, skills of providers, the use of technology, medical errors, and waiting times. Aggregate importance scores were estimated in 2001 and 2004 and compared using t-tests. Provincial comparisons were investigated using analysis of covariance (ANCOVA) with a Bonferroni correction of 0.005 (0.05/10). The covariates were sex, age, marital status, education, working status, and income. Public preferences were similar across provinces and consistent over the two periods; however, respondents from Quebec showed a pattern somewhat different in each year and over time. Overall, the importance scores in Quebec tended to be lower than those from the other provinces. Respondents from all provinces except Quebec ascribed the greatest value to 'skill of medical staff' in 2001 and 2004. Those from Quebec, however, gave the highest rating to 'skill of medical staff' in 2001 and 'medical errors' in 2004; the latter climbed from the 8th to the 1st place over time. All respondents gave 'waiting time for a non-emergency surgical procedure' the lowest score in both years, although its importance score increased a significant 18% between 2001 and 2004 excluding the responses from Quebec. Significant covariates were sex, marital status, and education. Public preferences can help inform the work of health care policy and decision makers, particularly that related to resource allocation decisions.

  13. Managerial performance and cost efficiency of Japanese local public hospitals: a latent class stochastic frontier model.

    Science.gov (United States)

    Besstremyannaya, Galina

    2011-09-01

    The paper explores the link between managerial performance and cost efficiency of 617 Japanese general local public hospitals in 1999-2007. Treating managerial performance as unobservable heterogeneity, the paper employs a panel data stochastic cost frontier model with latent classes. Financial parameters associated with better managerial performance are found to be positively significant in explaining the probability of belonging to the more efficient latent class. The analysis of latent class membership was consistent with the conjecture that unobservable technological heterogeneity reflected in the existence of the latent classes is related to managerial performance. The findings may support the cause for raising efficiency of Japanese local public hospitals by enhancing the quality of management. Copyright © 2011 John Wiley & Sons, Ltd.

  14. Incidence of and Risk Factors for Hospital-Acquired Diarrhea in Three Tertiary Care Public Hospitals in Bangladesh

    OpenAIRE

    Bhuiyan, Mejbah Uddin; Luby, Stephen P.; Zaman, Rashid Uz; Rahman, M. Waliur; Sharker, M. A. Yushuf; Hossain, M. Jahangir; Rasul, Choudhury H.; Ekram, A. R. M. Saifuddin; Rahman, Mahmudur; Sturm-Ramirez, Katharine; Azziz-Baumgartner, Eduardo; Gurley, Emily S.

    2014-01-01

    During April 2007–April 2010, surveillance physicians in adult and pediatric medicine wards of three tertiary public hospitals in Bangladesh identified patients who developed hospital-acquired diarrhea. We calculated incidence of hospital-acquired diarrhea. To identify risk factors, we compared these patients to randomly selected patients from the same wards who were admitted > 72 hours without having diarrhea. The incidence of hospital-acquired diarrhea was 4.8 cases per 1,000 patient-days. ...

  15. Factors affecting the informal payments in public and teaching hospitals

    Science.gov (United States)

    Aboutorabi, Ali; Ghiasipour, Maryam; Rezapour, Aziz; Pourreza, Abolghasem; Sarabi Asiabar, Ali; Tanoomand, Asghar

    2016-01-01

    Background: Informal payments in the health sector of many developing countries are considered as a major impediment to health care reforms. Informal payments are a form of systemic fraud and have adverse effects on the performance of the health system. In this study, the frequency and extent of informal payments as well as the determinants of these payments were investigated in general hospitals affiliated to Tehran University of Medical Sciences. Methods: In this cross-sectional study, 300 discharged patients were selected using multi-stage random sampling method. First, three hospitals were selected randomly; then, through a simple random sampling, we recruited 300 discharged patients from internal, surgery, emergency, ICU & CCU wards. All data were collected by structured telephone interviews and questionnaire. We analyzed data using Chi- square, Kruskal-Wallis and Mann-Whitney tests. Results: The results indicated that 21% (n=63) of individuals paid informally to the staff. About 4% (n=12) of the participants were faced with informal payment requests from hospital staff. There was a significant relationship between frequency of informal payments with marital status of participants and type of hospitals. According to our findings, none of the respondents had informal payments to physicians. The most frequent informal payments were in cash and were made to the hospitals’ housekeeping staff to ensure more and better services. There was no significant relationship between the informal payments with socio-demographic characteristics, residential area and insurance status. Conclusion: Our findings revealed that many strategies can be used for both controlling and reducing informal payments. These include training patients and hospitals’ staff, increasing income levels of employees, improving the quantity and quality of health services and changing the entrenched beliefs that necessitate informal payments. PMID:27390685

  16. Qualitative Performance Evaluation of Hospitals Using DEA, Balanced Scorecard and Servqual; A Case Study of General Hospitals of Yazd

    Directory of Open Access Journals (Sweden)

    M Asadi

    2011-02-01

    Full Text Available Introduction: Evaluation is an important factor in productivity context, and acts as a control system for other areas of productivity. Hospitals are large organizations incurring heavy expenses in every country. The level of efficiency in a hospital is a good criterion to understand how hospitals consume their resources. The goal of this research was to determine relative efficiency of 13 public hospitals in Yazd province by using integrated DEA, BSC and SERVQUAL model. Methods: In this study, relative efficiency of 13 public hospitals of Yazd province was calculated using data envelopment analysis technique(DEA and balanced score card and servqual. BSC was used as a tool for designing of performance evaluation indexes, while DEA was used as a tool of evaluating performance and ranking. Results: The mean relative efficiency of hospitals under study was about 0.945 in the Persian calendar year 2008-9. The efficiency levels of nine hospitals were borderline and the efficiency of four hospitals was less than 1. Hospital no.3 had the highest efficiency levels and hospital no.10 had the lowest efficiency level. Conclusion: In this stage, on the basis of references presented by the DEA model, solutions for increasing the quality performance levels of inefficient hospitals in fourth dimensions were determined and some suggestions were proposed. Although all performance indices of the inefficient hospitals need to be addressed, priorities have to be determined by the respective managers.

  17. Patient experience with outpatient encounters at public hospitals in Shanghai: Examining different aspects of physician services and implications of overcrowding.

    Science.gov (United States)

    Bao, Yuhua; Fan, Guanrong; Zou, Dongdong; Wang, Tong; Xue, Di

    2017-01-01

    Over 90% of outpatient care in China was delivered at public hospitals, making outpatient experience in this setting an important aspect of quality of care. To assess outpatient experience with different aspects of physician services at China's public hospitals and its association with overcrowding of the hospital outpatient departments. Retrospective analysis of a large survey of outpatient experience in Shanghai, China. We tested the hypotheses that patient experience was poorer with physician-patient communication, education, and shared decision-making and where and when there was greater overcrowding of the hospital outpatient departments. Ordered logistic models were estimated separately for general and specialty hospitals. 7,147 outpatients at 40 public hospitals in Shanghai, China, in 2014. Patient experience with physician services were self-reported based on 12 questions as part of a validated instrument. Indicators of overcrowding included time of visit (morning vs. afternoon, Monday vs. rest of the week) and hospital outpatient volume in the first half of 2014. Overall, patients reported very favorable experience with physician services. Two out of the 12 questions pertaining to both communication and shared decision-making consistently received lower ratings. Hospitals whose outpatient volumes were in the top two quartiles received lower patient ratings, but the relationship achieved statistical significance among specialty hospitals only. Inadequate physician-patient communication and shared decision-making and hospital overcrowding compromise outpatient experience with physician services at Chinese public hospitals. Effective diversion of patients with chronic and less complex conditions to community health centers will be critical to alleviate the extreme workloads at hospitals with high patient volumes and, in turn, improve patient experience.

  18. Intervention to increase mammography utilization in a public hospital.

    Science.gov (United States)

    Davis, T C; Berkel, H J; Arnold, C L; Nandy, I; Jackson, R H; Murphy, P W

    1998-04-01

    To study the effects of three approaches to increasing utilization of screening mammography in a public hospital setting in Northwest Louisiana. Randomized intervention study. Four hundred forty-five women aged 40 years and over, predominantly low-income and with low literacy skills, who had not had a mammogram in the preceding year. All interventions were chosen to motivate women to get a mammogram. Group 1 received a personal recommendation from one of the investigators. Group 2 received the recommendation plus an easy-to-read National Cancer Institute (NCI) brochure. Group 3 received the recommendation, the brochure, and a 12-minute interactive educational and motivational program, including a soap-opera-style video, developed in collaboration with women from the target population. Mammography utilization was determined at 6 months and 2 years after intervention. A significant increase (p = .05) in mammography utilization was observed after the intervention designed in collaboration with patients (29%) as compared with recommendation alone (21%) or recommendation with brochure (18%) at 6 months. However, at 2 years the difference favoring the custom-made intervention was no longer significant. At 6 months there was at least a 30% increase in the mammography utilization rate in the group receiving the intervention designed in collaboration with patients as compared with those receiving the recommendation alone or recommendation with brochure. Giving patients an easy-to-read NCI brochure and a personal recommendation was no more effective than giving them a recommendation alone, suggesting that simply providing women in a public hospital with a low-literacy-level, culturally appropriate brochure is not sufficient to increase screening mammography rates. In a multivariate analysis, the only significant predictor of mammography use at 6 months was the custom-made intervention.

  19. EMERGING ANTIMICROBIAL RESISTANCE IN HOSPITAL A THREAT TO PUBLIC HEALTH

    Directory of Open Access Journals (Sweden)

    Vichal Rastogi

    2013-01-01

    Full Text Available Background: Antimicrobial resistance(AMR threatens the health of many throughout the world, since both old and new infectious diseases remain a formidable public health threat. When pathogenic microorganisms can multiply beyond some critical mass in the face of invading antimicrobials, treatment outcome is compromised. This phenomenon is referred as antimicrobial resistance (AMR. Objective: This retrospective study was conducted to assess the overall antimicrobial resistance in bacterial isolates from tertiary care hospitals as majority of patients here receive empirical antibiotics therapy. Method: This retrospective study was carried out in teaching hospital, Greater Noida to determine prevalence of multidrug resistance in patients in relation to empirical antibiotic therapy in hospital. Various samples (pus,urine,blood were collected for bacterial culture and antibiotic sensitivity. Results: Total 500 bacterial strains isolated from ICU, surgery, obstetrics & gynaecology and orthopaedics and their sensitivity pattern was compared in this study. The highest number of resistant bacterias were of pseudomonas sp. i.e. 21(33.87% followed by 16(25.80% of staphylococcus aureus, 12(19.35% of Escherichia coli, Klebseilla sp & Proteus vulgaris were 05(8.06% each & Citrobacter sp. 03(4.83%. Total 62(12.4% bacterial isolates were found to be resistant to multiple drugs. The 31 (50% of these resistant bacteria were prevalent in ICU, 12(19.35% in Surgery, 11(17.74% in Gynaecology, 08(12.90% in Orthopaedics.. All the bacterial strains were resistant to common antibiotics like Penicillin, Amoxicillin, Doxycycline & Cotrimoxazole and some were even resistant to Imipenem. Conclusion: Therefore we have outlined the nature of the antimicrobial resistance problem as an important health issue for national and international community. It is advised to avoid use of empirical antibiotics therapy.

  20. 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…

  1. 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…

  2. Patient satisfaction questionnaire and quality achievement in hospital care: the case of a Greek public university hospital.

    Science.gov (United States)

    Matis, Georgios K; Birbilis, Theodossios A; Chrysou, Olga I

    2009-11-01

    The scope of this research has been to investigate the satisfaction of Greek patients hospitalized in a tertiary care university public hospital in Alexandroupolis, Greece, in order to improve medical, nursing and organizational/administrative services. It is a cross-sectional study involving 200 patients hospitalized for at least 24 h. We administered a satisfaction questionnaire previously approved by the Greek Health Ministry. Four aspects of satisfaction were employed (medical, hotel facilities/organizational, nursing, global). Using principal component analysis, summated scales were formed and tested for internal consistency with the aid of Cronbach's alpha coefficient. The non-parametric Spearman rank correlation coefficient was also used. The results reveal a relatively high degree of global satisfaction (75.125%), yet satisfaction is higher for the medical (89.721%) and nursing (86.432%) services. Moreover, satisfaction derived from the hotel facilities and the general organization was found to be more limited (76.536%). Statistically significant differences in participant satisfaction were observed (depending on age, gender, citizenship, education, number of previous admissions and self-assessment of health status at the first and last day of patients' stay) for the medical, nursing and hotel facilities/organizational dimension, but not for global satisfaction. The present study confirms the results of previously published Greek surveys.

  3. Strategic inventory management: An example of a public hospital

    Directory of Open Access Journals (Sweden)

    Murat Türk

    2011-02-01

    Full Text Available Businesses have to develop and implement effective stock policies to maximize profits by minimizing costs in today's market conditions. Since the stocks enterprises between 20% to 60% within total assets of manufacturing, effective implementation of stock control and management policies, has great importance for the future of business. Businesses’ execution of it’s stock policies at the lowest cost depends on the forecasting amount of stock based on demand at least error, and minimum stock level determination and the appropriate time and amount of orders given to it. Thus, time and cost savings will be achieved by ensuring balance of continuity and speed in production of goods and services in the production process.By the rapid changes in consumer preferences, the variety of products, technologies and competitors are rapidly changing and increasing in rate. By increases in product variety, stock control and management is becoming even more difficult and complex. In recent years, effective and efficient resource use and management began to be kept in the foreground in public institutions as well as private sector. Public hospitals have been diverged from other business such as restaurant and hotel since it is an inpatient treatment business. It’s obligation of keeping right supplies in right amount, in the right place at the right time and cost is stricter comparing other institutions.

  4. Strategic inventory management: an example of a public hospital

    Directory of Open Access Journals (Sweden)

    Murat Türk

    2011-02-01

    Full Text Available Businesses have to develop and implement effective stock policies to maximize profits by minimizing costs in today's market conditions. Since the stocks enterprises between 20% to 60% within total assets of manufacturings,  effective implementation of stock control and management policies, has great importance for the future of business.Businesses’ execution of it’s stock policies at the lowest cost depends on the forecasting amount of stock based on demand at least error, and minimum stock level determination and the appropriate time and amount of orders given to it. Thus, time and cost savings will be achieved by ensuring balance of continuity and speed in production of goods and services in the production process.By the rapid changes in consumer preferences, the variety of products, technologies and competitors are rapidly changing and increasing in rate. By increases in product variety, stock control and management is becoming even more difficult and complex.In recent years, effective and efficient resource use and management began to be kept in the foreground in public institutions as well as private sector. Public hospitals have been diverged from other business such as restaurant and hotel since it  is an inpatient treatment business.It’s obligation of keeping right supplies in right amount, in the right place at the right time and cost is more strict comparing other institutions.

  5. Costs of vaginal delivery and Caesarean section at a tertiary level public hospital in Islamabad, Pakistan

    Directory of Open Access Journals (Sweden)

    Zaman Shakila

    2010-01-01

    Full Text Available Abstract Background Public hospitals in developing countries, rather than the preventive and primary healthcare sectors, are the major consumers of healthcare resources. Imbalances in rational, equitable and efficient allocation of scarce resources lie in the scarcity of research & information on economic aspects of health care. The objective of this study was to determine the average cost of a spontaneous vaginal delivery and Caesarean section in a tertiary level government hospital in Islamabad, Pakistan and to estimate the out of pocket expenditures to households using these services. Methods This hospital based cost accounting cross sectional study determines the average cost of vaginal delivery and Caesarean section from two perspectives, the patient's and the hospital. From the patient's perspective direct and indirect expenditures of 133 post-partum mothers (65 delivered by Caesarean section & 68 by spontaneous vaginal delivery admitted in the maternity general ward were determined. From the hospital perspective the step down methodology was adopted, capital and recurrent costs were determined from inputs and cost centers. Results The average cost for a spontaneous vaginal delivery from the hospital's side was 40 US$ (2688 rupees and from the patient's perspective was 79 US$ (5278 rupees. The average cost for a Caesarean section from the hospital side was 162 US$ (10868 rupees and 204 US$ (13678 rupees from the patient's side. Average monthly household income was 141 ± 87 US$ for spontaneous vaginal delivery and 168 ± 97 US$ for Caesarean section. Three fourth (74% of households had a monthly income of less than 149 US$ (10000 rupees. Conclusion The apparently "free" maternity care at government hospitals involves substantial hidden and unpredicted costs. The anticipated fear of these unpredicted costs may be major factor for many poor households to seek cheaper alternate maternity healthcare.

  6. Should smallpox vaccine be made available to the general public?

    Science.gov (United States)

    May, Thomas; Silverman, Ross D

    2003-06-01

    In June 2002, the Advisory Committee on Immunization Practices (ACIP) approved draft recommendations concerning preparation for potential biological terror attacks that utilize the smallpox virus. ACIP recommends against both mandatory and voluntary vaccination of the general public. The present paper examines the moral and political considerations both for and against each of the general public vaccination options considered by the ACIP in the context of the state's authority over vaccination for the purposes of protecting public health. Although it is clear that compulsory mass vaccination is not justified at this time, the issues surrounding voluntary vaccination are more complex. Should smallpox vaccination prior to an outbreak be made available to the general public? The paper concludes that the vaccine should not be made available at this time. This conclusion, however, is based upon contingent features of current circumstances, which would change once an outbreak occurred. In the even of a terror-related outbreak of smallpox, the general public's access to voluntary vaccination would become justified, even in areas beyond where the outbreak has occurred.

  7. GENERAL GOVERNMENT DEFICIT AND PUBLIC DEBT IN EU MEMBER STATES

    OpenAIRE

    2011-01-01

    The aim of this article is the presentation and the attempt to analyse such phenomena as: an excessive general government deficit and public debt in EU Member States over the past 3 years. For the European Union the years 2008-2010 were the time when public finances of most member countries worsened dramatically. The average budget deficit in the EU increased during that period to a value of almost 7% compared to gross domestic product and public debt reached almost 80% of GDP. Referring the ...

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

    Science.gov (United States)

    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.

  9. General Characteristics of HIV/AIDS Patients in Ditan Hospital

    Institute of Scientific and Technical Information of China (English)

    刘彦春; 徐克沂; 张福杰; 赵红心; 李兴旺; 李秀兰; 闫会文

    2004-01-01

    Objective: To elucidate general characteristics of HIV/AIDS patients seeking care at Ditan Hospital in an attempt to guide early diagnosis in routine medical care. Materials and methods: A retrospective analysis of 185 HIV/AIDS cases from January 1990 to June 2002 was completed using SPSS statistical analysis. Results: Male to female ratio was 1.8:1. Subjects ranged in age from 1 year old to 64 years old. 16 cases were younger than 20 years old with the median age among the younger subset at 7.7 years. 169 cases were older than 20 years old with a median age of 36 years old. 29% of the subjects were peasants. The remaining 71%, were of other unspecifiedoccupations. 90.8% of individuals were of Han descent while 3.7% of individuals were of a minority heritage. 50.3% of subjects were married; 23.8% have never married; 8.1% were divorced; and the remaining 17.8% were of unknown marital status. Of those represented in this study, 36.8% came from the Henan province; 17.8% were from Beijing; 8.6% were from Shanxi; 31.4% from the other 20 provinces of China; and 5.4% from outside of China. Mode of transmission: 40.0% (74/185) contracted HIV through unprotected sexual contact; 29.2% (54/185) through receiving blood or plasma transfusions; 21.1%(39/185) through donating plasma; 7 cases were intravenous drug users; 7 cases were vertically transmitted. Mode of transmission was unknown in 4 cases. Clinical categories: An included 45 cases; B included 85 cases: C consisted of 76 cases. 12 cases were deceased. Initial presentation: 39 cases presented with_fever ,cough and diarrhea. 37 cases had fever and cough only-38 cases presented with chronic diarrhea. 16 cases were discovered incidentally at time of operation. 8 cases presented with fungal infection of the oral cavity or in esophagus. The common HIV associated symptoms and opportunistic infections were: weight loss and diarrhea, respiratory diseases, dermatologic diseases, anemia, neutropenia. Diseases of other organ

  10. 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

  11. THE RELATIONSHIP BETWEEN MARKETING MIX AND PATIENT LOYALTY IN INTENSIVE CARE UNIT, ANUTAPURA PUBLIC HOSPITAL PALU

    Directory of Open Access Journals (Sweden)

    Muh. Ryman Napirah

    2016-09-01

    Full Text Available Background: The problem generally faced by hospital is unable to provide something really needed by the customers. One of the main factors is the poor marketing mix of hospital that impacts to low quality and influences the patients loyality. Objective: The research aims to investigate the relationship between marketing mix and patient loyalty in intensive care unit at Anutapura Public Hospital Palu. Methods: This was a cross sectional study involving 97 persons who were randomly selected without considering the level of population. The data were analyzed thought univariat and bivariat on the significance level 95% (p<0,05. The marketing mix concept of 7P (product, price, place, promotion, people, process, dan physical evidence. Was used to guide this study. Results: The result of chi-square test indicated that there was a relationship of marketing mix product (p= 0,01, price (p= 0,00, promotion (p= 0,04, people (p= 0,00; and no relationship of marketing mix place (p= 0,21, process (p= 1,00, dan physical evidence (p= 1,00 with patient loyalty. Conclusion: It is expected tht the hospital of Anutapura Palu could increase the strategy of marketing mix for the sake of keeping the patients loyalty as the profit value of the hospital, especially for marketing place, process, and physical evidence.

  12. [Standardized management of acupuncture-moxibustion clinic in Singapore General Hospital].

    Science.gov (United States)

    Cui, Shu-Li; Tan, Kian Hian; Ong, Biauw Chi; Lim, Shih hui; Yong, Yang; Seah, Cheng Ngee; Huang, Youyi; Han, Seong Ng

    2014-02-01

    The standardized management of acupuncture-moxibustion in Singapore General Hospital is introduced. With gradual improvement of outpatient infrastructure, re-training of medical staff, strict disinfection of manipulation, periodical inspection of medical instruments, unified management of writing, saving and processing in medical records and public education of TCM knowledge, a standardized management system in accordance with modernized hospital is gradually established. As a result, efficiency and quality of clinical treatment is continuously increasing. From April of 1998 to December of 2012, a total of 74 654 times of treatment were performed, and treatment amount per day is gradually increased. The unusual condition of acupuncture is avoided. Periodical strict inspection of joint committee authenticated by domestic and overseas medical health organization is repeatedly passed and accepted. Additionally, three clinical researches funded by Singapore Health-care Company are still in progress in acupuncture-moxibustion department.

  13. Mapping US pediatric hospitals and subspecialty critical care for public health preparedness and disaster response, 2008.

    Science.gov (United States)

    Brantley, Mary D; Lu, Hua; Barfield, Wanda D; Holt, James B; Williams, Alcia

    2012-06-01

    The objective is to describe by geographic proximity the extent to which the US pediatric population (aged 0-17 years) has access to pediatric and other specialized critical care facilities, and to highlight regional differences in population and critical resource distribution for preparedness planning and utilization during a mass public health disaster. The analysis focused on pediatric hospitals and pediatric and general medical/surgical hospitals with specialized pediatric critical care capabilities, including pediatric intensive care units (PICU), pediatric cardiac ICUs (PCICU), level I and II trauma and pediatric trauma centers, and general and pediatric burn centers. The proximity analysis uses a geographic information system overlay function: spatial buffers or zones of a defined radius are superimposed on a dasymetric map of the pediatric population. By comparing the population living within the zones to the total population, the proportion of children with access to each type of specialized unit can be estimated. The project was conducted in three steps: preparation of the geospatial layer of the pediatric population using dasymetric mapping methods; preparation of the geospatial layer for each resource zone including the identification, verification, and location of hospital facilities with the target resources; and proximity analysis of the pediatric population within these zones. Nationally, 63.7% of the pediatric population lives within 50 miles of a pediatric hospital; 81.5% lives within 50 miles of a hospital with a PICU; 76.1% lives within 50 miles of a hospital with a PCICU; 80.2% lives within 50 miles of a level I or II trauma center; and 70.8% lives within 50 miles of a burn center. However, state-specific proportions vary from less than 10% to virtually 100%. Restricting the burn and trauma centers to pediatric units only decreases the national proportion to 26.3% for pediatric burn centers and 53.1% for pediatric trauma centers. This

  14. Perioperative nursing in public university hospitals: an ethnography.

    Science.gov (United States)

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

    2014-01-01

    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? 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. Patients were addressed as either human beings or objects. Likewise, the participants' technical skills were observed and described as either technical flair or a lack of technical skills/technophobia. The different ways in which the technical skills were handled and the different ways in which the patients were viewed contributed to the development of three levels of interaction between technology and nursing care: the interaction, declining interaction, and failing interaction levels. Nursing practice at the interaction level is characterized by flexibility and excellence, while practice at the declining interaction level is characterized by inflexibility and rigidity. Nursing practice at the failing interaction level is characterized by staff members working in isolation with limited collaboration with other staff members in operating rooms. Considering that the declining and failing interaction levels are characterized by inflexibility, rigidity, and isolation in nursing practice, nurses at these two levels must develop and improve their qualifications to reach a level of flexible

  15. Publicly Owned Treatment Works General Permit (POTW GP) ...

    Science.gov (United States)

    2017-04-10

    The Notice of Availability of the final National Pollutant Discharge Elimination System (NPDES) General Permits for the Discharge of Wastewater from Certain Publicly Owned Treatment Works Treatment Plants (POTW Treatment Plants) and Other Treatment Works Treating Domestic Sewage in the Commonwealth of Massachusetts and the State of New Hampshire was published in the Federal Register on July 6, 2011.

  16. Collaboration and interaction of first responders with the general public

    NARCIS (Netherlands)

    Emmerik, M. van; Dinesen, C.; Rijk, R. van; Bird, M.; Wester, M.; Hansen, L.J.; Vinther-Larsen, L.; Padron, C.; Boswinkel, R.; Ven, J. van de

    2016-01-01

    There is an increased focus on the need for collaboration between first responders and the general public. This type of collaboration requires soft skills that are not necessarily included in more traditional command and control trainings for first responders. Learning to collaborate with the genera

  17. Collaboration and interaction of first responders with the general public

    NARCIS (Netherlands)

    Emmerik, M. van; Dinesen, C.; Rijk, R. van; Bird, M.; Wester, M.; Hansen, L.J.; Vinther-Larsen, L.; Padron, C.; Boswinkel, R.; Ven, J. van de

    2016-01-01

    There is an increased focus on the need for collaboration between first responders and the general public. This type of collaboration requires soft skills that are not necessarily included in more traditional command and control trainings for first responders. Learning to collaborate with the

  18. General Public Space Travel and Tourism. Volume 2; Workshop Proceedings

    Science.gov (United States)

    ONeil, D. (Compiler); Mankins, J. (Editor); Bekey, I. (Editor); Rogers, T. (Editor); Stallmer, E. (Editor); Piland, W. (Editor)

    1999-01-01

    The Space Transportation Association and NASA conducted a General Public Space Travel study between 1996 and 1998. During the study, a workshop was held at Georgetown University. Participants included representatives from the travel, aerospace, and construction industries. This report is the proceedings from that workshop. Sections include infrastructure needs, travel packages, policy related issues, and potential near-term activities.

  19. INVESTIGATING THE PATIENT SATISFACTION WITHIN ROMANIAN PUBLIC AND PRIVATE HOSPITALS

    Directory of Open Access Journals (Sweden)

    Mihoc Florin

    2011-07-01

    Full Text Available Although it is not commonly accepted within healthcare services industry, the importance of marketing is more and more recognized nowadays by the organizations activating in the field. Current perception resides in a series of factors as: ethical aspects involved in the delivery process; special characteristics of the market; particular profile and behavior of the consumers of healthcare services and probably because of the inadequate understanding of the marketing role in the life of an organization. A deep analysis in the field of healthcare services will emphasize not only its complexity, but also its interdisciplinary feature under many aspects, as it is an area where many fields of interest are intersecting, both economic and social. It also reveals a particular field of study with many particular features - considered a sensitive field (Popa and Vladoi 2010: 232. Generated using the SERVQUAL model, the data presented in the paper are the result of a quantitative research designed to measure and compare the patient/client satisfaction degree for public and private medical services provided by the Romanian hospitals. The aim of the research is to identify and to measure the gap that appears between the patient/client’ expectations and perceptions regarding the delivered services; to identify the potential profile of the private Romanian hospitals’ clients regarding the demographic features and also to pin-point correlations between the image created in the mind of the Romanian patients/clients and the type of medical services (public or private they were using. We consider that the results of this research are valuable for the managers of the medical units in order to initiate series of actions aiming to improve the quality of their services and, as a result the patient/clients’ satisfaction degree. Later being one of the most important performance indicators of an organization that activates in a highly competitive business

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

    Science.gov (United States)

    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.

  1. The utilization of a paediatric emergency room in a general hospital in Kuwait.

    Science.gov (United States)

    al-Hay, A A; Boresli, M; Shaltout, A A

    1997-12-01

    A descriptive study was conducted in Al-Amiri Hospital, Kuwait to evaluate the use of the paediatric emergency room (PER) by children under 12 years of age over an 11-week period. Socio-demographic data on the families, reasons for the visits, the pattern of referral and the diagnoses were reviewed and analyzed. A total of 277 children were enrolled in the study, the majority of whom (81%) were generally well, only 4% requiring admission to hospital. The paediatrician in the emergency room considered that 64% of visits were not emergencies. Some form of treatment and one to two routine investigations were needed in 21% and 21.6%, respectively. Stated reasons for seeking medical care were: symptoms of the child (34%), unavailability of primary clinic at night (22%) and perceived better services in hospital (20%). The median of parental satisfaction at the end of the visit was 95%. We conclude that most visits to the PER at Al-Amiri Hospital are inappropriate and that intensive health education is required to improve use of the PER and to increase public awareness of the difference between primary care and paediatric emergency facilities.

  2. Profilaxia para tromboembolia venosa em um hospital geral Venous thromboembolism prophylaxis in a general hospital

    Directory of Open Access Journals (Sweden)

    Fernanda Fuzinatto

    2011-04-01

    Full Text Available OBJETIVO: Avaliar a prática de profilaxia para tromboembolia venosa (TEV em pacientes em um hospital geral. MÉTODOS: Estudo de coorte transversal conduzido no Hospital Nossa Senhora da Conceição, localizado na cidade de Porto Alegre (RS, com uma amostra constituída de pacientes internados selecionados randomicamente entre outubro de 2008 e fevereiro de 2009. Foram incluídos pacientes maiores de 18 anos e internados por mais de 48 h. Os critérios de exclusão foram pacientes em uso de anticoagulantes, história de doença tromboembólica, gestação e puerpério. A adequação da profilaxia foi avaliada seguindo as recomendações de um protocolo criado pela instituição e tendo como base principal a diretriz da American College of Chest Physician, oitava edição. RESULTADOS: Foram incluídos 262 pacientes com média de idade de 59,1 ± 16,6 anos. Os fatores de risco mais comuns foram imobilização (70,6%, infecção (44,3%, câncer (27,5%, obesidade (23,3% e cirurgia maior (14,1%. Na avaliação do nível de risco para TEV, 143 (54,6% e 117 pacientes (44,7%, respectivamente, foram classificados como de risco alto e moderado. No geral, 46,2% dos pacientes tiveram profilaxia adequada, assim como 25% dos pacientes com três ou mais fatores de risco e 18% dos pacientes com câncer, e houve diferenças estatisticamente significativas entre esses grupos quando comparados àqueles com menos de três fatores de risco e sem câncer (p OBJECTIVE: To evaluate the use of venous thromboembolism (VTE prophylaxis in a general hospital. METHODS: A cross-sectional cohort study at the Hospital Nossa Senhora da Conceição, located in the city of Porto Alegre, Brazil, involving a random sample of patients admitted between October of 2008 and February of 2009. We included patients over 18 years of age and hospitalized for more than 48 h. The exclusion criteria were anticoagulant use, pregnancy, puerperium, and a history of thromboembolic disease. The

  3. Cream skimming and hospital transfers in a mixed public-private system.

    Science.gov (United States)

    Cheng, Terence C; Haisken-DeNew, John P; Yong, Jongsay

    2015-05-01

    The increasing prominence of the private sector in health care provision has generated considerable interest in understanding its implications on quality and cost. This paper investigates the phenomenon of cream skimming in a mixed public-private hospital setting using the novel approach of analysing hospital transfers. We analyse hospital administrative data of patients with ischemic heart disease from the state of Victoria, Australia. The data set contains approximately 1.77 million admission episodes in 309 hospitals, of which 132 are public hospitals, and 177 private hospitals. We ask if patients transferred between public and private hospitals differ systematically in the severity and complexity of their medical conditions; and if so, whether utilisation also differs. We find that patients with higher disease severity are more likely to be transferred from private to public hospitals whereas the opposite is true for patients transferred to private hospitals. We also find that patients transferred from private to public hospitals stayed longer and cost more than private-to-private transfer patients, after controlling for patients' observed health conditions and personal characteristics. Overall, the evidence is suggestive of the presence of cream skimming in the Victorian hospital system, although we cannot conclusively rule out other mechanisms that might influence hospital transfers. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. An analysis of acute admissions to a general hospital psychiatric unit

    African Journals Online (AJOL)

    QuickSilver

    Statistics for 1999 showed that Helen Joseph Hospital admits on the average 53 new .... Lund C & Flisher AJ. South African Mental Health Process Indicators. .... paper) will fall well on the ears of general hospital management. Moosa and ...

  5. Stress level of people with psoriasis at a public hospital*

    Science.gov (United States)

    Leovigildo, Érida Silva; David, Rose Ana Rios; Mendes, Andreia Santos

    2016-01-01

    Background Psoriasis is a chronic dermatosis of unknown etiology with a tendency to relapse after treatment. The disease is frequently linked to psychological stress due to the embarrassment caused by the lesions. Objective To analyze the stress level presented by psoriasis patients followed at the Dermatology Service of a public hospital in Salvador, Bahia state, Brazil. Methods A cross-sectional study of a consecutive convenience sample composed of 60 participants. We used Lipp's Stress Symptoms Inventory for Adults to assess stress levels. The questionnaire identifies and classifies physical and psychological symptoms according to three stages of stress: alarming, resistance, and exhaustion. We also collected socio-demographic and clinical data that could be associated with psoriasis. Results 85% of the participants presented stress. Lipp's questionnaire results revealed that 48% were in the resistance stage and 37% in the exhaustion stage. Women presented higher levels of stress. Of the total 28 women, 64% were in exhaustion stage, 29% in the resistance stage, and only 7% presented no stress symptoms. Of the total 32 men, 44% were in resistance stage, 34% in exhaustion stage, and 22% presented no stress symptoms. Regarding physical and psychological symptoms, psychological symptomatology was prevalent (55%). Conclusions Based on the number of patients in exhaustion stage, we can conclude that stress levels of the participants were high regardless the type of psoriasis and treatment duration. PMID:27579739

  6. Working hours and health behaviour among nurses at public hospitals

    Directory of Open Access Journals (Sweden)

    Juliana da Costa Fernandes

    2013-09-01

    Full Text Available OBJECTIVE: to analyse the differences between genders in the description in the professional, domestic and total work hours and assess its association with health-related behaviour among nurses. METHODS: this is a transversal study carried out in 18 different public hospitals in the municipality of Rio de Janeiro. The data collection procedure was based on questionnaires. All nurses working with assistance were considered eligible (n=2,279. RESULTS: men and women showed significant differences in relation to working hours. The female group showed longer domestic and total work hours when compared to the group of men. In contrast, the number of hours spent on professional work was higher among men. For the women, both the professional hours and total work hours were often associated with excessive consumption of fried food and also coffee, lack of physical exercise and also the greater occurrence of overweight and obesity. CONCLUSION: both the professional hours and the domestic work hours need to be taken into account in studies about health, self-care and also the care provided within the context of nursing workers, particularly among women. The results add weight to the need for actions for health promotion in this occupational group and the importance of assessing the impact of long working hours on the health of workers.

  7. Physical Violence against General Practitioners and Nurses in Chinese Township Hospitals: A Cross-Sectional Survey

    Science.gov (United States)

    Xing, Kai; Jiao, Mingli; Ma, Hongkun; Qiao, Hong; Hao, Yanhua; Li, Ye; Gao, Lijun; Sun, Hong; Kang, Zheng; Liang, Libo; Wu, Qunhong

    2015-01-01

    Purpose The purpose of this study is to identify risk factors of physical violence in Chinese township hospitals. Methods A cross-sectional survey was used in a sample of 442 general practitioners and 398 general nurses from 90 township hospitals located in Heilongjiang province, China (response rate = 84.8%). Results A total of 106 of the 840 (12.6%) respondents reported being physically attacked in their workplace in the previous 12 months. Most perpetrators were the patients’ relatives (62.3%), followed by the patient (22.6%); 73.6% of perpetrators were aged between 20 and 40 years. Of the physical violence incidents, about 56.6% (n = 60) resulted in a physical injury, and 45.4% of respondents took two or three days of sick leave. Reporting workplace violence in hospitals to superiors or authorities was low (9.4%). Most respondents (62.8%) did not receive training on how to avoid workplace violence. Logistic regression analyses indicated that general nurses, aged 35 years or younger, and with a higher-level professional title were more likely to experience physical violence. Healthcare workers with direct physical contact (washing, turning, lifting) with patients had a higher risk of physical violence compared to other health care workers. Procedures for reporting workplace violence were a protective factor for physical violence; when in place, reporting after psychological violence (verbal abuse, bullying/mobbing, harassment, and threats) was more protective than waiting until an instance of physical violence (beating, kicking, slapping, stabbing, etc.). Conclusions Physical violence in Chinese township hospitals is an occupational hazard of rural public health concern. Policies, procedures, and intervention strategies should be undertaken to manage this issue. PMID:26571388

  8. Physical Violence against General Practitioners and Nurses in Chinese Township Hospitals: A Cross-Sectional Survey.

    Directory of Open Access Journals (Sweden)

    Kai Xing

    Full Text Available The purpose of this study is to identify risk factors of physical violence in Chinese township hospitals.A cross-sectional survey was used in a sample of 442 general practitioners and 398 general nurses from 90 township hospitals located in Heilongjiang province, China (response rate = 84.8%.A total of 106 of the 840 (12.6% respondents reported being physically attacked in their workplace in the previous 12 months. Most perpetrators were the patients' relatives (62.3%, followed by the patient (22.6%; 73.6% of perpetrators were aged between 20 and 40 years. Of the physical violence incidents, about 56.6% (n = 60 resulted in a physical injury, and 45.4% of respondents took two or three days of sick leave. Reporting workplace violence in hospitals to superiors or authorities was low (9.4%. Most respondents (62.8% did not receive training on how to avoid workplace violence. Logistic regression analyses indicated that general nurses, aged 35 years or younger, and with a higher-level professional title were more likely to experience physical violence. Healthcare workers with direct physical contact (washing, turning, lifting with patients had a higher risk of physical violence compared to other health care workers. Procedures for reporting workplace violence were a protective factor for physical violence; when in place, reporting after psychological violence (verbal abuse, bullying/mobbing, harassment, and threats was more protective than waiting until an instance of physical violence (beating, kicking, slapping, stabbing, etc..Physical violence in Chinese township hospitals is an occupational hazard of rural public health concern. Policies, procedures, and intervention strategies should be undertaken to manage this issue.

  9. A conceptual framework for selecting the most appropriate variables for measuring hospital efficiency with a focus on Iranian public hospitals.

    Science.gov (United States)

    Afzali, Hossein Haji Ali; Moss, John R; Mahmood, Mohammad Afzal

    2009-05-01

    Over the past few decades, there has been an increasing interest in the measurement of hospital efficiency in developing countries and in Iran. While the choice of measurement methods in hospital efficiency assessment has been widely argued in the literature, few authors have offered a framework to specify variables that reflect different hospital functions, the quality of the process of care and the effectiveness of hospital services. However, without the knowledge of hospital objectives and all relevant functions, efficiency studies run the risk of making biased comparisons, particularly against hospitals that provide higher quality services requiring the use of more resources. Undertaking an in-depth investigation regarding the multi-product nature of hospitals, various hospital functions and the values of various stakeholders (patient, staff and community) with a focus on the Iranian public hospitals, this study has proposed a conceptual framework to select the most appropriate variables for measuring hospital efficiency using frontier-based techniques. This paper contributes to hospital efficiency studies by proposing a conceptual framework and incorporating a broader set of variables in Iran. This can enhance the validity of hospital efficiency studies using frontier-based methods in developing countries.

  10. Perfil del embarazo prolongado en pacientes de un hospital general

    Directory of Open Access Journals (Sweden)

    Flor de Maria Chavarry Valencia

    2009-10-01

    Full Text Available Objetivo: Determinar las características maternas y perinatales de las pacientes con diagnóstico de embarazo prolongado (EP en un hospital general. Material y métodos: Estudio retrospectivo tipo serie de casos, realizado en el Hospital Nacional Cayetano Heredia del 1° de enero de 2000 al 31 de diciembre de 2004. Se incluyeron 341 pacientes con diagnóstico de EP (>42 semanas basado en la fecha de último periodo menstrual o ecografía del primer trimestre. Resultados: El 76% de pacientes tenían una edad entre 20 a 35 años con una media de 25,8 ± 6,1 años. El 47,5% eran nulíparas. El 71,3% había ya iniciado una labor de parto espontánea; 16,4% fueron inducidas y 12,3% tuvieron indicación de cesárea al ingreso. Del grupo con inicio de trabajo de parto espontáneo el 71,6% terminó en parto vaginal; 19,3% cesárea, y 9,1% parto vaginal instrumentado. De las inducciones, el 71,4% tuvo parto vaginal espontáneo, 23,2% cesárea y 5,4% instrumentado. El 62% terminó en parto vaginal espontáneo, 29,9% en cesárea y 7,4% instrumentado. El 85,9% fue adecuado para EG, 11,1% grande para la EG, y 3% pequeño para la EG. El 53,4% de RN tuvo de 37 a 41 semanas por Capurro; 45,7% fueron >42 semanas y 0,9% tuvo < 37 semanas. El Apgar a los 5 minutos fue de 7 a 10 en 333 casos, < 7 en 4 RN. Ocurrieron 4 óbitos fetales (1,1%. Conclusión: El EP se encontró en mayor frecuencia en pacientes adultas y nulíparas, el inicio del trabajo de parto espontáneo fue el más frecuente y la vía de parto vaginal la más frecuente. Las complicaciones fueron bajas en los RN vivos, sin embargo la tasa de mortalidad fetal fue elevada de 11 por mil. La indicación más frecuente de cesárea fue DCP y sufrimiento fetal agudo. (Rev Med Hered 2009;20:200-205.

  11. Presenting the science of the Sun to the general public

    Science.gov (United States)

    Choudhuri, Arnab Rai

    2016-07-01

    Although the science behind the Sun is so fascinating, there has not been sufficient worldwide effort in presenting this science to the general public. My recently published popular science book "Nature's Third Cycle: A Story of Sunspots" (Oxford University Press, 2015) is probably the first popular science book introducing the phenomenology of the solar cycle along with a non-technical account of dynamo theory. I shall discuss my perspective of the challenges involved in presenting the science of the Sun to the public. The Amazon link of my book is: http://www.amazon.co.uk/Natures-Third-Cycle-Story-Sunspots/dp/0199674752/

  12. Hospitable archean climates simulated by a general circulation model.

    Science.gov (United States)

    Wolf, E T; Toon, O B

    2013-07-01

    Evidence from ancient sediments indicates that liquid water and primitive life were present during the Archean despite the faint young Sun. To date, studies of Archean climate typically utilize simplified one-dimensional models that ignore clouds and ice. Here, we use an atmospheric general circulation model coupled to a mixed-layer ocean model to simulate the climate circa 2.8 billion years ago when the Sun was 20% dimmer than it is today. Surface properties are assumed to be equal to those of the present day, while ocean heat transport varies as a function of sea ice extent. Present climate is duplicated with 0.06 bar of CO2 or alternatively with 0.02 bar of CO2 and 0.001 bar of CH4. Hot Archean climates, as implied by some isotopic reconstructions of ancient marine cherts, are unattainable even in our warmest simulation having 0.2 bar of CO2 and 0.001 bar of CH4. However, cooler climates with significant polar ice, but still dominated by open ocean, can be maintained with modest greenhouse gas amounts, posing no contradiction with CO2 constraints deduced from paleosols or with practical limitations on CH4 due to the formation of optically thick organic hazes. Our results indicate that a weak version of the faint young Sun paradox, requiring only that some portion of the planet's surface maintain liquid water, may be resolved with moderate greenhouse gas inventories. Thus, hospitable late Archean climates are easily obtained in our climate model.

  13. 38 CFR 17.55 - Payment for authorized public or private hospital care.

    Science.gov (United States)

    2010-07-01

    ... hospital care authorized under 38 U.S.C. 1703 and 38 CFR 17.52 of this part or under 38 U.S.C. 1728 and 38... shall pay the transferring hospital an amount calculated by the HCFA PRICER for each patient day of care... public or private hospital care. 17.55 Section 17.55 Pensions, Bonuses, and Veterans' Relief...

  14. Public hospital palliative social work: addressing patient cultural diversity and psychosocial needs.

    Science.gov (United States)

    Parrish, Monique; Cárdenas, Yvette; Epperhart, Regina; Hernandez, Jose; Ruiz, Susana; Russell, Linda; Soriano, Karolina; Thornberry, Kathryn

    2012-01-01

    Through creative practice innovations and a wide range of professional competencies, social work has contributed substantively to the development of the palliative care field (Harper, 2011 ). As the field continues to grow and evolve, new opportunities are emerging to profile palliative social work in diverse health care settings. A statewide initiative to spread palliative care in California's public hospitals provided just such an opportunity. Palliative social workers from six public hospitals participating in the initiative formed a group to discuss palliative social work in this unique hospital setting. This article highlights the group's insights and experiences as they address the significant cultural diversity and psychosocial needs of public hospital patients receiving palliative care.

  15. Health-related behaviour among managers of Slovenian hospitals and institutes of public health

    Directory of Open Access Journals (Sweden)

    Jerneja Farkas

    2015-12-01

    Full Text Available Aim: Behavioural risk factors have a significant impact on health. We aimed to assess health-related behaviour, health status, and use of healthcare services among managers of Slovenian hospitals and institutes of public health. Methods: This was a cross-sectional study which included management (directors, scientific directors, directors’ deputies of Slovenian hospitals and institutes of public health (63 respondents; 57% women; overall mean age: 51±7 years; response rate: 74%. Data were obtained using an anonymous self-administered questionnaire. Results: About 35% of respondents were directors. More than half of the respondents were overweight or obese (52%, the majority were not sufficiently physically active (59% and overloaded with stress (87%. Hypercholesterolemia (36%, spinal disease (17%, and arterial hypertension (16% were most common chronic diseases. Whilst only few participants visited their general practitioner due their health complaints, blood pressure (76%, cholesterol (51%, and glucose (54% were measured within last year in most of the respondents. Conclusion: Our findings point to a high prevalence of overweight and obesity as well as workplace-related stress among Slovenian public health managers. Therefore, effective preventive strategies should be focused on stress management along with promotion of healthy behavioural patterns.

  16. Attitudes of Malaysian general hospital staff towards patients with mental illness and diabetes

    OpenAIRE

    Minas, H.; Zamzam, R; Midin, M; Cohen, A

    2011-01-01

    Abstract Background The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours...

  17. Tritium analysis of urine samples from the general Korean public.

    Science.gov (United States)

    Yoon, Seokwon; Ha, Wi-Ho; Lee, Seung-Sook

    2013-11-01

    The tritium concentrations of urine samples and the effective dose of the general Korean public were evaluated. To achieve accurate HTO analysis of urine samples, we established the optimal conditions for measuring the HTO content of urine samples. Urine samples from 50 Koreans who do not work at a nuclear facility were analyzed on the basis of the results. The average urine analysis result was 2.8 ±1 .4 Bq/L, and the range was 1.8-5.6 Bq/L. The measured values were lower than those reported for other countries. These results show that environmental factors and lifestyle differences are the main factors affecting the tritium level of the general public. © 2013 Elsevier Ltd. All rights reserved.

  18. [Relevant publications in ambulatory general internal medicine in 2007].

    Science.gov (United States)

    Amstutz, R; Humair, J P; Junod Perron, N; Malacarne, S; Nyffenegger, L; Rieder, J P; Steiner, A S; Motamed, S

    2008-01-30

    Screening procedures for genital Chlamydia infection, cancer risks linked to oral contraceptives, indications and efficacy of HPV vaccination, and diagnostic tools for celiac disease in adults; these are just a few of the general practice themes that were reviewed and analysed in 2007 by residents and chief residents at the Community medicine and primary care Service of the Geneva University Hospitals. These commented summaries, intended for all our colleagues, constitute Geneva's contribution to the literature data base initiated in 2005 by chief residents in Lausanne.

  19. Attitudes towards bariatric surgery in the general public.

    Science.gov (United States)

    Sikorski, Claudia; Luppa, Melanie; Dame, Katrin; Brähler, Elmar; Schütz, Tatjana; Shang, Edward; König, Hans-Helmut; Riedel-Heller, Steffi G

    2013-03-01

    Prevalence rates of obesity are still rising. Weight loss surgery (WLS) is the most invasive but also most effective treatment option when behavioral modification has failed. Research indicates that health care professionals hold ambivalent views on bariatric surgery, while views of the general public have not yet been investigated. In a German representative sample of n = 3,003 respondents in a computer-assisted telephone interview, n = 1,008 persons were interviewed on their views of the effectiveness of bariatric surgery and other interventions for obesity. Also, willingness to recommend a treatment was assessed. Lifestyle-based interventions were viewed as most effective in terms of weight loss. About 50 % of the population stated that WLS is "very effective" while still a quarter of respondents did not ascribe effectiveness to WLS. Higher age was associated with lower expectations of effectiveness while higher stigmatizing attitudes and genetic attributes for obesity were associated with higher expectations of effectiveness. Seventy-two percent would not recommend WLS or undergo it, if applicable, themselves. Higher educated respondents and those that viewed WLS as effective were more likely to recommend WLS. The German general public seems to be rather cautious regarding bariatric surgery. It may be assumed that false beliefs on the effectiveness and risk patterns of bariatric surgery are still very common, despite rising surgery numbers. Our results further emphasize the need for providing evidence-based information on bariatric surgery to the general public.

  20. Behavior Assessment in Children Following Hospital-Based General Anesthesia versus Office-Based General Anesthesia

    Directory of Open Access Journals (Sweden)

    LaQuia A. Vinson

    2016-08-01

    Full Text Available The purpose of this study was to determine if differences in behavior exist following dental treatment under hospital-based general anesthesia (HBGA or office-based general anesthesia (OBGA in the percentage of patients exhibiting positive behavior and in the mean Frankl scores at recall visits. This retrospective study examined records of a pediatric dental office over a 4 year period. Patients presenting before 48 months of age for an initial exam who were diagnosed with early childhood caries were included in the study. Following an initial exam, patients were treated under HBGA or OBGA. Patients were followed to determine their behavior at 6-, 12- and 18-month recall appointments. Fifty-four patients received treatment under HBGA and 26 were treated under OBGA. OBGA patients were significantly more likely to exhibit positive behavior at the 6- and 12-month recall visits p = 0.038 & p = 0.029. Clinicians should consider future behavior when determining general anesthesia treatment modalities in children with early childhood caries presenting to their office.

  1. Provision of essential health package in public hospitals: a case of Homabay County hospitals, Kenya.

    Science.gov (United States)

    Opon, Shadrack Ochieng

    2016-01-01

    Essential Health Packages (EHP) delivery is likely to strengthen service delivery. Healthcare utilization rate is 77% for the sick. 44% and 18% who don't seek care are hindered by cost and distance respectively. The overall child mortality rate in Kenya is 121/1000. In Homabay County, child mortality rate is 91/1000, and maternal mortality rate of 583/100000. The study looked into the provision of EHP in public hospitals in Homabay County. Cross-sectional research design was used. Two hospitals were conveniently due to their municipality location. The study targeted 213 Health workers and 350 patients. Stratified sampling and proportionate sampling was used among different health workers. Sample size was determined by Yamane Formula. The study sampled 138 health workers and 186 patients. Questionnaire and key interview guide were used to collect data. There are inadequate health workers based on 138 (100%) health workers. Insufficient drugs were reported by 138 (100%) health workers, and 120 (64.5%) patients. 115 (83.3%) health workers say ambulances are not operational. 26 (18.8%) health workers noted lack medical equipment, 138 (100%) are aware of patients referred elsewhere due to lack of medical equipment. 153 (82.3%) and 135 (72.6%) patients' health access is hindered by cost and distance respectively. 159 (85.5%) patients don't always find services needed. 159 (85.5%) patients affected by long waiting time. Low service provision/utilization rate in Homabay County results from lack of health workers, inadequate drugs, poor health infrastructure, and lack of access in terms of affordability, availability and distance.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. A substantial number of scientific publications originate from non-university hospitals.

    Science.gov (United States)

    Fedder, Jens; Nielsen, Gunnar Lauge; Petersen, Lars J; Rasmussen, Claus; Lauszus, Finn F; Frost, Lars; Hornung, Nete; Lederballe, Ole; Andersen, Jens Peter

    2011-11-01

    As we found no recent published reports on the amount and kind of research published from Danish hospitals without university affiliation, we have found it relevant to conduct a bibliometric survey disclosing these research activities. We retrieved all scientific papers published in the period 2000-2009 emanating from all seven Danish non-university hospitals in two regions, comprising 1.8 million inhabitants, and which were registered in a minimum of one of the three databases: PubMed MEDLINE, Thomson Reuters Web of Science and Elsevier's Scopus. In 878 of 1,252 papers, the first and/or last author was affiliated to a non-university hospital. Original papers made up 69% of these publications versus 86% of publications with university affiliation on first or last place. Case reports and reviews most frequently had authors from regional hospitals as first and/or last authors. The total number of publications from regional hospitals increased by 48% over the 10-year period. Publications were cited more often if the first or last author was from a university hospital and even more so if they were affiliated to foreign institutions. Cardiology, gynaecology and obstetrics, and environmental medicine were the three specialities with the largest number of regional hospital publications. A substantial number of scientific publications originate from non-university hospitals. Almost two thirds of the publications were original research published in international journals. Variations between specialities may reflect local conditions. not relevant. not relevant.

  4. Public and Private Hospital Services Reform Using Data Envelopment Analysis to Measure Technical, Scale, Allocative, and Cost Efficiencies

    Directory of Open Access Journals (Sweden)

    Ali Emrouznejad

    2012-07-01

    Full Text Available Background: The aim of this study was to suggest a suitable context to develop efficient hospitalsystems while maintaining the quality of care at minimum expenditures.Methods: This research aimed to present a model of efficiency for selected public and privatehospitals of East Azerbaijani Province of Iran by making use of Data Envelopment Analysis approachin order to recognize and suggest the best practice standards.Results: Among the six inefficient hospitals, 2 (33% had a technical efficiency score of lessthan 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.Conclusion: In general, the public hospitals are relatively more efficient than private ones; it isrecommended for inefficient hospitals to make use of the followings: transferring, selling, orrenting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals orother 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 improveremuneration for remaining staff and quality of health care services of hospitals, rural andurban health centers, support communities to start or sustain systematic risk and resource poolingand cost sharing mechanisms for protecting beneficiaries against unexpected health carecosts, compensate the capital depreciation, increasing investments, and improve diseases preventionservices and facilities in the provincial level.

  5. End-of-life hospital transfers in out-of-hours general practice.

    NARCIS (Netherlands)

    Korte-Verhoef, M.C. de; Pasman, H.R.W.; Schweitzer, B.P.M.; Francke, A.L.; Onwuteaka-Philipsen, B.D.; Deliens, L.

    2012-01-01

    Background: During the end of life, many patients experience transfers from home to hospital, and the majority of them die in a hospital. Aim: To explore the reasons for hospital transfers of palliative care patients in out-of-hours general practices. Methods: A retrospective descriptive chart study

  6. A comparison of antibiotic point prevalence survey data from four Irish regional/general hospitals.

    LENUS (Irish Health Repository)

    Naughton, C

    2011-06-01

    Point prevalence surveys (PPS) are increasingly used to examining and compare hospital antibiotic consumption. The aim of this study was to identify the (1) point prevalence of antibiotic use in one regional hospital and (2) compare PPS data from similar regional\\/general hospitals.

  7. [The department budget, in the context of the hospital global budget. Initial results in general medicine].

    Science.gov (United States)

    Besançon, F

    1984-02-23

    In a general hospital (Hôtel-Dieu, in the center of Paris), run with a global budget, budgets determined for each unit were introduced as an experiment in 1980. Physicians were in charge of certain expenses, mainly: linen, drugs, transportation of patients to and from other hospitals within Paris, and blood fractions. The whole does not exceed 4% of the turnover (FF 20 millions in 1980) of a 67 bed internal medicine unit. Other accounts deal with the stays, admissions, prescriptions of technical acts, laboratory analyses, and X-rays. In 1980, expenses were 11% more than budgeted, but the increase in stays and particularly in admissions was significantly greater. The resulting savings were 8.8% and 18.7% for stays and admissions respectively. Psychic reactions were variable. The subsequent budgets followed the fluctuations of recorded expenses, which were fairly important in both directions. The unit budget may be an advance or a regression, in a restrictive and past-perpetuating context. The coherence between the unit budget and the global hospital budget is questionable. Physicians were willing to take part in accounting and saving. They have good reason for not enlarging their financial responsibilities. Conversely, they may give more attention to diseases of public opinion.

  8. 21 CFR 880.6260 - Filtering facepiece respirator for use by the general public in public health medical emergencies.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Filtering facepiece respirator for use by the... Filtering facepiece respirator for use by the general public in public health medical emergencies. (a) Identification. A filtering facepiece respirator for use by the general public in public health...

  9. The effects of communication techniques on public relation activities: A sample of hospitality business

    OpenAIRE

    Şirvan Şen Demir

    2011-01-01

    Nowadays, firms who give importance to public relations have been increasing rapidly in numbers. All modern firms either found public relations department in their body to deal with public relations operations or outsource this activity to consultants in order to communicate with target populations. Among the firms in tourism sector, hospitality companies are the ones that use public relations the most. The purpose of this study is to investigate the communication techniques in public relatio...

  10. Policy and implementation of user fees in Jamaican public hospitals.

    Science.gov (United States)

    Lewis, M A; Parker, C

    1991-06-01

    User fees and other forms of copayment for health care are becoming of increasing interest to policymakers in developing countries. As indigenous populations continue to expand in response to current and historically high fertility, and government resources become constrained due to macroeconomic circumstances, publicly provided health care is being squeezed financially. Most developing countries have committed their governments to either providing for all health care or at least ensuring that all citizens have access to health care regardless of ability to pay. This has translated in most contexts into blanket coverage for the entire population financed and generally provided by the government. Recent periods of slow growth, high debt burdens and restricted spending on high recurrent cost sectors, such as health care under International Monetary Fund and other donor agreements have reduced many developing countries' budgets and often the real value of health expenditures. The costs of inputs (personnel, drugs and consumables), however, have not declined and quality or quantity have been necessarily reduced. At the same time, options for financial relief outside the tax system have become of increasing interest to financially constrained governments. User charges are straightforward, easily understood and can in theory be profitable in the short term. From a fairness perspective, they also charge those who actually use the health system. Their major drawback for policymakers is the potential for undermining equity in the health system.

  11. Employees’ Commitment to the Organization of a Public District Hospital: a Case Study

    Directory of Open Access Journals (Sweden)

    Eyaggelia Tsolaki

    2013-01-01

    Full Text Available Background: The employees' satisfaction from their job and their commitment to the organization appears to be one of the most determinants factors of organizational effectiveness.Aim: The aim of this study was the research of commitment to the organization of employees' working at Sparta General Hospital, as well as the correlation between job satisfaction and social, economic, demographic or other factors.Methodology: The research’s sample included 121 employees from all departments of a public district hospital. For research purposes, the Organizational Commitment Questionnaire was used. Data specially designed for the research’s purposes.Results: The largest sample’s proportion, declared moderate to very satisfy by their job at that Hospital. The particular job demands, exhausting timetables, stress and organizational weaknesses of the Greek Health System seem to have been key components of the problem. Also, for a large sample proportion, the job demands affect negatively the time and energy that Sparta General Hospital employees’ dedicate to themselves and to their families. Almost half of the participants replied that they are not at all satisfied with their payroll. Regarding the rates of emotional, standing and exemplary commitment, showed that gender, education level, marital status, age and total years of professional seniority correlated with the level of emotional commitment. To higher affective commitment is positively correlated with age of employees and years of service.Conclusions: The research of commitment to the organization can contribute substantially in improving the hospital’s and health system’s effectiveness, the increment of job’s satisfaction, the employees’ efficiency.

  12. 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.

  13. Is the pro-competition policy an effective solution for China's public hospital reform?

    Science.gov (United States)

    Pan, Jay; Qin, Xuezheng; Hsieh, Chee-Ruey

    2016-10-01

    The new round of health care reforms in China achieved significant initial results. New and emerging problems coinciding with the deepening of the reforms, however, require further institutional changes to strengthen the competition mechanism and promote public hospital efficiency. This paper provides a conceptual framework and preliminary assessment of public hospital competition in China. Specifically, we distinguish between two closely related concepts - competition and privatization, and identify several critical conditions under which hospital competition can be used as a policy instrument to improve health care delivery in China. We also investigate the current performance and identify several unintended consequences of public hospital competition - mainly, medical arms race, drug over-prescription and the erosion of a trusting relationship between patients and physicians. Finally, we discuss the policy options for enhancing the internal competition in China's hospital market, and conclude that public investment on information provision is key to reaping the positive outcomes of pro-competition policies.

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

    Directory of Open Access Journals (Sweden)

    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

  15. Stakeholders Involvement in Performance Management in Public General Schools

    Directory of Open Access Journals (Sweden)

    Kristi Ploom

    2013-01-01

    Full Text Available In response to increasing concerns with the legitimacy and efficiency of public spending, performance management as a part of world-wide public sector reform, called New Public Management (NPM has taken place. This is also the case of educational sector. In Estonian education system, legislation formally enables to design an integrated performance management system. But there is few research done to investigate how these policies and regulations ought to be put into force in order to gain the benefits considering the schools' and pupils' better performance. This study investigates how different stakeholders are involved into the performance management in Estonian general schools. The study is based on empirical survey data gathered from 303 schools providing secondary education in Estonia. The research findings have three main implications. Firstly, the paper contributes to the scarce knowledge about implementation of performance management issues in public schools. Our analysis revealed that compilation of school development plans in Estonian schools is rather a formal obligation. Therefore we propose that the analysis and discussion of the school development plans is needed to organize on regional level, involving all main stakeholders of a school. Secondly, we suggest that in the circumstances of a decentralised education system, like in Estonia, it is needed to implement, central practical performance assessment principles and guidance for the schools. Thirdly, it is highly necessary to improve schools’ cooperation with different stakeholder groups. Also the framework involving different stakeholder groups in the decentralized schools management system should be built up.

  16. Medicines use among general public in Taif, KSA

    Directory of Open Access Journals (Sweden)

    Qasem M. A. Abdallah

    2014-01-01

    Full Text Available Objectives: Patient practice toward medication including the extent of self-medication has an important impact on therapeutic outcome. Therefore, this study aimed to assess general public practice toward the usage of medicines in Taif city. Materials and Methods: A cross-sectional research design using nonprobability convenience sampling technique was used in this study. Data were collected face-to-face from literate adults in public areas such as malls, shopping centers, and health centers. Data were analyzed using SPSS version 16 and significant values of difference were determined using the Chi-square and Fisher Exact tests. Results: Nine hundred questionnaires were successfully collected from literate adults in Taif city over 8 weeks. Eighty percent of respondents tend to stop taking their medications once they feel good. In addition, only 62% of respondents refer to pharmacists or doctors once they feel unwell. On the other hand, one-fifth of respondents store their medications as directed by the pharmacist or as written in the drug leaflet. Furthermore, as little as 12% of respondents consult a doctor or a pharmacist once they miss their medication dose. Conclusion: This study demonstrates that public in Taif city has, to a certain extent, improper practice toward medicine. Thus, it is of urge for healthcare and policymakers to develop healthcare programs aiming to enhance practice of public toward medicines.

  17. The association between insurance status and in-hospital mortality on the public medical wards of a Kenyan referral hospital.

    Science.gov (United States)

    Stone, Geren S; Tarus, Titus; Shikanga, Mainard; Biwott, Benson; Ngetich, Thomas; Andale, Thomas; Cheriro, Betsy; Aruasa, Wilson

    2014-01-01

    Observational data in the United States suggests that those without health insurance have a higher mortality and worse health outcomes. A linkage between insurance coverage and outcomes in hospitalized patients has yet to be demonstrated in resource-poor settings. To determine whether uninsured patients admitted to the public medical wards at a Kenyan referral hospital have any difference in in-hospital mortality rates compared to patients with insurance, we performed a retrospective observational study of all inpatients discharged from the public medical wards at Moi Teaching and Referral Hospital in Eldoret, Kenya, over a 3-month study period from October through December 2012. The primary outcome of interest was in-hospital death, and the primary explanatory variable of interest was health insurance status. During the study period, 201 (21.3%) of 956 patients discharged had insurance. The National Hospital Insurance Fund was the only insurance scheme noted. Overall, 211 patients (22.1%) died. The proportion who died was greater among the uninsured compared to the insured (24.7% vs. 11.4%, Chi-square = 15.6, phospital mortality with insurance. After adjusting for comorbid illness, employment status, age, HIV status, and gender, the association between insurance status and mortality remained statistically significant (adjusted odds ratio (AOR) = 0.40, 95% CI 0.24-0.66) and similar in magnitude to the association between HIV status and mortality (AOR = 2.45, 95% CI 1.56-3.86). Among adult patients hospitalized in a public referral hospital in Kenya, insurance coverage was associated with decreased in-hospital mortality. This association was comparable to the relationship between HIV and mortality. Extension of insurance coverage may yield substantial benefits for population health.

  18. Transferable and non-transferable drug resistance in enteric bacteria from hospital and from general practice

    DEFF Research Database (Denmark)

    Møller, JK; Bak, AL; Bülow, P

    1976-01-01

    Drug resistance to 8 different antibiotics in Enterobacteriaceae isolated from different hospitals and two groups of general practitioners was studied. Escherichia coli dominated among the 632 strains investigated. Drug resistance was found in 62% of the 512 hospital strains and in 38% of the 120...... strains from general practice. Multiple resistance was common especially in strains from hospital. R factors was found in 23% of the 317 drug-resistant strains from hospital and in 11% of the 46 drug-resistant strains from general practice. Resistance to streptomycin, sulphonamide and tetracycline either...

  19. Mortality during first hospital admission in a population that begins chronic dialysis in a general hospital

    OpenAIRE

    Herrera Añazco, Percy; Médico Asistente, Servicio de Nefrología, Hospital Nacional 2 de Mayo, Lima, Perú; Docente de la Facultad de Medicina, Universidad Científica del Sur, Lima, Perú; Docente de la Facultad de Medicina, Universidad Nacional de Piura, Piura, Perú.; Palacios Guillén, Melissa; Médico Asistente, Servicio de Nefrología, Hospital Daniel Alcides Carrión, Lima, Perú; Docente, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú.; Chipayo Gonzales, David; Médico Residente, Servicio de Nefrología, Hospital Nacional 2 de Mayo, Lima, Perú.; Silveira Chau, Manuela; Médico Asistente, Unidad Médica Empresarial, Clínica Internacional, Lima, Perú.

    2013-01-01

    The Health Ministry attends Peruvian population without social security and without a national dialysis program. Attention is limited to a few hospitals with dialysis centers. objectives: To determine mortality in the first hospitalization for dialysis in a population without social security. design: Descriptive study. Setting: Hospital Nacional Dos de Mayo, Lima, Peru. Patients: Patients with chronic renal disease. Interventions: We studied patients who started dialysis from January to Decem...

  20. Microbiological etiology of bacterial prostatitis in general hospital and primary care clinic in Korea

    Directory of Open Access Journals (Sweden)

    Yong Sun Choi

    2013-09-01

    Conclusions: The total portion of chronic bacterial prostatitis was 59.3% (174/293. Culture-positive patients in the PCC were significantly higher than in the general hospital, but the number of PCR positive patients in the PCC was the same as in the general hospital.

  1. A Level Field for Private and Public Hospitals

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    China will encourage more private and foreign investment in hospitals and clinics The State Council on December 3 announced new policies to encourage private and foreign capital in China’s medical sector to meet the country’s

  2. Total quality management in accredited New South Wales hospitals: a public/private comparison.

    Science.gov (United States)

    Bartlett, M; Hatcher, D; Johnson, A; Dixon, K

    1997-01-01

    Analysis of data collected in a 1994-95 survey of accredited New South Wales hospitals examined the adoption of key elements of total quality management practice in the public and private sectors. In a number of areas of practice widely considered to be central to a hospital's total quality management efforts, there was no statistically significant difference between the two sectors. Where differences existed, total quality management practices more likely to be adopted by public hospitals were limited in their scope and likely to be explained by structural peculiarities. In contrast, private hospitals were more likely to adopt practices more critical to the successful implementation of total quality management.

  3. Presenting particle physics and quantum mechanics to the general public

    CERN Document Server

    Strauss, J

    2015-01-01

    The job of a physicist is to describe Nature. General features, hypotheses and theories help to describe physics phenomena at a more abstract, fundamental level, and are sometimes tacitly assigned some sort of real existence; doing so appears to be of little harm in most of classical physics. However, missing any tangible connection to everyday experience, one better always bears in mind the descriptive nature of any efforts to grasp the quantum. And elementary particles interact in the quantum world, of course. When communicating the world of elementary particles to the general public, the Bayesian approach of an ever ongoing updating of the depiction of reality turns out to be virtually indispensable. The human experience of providing a series of increasingly better descriptions generates plenty of personal pleasures, for researchers as well as for amateurs. A suggestive analogy for improving our understanding of the world, even the seemingly paradoxical quantum world, may be found in recent insight into ho...

  4. Our experiences with vancomycin-resistant enterococci in Jesenice General hospital

    Directory of Open Access Journals (Sweden)

    Helena Ribič

    2007-11-01

    Full Text Available Background: Vancomycin-resistant enterococci (VRE present a great problem in health care, especially because of their resistance to many groups of antibiotics and because of the way of their spreading in health care and long-term care institutions. Genes responsible for resistance to vancomycin can be transmitted to other species of enterococci and also to other grampositive cocci, for example Staphylococcus aureus. Experts anticipate that failure to control methicilin-resistant S. aureus and VRE may make control of vancomycin-resistant S. aureus impossible.Methods: In the medical microbiology laboratory of Institute Public Health Kranj we perform microbiology diagnosis for Jesenice General Hospital, where surveillance culturing for VRE started in May 2007. Until 15th June, 364 surveillance samples for VRE were taken from 92 patients. We also analysed the results of enterococci that were isolated in our laboratory during routine work in the period from 2004 to 2006.Results: In the three-year period we isolated 1593 strains of enterococci and among them 7 strains were VRE. In the Jesenice General Hospital, the first strain of vancomycin-resistant Enterococcus faecium was isolated in May 2007 in a patient, treated in internal intensive care unit. Nine strains of VRE with the same resistance type in nine patients followed the first case. The first four patients with VRE were moved from the same hospital. Among next six patients the common risk factor was contact with VRE positive patient.Conclusions: Control of VRE strains claims for intensive action. Active surveillance of colonised and infected patients, contact precautions with barrier isolation, intensive hand hygiene measures, aggressive environmental decontamination and prudent use of antimicrobials are needed.

  5. A point-prevalence survey of public hospital inpatients with palliative care needs in Cape Town, South Africa.

    Science.gov (United States)

    van Niekerk, L; Raubenheimer, P J

    2014-02-01

    To assess the need for palliative care among inpatients occupying acute beds in the public sector hospitals of the Cape Town Metropole. A cross-sectional, contemporaneous, point-prevalence study was performed at 11 public sector hospitals in the Cape Town Metropole using a standardised palliative care identification tool. Data were collected on the socio-demographic characteristics, diagnoses, and prior and current care planning of patients. The case notes of 1 443 hospital inpatients were surveyed, and 16.6% were found to have an active life-limiting disease. The mean age of the group was 56 years. The diagnoses were cancer in 50.8%, organ failure in 32.5%, and HIV/tuberculosis in 9.6%. The greatest burden of disease was in the general medical wards, to which an overall 54.8% of patients meeting the requirements for palliative care were admitted. This study provides evidence for the need for palliative care services in public sector hospitals and in the health system as a whole. The young age of patients and the high prevalences of end-stage renal failure and HIV are unique, and the burden in the general medical wards suggests a focus for initial inpatient programmes.

  6. [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.

  7. Specialized consultant in radiological safety to the Ciudad del Carmen general hospital, PEMEX; Asesoria especializada en seguridad radiologica al hospital general Ciudad del Carmen, PEMEX

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Hernandez C, J. E.; Rodriguez A, F.; Garcia A, J

    2003-02-15

    The Ciudad del Carmen general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  8. [Psychosocial stress environment and health workers in public health: Differences between primary and hospital care].

    Science.gov (United States)

    García-Rodríguez, Antonio; Gutiérrez-Bedmar, Mario; Bellón-Saameño, Juan Ángel; Muñoz-Bravo, Carlos; Fernández-Crehuet Navajas, Joaquín

    2015-01-01

    To describe the psychosocial environment of health professionals in public health in primary and hospital care, and compare it with that of the general Spanish working population, as well as to evaluate the effect of psychosocial risk factors on symptoms related to perceived stress. Cross-sectional study with stratified random sampling. Health care workers in the province of Granada, distributed in 5 hospitals and 4 health districts. A total of 738 employees (medical and nursing staff) of the Andalusian Health Service (SAS) were invited to take part. CopSoQ/Istas21 questionnaire developed for the multidimensional analysis of the psychosocial work environment. Stress symptoms were measured with the Stress Profile questionnaire. The response rate was 67.5%. Compared with the Spanish workforce, our sample showed high cognitive, emotional, and sensory psychological demands, possibilities for development and sense of direction in their work. Primary care physicians were the group with a worse psychosocial work environment. All the groups studied showed high levels of stress symptoms. Multivariate analysis showed that variables associated with high levels of stress symptom were younger and with possibilities for social relations, role conflict, and higher emotional demands, and insecurity at work. Our findings support that the psychosocial work environment of health workers differs from that of the Spanish working population, being more unfavorable in general practitioners. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  9. Incidence of and risk factors for hospital-acquired diarrhea in three tertiary care public hospitals in Bangladesh.

    Science.gov (United States)

    Bhuiyan, Mejbah Uddin; Luby, Stephen P; Zaman, Rashid Uz; Rahman, M Waliur; Sharker, M A Yushuf; Hossain, M Jahangir; Rasul, Choudhury H; Ekram, A R M Saifuddin; Rahman, Mahmudur; Sturm-Ramirez, Katharine; Azziz-Baumgartner, Eduardo; Gurley, Emily S

    2014-07-01

    During April 2007-April 2010, surveillance physicians in adult and pediatric medicine wards of three tertiary public hospitals in Bangladesh identified patients who developed hospital-acquired diarrhea. We calculated incidence of hospital-acquired diarrhea. To identify risk factors, we compared these patients to randomly selected patients from the same wards who were admitted > 72 hours without having diarrhea. The incidence of hospital-acquired diarrhea was 4.8 cases per 1,000 patient-days. Children diarrhea than older children. The risk of developing hospital-acquired diarrhea increased for each additional day of hospitalization beyond 72 hours, whereas exposure to antibiotics within 72 hours of admission decreased the risk. There were three deaths among case-patients; all were infants. Patients, particularly young children, are at risk for hospital-acquired diarrhea and associated deaths in Bangladeshi hospitals. Further research to identify the responsible organisms and transmission routes could inform prevention strategies. © The American Society of Tropical Medicine and Hygiene.

  10. Implementation of a Prototype Generalized Network Technology for Hospitals *

    OpenAIRE

    Tolchin, S. G.; Stewart, R. L.; Kahn, S. A.; Bergan, E. S.; Gafke, G. P.; Simborg, D.W.; Whiting-O'Keefe, Q. E.; Chadwick, M. G.; McCue, G. E.

    1981-01-01

    A demonstration implementation of a distributed data processing hospital information system using an intelligent local area communications network (LACN) technology is described. This system is operational at the UCSF Medical Center and integrates four heterogeneous, stand-alone minicomputers. The applications systems are PID/Registration, Outpatient Pharmacy, Clinical Laboratory and Radiology/Medical Records. Functional autonomy of these systems has been maintained, and no operating system c...

  11. Cost estimate of hospital stays for premature newborns in a public tertiary hospital in Brazil

    Directory of Open Access Journals (Sweden)

    Claudia Maria Desgualdo

    2011-01-01

    Full Text Available OBJECTIVES: To estimate the direct costs of hospital stays for premature newborns in the Interlagos Hospital and Maternity Center in São Paulo, Brazil and to assess the difference between the amount reimbursed to the hospital by the Unified Health System and the real cost of care for each premature newborn. METHODS: A cost-estimate study in which hospital and professional costs were estimated for premature infants born at 22 to 36 weeks gestation during the calendar year of 2004 and surviving beyond one hour of age. Direct costs included hospital services, professional care, diagnoses and therapy, orthotics, prosthetics, special materials, and blood products. Costs were estimated using tables published by the Unified Health System and the Brasindice as well as the list of medical procedures provided by the Brazilian Classification of Medical Procedures. RESULTS: The average direct cost of care for initial hospitalization of a premature newborn in 2004 was $2,386 USD. Total hospital expenses and professional services for all premature infants in this hospital were $227,000 and $69,500 USD, respectively. The costs for diagnostic testing and blood products for all premature infants totaled $22,440 and $1,833 USD. The daily average cost of a premature newborn weighing less than 1,000 g was $115 USD, and the daily average cost of a premature newborn weighing more than 2,500 g was $89 USD. Amounts reimbursed to the hospital by the Unified Health System corresponded to only 27.42% of the real cost of care. CONCLUSIONS: The cost of hospital stays for premature newborns was much greater than the amount reimbursed to the hospital by the Unified Health System. The highest costs corresponded to newborns with lower birth weight. Hospital costs progressively and discretely decreased as the newborns' weight increased.

  12. Assessment of antiretroviral treatment outcome in public hospitals ...

    African Journals Online (AJOL)

    Bernt Lindtjørn

    2School of Public Health, Addis Ababa University, Cell phone: 0911-405652, P.O. Box: 14 575, Addis Ababa, ... Method: A historical retrospective cohort study design was used for patients ... Low CD4 cell count, gender and timing of ARV regimen combinations had ... chronic care and retention of physicians in the public.

  13. Factors affecting the technical efficiency of general hospitals in Iran: data envelopment analysis.

    Science.gov (United States)

    Kalhor, Rohollah; Amini, Saeed; Sokhanvar, Mobin; Lotfi, Farhad; Sharifi, Marziye; Kakemam, Edris

    2016-03-01

    Restrictions on resource accessibility and its optimal application is the main challenge in organizations nowadays. The aim of this research was to study the technical efficiency and its related factors in Tehran general hospitals. This descriptive analytical study was conducted retrospectively in 2014. Fifty-four hospitals with private, university, and social security ownerships from the total 110 general hospitals were randomly selected for inclusion into this study on the basis of the share of ownership. Data were collected using a checklist with three sections, including background variables, inputs, and outputs. Seventeen (31.48%) hospitals had an efficiency score of 1 (highest efficiency score). The highest average efficiency score was in social security hospitals (84.32). Private and university hospitals ranked next with an average of 84.29 and 79.64, respectively. Analytical results showed that there was a significant relationship between hospital ownership, hospital type in terms of duty and specialization, educational field of the chief executive officer, and technical efficiency. There was no significant relationship between education level of hospital manager and technical efficiency. Most of the studied hospitals were operating at low efficiency. Therefore, policymakers should plan to improve the hospital operations and promote hospitals to an optimal level of efficiency.

  14. Management in public and private hospital in Greece

    Directory of Open Access Journals (Sweden)

    Christos Gogos

    2011-01-01

    Full Text Available The current Greek hospital, included in a complex system of health, is compelled in the benefit of differentiated spectrum of health services. The increased cost, the closeness of resources and the continuously increased demands and requirements for quality, impose the adoption of an administration-management system, on one side for the confrontation of challenges and changes, on the other for the achievement of placed objectives. The present literature review attempts to analyze the processes of Greek hospital's management, thru Greek environment.

  15. A Level Field for Private and Public Hospitals

    Institute of Scientific and Technical Information of China (English)

    LAN XINZHEN

    2010-01-01

    @@ The State Council on December 3 announced new policies to encourage private and foreign capital in China's medical sector to meet the country's diversifying demands on health care. The new policies, dubbed the "guideline to encourage and lead social capital to sponsor health-care institutes," stipulated that social capital should enjoy preferential treatment as China adjusts its medical resources, and social capital will be encouraged to participate in restructuring the hospital system. As an added bonus, overseas investments are being welcomed to sponsor hospitals and the process of involving more foreign investors will be further simplified in the coming years.

  16. Providing health information to the general public: a survey of current practices in academic health sciences libraries.

    Science.gov (United States)

    Hollander, S M

    2000-01-01

    A questionnaire was mailed to 148 publicly and privately supported academic health sciences libraries affiliated with Association of American Medical Colleges (AAMC-accredited medical schools in the United States and Canada to determine level of access and services provided to the general public. For purposes of this study, "general public" was defined as nonaffiliated students or health care professionals, attorneys and other nonhealth-related professionals, patients from affiliated or other hospitals or clinics, and general consumers. One hundred five (71%) libraries responded. Results showed 98% of publicly supported libraries and 88% of privately supported libraries provided access to some or all of the general public. Publicly supported libraries saw greater numbers of public patrons, often provided more services, and were more likely to circulate materials from their collections than were privately supported libraries. A significant number of academic health sciences libraries housed a collection of consumer-oriented materials and many provided some level of document delivery service, usually for a fee. Most allowed the public to use some or all library computers. Results of this study indicated that academic health sciences libraries played a significant role in serving the information-seeking public and suggested a need to develop written policies or guidelines covering the services that will be provided to minimize the impact of this service on primary clientele.

  17. Adverse events in hospitalised cancer patients: a comparison to a general hospital population

    DEFF Research Database (Denmark)

    Haukland, Ellinor; von Plessen, Christian; Nieder, Carsten

    2017-01-01

    ) compared to a general hospital population. Material and methods: A total of 6720 patient records were retrospectively reviewed comparing AEs in hospitalised cancer patients to a general hospital population in Norway, using the IHI Global Trigger Tool method. Results: 24.2 percent of admissions for cancer...... risk. The rate of AEs increases by 1.05 times for each day spent in hospital. For every year increase in age, the risk for AEs increases by 1.3%. Cancer patients more often have hospital-acquired infections, other surgical complications and AEs related to medications. Conclusions: Because of higher age...

  18. Can the use of Electronic Health Records in General Practice reduce hospitalizations for diabetes patients?

    DEFF Research Database (Denmark)

    Kongstad, Line Planck; Mellace, Giovanni; Rose Olsen, Kim

    on Electronic Health Records (EHR) on diabetes patients total hospitalizations, diabetes related hospitalizations and hospitalizations with diabetes and cardiovascular related Ambulatory Care Sentive Conditions (ACSC). We use a rich nationwide panel dataset (2004-2013) with information of stepwise enrolment......Disease management programmes (DMP) in the general practice sector are increasingly used to improve health of chronically ill patients, reduce hospitalizations and thereby costs. The aim of this paper is to estimate the causal effects of the enrolment of general practices (GP) in a DMP based...

  19. Motivation of the nursing staff in and a framework of realistic motives in a public hospital

    National Research Council Canada - National Science Library

    Yannis Markovits; Sofia Monastiridou

    2011-01-01

    ...: The presentation of selected motivation theories through literature review and the development of a framework of realistic motives applied to the nursing staff of a public hospital. Material-Method...

  20. SANTA vs. public tuberculosis hospitals: the patient experience in the Free State, 2001/2002

    Directory of Open Access Journals (Sweden)

    J.C Heunis

    2007-09-01

    Full Text Available This paper reflects on the appropriateness of the decision to close down a nongovernmental organisation (NGO, state-aided tuberculosis (TB hospital in the Free State in 2003. Henceforth hospitalisation of TB patients would take place at public district hospitals. A survey conducted late-2001/'early-2002 revealed a more positive patient experience of hospitalisation forTB in public hospitals than in the NGO hospital. Consideration of the patient experience serves to inform the debate concerning continued outsourcing of TB hospital care to NGOs in South Africa. This study discusses comparative findings in respect of patients’ biographic and socio-economic characteristics, health beliefs, satisfaction with hospitalisation, experience of stigmatisation, adherence to treatment and absconding from hospital.

  1. Economies of scale and optimal size of hospitals: Empirical results for Danish public hospitals

    DEFF Research Database (Denmark)

    Kristensen, Troels

    Context and aim: The Danish hospital sector is facing a significant rebuilding programme, driven by a : The Danish hospital sector is facing a significant rebuilding programme, driven by a political desire to concentrate activity in fewer and larger hospitals. Our aim is to analyse whether...... the current configuration of Danish hospitals is subject to scale economies that may justify such plans and to estimate an optimal hospital size. Methods: We estimate cost functions using panel data on total costs, DRG-weighted casemix, and number : We estimate cost functions using panel data on total costs......, DRG-weighted casemix, and number of beds for three years from 2004-2006. A short-run cost function is used to derive estimates of long-run scale economies by applying the envelope condition. Results: We identify moderate to significant long-run economies of scale when applying two alternative We...

  2. The Impact of China's Entry into WTO on Chinese Public Hospitals

    Institute of Scientific and Technical Information of China (English)

    王宇

    2006-01-01

    China's entry into WTO has had a tremendous effect on Chinese public hospitals as it introduced some challenges and, ushered in an opportunity to provide a new development space. This report aims at to analyze and evaluate the initial impact of China's entry into the WTO on Chinese public hospitals, particularly in the field of the human resources department, financial department and quality service control department. As well as make feasible recommendations to the Chinese government.

  3. Two Important Factors That Effects Patient Satisfaction In A Public Hospital: Communication And Patient Safety Culture

    OpenAIRE

    Vural, Fisun; AYDIN, Ayşe; FİL, Şükran; Torun, Sebahat; Vural, Birol

    2015-01-01

    The measurement of patient satisfaction in health care services is an important measure of quality service provision. The aim of this study was to determine hospitalized patient satisfaction in a public hospital and the related factors affecting satisfaction. Patient satisfaction survey was applied to 120 hospitalized patients during face to face interviews. The major components of healthcare satisfaction were analysed separately as: the personal characteristics of patients, healthcare staffs...

  4. Kodamaea (Pichia) ohmeri fungemia in a pediatric patient admitted in a public hospital

    NARCIS (Netherlands)

    De Barros, J.D.; Do Nascimento, S.M.; de Araujo, F.J.; Braz Rde, F.; Andrade, V.S.; Theelen, B.J.F.; Boekhout, T.; Illnait-Zaragozi, M.T.; Gouveia, M.N.; Fernandes, M.C.; Monteiro, M.G.; De Oliveira, M.T.

    2009-01-01

    Kodamaea (Pichia) ohmeri is a yeast species that has not been reported to be a frequent cause of human infections. The current report describes a case of fungemia caused by K. ohmeri in a 3-year-old female patient hospitalized in the public hospital Maria Alice Fernandes, Natal, RN, Brazil. The

  5. Collaboration between physicians and a hospital-based palliative care team in a general acute-care hospital in Japan

    Directory of Open Access Journals (Sweden)

    Nishikitani Mariko

    2010-06-01

    Full Text Available Abstract Background Continual collaboration between physicians and hospital-based palliative care teams represents a very important contributor to focusing on patients' symptoms and maintaining their quality of life during all stages of their illness. However, the traditionally late introduction of palliative care has caused misconceptions about hospital-based palliative care teams (PCTs among patients and general physicians in Japan. The objective of this study is to identify the factors related to physicians' attitudes toward continual collaboration with hospital-based PCTs. Methods This cross-sectional anonymous questionnaire-based survey was conducted to clarify physicians' attitudes toward continual collaboration with PCTs and to describe the factors that contribute to such attitudes. We surveyed 339 full-time physicians, including interns, employed in a general acute-care hospital in an urban area in Japan; the response rate was 53% (N = 155. We assessed the basic characteristics, experience, knowledge, and education of respondents. Multiple logistic regression analysis was used to determine the main factors affecting the physicians' attitudes toward PCTs. Results We found that the physicians who were aware of the World Health Organization (WHO analgesic ladder were 6.7 times (OR = 6.7, 95% CI = 1.98-25.79 more likely to want to treat and care for their patients in collaboration with the hospital-based PCTs than were those physicians without such awareness. Conclusion Basic knowledge of palliative care is important in promoting physicians' positive attitudes toward collaboration with hospital-based PCTs.

  6. Management practices in Australian healthcare: can NSW public hospitals do better?

    Science.gov (United States)

    Agarwal, Renu; Green, Roy; Agarwal, Neeru; Randhawa, Krithika

    2016-05-16

    Purpose - The purpose of this paper is to investigate the determinants of best management practices in an Australian state-run healthcare system, namely New South Wales (NSW), and studies the impact of a range of hospital factors in driving best management practices as a means of enhancing healthcare delivery. Design/methodology/approach - This study adapts a unique survey instrument globally tested to quantify the multi-dimensional nature of hospital management practices in 42 acute care public hospitals of NSW. The authors then analysed the role of hospital-specific characteristics in driving best management practices, namely hospital size (measured by the number of hospital beds, employees and doctors), level of skill and education, degree of hospital manager autonomy and organisational hierarchy. Findings - The findings of this study show the areas of strength and potential areas of improvement in NSW hospitals. The authors find a positive association between the adoption of better management practices and hospital size (measured by the number of hospital beds and employees), level of skills and education, degree of hospital manager autonomy and organisational hierarchy. However, hospital size as measured by the number of doctors did not have a statistically significant relationship. Practical implications - This paper is of interest to both hospital administrators, clinical doctors and healthcare policy-makers who want to improve and develop strategies for better management in the healthcare sector. Originality/value - This study provides an internationally comparable robust measure of management capability in public hospitals, and contributes to the evidence-base of management practices and performance in hospitals.

  7. Assessment of Operational Maintenance in Public Hospitals Buildings in the Gaza Strip

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    Adnan Enshassi

    2015-01-01

    Full Text Available The issue of public hospitals buildings’ maintenance in Palestine is regarded as a challenging issue. The lack of attention to maintenance management in hospitals has led to deterioration of buildings and reduced the health care services. The aim of this paper is to assess the current practice of maintenance process and management in public hospitals buildings in the Gaza Strip. A questionnaire survey that distributed to 13 public hospitals, which are administered by the Ministry of Health (MoH in the Gaza Strip, was used to collect the primary data for this study. The results of this study present an overview of the current situation of the maintenance process in public hospitals buildings in the Gaza Strip. The findings indicated that while the corrective maintenance is implemented in all the 13 public hospitals, preventive maintenance is employed along with corrective maintenance, only in three hospitals. In addition, the findings indicated variances in responding to maintenance requests, while 50% of the maintenance departments took few hours to respond to maintenance requests, the rest took a few days to respond, this can be explained due to lack of spare parts and qualified staff. The study showed also that there is a shortage in training the hospital facility’s users on how to report maintenance problems. The results of this study indicated that most hospitals in the Gaza Strip have no maintenance plan for medical equipment; they do not have quality control system for repair and preventive maintenance. It is recommended to employ experience maintenance staff in order to prepare adequate maintenance plan and detailed check list, which is required for preventive maintenance. The MoH should organize specialized training courses in maintenance management for their staff in order to improve their effectiveness and efficiency. Hospitals in Gaza should make sure that all spare parts available in their storages for immediate action when

  8. Discussion on a Public Hospital's Practice in Culture Shaping and Innovative Development.

    Science.gov (United States)

    Zhang, Peiying

    2015-05-01

    Culture shaping is an important part of a hospital's quality management to enhance its medical service, improve doctor-patient relations, and cement its brand image (Jianping and Hong in Chinese Hospital Management 29(1):36-37, 2009). First built in 1953, Xuzhou Central Hospital is a tertiary general hospital in the Huaihai Economic Zone and has won a series of honorary titles for its reforms, innovations, and the level of medical services provided. In recent years, the hospital has increased its efforts in culture shaping through the construction of special departments, medical services, hospital culture, and professional ethics. This has resulted in substantial progress in the hospital's medical capabilities and service quality, and laid a solid foundation to achieve its ambitious goal of becoming a nationally prestigious hospital, among the best in Jiangsu and a regional healthcare center in the Huaihai Economic Zone.

  9. Parasuicide among youth in a general hospital in South Africa

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    T Mhlongo

    1999-09-01

    Full Text Available Parasuicide cases among youth (15-24 years referred to the clinical psychology section of a regional hospital from 1995 to 1998 were reviewed. In all 100 cases (37 males and 63 females were identified being about 10% of the caseload. As part of the clinical psychological assessment sociodemographic, clinical characteristics, trigger factors, employed methods and suicide intentions were analysed. Most patients were students (79% or unemployed (16%. The major method employed to attempt suicide was ingestion of harmful substances (like paraffin, pesticides or battery acid(73%. Acute social conflicts (38%, socio-economic deprivation (17%, AIDS phobia (17%, academic failure (14%, teenage pregnancy (10% and mental illness (5% triggered suicide attempts. Fifty-eight percent of the attempts were categorised as demonstrative and 27% as genuine. The psychodynamics of parasuicides are discussed in case studies and with reference to other studies.

  10. Evaluation of thromboprophylaxis in medium-sized general hospital

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    Cesar Roberto Busato

    2014-03-01

    Full Text Available CONTEXT: Deep vein thrombosis (DVT is a serious, common disease whose complications include pulmonary thromboembolism (PTE and postthrombotic syndrome. The importance and benefits of correct and effective pharmacological prophylaxis for DVT are well documented. OBJECTIVES: The aims of this study were to evaluate adequacy of prophylaxis for DVT and PTE at the Santa Casa de Misericórdia de Ponta Grossa (SCMPG, Paraná, Brazil, and determine risk stratification for patients hospitalized in this institution. METHODS: A cohort study was conducted to assess DVT prophylaxis of patients hospitalized on May 15th, 2009. The study population consisted of a sample of 104 patients, subdivided into clinical and surgical groups and stratified into different specialties. Correct use of DVT prophylaxis was evaluated according to recommendations published by The Brazilian Society for Angiology and Vascular Surgery and took into account prophylactic methods specified explicitly in information found in each patient's medical chart. RESULTS: Of the 104 patients interviewed, 51 (49.04% were clinical patients and 53 (50.96% surgical. Based on risk stratification, 17 (16.35% were classified as low risk, 37 (35.58% as moderate risk, 46 (44.23% as high risk and 4 (3.85% as extremely high risk for DVT/PTE. A total of 68 patients (65.38% received prophylaxis, but of these only 56 (53.85% received the correct prophylaxis, and 36 (34.62% did not receive any prophylaxis. CONCLUSION: The rates of prophylaxis use for DVT and PTE in this service are higher than rates published in the literature.

  11. Epidemiology of carbapenemase producing Enterobacteriaceae in a general hospital

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    Amina Kandeel

    2015-06-01

    Full Text Available Objective: Detect the presence of carbapenemases producing Enterobacteriaceae (CPE and associated epidemiologi­cal, microbiological, and clinical characteristics of patients in our hospital Methods: During 15 months period, all non duplicate Enterobacteriaceae isolates with reduced susceptibility to car­bapenem detected by MicroScan WalkAway system and confirmed by E test were collected. These suspected isolates were further screened by modified Hodge test and carbapenemase inhibition discs to identify CPE. Results: Out of 54 suspected Enterobacteriaceae isolates, 44 (88.5% isolates were either extended spectrum beta-lac­tamases (ESBLs or AmpC producers with porin loss whereas 10 isolates (18.5% were confirmed to produce carbapen­emase representing (0.74% of the total Enterobacteriaceae. Among these 10 isolates, 6 were OXA 48 producers and 2 isolates were class B and class A each. Six out of the 10 CPE were detected in ICU and specimen source was tracheal aspirate in 5 CPE isolates. All CPE isolates were sensitive to colistin and all but one to tigecycline. All patients had history of previous antibiotic exposure and hospital stays for more than 5 days. Conclusion: Although CPE is not the main cause of carbapenem resistance in Enterobacteriaceae in our setting, its emergence there represents a serious infection control and therapeutic challenge. This mandates its early detection using MHT and carbapenemase inhibition tests together with strict infection control measures to limit its spread. J Mi­crobiol Infect Dis 2015;5(2: 57-62

  12. Consent for use of clinical leftover biosample: a survey among Chinese patients and the general public.

    Science.gov (United States)

    Ma, Yi; Dai, HuiLi; Wang, LiMin; Zhu, LiJun; Zou, HanBing; Kong, XianMing

    2012-01-01

    Storage of leftover biosamples generates rich biobanks for future studies, saving time and money and limiting physical impact to sample donors. To investigate the attitudes of Chinese patients and the general public on providing consent for storage and use of leftover biosamples. Cross-sectional surveys were conducted among randomly selected patients admitted to a Shanghai city hospital (n = 648) and members of the general public (n = 492) from May 2010 to July 2010. Face-to-face interviews collected respondents-report of their willingness to donate residual biosample, trust in medical institutions, motivation for donation, concerns of donated sample use, expectations for research results return, and so on. The response rate was 83.0%. Of the respondents, 89.1% stated that they completely understood or understood most of questions. Willingness to donate residual sample was stated by 64.7%, of which 16.7% desired the option to withdraw their donations anytime afterwards. Only 42.3% of respondents stated they "trust" or "strongly trust" medical institutions, the attitude of trusting or strongly trusting medical institutions were significantly associated with willingness to donate in the general public group.(p<0.05) The overall assent rate for future research without specific consents was also low (12.1%). Hepatitis B virus carriers were significantly less willing than non-carriers to donate biosamples (32.1% vs. 64.7%, p<0.001). Low levels of public trust in medical institutions become serious obstacle for biosample donation and biobanking in China. Efforts to increase public understanding of human medical research and biosample usage and trust in the ethical purposes of biobanking are urgently needed. These efforts will be greatly advanced by the impending legislation on biobanking procedures and intent, and our results may help guide the structure of such law.

  13. Consent for use of clinical leftover biosample: a survey among Chinese patients and the general public.

    Directory of Open Access Journals (Sweden)

    Yi Ma

    Full Text Available BACKGROUND: Storage of leftover biosamples generates rich biobanks for future studies, saving time and money and limiting physical impact to sample donors. OBJECTIVE: To investigate the attitudes of Chinese patients and the general public on providing consent for storage and use of leftover biosamples. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional surveys were conducted among randomly selected patients admitted to a Shanghai city hospital (n = 648 and members of the general public (n = 492 from May 2010 to July 2010. MAIN OUTCOME MEASURES: Face-to-face interviews collected respondents-report of their willingness to donate residual biosample, trust in medical institutions, motivation for donation, concerns of donated sample use, expectations for research results return, and so on. RESULTS: The response rate was 83.0%. Of the respondents, 89.1% stated that they completely understood or understood most of questions. Willingness to donate residual sample was stated by 64.7%, of which 16.7% desired the option to withdraw their donations anytime afterwards. Only 42.3% of respondents stated they "trust" or "strongly trust" medical institutions, the attitude of trusting or strongly trusting medical institutions were significantly associated with willingness to donate in the general public group.(p<0.05 The overall assent rate for future research without specific consents was also low (12.1%. Hepatitis B virus carriers were significantly less willing than non-carriers to donate biosamples (32.1% vs. 64.7%, p<0.001. CONCLUSIONS: Low levels of public trust in medical institutions become serious obstacle for biosample donation and biobanking in China. Efforts to increase public understanding of human medical research and biosample usage and trust in the ethical purposes of biobanking are urgently needed. These efforts will be greatly advanced by the impending legislation on biobanking procedures and intent, and our results may help guide the structure

  14. Providing health information to the general public: a survey of current practices in academic health sciences libraries*

    Science.gov (United States)

    Hollander, Sue M.

    2000-01-01

    A questionnaire was mailed to 148 publicly and privately supported academic health sciences libraries affiliated with Association of American Medical Colleges (AAMC)–accredited medical schools in the United States and Canada to determine level of access and services provided to the general public. For purposes of this study, “general public” was defined as nonaffiliated students or health care professionals, attorneys and other nonhealth-related professionals, patients from affiliated or other hospitals or clinics, and general consumers. One hundred five (71%) libraries responded. Results showed 98% of publicly supported libraries and 88% of privately supported libraries provided access to some or all of the general public. Publicly supported libraries saw greater numbers of public patrons, often provided more services, and were more likely to circulate materials from their collections than were privately supported libraries. A significant number of academic health sciences libraries housed a collection of consumer-oriented materials and many provided some level of document delivery service, usually for a fee. Most allowed the public to use some or all library computers. Results of this study indicated that academic health sciences libraries played a significant role in serving the information-seeking public and suggested a need to develop written policies or guidelines covering the services that will be provided to minimize the impact of this service on primary clientele. PMID:10658965

  15. APPLICATION OF VSM IN A PUBLIC BRAZILIAN HOSPITAL

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    Guilherme Luz Tortorella

    2015-12-01

    Full Text Available During the last decade, there has been a demand for public services to enhance management practices and attain results comparable to those experienced in the private sector. The need for achieving higher quality standards in public services has highlighted the importance of exploring new management techniques to account for the obsolescence in those organizations’ administrative models, with particular emphasis on healthcare services. This paper reports the application of one such new management technique, named Value Stream Mapping (VSM, in the sterilized unit of a public healthcare organization. We present here the benefits of analyzing healthcare processes using VSM, contributing to the existing body of knowledge on Lean management by examining the validity of applying its principles and practices in contexts other than manufacturing.

  16. Public sector buying spree. In a spate of Sunbelt deals, four publicly owned systems have bought five hospitals to adapt to market pressures.

    Science.gov (United States)

    Evans, Melanie

    2006-10-23

    Like traders in the pits, public hospital systems have been yelling "Buy, buy" in recent months. The commodities in question: not-for-profit hospitals. With a Wall Street spirit, public hospitals claim the latest acquisitions are simply a response to market pressure. Economist Stephen Zuckerman, left, calls the trend "surprising." Major pros and cons, however, give this particular investment high stakes.

  17. [The libraries of the public hospitals in Spain. An economic analysis. The Research Group on Libraries].

    Science.gov (United States)

    Sánchez Gómez, C; Lázaro y de Mercado, P; Poza Sanz, M A; Estrada Lorenzo, J M

    1999-01-01

    The continuous increase in scientific knowledge in the health field, the development of new technologies and the rising cost of publications means that libraries are essential for patient care, medical education and research. In Spain some deficiencies have been seen in hospital libraries, and their cost is unknown. To analyze the cost of public hospital libraries in Spain and to estimate the cost of adapting them to international standards. Cross-sectional survey of public hospitals larger than 100 beds, or smaller public hospitals with teaching accreditation. Information on the variables of interest was collected by questionnaire mailed to the libraries and followed up by telephone. Data collection was completed in 1996. The information on costs is for 1994. A sensitivity analysis was done to examine the effects of imprecise estimates and assumptions. Of the 314 hospitals identified, 211 (67.2%) had libraries. The 1994 cost of the of the 211 libraries was 3,060 million pesetas (mean cost: 14.5 million pesetas). Personnel costs were the most important item (38% of the total), followed by the cost of subscriptions (29%). The cost of hospital libraries represented 0.08% of national public expenditures on health. The cost of correcting inadequacies in accordance with international standards would increase spending by about 400 million pesetas the first year (0.01% of public spending on health). The cost of hospital libraries represents only a small fraction of public spending on health. Correction of the observed deficiencies and the importance of libraries in the health system would require increasing spending to about 0.1% of public spending on health.

  18. [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

  19. Care complexity in the general hospital - Results from a European study

    NARCIS (Netherlands)

    de Jonge, P; Huyse, FJ; Slaets, JPJ; Herzog, T; Lobo, A; Lyons, JS; Opmeer, BC; Stein, B; Arolt, [No Value; Balogh, N; Cardoso, G; Fink, P; Rigatelli, M; van Dijck, R; Mellenbergh, GJ

    2001-01-01

    There is increasing pressure to effectively treat patients with complex care needs from the moment of admission to the general hospital. In this study, the authors developed a measurement strategy for hospital-based care complexity. The authors' four-factor model describes the interrelations between

  20. A cost study of a general practitioner hospital in the Netherlands.

    NARCIS (Netherlands)

    Hakkart-van Roijen, L.; Moll van Charante, E.P.; Bindels, P.J.E.; Yzermans, C.J.; Rutten, F.F.H.

    2004-01-01

    To perform a cost study of the first general practitioner (GP) hospital in the Netherlands. We conducted a cost study in a GP hospital in the Netherlands. Data on healthcare utilisation from 218 patients were collected for a period of one year. The costs of admission to the GP hosptial were compared

  1. Researches regarding the Morton ether inhaler at Massachusetts General Hospital, Boston.

    Science.gov (United States)

    Haridas, Rajesh P; Mifflin, Jeffrey A

    2013-11-01

    The Morton ether inhaler in the possession of Massachusetts General Hospital, Boston, MA, was traced back to 1906 when the earliest known photograph of it was published. The authors believe that the inhaler was given by William T. G. Morton, MD, to J. Mason Warren, MD, in January 1847. The inhaler was acquired by the Warren Anatomical Museum at an unknown date, loaned to Massachusetts General Hospital in October 1946, and placed on permanent loan to Massachusetts General Hospital in April 1948. Many documents relating to the inhaler have disappeared, and it was only identified in 2009 as the inhaler that probably belonged to J. Mason Warren, MD. The inhaler is not believed to be the one that Morton used on October 16, 1846, at Massachusetts General Hospital. It is the only known example of a Morton ether inhaler with valves (excluding replicas or reproduction inhalers) and is probably of similar design to the inhaler that Morton used on October 16, 1846.

  2. [For the improvement of management and assurance in clinical laboratories of education hospitals--from the meeting of clinical laboratory members of public university or college hospitals].

    Science.gov (United States)

    Yoshida, Hiroshi

    2004-03-01

    Clinical laboratory members, composed of medical doctors, laboratory technologists and office staff from 8 public university or college hospitals and one medical center, have an annual meeting, in which achievements including tested numbers, income, outsourcing ratio, and so on were reported and various agendas from each institution were discussed. The number of agendas for general discussion and in the technologist division has been increasing, which reflects that variables, including management in clinical laboratories, needing solutions have been increasing. Information obtained through discussion could help in the determination of management and the improvement of education and quality assurance in clinical laboratories.

  3. Prevalence trends of oral squamous cell carcinoma. Mexico City’s General Hospital experience

    Science.gov (United States)

    Hernández-Guerrero, Juan C.; Jacinto-Alemán, Luís F.; Jiménez-Farfán, María D.; Macario-Hernández, Alejandro; Hernández-Flores, Florentino

    2013-01-01

    Objective: Recent reports suggest an increase in oral squamous cell carcinoma (OSCC) frequency. To improve programs in public health, it is necessary to understand the epidemiological conditions. The aim of this study was to analyze the trend in gender, age, anatomic zone and OSCC stage from Mexico City’s General Hospital patients from 1990 to 2008. Study design: A retrospective review of all OSCC cases diagnosed by the Pathology Department of the Mexico City General Hospital was performed. Demographic data, in addition to anatomic zone and histological degree of differentiation were obtained. Central tendency, dispersion and prevalence rate per 100,000 individuals were determined. Results: A total of 531 patients were diagnosed with OSCC; 58.4% were men, giving a male:female ratio of 1.4:1, and the mean age was 62.5 ± 14.9 years. The predominant anatomic zone was the tongue (44.7%), followed by the lips (21.2%) and gums (20.5%). The most frequent histological degree was moderately differentiated in 325 cases (61.2%). The rates of OSCC prevalence showed similar patterns in terms across time. A significant correlation (P = 0.007) between anatomic zone and age was observed. Conclusion: According to our results, the prevalence of OSCC does not show important variations; however, a relationship between age and anatomic zone was observed. These data could be used as parameters for the diagnosis of OSCC as well as for the development and dissemination of preventive programs for the early detection of oral cancer. Key words:Oral squamous cell carcinoma, prevalence, histology degree and anatomic zone. PMID:23385493

  4. Injectional anthrax at a Scottish district general hospital.

    Science.gov (United States)

    Inverarity, D J; Forrester, V M; Cumming, J G R; Paterson, P J; Campbell, R J; Brooks, T J G; Carson, G L; Ruddy, J P

    2015-04-01

    This retrospective, descriptive case-series reviews the clinical presentations and significant laboratory findings of patients diagnosed with and treated for injectional anthrax (IA) since December 2009 at Monklands Hospital in Central Scotland and represents the largest series of IA cases to be described from a single location. Twenty-one patients who fulfilled National Anthrax Control Team standardized case definitions of confirmed, probable or possible IA are reported. All cases survived and none required limb amputation in contrast to an overall mortality of 28% being experienced for this condition in Scotland. We document the spectrum of presentations of soft tissue infection ranging from mild cases which were managed predominantly with oral antibiotics to severe cases with significant oedema, organ failure and coagulopathy. We describe the surgical management, intensive care management and antibiotic management including the first description of daptomycin being used to treat human anthrax. It is noted that some people who had injected heroin infected with Bacillus anthracis did not develop evidence of IA. Also highlighted are biochemical and haematological parameters which proved useful in identifying deteriorating patients who required greater levels of support and surgical debridement.

  5. Recording and Management of CCT in a Public Hospital in the Region of Laconia in Greece

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    Georgia Gkiouzeli

    2013-01-01

    Full Text Available Background: Cranium-cerebral traumas in today’s era are a serious public health problem with bothsocial and economic dimensions. They are characterized as an ‘epidemic’, due to the increase in car accidents and they particularly affect the productive population.The objective of this study was to investigate the occurrence and allocation of Cranium-cerebral traumas among the population in the Prefecture of Laconia, in order to determine the explanatory factors or risk factors, the record of how they are managed (diagnosis, therapy, and outcome and their correlation with demographics and other factors.Methodology: This study was conducted with the collection of data from hospital archives and Emergency Department logbooks from the General Hospital of Sparta. Specifically designed record forms were used which included patient demographics, means of arrival to the hospital, the clinical pictures, the gravity of the injury, possible accompanying injuries, diagnostic tests, treatment and outcome, as well as evidence related to the causes of the injury.Results: 2352 cases of children and adults with Cranium-cerebral traumas were included in this study who came to the Emergency Department from 1st of January 2005 to 31st of December 2010. The cause of Cranium-cerebral traumas in adults is affected by gender, nationality and place of residence, while in children it is affected by place of residence and the means of arrival to the Emergency Department. Respectively, the outcome of Cranium–cerebral traumas in adults is affected by place of residence and their means of arrival to the hospital while in children it is affected by nationality and place of residence.Conclusions: This study has revealed the magnitude of the problem and the epidemiological characteristics of Cranium-cerebral traumas in the Prefecture of Laconia, with the ultimate need for intervention at a level of prevention. Proposals regard the improvement in road networks, informative

  6. 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

  7. [Mental Health in the General Hospital: Results of the Patient Health Questionnaire (PHQ) in Four Hospital Services].

    Science.gov (United States)

    Castro-Camacho, Leonidas; Escobar, Juan Manuel; Sáenz-Moncaleano, Camilo; Delgado-Barrera, Lucía; Aparicio-Turbay, Soraya; Molano, Juan Carlos; Noguera, Efraín

    2012-03-01

    Few individuals have access to mental health services due in part to underdetection. As it is more likely to consult for medical conditions, primary care may be a useful gateway for early detection of mental health problems. Detection of the frequency of mental health problems in four hospital services at the Fundación Santa Fe de Bogotá: Outpatient unit, hospitalization, emergency department, and primary care through a brief detection questionnaire, the Patient Health Questionnaire (PHQ). Cross-sectional study of patients seen at the four services who answered a Demographic Data Questionnaire and the PHQ together with information gathered about current medical diagnosis, history of visits, and hospitalizations during the last year. 1094 patients seen at the four hospital services between September 2010 and May 2011 were selected at random. A mental health problem was detected in 36.7% of the total sample. Major depressive disorder (7.3%), alcohol abuse (14.4%), and any anxiety disorder (7.7%) showed the highest prevalence with the emergency department showing the highest frequency of detection. The usefulness of a brief detection questionnaire such as the PHQ in hospital settings is demonstrated and implications in the design of mental health programs in the general hospital are discussed. The need to replicate this study in other settings and to undertake further research is outlined. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

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

    Science.gov (United States)

    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.

  9. A 5-year audit of outcome of apicectomies carried out in a district general hospital.

    OpenAIRE

    Lyons, A. J.; Hughes, C E; Dixon, E. J.

    1995-01-01

    Success rates of up to 90% have been claimed for apicectomy. However, the conditions that this procedure is carried out under at district general hospitals may be at variance with such studies. A 5-year audit of outcome was therefore carried out within a district general hospital. It was found that 89% of apicected teeth still remained at 5 years. Outcome was not influenced by any of the factors examined, and could not be predicted radiographically. Most failures occurred after the average po...

  10. Psychiatric wards in general hospitals - the opinions of psychiatrists employed there

    Directory of Open Access Journals (Sweden)

    Janusz Chojnowski

    2016-04-01

    The psychiatrists employed in the psychiatric wards in general hospitals in Poland evaluate this organisational model positively. However, the destabilisation of economic foundations of these wards reported in the world literature was also reflected in the results of a survey conducted in Poland. There is a need to develop standards for the organisation and financing departments of psychiatry in general hospitals providing them stable status in the healthcare system in Poland.

  11. Private medical services in the Italian public hospitals: the case for improving HRM.

    Science.gov (United States)

    De Pietro, Carlo

    2006-08-22

    This study explores how Italian public hospitals can use private medical activities run by their employed physicians as a human resources management (HRM) tool. It is based on field research in two acute-care hospitals and a review of Italian literature and laws. The Italian National Health Service (NHS) allows employed physicians to run private, patient-funded activities ("private beds", surgical operations, hospital outpatient clinics, etc.). Basic regulation is set at the national level, but it can be greatly improved at the hospital level. Private activities, if poorly managed, can damage efficiency, equity, quality of care, and public trust in the NHS. On the other hand, hospitals can also use them as leverage to improve HRM, with special attention to three issues: (1) professional evaluation, development, and training; (2) compensation policies; (3) competition for, and retention of, professionals in short supply. The two case studies presented here show great differences between the two hospitals in terms of regulation and organizational solutions that have been adopted to deal with such activities. However, in both hospitals, private activities do not seem to benefit HRM. Private activities are not systematically considered in compensation policies. Moreover, private revenues are strongly concentrated in a few physicians. Hospitals use very little of the information provided by the private activities to improve knowledge management, career development, or training planning. Finally, hospitals do not use private activities management as a tool for competing in the labor market for health professionals who are in short supply.

  12. 78 FR 10174 - Public Availability of General Services Administration FY 2012 Service Contract Inventory

    Science.gov (United States)

    2013-02-13

    ... ADMINISTRATION Public Availability of General Services Administration FY 2012 Service Contract Inventory AGENCY: General Services Administration (GSA). ACTION: Notice of Public Availability of FY 2012 Service Contract... Appropriations Act Public Law 111-117, GSA is publishing this notice to advise the public of the availability...

  13. 77 FR 5253 - Public Availability of General Services Administration FY 2011 Service Contract Inventory

    Science.gov (United States)

    2012-02-02

    ... ADMINISTRATION Public Availability of General Services Administration FY 2011 Service Contract Inventory AGENCY: Office of Acquisition Policy (MV); General Services Administration (GSA). ACTION: Notice of public... Act Public Law 111-117, GSA is publishing this notice to advise the public of the availability of...

  14. Well-Differentiated Thyroid Cancer: The Philippine General Hospital Experience

    Directory of Open Access Journals (Sweden)

    Tom Edward N. Lo

    2016-03-01

    Full Text Available BackgroundWell-differentiated thyroid cancer (WDTC is the most common form of thyroid malignancy. While it is typically associated with good prognosis, it may exhibit higher recurrence and mortality rates in selected groups, particularly Filipinos. This paper aims to describe the experience of a Philippine Hospital in managing patients with differentiated thyroid cancer.MethodsWe performed a retrospective cohort study of 723 patients with WDTC (649 papillary and 79 follicular, evaluating the clinicopathologic profiles, ultrasound features, management received, tumor recurrence, and eventual outcome over a mean follow-up period of 5 years.ResultsThe mean age at diagnosis was 44±13 years (range, 18 to 82, with a majority of cases occurring in the younger age group (<45 years. Most tumors were between 2 and 4 cm in size. The majority of papillary thyroid cancers (PTCs, 63.2% and follicular thyroid cancers (FTCs, 54.4% initially presented as stage 1, with a greater proportion of FTC cases (12.7% vs. 3.7% presenting with distant metastases. Nodal metastases at presentation were more frequent among patients with PTC (29.9% vs. 7.6%. A majority of cases were treated by complete thyroidectomy, followed by radioactive iodine therapy and thyroid stimulating hormone suppression, resulting in a disease-free state. Excluding patients with distant metastases at presentation, the recurrence rates for papillary and FTC were 30.1% and 18.8%, respectively.ConclusionOverall, PTC among Filipinos was associated with a more aggressive and recurrent behavior. FTC among Filipinos appeared to behave similarly with other racial groups.

  15. Association between follicular gastritis and Helicobacter pylori in children seen at a public hospital in Peru.

    Science.gov (United States)

    Mejia, C R; Vera, C A; Huiza-Espinoza, L

    2016-01-01

    For the last 15 years, infection from Helicobacter pylori (H. pylori) has been recognized in gastritis pathogenesis, and is known to trigger an important inflammatory response in these patients. To determine the association between follicular gastritis and H. pylori infection in children seen at a public hospital in Peru. An analytic, cross-sectional study was conducted on all the children treated at the Hospital Nacional Docente Madre "Niño San Bartolomé" in Lima, Peru, within the time frame of 2011-2012. All the personal data from the patients' medical histories and endoscopic procedures were collected. The crude prevalence ratios (PR) were obtained and adjusted (aPR) with their 95% confidence intervals (95%CI), using generalized linear models with the binomial family and log link function. A total of 123 children met the study criteria. Forty-eight (39%) of the study sample were girls and the mean age of the children was 12 years. H. pylori was present in 44% of the sample and 9% presented with more than 100 bacteria per field (classified as +++). Thirty-five percent of the children had esophagitis due to concomitant reflux. The presence of H. pylori was associated with follicular gastritis (Pgastritis had a greater likelihood of having H. pylori than those that did not present with gastritis. These results can be extrapolated to other similar populations and should be evaluated in each setting so that this does not become a public health problem within the next few years. Copyright © 2016 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

  16. Teamwork and collaboration among doctors and nurses in two public hospitals in China

    OpenAIRE

    Li, F; Xu, H.; Johnston, JM

    2013-01-01

    The Work-related Collaboration among Doctor-Nurse Scale (WCDNS) was ad-ministered to 398 doctors and nurses working in one of two hospitals in Guangzhou to assess 1) inter professional (doctor-nurse) differences in collaboration and teamwork and 2) inter hospital (general-specialist) differences in doctor nurse collaboration. Significant between profession and hospital differences were observed. Implications for future studies in doctor-nurse collaboration are discussed.

  17. BIOMEDICAL SOLID WASTE MANAGEMENT PRACTICES IN MAJOR PUBLIC HOSPITALS OF SHIMLA CITY

    OpenAIRE

    Saurabh; Salig Ram; Anmol K

    2014-01-01

    BACKGROUND: The actual biomedical waste management situation in the democratic developing country like India is grim. Even though there are Rules stipulating the method of safe disposal of Bio-medical Waste (BMW), hospital waste generated by Government Hospitals is still largely being dumped in the open, waiting to be collected along with general waste. OBJECTIVES: To assess the waste handling and treatment system of hospital bio-medical solid waste METHODOLOGY: A Cross se...

  18. Etiological study of generalized lymphadenopathy in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Subrata Halder

    2016-08-01

    Results: Among 116 patients of generalized lymphadenopathy 59.5% were non-malignant causes where 40.5% diagnosed as malignant causes. Among them tuberculosis consist of 39 (33.6%, NHL 18 (15.5%, reactive lymphadenopathy 16 (13.8%, CLL and HD 8 (6.9% each, ALL 7 (6%, SLE 5(4.3%, Kikuchi's disease 4 (3.4%, AML and RA 3 (2.6% each and castleman's disease, phenytoin lymphadenopathy, metastatic lung and breast carcinoma 1 (0.9% each. Cervical groups of lymph nodes were most commonly involved 86 patients (74.1% followed by axillary groups 73 patients (62.9%. Lymph nodes size 1.5cm were due to malignant and non-malignant granulomatous cases. FNAC give definite diagnosis 80.9% malignant cases where 76.8% in non-malignant cases. HPE shown definite diagnosis in 100% cases both malignant and non-malignant diseases. Conclusions: Tuberculosis is most common cause of generalized lymphadenopathy followed by lymphoma. And reactive lymphadenitis is also an important consideration. [Int J Res Med Sci 2016; 4(8.000: 3542-3548

  19. Cancer-related false knowledge in relatives of cancer patients and the general public.

    Science.gov (United States)

    Turhal, N S; Dane, F; Ulus, C; Sari, S; Senturk, N; Bingol, D

    2010-01-01

    Although there are many myths about cancer in Turkey, there is no study evaluating Turkish public's knowledge about cancer. The goals of our research were to: 1) measure the extent of knowledge of cancer among the Turkish public; 2) determine the differences in extent of cancer-related knowledge between participants who have relatives with cancer and those who do not; and 3) determine the sources of knowledge possessed. Data were obtained from a total of 415 participants (244 female, 171 male), all of them sitting at the Marmara University Faculty of Medicine Hospital (MUFMH) outpatient clinic waiting area for non-cancer-related reasons. Each participant completed a 3-part questionnaire. Appropriate statistical tests were used for comparison. The mean age was 41 years. Of 415 participants, 65.3% stated that they had one or more cancer patient in their immediate family; 70.1% of the participants had a high-school education or greater. The questionnaire showed that, depending on the question, anywhere from 1.7% to 88.5% of the general public possesses some false information; furthermore, the difference in accuracy between relatives of cancer patients and non-relatives was marginal. Only 3 specific questions, related to the following ideas, rendered answers that were statistically significantly different between these 2 groups: breast cancer is only seen in females (p cancer (p cancer is always very painful (p knowledge about cancer was unacceptably high in our cohort. Broader efforts should be made to inform the Turkish public about cancer.

  20. A review of governance of maternity services at South Tipperary general hospital

    LENUS (Irish Health Repository)

    Flory, David

    2015-09-01

    This review of the governance of maternity services at South Tipperary General Hospital has focussed on the systems and processes for assurance of service quality, risk management and patient safety primarily inside the hospital but also in the Hospital Group structure within which it operates. The effectiveness of the governance arrangements is largely determined by the quality of the leadership and management – both clinical and general – which designs, implements, and oversees those systems and processes and is ultimately responsible and accountable.\\r\

  1. The First Stages of Liberalization of Public Hospitals in Iran: Establishment of Autonomous Hospitals and the Barriers.

    Directory of Open Access Journals (Sweden)

    Nader Markazi-Moghaddam

    2014-12-01

    Full Text Available Liberalization and decentralization of public sector has been triggered in some developing countries and in Iran by the Ministry of Health and Medical Education (MOHME that granted autonomy to 54 public hospitals. However, establishment of such a complex organizational reform was rather unsuccessful. We aimed to explore the obstacles and barriers caused such a failure and their mechanisms.Using a qualitative approach in 2013, we consulted key informants at the autonomous hospitals and their affiliating universities. Data collection was done within two phases: (i 276 unstructured questionnaires asking respondents of barriers, and (ii 23 semi-structured interviews from the first phase's key respondents. The first phase data were analyzed using thematic analysis and the second's by framework approach based on the frame shaped at the first phase.Nine obstacles were recognized including "autonomous hospitals' board composition", "delay in announcing autonomous hospitals' charges by the MOHME", "lack of financing by the committed organizations", "poor follow up for implementation of the reform", "irregular board meetings", "lack of an external overseer", "shortage of full-time physicians", "lack of management stability", and "health insurance organizations' delayed payments".The MOHME and insurance organizations did not pay the reform expenses. There were some competing motives as well to slow the reform or to shut it down. The stages of policy formulation and implementation were done separately in Iran, so this big organizational reform encountered serious obstacles.

  2. 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.

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

    Science.gov (United States)

    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.

  4. Obstetric near miss and deaths in public and private hospitals in Indonesia

    Directory of Open Access Journals (Sweden)

    Stanton Cynthia

    2008-03-01

    Full Text Available Abstract Background Falling numbers of maternal deaths have stimulated an interest in investigating cases of life threatening obstetric morbidity or near miss. The purpose of this study was to document the frequency and causes of near miss and maternal deaths in four hospitals in West Java, Indonesia. Methods Cross sectional study in four hospitals in two districts in Banten province, Indonesia. We reviewed registers and case notes to identify the numbers and causes of near miss and death between November 2003 and October 2004. Near miss cases were defined based on organ dysfunction, clinical and management criteria. Near miss were categorized by whether or not the woman was at a critical state at admission by reviewing the final signs at admission. Results The prevalence of near miss was much greater in public than in private hospitals (17.3% versus 4.2%, p = 0.000. Hemorrhage and hypertensive diseases were the most common diagnoses associated with near miss, and vascular dysfunction was the most common criterion of organ dysfunction. The occurrence of maternal deaths was 1.6%, with non-obstetric complications as the leading cause. The majority (70.7% of near miss in public hospitals were in a critical state at admission but this proportion was much lower in private hospitals (31.9%. Conclusion This is the first study to document near miss in public and private hospitals in Indonesia. Close to a fifth of admissions in public hospitals were associated with near miss; and the critical state in which the women arrived suggest important delays in reaching the hospitals. Even though the private sector takes an increasingly larger share of facility-based births in Indonesia, managing obstetric emergencies remains the domain of the public sector.

  5. Assessment of postgraduate educational environment in public and private hospitals of Karachi.

    Science.gov (United States)

    Sheikh, Shiraz; Kumari, Bhavita; Obaid, Munazza; Khalid, Noman

    2017-02-01

    To assess the environment of postgraduate fellowship training in teaching hospitals of an urban centre. The cross-sectional study was conducted at one public-sector and two private-sector teaching hospitals in Karachi from December 2014 to June 2015. Data was collected by using a modified version of Postgraduate Hospital Educational Environment Measure, a validated questionnaire, for which clinical residents were selected through convenience sampling. Data was analyzed using SPSS 16. Of the 302 participants, 168(55.6%) were males and 134(44.4%) were females. The overall mean age of the respondents was 28.46±3.03 years. The internal reliability of the questionnaire was good with a Cronbach's alpha of 0.92. The overall mean score of 93.96±20.79suggested more positive than negative perception with room for improvement. After adjusting for all important socio-demographic and residency co-variates, residency in a private hospital was positively associated with Postgraduate Hospital Educational Environment Measure score (p<0.01) compared to residency in public hospitals. There is an urging need to standardise postgraduate training in terms of teaching, autonomy and social support in public and private hospitals of Karachi.

  6. Comparative heart failure profile over a 3-year period in a Romanian general hospital

    Directory of Open Access Journals (Sweden)

    Pop D

    2013-07-01

    Full Text Available Dana Pop,1 Oana Maria Penciu,1 Adela Viviana Sitar-Taut,2 Dumitru Tudor Zdrenghea11Department of Cardiology, Clinical Rehabilitation Hospital, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania; 2"Babes-Bolyai" University, Cluj-Napoca, RomaniaBackground: Heart failure (HF has become an increasingly significant public health problem, associated with repeated hospitalizations, high costs, low quality of life, and decreased survival rate. The progress of the disease may be slowed if treatment is administered in accordance with current guidelines.Objectives: To compare the clinical profile of HF patients in a Romanian general hospital over a 3-year period.Methods and results: We studied two cohorts of patients admitted in the cardiology department of a rehabilitation hospital with a diagnosis of chronic HF New York Heart Association class II–IV. The first, in 2006, included 415 patients, 67.08 ± 10.59 years; the second, in 2009, included 500 patients, 67.31 ± 11.27 years. Considering all patients, the left ventricle ejection fraction (LVEF was not statistically different in the two cohorts. Compared to the 2006 cohort, the 2009 female cohort had higher LVEF (60.49% ± 13.41% vs 64.42% ± 13.79%, P < 0.05, while males over 65 years of age had lower LVEF (52.75% ± 15.02% vs 54.37% ± 15.23%, P = NS. For females, the probability of having LVEF ,45% was higher in 2006 (odds ratio = 1.573. HF with preserved LVEF was more common in females, both in 2006 (78.2% vs 54.2% and 2009 (87.2% vs 57.3%. In the 2009 cohort, LVEF was higher both in young patients (59.08% ± 14.22% vs 55.35% ± 14.92% and patients ≥ than 75 years of age (62.28% ± 13.81% vs 56.79% ± 14.81% compared to the 2006 cohort. Ischemic heart disease was the main underlying cause for HF in both cohorts.Conclusion: HF appeared to have the same clinical profile over a 3-year period. Females diagnosed with HF showed higher rates of preserved LVEF.Keywords: heart

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

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    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.

  8. To what extent does employer-paid health insurance reduce the use of public hospitals?

    Science.gov (United States)

    Søgaard, Rikke; Pedersen, Morten Saaby; Bech, Mickael

    2013-11-01

    This study examines the extent to which employer-paid health insurance has led to substitution of public with private hospital use in Denmark. Individual-person-level data for the entire Danish privately employed, full-time working population is used in an observational design. The effect of having employer-paid health insurance on the utilisation of public hospitals is estimated using propensity score matching in order to control for risk selection, based on a number of individual- and company-level characteristics. The outcome is defined as the total consumption of health care services provided by public hospitals. The effect of employer-paid health insurance is estimated to correspond to a significant 10% reduction in the total use of public hospitals. The effect appears to be robust to alternative methodological specifications and is supported from the analysis of alternative outcome measures. The rise in the number of individuals with employer-paid health insurance seems to have alleviated the pressure on public hospitals in Denmark. Future studies should confirm the magnitude of this effect, preferably based on empirical data with repeated measurements of insurance status. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Who's that sleeping in my bed? Potential and actual utilization of public and private in-patient beds in Irish acute public hospitals.

    Science.gov (United States)

    O'Reilly, Jacqueline; Wiley, Miriam

    2010-10-01

    To examine the impact of the unusual public/private mix on public and private in-patient bed utilization within Irish acute public hospitals. Data from the Department of Health and Children and the Hospital In-Patient Enquiry were used to estimate and compare potential and actual utilization of public and private designated in-patient beds in 54 acute public hospitals from 2000 to 2004. Private in-patients used more bed days than were potentially available to them in 14.1% of hospital-year observations. The equivalent figure for public in-patients was 12.6%. Although the prevalence of excess utilization of private beds was relatively small, it did increase over the study period. Hospitals with excess private utilization were characterized by a relatively low proportion of private- or non-designated beds despite their patient profile being broadly similar to that of hospitals where there was no excess private utilization. Despite policies designed to limit private practice in Irish acute public hospitals, some hospitals have apparently been able to overcome these restrictions. In a system where financial incentives to treat private patients exist both for consultants and hospitals, it is not clear whether this excess private practice in public hospitals reflects a more efficient utilization of resources (when demand from public patients is low) or the displacement of public patients in favour of private patients. However, that a smaller number on hospital waiting lists possess private health insurance provides some support for the displacement hypothesis. Thus, it appears that policy-makers may need to reconsider attempts to ensure an appropriate division of acute public hospital resources between public and private patients.

  10. Utilisation of community pharmacists by the general public in Malaysia.

    Science.gov (United States)

    Chua, Siew Siang; Lim, Kien Ping; Lee, Hong Gee

    2013-02-01

    The study was conducted to assess how the general public in the Klang Valley, Malaysia, utilised community pharmacists. This was a prospective observational study which documented interactions between community pharmacists and their customers. A researcher was stationed in 10 participating community pharmacies around the Klang Valley to observe and record all the interactions, using a structured data-collection form. KEYS FINDINGS: Interactions between 1914 customers and the pharmacists of the 10 community pharmacies were recorded. A total of 2199 requests were made by these customers. The main types of request were for medications by brand name (32.2%), advice on minor health problems (25.9%) and for health supplements (11.7%). Only 65 prescriptions were received by the community pharmacies; that is, fewer than two prescriptions per pharmacy per day. The pharmacists provided counselling for only 54.4% of the requests where a medication or health supplement was dispensed. Counselling by pharmacist was significantly associated with the type of request (P Malaysia was to purchase a particular medication. Few prescriptions were filled at community pharmacies in Malaysia, indicating the under-utilisation of community pharmacists as a safety net for prescribed medications in primary care. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

  11. 38 CFR 17.50 - Use of Department of Defense, Public Health Service or other Federal hospitals with beds...

    Science.gov (United States)

    2010-07-01

    ... Defense, Public Health Service or other Federal hospitals with beds allocated to the Department of... of Department of Defense, Public Health Service or other Federal hospitals with beds allocated to the... hospital covered by the agreement, care may be authorized within the bed allocation for any veteran...

  12. HOSPITAL PATIENT DATABASE MANAGEMENT SYSTEM ‘A Case Study of General Hospital NORTH-BANK Makurdi- Nigeria’

    Directory of Open Access Journals (Sweden)

    Oye Nathaniel David

    2014-03-01

    Full Text Available Health care in Nigeria as in many other countries is confronted with growing demand for medical treatment and services. The medical records must appropriately have all of the patients’ medical history. Physicians must maintain flawless records, because this document serves a number of purposes. This study on hospital patient datable management system was design to transform the manual way of searching, sorting, keeping and accessing patient medical information (files into electronic medical record (EMR in order to solve the problem associate with manual method. The existing system (manual has been studied and hence a computer based application was provided to replace this manual method. These computer based systems generate the patient report as the patient register in and out of the hospital. This paper generally looks for a more accurate, reliable and efficient method of computer to facilitate patient record’s keeping in General Hospitals to ensure efficient outcome that will lessen time consuming. The study proposed that the design of hospital patient database record will be a solution to the problem being experienced by the current manual method of keeping patient medical record.

  13. General Issues Concerning Needs Analysis in Local Public Institutions

    Directory of Open Access Journals (Sweden)

    Veronica JUNJAN

    2005-10-01

    Full Text Available Needs assessment in local public institutions was not very present so far in a systematic manner in Romanian specialized literature on administrative reform. Current study uses interviews with candidates for a public administration master program to investigate civil servants motivation of pursuing graduatelevel studies and their perception on current needs of the work in local public institutions. Motivation for pursuing graduate studies is located mainly on the need to update and diversify their professional knowledge, and not as much on promotion-related reasons. The perceived needs are related to management of public institutions, structure of information system, legislation and European integration, human resource management and public relations.

  14. Crisis & commitment: 150 years of service by Los Angeles county public hospitals.

    Science.gov (United States)

    Cousineau, Michael R; Tranquada, Robert E

    2007-04-01

    The Los Angeles County University of Southern California Medical Center will open soon, replacing the county's current 74-year-old facility with a modern, although smaller, facility. Los Angeles County has provided hospital care to the indigent since 1858, during which time, the operation of public hospitals has shifted from a state-mandated welfare responsibility to a preeminent part of the county's public health mission. As this shift occurred, the financing of Los Angeles County hospitals changed from primarily county support to state and federal government sources, particularly Medicaid. The success of the new hospital will depend on whether government leaders at all levels provide the reforms needed to help the county and its partners stabilize its funding base.

  15. 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.

  16. Microbial contamination of nonsterile pharmaceuticals in public hospital settings

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    Veronica Mugoyela

    2010-09-01

    Full Text Available Veronica Mugoyela1, Kennedy D Mwambete21Department of Medicinal Chemistry, 2Department of Pharmaceutical Microbiology, University of Health and Allied Sciences, Dar es Salaam, TanzaniaPurpose: Contamination of pharmaceuticals with microorganisms irrespective whether they are harmful or nonpathogenic can bring about changes in physicochemical characteristics of the medicines. Although sterility is not a requirement in official compendia for nonsterile pharmaceuticals, bioburdens need to be within acceptable limits. Therefore, this study investigated microbial contamination of 10 nonsterile pharmaceuticals frequently delivered to outpatients by identifying and quantifying microbial contaminants and susceptibility pattern testing on the microbes isolated.Methods: The study was carried out at Amana Municipal Hospital in Dar es Salaam, Tanzania. The protocol for the study involved structured selection of representative tablets, syrups, and capsules from the hospital’s outpatient pharmacy. Constitutive microorganisms were elaborated and enumerated using standard microbiologic procedures.Results: Results showed that 50% of all tested products were heavily contaminated, and the predominant contaminants comprised Klebsiella, Bacillus, and Candida species. Furthermore, the results showed that the isolated Bacillus and Klebsiella species were resistant to Augmentin® and cloxacillin. The differences in means for cfu/mL and zones of inhibition among the microorganisms isolated were considered significant at P < 0.05.Conclusion: The nonsterile pharmaceuticals were presumably microbiologically contaminated due to poor handling during dispensing, repackaging, and/or nonadherence to good manufacturing practice. Therefore, training and educating the dispensers, as well as patients, on the proper handling and use of medicines cannot be overemphasized, because these are key aspects in controlling cross-contamination of medicines.Keywords: microorganisms

  17. Interactions Between Alternative Therapies and Mental Health Services in Public Hospitals of Argentina

    Directory of Open Access Journals (Sweden)

    Mercedes Saizar

    2012-07-01

    Full Text Available In this article, the authors describe the phenomenon of therapeutic complementarity between alternatives therapies and biomedicine in public hospitals of Buenos Aires (Argentina. They contextualize the phenomenon in a global and local field. Features specific to Argentina make this phenomenon interesting. The first of these is that biomedicine is the only type of medicine that is legally authorized to act on the body; nevertheless, alternative practices have flourished not only in the private health sector but also in the public hospitals run by the state. A second feature refers to the alternative practices in the Mental Health Area that bring about a singular interaction between two different therapeutic models. Based on a qualitative study in public hospitals, the authors look into the reasons that generate the phenomenon, underlining the forms in which it expresses itself and the complexity of a field under construction that implies the resignification of the concepts related to health and disease.

  18. Comparison of thromboprophylaxis patterns in arthroplasty in public and private hospitals

    Science.gov (United States)

    Cortada, Aline Pinheiro dos Santos; da Silva, Telma Gomes; da Silva, André Campos; Golmia, Ricardo Prado; Guerra, Renata Leborato; Takemoto, Maíra Libertad Soligo; Monteiro, Roberta Dyonisio Canaveira; Scheinberg, Morton Aaron

    2015-01-01

    Objective To compare therapy for prophylaxis of venous thromboembolism and costs related to hospitalization of patients undergoing total knee and hip replacement within the context of the Brazilian health system. Methods A retrospective study of patients undergoing arthroplasty in 2010 in a public hospital and two private hospitals in the state of São Paulo, conducted by means of medical record review. Costs were estimated based on the use of health care resources during hospitalization. A descriptive analysis was performed using frequency and mean (standard deviation) according to the type of care delivered (by public or private organization). Results A total of 215 patients were evaluated, and 56.3% were submitted to knee surgery and 43.7%, to hip replacement. Approximately 88% and 98% of patients from public and private health services, respectively, received some form of venous thromboembolism prophylaxis, and enoxaparin was the drug most widely used in both systems. The total cost of prophylaxis was R$ 1,873.01 (R$ 26.38 per patient) in the public service and R$ 21,559.73 (R$ 163.33 per patient) in the private service. For the individuals who presented with thromboembolism, the average cost of hospitalization was R$ 6,210.80 and R$ 43,792.59 per patient in public and private health services, respectively. Conclusion Thromboembolism prophylaxis in patients undergoing arthroplasty is most commonly used in the private health services than public organizations, despite its high costs in both services. The cost per patient with thrombosis during hospitalization was higher than the total cost of prophylaxis, suggesting that prevention is associated to better cost-benefit ratio. PMID:26313439

  19. Compensation of home health, public health, and hospital nurses. Extrinsic and intrinsic rewards.

    Science.gov (United States)

    Hughes, K K; Marcantonio, R J

    1991-11-01

    Despite the proliferation of home health agencies and increased numbers of nurses working in these settings, little is known about home health nurses or how they might differ from their public health and hospital counterparts. The authors discuss differences in monetary compensation and skill usage, as well as the relationship between compensation and retention, among hospital, home health, and public health staff nurses. The results show that these nurses receive different intrinsic and extrinsic rewards and that their reasons for remaining with their employers are similar, yet unique. Implications for nurse administrators and educators are discussed, along with recommendations for further research.

  20. Public Governance Principles in General Education School Management of Latvia

    OpenAIRE

    Rečs, Normunds

    2015-01-01

    In contemporary world the effect of globalisation and information technologies cause transformational processes of states` public management that promote the application of new managament approaches and principles in public institution management.The changes in the public managament have effected and still effects processes of management also in education. The increase of school autonomy, a stronger focus on the process of education and its results created the need to expand the application o...

  1. Incidence rates of in-hospital carpal tunnel syndrome in the general population and possible associations with marital status

    Directory of Open Access Journals (Sweden)

    Melani Carla

    2008-10-01

    Full Text Available Abstract Background Carpal tunnel syndrome (CTS is a socially relevant condition associated with biomechanical risk factors. We evaluated age-sex-specific incidence rates of in-hospital cases of CTS in central/northern Italy and explored relations with marital status. Methods Seven regions were considered (overall population, 14.9 million over 3–6-year periods between 1997 and 2002 (when out-of-hospital CTS surgery was extremely rare. Incidence rates of in-hospital cases of CTS were estimated based on 1 codified demographic, diagnostic and intervention data in obligatory discharge records from all Italian public/private hospitals, archived (according to residence on regional databases; 2 demographic general population data for each region. We compared (using the χscore test age-sex-specific rates between married, unmarried, divorced and widowed subsets of the general population. We calculated standardized incidence ratios (SIRs for married/unmarried men and women. Results Age-standardized incidence rates (per 100,000 person-years of in-hospital cases of CTS were 166 in women and 44 in men (106 overall. Married subjects of both sexes showed higher age-specific rates with respect to unmarried men/women. SIRs were calculated comparing married vs unmarried rates of both sexes: 1.59 (95% confidence interval [95% CI], 1.57–1.60 in women, and 1.42 (95% CI, 1.40–1.45 in men. As compared with married women/men, widows/widowers both showed 2–3-fold higher incidence peaks during the fourth decade of life (beyond 50 years of age, widowed subjects showed similar trends to unmarried counterparts. Conclusion This large population-based study illustrates distinct age-related trends in men and women, and also raises the question whether marital status could be associated with CTS in the general population.

  2. Waste management in three public hospitals of Mato Grosso do Sul, Brazil

    Directory of Open Access Journals (Sweden)

    Keila Tivirolli

    2010-09-01

    Full Text Available Objectives: To assess the management of health service waste generated in three public hospitals of Mato Grosso do Sul (Brazil, including qualitative and quantitative parameters. Methods: This was an observational and descriptive study. We assessed the waste management in two large public hospitals (HG1, 240 hospital beds and HG2, 343 beds and in a small sized one (HP, 35 hospital beds. The data were collected in situ, by direct observation of the procedures for waste management and by quantifying the mass of waste generated by working sector in the three hospitals. Results: The study revealed that the internal management of waste generated in the three health care unities was not adequate, and that their workers were not trained on the proper management of waste and the use of personal protective equipment. The average rates of waste generation determined in HG1, HG2 and HP were, respectively, 4.7, 4.8 and 2.4 Kg.hospital bed-1.day-1, that fit the range of values reported in the literature. Conclusion: The detected inadequacies directly put at risk the health of workers and others who attend the three assessed hospitals and the outside comunity, which may be exposed to pathogens or toxic agents present in such waste

  3. An Assessment of the State of Maintenance of Public Hospital Buildings in Southwest Nigeria

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    Olumide Adenuga

    2012-11-01

    Full Text Available This study examines the state of maintenance of public hospitalbuildings in Southwest Nigeria, and in the process identifi es thesignifi cant difference(s in the operational state of Federal andState-owned public hospitals within the study area. In achievingthe aim, the study adopts a survey technique with a total of552 questionnaires, comprising 206 sampled maintenancestaff and 346 users of public hospitals. The survey covers 46public hospitals representing 40% of the total number of publichospitals existing in Southwest Nigeria. The 46 public hospitalsconsist of all the 11 Federal-owned hospitals and 35 randomlyselected State-owned. Data collected are analysed using theKendall Coeffi cient of Concordance and Pearson Chisquare. Thefi ndings of the study reveal that the state of maintenance of publichospital buildings is good. While the structure/fabric and physicalconditions are rated highly, the services are poorly rated. Thisstudy, which hypothesises that there is no difference in the stateof maintenance, fi nds statistical difference in the performance ofthe services. It recommends that Federal and State governmentsaddress neglect in the services sector and plan their maintenanceprogrammes more effectively.

  4. [Chronic Chagasic Cardiomyopathy at the Hospital General de Zona no. 24 IMSS. Poza Rica, Veracruz].

    Science.gov (United States)

    Olivera-Mar, Amonario; Hernández-Vicencio, Catalina; Camacho-Marie, Margarita; Hernández-Becerril, Nidia; Monteón-Padilla, Víctor M; Vallejo, Maite; Reyes, Pedro A

    2006-01-01

    Northern Veracruz has conditions, biotic and abiotic, to support Triatomine bugs and vectorial transmission of Trypanosoma cruzi to human beings. Therefore we explore seroprevalence of antibodies to this parasite and the presence of Chronic Chagasic Cardiopathy (CCC) at Cardiology ward in a General Hospital serving North of Veracruz State, and neighbord states Hidalgo, Puebla San Luis Potosi and Tamaulipas. We search for consecutive adult patients attending outpatient and beds assigned to Cardiology between March through September, 2003. An epidemiology questionnaire, clinical work up, chest roentgenogram, 12 lead peripheral EKG and transthoracic echocardiogram were performed in 240 female/males patients. All of them were bled to blindly search for T. cruzi antibodies. Seroprevalence was 8%, 49 cases of dilated cardiomyopathy were diagnosed 23 attributed to chronic diseases such as systemic hypertension diabetes mellitus or ischemic heart disease 12 with idiopathic disease and 14 (29%) had CCC. The latter accumulated epidemiologic features suggestive of vectorial infection. Four additional individuals without CCC but having specific antibodies were considered indeterminate Chagasic cases. This case series identify American Trypanosomiasis among 19 people attending a Cardiology Service, and 14 of them had a severe heart disease linked to progressive and fatal course. This observation points out that Chagas disease could be a regional public health problem in Northern Veracruz.

  5. Pattern of gastrointestinal diseases in adult patients admitted to Samtah General Hospital, Gizan region, Saudi Arabia

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    Aderoju Emmanuel

    1999-01-01

    Full Text Available To determine the relative frequencies of gastrointestinal diseases (GI in patients admitted to Samtah General Hospital, Gizan, the records of 2,442 adults admitted to the medical and surgical services for gastrointestinal diseases during the period 1413 to 1416 were analyzed retrospectively. 1,028 patients had acute appendicitis. The remaining 1,414 patients were admitted for various other GI diseases. In these 1,414 patients the commonest diseases were gastrointestinal infections (36.4%, peptic ulcer disease (19%, gall bladder disease (18.5%, viral hepatitis and its sequelae (20.7%. Despite the high prevalence of cholelithiasis, acute pancreatitis was uncommon (0.1 %. Inflammatory bowel disease was rare. There was no gender - related difference in the prevalence of gastrointestinal infections, peptic ulcer disease and carcinoma of the stomach. Males were significantly more afflicted than females with viral hepatitis (p< 0.0001, cirrhosis of the liver (p< 0.0001, hepatocellular carcinoma (p< 0.0005, variceal bleeding (p< 0.0005, and peptic ulcer bleeding (p< 0.005. As a large proportion of our patients had preventable diseases, it is expected that immunization and other public health measures will reduce the frequency of these diseases in the future.

  6. [Pharmaceutical Service after the Fukushima Disaster: A Case Report of Soma General Hospital].

    Science.gov (United States)

    Fukunaga, Hisanori; Momonoi, Toshiyuki; Kumakawa, Hiromi

    2016-01-01

      Despite being damaged by the 2011 Tohoku earthquake, tsunami, and nuclear disaster, Soma General Hospital, located approximately 40 km north of Fukushima Daiichi nuclear power plant, was able to fulfill its role as a key regional hospital in northeast Fukushima. To elucidate the pharmaceutical service in response to the disaster, we investigated the hospital's operations in 2011 according to the medical records and prescriptions. One of the difficulties that the department of pharmaceutical service faced at that time was the increase in emergency healthcare requests by evacuated patients from other hospitals and clinics. Herein, we propose the following countermeasures to be considered in future disaster preparations: (1) establishing a medical and pharmaceutical service coordinator for disaster relief; (2) sharing all local patients' medical information in emergencies (at least contraindicated drugs or allergy history); and (3) reviewing disaster stockpiles, especially pharmaceuticals (both at the hospital and in nearby locations).

  7. Validity and reliability of Turkish version of "Hospital Survey on Patient Safety Culture" and perception of patient safety in public hospitals in Turkey

    OpenAIRE

    Filiz Emel; Bodur Said

    2010-01-01

    Abstract Background The Hospital Survey on Patient Safety Culture (HSOPS) is used to assess safety culture in many countries. Accordingly, the questionnaire has been translated into Turkish for the study of patient safety culture in Turkish hospitals. The aim of this study is threefold: to determine the validity and reliability of the translated form of HSOPS, to evaluate physicians' and nurses' perceptions of patient safety in Turkish public hospitals, and to compare finding with U.S. hospit...

  8. MANAGEMENT OF DIABETES IN ACUTE MYOCARDIAL INFARCTION IN CELJE GENERAL HOSPITAL IN 1999

    Directory of Open Access Journals (Sweden)

    Gregor Veninšek

    2001-12-01

    Full Text Available Background. DIGAMI study showed that intrahospital mortality and mortality at one year after myocardial infarction can be significantly reduced in diabetics treated in acute phase of myocardial infarction by GI infusion and afterwards for at least three months with intensive insulin treatment. Mortality can be reduced for more than 50% in a subgroup of patients younger than 70 years, without congestive heart failure, with first myocardial infarction, not treated with insulin or digitalis. In this perspective we reviewed treatment of diabetics with acute myocardial infarction in 1999 in Celje General Hospital.Methods. We reviewed documentation of treatment of all diabetics with acute myocardial infarction treated in Celje General Hospital in 1999. We collected data on number of newly discovered diabetes, on previous treatment of diabetes, on treatment of diabetes during hospitalization and at discharge, on drugs used for treatment of diabetes and on mortality during hospitalization.Results. Diabetics presented 20% of all patients with acute myocardial infarction treated in Celje General Hospital in 1999. None of patients received GI infusion, none had intensively managed blood sugar. 24% of patients were treated with sulfonylureas in acute phase of myocardial infarction. 33% of patients were discharged from hospital with insulin therapy. Intrahospital mortality was 9%, comparable with patients without diabetes.Conclusions. In 1999 was intrahospital treatment of diabetics with acute myocardial infarction in Celje General Hospital successful as their intrahospital mortality equaled non-diabetics. Treatment of diabetes itself, during hospitalization and after discharge, on the other hand, in 1999 had not been up to date according to results of recent studies. In our opinion, it is mandatory for diabetologist to make part of the team that treats diabetic with acute myocardial infarction

  9. Recreational activities performed with neoplasia carrier Inpatients in a general hospital

    OpenAIRE

    2012-01-01

    This study aims at apprehending the contribution of recreational activities in the treatment of hospitalized cancer patients and identifying the most stimulating resources for them. This is a qualitative research of phenomenological nature, it was approved by the Ethics in Research Committee, Protocol 139/2010. It was conducted with patients with cancer in a general hospital, located in Alfenas, in March and April, 2011.The research began from these guiding questions: What are your thoughts o...

  10. 78 FR 73863 - Public Availability of General Services Administration FY 2013 Federal Activities Inventory...

    Science.gov (United States)

    2013-12-09

    ... ADMINISTRATION Public Availability of General Services Administration FY 2013 Federal Activities Inventory Reform (FAIR) Act Inventory AGENCY: General Services Administration (GSA). ACTION: Notice of public... the Federal Activities Inventory Reform (FAIR) Act of 1998, Public Law 105-270, and Office...

  11. 77 FR 54917 - Public Availability of General Services Administration FY 2012 Federal Activities Inventory...

    Science.gov (United States)

    2012-09-06

    ... ADMINISTRATION Public Availability of General Services Administration FY 2012 Federal Activities Inventory Reform (FAIR) Act Inventory AGENCY: General Services Administration (GSA). ACTION: Notice of Public... accordance with the FAIR Act of 1998, Public Law 105-270, and Office of Management and Budget (OMB)...

  12. Outsourcing and benchmarking in a rural public hospital: does economic theory provide the complete answer?

    Science.gov (United States)

    Young, S H

    2003-01-01

    The ideology and pronouncements of the Australian Government in introducing 'competitive neutrality' to the public sector has improved efficiency and resource usage. In the health sector, the Human Services Department directed that non-clinical and clinical areas be market tested through benchmarking services against the private sector, with the possibility of outsourcing. These services included car parking, computing, laundry, engineering, cleaning, catering, medical imaging (radiology), pathology, pharmacy, allied health and general practice. Managers, when they choose between outsourcing, and internal servicing and production, would thus ideally base their decision on economic principles. Williamson's transaction cost theory studies the governance mechanisms that can be used to achieve economic efficiency and proposes that the optimal organisation structure is that which minimises transaction costs or the costs of exchange. Williamson proposes that four variables will affect such costs, namely: (i) frequency of exchange; (ii) asset specificity; (iii) environmental uncertainty; and (iv) threat of opportunism. This paper provides evidence from a rural public hospital and examines whether Williamson's transaction cost theory is applicable. Case study research operates within the interpretivism paradigm and is used in this research to uncover why the outsourcing decision was made. Such research aims to study real-life experiences by examining the way people think and act and, in contrast to positivism, allows the interviewer to participate to better understand the details and features of the experiences. In the present research, individual interviews were conducted with managers of the hospital and owners and staff of the vendor organisations using semi- and unstructured questions to ascertain the extent of, and processes used in, outsourcing specific functional areas, and areas that were not outsourced. Pathology, radiology, dental technician services and lawn

  13. Undergraduate radiology education in private and public teaching hospitals in Karachi, Pakistan: teaching duties, methodologies, and rewards

    Directory of Open Access Journals (Sweden)

    Nadeem N

    2013-03-01

    Full Text Available Naila Nadeem,1,* Ranish Deedar Ali Khawaja,2,3,* Madiha Beg,1 Muhammad Naeem,4 Zain Majid41Department of Radiology, 2Aga Khan University Hospital, Karachi, Pakistan; 3Massachusetts General Hospital, Harvard Medical School, Boston, USA; 4Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan*These authors contributed equally to this workBackground: In an integrated method of education, medical students are introduced to radiology in their preclinical years. However, no study has been conducted in Pakistan to demonstrate an academic framework of medical radiology education at an undergraduate level. Therefore, we aimed to document and compare the current level of teaching duties, teaching methodologies, and teaching rewards among radiologists and residents in private and public teaching hospitals in Karachi, Pakistan.Methods: A survey was conducted among 121 radiologists and residents in two private and two public teaching hospitals in Karachi, Pakistan. Radiologists who were nationally registered with the Pakistan Medical and Dental Council either part-time or full-time were included. Radiology residents and fellows who were nationally registered with the Pakistan Medical and Dental Council were also included. Self-administered questionnaires addressing teaching duties, methods, and rewards were collected from 95 participants.Results: The overall response rate was 78.51% (95/121. All of the radiologists were involved in teaching residents and medical students, but only 36% reported formal training in teaching skills. Although most of the respondents (76% agreed that medical students appeared enthusiastic about learning radiology, the time spent on teaching medical students was less than five hours per week annually (82%. Only 37% of the respondents preferred dedicated clerkships over distributed clerkships (41%. The most common preferred teaching methodology overall was one-on-one interaction. Tutorials, teaching rounds, and

  14. General Public Space Travel and Tourism. Volume 1; Executive Summary

    Science.gov (United States)

    ONeil, Daniel (Compiler); Bekey, Ivan; Mankins, John; Rogers, Thomas F.; Stallmer, Eric W.

    1998-01-01

    Travel and tourism is one of the world's largest businesses. Its gross revenues exceed $400 billion per year in the U.S. alone, and it is our second largest employer. U.S. private sector business revenues in the space information area now approximate $10 billion per year, and are increasing rapidly. Not so in the human spaceflight area. After spending $100s of billions (1998 dollars) in public funds thereon, and continuing to spend over $5 billion per year, the government is still the only customer for human spaceflight goods and services. Serious and detailed consideration was first given to the possibility of space being opened up to trips by the general public three decades ago, and some initial attempts to do so were made a dozen years ago. But the difficulties were great and the Challenger disaster put an end to them. In recent years professional space tourism studies have been conducted in the United Kingdom, Germany and, especially, Japan. In the U.S., technological progress has been pronounced; we have had nearly a decade's experience in seeing our astronauts travel to-from low Earth orbit (LEO) safely, and we expect to commence assembly of a LEO space station housing a half-dozen people this year. Too, NASA and our space industry now have new and promising space transportation development programs underway, especially the X-33 and X-34 programs, and some related, further generation, basic technology development programs. And five private companies are also working on the design of new surface - LEO vehicles. The first professional space tourism market studies have been conducted in several countries in the past few years, especially in Japan and here. The U.S. study makes it clear that, conceptually, tens of millions of us would like to take a trip to space if we could do so with reasonable safety, comfort and reliability, and at an acceptable price. Initial businesses will address the desires of those willing to pay a greater price and accept a greater

  15. A 5-year audit of outcome of apicectomies carried out in a district general hospital.

    Science.gov (United States)

    Lyons, A. J.; Hughes, C. E.; Dixon, E. J.

    1995-01-01

    Success rates of up to 90% have been claimed for apicectomy. However, the conditions that this procedure is carried out under at district general hospitals may be at variance with such studies. A 5-year audit of outcome was therefore carried out within a district general hospital. It was found that 89% of apicected teeth still remained at 5 years. Outcome was not influenced by any of the factors examined, and could not be predicted radiographically. Most failures occurred after the average postoperative review period of 10.5 months. Patient satisfaction with the procedure was high at over 90%. Based on these results it was concluded that apicectomy was an effective procedure when carried out by staff of all grades within the district general hospital, and that repeated follow-up appointments with radiographs over the first postoperative year were not useful. PMID:7574319

  16. Hospital innovativeness and organizational performance: evidence from English public acute care.

    Science.gov (United States)

    Salge, Torsten Oliver; Vera, Antonio

    2009-01-01

    Hospitals around the world dedicate increasing attention and resources to innovation. However, surprisingly little is known about the nature of hospital innovativeness and its relationship with organizational performance. Given both the specific characteristics of the hospital sector and the rather mixed evidence from other industries, a positive innovation-performance link should not be taken for granted but requires empirical examination. The purposes of this study were to introduce a perspective of hospitals as vital generators of innovation, to unpack the concept of innovativeness, to propose a measurement model for hospital innovativeness, and to empirically investigate the innovativeness-performance relationship. We conducted a large-scale empirical study among the entire population of public hospital organizations that are part of the English National Health Service (n = 173) and analyzed the data using exploratory factor and regression analyses. Our analyses suggest a significant positive relationship between science- and practice-based innovativeness and clinical performance but provide less unambiguous support for the existence of such a relationship between innovativeness and administrative performance. In particular, we find that higher levels of innovativeness are rather associated with superior quality of care than with measurable bottom-line financial benefits. Hospitals investing in innovation-generating activities might find their efforts well rewarded in terms of tangible clinical performance improvements. However, to achieve measurable financial benefits, numerous hospitals have yet to discover and capture the commercial value of some of their innovations-a challenging task that requires a holistic innovation management and an effective network of complementary partners.

  17. Attitudes of Malaysian general hospital staff towards patients with mental illness and diabetes

    Directory of Open Access Journals (Sweden)

    Midin Marhani

    2011-05-01

    Full Text Available Abstract Background The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours towards a patient with mental illness than towards a patients with a general health problem - diabetes. Methods General hospital health professionals in Malaysia were randomly allocated one of two vignettes, one describing a patient with mental illness and the other a patient with diabetes, and invited to complete a questionnaire examining attitudes and health care practices in relation to the case. The questionnaires completed by respondents included questions on demographics, training in mental health, exposure in clinical practice to people with mental illness, attitudes and expected health care behaviour towards the patient in the vignette, and a general questionnaire exploring negative attitudes towards people with mental illness. Questionnaires with complete responses were received from 654 study participants. Results Stigmatising attitudes towards persons with mental illness were common. Those responding to the mental illness vignette (N = 356 gave significantly lower ratings on care and support and higher ratings on avoidance and negative stereotype expectations compared with those responding the diabetes vignette (N = 298. Conclusions Results support the view that, in the Malaysian setting, patients with mental illness may receive differential care from general hospital staff and that general stigmatising attitudes among professionals may influence their care practices. More direct measurement of clinician behaviours than able to be implemented

  18. Assessment of general public satisfaction with public healthcare services in Kedah, Malaysia.

    Science.gov (United States)

    Hassali, Mohammed Azmi; Alrasheedy, Alian A; Ab Razak, Basyirah Afifah; Al-Tamimi, Saleh Karamah; Saleem, Fahad; Ul Haq, Noman; Aljadhey, Hisham

    2014-01-01

    Patient satisfaction is considered an essential component of healthcare services evaluation and an additional indicator of the quality of healthcare. Moreover, patient satisfaction may also predict health-related behaviours of patients such as adherence to treatment and recommendations. The study aimed to assess patients' level of satisfaction with public healthcare services and to explore the association between socio-demographic and other study variables and patient satisfaction level. A cross-sectional study was conducted using selfadministered questionnaires distributed to a convenience sample of the general public in Kedah, Malaysia. A total of 435 out of 500 people invited to participate in the study agreed to take part, giving a response rate of 87 per cent. In this study, only approximately half of the participants (n=198, 45.5 per cent) were fully satisfied with the current healthcare services. The majority of the participants agreed that doctors had given enough information about their state of health (n=222, 51 per cent) and were competent and sympathetic (n=231, 53.1 per cent). Almost half of the participants (n=215, 49.5 per cent) agreed that the doctors took their problems seriously. Only 174 (40 per cent) participants agreed that doctors had spent enough time on their consultation session. Some respondents (n=266, 61.2 per cent) agreed that healthcare professionals in the public health sector were highly skilled. The majority of the respondents described amenities, accessibility and facilities available in the public healthcare sector as good or better. In this study, waiting time was significantly associated with patient satisfaction as the results showed that those who waited longer than two hours were less satisfied with the services than those who waited under two hours. The study findings showed that approximately half of the respondents were fully satisfied with current healthcare services. In this study, waiting time was the main factor that

  19. 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 cataract surgery decreased statistically significantly during the study...

  20. Public Knowledge and Behaviours Regarding Antibiotics Use: A Survey among the General Public

    Directory of Open Access Journals (Sweden)

    Khalil Y Abujheisha

    2017-06-01

    Full Text Available Background: Antimicrobial resistance is associated with increased number of illness, mortality, and health care costs. The incorrect use, excessive prescription and prolonged administration of antibiotics are some factors which allow the growth of resistant bacteria leading to the emergence and spread of bacterial resistance to antibiotics. Several studies about antibiotic use have shown that behaviour towards antibiotics differs among countries, depending on culture, habits, education, and health care organization. The aim of this pilot study was to inspect the attitudes and knowledge regarding antibiotics among the public in Saudi Arabia. Methods: A cross-sectional survey using a validated questionnaire was carried out from January to February 2017 within the public, including hospital attendees and patients come for a consultation at the Prince Sattam university hospital. A total of 670 participants were included in this study. They have been chosen using a suitable sampling method. Persons incorporated in this survey who were above 18 years old and familiar with the term “antibiotics”. Results: The majority of respondents get informed about the use of antibiotics from Pharmacists (79.94%, and Physicians (76.14% and 50.3% (n=331 of the respondents reported using antibiotics six months before the survey. Regarding the source of antibiotics, (42.55% of the respondents usually gets the antibiotics after a consultation with the doctor, while 53.8% declared that their antibiotics were acquired from a retail pharmacy and a few of them (3.65% get the antibiotics from family and friends. The justification of participants for having antibiotics was mostly due to fever (41.34% or respiratory infections (22.19%. About 33.5% stated that they did not complete the treatment course and the reason was they felt better. Almost 57% indicated that they had ever kept an antibiotic at home for emergency need while 28.57% use leftover antibiotics in case they

  1. A comparative analysis of exposure doses between the radiation workers in dental and general hospital

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Nam Hee; Chung, Woon Kwan; Dong, Kyung Rae; Ju, Yong Jin; Song, Ha Jin [Dept. of Nuclear Engineering, Chosun University, Gwangju (Korea, Republic of); Choi, Eun Jin [Dept. of Public Health and Medicine, Dongshin University, Naju (Korea, Republic of)

    2015-02-15

    Research and investigation is required for the exposure dose of radiation workers to work in the dental hospital as increasing interest in exposure dose of the dental hospital recently accordingly, study aim to minimize radiation exposure by making a follow-up study of individual exposure doses of radiation workers, analyzing the status on individual radiation exposure management, prediction the radiation disability risk levels by radiation, and alerting the workers to the danger of radiation exposure. Especially given the changes in the dental hospital radiation safety awareness conducted the study in order to minimize radiation exposure. This study performed analyses by a comparison between general and dental hospital, comparing each occupation, with the 116,220 exposure dose data by quarter and year of 5,811 subjects at general and dental hospital across South Korea from January 1, 2008 through December 31, 2012. The following are the results obtained by analyzing average values year and quarter. In term of hospital, average doses were significantly higher in general hospitals than detal ones. In terms of job, average doses were higher in radiological technologists the other workers. Especially, they showed statistically significant differences between radiological technologists than dentists. The above-mentioned results indicate that radiation workers were exposed to radiation for the past 5 years to the extent not exceeding the dose limit (maximum 50 mSv y{sup -1}). The limitation of this study is that radiation workers before 2008 were excluded from the study. Objective evaluation standards did not apply to the work circumstance or condition of each hospital. Therefore, it is deemed necessary to work out analysis criteria that will be used as objective evaluation standard. It will be necessary to study radiation exposure in more precise ways on the basis of objective analysis standard in the future. Should try to minimize the radiation individual dose of

  2. Selected aspects of the logistics network of public hospitals in the competitive market of health services

    Directory of Open Access Journals (Sweden)

    Justyna Majchrzak-Lepczyk

    2016-12-01

    Full Text Available Background: The below considerations provide an overview of the issues of sustainable development, logistics, to financial engineering instruments and the role of intellectual capital in the process of transformation of public hospitals. The aim of this research was to assess the competitiveness of the network of public hospitals in the market of health services based on literature studies, as well as empirical research. Methods: Empirical study using a questionnaire survey was conducted in the period from January 2007 to December 2011, in the area of Warmia and Mazury, Pomerania and Wielkopolska. The goal of this questionnaire survey was to know the medical staff reviews issues related to adaptation to the nature of the network of public hospitals methods and logistics tools, sustainable development, corporate social responsibility - CSR. The study was carried out in 104 public hospitals, on a sample of 8975 respondents. Results and conclusions: Analysis of the completed study showed that the logistic processes and their improvement in the health sector play a significant role. The surveyed entities explicitly draw attention to the need for information systems,  pro-environment activities, access to information, or the use of GS1 global standards. These tools allow you to increase the efficiency of supply chains, ensuring not only tracking and tracing of products from the manufacturer to the patient, but also enabling better protection against making a mistake or counterfeit products.

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

    African Journals Online (AJOL)

    1990-08-04

    Aug 4, 1990 ... about expenditure in the public and the private health care sectors. ... Groote Schuur Hospital and Department of Community .... from 1985/86 is due to expenditure on equipment (non- .... much work is still required to correct the methodological .... and Eric Wilson, Miss D. McIntyre, and Messrs Renee Trmer,.

  4. Mammography in public hospitals at Rio de Janeiro: a quality assurance program

    Energy Technology Data Exchange (ETDEWEB)

    Briquet, C.; Coutinho, C.M.C.; Mota, H.C.; Tavares, E. [Instituto de Radioprotecao e Dosimetria/ Commisao Nacional de Energia Nuclear. Av. Salvador Allende, s/n CEP: 22780-160. Rio de Janeiro (Brazil)

    1998-12-31

    This paper presents the preliminary results and the methodology followed by the implementation of a Quality Assurance Program in public hospitals at Rio de Janeiro. We observed that the main problems of image are due to the processing. None facility has a dedicated processor and the processor daily quality control is a concern not yet adopted. (Author)

  5. 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.

  6. 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

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

    Science.gov (United States)

    Dearlove, J V; Bialous, S A; Glantz, S A

    2002-06-01

    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. 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. 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. 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.

  8. Financing and planning of public and private not-for-profit hospitals in the European Union.

    Science.gov (United States)

    Thompson, Ceri R; McKee, Martin

    2004-03-01

    While much has been written about health care financing in Europe in recent years, discussion has almost entirely focused on revenue. In contrast, there has been remarkably little written on financing of capital investment in European health care systems. Yet major changes are underway in several countries, in particular involving new forms of public-private partnerships (PPP). At the same time, there is growing recognition of the way in which the inherited structure of the health care delivery system constrains the system's ability to adapt to changing circumstances. This paper reports the results of a survey undertaken among key informants in the member states of the European Union to begin to ascertain existing practices and future plans in relation to hospital planning and financing amongst public and private not-for-profit hospitals. The locus of hospital planning decisions reflect the constitutional framework of the country involved, and thus the emphasis on national or local plans. There has been an expansion of private sector involvement, with four basic models identified: private loans direct to the hospital; private loans to a regional health body; a PPP where the private sector's role is to build, design and operate the non-clinical functions of the hospital; and, finally, a PPP, where the private sector's involvement also includes management of the clinical functions of the hospital. It is too early to say whether these approaches will be more successful than the models they are replacing.

  9. Review of paediatric cardiology services in district general hospitals in the United Kingdom.

    Science.gov (United States)

    Andrews, Hannah; Singh, Yogen

    2016-03-01

    Following the Safe and Sustainable review of Paediatric Services in 2012/2013, National Health Service England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology in all non-specialist hospitals. To understand the variation in local paediatric cardiology services provided across district general hospitals in the United Kingdom. An internet-based questionnaire was sent out via the Paediatrician with Expertise in Cardiology Special Interest Group and the Neonatologists with Interest in Cardiology and Haemodynamics contact databases and the National Health Service directory. Non-responders were followed-up via telephone. The response rate was 80% (141 of 177 hospitals), and paediatricians with expertise in cardiology were available in 68% of those. Local cardiology clinics led by paediatricians with expertise in cardiology were provided in 96 hospitals (68%), whereas specialist outreach clinics were held in 123 centres (87%). A total of 11 hospitals provided neither specialist outreach clinics nor any local cardiology clinics led by paediatricians with expertise in cardiology. Paediatric echocardiography services were provided in 83% of the hospitals, 12-lead electrocardiogram in 96%, Holter electrocardiogram in 91%, and exercise testing in only 47% of the responding hospitals. Telemedicine facilities were established in only 52% of the centres, where sharing echocardiogram images via picture archiving and communication system was used most commonly. There has been a substantial increase in the availability of paediatricians with expertise in cardiology since 2008. Most of the hospitals are well-supported by specialist cardiology centres via outreach clinics; however, there remains significant variation in the local paediatric cardiology services provided across district general hospitals in the United Kingdom.

  10. Crowdsourcing the General Public for Large Scale Molecular Pathology Studies in Cancer

    Directory of Open Access Journals (Sweden)

    Francisco J. Candido dos Reis

    2015-07-01

    Interpretation: Crowdsourcing of the general public to classify cancer pathology data for research is viable, engages the public and provides accurate ER data. Crowdsourced classification of research data may offer a valid solution to problems of throughput requiring human input.

  11. Developmental Outcome of Very Low Boy Weight Babies Born in a Regional Public Hospital in Hong Kong%Regional Public Hospital in Hong Kong

    Institute of Scientific and Technical Information of China (English)

    KNR Yuen; CB Chow; D Allison

    2009-01-01

    Objectives To investigate the Short term development outcome of a cohort of Very low Birth Weight(VLRW)babies(i.e.Birth-weight less than 1500 g.)born in a Hong Kong regional public hospital in 2001.Design Non-randomized prospective cohort Study.Setting Regional public hospital in Hong Kong.Partieipants 29 babies with birth weight of less than 1500 g(i.e.very low birth weight babies)who were bom and survived to discharge in Kwong Wah Hospital in the period between lst January 2001 to 31st December 2001.Main outoome measures Deveiopmcntal outcome.Results A total of 27 very low birth weight babies(15 males and 12 females)were included in the study.The mean gestational age of the cohort was 28.6 weeks±3.08 weeks.The mean birth weight of the cohort of babies was 1120 g±270 g.Two patients defaulted follow up and assessment in the first two years of life.At the chronological age of 4 vears old,21 out of 25 babies (84%)had normal growth and development.Four out of 25 babies were found to have developmental delay,including one baby with severe handicap.Conehmion With advances in medical care,many low birth weight babies can now 8urvive,but a number of these high risk babies may have long term developmental problems.It is important to monitor these patients closely after discharge from hospital so that early identification and rehabilitation of developmental problems can be possible.

  12. 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.

  13. 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.

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. A generic discrete-event simulation model for outpatient clinics in a large public hospital.

    Science.gov (United States)

    Weerawat, Waressara; Pichitlamken, Juta; Subsombat, Peerapong

    2013-01-01

    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.

  17. 试论2011年全国综合医院效益分析%On the Benefit Analysis of the National General Hospital in 2011

    Institute of Scientific and Technical Information of China (English)

    李敏

    2012-01-01

    2011年全国综合性医院运营良好,资产规模扩张快,流动资金利用力强.加强资产管理、加强成本核算,控制成本支出,提高医院管理水平,公立医院要注意医院资产借债筹资比重,私立医院应加强运用外部资金能力.%In 2011, general hospital operated well and their expansion of the assets scale was fast, and the utilization of liquidity was strong. In order to strengthen asset management, and cost accounting, control costs, and improve the level of hospital management, the public hospitals should pay attention to the proportion of debt financing for hospital assets, and the private hospitals should strengthen the use of external funds.

  18. Psychological impact of the pandemic (H1N1) 2009 on general hospital workers in Kobe.

    Science.gov (United States)

    Matsuishi, Kunitaka; Kawazoe, Ayako; Imai, Hissei; Ito, Atsushi; Mouri, Kentaro; Kitamura, Noboru; Miyake, Keiko; Mino, Koichi; Isobe, Masanori; Takamiya, Shizuo; Hitokoto, Hidefumi; Mita, Tatsuo

    2012-06-01

    In order for hospitals to work efficiently in a pandemic, it is important to know how a pandemic affects the hospital staff. The aim of the present study was to investigate the psychological impact of the pandemic (H1N1) 2009 on hospital workers and how it was affected by the characteristics of the hospital, gender, age, job and work environment. In late June 2009, soon after the pandemic had ended in Kobe city, Japan, a questionnaire was distributed consisting of questions on sociodemographic characteristics, 19 stress-related questions and the Impact of Event Scale (IES) to all 3635 employees at three core general hospitals in Kobe. Exploratory factor analysis was applied to the 19 stress-related questions, and this produced four factors for evaluation (anxiety about infection, exhaustion, workload, and feeling of being protected). Multiple regression models were used to evaluate the association of personal characteristics with each score of the four factors and the IES. Valid answers were received from 1625 employees. Workers at a hospital with intense liaison psychiatric services felt less psychological impact. Workers at a hospital that provided staff with information about the pandemic less frequently, felt unprotected. Workers in work environments that had a high risk of infection felt more anxious and more exhausted. The total IES score was higher in workers in high-risk work environments. It is important for hospitals to protect hospital workers during a pandemic and to rapidly share information about the pandemic. Liaison psychiatric services can help to reduce the impact of the pandemic on hospital workers. © 2012 The Authors. Psychiatry and Clinical Neurosciences © 2012 Japanese Society of Psychiatry and Neurology.

  19. 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.

  20. Implementation of quality of care indicators for third-level public hospitals in Mexico

    Directory of Open Access Journals (Sweden)

    Pedro Jesús Saturno-Hernández

    2017-05-01

    Full Text Available Objective. To select, pilot test and implement a set of indi­cators for tertiary public hospitals. Materials and meth­ods. Quali-quantitative study in four stages: identification of indicators used internationally; selection and prioritization by utility, feasibility and reliability; exploration of the quality of sources of information in six hospitals; pilot feasibility and reliability, and follow-up measurement. Results. From 143 indicators, 64 were selected and eight were prioritized. The scan revealed sources of information deficient. In the pilot, three indicators were feasible with reliability limited. Has conducted workshops to improve records and sources of information; nine hospitals reported measurements of a quarter. Conclusions. Eight priority indicators could not be measured immediately due to limitations in the data sources for its construction. It is necessary to improve mechanisms of registration and processing of data in this group of hospital.

  1. The use of the truth and deception in dementia care amongst general hospital staff.

    Science.gov (United States)

    Turner, Alex; Eccles, Fiona; Keady, John; Simpson, Jane; Elvish, Ruth

    2017-08-01

    Deceptive practice has been shown to be endemic in long-term care settings. However, little is known about the use of deception in dementia care within general hospitals and staff attitudes towards this practice. This study aimed to develop understanding of the experiences of general hospital staff and explore their decision-making processes when choosing whether to tell the truth or deceive a patient with dementia. This qualitative study drew upon a constructivist grounded theory approach to analyse data gathered from semi-structured interviews with a range of hospital staff. A model, grounded in participant experiences, was developed to describe their decision-making processes. Participants identified particular triggers that set in motion the need for a response. Various mediating factors influenced how staff chose to respond to these triggers. Overall, hospital staff were reluctant to either tell the truth or to lie to patients. Instead, 'distracting' or 'passing the buck' to another member of staff were preferred strategies. The issue of how truth and deception are defined was identified. The study adds to the growing research regarding the use of lies in dementia care by considering the decision-making processes for staff in general hospitals. Various factors influence how staff choose to respond to patients with dementia and whether deception is used. Similarities and differences with long-term dementia care settings are discussed. Clinical and research implications include: opening up the topic for further debate, implementing staff training about communication and evaluating the impact of these processes.

  2. Care for patients with cerebrovascular disease in a general hospital. 2 years experience

    Directory of Open Access Journals (Sweden)

    Joan Omar Rojas Fuentes

    2010-08-01

    Full Text Available Background: The care of patients with cerebrovascular disease requires an organized system from pre-hospital care until discharge of the patient, to ensure the continuity of rehabilitation. In order to provide differentiated services to patients with this condition was created in the General Hospital Universitario "Dr. Gustavo Lima Aldereguía "a specialized room for attention to these diseases and the rehabilitation of patients. Objective: To determine the benefits obtained with differentiated services to patients with cerebrovascular disease in a general hospital. Methods: Descriptive case series that included 1038 patients admitted to the specialized chamber for cerebrovascular disease. We analyzed the following variables: stay, type of cerebrovascular disease, clinical classification, the Barthel index and discharge status. Results: 972 patients suffered from cerebrovascular disease, hospital stay was reduced by two days, the attention of specialized equipment increased from 51.75% to 79.2% patients were discharged with a mild degree of functional dependence. Conclusions: The differentiated services to cerebrovascular disease in general hospitals shows benefits for patients.

  3. Care of severe head injury patients in the Sarawak General Hospital: intensive care unit versus general ward.

    Science.gov (United States)

    Sim, S K; Lim, S L; Lee, H K; Liew, D; Wong, A

    2011-06-01

    Intensive care for severe head injury patients is very important in the prevention and treatment of secondary brain injury. However, in a resources constraint environment and limited availability of Intensive Care Unit (ICU) beds in the hospitals, not all severe head injury patients will receive ICU care. This prospective study is aimed to evaluate the outcome of severe head injured patients who received ICU and general ward care in Sarawak General Hospital (SGH) over a 6-month period. A total of thirty five severe head injury patients were admitted. Twenty three patients (65.7%) were ventilated in general ward whereas twelve patients (34.3%) were ventilated in ICU. Overall one month mortality in this study was 25.7%. Patients who received ICU care had a lower one month mortality than those who received general ward care (16.7% vs 30.4%), although it was not statistically different. Multivariate analysis revealed only GCS on admission (OR 0.731; 95% CI 0.460 to 0.877; P=0.042) as the independent predictive factor for one month mortality in this study.

  4. Short and medium-term outcomes for general surgery in nonagenarian patients in a district general hospital.

    Science.gov (United States)

    Hayes, A J; Davda, A; El-Hadi, M; Murphy, P; Papettas, T

    2016-07-01

    Introduction Surgeons are increasingly performing surgery on older patients. There are currently no tools specifically for risk prediction in this group. The aim of this study was to review general surgical operations carried out on patients aged over 90 years and their outcome, before comparing these with predictors of morbidity and mortality. Methods A retrospective review was carried out at our district general hospital of all general surgery patients aged over 90 years who underwent a general surgical operation over a period of 14 years. Information collected included demographics, details of procedures, P-POSSUM (Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity), complications and outcomes. Results A total of 119 procedures were carried out, 72 involving entry into the peritoneal cavity. Overall, 14 patients (12%) died within 30 days and 34 (29%) died within one year. Postoperative complications included infection (56%), renal failure (24%), need for transfusion (17%) and readmission within 30 days (11%). Logistical regression analysis showed that the P-POSSUM correlated well with observed mortality and infection was a significant predictor of in-hospital mortality (p=0.003). Conclusions The P-POSSUM correlates significantly with outcome and should be used when planning major elective or emergency surgery in patients over 90 years of age. Infective complications appear to be a significant predictor of postoperative mortality. This study supports operative intervention as an option in this extreme age group but we emphasise the importance of appropriate patient selection and judicious clinical care.

  5. Conflict management in public university hospitals in Turkey: a pilot study.

    Science.gov (United States)

    Tengilimoglu, Dilaver; Kisa, Adnan

    2005-01-01

    By nature, hospitals are extremely complex organizations, combining many different professional groups within an intricate administrative structure. Conflicts therefore expectedly arise between individuals, groups, and departments. It is in the interest of health care administrators to periodically assess the major factors giving rise to these conflicts. In this study, a questionnaire designed to measure sources of conflict in the workplace was completed by 204 staff members at Gazi University Hospital. Of the participants, 30.9% were physicians, and 12.5% were administrators at various levels; 61.5% were female, and 38.5% were male. In terms of work experience, 52.6% of participants had worked less than 5 years at the hospital. The results of the study show that educational differences among the hospital staff were a major barrier to good communication and information flow between groups. Professionals in the same specialties experienced fewer conflicts. Another source of conflict was that resource allocation was considered unfair across departments. Although the hospital management provided an ombudsman for staff concerns, staff rarely resorted to the ombudsman because of the stigma associated with complaining. A lack of opportunity for career advancement was mentioned by 52% of the participants as a source of conflict. At present, job performance and rewards are not closely related in public university hospitals in Turkey because promotions and pay raises are strictly limited by law. Bureaucracy was also perceived to be a source of conflict, with 48.4% of participants saying that their performance was less than optimal because of the presence of multiple supervisors. This pilot study suggests that in Turkey, legislative reform is needed to give public university hospitals more flexibility regarding work incentives, open-door policies at the administrative level, and social interactions to improve teamwork among hospital staff.

  6. Opening the Black Box: The Experiences and Lessons From the Public Hospitals Autonomy Policy in Iran.

    Science.gov (United States)

    Doshmangir, Leila; Rashidian, Arash; Jafari, Mehdi; Takian, Amirhossein; Ravaghi, Hamid

    2015-07-01

    Policy formulation and adoption often happen in a black box. Implementation challenges affect and modify the nature of a policy. We analyzed hospitals' autonomy policy in Iran that was intended to reduce hospitals' financial burden on government and improve their efficiency. We followed a retrospective case-study methodology, involving inductive and deductive analyses of parliamentary proceedings, policy documents, gray literature, published papers and interview transcripts. We analyzed data to develop a policy map that included important dates and events leading to the policy process milestones. We identified four time-periods with distinctive features: 'moving toward the policy' (1989 - 1994), disorganized implementation' (1995 - 1997), 'continuing challenges and indecisiveness in hospitals financing' (1998 - 2003), and 'other structural and financial policies in public hospitals' (2004 to date). We found that stakeholders required different and conflicting objectives, which certainly resulted in an unsatisfactory implementation process. The policy led to long-lasting and often negative changes in the hospital sector and the entire Iranian health system. Hospital autonomy appeared to be an ill-advised policy to remedy the inefficiency problems in low socioeconomic areas of the country. The assumption that hospital autonomy reforms would necessarily result in a better health system, may be a false assumption as their success relies on many contextual, structural and policy implementation factors.

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

    Directory of Open Access Journals (Sweden)

    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

  8. Relationship between psychiatric nurse work environments and nurse burnout in acute care general hospitals.

    Science.gov (United States)

    Hanrahan, Nancy P; Aiken, Linda H; McClaine, Lakeetra; Hanlon, Alexandra L

    2010-03-01

    Following deinstitutionalization, inpatient psychiatric services moved from state institutions to general hospitals. Despite the magnitude of these changes, evaluations of the quality of inpatient care environments in general hospitals are limited. This study examined the extent to which organizational factors of the inpatient psychiatric environments are associated with psychiatric nurse burnout. Organizational factors were measured by an instrument endorsed by the National Quality Forum. Robust clustered regression analysis was used to examine the relationship between organizational factors in 67 hospitals and levels of burnout for 353 psychiatric nurses. Lower levels of psychiatric nurse burnout was significantly associated with inpatient environments that had better overall quality work environments, more effective managers, strong nurse-physician relationships, and higher psychiatric nurse-to-patient staffing ratios. These results suggest that adjustments in organizational management of inpatient psychiatric environments could have a positive effect on psychiatric nurses' capacity to sustain safe and effective patient care environments.

  9. Upper urinary tract stone disease: the changing management in a district general hospital.

    OpenAIRE

    Goble, N M; Hammonds, J C; Wells, I P

    1987-01-01

    The advent of percutaneous nephrolithotomy (PCN) and ureteroscopy, in combination with stone disruption techniques, has dramatically altered the management of upper urinary tract stone disease. These advances are not necessarily confined to the teaching centres. The problems encountered introducing these techniques in a District General Hospital and their impact on the surgical management of upper urinary tract stones is presented.

  10. Critical care research in a district general hospital: the first year.

    Science.gov (United States)

    Camsooksai, Julie; Barnes, Helena; Reschreiter, Henrik

    2013-09-01

    Until recently, research in critical care units has usually taken place in university teaching hospitals. The 'general' critical care unit patient population is broader than this and the research needs to reflect this. As a general critical care unit in a district general hospital we wanted to set-up research within our own department, as part of the critical care team and part of our culture. With extensive background communication, drive and hard work, the support of the hospital Research and Development department was gained and Comprehensive Local Research Network funding successfully applied for. A research team was established and a model for the Research Nurse role was developed and implemented. This model is described. Participation in national trials commenced and the research portfolio is growing. Networking with other teams also proved valuable. Research has been established as part of the 'culture' of the day-to-day work and the staff have embraced this. Dedicated Research Nurse posts and education of the whole team have ensured successful implementation and recruitment of the studies. Experiences of the first year are shared and discussed here. Sharing experience of developing research within a critical care unit in a district general hospital, and a suggested model for a new Research Nurse role, may benefit other similar units in their efforts to establish research.

  11. Two decades of external peer review of cancer care in general hospitals; the Dutch experience

    NARCIS (Netherlands)

    Kilsdonk, M.J.; Siesling, S.; Otter, R.; Harten, van W.H.

    2015-01-01

    External peer review was introduced in general hospitals in the Netherlands in 1994 to assess and improve the multidisciplinary team approach in cancer care. This paper aims to explore the value, perceived impact, and (future) role of external peer review in cancer care. Semistructured interviews we

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  14. Family caregivers in public tertiary care hospitals in Bangladesh: risks and opportunities for infection control.

    Science.gov (United States)

    Islam, M Saiful; Luby, Stephen P; Sultana, Rebeca; Rimi, Nadia Ali; Zaman, Rashid Uz; Uddin, Main; Nahar, Nazmun; Rahman, Mahmudur; Hossain, M Jahangir; Gurley, Emily S

    2014-03-01

    Family caregivers are integral to patient care in Bangladeshi public hospitals. This study explored family caregivers' activities and their perceptions and practices related to disease transmission and prevention in public hospitals. Trained qualitative researchers conducted a total of 48 hours of observation in 3 public tertiary care hospitals and 12 in-depth interviews with family caregivers. Family caregivers provided care 24 hours a day, including bedside nursing, cleaning care, and psychologic support. During observations, family members provided 2,065 episodes of care giving, 75% (1,544) of which involved close contact with patients. We observed family caregivers washing their hands with soap on only 4 occasions. The majority of respondents said diseases are transmitted through physical contact with surfaces and objects that have been contaminated with patient secretions and excretions, and avoiding contact with these contaminated objects would help prevent disease. Family caregivers are at risk for hospital-acquired infection from their repeated exposure to infectious agents combined with their inadequate hand hygiene and knowledge about disease transmission. Future research should explore potential strategies to improve family caregivers' knowledge about disease transmission and reduce family caregiver exposures, which may be accomplished by improving care provided by health care workers. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  15. TRANSPORT OF PATIENTS FOR PRIMARY PTCA FROM GENERAL HOSPITAL NOVO MESTO TO LJUBLJANA IN 2002

    Directory of Open Access Journals (Sweden)

    Renata Okrajšek

    2004-12-01

    Full Text Available Background. The treatment of acute coronary syndrome (ACS with ST-segment elevation with primary percutaneous transluminal coronary angioplasty (PTCA is the best way to treat these patients. Primary PTCA is also practicable with patients who are admitted into institution without catheter laboratory. The transport of patients into the tertiary institution is safe, but it is important to keep the time of ischemia as short as possible and to reach the time interval of door-balloon as recommended by the guidelines. The ACS patients with ST-segment elevation that were directed into General Hospital Novo mesto after examination at the internistic emergency department have been redirected to KC Ljubljana for realization of PTCA since October 2001.Methods. A prospective analysis of patients with ACS with STsegment elevation, who had been transferred from General Hospital Novo mesto to KC Ljubljana in the period from January 1, 2002 to December 31, 2002 to have a primary PTCA, was performed. The analysis comprised the following: the time interval of handling the patients at Internistic department of General Hospital Novo mesto, the time of transport of patients to Ljubljana and total time interval from the arrival of patients to General Hospital Novo mesto to the first inflation of balloon in Ljubljana. We monitored the complications that occurred during the treatment of the patients.Results. In the above mentioned period 29 patients (24 males and 5 females were transported from the General Hospital Novo mesto to the KC Ljubljana to have a primary PTCA performed. The total time interval measured between the patients’ arrival to General Hospital Novo mesto to the first inflation of balloon in Ljubljana in the year 2002 was 145 minutes, which is 17 minutes better than in the previous period. The time interval recommended by the guidelines was achieved with four patients.Conclusions. By recognizing the problems that had encountered with directing the

  16. Survey of the Information-Seeking Behaviour of Hospital Professionals at a Public Cancer Hospital in Greece Proves the Value of Hospital Libraries. A Review of: Kostagiolas, P. A., Ziavrou, K., Alexias, G., & Niakas, D. (2012. Studying the information-seeking behavior of hospital professionals: The case of METAXA Cancer Hospital in Greece. Journal of Hospital Librarianship, 12(1, 33-45.

    Directory of Open Access Journals (Sweden)

    Antonio DeRosa

    2013-06-01

    Full Text Available Objective – To study the information-seeking practices of hospital staff and weigh the impact of hospital libraries on effective information-seeking.Design – Survey questionnaire.Setting – Large public cancer hospital in Greece.Subjects – The authors surveyed 49 physicians, 43 nursing staff members, 25 administrative staff members, 23 paramedical staff members, and 5 technical staff members, totaling 145 health professionals.Methods – Participants were given a questionnaire comprised of five parts: general information (including gender, age, education, position, and professional experience; questions on computer and Internet accessibility; questions regarding individual information needs; questions on information-seeking obstacles; and a question regarding the satisfaction with the current degree of information availability in the hospital. The last question was ranked using a 5-point Likert scale. Each questionnaire was distributed with a cover letter explaining the anonymity and consent of the respondent. Hospital members were randomly selected using a number generator and respondents returned completed surveys to the hospital personnel office in a sealed envelope within a specified time frame. The sampled group was representative of the overall population of the hospital.Main Results – The authors discuss demographic data of respondents: 65.7% were women; 56.7% were over 40 years old; 29.0% were graduates of higher technological institutes; 28.3% were university graduates; 9.7% held a postgraduate degree; 8.3% had a PhD; and 1.4% had only secondary education. As for the remainder of the survey questions: 64% of respondents had access to the Internet both at home and at work, while only 8.2% had no access to the Internet at all; most respondents noted using the Internet for seeking scientific information (83.0% and e-mail communication (65.3%; the main obstacle respondents noted experiencing when seeking information was the lack of

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

    Directory of Open Access Journals (Sweden)

    Hao Li PhD

    2015-09-01

    Full Text Available 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.

  18. Determinants of telemedicine acceptance in selected public hospitals in Malaysia: clinical perspective.

    Science.gov (United States)

    Zailani, Suhaiza; Gilani, Mina Sayyah; Nikbin, Davoud; Iranmanesh, Mohammad

    2014-09-01

    The purpose of this study is to explore the determinants of telemedicine acceptance in selected public hospitals in Malaysia and to investigate the effect of health culture on the relationship between these determinants and telemedicine acceptance. Data were gathered by means of a survey of physicians and nurses as the main group of users of telemedicine technology from hospitals that are currently using telemedicine technology. The results indicated that government policies, top management support, perception of usefulness and computer self-efficiency have a positive and significant impact on telemedicine acceptance by public hospitals in Malaysia. The results also confirmed the moderating role of health culture on the relationship between government policies as well as perceived usefulness on telemedicine acceptance by Malaysian hospitals. The results are useful for decision-makers as well as managers to recognize the potential role of telemedicine and assist in the process of implementation, adoption and utilization, and, therefore, spread the usage of telemedicine technology in more hospitals in the country.

  19. Emergency department physician training in Jamaica: a national public hospital survey

    Directory of Open Access Journals (Sweden)

    Williams Eric W

    2008-10-01

    Full Text Available Abstract Background Emergency Department (ED medical officers are often the first medical responders to emergencies in Jamaica because pre-hospital emergency response services are not universally available. Over the past decade, several new ED training opportunities have been introduced locally. Their precise impact on the health care system in Jamaica has not yet been evaluated. We sought to determine the level of training, qualifications and experience of medical officers employed in public hospital EDs across the nation. Methods A database of all medical officers employed in public hospital EDs was created from records maintained by the Ministry of Health in Jamaica. A specially designed questionnaire was administered to all medical officers in this database. Data was analyzed using SPSS Version 10.0. Results There were 160 ED medical officers across Jamaica, of which 47.5% were males and the mean age was 32.3 years (SD +/- 7.1; Range 23–57. These physicians were employed in the EDs for a mean of 2.2 years (SD +/- 2.5; Range 0–15; Median 2.5 and were recent graduates of medical schools (Mean 5.1; SD +/- 5.9; Median 3 years. Only 5.5% of the medical officers had specialist qualifications (grade III/IV, 12.8% were grade II medical officers and 80.5% were grade I house officers or interns. The majority of medical officers had no additional training qualifications: 20.9% were exposed to post-graduate training, 27.9% had current ACLS certification and 10.3% had current ATLS certification. Conclusion The majority of medical officers in public hospital EDs across Jamaica are relatively inexperienced and inadequately trained. Consultant supervision is not available in most public hospital EDs. With the injury epidemic that exists in Jamaica, it is logical that increased training opportunities and resources are required to meet the needs of the population.

  20. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Science.gov (United States)

    2010-07-01

    ... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public Health... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Emergency use of Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51...

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

    Science.gov (United States)

    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.

  2. First Chinese public hospital wins Joint Commission International accreditation: the Health Information Department played a key role in the process.

    Science.gov (United States)

    Shaffer, Audrey; Jun, Cheng Li

    2008-07-01

    Sir Run Run Shaw Hospital in Hangzhou, China spent five years preparing for a Joint Commission International accreditation survey. In March 2007 it became the first public hospital on the Chinese mainland to attain international accreditation. The Health Information Department, managed according to Western standards, played an integral role in preparing the hospital for the survey.

  3. SERVICE QUALITY PERCEPTIONS AND PATIENTS' SATISFACTION: A COMPARATIVE CASE STUDY OF A PUBLIC AND A PRIVATE SECTOR HOSPITAL IN PAKISTAN

    OpenAIRE

    Kanwal Nasim; Saquib Yusaf Janjua

    2014-01-01

    Management of hospitals should take initiatives to improve the overall service quality of patient care. Regular feed-back from patients should be taken and rules should be made considering the expectations and requirements of patients. This study attempts to examine the satisfaction of patients from service quality they received from hospitals. Moreover, satisfaction is measured in both public and private hospital.

  4. Free does not mean affordable: maternity patient expenditures in a public hospital in Bangladesh

    Directory of Open Access Journals (Sweden)

    Khan Suhaila H

    2005-01-01

    Full Text Available Abstract Objective This study investigated a the amount and types of out-of-pocket expenditures by patients for nominally free services in a large public hospital in Bangladesh, b the factors influencing these expenses, and c the impact of these expenses on household income. Methods Eighty-one maternity patients were interviewed during their hospitalization in the Dhaka Medical College Hospital. Patients were selected by quota sample to match the distribution of maternity patient categories in the hospital. Patients were interviewed with a semi-structured, in-depth questionnaire. Results All interviewees incurred substantial out-of-pocket expenditures for travel, hospital admission fees, medicine, tests, food, and tips. Only two of the expenditures, travel expenses and admission fees, were not supposed to be provided free of charge by the hospital. The median total per-patient expenditure was $65 (range $2–$350, equivalent to 7% (range 0.04%–225% of annual household income. Half of all patients reported that their families had to borrow to pay for care at interest rates of 5%–30% per month. A third of these families reported selling jewelry, land or household items to moneylenders. The rural patients reported more difficulty in paying for care than the urban patients. Factors increasing the expenditures were duration of hospitalization, rural residence, and necessary (e.g. C-section, hysterectomy and unnecessary (e.g. episiotomy medical procedures. Conclusion Free maternity services in Bangladesh impose large out-of-pocket expenditures on patients. Authorities could reduce the burden by reducing the duration of hospital stays, limiting use of medical procedures, eliminating tips, and moving routine services closer to potential users. Fee for service could reduce unofficial expenditures if the fee were lower than and replaced typical unofficial expenditures, otherwise adding service fees without reform of current hospital practices would

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

    Science.gov (United States)

    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.

  6. The relationship between indicators of socioeconomic status and cesarean section in public hospitals

    Science.gov (United States)

    Faisal-Cury, Alexandre; Menezes, Paulo Rossi; Quayle, Julieta; Santiago, Kely; Matijasevich, Alicia

    2017-01-01

    ABSTRACT OBJECTIVE To assess the relationship between indicators of socioeconomic status and cesarean section in public hospitals that adopt standardized protocols of obstetrical care. METHODS This was a prospective cohort study conducted between May 2005 and January 2006 with 831 pregnant women recruited from 10 public primary care clinics in São Paulo, Brazil. Demographic and clinical characteristics were collected during pregnancy. The three main exposures were schooling, monthly family income per capita, and residential crowding. The main outcome was cesarean section at three public hospitals located in the area. Crude and adjusted risk ratios (RR), with 95% confidence intervals were calculated using Poisson regression with robust variance. We examined the effects of each exposure variable on cesarean section accounting for potential confounders by using four different models: crude, adjusted by mother’s characteristics, by obstetrical complications, and by the other two indicators of socioeconomic status. RESULTS Among the 757 deliveries performed in the public hospitals, 215 (28.4%) were by cesarean section. In the bivariate analysis, cesarean section was associated with higher family income per capita, higher education, lower residential crowding, pregnancy planning, white skin color, having a partner, and advanced maternal age. In the multivariate analysis, after adjustment for covariates, none of the socioeconomic status variables remained associated with cesarean section. CONCLUSIONS In this group, the chance of women undergoing cesarean section was not associated with indicators of socioeconomic status only, but was defined in accordance with major obstetric and clinical conditions. PMID:28355336

  7. The relationship between indicators of socioeconomic status and cesarean section in public hospitals.

    Science.gov (United States)

    Faisal-Cury, Alexandre; Menezes, Paulo Rossi; Quayle, Julieta; Santiago, Kely; Matijasevich, Alicia

    2017-03-23

    To assess the relationship between indicators of socioeconomic status and cesarean section in public hospitals that adopt standardized protocols of obstetrical care. This was a prospective cohort study conducted between May 2005 and January 2006 with 831 pregnant women recruited from 10 public primary care clinics in São Paulo, Brazil. Demographic and clinical characteristics were collected during pregnancy. The three main exposures were schooling, monthly family income per capita, and residential crowding. The main outcome was cesarean section at three public hospitals located in the area. Crude and adjusted risk ratios (RR), with 95% confidence intervals were calculated using Poisson regression with robust variance. We examined the effects of each exposure variable on cesarean section accounting for potential confounders by using four different models: crude, adjusted by mother's characteristics, by obstetrical complications, and by the other two indicators of socioeconomic status. Among the 757 deliveries performed in the public hospitals, 215 (28.4%) were by cesarean section. In the bivariate analysis, cesarean section was associated with higher family income per capita, higher education, lower residential crowding, pregnancy planning, white skin color, having a partner, and advanced maternal age. In the multivariate analysis, after adjustment for covariates, none of the socioeconomic status variables remained associated with cesarean section. In this group, the chance of women undergoing cesarean section was not associated with indicators of socioeconomic status only, but was defined in accordance with major obstetric and clinical conditions.

  8. The relationship between indicators of socioeconomic status and cesarean section in public hospitals

    Directory of Open Access Journals (Sweden)

    Alexandre Faisal-Cury

    Full Text Available ABSTRACT OBJECTIVE To assess the relationship between indicators of socioeconomic status and cesarean section in public hospitals that adopt standardized protocols of obstetrical care. METHODS This was a prospective cohort study conducted between May 2005 and January 2006 with 831 pregnant women recruited from 10 public primary care clinics in São Paulo, Brazil. Demographic and clinical characteristics were collected during pregnancy. The three main exposures were schooling, monthly family income per capita, and residential crowding. The main outcome was cesarean section at three public hospitals located in the area. Crude and adjusted risk ratios (RR, with 95% confidence intervals were calculated using Poisson regression with robust variance. We examined the effects of each exposure variable on cesarean section accounting for potential confounders by using four different models: crude, adjusted by mother’s characteristics, by obstetrical complications, and by the other two indicators of socioeconomic status. RESULTS Among the 757 deliveries performed in the public hospitals, 215 (28.4% were by cesarean section. In the bivariate analysis, cesarean section was associated with higher family income per capita, higher education, lower residential crowding, pregnancy planning, white skin color, having a partner, and advanced maternal age. In the multivariate analysis, after adjustment for covariates, none of the socioeconomic status variables remained associated with cesarean section. CONCLUSIONS In this group, the chance of women undergoing cesarean section was not associated with indicators of socioeconomic status only, but was defined in accordance with major obstetric and clinical conditions.

  9. [Nurses of large public hospitals in Rio de Janeiro: socio demographic and work related characteristics].

    Science.gov (United States)

    Griep, Rosane Härter; da Fonseca, Maria de Jesus Mendes; Melo, Enirtes Caetano Prates; Portela, Luciana Fernandes; Rotenberg, Lucia

    2013-09-01

    The study aimed at analyzing socio-demographic and working characteristics of nurses from public hospitals. It was carried out a cross-sectional study, involving 3.229 nurses from the eighteen largest public hospitals of the city of Rio de Janeiro. It was observed a feminine predominance (87.3%), with mean age of 39.9 ± 10 years. Around 7% referred having master or doctorate degree, 58.5% got their degree from public institutions and 24.5% used to work at the health sector before becoming nurses. Half the group has thought of abandoning their career, and almost a quarter is unsatisfied with their profession. Around 10% searched for a job outside nursing area in the previous month and 30% searched for a job in the same working area. Night work, engagement in more than one job and long professional work hours were more frequently found among men. The study has pointed challengeable aspects of nurses' profession. Results can subsidize support strategies to improve the working conditions in public hospitals due to their comprehensiveness.

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

    Science.gov (United States)

    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.

  11. Wage Inequity: Within-Market Comparative Analysis of Salary for Public Health Nurses and Hospital Nurses.

    Science.gov (United States)

    Issel, L Michele; Lurie, Christine Fitzpatrick; Bekemeier, Betty

    2016-01-01

    The labor market perspective focuses on supply and demand for registered nurses (RNs) as employees. This perspective contrasts with beliefs in the public health sector that RNs working in local health departments (LHD) as public health nurses (PHNs) accept lower wages because of factors other than market demand. This study sought to describe the extent to which hourly wages of RNs working in LHDs are competitive with hospital RN wages within the same county market. A repeated measures survey design was used in collecting 2010 and 2014 data. The unit of analysis was the county, as an RN labor market for LHDs and hospitals. Survey questions captured factors common in human resources benefits and wage packages, such as differential pay, hourly rate pay based on years of experience, components of benefit packages (eg, sick and vacation leave), and reimbursement for education. Within each county, the LHD and all hospitals constituted a "market," yielding a potential 12 markets in our study sample. Human resources representatives from each of the 12 LHDs and from all hospitals within those 12 counties were invited to participate. We conducted comparisons with survey data using t test of mean differences on mean RN wages across years of experience. On average, LHDs paid significantly less than hospitals in their markets, at all levels of RN experience, and this gap increased with RN experience in the sample markets. Salary compression was evident in 2010 and worsened for PHNs in 2014, when compared with hospital RNs. In 2014, 100% of the sample LHDs offered reimbursements for continuing education for PHNs compared with 89% of hospitals providing this benefit. This study contributes to our understanding of the human resources challenges faced by LHDs and provides evidence elucidating resources issues that need to be addressed in order to improve recruitment and retention of PHNs.

  12. Physiotherapy in the eyes of the general public

    OpenAIRE

    ZACHOVÁ, Pavla

    2012-01-01

    This bachelor degree thesis offers an analysis of the views of the lay public, i.e., non-medical persons, about physiotherapy. Physiotherapy forms a part of the complex process of rehabilitation, and plays an important role in preventive, diagnostic and medical care. This thesis consists of two sections: theory and practical. The theory section deals with the history of physiotherapy, complex rehabilitation and the International Classification of Functioning, Disabilities and Health. The chap...

  13. Study of Patients Absconding Behavior in a General Hospital at Southern Region of Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Khammarnia

    2015-03-01

    Full Text Available Background Patients’ escape from hospital imposes a significant cost to patients as well as the health system. Besides, for these patients, exposure to adverse events (such as suicide, self-harm, violence and harm to hospital reputation are more likely to occur compared to others. The present study aimed to determine the characteristics of the absconding patients in a general hospital through a case-control design in Shiraz, Iran. Methods This case-control study was conducted on 413 absconded patients as case and 413 patients as control in a large general hospital in Shiraz, southern Iran. In this study, data on the case and control patients was collected from the medical records using a standard checklist in the period of 2011–3. Then, the data were analyzed using descriptive and analytical statistics, through SPSS 16. Results The finding showed that 413 patients absconded (0.50% and mean of age in case group was 40.98 ± 16.31 years. In univariate analysis, variables of gender [Odds Ratio (OR= 2], ward (OR= 1.22, insurance status (OR= 0.41, job status (OR= 0.34 and residence expenditure were significant. However, in multivariate analysis significant variables were age (ORadj= 0.13, gender (ORadj= 2.15, self-employment/unemployed (ORadj= 0.47, emergency/admission (ORadj= 2.14, internal/admission (ORadj= 3.16, insurance status (ORadj= 4.49 and residence expenditure (ORadj= 1.15. Conclusion Characteristics such as middle age, male gender, no insurance coverage, inability to afford hospital expenditures and admission in emergency department make patients more likely abscond from the hospital. Therefore, it may be necessary to focus efforts on high-risk groups and increase insurance coverage in the country to prevent absconding from hospital.

  14. Filamentous fungi vectored by ants (Hymenoptera: Formicidae) in a public hospital in North-Eastern Brazil.

    Science.gov (United States)

    Aquino, R S S; Silveira, S S; Pessoa, W F B; Rodrigues, A; Andrioli, J L; Delabie, J H C; Fontana, R

    2013-03-01

    The increase in opportunistic fungal infections has led to the search for putative sources of contamination in hospital environments. Ants in a public hospital in Itabuna, north-eastern Brazil were examined for carriage of filamentous fungi. During a year-long survey, ants from different hospital areas were sampled. Preference was given to locations where it was possible to observe ants actively foraging. The fungi found on the ants' integument were cultured and identified. A total of 106 ant workers belonging to 12 species in 11 genera were collected. A total of 47 fungal strains was isolated from 40% of the ants (N = 42). We found 16 fungal species in 13 genera associated with the ant workers. The prevalent fungal genera were Aspergillus, Purpureocillium and Fusarium. The ants Tapinoma melanocephalum, Paratrechina longicornis and Pheidole megacephala were associated with six fungal genera; and four genera of fungi were associated with Solenopsis saevissima workers. Fungal diversity was higher in the following hospital areas: nursery, hospital beds, breastmilk bank and paediatrics. Ants act as carriers of soil and airborne fungal species, and ant control in hospital areas is necessary to prevent the dissemination of such micro-organisms. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  15. Comparing salivary cotinine concentration in non-smokers from the general population and hospitality workers in Spain.

    Science.gov (United States)

    Martínez-Sánchez, Jose M; Fu, Marcela; Pérez-Ríos, Mónica; López, María J; Moncada, Albert; Fernández, Esteve

    2009-12-01

    The objective was to compare the pattern of exposure to second-hand smoke (SHS) among non-smokers in the general population and in hospitality workers. We used the adult (16-64 years) non-smokers of two independent studies (general population and hospitality workers) in Spain. We assessed the exposure to SHS by means of questionnaire and salivary cotinine concentration. The salivary cotinine concentration by sex, age, educational level, day of week of saliva collection, and exposure to SHS were always higher in hospitality workers than in the general population. Our results indicated that non-smoker hospitality workers have higher levels of exposure to SHS than general population.

  16. Perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general.

    OpenAIRE

    Casas, Paola; Médico Geriatra, Hospital Nacional Cayetano Heredia. Lima.; Varela, Luis; Médico Internista-Geriatra, Hospital Nacional Cayetano Heredia. Instituto de Gerontología, Universidad Peruana Cayetano Heredia. Lima.; Tello, Tania; Médico Geriatra, Hospital Nacional Cayetano Heredia. Instituto de Gerontología, Universidad Peruana Cayetano Heredia. Lima.; Ortiz, Pedro; Médico Internista, Hospital Nacional Arzobispo Loayza. Instituto de Gerontología, Universidad Peruana Cayetano Heredia. Lima.; Chávez, Helver; Médico Internista-Geriatra, Hospital Nacional Cayetano Heredia. Instituto de Gerontología, Universidad Peruana Cayetano Heredia. Lima.

    2012-01-01

    Objetivo: Describir el perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general. Material y métodos: Estudio descriptivo, transversal, realizado a través de encuestas aplicadas a pacientes en la consulta ambulatoria de geriatría del Hospital Nacional Cayetano Heredia (HNCH), entre agosto de 2011 y enero 2012. Resultados: Se evaluaron 290 pacientes, el 69,3% fueron mujeres; el 65,5% tenía entre 60 y 79 años. La hipertensión arterial fue el diagnóstico más frecuente (55,...

  17. [Participatory planning in health organizations: the case of the Bonsucesso General Hospital, Rio de Janeiro, Brazil].

    Science.gov (United States)

    Lima, Juliano de Carvalho; Faveret, Ana Cecília; Grabois, Victor

    2006-03-01

    This article presents the experience with participatory planning in the Bonsucesso General Hospital in Rio de Janeiro, Brazil, from 2003 to 2004. The participatory and communicative characteristics and the resulting institutional format are identified for guaranteeing the implementation of collective decisions from the planning workshops. The limits of implementation in participatory planning and management proposals are argued from the perspective of change and power relations in these institutions. The results support the notion that projects involving changes in hospitals and failing to take into account the different internal rationalities and power relations end up having reduced potential for implementation.

  18. Perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general.

    OpenAIRE

    Paola Casas; Luis Varela; Tania Tello; Pedro Ortiz; Helver Chávez

    2012-01-01

    Objetivo: Describir el perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general. Material y métodos: Estudio descriptivo, transversal, realizado a través de encuestas aplicadas a pacientes en la consulta ambulatoria de geriatría del Hospital Nacional Cayetano Heredia (HNCH), entre agosto de 2011 y enero 2012. Resultados: Se evaluaron 290 pacientes, el 69,3% fueron mujeres; el 65,5% tenía entre 60 y 79 años. La hipertensión arterial fue el diagnóstico más frecuente (55,...

  19. The Division of Libraries Serving the General Public--A Survey.

    Science.gov (United States)

    Glashoff, Ilona

    This paper provides an overview of the International Federation of Library Associations and Institutions (IFLA) Division III, a forum for the IFLA sections and round tables comprising libraries serving the general public, as well as special library services directed to specific groups of the general public, such as children, linguistic minorities,…

  20. Wildlife value orientations among hunters, landowners and the general public

    DEFF Research Database (Denmark)

    Gamborg, Christian; Jensen, Frank Søndergaard

    2016-01-01

    . Significant differences in wildlife value orientations were found. Mutualists and distanced dominated in the public; most landowners and hunters were utilitarian followed by pluralist. Male hunters were more utilitarian than female. More active hunters were more utilitarian; hunters belonging to a hunting...... association were more utilitarian than those who did not belong to associations. Full-time farmers were more utilitarian than part-time farmers, and conventional farmers were more utilitarian than organic farmers. No significant difference with regard to residence for all three groups was found. Future...

  1. Technical efficiency of public district hospitals in Madhya Pradesh, India: a data envelopment analysis

    Directory of Open Access Journals (Sweden)

    Tej Ram Jat

    2013-09-01

    Full Text Available Background: Scarcity of resources for healthcare is a well-acknowledged problem. In this context, efficient utilization of existing financial and human resources becomes crucial for strengthening the healthcare delivery. The assessment of efficiency of health facilities can guide decision makers in ensuring the optimum utilization of available resources. Objective: The objective of this study was to evaluate the technical efficiency (TE of the public district hospitals in Madhya Pradesh, India, with special emphasis on maternal healthcare services, using data envelopment analysis (DEA. Methods: Data from 40 district hospitals from January to December 2010 were collected from the health management information system and other records of the department of health and family welfare of the state. DEA was performed with input orientation and variable returns to scale assumption. Results: TE and scale efficiency scores of the district hospitals were 0.90 (SD = 0.14 and 0.88 (SD = 0.15, respectively. Of the total district hospitals in the study, 20 (50% were technically efficient constituting the ‘best practice frontier’. The other half were technically inefficient, with an average TE score of 0.79 (SD = 0.12 meaning that these hospitals could produce the same outputs by using 21% less inputs from current input levels. Twenty-six (65% district hospitals were found to be scale inefficient, manifesting a mean score of 0.81 (SD = 0.16. Conclusions: Half of the district hospitals in the study were operating inefficiently. Decision makers and administrators in the state should identify the causes of the observed inefficiencies and take appropriate measures to increase efficiency of these hospitals.

  2. Theoretical exploration of modern public hospital management system%现代公立医院管理制度的理论探索

    Institute of Scientific and Technical Information of China (English)

    秦银河

    2016-01-01

    建立现代公立医院管理制度是我国公立医院改革的核心内容,是解决人民群众看病就医现实问题的重要保证,是建设健康中国的重大战略举措。本文从总体要求、改革政府治理医院制度、规范医院内部管理制度、创新医院服务社会制度、强化组织领导五个方面进行了阐述,以促进现代公立医院管理制度的建立。%AbstractThe establishment of modern public hospital management system is the core of the reform of public hospitals in China, is an important guarantee to solve the problems of the people to see a doctor for medical treatment, and is a major strategic move to build a healthy China. The opinion was clarifi ed based on the general requirements, governance reform of hospital system, the regular hospital internal management system, innovation of hospital and society system, and strengthening organizational leadership, in order to promote the establishment of modern public hospital management system.

  3. [Caring for illegal immigrants within the public hospital: the need for an urgent solution].

    Science.gov (United States)

    Meltzer, Eyal; Elkayam, Ori

    2003-06-01

    There are a quarter of a million or more foreign laborers that work in Israel. Most of these foreign laborers lack a work permit and medical insurance. Hence, this population has low access to ambulatory medical care, with obvious consequences. When being treated in the public hospital, these illegal immigrants and the doctors caring for them face many problems, both practical and ethical. We review a number of cases illustrating some of these problems, and the danger they present to the work ethics and integrity of the public medical facility.

  4. Communicating airport noise emission data to the general public.

    Science.gov (United States)

    Gasco, Luis; Asensio, Cesar; de Arcas, Guillermo

    2017-05-15

    Despite the efforts that the aviation industry has undertaken during the last few decades, noise annoyance remains high, partly because of the continuous transport demands of modern societies and partly because of changes in citizen expectations and their growing environmental concerns. Although modern aircraft are considerably quieter than their predecessors, the number of complaints has not decreased as much as expected. Therefore, the aeronautical sector has tried more sociological and/or psychological strategies to gain acceptance through awareness and community engagement. In this regard, noise communication to the public is crucial for managers and policy makers. Noise information is a difficult technical topic for non-experts, which is an issue that must first be addressed to take advantage of the new possibilities that have recently been opened by the internet and information and communication technologies. In this review paper, we have compiled the literature that shows the increasing importance of communicating noise information from aircraft and the variety of indicators used to communicate with the public. We also examined the methods of representing noise data, using visualization strategies, and new tools airports are currently using to address this communication problem. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. The involvement of a consumer council in organizational decision making in a public psychiatric hospital.

    Science.gov (United States)

    Linhorst, D M; Eckert, A; Hamilton, G; Young, E

    2001-11-01

    This article describes a consumer group within a public psychiatric hospital that serves primarily a forensic population. Some barriers to participation included the severity of some clients' mental illness, an organizational culture that does not fully support participation, the lack of clients' awareness of problems or alternative actions, and inherent power imbalances between clients and staff. Despite these barriers, the consumer group has made improvements for facility clients. Some factors associated with this success included strong administrative support, the allocation of a highly qualified staff liaison to work with the group, and the integration of the group into the facility's formal decision-making structure. Lessons are offered for the development of similar groups within public psychiatric hospitals and community-based mental health agencies.

  6. [Validation of a scale to assess the labour quality of life in public hospitals from Tlaxcala].

    Science.gov (United States)

    Hernández-Vicente, Irma Alejandra; Lumbreras-Guzmán, Marivel; Méndez-Hernández, Pablo; Rojas-Lima, Elodia; Cervantes-Rodríguez, Margarita; Juárez-Flores, Clara Arlina

    2017-01-01

    To validate a scale for assessing the labour quality of life in public hospitals (LQL-PH) from Tlaxcala, Mexico. The instrument was validated among 669 health workers from six hospitals from the Ministry of Health of Tlaxcala, Mexico. Content validity was by inquiry to experts, construct validity by factor analysis, criterion validity by comparing with other scales, and reliability with Cronbach's Alpha. The factor analysis uncovered four dimensions: "individual welfare", "conditions and labour environment", "organization", and "well-being accomplished by the work"; reliability was 0.921. Workers who perceibed better LQL-PH were: under 50 years old, with temporary contract, with less seniority in job, with work schedule at daytime of weekends, and those with academic degree. LQL-PH showed to be an instrument phsycometrically valid and reliable. It's recommendable to prove this scale in other public and private health institutions, as well as its relationship with key health care indicators of labour performance and management.

  7. IMPACTS OF JOB RESOURCES ON NURSES’ PERFORMANCE WORKING IN PUBLIC SECTOR HOSPITALS

    Directory of Open Access Journals (Sweden)

    Rabiul Islam

    2013-01-01

    Full Text Available Job resources refers to the physical, psychological, social or organizational aspects of the job which are necessary in the achievement of goals and objectives, necessary for the reduction of the negative effects of job demands including the associated psychological and psychological costs and which promote personal growth, learning and development. The aim of the study is to analysis the impacts of job resources on nurses’ performance working in public hospitals. In order to achieve the study objective, a survey conducted. Questionnaires distributed to the public sector hospital’s manager in Saudi Arabia. The findings of the study turn out to be true; the study will contribute to both theory and practice. Through the present study, the researcher expects the findings to shed light on the research conducted regression to analysis the impacts of job resources on nurses’ performance.

  8. Assessing Accrual Accounting Reform in Greek Public Hospitals: An Empirical Investigation

    Directory of Open Access Journals (Sweden)

    Dimitrios Vasiliou

    2011-03-01

    Full Text Available During the last decades, several countries worldwide have introduced financial management reforms, as an important part of the New Public Management (NPM initiative at one or more levels of government sector, by either replacing or transforming their traditional budgetary cash accounting systems towards a business-like accrual accounting concept. Following the example of this upcoming managerial trend, the Greek government introduced in 2003 the accrual basis accounting into public hospitals, as the hospital sector is one of the areas where NPM reforms have been introduced in search of higher efficiency, effectiveness and economy in service production.The purpose of this paper is twofold. The first goal is to provide an overview of the government sector reform initiatives in Greece and to present empirical evidence regarding the adoption level of the accrual basis accounting standards in the Greek public Health sector. The second goal of the research is to investigate the impact of a range of potentially contingent factors on hospitals compliance with the accrual financial and cost accounting reform.The present analysis is based on the results of an empirical survey that took place during 2009. For the purposes of this survey, a structured questionnaire was prepared and sent to the Chief Financial Officers (CFOs of 132 Greek public hospitals. In particular, alinear regression model analysis was used to examine the cross-sectional differences on a number of explanatory and implementation factors of the accounting reform adoption level.The empirical evidence reveals that the level of accrual and especially cost accounting adoption in Greek public hospitals is realized only to a limited extent. In particular, results show that the level of reform adoption is positively related to IT quality, reform related training, education level of accounting staff, and professional consultants’ support. However, no significant relationship was found between

  9. Prevalence and risk factors of low back pain among nurses in a Thai public hospital.

    Science.gov (United States)

    Sopajareeya, Chuliporn; Viwatwongkasem, Chukiat; Lapvongwatana, Punyarat; Hong, Oisaeng; Kalampakorn, Surintorn

    2009-12-01

    To determine the prevalence and risk factors causing low back pain in Thai nurses working in a public hospital. A cross-sectional study was conducted among 265 Thai Hospital nurses between July and August 2008. A self-reported questionnaire was used to collect the data onsite. Risk factors including personal factors, working factors, job stress, health behavior, and work environment were measured. Data were analyzed by frequency distribution, mean, standard deviation, and logistic regression. The prevalent rate of low back pain based upon the nurses' report in the previous 12 months was 61.5%. Logistic regression analysis indicated that moving patients in bed without assistance and a lack of back muscle exercise were the significant risk factors causing low back pain among nurses (p back pain among Thai Hospital nurses was high. Further steps should be taken to prevent LBP by designing and implementing preventive factor-based interventions.

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

    Science.gov (United States)

    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.

  11. Race, Apology, and Public Memory at Maryland's Hospital for the 'Negro' Insane

    Directory of Open Access Journals (Sweden)

    Zosha Stuckey

    2017-03-01

    Full Text Available To respond to a recent demand of the ACLU of Maryland, and to augment theories from Disability Incarcerated (2014 about the convergence of race, disability, and due process (or lack thereof, this essay analyzes the extent to which racism informed the creation of Maryland's Hospital for the 'Negro' Insane (Crownsville Hospital. In order to understand the extent of racism in Crownsville's earlier years, I will take into account 14 categories within conditions of confinement from 1921-1928 and compare them to the nearby, white asylum. Ultimately, the hospital joins the ranks of separate and unequal (Plessy vs. Ferguson institutions founded alongside a rhetoric of fear that the Baltimore Sun daily paper deemed "a Black invasion" of the city of Baltimore. Even more, I add to public memory of this racialized space invoking the rhetorical frame, as Kendall Phillips advises, of responsibility and apology (versus absolution within the context of present-day racial justice movements.

  12. Analyzing patient's waiting time in emergency & trauma department in public hospital - A case study

    Science.gov (United States)

    Roslan, Shazwa; Tahir, Herniza Md; Nordin, Noraimi Azlin Mohd; Zaharudin, Zati Aqmar

    2014-09-01

    Emergency and Trauma Department (ETD) is an important element for a hospital. It provides medical service, which operates 24 hours a day in most hospitals. However overcrowding is not exclusion for ETD. Overflowing occurs due to affordable services provided by public hospitals, since it is funded by the government. It is reported that a patient attending ETD must be treated within 90 minutes, in accordance to achieve the Key Performance Indicator (KPI). However, due to overcrowd situations, most patients have to wait longer than the KPI standard. In this paper, patient's average waiting time is analyzed. Using Chi-Square Test of Goodness, patient's inter arrival per hour is also investigated. As conclusion, Monday until Wednesday was identified as the days that exceed the KPI standard while Chi-Square Test of Goodness showed that the patient's inter arrival is independent and random.

  13. Parenteral Admixture Compatibility in Neurosurgery Ward in Prof. Dr. Margono Soekarjo Regional Public Hospital

    Directory of Open Access Journals (Sweden)

    Laksmi Maharani

    2014-03-01

    Full Text Available Parenteral admixtures (intravenous admixtures have been done commonly in hospitals. However, it has a possibility of failures, like incompatibilities and changes in drug stabilities. The aim of this study was to determine the rate of drug incompatibilities in mixing parenteral preparations in neurosurgery ward in Prof. Dr. Margono Soekarjo Regional Public Hospital which undergo physical incompatibility observed in organoleptic. This study was a prospective descriptive research for one month period. Data were collected and analyzed descriptively. The results showed that from 667 parenteral admixtures in neurosurgery ward in Prof Dr Margono Soekarjo Hospital in February 2010, there were 0.45% potential incompatibility and 2.55% actual incompatibility happened. Actual incompatibility shown as crystal 0.17%, sediment 0.17%, and 2.04% was non-permanent haze in phenytoin and sodium chloride or ringer lactate admixtures.

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

    OpenAIRE

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

    2013-01-01

    OBJECTIVES: 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. METHODS: Cross-sectional study in which data were collected from medical records of patients in the period from July to December 2008. RESULTS: 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,t...

  15. Anemia and hemoglobinopathies in pregnant women attended in a public hospital

    OpenAIRE

    Sakamoto, Tatiana Mary; Ivo, Maria Lúcia; Blum, Maria Aparecida Rogado; Pontes, Elenir Rose Jardim Cury; Ferreira Júnior,Marcos Antonio; DOMINGOS, Claudia Regina Bonini

    2012-01-01

    Objectives: to identify the demographic profile and frequency of anemia and hemoglobinopathies, as a basis for future implementation of actions aimed at pregnant women in the public health domain. Method: this is a cross-sectional study developed with pregnant women attended in a university hospital at Mato Grosso do Sul, Brazil. Blood samples were collected for the erythrogram analysis for detection of anemia and selective and specific tests for abnormal hemoglobin. The patients regarded as ...

  16. Impact of cultural factors on attitude toward using ERP systems in public hospitals

    OpenAIRE

    Tomás Escobar-Rodríguez; Lourdes Bartual-Sopena

    2015-01-01

    The main problems that arise in adopting most enterprise resources planning (ERP) strategies come from organizational, rather than technical, issues, for example, social and cultural barriers, and user resistance. This paper analyzes the impact of cultural factors on user attitudes toward ERP use in public hospitals and identifying influencing factors. The theoretical grounding for this research is the Technology Acceptance Model (TAM). The proposed model has six constructs (“resistance to be...

  17. Technical efficiency of public district hospitals and health centres in Ghana: a pilot study

    Directory of Open Access Journals (Sweden)

    Kirigia Joses M

    2005-09-01

    Full Text Available Abstract Background The Government of Ghana has been implementing various health sector reforms (e.g. user fees in public health facilities, decentralization, sector-wide approaches to donor coordination in a bid to improve efficiency in health care. However, to date, except for the pilot study reported in this paper, no attempt has been made to make an estimate of the efficiency of hospitals and/or health centres in Ghana. The objectives of this study, based on data collected in 2000, were: (i to estimate the relative technical efficiency (TE and scale efficiency (SE of a sample of public hospitals and health centres in Ghana; and (ii to demonstrate policy implications for health sector policy-makers. Methods The Data Envelopment Analysis (DEA approach was used to estimate the efficiency of 17 district hospitals and 17 health centres. This was an exploratory study. Results Eight (47% hospitals were technically inefficient, with an average TE score of 61% and a standard deviation (STD of 12%. Ten (59% hospitals were scale inefficient, manifesting an average SE of 81% (STD = 25%. Out of the 17 health centres, 3 (18% were technically inefficient, with a mean TE score of 49% (STD = 27%. Eight health centres (47% were scale inefficient, with an average SE score of 84% (STD = 16%. Conclusion This pilot study demonstrated to policy-makers the versatility of DEA in measuring inefficiencies among individual facilities and inputs. There is a need for the Planning and Budgeting Unit of the Ghana Health Services to continually monitor the productivity growth, allocative efficiency and technical efficiency of all its health facilities (hospitals and health centres in the course of the implementation of health sector reforms.

  18. Cost analysis for efficient management: diabetes treatment at a public district hospital in Thailand.

    Science.gov (United States)

    Riewpaiboon, Arthorn; Chatterjee, Susmita; Piyauthakit, Piyanuch

    2011-10-01

    OBJECTIVE  The study estimated cost of illness from the provider's perspective for diabetic patients who received treatment during the fiscal year 2008 at Waritchaphum Hospital, a 30-bed public district hospital in Sakhon Nakhon province in northeastern Thailand. METHODS  This retrospective, prevalence-based cost-of-illness study looked at 475 randomly selected diabetic patients, identified by the World Health Organization's International Classification of Diseases, 10th revision, codes E10-E14. Data were collected from the hospital financial records and medical records of each participant and were analysed with a stepwise multiple regression. KEY FINDINGS  The study found that the average public treatment cost per patient per year was US$94.71 at 2008 prices. Drug cost was the highest cost component (25% of total cost), followed by inpatient cost (24%) and outpatient visit cost (17%). A cost forecasting model showed that length of stay, hospitalization, visits to the provincial hospital, duration of disease and presence of diabetic complications (e.g. diabetic foot complications and nephropathy) were the significant predictor variables (adjusted R(2) = 0.689). CONCLUSIONS  According to the fitted model, avoiding nephropathy and foot complications would save US$19 386 and US$39 134 respectively per year. However, these savings are missed savings for the study year and the study hospital only and not projected savings, as that would depend on the number of diabetic patients managed in the year, the ratio of complicated to non-complicated cases and effectiveness of the prevention programmes. Nonetheless, given the high avoidable cost associated with complications of diabetes, healthcare providers in Thailand should focus on initiatives that delay the progression of complications in diabetic patients.

  19. The clinical pathway for hypertensive patient of local health unit, hospitals and general practitioners, the Milan experience.

    Science.gov (United States)

    Donzelli, Alberto; Sghedoni, Donatella; Carelli, Francesco A; Chirchiglia, Saverio; Manunta, Paolo

    2011-01-01

    The Clinical Pathway (in its complete definition Diagnostic, Clinical and Therapeutic Pathway - Percorso Diagnostico Terapeutico Assistenziale - PDTA), originally started to deal with the newly diagnosed hypertensive patient, developed also recommendations for the first-line drugs in case of specific indications/contraindications and organ damages. It has been developed by a working group of specialists in cardiology, nephrology, internal medicine (faculty included) designated by their hospitals (both public and private accredited), including all the main city hospitals, by general practitioners designated by the Medical Unions SNAMI, FIMMG, SMI and SiMI and by public health doctors belonging to the Local Health Unit of Milan, who have coordinated the proceedings and have guaranteed that possible conflicts of interest of single participants could not interfere with the PDTA, anyway approved by all in July 2009. The PDTA deals with the measuring and self- home-monitoring of blood pressure (BP) and the diagnosis of hypertension; it revises, sometimes "dries up" and rationalizes the recommendations for diagnostic tests and specialist evaluations; it develops prevention and non-pharmacological treatments, proposing also tools for patients and for prescribing correct nutrition and physical activity and a structured program for BP monitoring; but the main feature is the innovations brought in the proposed drug treatment in comparison with the current clinical practice.

  20. Prevalence of intestinal parasite infections among patients in local public hospitals of Hail, Northwestern Saudi Arabia.

    Science.gov (United States)

    Hassen Amer, Omar; Ashankyty, Ibraheem M; Haouas, Najoua Al Sadok

    2016-01-01

    To evaluate the prevalence of intestinal parasites among patients in Hail, Northwestern Saudi Arabia. Stool samples were collected from 130 patients (69 females and 61 males) in Hail General Hospital. Each sample was examined by direct wet mount microscopic examination using both normal saline and Lugol's iodine preparation and concentration techniques using salt and formol-ether solutions. Permanent stained smears were performed for intestinal coccidian using modified Ziehl-Neelsen technique. The overall prevalence of intestinal parasitic infection was 45.38% (59 cases). Forty-four (33.84%) were found to be infected with one or more intestinal protozoa, 5 (3.84%) were infected with helminthes and 10 (7.69%) had mixed infection with both helminthes and protozoa. The most common intestinal helminth detected was Ancylostoma duodenale (n = 5, 3.84%), followed by Ascaris lumbricoides, Taenia sp. and Trichuris trichiura (n = 2 for each species, 1.5%). For intestinal protozoa, the coccidian Cryptosporidium parvum (n = 25, 19.23%) was the most common followed by Entamoeba histolytica/dispar (n = 21, 16.15%), Giardia lamblia (n = 15, 11.54%), Entamoeba coli (n = 5, 3.85%) and Blastocystis hominis (n = 3, 2.30%). The prevalence of intestinal parasitic infections in females was significantly higher than in males (P < 0.05). This is the first study highlighting that intestinal parasites are still an important public health problem in Northwestern Saudi Arabia. Therefore, health education would be the best way to prevent from intestinal parasite infections which are mainly food borne diseases. Copyright © 2016 Hainan Medical College. Production and hosting by Elsevier B.V. All rights reserved.

  1. Prevalence of intestinal parasite infections among patients in local public hospitals of Hail, Northwestern Saudi Arabia

    Institute of Scientific and Technical Information of China (English)

    Omar Hassen Amer; Ibraheem M Ashankyty; Najoua Al Sadok Haouas

    2016-01-01

    Objective: To evaluate the prevalence of intestinal parasites among patients in Hail, Northwestern Saudi Arabia. Methods: Stool samples were collected from 130 patients (69 females and 61 males) in Hail General Hospital. Each sample was examined by direct wet mount microscopic examination using both normal saline and Lugol’s iodine preparation and concentration techniques using salt and formol-ether solutions. Permanent stained smears were performed for intestinal coccidian using modified Ziehl-Neelsen technique. Results: The overall prevalence of intestinal parasitic infection was 45.38% (59 cases). Forty-four (33.84%) were found to be infected with one or more intestinal protozoa, 5 (3.84%) were infected with helminthes and 10 (7.69%) had mixed infection with both helminthes and protozoa. The most common intestinal helminth detected was Ancylostoma duodenale (n=5, 3.84%), followed by Ascaris lumbricoides, Taenia sp. and Trichuris trichiura (n=2 for each species, 1.5%). For intestinal protozoa, the coccidian Cryptosporidium parvum (n=25, 19.23%) was the most common followed by Entamoeba histolytica/dispar (n=21, 16.15%), Giardia lamblia (n=15, 11.54%), Entamoeba coli (n=5, 3.85%) and Blastocystis hominis (n=3, 2.30%). The prevalence of intestinal parasitic infections in females was significantly higher than in males (P<0.05). Conclusions: This is the first study highlighting that intestinal parasites are still an important public health problem in Northwestern Saudi Arabia. Therefore, health education would be the best way to prevent from intestinal parasite infections which are mainly food borne diseases.

  2. Implementation of a trauma registry in a Brazilian public hospital: the first 1,000 patients.

    Science.gov (United States)

    Carreiro, Paulo Roberto Lima; Drumond, Domingos André Fernandes; Starling, Sizenando Vieira; Moritz, Mônica; Ladeira, Roberto Marini

    2014-01-01

    Show the steps of a Trauma Registry (TR) implementation in a Brazilian public hospital and evaluate the initial data from the database. Descriptive study of the a TR implementation in João XXIII Hospital (Hospital Foundation of the state of Minas Gerais) and analysis of the initial results of the first 1,000 patients. The project was initiated in 2011 and from January 2013 we began collecting data for the TR. In January 2014 the registration of the first 1000 patients was completed. The greatest difficulties in the TR implementation were obtaining funds to finance the project and the lack of information within the medical records. The variables with the lowest completion percentage on the physiological conditions were: pulse, blood pressure, respiratory rate and Glasgow coma scale. Consequently, the Revised Trauma Score (RTS) could be calculated in only 31% of cases and the TRISS methodology applied to 30.3% of patients. The main epidemiological characteristics showed a predominance of young male victims (84.7%) and the importance of aggression as a cause of injuries in our environment (47.5%), surpassing traffic accidents. The average length of stay was 6 days, and mortality 13.7%. Trauma registries are invaluable tools in improving the care of trauma victims. It is necessary to improve the quality of data recorded in medical records. The involvement of public authorities is critical for the successful implementation and maintenance of trauma registries in Brazilian hospitals.

  3. Implementation of a trauma registry in a brazilian public hospital: the first 1,000 patients

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    Paulo Roberto Lima Carreiro

    Full Text Available OBJECTIVE: Show the steps of a Trauma Registry (TR implementation in a Brazilian public hospital and evaluate the initial data from the database.METHODS: Descriptive study of the a TR implementation in João XXIII Hospital (Hospital Foundation of the state of Minas Gerais and analysis of the initial results of the first 1,000 patients.RESULTS: The project was initiated in 2011 and from January 2013 we began collecting data for the TR. In January 2014 the registration of the first 1000 patients was completed. The greatest difficulties in the TR implementation were obtaining funds to finance the project and the lack of information within the medical records. The variables with the lowest completion percentage on the physiological conditions were: pulse, blood pressure, respiratory rate and Glasgow coma scale. Consequently, the Revised Trauma Score (RTS could be calculated in only 31% of cases and the TRISS methodology applied to 30.3% of patients. The main epidemiological characteristics showed a predominance of young male victims (84.7% and the importance of aggression as a cause of injuries in our environment (47.5%, surpassing traffic accidents. The average length of stay was 6 days, and mortality 13.7%.CONCLUSION: Trauma registries are invaluable tools in improving the care of trauma victims. It is necessary to improve the quality of data recorded in medical records. The involvement of public authorities is critical for the successful implementation and maintenance of trauma registries in Brazilian hospitals.

  4. Integrating context-aware public displays into a mobile hospital information system.

    Science.gov (United States)

    Favela, Jesus; Rodríguez, Marcela; Preciado, Alfredo; González, Victor M

    2004-09-01

    Hospitals are convenient settings for deployment of ubiquitous computing technology. Not only are they technology-rich environments, but their workers experience a high level of mobility resulting in information infrastructures with artifacts distributed throughout the premises. Hospital information systems (HISs) that provide access to electronic patient records are a step in the direction of providing accurate and timely information to hospital staff in support of adequate decision-making. This has motivated the introduction of mobile computing technology in hospitals based on designs which respond to their particular conditions and demands. Among those conditions is the fact that worker mobility does not exclude the need for having shared information artifacts particular locations. In this paper, we extend a handheld-based mobile HIS with ubiquitous computing technology and describe how public displays are integrated with handheld and the services offered by these devices. Public displays become aware of the presence of physicians and nurses in their vicinity and adapt to provide users with personalized, relevant information. An agent-based architecture allows the integration of proactive components that offer information relevant to the case at hand, either from medical guidelines or previous similar cases.

  5. The fall and rise of TQM at a public mental health hospital.

    Science.gov (United States)

    Chowanec, G D

    1996-01-01

    Public mental health care is undergoing a period of fundamental change as it attempts to adapt to an environment characterized by increasing fiscal constraints, the need to demonstrate effectiveness of services, and consumer empowerment. Total quality management (TQM) provides a framework that enables mental health care to meet these demands. The author provides his perspective on a public, multipurpose psychiatric hospital's (Georgia Regional Hospital at Augusta) experience in making the transition from quality assurance to TQM. Successful implementation of TQM rests on clinical staff's viewing TQM as a useful mechanism for achieving agreed-on patient/customer goals. Staff cannot simply do what they have been doing, but now do it better; there needs to be an understanding of what "better" means. TQM'S INTRODUCTION AND REINTRODUCTION: When first introduced in 1992, TQM was viewed by staff as the latest variant of quality assurance--and was therefore unsuccessful. When reintroduced in 1993, TQM contributed to the development of a psychosocial rehabilitation program. The staff's active involvement in establishing patient-specific goals was critical to the program's success. The hospital's Performance Improvement Committee has spearheaded the monitoring of treatment programs and the development of critical paths. In developing critical paths, the treatment team sets goals for patients' improvement both within the hospital and postdischarge and for treatment processes. The keys to a successful TQM program are effective leadership, a clear organizational mission, customer-oriented performance goals, staff empowerment, and the application of the scientific method to the workings of the organization.

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

    Science.gov (United States)

    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.

  7. Troponin T: role in altering patient management and enabling earlier discharge from a district general hospital.

    Science.gov (United States)

    Owen, A; Khan, W; Griffiths, K D

    2001-03-01

    The use of troponin T to facilitate early patient discharge was investigated in a prospective study in a district general hospital. Troponin T was measured in 91 patients admitted over a period of 6 months with chest pain but without evidence of myocardial infarction. The main outcome measure was length of hospital stay. A negative troponin T was found in 70 patients. Fifty of these were discharged within 24 h of the troponin result being available and they had a significantly shorter hospital stay than a case control group and a historical control group from the previous 6 months. Troponin T measurement has a role in altering patient management by enabling early discharge, resulting in significant cost savings and increasing bed availability.

  8. Factors Affecting The Adoption Of Mhealth In Maternal Health Care In Nakuru Provincial General Hospital

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    Simon Munyua

    2015-08-01

    Full Text Available Abstract Access to timely and quality maternal health care remains to be a major development challenge in many developing economies particularly in Kenya. The countrys system of providing maternal health care also continue to be anchored on conventional methods of physical presence of the patient and the doctor in a hospital setup. The countrys ICT and health policies also place very little emphasis on the use of these platforms. This study therefore sought to establish the factors affecting the adoption of mHealth by focusing on maternal health in Nakuru Provincial General Hospital. Objectives of the study were to determine the extent to knowledge and awareness affects the adoption of mHealth in maternal health care at Nakuru PGH to identify the government policies affecting the adoption of mHealth in maternal health care at Nakuru PGH to assess how access to technology affects the adoption of mHealth in maternal healthcare to establish the effects of ICT infrastructure on the adoption of mHealth in maternal health care and to identify the cost aspects affecting the adoption of mHealth in maternal health care at Nakuru Provincial General Hospital. It is envisaged that the study could provide useful information on the adoption of mHealth in managing maternal health care in Nakuru Provincial General Hospital. Descriptive survey research design will be used where all the medical staff and patients of Nakuru Provincial General Hospital was surveyed. The study population therefore was made up of 24 medical staff and 3460 mothers visiting the antenatal clinic selected using clustered random sampling technique. The main instrument for primary data collection was the questionnaire. Data analysis was then done using both descriptive and inferential statistics. Descriptive statistics to be used include frequency counts percentages and measures of central tendency. Inferential statistics on the other hand include t-test analysis and spearman correlation

  9. ROMANIA'S PUBLIC DEBT AND GENERAL FRAMEWORK FISCAL-BUDGETARY POLICY

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    CHIRCULESCU MARIA FELICIA

    2014-05-01

    Full Text Available We appreciate that a developing country cannot build a solid democracy, based on a competitive economy and a system of social and economic infrastructure upgraded, rather than calling on foreign funding, generating external debt. At the basis of capitalist economies development credit is widely used at macro-economic level. Its role is to provide the opportunity to spend now and pay in a period to come, when the investment start to bring profit. For Romania, as well, for any State that resort to foreign loans, it is important that they be used for the development and modernization of the economy and infrastructure services and consumption, not only because it creates the potential for achieving sustainable growth, including by stimulating exports, creating the necessary resources as public foreign debt service to be honored.

  10. Hospital volunteerism as human resource solution: Motivation for both volunteers and the public health sector

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    Guinevere M. Lourens

    2017-01-01

    Full Text Available Background: A volunteer programme with 50 registered volunteers was established in 2007 at a secondary-level public, semi-rural regional hospital in the Cape Winelands, South Africa. This was a rapid response to the extensive renovations and system changes brought about by the hospital revitalisation initiated in 2006 and the resultant expanded services, which required additional human resources. This study describes the hospital volunteer programme and provides hospital administrators with practical planning guidance for hospital volunteer programme implementation.Purpose: The purpose of this study is to (1 describe the outcomes of the hospital volunteer programme implementation intervention and (2 to make sound recommendations for volunteer programme implementation.Methodology and approach: A qualitative case-study methodology was employed using purposive sampling as a technique. Participants were recruited from a public hospital in the Western Cape. A case-study design was applied to explore the hospital volunteer programme implementation. In-depth interviews and a focus group discussion with thematic content analysis of transcripts as well as document reviews were conducted to conclude the study during 2015. The key participants were individually interviewed and included two members of the hospital management, two volunteers and one volunteer coordinator. A focus group discussion consisting of three volunteers was also conducted.Findings: The findings of this study indicate that a volunteer programme can meet needs and be a motivational force for both the individual volunteer and the organisation. However, it requires co-ordination and some secure funding to remain sustainable. Such a programme holds huge benefits in terms of human resource supplementation, organisational development, as well as the possibility of gainful employment for the previously unemployed.Practical implications: In practice, a health service contemplating a volunteer

  11. The effects of communication techniques on public relation activities: A sample of hospitality business

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    Şirvan Şen Demir

    2011-07-01

    Full Text Available Nowadays, firms who give importance to public relations have been increasing rapidly in numbers. All modern firms either found public relations department in their body to deal with public relations operations or outsource this activity to consultants in order to communicate with target populations. Among the firms in tourism sector, hospitality companies are the ones that use public relations the most. The purpose of this study is to investigate the communication techniques in public relation and effects of these techniques on public relation activities. A literature review was conducted for research model and then questionnaire was developed from the studies in the literature. Data were collected by researchers in face-to-face interviews with 145 supervisors who are responsible for public relation activities of the hotel and were analyzed with SPSS statistical programs. Structural and convergent validity of the data have revealed with the explanatory factor analysis. It was tested using a regression analysis to determine the effects of independent variables on dependent variables. As a result, independent variables have positive effects on the dependent variables.

  12. Public Health Aspects of Paediatric Dental Treatment under General Anaesthetic

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    William Murray Thomson

    2016-06-01

    Full Text Available Early childhood caries (ECC has negative psychosocial effects on children, with chronic pain, changed eating habits, disrupted sleep and altered growth very common, and it disrupts the day-to-day lives of their families. The treatment of young children with ECC places a considerable burden on health systems, with a considerable amount having to be provided under general anaesthesia (GA, which is resource-intensive. Justifying its use requires evidence of the efficacy of treatment in improving the lives of affected children and their families. This paper discusses the available evidence and then makes some suggestions for a research agenda.

  13. A STUDY ON THE CULTURAL DIFFERENCES BETWEEN PUBLIC AND PRIVATE HOSPITALS IN BUCHAREST

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    Dobre Ovidiu Iliuta

    2013-07-01

    Full Text Available Turnover rates for hospital personnel (nurses, doctors and auxiliary staff have been increasing in recent years, especially in the public sector, being the result of a couple of factors. I believe that one of the main causes is related to organizational culture aspects. This research analyses if dated facilities, unpleasant work environment and lack of personnel contribute to a low job satisfaction and involvement. The study also compares the results obtained from persons working in the public sectors with the results given by respondents from private clinics. An organization’s culture could be strong or weak, being dependent to cohesiveness, value consensus and individual commitment to collective goals. Effective cultures help organizations anticipate and adapt to environment changes, thus proactive cultures should enhance and support profitability on the long-run. This research also investigates strength of the occupational culture by comparing the results obtained in the public sector with results from private sector. My study is developed on 63 professionals working in the medical system and it is based mainly on quantitative methods. The instrument of the research is the structured questionnaire. The main goal of the study is to highlight the significant cultural differences between the state-owned and public-owned hospitals and to assess if they have a greater influence to the institutions, as compared to common occupational values and norms. The implications of my research for the field of organizational behavior refers to the fact that I have identified the organizational elements that are common to both public and private hospitals, influenced by a strong occupational culture, and those that differ significantly, being the result of underfunding and poor management. As a conclusion, I consider that this is a great starting point for further research in the field and I plan to enlarge the investigation on a greater number or

  14. [General information system through whole hospital and electronic medical record system].

    Science.gov (United States)

    Goto, Takaaki

    2006-02-01

    A new system has been introduced and implemented at the Nagoya City University Hospital since January 2004 in order to improve services for patients and general operation for management of the hospital. General Information System has been consisted with Electronic Medical Record System (EMRS), which is the core of all system and divisional system such as Clinical Laboratory Tests, Images, Medical Accounting and so on. A new system has been built and operated to work with the EMRS at the Department of Central Clinical Laboratory (CCL). To cooperate with the new system, we have constructed and operated directly the EMRS such as automatic registration the latest information on infectious diseases and blood transfusions, clinical reports on laboratory test through the hospital news and/or e-mail, introducing laboratory pre test before the consultation, rapid reports of panic values to the doctor in charge of the patients directly, the new system build up a closer cooperation between division of blood transfusion division and that of immuno-chemistry in CCL through EMRS. The new system has been brought not only efficiency and strengthen of function in CCL but also strengthen the service to patients in the hospital.

  15. Influenza and pneumococcal vaccinations in dialysis patients in a London district general hospital.

    Science.gov (United States)

    Wilmore, Stephanie M S; Philip, Keir E; Cambiano, Valentina; Bretherton, Christopher P; Harborne, Josephine E; Sharma, Aditi; Jayasena, Shyama D

    2014-02-01

    Patients on dialysis mount reduced immune responses compared with the general population. The Department of Health advises that these patients receive influenza and pneumococcal vaccinations at regular intervals-once yearly and every five years, respectively. This article investigates the uptake of these vaccinations in this patient population and seeks to examine factors that may influence vaccination status such as patient's language and presence of a general practitioner (GP) electronic vaccination reminder system. It also explores preferred site of vaccination for patients and GPs as these are primary care vaccinations yet patients have more frequent contact with their dialysis unit than their GP, blurring the boundaries between primary and specialized care. This is a retrospective study of all patients registered as dialysing at the North Middlesex University Hospital NHS Trust (NMUH) in September 2011. Information was obtained through GP letters, GP and patient questionnaires. Of 154 patients, 133 were included in the data analysis. Nineteen per cent were up-to-date with both vaccinations and 67% with their influenza vaccination. Fifty per cent had received the influenza vaccination in the last two consecutive years. Thirty per cent were not up-to-date with either vaccination. There was no evidence of a difference in uptake in 2009 (P = 0.7564) and in 2010 (P = 0.7435) among those who could and could not speak English. Twenty-five per cent of GPs and 58.6% of patients preferred vaccination to occur in the dialysis unit. Unfortunately a high number of GPs did not provide information on whether they used an electronic vaccination reminder but the analysis from the information provided by the few respondents did not reveal any correlation between the presence of an electronic reminder and vaccination status. Most dialysis patients were not up-to-date with both vaccinations. They were, however, more up-to-date with their influenza than their pneumococcal

  16. Crisis management, capabilities and preparedness: the case of public hospitals in Iran.

    Science.gov (United States)

    Najafbagy, Reza

    2010-01-01

    Crises occurred in recent decades show that organizations' preparedness to predict and respond to undesired problems is directly related to the degree of their capabilities and preparedness to manage crises in this context, hospitals compared to other organizations are more viable to suffer damages if a crisis occurs. This study investigates the degree of public hospitals capabilities and preparedness to handled possible crises. Responses from hospital managers and directors show that most of them were not familiar with crisis management, while majority of them mentioned that they had crisis management plan and committee in their hospitals. Moreover, most of the respondents believed that if a crisis occurs in the hospital, patients, personnel and documents will be the first victims of the crisis. The study also indicates that having a crisis plan and crisis committee without being familiar with knowledge of crisis management, do not help managers to cope with crisis. Moreover, correlations show that older managers were more familiar with crisis management experiences abroad, and defined responsibilities contributed to setting up crisis committee, and taking crisis seriously.

  17. Antibiotic resistance and therapeutic management of sepsis in a Malaysian public Hospital

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    Forouzan Bayat Nejad

    2009-12-01

    Full Text Available This study aims to document the microbial profile and pattern of use of antibiotics in the government hospital of Penang state, Malaysia. An audit was conducted in 2007 in the general medical ward of Hospital Pulau Pinang, Malaysia. The mortality rate was 54.22% with severesepsis or septicaemia. Mithicillin resistant staphylococcus aureus caused 37% of deaths, while 33% of deaths involved Klebsiella Spp. Commonly prescribed antibiotics included; cloxacillin 500mg (qid 20%, tazocin 2gm (bid1.1%, and vancomycin 1gm (od 27%. We report the useof high doses of antibiotics in the six months prior to anotable rise in resistant infections.

  18. [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

  19. Noise at night in hospital general wards: a mapping of the literature.

    Science.gov (United States)

    Fillary, Julie; Chaplin, Hema; Jones, Gill; Thompson, Angela; Holme, Anita; Wilson, Patricia

    English NHS inpatient surveys consistently identify that noise at night in hospitals and its impact on patients' sleep is a persisting problem that needs addressing. To identify how noise at night in hospital affects patients on general wards and the range of interventions aimed at reducing the problem, a systematic mapping of the literature was undertaken. All primary studies and relevant literature published January 2003-July 2013 were included. Key issues identified in the literature included noise levels and causes, impact on patient experience, and lack of staff awareness. Interventions to reduce noise were targeted at staff education, behaviour modification, care organisation and environmental solutions. The scoping suggested that when compared with specialist units, there is little evidence on effective interventions reducing disturbance from night-time noise on general wards. The available evidence suggests a whole systems approach should be adopted to aid quality sleep and promote recovery.

  20. Using science centers to expose the general public to the microworld

    Energy Technology Data Exchange (ETDEWEB)

    Malamud, E. [Fermi National Accelerator Lab., Batavia, IL (United States)]|[Science and Technology Interactive Center, Aurora, IL (United States)

    1994-08-01

    Despite the remarkable progress in the past decades in understanding our Universe, we particle physicists have failed to communicate the wonder, excitement, and beauty of these discoveries to the general public. I am sure all agree there is a need, if our support from public funds is to continue at anywhere approximating the present level, for us collectively to educate and inform the general public of what we are doing and why. Informal science education and especially science and technology centers can play an important role in efforts to raise public awareness of particle physics in particular and of basic research in general. Science Centers are a natural avenue for particle physicists to use to communicate with and gain support from the general public.

  1. Psiquiatría de Enlace. Experiencia en el Hospital General de México

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    I.C. González-Salas

    2014-07-01

    El objetivo de este trabajo es revisar algunos antecedentes históricos de la Salud Mental en México y en el Hospital General de México «Dr. Eduardo Liceaga» (HGM-DEL considerando la evolución institucional y las características de los pacientes que recibe el Servicio de Salud Mental, como parte del equipo multidisciplinario de salud.

  2. Trends in surgical site infections in general surgery at a tertiary hospital

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    B. Ravinder Reddy

    2012-01-01

    Full Text Available Surgical site infections (SSI are a preventable cause of hospital acquired infections, which increase morbidity and mortality. This is a retrospective analysis of SSIs in patients undergoing general surgical and gastroenterological operations. The observed incidence was 3.63%. The commonest procedures resulting in SSI were those who underwent laparotomy for bowel resections. The commonest organisms isolated were Enterococcus and Klebsiella species. SSIs can be further reduced by strict adherence to SSI prevention guide-lines.

  3. A qualitative study on nurses' reactions to inpatient suicide in a general hospital

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    Shujie Wang

    2016-12-01

    Conclusions: Nurses who experienced inpatient suicide became stressed. Effective interventions must be implemented to improve the coping mechanisms of nurses against the negative consequences of inpatient suicide. The findings of this study will allow administrators to gain insight into the impacts of inpatient suicides on nurses in general hospitals. Such information can be used to develop effective strategies and provide individual support and ongoing education. Consequently, nurses will acquire suicide prevention skills and help patients achieve swift recovery.

  4. Analysis of referrals received by a psychiatric unit in a general hospital Part 2

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    VJ Ehlers

    2002-01-01

    Full Text Available The study sought to analyse the referrals received by a psychiatric unit in a general hospital in the Western Cape by studying the referral letters and the referral responses.

    Opsomming
    Hierdie navorsing het gepoog om verwysings te ontleed wat deur 'n psigiatriese eenheid in 'n algemene hospitaal in die Wes Kaap ontvang is. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

  5. Cost accounting of radiological examinations. Cost analysis of radiological examinations of intermediate referral hospitals and general practice.

    Science.gov (United States)

    Lääperi, A L

    1996-01-01

    The purpose of this study was to analyse the cost structure of radiological procedures in the intermediary referral hospitals and general practice and to develop a cost accounting system for radiological examinations that takes into consideration all relevant cost factors and is suitable for management of radiology departments and regional planning of radiological resources. The material comprised 174,560 basic radiological examinations performed in 1991 at 5 intermediate referral hospitals and 13 public health centres in the Pirkanmaa Hospital District in Finland. All radiological departments in the hospitals were managed by a specialist in radiology. The radiology departments at the public health care centres operated on a self-referral basis by general practitioners. The data were extracted from examination lists, inventories and balance sheets; parts of the data were estimated or calculated. The radiological examinations were compiled according to the type of examination and equipment used: conventional, contrast medium, ultrasound, mammography and roentgen examinations with mobile equipment. The majority of the examinations (87%) comprised conventional radiography. For cost analysis the cost items were grouped into 5 cost factors: personnel, equipment, material, real estate and administration costs. The depreciation time used was 10 years for roentgen equipment, 5 years for ultrasound equipment and 5 to 10 years for other capital goods. An annual interest rate of 10% was applied. Standard average values based on a sample at 2 hospitals were used for the examination-specific radiologist time, radiographer time and material costs. Four cost accounting versions with varying allocation of the major cost items were designed. Two-way analysis of variance of the effect of different allocation methods on the costs and cost structure of the examination groups was performed. On the basis of the cost analysis a cost accounting program containing both monetary and

  6. Knowledge and Attitude of 851 Nursing Personnel toward Depression in General Hospitals of Korea.

    Science.gov (United States)

    Park, Seon-Cheol; Lee, Hwa-Young; Lee, Dong-Woo; Hahn, Sang-Woo; Park, Sang-Ho; Kim, Yeo-Ju; Choi, Jae Sung; Lee, Ho-Sung; Lee, Soyoung Irene; Na, Kyoung-Sae; Jung, Sung Won; Shim, Se-Hoon; Choi, Joonho; Paik, Jong-Woo; Kwon, Young-Joon

    2015-07-01

    Our study aimed to examine the knowledge and attitude of nursing personnel toward depression in general hospitals of Korea. A total of 851 nursing personnel enrolled at four university-affiliated general hospitals completed self-report questionnaires. Chi-square tests were used to compare the knowledge and attitude of registered or assistant nurses toward depression. In addition, binary logistic regression analysis was used to adjust for the following confounders: age-group and workplace. Registered and assistant nurses differed in their knowledge and attitude toward depression. The proportion of rational and/or correct responses were higher in registered nurses than assistant nurses for the following: constellation of depressive symptoms defined by DSM-IV (adjusted odds ratio [aOR], 3.876; Ppsychological stress as a cause of depression (aOR, 4.370; Ppersonnel need to be developed in Korea. Our findings can contribute to the development of a general hospital-based model for early detection of depression in patients with chronic medical diseases.

  7. Indications of Tonsillectomy and Adenoidectomy in Dr. Hasan Sadikin General Hospital Bandung

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    Dini Atiyah

    2015-03-01

    Full Text Available Background: Tonsillectomy is the intervention to take out the palatine tonsils either whole or sub capsular, while adenoidectomy is the intervention of extraction of the adenoid gland which is commonly done with curettage method. Both interventions are done to eliminate repeated infections and also obstructions due to inflammation and hypertrophy of the tonsils and adenoids. This study was conducted to examine the indications of tonsillectomy and adenoidectomy in the Departement of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital Bandung in the period of January 2009–December 2011. Methods: A cross-sectional descriptive study was conducted in October–November of 2012 using 207 medical records of patients who had tonsillectomy and adenoidectomy executed in the Department of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital, Bandung in the period of January 2009–December 2011. Data collected were age, gender, main complaint, tonsil size, history of repeated infections, history of snoring as well as of Obstructive Sleep Apnea Syndrome (OSAS. The indication for tonsillectomy and adenoidectomy such as infection, obstruction and neoplasia was selected. Results: The indications of tonsillectomy and adenoidectomy were infection at 106 (51.2% patients, obstruction at 100 (48.3% patients, and neoplasia at 1 (0.05% patient. Conclusions: The most numerous indications for tonsillectomy and tonsilloadenoidectomy in the Department of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital were infection.

  8. Obsessive-compulsive disorder in general hospital outpatients: prevalence, correlates, and comorbidity in Lanzhou, China.

    Science.gov (United States)

    Lihua, Ma; Tao, Zhang; SiYong, Huang; Suwen, Wei; Xiaoxuan, Yuan; Yichen, Guo; Caiyun, Zhang; Yan, Bai

    2014-09-01

    The prevalence of obsessive-compulsive disorder (OCD), risk factors, and comorbidity rates of Chinese outpatients in Lanzhou general hospitals are unknown. The prevalence rate of OCD was estimated in a representative sample of outpatients in three classes of general hospitals in Lanzhou, China. The rate of OCD within the sample, which was composed of 1,576 individuals aged 16 years or older, was assessed using the World Health Organization Composite International Diagnostic Interview Version 3.0. The weighted prevalence of OCD were 4.31% (lifetime), 2.86% (12-month), and 1.97% (30-day). Multivariate logistic regression identified the following independent predictors of having lifetime OCD: having a higher level of education, being unemployed, an internal medicine outpatient, a female, 16-35 years old, divorced/widowed/separated, and having a low family income. OCD had a significant comorbid association with neuroses, based on the International Statistical Classification of Diseases and Related Health Problems-10th Revision. These findings show a lower prevalence rate of OCD in Lanzhou general hospitals than that reported for some specialized outpatient clinics in Western countries. Further investigations are required to explore the relationships between OCD and the risk factors identified in the current study. Resolving methodological problems may lead to more accurate prevalence estimates in future epidemiological studies. Our findings suggest that there is an urgent need to improve the ability of clinicians to detect OCD in outpatients. © 2013 Wiley Publishing Asia Pty Ltd.

  9. Trends in fatalities due to poisoning at Umtata General Hospital, Mthatha (1993–2005

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    Banwari L. Meel

    2009-04-01

    Full Text Available Poisoning is a common method of committing suicide in this region of South Africa. Females generally ingest poisons but it is increasingly becoming common in males too. This is a record review of autopsies carried out at the Umtata (Mthatha General Hospital mortuary, which forms part of the teaching hospital of the Walter Sisulu University Medical School. There were 10 230 unnatural deaths between 1993 and 2005. Of these deaths, 161 (1.6% were deaths due to poisoning. There was a marked increase in death by poisoning from 2.5% in 1993 to 13.7% in 2004. The highest percentage (17.4% of poison-related deaths was in 2001, and the lowest (2.5% was in 1993 and 1994. About two-thirds of victims (66% were males, and more than half of the victims (51.5% were in the 11 to 30 age group. There is an increasing trend in fatalities due to poisoning at Umtata General Hospital, Mthatha.

  10. A multilevel analysis on the relationship between neighbourhood poverty and public hospital utilization: is the high Indigenous morbidity avoidable?

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    Guthridge Steven L

    2011-09-01

    Full Text Available Abstract Background The estimated life expectancy at birth for Indigenous Australians is 10-11 years less than the general Australian population. The mean family income for Indigenous people is also significantly lower than for non-Indigenous people. In this paper we examine poverty or socioeconomic disadvantage as an explanation for the Indigenous health gap in hospital morbidity in Australia. Methods We utilised a cross-sectional and ecological design using the Northern Territory public hospitalisation data from 1 July 2004 to 30 June 2008 and socio-economic indexes for areas (SEIFA from the 2006 census. Multilevel logistic regression models were used to estimate odds ratios and confidence intervals. Both total and potentially avoidable hospitalisations were investigated. Results This study indicated that lifting SEIFA scores for family income and education/occupation by two quintile categories for low socio-economic Indigenous groups was sufficient to overcome the excess hospital utilisation among the Indigenous population compared with the non-Indigenous population. The results support a reframing of the Indigenous health gap as being a consequence of poverty and not simplistically of ethnicity. Conclusions Socio-economic disadvantage is a likely explanation for a substantial proportion of the hospital morbidity gap between Indigenous and non-Indigenous populations. Efforts to improve Indigenous health outcomes should recognise poverty as an underlying determinant of the health gap.

  11. Establishment of national laboratory standards in public and private hospital laboratories.

    Science.gov (United States)

    Anjarani, Soghra; Safadel, Nooshafarin; Dahim, Parisa; Amini, Rana; Mahdavi, Saeed; Mirab Samiee, Siamak

    2013-01-01

    In September 2007 national standard manual was finalized and officially announced as the minimal quality requirements for all medical laboratories in the country. Apart from auditing laboratories, Reference Health Laboratory has performed benchmarking auditing of medical laboratory network (surveys) in provinces. 12(th) benchmarks performed in Tehran and Alborz provinces, Iran in 2010 in three stages. We tried to compare different processes, their quality and accordance with national standard measures between public and private hospital laboratories. The assessment tool was a standardized checklist consists of 164 questions. Analyzing process show although in most cases implementing the standard requirements are more prominent in private laboratories, there is still a long way to complete fulfillment of requirements, and it takes a lot of effort. Differences between laboratories in public and private sectors especially in laboratory personnel and management process are significant. Probably lack of motivation, plays a key role in obtaining less desirable results in laboratories in public sectors.

  12. Motivation of the nursing staff in and a framework of realistic motives in a public hospital

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    Yannis Markovits

    2011-10-01

    Full Text Available The motivation of human resources and in particular of the nursing staff is a crucial issue that influences their job satisfaction, as well as patients' satisfaction from the health services offered. Aim: The presentation of selected motivation theories through literature review and the development of a framework of realistic motives applied to the nursing staff of a public hospital. Material-Method: The Greek and international bibliography has been reviewed, and in particular papers on the motivation theories of human resources in hospitals (the hierarchy of human needs theory, the two-factor theory of motivation, the achievement theory of motivation, and the expectancy theory published during the last ten years via PubMed and Science Direct. Results: A series of motives could be developed that by themselves are not the solution to the problem of employee performance and effectiveness, and their application could be a combination of different models or examined case by case, depending on the functional department of the public hospital. The economic motives and the negative motives cannot, by and large, be applied by management, thus, motives having to do with training, organization and coordination of human resources, communication and fair treatment are the most realistic and applicable ones, for this particular workplace. Conclusions: The motives presented in the current paper are not the panacea for the work performance and effectiveness and they are not a complete record of all potential motives. The application of motives could be combinational or could be contingently examined for the department of the public hospital applied, as well as the nursing staff employed, i.e., specificities related to knowledge, experience, abilities. Furthermore, the duties performed by the nursing staff and the policy implemented by management towards the human resources affect the offered motives.

  13. Insurance status of patients admitted to specialty cardiac and competing general hospitals: are accusations of cherry picking justified?

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    Cram, Peter; Pham, Hoangmai H; Bayman, Levent; Vaughan-Sarrazin, Mary S

    2008-05-01

    There has been widespread concern that procedurally oriented specialty hospitals select well-insured patients for admission, while avoiding the underinsured, but data are limited. To determine if specialty cardiac hospitals admit a higher proportion of well-insured patients than general hospitals and/or preferentially transfer patients with less generous insurance to other acute care hospitals. A retrospective study of patients admitted to specialty cardiac and general hospitals with acute myocardial infarction (AMI; N = 41,863), congestive heart failure (CHF; N = 51,696), percutaneous coronary intervention (PCI; N = 73,966), and coronary artery bypass grafting (CABG; N = 33,327) using 2000-2004 all-payor data from Arizona, California, and Texas. Proportion of all admissions in specialty and general hospitals with more generous insurance (Medicare or private insurance), interhospital transfer patterns of patients with less generous insurance by specialty and general hospitals. Specialty hospitals admitted a higher proportion of patients with more generous insurance for both the medical cohort (AMI and CHF) (92.4% vs. 89.0%; P hospital, odds of admission to specialty hospitals were significantly higher for patients with more generous insurance compared to patients with less generous insurance for the medical cohort [odds ratio (OR), 1.16; 95% confidence interval (CI), 1.07-1.27; P hospitals were more or less likely to transfer patients with more or less generous insurance to another hospital. The analysis was limited to 3 states and we were unable to track the care of patients after transfer. Patients with more generous insurance are significantly more likely to gain admission to specialty hospitals. Alternatively, we found no evidence that specialty hospitals preferentially transfer patients with less generous insurance who are admitted. Overall, these findings suggest that specialty hospitals may contribute to segregation of the healthcare system along

  14. Stenotrophomonas maltophilia infections in a general hospital: patient characteristics, antimicrobial susceptibility, and treatment outcome.

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    George Samonis

    Full Text Available INTRODUCTION: Stenotrophomonas maltophilia is acquiring increasing importance as a nosocomial pathogen. METHODS: We retrospectively studied the characteristics and outcome of patients with any type of S. maltophilia infection at the University Hospital of Heraklion, Crete, Greece, between 1/2005-12/2010. S. maltophilia antimicrobial susceptibility was tested with the agar dilution method. Prognostic factors for all-cause in-hospital mortality were assessed with multivariate logistic regression. RESULTS: Sixty-eight patients (median age: 70.5 years; 64.7% males with S. maltophilia infection, not related to cystic fibrosis, were included. The 68 patients were hospitalized in medical (29.4%, surgical (26.5%, hematology/oncology departments (23.5%, or the intensive care units (ICU; 20.6%. The most frequent infection types were respiratory tract (54.4%, bloodstream (16.2%, skin/soft tissue (10.3%, and intra-abdominal (8.8% infection. The S. maltophilia-associated infection was polymicrobial in 33.8% of the cases. In vitro susceptibility was higher to colistin (91.2%, trimethoprim/sulfamethoxazole and netilmicin (85.3% each, and ciprofloxacin (82.4%. The empirical and the targeted treatment regimens were microbiologically appropriate for 47.3% and 63.6% of the 55 patients with data available, respectively. Most patients received targeted therapy with a combination of agents other than trimethoprim/sulfamethoxazole. The crude mortality and the mortality and the S. maltophilia infection-related mortality were 14.7% and 4.4%, respectively. ICU hospitalization was the only independent prognostic factor for mortality. CONCLUSION: S. maltophilia infection in a general hospital can be associated with a good prognosis, except for the patients hospitalized in the ICU. Combination reigmens with fluoroquinolones, colistin, or tigecycline could be alternative treatment options to trimethoprim/sulfamethoxazole.

  15. IRS General Counsel Memorandum threatens some hospital-physician joint ventures.

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    Driscoll, T L; Schieble, M T

    1992-03-01

    To defend against the heightened scrutiny of hospital-physician relations expected from the IRS, hospital management should closely examine any activities now conducted with physicians to determine whether each activity, as organized and operated, furthers the hospital's charitable mission of promoting the health of its community, rather than merely enhancing the financial health of the institution itself. Any arrangements that do not appear to satisfy the principles enunciated in GCM 39862 should be examined to see if they should be restructured or dissolved. In structuring new transactions and examining existing arrangements, the following principles should be kept in mind: 1. Transactions should not be premised upon increased utilization or physician referrals. Enhancing or protecting market share, even for the purpose of preserving an institution's presence in the community, will likely no longer be accepted as a justification for pursuing joint venture arrangements. In justifying such ventures, management must distinguish between benefit to the community and benefit to the institution. 2. Transactions whereby existing services or equipment are "spun off" to a hospital-physician joint venture run a serious risk of enhanced IRS scrutiny. 3. Transactions creating or providing new facilities or services should be more favorably perceived, particularly where participants other than the hospital take an active role in managing the venture. Where the hospital is the sole general partner and merely manages what it would have managed had there been no physician investors, the question of why physicians are involved will likely be of greater concern than it has been in the past.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Assessing the roles of brokerage: an evaluation of a hospital-based Public Health epidemiologist program in North Carolina.

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    Bevc, Christine A; Markiewicz, Milissa L; Hegle, Jennifer; Horney, Jennifer A; MacDonald, Pia D M

    2012-11-01

    The North Carolina Division of Public Health established an innovative program in 2003 that placed public health epidemiologists (PHEs) in hospitals around the state to improve communication between hospitals and local public health departments (LHDs) and bolster public health surveillance and response. To use social network analysis to assess how the hospital-based PHE program in North Carolina facilitates the exchange of public health surveillance information. Using a Gould-Fernandez brokerage analysis, this study examines communication among organizational actors and their dependence on third parties to broker information and knowledge. Survey and interview data were collected to identify the interorganizational network among 220 organizational actors and their public health surveillance-related activities, including 11 PHEs, 100 county-level offices of North Carolina's 85 LHDs, and 109 hospitals. Social network analysis is used to calculate the frequency with which an actor serves as an intermediary in each of the 5 brokerage roles as well as total brokerage equal to the sum of the number of times an actor occupies each role. Results identify a frequent tendency for PHEs to serve as an intermediary between LHDs and hospitals. Interactions between these entities are frequently facilitated by PHEs, with a high measure of degree centrality by LHDs and a low frequency of brokerage among hospitals. Results validate PHEs' mission to enhance communication between LHDs and hospitals around communicable disease surveillance, reporting, and management.

  17. Diagnoses, Requests and Timing of 503 Psychiatric Consultations in Two General Hospitals

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    Elahe Sahimi Izadian

    2012-01-01

    Full Text Available The high comorbidity of medical and psychiatric diagnoses in the general hospital population requires collaboration between various medical fields to provide comprehensive health care. This study aims to find the rate of psychiatric consultations, their timing and overall diagnostic trend in comparison to previous studies. Tehran University of Medical Sciences has got an active psychiatric consultation-liaison service which includes services provided by four faculty psychiatrists (two full-time and two part-time. This study was done in two general hospitals by simple sampling in available cases. For each consultation, a board-certified faculty psychiatrist conducted a clinical evaluation based on DSM-IV-TR. Other than psychiatric diagnoses, socio-demographic variables, relative consultation rates, reasons for referral, medical diagnoses and the time stay after admission were assessed. Among 503 patients who were visited by the consultation-liaison service, there were 54.3% female with mean age of 39.8 years. In 90.1% of consultations, at least one DSM-IV-TR diagnosis was made. The most frequent diagnosis groups were mood disorder (43.5%, adjustment disorder (10.9% and cognitive disorder (7.6%. In about 10.9% of the consultations, multiple psychiatric diagnoses were made. The mean length of hospital stay before the consultation was 12.56 days (range=1-90, SD=13. Based on our findings, the mood and cognitive disorders still remain major foci of consultation-liaison practice in general hospitals; however our findings showed high rate of adjustment disorders diagnosis and ambiguous request for psychiatric consultation which need more interdisciplinary interaction.

  18. Assessment of the culture of safety in public hospitals in Brazil 1

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    de Carvalho, Rhanna Emanuela Fontenele Lima; Arruda, Lidyane Parente; do Nascimento, Nayanne Karen Pinheiro; Sampaio, Renata Lopes; Cavalcante, Maria Lígia Silva Nunes; Costa, Ana Carolina Pinto

    2017-01-01

    ABSTRACT Objective: to assess the culture of safety in three public hospitals. Method: transversal study undertaken in three Brazilian public hospitals, with health professionals through applying the Safety Attitudes Questionnaire (SAQ). Scores greater than or equal to 75 were considered positive. Results: a total of 573 professionals participated in the study, including nurse technicians and auxiliary nurses 292 (51%), nurses 105 (18.3%), physicians 59 (10.3%), and other professionals 117 (20.4%). The mean of the SAQ varied between 65 and 69 in the three hospitals. Among the domains, however, 'Job satisfaction' presented a higher score, and the opposite was observed for the domain 'Perceptions of management'. The outsourced professionals presented a better perception of the culture of safety than did the statutory professionals. The professionals with higher education presented a better perception of the stressing factors than did the professionals educated to senior high school level. Conclusion: the level of the culture of safety found is below the ideal. The managerial actions are considered the main contributing factor to the culture's weakness; however, the professionals demonstrated themselves to be satisfied with the work. PMID:28301029

  19. Motivation and Factors Affecting It among Health Professionals in the Public Hospitals, Central Ethiopia.

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    Dagne, Tesfaye; Beyene, Waju; Berhanu, Negalign

    2015-07-01

    Motivation is an individual's degree of willingness to exert and maintain an effort towards organizational goals. This study assessed motivational status and factors affecting it among health professionals in public hospitals of West Shoa Zone, Oromia Region. Facility based cross-sectional survey was employed. All health professionals who served at least for 6 months in Ambo, Gedo and Gindeberet hospitals were included. Self-administered Likert scale type questionnaire was used. Data were analyzed using SPSS version 20. Mean motivation calculated as percentage of maximum scale score was used. Bivariate and multiple linear regression analyses were done to see the independent effects of explanatory variables. The overall motivation level of health professionals was 63.63%. Motivation level of health professionals varied among the hospitals. Gindeberet Hospital had lower motivation score as compared to Ambo Hospital (B = -0.54 and 95% CI; -0.08,-0.27). The mean motivation score of health professionals who got monthly financial benefit was significantly higher than those who did not (B = 0.71 and 95% CI; 0.32, 1.10). Environmental factors had higher impact on doctors' motivation compared to nurses' (B = 0.51 and 95% CI; 0.10, 0.92). Supervisor-related factors highly varied in motivation relative to other variables. Motivation of health professionals was affected by factors related to supervisor, financial benefits, job content and hospital location. Efforts should be made to provide financial benefits to health professionals as appropriate especially, to those who did not get any such benefits. Officially recognizing best performance is also suggested.

  20. [Characteristics of health seeking behaviors for patients with psoriasis in a general hospital].

    Science.gov (United States)

    Li, Xia; Luo, Dan; Qiu, Yangyang; Chen, Mingliang; Su, Juan; Yi, Mei

    2016-06-28

    To explore the characteristics of health seeking behaviors and relevant factors among the outpatients with psoriasis in a general hospital, and to provide scientific evidence to modify the inappropriate health seeking behaviors for psoriasis patients and improve the therapeutic effect. 
 Using cross-sectional study design, a dermatological clinic in a general hospital was selected for this study. Two hundred psoriasis outpatients from 1st April to 30th September in 2014 were enrolled. A series of questionnaires were used to collect information regarding the social-demographic characteristics, health seeking behaviors, knowledge on psoriasis, and depressive and anxious symptoms.
 Among 200 psoriasis outpatients, 141 patients (70.5%) experienced transfer treatment. One hundred and eighty-two patients (91.0%) went to formal hospitals in county for treatment when symptoms were firstly displayed; the other 18 patients (9.0%) went to village or community clinics, or the private clinics. Over 50% patients chose municipal hospital and 35.0% patients went to provincial hospital for medical treatment among the 182 patients. Ninety-one percent of the patients made decision for the first treatment after consulting with their spouses or relatives. According to the definition of the appropriate health seeking behavior in this study, 50 patients (25%) had inappropriate health seeking behaviors. Logistic regression analysis showed inappropriate health seeking behaviors correlated with the family whose income was less than 3 000 yuan per person per month (OR=2.232, 95%CI 1.086 to 4.585), patients who made the decision for the treatment with no discussion with other people when the symptoms appeared (OR=3.016, 95%CI 1.023 to 8.893), and the high score of the International Psoriasis Severity Index (OR=1.043, 95%CI 1.001 to 1.088). 
 The dermatological practitioner should pay more attention to the factors, such as social-demographical characteristics, especially the low level of

  1. Idosos asilados em hospitais gerais Long-term care elderly residents in general hospitals

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    Milton Luiz Gorzoni

    2006-12-01

    Full Text Available Instituições de longa permanência para idosos interagem periodicamente com hospitais gerais para internações de casos agudos ou dos que necessitam de métodos diagnósticos complexos e da atenção de várias especialidades simultaneamente. A decisão de indicar hospitalização é multifatorial, sendo influenciada por circunstâncias como a gravidade do quadro clínico e a infra-estrutura das instituições de longa permanência para idosos. Internações hospitalares apresentam benefícios e riscos, como o desenvolvimento de iatrogenias, delirium e declínios funcionais, podendo resultar em piora do estado geral e da qualidade de vida do idoso asilado durante e/ou após a hospitalização. O objetivo do estudo foi abordar aspectos peculiares na avaliação, tratamento e manejo de idosos asilados em internações hospitalares, particularmente quanto a cuidados que os auxiliem efetivamente nessas circunstâncias. Discutiram-se situações freqüentes como delirium, iatrogenias, desnutrição, declínio funcional e cuidados paliativos e características próprias de residentes em instituições para idosos durante internações em hospitais gerais.Long-term care facilities for the elderly have regularly to work together with general hospitals to provide care to acutely ill residents or when they require all together more complex diagnostic procedures and multi-specialty care. The decision to hospitalize a nursing home elderly resident is multifactorial and it is based on factors such as illness severity and care facility infrastructure. Hospitalizations have benefits and risks such developing iatrogenic diseases, delirium, and functional decline, which may deteriorate patients' general condition and their quality of life during and/or after hospitalization. This study aimed at addressing specific aspects of assessment, treatment and management of nursing home elderly who require to be hospitalized, especially focusing on their effective care

  2. Tackling the climate targets set by the Paris Agreement (COP 21): Green leadership empowers public hospitals to overcome obstacles and challenges in a resource-constrained environment.

    Science.gov (United States)

    Weimann, E; Patel, B

    2016-12-21

    The healthcare sector itself contributes to climate change, the creation of hazardous waste, use of toxic metals such as mercury, and water and air pollution. To mitigate the effect of healthcare provision on the deteriorating environment and avoid creating further challenges for already burdened health systems, Global Green Hospitals was formed as a global network. Groote Schuur Hospital (GSH), as the leading academic hospital in Africa, joined the network in 2014. Since then, several projects have been initiated to reduce the amount of general waste, energy consumption and food waste, and create an environmentally friendlier and more sustainable hospital in a resource-constrained public healthcare setting. We outline the various efforts made to reduce the carbon footprint of GSH and reduce waste and hazardous substances such as mercury and polystyrene, and elaborate how obstacles and resistance to change were overcome. The hospital was able to halve the amount of coal and water used, increase recycling by 50% over 6 months, replace polystyrene cups and packaging with Forest Stewardship Council recyclable paper-based products, reduce the effect of food wastage by making use of local farmers, and implement measures to reduce the amount of expired pharmaceutical drugs. To improve commitment from all involved roleplayers, political leadership, supportive government policies and financial funding is mandatory, or public hospitals will be unable to tackle the exponentially increasing costs related to climate change and its effects on healthcare.

  3. Tackling the climate targets set by the Paris Agreement (COP 21: Green leadership empowers public hospitals to overcome obstacles and challenges in a resource-constrained environment

    Directory of Open Access Journals (Sweden)

    E Weimann

    2017-01-01

    Full Text Available The healthcare sector itself contributes to climate change, the creation of hazardous waste, use of toxic metals such as mercury, and water and air pollution. To mitigate the effect of healthcare provision on the deteriorating environment and avoid creating further challenges for already burdened health systems, Global Green Hospitals was formed as a global network. Groote Schuur Hospital (GSH, as the leading academic hospital in Africa, joined the network in 2014. Since then, several projects have been initiated to reduce the amount of general waste, energy consumption and food waste, and create an environmentally friendlier and more sustainable hospital in a resource-constrained public healthcare setting. We outline the various efforts made to reduce the carbon footprint of GSH and reduce waste and hazardous substances such as mercury and polystyrene, and elaborate how obstacles and resistance to change were overcome. The hospital was able to halve the amount of coal and water used, increase recycling by 50% over 6 months, replace polystyrene cups and packaging with Forest Stewardship Council recyclable paper-based products, reduce the effect of food wastage by making use of local farmers, and implement measures to reduce the amount of expired pharmaceutical drugs. To improve commitment from all involved roleplayers, political leadership, supportive government policies and financial funding is mandatory, or public hospitals will be unable to tackle the exponentially increasing costs related to climate change and its effects on healthcare.

  4. Use of antibacterial drugs in Jesenice General hospital in years 1998 to 2004

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    Brigita Mavsar-Najdenov

    2007-11-01

    Full Text Available Background: Continuous monitoring of drug consumption is an important strategy for prudent and cost-effective use of drugs. Antimicrobials are among the most prescribed drugs in outpatient practice and in hospital care. In most cases antimicrobials are improperly prescribed or are even misused. Irrational use of antimicrobials is clinically ineffective and leads to higher treatment costs. Clinical ineffectiveness due to irrational use additionally leads to loss of confidence in antimicrobial drugs, unnecessary exposure of patients and development of antimicrobial resistance. Antimicrobial resistance has become a major global health problem as it presents an imperative for development of new potent antimicrobials which are necessarily associated with markedly higher treatment costs.Material and methods: This survey was focused on rational prescribing of antimicrobial drugs. The data on consumption of antimicrobials for various clinical departments of the Jesenice General Hospital were collected by the hospital pharmacy. WHO ATC 2005 classification system, which ranks antimicrobials in a large group J01: drugs for systemic treatment of bacterial infections and Defined Daily Dose as a measuring unit according to the WHO ATC/DDD methodology was used. Antimicrobial use at the Jesenice General Hospital in the period between 1998 and 2004 was estimated by the Department of Infectious Diseases, Medical Centre Ljubljana as a part of European Surveillance on Antibiotic Consumption project (ESAC. Statistical part of survey was performed by the Chair of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Ljubljana.Results: After year 2000 a trend of decrease in antimicrobial consumption was observed. Compared to European Surveillance on Antibiotic Consumption results in the year 2003 higher usage of penicillins with extended spectrum, fluoroquinolones and 3rd generation cephalosporins in Slovenian hospitals was estimated. These three

  5. Changing Smoking Behavior of Staff at Dr. Zainoel Abidin Provincial General Hospital, Banda Aceh

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    Said Usman

    2014-01-01

    Full Text Available Smoking tobacco is a habit of individuals. Determinants of smoking behavior are multiple factors both within the individual and in the social environment around the individual. Staff smoking has been an undesirable phenomenon at Dr. Zainoel Abidin Provincial General Hospital in Banda Aceh. Health promotion efforts are a strategy that has resulted in behavioral changes with reductions in smoking by staff. This action research was designed to analyze changes in smoking behavior of hospital staff. The sample for this research was all 152 male staff who were smokers. The results of this research showed that Health Promotion Interventions (HPI consisting of personal empowerment plus social support and advocacy to improve employee knowledge and attitudes influenced staff to stop or to significantly. HPI employed included counseling programs, distribution of antismoking leaflets, putting up antismoking posters, and installation of no smoking signs. These HPI proved effective to increase knowledge and create a positive attitude to nonsmoking that resulted in major reductions in smoking by staff when offsite and complete cessation of smoking whilst in the hospital. Continuous evaluation, monitoring, and strengthening of policies banning smoking should be maintained in all hospitals.

  6. Incidence of ocular emergencies in the emergency room of the University General Hospital of Cienfuegos

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    Armando Rafael Milanés Armengol

    2015-02-01

    Full Text Available Background: There are few international and national studies on the incidence of ocular emergencies though there are frequent complaints. Objective: To determine the incidence and types of emergencies attended by the department of Ophthalmology at the General University Hospital of Cienfuegos. Methods: Case series study of all patients attended in the Emergency Department of Ophthalmology in Cienfuegos Hospital from March 2013 to March 2014. There were analyzed: name of the patient, sex, age, origin, diagnosis emergency, classification code colors, total of patients requiring surgical treatment and hospitalization. Results: Predominated aged 41-60 years (35.8%, males (58.6% and the largest number of cases attended corresponded to patients in the provincial capital. There was a predominance of green code (70.9%; the conditions most represented were inflammations of annexes followed by injuries; 72 patients needed surgery, (0.38% and 59 required hospitalizations, the rest of the patients were on ambulatory treatment with follow up in outpatient department ( 0.31%. Conclusions: The incidence of true ophthalmologic emergencies was low, for inflammatory conditions of Annexes classified as green code, were the most frequent cause of patient care; conditions that can be treated in primary services, indicating to mismanagement of physicians in the treatment of these ophthalmic conditions with consequent social and economic burden involving secondary services.

  7. Technical and organisational aspects in enterprise resource planning systems implementation: lessons from a Spanish public hospital

    Science.gov (United States)

    Escobar-Rodriguez, Tomas; Escobar-Pérez, Bernabe; Monge-Lozano, Pedro

    2014-09-01

    Public resources should always be managed efficiently, more so in times of crisis. Due to the specific characteristics of the healthcare sector, there is a need for special attention, especially in regards to hospitals. Administrators need useful tools to be able to efficiently manage available resources, such as enterprise resource planning (ERP) systems. Therefore, an analysis of the effects of their implementation and use in hospitals is valuable. This study has two purposes. One is to analyse the role ERP systems play in aiding the integration of hospital data, with focus on user satisfaction as well as possible resistance to change. The other purpose is to analyse the effects of implanting and using ERP systems in the hospital environment and identifying how certain variables influence the process, especially the existence of different organisational cultures. Results indicate that clinical information has become notably more integrated, despite the lack of flow in the economic-financial area. The heterogeneous nature of the different groups, clinical (Medical, Nursing) and non-clinical (Economic-Financial, Accounting), had a negative influence on the implementation process, and limited the integration of information as well as the system's performance.

  8. Violence in the nursing workplace - a descriptive correlational study in a public hospital.

    Science.gov (United States)

    Chen, Kang-Pan; Ku, Yan-Chiou; Yang, Hsiu-Fan

    2013-03-01

    To explore the prevalence, types and sources of violence in the nursing workplace and to assess the factors related to violence. Workplace violence in nursing is not a new phenomenon; in recent years, much more attention has been paid to the issue in Taiwan. Few studies, however, have investigated the overall distribution of violence and the reasons for not reporting these incidents in nursing workplaces. This descriptive, correlational study used structured questionnaires to collecting information about workplace violence experienced by nurses over the last year. Nurses (n = 880) working in a public hospital in southern Taiwan were invited to complete the questionnaires, with a response rate of 89·9%. Nurses working in outpatient units and emergency rooms experienced more frequent violence than those on surgical wards and intensive care units. These findings provide evidence of workplace violence in hospitals and may aid hospital and nursing administration to reduce and control violence. RELEVANCE TO NURSING PRACTICE: These results provide evidence in relation to the importance of effective communication training to nurses and will assist hospital administrations in establishing higher-quality, healthy workplace environments. © 2012 Blackwell Publishing Ltd.

  9. Management of Sigmoid Volvulus in Three General Community Hospitals of the Cuban Medical Mission in Bolivia

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    Jorge Luís Estepa Pérez

    2013-02-01

    Full Text Available Background: Sigmoid volvulus is an emergency that occurs very frequently in the South American Andean area hospitals. It accounts for over 50% of all intestinal obstructions and still retains high mortality rates. Objective: To characterize the management of sigmoid volvulus. Methods: A prospective and descriptive study was conducted including all patients with sigmoid volvulus who attended three general community hospitals of the Cuban medical mission in Bolivia from June 2006 to June 2007 and were treated trough general surgery. We analyzed the following variables: age, sex, medical history, surgical diagnosis, classification and type of surgery, surgery performed, evolution, complications, use of antibiotic-prophylaxis and admission to intensive care units. The information was obtained from medical records, operative reports and a data collector model. Results: Sigmoid volvulus occurred more frequently in the Yapacaní hospital, department of Santa Cruz; the predominant age group was that from 55 to 64 years old as well as the predominant sex was that of males. Chagas disease was detected in most of the patients studied. Among symptoms those that predominated were distension, abdominal pain and stool detention. Decompression, devolvulation and surgical treatment were the processes followed in all cases, being the Rankin-Mikulicz colostomy the most widely used. No patients underwent a second surgery, and there were no mortality rates. Conclusions: Decompression, devolvulation and surgical treatment were the processes followed in all cases, being the Rankin-Mikulicz colostomy the most widely used. Most patients had a satisfactory evolution.

  10. Doctors as managers: moving towards general management? The case of unitary management reform in Norwegian hospitals.

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    Mo, Tone Opdahl

    2008-01-01

    The paper seeks to explore whether the development in department management in Norwegian hospitals after the unitary management reform in 2001 constitutes a development in the direction of general management. Interviews were conducted with ten managers from different levels in a large Norwegian university hospital in 2001-2002, as a unitary management model was implemented. There is an emerging change of practice among the physician managers according to this study. The manager function is more explicit and takes a more general responsibility for the department and the professions. However, the managerial function is substantiated by conditions related to the professional field of knowledge, which gives legitimacy within a medical logic. Contact with the clinic is stressed as important, but it is possible to adjust both amount and content of a clinical engagement to the demands of the new manager position. This has both a symbolic and a practical significance, as it involves both legitimacy and identity issues. The paper shows that the institutionalised medical understanding of management has a bearing on managerial reforms. Managerial changes need to relate to this if they are to have consequences for the managerial roles and structures on department level in hospitals. The paper suggests that the future development of this role will depend on the way the collectivist and individualist aspects of responsibility are handled, as well as on the further development of managerial knowledge of physicians.

  11. Twenty years of electroconvulsive therapy in a psychiatric unit at a university general hospital

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    Amilton dos Santos Jr.

    2013-01-01

    Full Text Available Objective: To describe the sociodemographic and clinical profile of patients who underwent electroconvulsive therapy (ECT at a university general hospital. Method: In this retrospective study, records from all patients undergoing ECT between January 1988 and January 2008 at the psychiatric unit of the general hospital of Universidade Estadual de Campinas (UNICAMP were reviewed. Telephone contact was made with patients/relatives to collect follow-up data. Results: A total of 200 charts were reviewed. The majority of patients were women, with a mean age of 39 years, and history of psychiatric hospitalization. The main indications for ECT were depression and catatonia. Complications were observed in less than half of the cases, and most were temporary and not severe. There was a good psychiatric outcome for 89.7% of the patients, especially for catatonic patients (100%, p = 0.02. Thirty-four percent of the cases were later contacted by telephone calls, at a mean of 8.5 years between the procedure and the contact. Among these, three (1.5% reported persistent memory disorders and 73% considered ECT a good treatment. Conclusion: ECT has been performed according to international guidelines. In the vast majority of cases, undesirable effects were temporary and not severe. Response to ECT was positive in most cases, particularly in catatonic patients.

  12. Differences in Sepsis Treatment and Outcomes between Public and Private Hospitals in Brazil: A Multicenter Observational Study

    Science.gov (United States)

    Conde, Katia Aparecida Pessoa; Silva, Eliezer; Silva, Carla Oliveira; Ferreira, Elaine; Freitas, Flavio Geraldo Rezende; Castro, Isac; Rea-Neto, Alvaro; Grion, Cintia Magalhaes Carvalho; Moura, Anselmo Dornas; Lobo, Suzana Margareth; Azevedo, Luciano Cesar Pontes; Machado, Flavia Ribeiro

    2013-01-01

    Background Previous studies showed higher sepsis mortality rates in Brazil compared to other developed or developing countries. Moreover, another trial demonstrated an increased mortality rate in public hospitals compared to private hospitals in Brazil. The reasons for these findings may include delayed recognition and inadequate treatment of sepsis in public facilities. We designed this study to evaluate the factors associated with mortality in septic patients admitted to intensive care units in a network of public and private institutions. Materials and Methods This study is a retrospective analysis of a prospective cohort of sepsis patients in 19 private and public institutions in Brazil. We analyzed data from the original database and collected additional data to assess compliance to the treatment guidelines and to determine the time from the onset of organ dysfunction and the sepsis diagnosis by the healthcare team. Results A total of 396 patients were analyzed. Patients in public hospitals were younger, had a greater number of dysfunctional organs at baseline and a lower chance to have sepsis diagnosed within two hours of the onset of organ dysfunction. Private hospitals had a better compliance to lactate and blood culture sampling and maintenance of glycemic control. The multivariate analysis showed that age, disease severity at baseline and being treated at a public hospital were independent risk factors for mortality. A delay in the sepsis diagnosis of longer than two hours was associated with mortality only in the public setting. Conclusions We confirmed a lower sepsis mortality rate in the private hospitals of this network. Being treated in a public hospital was an independent factor for mortality. Delayed recognition of sepsis was more frequent in public institutions and this might have been associated with a higher mortality. Improving sepsis recognition and early diagnosis may be important targets in public institutions. PMID:23762255

  13. A General Construction of IND-CCA2 Secure Public Key Encryption

    DEFF Research Database (Denmark)

    Kiltz, Eike; Malone-Lee, John

    2003-01-01

    We propose a general construction for public key encryption schemes that are IND-CCA2 secure in the random oracle model. We show that the scheme proposed in [1, 2] fits our general framework and moreover that our method of analysis leads to a more efficient security reduction.......We propose a general construction for public key encryption schemes that are IND-CCA2 secure in the random oracle model. We show that the scheme proposed in [1, 2] fits our general framework and moreover that our method of analysis leads to a more efficient security reduction....

  14. A General Construction of IND-CCA2 Secure Public Key Encryption

    DEFF Research Database (Denmark)

    Kiltz, Eike; Malone-Lee, John

    2003-01-01

    We propose a general construction for public key encryption schemes that are IND-CCA2 secure in the random oracle model. We show that the scheme proposed in [1, 2] fits our general framework and moreover that our method of analysis leads to a more efficient security reduction.......We propose a general construction for public key encryption schemes that are IND-CCA2 secure in the random oracle model. We show that the scheme proposed in [1, 2] fits our general framework and moreover that our method of analysis leads to a more efficient security reduction....

  15. Training programs in remote sensing for professionals, students and the general public

    Science.gov (United States)

    Galeano, R.

    1987-01-01

    What remote sensing is, how and why it is used, and why more people should be trained in the field is discussed. Suggestions are offered concerning differences in teaching technicians, the general public, and children in schools.

  16. [Patient safety culture and related factors in a network of Spanish public hospitals].

    Science.gov (United States)

    Gama, Zenewton André da Silva; Oliveira, Adriana Catarina de Souza; Hernández, Pedro Jesus Saturno

    2013-02-01

    The objectives were to describe Patient Safety Culture (PSC) in a regional network of public hospitals, according to the perceptions of health professionals, and analyze the influence of socio-professional factors. A survey was conducted with 1,113 professionals from eight Spanish hospitals, using a questionnaire that explores 12 dimensions of PSC. Perceptions were described through the Percentage of Positive (PPR) and Negative Responses (PNR) by dimension, and the association of factors was analyzed using multivariate linear regression. The dimension "Teamwork within the same Unit" had the highest PPR (73.5), and "Staffing" the highest PNR (61). The variables "Service" (Pharmacy, Surgical Center) and "Profession" (Nurses) were significantly associated to positive assessments. Thus, strategies to improve PSC should prioritize rational distribution of human resources, and take advantage of the positive perceived relationship within Units. Moreover, pharmaceutical and surgical services, as well as nurses should probably be benchmarked by other services and professionals.

  17. Impact of cultural factors on attitude toward using ERP systems in public hospitals

    Directory of Open Access Journals (Sweden)

    Tomás Escobar-Rodríguez

    2015-07-01

    Full Text Available The main problems that arise in adopting most enterprise resources planning (ERP strategies come from organizational, rather than technical, issues, for example, social and cultural barriers, and user resistance. This paper analyzes the impact of cultural factors on user attitudes toward ERP use in public hospitals and identifying influencing factors. The theoretical grounding for this research is the Technology Acceptance Model (TAM. The proposed model has six constructs (“resistance to be controlled”, “resistance to change”, “perceived risks”, “perceived usefulness”, “perceived ease of use”, and “attitude toward using”, and nine hypotheses have been generated from the connections between these six constructs. Results suggest important practical implications for attitude toward using ERP and to develop an understanding about how to improve this attitude in hospitals.

  18. Incorporation of public hospitals: a "silver bullet" against overcapacity, managerial bottlenecks and resource constraints? Case studies from Austria and Estonia.

    Science.gov (United States)

    Fidler, Armin H; Haslinger, Reinhard R; Hofmarcher, Maria M; Jesse, Maris; Palu, Toomas

    2007-05-01

    This paper presents a new approach for incorporating public hospitals by contrasting the experience from an "old" EU country (Austria) with a new EU member state (Estonia). In the EU (including the new member states) hospital overcapacity is a serious problem, from a technical, fiscal and political perspective. Few countries have succeeded in establishing an appropriate framework for resource management and for guaranteeing long-term financial viability of their hospital network. Many countries are in search of effective policies for improved hospital management and more cost-effective resource use in the health sector. Over the past decade, experiences in Austria and Estonia have emerged as innovative examples which may provide lessons for other EU countries and beyond. This paper describes the evolution of public hospitals from public budgetary units and public management to incorporated autonomous organizations under private corporate law, resulting in a contractual relationship between (public) owners and private hospital management. Outdated and inefficient public sector structures were replaced by more agile corporate management. The arrangement allows for investments, operating costs and budgeting according to strategic business goals as opposed to political "fiat". Shielding hospitals from local political influence is an important aspect of this concept. Horizontal integration through networking of public hospitals and introducing private management helps create a new corporate culture, allowing for more flexibility to achieve efficiencies through downsizing and economies of scale. Based on contracts the new balance between ownership and managerial functions create strong incentives for a more business-like, results-oriented and consumer-friendly management. This was achieved both in Austria and Estonia in a politically sensitive way, adopting a long-term vision and by protecting the interests of hospital owners and staff.

  19. A safety culture assessment by mixed methods at a public maternity and infant hospital in China

    Directory of Open Access Journals (Sweden)

    Listyowardojo TA

    2017-07-01

    Full Text Available Tita Alissa Listyowardojo,1 Xiaoling Yan,2,3 Stephen Leyshon,1 Bobbie Ray-Sannerud,1 Xin Yan Yu,4 Kai Zheng,4 Tao Duan2,3 1Life Sciences Program, Group Technology and Research, DNV GL, Hovik, Norway; 2Quality and Safety Department, Shanghai First Maternity and Infant Hospital, 3Tongji University School of Medicine, Shanghai, 4Healthcare Department, Business Assurance, DNV GL, Beijing, China Objective: To assess safety culture at a public maternity hospital in Shanghai, China, using a sequential mixed methods approach. The study was part of a bigger study looking at the application of the mixed methods approach to assess safety culture in health care in different organizations and countries.Methodology: A mixed methods approach was utilized by first distributing the Safety Attitudes Questionnaire measuring six safety culture dimensions and five independent items to all hospital staff (n=1482 working in 18 departments at a single hospital. Afterward, semistructured interviews were conducted using convenience sampling, where 48 hospital staff from nine departments at the same hospital were individually interviewed.Results: The survey received a response rate of 96%. The survey findings show significant differences between the hospital departments in almost all safety culture dimensions and independent items. Similarly, the interview findings revealed that there were different, competing priorities between departments perceived to result in a reduced quality of collaboration and bottlenecks in care delivery. Another major finding was that staff who worked more hours per week would perceive working conditions significantly more negatively. Issues related to working conditions were also the most common concerns discussed in the interviews, especially the issue on high workload. High workload was also reflected in the fact that 91.45% of survey respondents reported that they worked 40 hours or longer per week. Finally, interview findings complemented

  20. Healthcare professional perspectives on quality and safety in New Zealand public hospitals: findings from a national survey.

    Science.gov (United States)

    Gauld, Robin; Horsburgh, Simon

    2014-02-01

    Few studies have sought to measure health professional perceptions of quality and safety across an entire system of public hospitals. Therefore, three questions that gauge different aspects of quality and safety were included in a national New Zealand survey of clinical governance. Three previously used questions were adapted. A total of 41040 registered health professionals employed in District Health Boards were invited to participate in an online survey. Analyses were performed using the R statistical environment. Proportional odds mixed models were used to quantify associations between demographic variables and responses on five-point scales. Relationships between other questions in the survey and the three quality and safety questions were quantified with the Pearson correlation coefficient. A 25% response rate delivered 10303 surveys. Fifty-seven percent of respondents (95% CI: 56-58%) agreed that health professionals in their District Health Board worked together as a team; 70% respondents (95% CI: 69-70%) agreed that health professionals involved patients and families in efforts to improve patient care; and 69% (95% CI: 68-70%) agreed that it was easy to speak up in their clinical area if they perceived a problem with patient care. Correlations showed links between perceptions of stronger clinical leadership and performances on the three questions, as well as with other survey items. The proportional mixed model also revealed response differences by respondent characteristics. The findings suggest positive commitment to quality and safety among New Zealand health professionals and their employers, albeit with variations by district, profession, gender and age, but also scope for improvement. The study also contributes to the literature indicating that clinical leadership is an important contributor to quality improvement. WHAT IS KNOWN ABOUT THE TOPIC? Various studies have explored aspects of healthcare quality and safety, generally within a hospital or

  1. Outbreaks of emerging infectious diseases: Risk perception and behaviour of the general public

    NARCIS (Netherlands)

    M. Bults (Marloes)

    2014-01-01

    markdownabstract__Abstract__ This thesis focuses on risk perception and behaviour of the public during the outbreaks of emerging infectious diseases. It consists of studies on Influenza A (H1N1), Q fever and Lyme disease. These studies were conducted among both the general public and specific

  2. Outbreaks of emerging infectious diseases: Risk perception and behaviour of the general public

    NARCIS (Netherlands)

    M. Bults (Marloes)

    2014-01-01

    markdownabstract__Abstract__ This thesis focuses on risk perception and behaviour of the public during the outbreaks of emerging infectious diseases. It consists of studies on Influenza A (H1N1), Q fever and Lyme disease. These studies were conducted among both the general public and specific risk

  3. Clinical Presentation of General Paralysis of the Insane in a Dutch Psychiatric Hospital, 1924-1954.

    Science.gov (United States)

    Daey Ouwens, Ingrid M; Lens, C Elisabeth; Fiolet, Aernoud T L; Ott, Alewijn; Koehler, Peter J; Verhoeven, Willem M A

    2015-01-01

    General paralysis of the insane (GPI) or dementia paralytica was once a fatal complication of syphilitic infection and a major reason for psychiatric hospitalization. Nowadays, physicians consider GPI to be exceptional. It should be noted, however, that syphilis re-emerged worldwide at the turn of the 20th to 21st century and a revival of GPI can, therefore, be expected. Advanced diagnosis is crucial in that treatment in the early, inflammatory phase is warranted before irreversible tissue damage occurs. Therefore, a renewed clinical awareness of the broad spectrum of psychiatric and neurologic signs and symptoms of GPI is needed. In this historical cohort study, comprising 105 patients with GPI admitted to the Dutch Vincent van Gogh Psychiatric Hospital in the period 1924-1954, the clinical presentation of this invalidating disorder is investigated and described in detail.

  4. Recreational activities performed with neoplasia carrier Inpatients in a general hospital

    Directory of Open Access Journals (Sweden)

    Caroline de Castro Moura

    2012-09-01

    Full Text Available This study aims at apprehending the contribution of recreational activities in the treatment of hospitalized cancer patients and identifying the most stimulating resources for them. This is a qualitative research of phenomenological nature, it was approved by the Ethics in Research Committee, Protocol 139/2010. It was conducted with patients with cancer in a general hospital, located in Alfenas, in March and April, 2011.The research began from these guiding questions: What are your thoughts on the recreational team work and the activities they do? What do you suggest for this group to be developed? It was perceived that ludic activities help patients to face the disease, that they eased the interaction between the recreational group and the multiprofessional team, besides providing a happy and welcoming environment. The most well accepted activities were music and games the clowns provided. We suggest implementing the humanization by using ludic resources.

  5. Key Performance Indicators for Maintenance Management Effectiveness of Public Hospital Building

    Directory of Open Access Journals (Sweden)

    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.

  6. Epidemia de influenza A(H1N1 en la Argentina: Experiencia del Hospital Nacional Profesor Alejandro Posadas Influenza A(H1N1 epidemic in Argentina: Experience in a National General Hospital (Hospital Nacional Profesor Alejandro Posadas

    Directory of Open Access Journals (Sweden)

    2009-10-01

    Full Text Available Se describe la preparación y la atención médica durante la epidemia de influenza A(H1N1 (junio 2009 en un hospital general de agudos, público, de alta complejidad; con diagnóstico de laboratorio, internación general y cuidados intensivos (UCI. Se elaboró un plan para aumentar la capacidad asistencial, reasignar recursos y garantizar la bioseguridad. La consulta fue 7.1 ± 3.8 veces mayor que en 2006-2008. La detección de casos de A(H1N1 fue confirmada por PCR-RT en 186/486 (38.3% pacientes internados y en 56/176 (31.8% ambulatorios. Internados: mediana de edad 20 años; 75% menores de 45 y 32.3% menores de 15. Mortalidad global: 6.8%; 9.1% en los positivos. Adultos: recepción en un área de atención ambulatoria, internación (aislamiento y ventilación mecánica. Sala general: ingresaron 110 pacientes (5 veces más que 1999-2006 con saturación de oxígeno The preparation and medical care during the influenza A(H1N1 outbreak (June 2009 in a high complexity level, public, general hospital with laboratory diagnosis, general and intensive care (ICU hospitalization is described. A plan was designed to increase the hospital's surge capacity, reallocate resources and guarantee bio-safety. The number of consultations was 7.1 ± 3.8 times higher than during June 2006-2008. Detection of A(H1N1 cases were confirmed by PCR-RT in 186/486 (38.3% in-patients and 56/176 (31.8% out-patients. Median age among in-patients was 20 years; 75% < 45 and 32.3% < 15. Global mortality: 6.8%; 9.1% among confirmed cases. Adults were directed to a reception area of out-patient care, hospitalization (isolation and mechanical ventilation. General ward: 110 patients with oxygen saturation < 96% and/or risk factors (65.5% had asthma, chronic obstructive pulmonary disease, obesity, pregnancy or other were admitted (5 times more than in 1999-2006. Chest X-ray showed lung infiltrates and/or lung consolidation in 97.3%. Severe hypoxemia: 43.5%. There were no significant

  7. 公立医院法律属性分析%Analysis on Legal Attributes of Public Hospitals

    Institute of Scientific and Technical Information of China (English)

    曹培杰; 程跃华; 刘子锋

    2014-01-01

    Through systematic examination of public hospital legal attribute legislation, policy evolution, global public hospitals' organizational change, and the change in public hospital autonomy ( i.e. legal persons' independence ), this paper discusses property and will independence of public hospitals in China, and reveals the reality that the public hospitals in China don't really have the rights of legal person. Based on the systematic introduction to the theoretical concept of corporate body in continental law system, and the comparison of the legislation situation in public hospitals of Japan, Taiwan and Hong Kong, this paper defines the legal attributes of public hospitals in China, and suggests the idea that public hospitals in China should be modified as corporate body under private legal person.%本文通过对公立医院法律属性立法、政策沿革、全球公立医院组织变革以及公立医院自主权(即法人独立性)变化等方面进行系统梳理,结合我国公立医院财产、意志独立性加以探讨,揭示了我国公立医院存在不具有法人之实的问题。在系统介绍大陆法系财团法人理论概念的基础上,通过比较日本、我国台湾和香港地区公立医院的立法情况,对我国公立医院法律属性作出界定,提出了我国公立医院应当改造为私法人下的财团法人的观点。

  8. Patients’ perception of quality service delivery of public hospitals in Nigeria using analytical hierarchy process

    Directory of Open Access Journals (Sweden)

    Emmanuel Olateju Oyatoye

    2016-07-01

    Full Text Available Introduction: Patients are recently more aware and conscious. This is because of the belief that a high level of quality can translate into patient satisfaction. This is critical for healthcare providers as they deal with life. This recognition by both the service provider and service receivers made the government to establish units of service commission (SERVICOM in each of the governmental agencies including hospitals in Nigeria to monitor the level of quality of service delivery. However, to what extent do patients’ perceptions about health services seem to have been largely recognized remain unclear by health care providers, despite the (SERVICOM units in public institutions in Nigeria? Method: A cross-sectional analytical study using convenient sample method, based on the fact that not every patient of the selected hospitals can be chosen, was performed on 400 patients who received health services at four different public hospitals in Ogun state Nigeria. The selection of these hospitals was based on the zones in the state (Egba, Ijebu, Remo and Yewa area of Ogun-state. The instrument was a valid and reliable analytical hierarchy process based questionnaire containing five service quality dimensions. Data were analyzed using SPSS, Expert choice and Microsoft Excel software to determine the perception of patients towards service quality delivery in pairwise comparison of judgment consistent at less than 10%. Results:The results showed the composite priorities of the patients’ perception with respect to determinants of the patients’ perception towards quality of services delivered in the public hospitals in Nigeria. The most important factor to patients was the reliability dimension with composite priority 0.24 or 24% followed by the responsiveness dimension with 0.22 assurance dimension 0.21, tangibility dimension with 0.21, and the least determinant factor was the empathy dimension with 0.1101. Conclusion: Based on the results, the

  9. Workplace violence against physicians and nurses in Palestinian public hospitals: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Kitaneh Mohamad

    2012-12-01

    Full Text Available Abstract Background Violence against healthcare workers in Palestinian hospitals is common. However, this issue is under researched and little evidence exists. The aim of this study was to assess the incidence, magnitude, consequences and possible risk factors for workplace violence against nurses and physicians working in public Palestinian hospitals. Methods A cross-sectional approach was employed. A self-administered questionnaire was used to collect data on different aspects of workplace violence against physicians and nurses in five public hospitals between June and July 2011. The questionnaires were distributed to a stratified proportional random sample of 271 physicians and nurses, of which 240 (88.7% were adequately completed. Pearson’s chi-square analysis was used to test the differences in exposure to physical and non-physical violence according to respondents’ characteristics. Odds ratios and 95% confidence intervals were used to assess potential associations between exposure to violence (yes/no and the respondents’ characteristics using logistic regression model. Results The majority of respondents (80.4% reported exposure to violence in the previous 12 months; 20.8% physical and 59.6% non-physical. No statistical difference in exposure to violence between physicians and nurses was observed. Males’ significantly experienced higher exposure to physical violence in comparison with females. Logistic regression analysis in