WorldWideScience

Sample records for public hospital services

  1. 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.

  2. 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.

  3. 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.

  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. 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.

  6. 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...

  7. [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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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...

  14. 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.

  15. PHYSICAL EVIDENCE AND QUALITY SERVICE DELIVERY IN PUBLIC HOSPITALS IN GHANA

    Directory of Open Access Journals (Sweden)

    Edem Max Azila-Gbettor

    2013-09-01

    Full Text Available This study examines the value of physical environment in the delivering of quality healthcare or service in public hospitals in Ghana. Twelve set of self-administered questions were designed using Baker’s (1987 typology of servicescape. A descriptive univariate analysis was applied for the study. Based on 233 usable questionnaires retrieved from respondents, the study indicates a strong link between physical environment and quality healthcare delivery and the choice of healthcare facility. It is there by recommended that improvement in quality service delivery may be better served and improved by improving the servicescape/physical element in the services mix.

  16. 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

  17. 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.

  18. 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

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

    Directory of Open Access Journals (Sweden)

    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

  20. [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

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

    Directory of Open Access Journals (Sweden)

    Kanwal Nasim

    2014-09-01

    Full Text Available 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.

  2. 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.

  3. 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.

  4. 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.

  5. Factors influencing inpatients’ satisfaction with hospitalization service in public hospitals in Shanghai, People’s Republic of China

    Directory of Open Access Journals (Sweden)

    Chen H

    2016-04-01

    Full Text Available Haiping Chen,1 Meina Li,1 Jingrui Wang,1 Chen Xue,1 Tao Ding,1 Xin Nong,2 Yuan Liu,1 Lulu Zhang11Department of Military Health Management, College of Health Service, Second Military Medical University, Shanghai, 2Department of Medical Research, Rizhao Maternity and Infant Hospital, Shandong, People’s Republic of ChinaObjective: The aim of this study was to observe the current status of inpatient satisfaction and analyze the possible factors influencing patient satisfaction during hospitalization.Methods: A cross-sectional investigation was conducted to obtain basic information about inpatient satisfaction, and statistical methods were used to describe and analyze the data. A total of 878 questionnaires were included in this study. A 5-point Likert scale rating was employed to assess items related to hospitalization care. Nonparametric tests and ordinal logistic analysis were used to explore the relationship between predictors and the patients’ overall satisfaction.Results: Among the respondents, 89.75% were satisfied overall with the service they received during hospitalization, while 0.57% reported dissatisfaction. Inpatient demographic characteristics such as sex of the patients, occupation, age, and residence had significant associations with satisfaction, while monthly income and marital status did not. Additionally, the statistical outcome indicated that doctors’ and nurses’ service attitudes, and expenditure and environment were found to have an impact on the inpatient satisfaction ratings, with odds ratio of 2.43, 3.19, and 2.72, respectively.Conclusion: This study emphasizes the influence of sex of the patients, the service attitudes of the doctors and nurses, and expenditure and environment on inpatient satisfaction. An increase in satisfaction ratings concerning the areas of doctors’ and nurses’ service attitudes, and expenditure and environment can improve the overall satisfaction levels. Responsible health management

  6. Current status, challenges and the way forward for clinical pharmacy service in Ethiopian public hospitals.

    Science.gov (United States)

    Bilal, Arebu Issa; Tilahun, Zelalem; Gebretekle, Gebremedhin Beedemariam; Ayalneh, Belete; Hailemeskel, Bisrat; Engidawork, Ephrem

    2017-05-19

    Clinical pharmacy service has evolved steadily over the past few decades and is now contributing to the 'patient care journey' at all stages. It is improving the safety and effectiveness of medicines and has made a significant contribution to the avoidance of medication errors. In Ethiopia, clinical pharmacy service is in its initial phase, being started in July 2013. This study therefore aimed at assessing the status, challenges and way forward of clinical pharmacy service in the country. A cross-sectional survey was conducted in six regional states and one city- administration in September 2014. A total of 51 hospitals were included in the study. Both qualitative and quantitative methods were employed for data collection. A total of 160 pharmacy graduates, and 51 pharmacy heads participated in the study. Internal Medicine and Pediatric wards were the major wards where the graduates provide clinical pharmacy service. Almost 94% of the new graduates were found to be involved in clinical pharmacy service, but 47% of them rated their service as poor. The overall satisfaction of the graduates was close to 36%. Thirteen hospitals discontinued and two hospitals not even initiated the service largely due to shortage of pharmacists and lack of management support. About 44% of the surveyed hospitals documented the clinical pharmacy service provided using either developed or adopted formats. Lack of awareness by the medical fraternity, high attrition rate, lack of support from the management as well as from the health care team, readiness of the graduates to deliver the service, and shortage of pharmacists were identified by the key informants as the major stumbling block to deliver clinical pharmacy service. Clinical pharmacy service is initiated in most of the surveyed hospitals and a large proportion of the graduates were involved in the service. Although there is a great enthusiasm to promote clinical pharmacy service in the surveyed hospitals, efforts made to

  7. 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.

  8. 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.

  9. Measuring patients' satisfaction with pharmaceutical services at a public hospital in Qatar.

    Science.gov (United States)

    Khudair, Imran Fahmi; Raza, Syed Asif

    2013-01-01

    The aim of this paper is to study pharmacy service impact on patient satisfaction and to determine what factors saliently link with pharmaceutical service performance at Hamad General Hospital. A patient satisfaction questionnaire was designed using the literature and consultation with Hamad General Hospital medical experts. The questionnaire contained 22 items that focused on five influencing factors: promptness; attitude; supply; location; medication education; and respondent demographic aspects. A total of 220 respondents completed the questionnaire. An exploratory factor analysis was used to group items and a structural equation model was developed to test causality between five factors along with their influence on patient satisfaction. The study establishes statistical evidence that patient satisfaction is positively influenced by service promptness, pharmacist attitude, medication counseling, pharmacy location and waiting area. Several socio-demographic characteristics have statistically different effect on satisfaction, notably: gender; marital status; health status; age; educational level; and ethnicity. However, medication supply did not influence patient satisfaction. Pharmaceutical services are recognized as an essential healthcare-system component. Their impact on customer satisfaction has been investigated in many countries; however, there is no such study in Qatar. The findings identify pharmaceutical service performance indicators and provide guidelines to improve Qatari pharmaceutical services.

  10. 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.

  11. CDBG Public Services Activity

    Data.gov (United States)

    Department of Housing and Urban Development — CDBG activity related to public services, including senior services, legal services, youth services, employment training, health services, homebuyer counseling, food...

  12. The way the quality of health services is perceived and treated by the managerial personnel of public hospitals

    Directory of Open Access Journals (Sweden)

    Anna Rybarczyk-Szwajkowska

    2016-06-01

    Full Text Available Background: Managerial knowledge and skills as well as profound understanding of goals and objectives of management determine the effectiveness and efficiency in all areas of managerial activities. In particular, this applies to the quality of healthcare services, perceived as a compliance between the effects (of medical treatment and the assumed relevant objectives (defined/desired health condition. The aim of the research was to distinguish and define the way the health service quality is perceived by the hospital managerial personnel. Material and Methods: The questionnaire was mailed to 836 members of the managerial personnel of public hospitals in the Łódź province. Of this number 122 questionnaires were returned. Results: Only 22 (18.49% of respondents presented the definition of quality. Attempts to meet patients’ expectations and to satisfy them were found to be the prevailing perception of the healthcare quality and 96.64% of respondents considered competences of medical staff contributory. Almost 64% of respondents disagree with the opinion that the number of medical staff does not affect the service quality. According to the respondents, a 46% increase in financial resources on average could significantly improve the quality of healthcare services. More than half (66.76% of respondents claim that healthcare services that are available cover 82% of patients’ needs. Almost 57% (56.52% of respondents consider that the subordinate- superior relationship influences their work involvement. According to 42.61% of respondents, the offered incentives encourage actions for the quality improvement. Conclusions: The results of the research indicate the need to develop a clear cut definition of the health service quality by the managerial personnel of public hospitals and to change their understanding, perception and treatment of the discussed issue, which provides a basis for the effective and efficient hospital management. Med Pr 2016

  13. Quality of Care and Services of a Public Hospital: Awareness and Assessment

    Directory of Open Access Journals (Sweden)

    Abdel-ilah Aziane

    2015-04-01

    Full Text Available In order to give everyone access to quality care, this study attempts to make quality awareness, highlighting the importance of the implementation of the quality management system in health care facilities. The objective of our work is to make a quality awareness, to analyze the current situation and to provide recommendations. The analysis of the existing situation consists of identifying, describing, and analyzing the key processes implemented, listing the dysfunctions, classifying them, deciding on the corresponding actions and putting in place indicators and dashboards, which will help track improvements. The overall situation of the hospital regarding the requirements of ISO 9001 indicated a respect of about 28% of the requirements of the standard. The state of the premises of the establishment does not indicate a clear organization at the hospital. The hospital environment is a prerequisite to the establishment of a system of quality management that enables you to deploy a clear and shared policy to improve the quality of care and services.

  14. The effect of internal marketing on job satisfaction in health services: a pilot study in public hospitals in Northern Greece

    Directory of Open Access Journals (Sweden)

    Priporas Constantinos-Vasilios

    2011-10-01

    Full Text Available Abstract Background The purpose of this study was to explore the effect of internal marketing on job satisfaction in health services, particularly in public hospitals in Northern Greece. Methods A questionnaire with three sections was used. The first one referred to internal marketing by using Foreman and Money's scale, while the second one contained questions on job satisfaction based on Stamps and Piermonte's work. The last section included demographic questions. Three categories of health care professionals, nurses, doctors and paramedic personnel working in public hospitals have participated. Results Doctors tend to be more satisfied with their job than nurses in the same hospitals. Male personnel also tend to be more satisfied with their job than female. Time-defined work contract personnel have a greater level of job satisfaction than permanent personnel. Marital status, position, and educational level have no statistically significant impact on job satisfaction. A slight decline in job satisfaction occurs as the personnel age. Conclusions Internal marketing has a positive effect on the job satisfaction of hospital staff in Northern Greece. Also, doctors and male personnel seem to have greater levels of job satisfaction. Staff with time-defined work contracts with the hospital are more satisfied than permanent staff, and as the staff age, there is a slight decline in job satisfaction.

  15. The effect of internal marketing on job satisfaction in health services: a pilot study in public hospitals in Northern Greece.

    Science.gov (United States)

    Iliopoulos, Efthymios; Priporas, Constantinos-Vasilios

    2011-10-09

    The purpose of this study was to explore the effect of internal marketing on job satisfaction in health services, particularly in public hospitals in Northern Greece. A questionnaire with three sections was used. The first one referred to internal marketing by using Foreman and Money's scale, while the second one contained questions on job satisfaction based on Stamps and Piermonte's work. The last section included demographic questions. Three categories of health care professionals, nurses, doctors and paramedic personnel working in public hospitals have participated. Doctors tend to be more satisfied with their job than nurses in the same hospitals. Male personnel also tend to be more satisfied with their job than female. Time-defined work contract personnel have a greater level of job satisfaction than permanent personnel. Marital status, position, and educational level have no statistically significant impact on job satisfaction. A slight decline in job satisfaction occurs as the personnel age. Internal marketing has a positive effect on the job satisfaction of hospital staff in Northern Greece. Also, doctors and male personnel seem to have greater levels of job satisfaction. Staff with time-defined work contracts with the hospital are more satisfied than permanent staff, and as the staff age, there is a slight decline in job satisfaction.

  16. The effect of internal marketing on job satisfaction in health services: a pilot study in public hospitals in Northern Greece

    Science.gov (United States)

    2011-01-01

    Background The purpose of this study was to explore the effect of internal marketing on job satisfaction in health services, particularly in public hospitals in Northern Greece. Methods A questionnaire with three sections was used. The first one referred to internal marketing by using Foreman and Money's scale, while the second one contained questions on job satisfaction based on Stamps and Piermonte's work. The last section included demographic questions. Three categories of health care professionals, nurses, doctors and paramedic personnel working in public hospitals have participated. Results Doctors tend to be more satisfied with their job than nurses in the same hospitals. Male personnel also tend to be more satisfied with their job than female. Time-defined work contract personnel have a greater level of job satisfaction than permanent personnel. Marital status, position, and educational level have no statistically significant impact on job satisfaction. A slight decline in job satisfaction occurs as the personnel age. Conclusions Internal marketing has a positive effect on the job satisfaction of hospital staff in Northern Greece. Also, doctors and male personnel seem to have greater levels of job satisfaction. Staff with time-defined work contracts with the hospital are more satisfied than permanent staff, and as the staff age, there is a slight decline in job satisfaction. PMID:21981753

  17. Escalation of oncologic services at the end of life among patients with gynecologic cancer at an urban, public hospital.

    Science.gov (United States)

    Wu, Eijean; Rogers, Anna; Ji, Lingyun; Sposto, Richard; Church, Terry; Roman, Lynda; Tripathy, Debu; Lin, Yvonne G

    2015-03-01

    Use of oncology-related services is increasingly scrutinized, yet precisely which services are actually rendered to patients, particularly at the end of life, is unknown. This study characterizes the end-of-life use of medical services by patients with gynecologic cancer at a safety-net hospital. Oncologic history and metrics of medical use (eg, hospitalizations, chemotherapy infusions, procedures) for patients with gynecologic oncology who died between December 2006 and February 2012 were evaluated. Mixed-effect regression models were used to test time effects and construct usage summaries. Among 116 subjects, cervical cancer accounted for the most deaths (42%). The median age at diagnosis was 55 years; 63% were Hispanic, and 65% had advanced disease. Only 34% died in hospice care. The median times from do not resuscitate/do not intubate documentation and from last therapeutic intervention to death were 9 days and 55 days, respectively. Significant time effects for all services (eg, hospitalizations, diagnostics, procedures, treatments, clinic appointments) were detected during the patient's final year (P care used significantly fewer resources toward the end of life. To our knowledge, this is the first report enumerating medical services obtained by patients with gynecologic cancer in a large, public hospital during the end of life. Marked changes in interventions in the patient's final 2 months highlight the need for cost-effective, evidence-based metrics for delivering cancer care. Our data emphasize continuity of care as a significant determinant of oncologic resource use during this critical period. Copyright © 2015 by American Society of Clinical Oncology.

  18. Medical Virtual Public Services

    Directory of Open Access Journals (Sweden)

    Iulia SURUGIU

    2008-01-01

    Full Text Available The healthcare enterprises are very disconnected. This paper intends to propose a solution that will provide citizens, businesses and medical enterprises with improved access to medical virtual public services. Referred medical services are based on existing national medical Web services and which support medically required services provided by physicians and supplementary health care practitioners, laboratory services and diagnostic procedures, clinics and hospitals’ services. Requirements and specific rules of these medical services are considered, and personalization of user preferences will to be supported. The architecture is based on adaptable process management technologies, allowing for virtual services which are dynamically combined from existing national medical services. In this way, a comprehensive workflow process is set up, allowing for service-level agreements, an audit trail and explanation of the process to the end user. The process engine operates on top of a virtual repository, providing a high-level semantic view of information retrieved from heterogeneous information sources, such as national sources of medical services. The system relies on a security framework to ensure all high-level security requirements are met. System’s architecture is business oriented: it focuses on Service Oriented Architecture - SOA concepts, asynchronously combining Web services, Business Process Management – BPM rules and BPEL standards.

  19. Drug information service awareness program and its impact on characteristics of inquiries at DIS unit in Malaysian public hospital

    Directory of Open Access Journals (Sweden)

    Aida Azlina Ali

    2013-01-01

    Full Text Available Objectives : To study the Drug Information Service (DIS awareness program organized by a DIS unit in Malaysian hospital through utilization of provided services by the healthcare professionals, allied healthcare providers, patients and the public, and to identify the characteristics of inquiries received. Materials and Methods : An awareness program to promote the services of the DIS unit was held throughout the month of March in 2010. Drug information queries forms that have been documented six months prior to (September 2009-February 2010 and six months after (April-September 2010 the awareness program were collected and assessed. Mean monthly inquiries volumes pre- and post-program were compared to evaluate the effectiveness of the program. Types of information requestors, inquiries, reference sources, and drug class information were identified and evaluated. Results: A total of 747 drug information queries forms were received during the study period. The mean total utilization of the DIS unit services after (63.67 ± 18.24 the DIS awareness program was increased but not significant (P < 0.05 when compared to records before (60.83 ± 21.49 the program. Majority of the DIS service users were the pharmacist (67.5%, followed by the doctors (24.9%. Most inquiries were regarding the dosage and route of administration of drugs (61.4%. The most frequently referred sources of information were the Micromedex and the Internet (37.3%. The most common inquiries were related to the anti-infective agents (37.8%. Conclusion: Provision of sufficient and accurate drug information to the healthcare professionals, patients, and the public is crucial to ensure optimization of therapy. The utilization of services provided by the DIS unit should be supported. Frequent DIS awareness program should be undertaken to promote and encourage the use of services.

  20. Public and private maternal health service capacity and patient flows in Southern Tanzania: using a geographic information system to link hospital and national census data.

    Science.gov (United States)

    Tabatabai, Patrik; Henke, Stefanie; Sušac, Katharina; Kisanga, Oberlin M E; Baumgarten, Inge; Kynast-Wolf, Gisela; Ramroth, Heribert; Marx, Michael

    2014-01-01

    Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6) in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds), provider-fees for obstetric services and patient turnover (antenatal care, births). Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. The contribution of faith-based organizations (FBOs) to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising partners in health programming. Inclusive partnerships could increase

  1. Public and private maternal health service capacity and patient flows in southern Tanzania: using a geographic information system to link hospital and national census data

    Directory of Open Access Journals (Sweden)

    Patrik Tabatabai

    2014-01-01

    Full Text Available Background: Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. Objective: To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. Design: A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6 in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds, provider-fees for obstetric services and patient turnover (antenatal care, births. Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. Results: The contribution of faith-based organizations (FBOs to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. Conclusions: We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising

  2. Public and private maternal health service capacity and patient flows in southern Tanzania: using a geographic information system to link hospital and national census data

    Science.gov (United States)

    Tabatabai, Patrik; Henke, Stefanie; Sušac, Katharina; Kisanga, Oberlin M. E.; Baumgarten, Inge; Kynast-Wolf, Gisela; Ramroth, Heribert; Marx, Michael

    2014-01-01

    Background Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. Objective To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. Design A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6) in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds), provider-fees for obstetric services and patient turnover (antenatal care, births). Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. Results The contribution of faith-based organizations (FBOs) to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. Conclusions We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising partners in health

  3. Service Robots for Hospitals

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan

    services to maintain the quality of healthcare provided. This thesis and the Industrial PhD project aim to address logistics, which is the most resource demanding service in a hospital. The scale of the transportation tasks is huge and the material flow in a hospital is comparable to that of a factory. We...... believe that these transportation tasks, to a great extent, can be and will be automated using mobile robots. This thesis consequently addresses the key technical issues of implementing service robots in hospitals. In simple terms, a robotic system for automating hospital logistics has to be reliable...... manual work and offer many advantages beyond robotics. Finally, this thesis outlines our contributions in representation of multi-floor buildings, which is a vital requirement to achieve robust and practical, real-world service robot applications....

  4. Hospitality Services. Curriculum Guide.

    Science.gov (United States)

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This guide, which was developed as part of Texas' home economics education program, is intended to assist teachers of a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The first 40% of the approximately 600-page guide consists of strategies for teaching each of 29 essential…

  5. Satisfaction and adherence of patients with amputations to physiotherapy service at public hospitals in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Verusia, Chetty; Tanuja, Dunpath; Simira, Meghnath; Sarisha, Mothalal; Varuna, Sewmungal; Ursula, Kunene; Thalente, Ntshakala

    2015-06-01

    Individuals who have undergone a lower limb amputation require comprehensive rehabilitation from the multidisciplinary team to ensure optimal treatment outcomes and social integration. Physiotherapists play a pivotal role within the multidisciplinary team and offer patients physical and psychosocial rehabilitative care. Determining patients' satisfaction levels and exploring factors affecting adherence to physiotherapy interventions can inform practice and improve service delivery of rehabilitation within resource poor settings such as South Africa. To determine the level of satisfaction with physiotherapy services rendered to acute and sub-acute in-patients with lower limb amputations and to explore factors affecting adherence to physiotherapy intervention. A prospective survey of 35 patients with lower limb amputations from four public hospitals in South Africa was undertaken. A modified version of the Hampstead rehabilitation centre patient satisfaction questionnaire was utilised. Majority of participants were satisfied with the physiotherapy services whilst a few reported dissatisfaction. Three themes emerged whilst exploring the patients' experience relating to adherence to physiotherapy programmes. Themes included service delivery, patient-therapist interaction and participation barriers and facilitators. Recommendations aimed to improve quality of care and healthcare outcomes thereby enhancing the participants' adherence to the physiotherapy programme.

  6. Public opinion on public services

    NARCIS (Netherlands)

    Evelien Eggink; Debbie Verbeek-Oudijk; Evert Pommer

    2013-01-01

    Original titel: Burgers over de kwaliteit van publieke diensten Most citizens come into contact with public services, for example as a patient, as a student or pupil, as a passenger on public transport or as a museum visitor. More and more importance is being attached to the quality of those service

  7. Quality care, public perception and quick-fix service management: a Delphi study on stressors of hospital doctors in Ireland

    Science.gov (United States)

    Hayes, Blanaid; Fitzgerald, Deirdre; Doherty, Sally; Walsh, Gillian

    2015-01-01

    Objectives To identify and rank the most significant workplace stressors to which consultants and trainees are exposed within the publicly funded health sector in Ireland. Design Following a preliminary semistructured telephone interview, a Delphi technique with 3 rounds of reiterative questionnaires was used to obtain consensus. Conducted in Spring 2014, doctors were purposively selected by their college faculty or specialty training body. Setting Consultants and higher specialist trainees who were engaged at a collegiate level with their faculty or professional training body. All were employed in the Irish publicly funded health sector by the Health Services Executive. Participants 49 doctors: 30 consultants (13 male, 17 female) and 19 trainees (7 male, 12 female). Consultants and trainees were from a wide range of hospital specialties including anaesthetics, radiology and psychiatry. Results Consultants are most concerned with the quality of healthcare management and its impact on service. They are also concerned about the quality of care they provide. They feel undervalued within the negative sociocultural environment that they work. Trainees also feel undervalued with an uncertain future and they also perceive their sociocultural environment as negative. They echo concerns regarding the quality of care they provide. They struggle with the interface between career demands and personal life. Conclusions This Delphi study sought to explore the working life of doctors in Irish hospitals at a time when resources are scarce. It identified both common and distinct concerns regarding sources of stress for 2 groups of doctors. Its identification of key stressors should guide managers and clinicians towards solutions for improving the quality of patient care and the health of care providers. PMID:26700286

  8. The impact of total quality service (TQS) on healthcare and patient satisfaction: an empirical study of Turkish private and public hospitals.

    Science.gov (United States)

    Bakan, Ismail; Buyukbese, Tuba; Ersahan, Burcu

    2014-01-01

    This paper attempts to measure patients' perceptions of the quality of services in public and private healthcare centers in Turkey. The main aim was to examine the impact of the dimensions of patient-perceived total quality service (TQS) on patients' satisfaction. The research framework and hypotheses are derived from a literature review of service quality and quality in the healthcare industry. The research data were collected through questionnaires and then statistically analyzed using descriptive statistics, Pearson product moment correlation and linear regression. The results suggest that service quality perceptions positively influence patient satisfaction with overall hospital care (SOHC). The most important factors identified in the regression model regarding patient SOHC are the quality of the hospital's social responsibility, administrative processes and overall experience of medical care received. These factors explain 74% of the variance in SOHC. The findings of the study can be used to improve TQS in both private and public hospitals. Copyright © 2013 John Wiley & Sons, Ltd.

  9. Using caregivers’ perceptions of rehabilitation services for children with Cerebral Palsy at public sector hospitals to identify the components of an appropriate service

    Directory of Open Access Journals (Sweden)

    G.M. Saloojee

    2011-02-01

    Full Text Available Despite  a  growing  body  of  evidence  favouring  a  family-centred approach to rehabilitation services for children with cerebral palsy (cp, the essential components for a quality service for children with disabilities and their families living in poorly-resourced South African (SA settings  remains unknown.  The  study  aimed  to  identify  key  components of  an appropriate  rehabilitation  service  which  would  meet  the  needs of children  with  CP  and  their  caregivers  at  SA  public  sector  hospitals. This cross-sectional descriptive study used the modified Measure of processes of care (Mpoc-20 questionnaire together with two open-endedquestions with  a  convenience  sample  of  caregivers attending therapy  at  CP  Clinics in gauteng and limpopo hospitals. A total of 263 caregivers attending cerebral palsy clinics at 31 public sector hospitals in gauteng and limpopo were interviewed. Kind and caring attitudes, exercises or “training” for the child,  and  practical  assistance  (handling  ideas  and suggestions,  assistive devices, food supplements, nappies, advice were components of care most valued. The most frustration was caused by long queues waiting for files or at the pharmacy and being treated disrespectfully whilst providing caregivers with information and explanations regarding treatment choice were services that could be improved.  Key components for  an  appropriate  therapy  service  include  caring  and respectful  attitudes,  hands-on  therapy,  handling  suggestions and practical assistance. Logistical and administrative procedures together with disrespectul and unhelpful attitudes negatively impact rehabilitation service delivery.

  10. 42 CFR 447.280 - Hospital providers of NF services (swing-bed hospitals).

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Hospital providers of NF services (swing-bed... Inpatient Hospital and Long-Term Care Facility Services Swing-Bed Hospitals § 447.280 Hospital providers of NF services (swing-bed hospitals). (a) General rule. If the State plan provides for NF services...

  11. The Effects of Temporary Services and Contracting Out on Low-Skilled Workers: Evidence from Auto Suppliers, Hospitals, and Public Schools. Staff Working Paper.

    Science.gov (United States)

    Erickcek, George; Houseman, Susan; Kalleberg, Arne

    A study examined why employers use temporary agency and contract company workers and implications of these practices for wages, benefits, and working conditions of workers in low-skilled labor markets. Case studies in manufacturing (automotive supply), services (hospitals), and public sector (primary and secondary schools) industries defined the…

  12. The Effects of Temporary Services and Contracting Out on Low-Skilled Workers: Evidence from Auto Suppliers, Hospitals, and Public Schools. Staff Working Paper.

    Science.gov (United States)

    Erickcek, George; Houseman, Susan; Kalleberg, Arne

    A study examined why employers use temporary agency and contract company workers and implications of these practices for wages, benefits, and working conditions of workers in low-skilled labor markets. Case studies in manufacturing (automotive supply), services (hospitals), and public sector (primary and secondary schools) industries defined the…

  13. Models of Public Service Provision

    DEFF Research Database (Denmark)

    Andersen, Lotte Bøgh; Kristensen, Nicolai; Pedersen, Lene Holm

    2013-01-01

    This article extends the framework of Le Grand (2003, 2010) to encompass responsiveness, and the main argument is that the combination of employee motivation, user capacity, and models of public service provision potentially has serious implications for responsiveness across service areas. Although...... research on employee motivation thrives, especially in the public service motivation (PSM) literature, few studies have investigated user capacity empirically, and we know little about the combination of PSM, user capacity and models of service provision. Analyzing four central service areas (day care......, schools, hospitals, and universities), we find variations in both user capacity and PSM. Taking this variation as a point of departure we discuss what implications different combinations of employee motivation, user capacity, and models of public service provision may have for responsiveness....

  14. 42 CFR 419.22 - Hospital outpatient services excluded from payment under the hospital outpatient prospective...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Hospital outpatient services excluded from payment under the hospital outpatient prospective payment system. 419.22 Section 419.22 Public Health CENTERS... PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES Categories of Hospitals and Services...

  15. 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.

  16. NAIP Public Image Services

    Data.gov (United States)

    Farm Service Agency, Department of Agriculture — This map provides a preview and information about the National Agriculture Imagery Program (NAIP) image services available on the APFO public image server. Click on...

  17. Availability and use of emergency obstetric care services in public hospitals in Laos PDR: a systems analysis.

    Science.gov (United States)

    Douangphachanh, Xaysomphou; Ali, Moazzam; Outavong, Phathammavong; Alongkon, Phengsavanh; Sing, Menorath; Chushi, Kuroiwa

    2010-12-01

    The maternal mortality ratio in Laos in 2005 was 660 per 100,000 lives birth which was the third highest in Asia-Pacific Region. The objective was to determine the availability and use of emergency obstetric care (EmOC) in provincial and district hospitals in Borikhamxay, Khammouane, and Savannakhet provinces using UN guidelines. A hospital-based cross sectional survey was conducted from January to March 2008. All district (30) and provincial hospitals (3) from three provinces were included. Analysis was based on hospital records reflecting 12 months of facility data. Data indicates that only 14 hospitals (42.4%) were providing EmOC services, i.e., 9 basic, 5 comprehensive services. The proportion of births in EmOC facilities was only 11.2%, the met need was a very low 14.5%, and the cesarean section rate was only 0.9%. The case fatality rate in Borikhanxay province was 2.8%; in Khammouane and in Savannakhet provinces it was less than 1%. Record keeping at hospitals was poor. Signal functions provided in the last three months showed only 48.5% of the facilities performed assisted vaginal delivery. This is the first study in Lao PDR to assess EmOC services. Almost all the indicators were below the UN recommendations. Health planners must take evidence-based decisions to rectify and improve the situation in the hospitals regarding EmOC services. These data can therefore help government to assign and allocate budgets appropriately, and help policymakers and planners to identify systemic bottlenecks and prioritize solutions and will help in improving maternal health.

  18. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Science.gov (United States)

    2010-10-01

    ... Definitions § 440.140 Inpatient hospital services, nursing facility services, and intermediate care facility... 42 Public Health 4 2010-10-01 2010-10-01 false Inpatient hospital services, nursing facility services, and intermediate care facility services for individuals age 65 or older in institutions...

  19. Strategies to develop and promote public-private partnerships (PPPs) in the provision of hospital services in Iran: a qualitative study.

    Science.gov (United States)

    Sadeghi, Ahmad; Barati, Omid; Bastani, Peivand; Daneshjafari, Davood; Etemadian, Masoud

    2016-04-01

    Public-Private Partnerships (PPPs) have been constructively considered in recent years to reform health sectors in many countries. This study aimed at explaining the strategies to develop and promote PPPs in the provision of hospital services in Iran. This qualitative study was conducted in 2015. The study population consisted of experts and professionals of the health system and individuals familiar with PPPs and roles in the development of such models in hospital services in Iran that were selected through purposeful sampling, and semi-structured interviews were used for data collection. To this end, 18 experts and professionals of the health system and individuals familiar with PPPs and roles in the development of such models in hospital services in Iran were selected. The data were analyzed and classified using MAXQDA10 software and content analysis, respectively. According to the results of this study, four main themes and 20 subthemes in terms of strategies to develop and promote PPPs in the provision of hospital services in Iran were identified, including changes in policies and laws, socio-cultural changes, improvement of mechanisms and current processes, and financial and capital capacity building. To develop and promote PPPs in the provision of hospital services, there is a need to consider prerequisites and measures to help such partnerships to be effective and produce valuable results.

  20. Public Service Motivation

    Directory of Open Access Journals (Sweden)

    Raluca-Marilena Mihalcioiu

    2011-05-01

    Full Text Available Public Service Motivation concept was developed in North America and focuses on specific motivations of public servants, such as employee satisfaction, organizational commitment, reward preferences, organizational and individual performance. Other types of motivation, as financial consideration, are relevant but have less important influences with regard to this kind of work outcomes. This strengthen the assertion for a diversified motivational strategy, which affect various types of motivation, while not losing sight of the public value that one organization shows and therefore valuing public service motivation as a specific contribution to work outcomes. The concept has been increasingly applied in European public administration. This paper presents Status Quo of international Public Service Motivation research and locates in them empirical evidences from contries that are already working with this concept, like Austria. It also analyses implications for central questions of public management. The main focus of this article is general appropriateness and possible applications for Romanian public management research.

  1. Public services, personal benefits

    NARCIS (Netherlands)

    Bob Kuhry; Evert Pommer; Jedid-Jah Jonker; John Stevens

    2006-01-01

    Original title: Publieke productie & persoonlijk profijt. This report looks in detail at the costs of public services (such as care, education, public administration and safety) and the benefits that citizens derive from the government expenditure involved in delivering those services. In

  2. Public services, personal benefits

    NARCIS (Netherlands)

    Bob Kuhry; Evert Pommer; Jedid-Jah Jonker; John Stevens

    2006-01-01

    Original title: Publieke productie & persoonlijk profijt. This report looks in detail at the costs of public services (such as care, education, public administration and safety) and the benefits that citizens derive from the government expenditure involved in delivering those services. In 2003,

  3. Abortion services at hospitals in Istanbul.

    Science.gov (United States)

    O'Neil, Mary Lou

    2017-04-01

    Despite the existence of a liberal law on abortion in Turkey, there is growing evidence that actually securing an abortion in Istanbul may prove difficult. This study aimed to determine whether or not state hospitals and private hospitals that accept state health insurance in Istanbul are providing abortion services and for what indications. Between October and December 2015, a mystery patient telephone survey of 154 hospitals, 43 public and 111 private, in Istanbul was conducted. 14% of the state hospitals in Istanbul perform abortions without restriction as to reason provided in the current law while 60% provide the service if there is a medical necessity. A quarter of state hospitals in Istanbul do not provide abortion services at all. 48.6% of private hospitals that accept the state health insurance also provide for abortion without restriction while 10% do not provide abortion services under any circumstances. State and private hospitals in Istanbul are not providing abortion services to the full extent allowed under the law. The low numbers of state hospitals offering abortions without restriction indicates a de facto privatization of the service. This same trend is also visible in many private hospitals partnering with the state that do not provide abortion care. While many women may choose a private provider, the lack of provision of abortion care at state hospitals and those private hospitals working with the state leaves women little option but to purchase these services from private providers at some times subtantial costs.

  4. UHS development and hospital services rationing.

    Science.gov (United States)

    Ribeiro, José Mendes

    2009-01-01

    We analyze Brazilian health system in comparative perspective. Middle income beneficiaries migration to pre-paid private insurance makes Brazilian case similar to United States. Public hospital services delivery shows an important retrenchment enhanced by demographic growth and new expectations due to constitutional definitions. Retrenchment is selective and concentrates on obstetric and clinic services and private for-profit services. To ensure equal access it is necessary to improve public spending; diminish out-of-pocket spending; develop organizational reforms; improve government capacity.

  5. Hospitality Services. Student Activity Book.

    Science.gov (United States)

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This student activity book contains pencil-and-paper activities for use in a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The activities are organized into 29 chapters on the following topics: hospitality services industry; professional ethics; organization/management structures in…

  6. Improving sexual health for HIV patients by providing a combination of integrated public health and hospital care services; a one-group pre- and post test intervention comparison

    Directory of Open Access Journals (Sweden)

    Dukers-Muijrers Nicole HTM

    2012-12-01

    Full Text Available Abstract Background Hospital HIV care and public sexual health care (a Sexual Health Care Centre services were integrated to provide sexual health counselling and sexually transmitted infections (STIs testing and treatment (sexual health care to larger numbers of HIV patients. Services, need and usage were assessed using a patient perspective, which is a key factor for the success of service integration. Methods The study design was a one-group pre-test and post-test comparison of 447 HIV-infected heterosexual individuals and men who have sex with men (MSM attending a hospital-based HIV centre serving the southern region of the Netherlands. The intervention offered comprehensive sexual health care using an integrated care approach. The main outcomes were intervention uptake, patients’ pre-test care needs (n=254, and quality rating. Results Pre intervention, 43% of the patients wanted to discuss sexual health (51% MSM; 30% heterosexuals. Of these patients, 12% to 35% reported regular coverage, and up to 25% never discussed sexual health topics at their HIV care visits. Of the patients, 24% used our intervention. Usage was higher among patients who previously expressed a need to discuss sexual health. Most patients who used the integrated services were new users of public health services. STIs were detected in 13% of MSM and in none of the heterosexuals. The quality of care was rated good. Conclusions The HIV patients in our study generally considered sexual health important, but the regular counselling and testing at the HIV care visit was insufficient. The integration of public health and hospital services benefited both care sectors and their patients by addressing sexual health questions, detecting STIs, and conducting partner notification. Successful sexual health care uptake requires increased awareness among patients about their care options as well as a cultural shift among care providers.

  7. Impact of a medical university on laparoscopic surgery in a service-oriented public hospital in the Caribbean

    Directory of Open Access Journals (Sweden)

    Cawich SO

    2016-11-01

    Full Text Available Shamir O Cawich,1 Suresh Pooran,2 Barbara Amow,2 Ernest Ali,2 Fawwaz Mohammed,1 Marlon Mencia,1 Samuel Ramsewak,1 Seetharaman Hariharan,1 Vijay Naraynsingh1 1Department of Clinical Surgical Sciences, University of the West Indies, St Augustine, 2North West Regional Health Authority, Port of Spain General Hospital, Port of Spain, Trinidad and Tobago Introduction: The Caribbean lags behind global trends for volume and complexity of laparoscopic operations. In an attempt to promote laparoscopy at a single facility, a partnership was formed between the University of the West Indies (UWI and the Port of Spain General Hospital in Trinidad and Tobago. This study seeks to document the effect of this partnership on laparoscopic practice.Materials and methods: In this partnership, the UWI took the bold step of volunteering to staff a surgical team if the Ministry of Health provided the necessary legislative changes. On August 1, 2013, a UWI team was introduced with a mandate to optimize teaching and promote laparoscopic surgery. The UWI team had a similar staff complement to the existing service-oriented teams. There was no immediate investment in equipment, hospital beds, ICU beds, or operating room space. Therefore, the new team was introduced with limited change in existing conditions, resources, and equipment.Results: There were 252 laparoscopic operations performed over the study period. After introduction of the UWI team, there was an increase in the mean number of unselected laparoscopic operations (3.17 vs 10.83 cases per month; P<0.001; 95% confidence interval [95% CI] −8.5 to −6.84; standard error of the difference [SED] 0.408, the mean number of basic laparoscopic operations (3.17 vs 6.94 cases per month; P<0.0001; 95% CI −4.096 to −3.444; SED 0.165, the mean number of advanced laparoscopic operations (0 vs 3.89; P<0.0001, the number of teams undertaking unselected laparoscopic operations (2 vs 5, and the number of teams independently

  8. Dynamic public service mediation

    NARCIS (Netherlands)

    Hofman, W.; Staalduinen, M. van

    2010-01-01

    This paper presents an approach to dynamic public service mediation. It is based on a conceptual model and the use of search and ranking algorithms. The conceptual model is based on Abstract State Machine theory. Requirements for dynamic service mediation were derived from a real-world case. The con

  9. Elementary Rehabilitation Nursing Care; a Manual for Nurses and Ancillary Workers in Nursing Homes, Hospitals, Convalescent Facilities, and Public Health Agencies. Public Health Service Publication No. 1436.

    Science.gov (United States)

    Colorado State Dept. of Public Health, Denver. Public Health Nursing Section.

    This guide for teacher and student use presents a comprehensive program of physical rehabilitation for aged and physically disabled patients. Developed by the Public Health Nursing Section, the manual was tested by state health department personnel and persons doing inservice teaching in their respective nursing homes. The program is designed to…

  10. 42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

    Science.gov (United States)

    2010-10-01

    ... Definitions § 440.20 Outpatient hospital services and rural health clinic services. (a) Outpatient hospital... agency may exclude from the definition of “outpatient hospital services” those types of items and... 42 Public Health 4 2010-10-01 2010-10-01 false Outpatient hospital services and rural health...

  11. Impact of the Joint Statement by the American Academy of Pediatrics/US Public Health Service on thimerosal in vaccines on hospital infant hepatitis B vaccination practices.

    Science.gov (United States)

    Hurie, M B; Saari, T N; Davis, J P

    2001-04-01

    To determine the impact of the American Academy of Pediatrics/US Public Health Service (AAP/USPHS) joint statement on thimerosal in vaccines on hospital infant hepatitis B vaccination policies in Wisconsin. The nurse managers of hospital newborn nurseries (n = 110) were surveyed by mail. Nonresponders were resurveyed. Twelve hospitals no longer provided obstetric services. Of the remaining 98 hospitals, 84 (86%) responded to the initial mailing and 14 (14%) responded to the second mailing. The number of hospitals that offered hepatitis B vaccine to infants before July 1999 was compared with that in March 2000. The number of hospitals that had policies in place to vaccinate infants whose mothers' hepatitis B surface antigen status (HBsAg) was positive or unknown during the thimerosal alert (July 1999 through November 1999) was compared with that in March 2000. Before July 1999, 81% of the hospitals representing 84% of reported Wisconsin births routinely offered hepatitis B vaccine to all infants. By March 2000, 50% of hospitals, representing 43% of births, had resumed routine infant hepatitis B vaccination. Physician decision to use a combination Haemophilus influenzae type b hepatitis B vaccine was the most frequently given reason for not reinstituting infant hepatitis B vaccination. During the thimerosal alert, 23% of hospitals did not have policies to vaccinate infants whose mothers were HBsAg-positive and 51% did not have policies to vaccinate infants whose mothers' HBsAg status was unknown. By March 2000, 6% of hospitals still did not have policies to vaccinate infants whose mothers were HBsAg-positive and 24% did not have policies to vaccinate infants whose mothers' HBsAg status was unknown. The AAP/USPHS joint statement on thimerosal in vaccines has resulted in a 38% decrease in the number of hospitals routinely offering infants hepatitis B vaccine. Although thimerosal-free hepatitis B vaccine is now available, some hospitals still do not have appropriate

  12. 公立医院医疗服务体系构建的创新%Innovation of Building Medical Service System of Public Hospital

    Institute of Scientific and Technical Information of China (English)

    胡敏敏

    2012-01-01

    当前我国公立医院医疗服务质量与患者的实际需求和服务期望值存在较大距离,本文以无锡二院对人性化医疗服务体系的探索为例,从医疗服务的人性化、医疗流程的合理性、保障服务的及时性等方面进行了介绍,并对改革的动因及成效进行了分析.%There is huge gap between the public hospital medical service quality and the real demands and anticipation from patients. This article introduces the practice in humanized medical service system of Wuxi No.2 People's Hospital from the perspectives of humanized medical services, reasonable medical process, and the timeliness of services. And it also analyzes the motive and effects of service reform.

  13. Value for Money and Policy Review of the Economic Cost and Charges Associated with Private and Semi-Private Treatment Services in Public Hospitals - Final Report

    OpenAIRE

    Department of Health

    2010-01-01

    This Value for Money and Policy Review (VFM&PR) of the Economic Cost and Charges Associated with Private and Semi-Private Treatment Services in Public Hospitals was initiated by the Department of Health and Children in June 2009 and was conducted under the auspices of the Governmentâ?Ts Value for Money & Policy Review Initiative 2009-2011. The Review was overseen by an independently chaired National Steering Group comprised of senior representatives from the Department of Health and Children...

  14. VT - Vermont Hospital Service Areas

    Data.gov (United States)

    Vermont Center for Geographic Information — Hospital service areas (HSAs) are organized by towns and are based on inpatient discharges where the diagnosis indicated the need for immediate care. Plurality...

  15. On Additional Establishment of Pharmaceutical Services Fee in Public Hospital in China%我国公立医院增设药事服务费浅见

    Institute of Scientific and Technical Information of China (English)

    张安发

    2011-01-01

    目的:为我国公立医院增设药事服务费提供参考.方法:通过对药事服务费的定义和性质的思考,结合本地区的经济和消费水平分析药事服务费的收取方案、收取方式及标准.结果与结论:合理的收费方案应当是患者到药房取药时收取1次费用.门诊药事服务费在患者每人次诊断后随医药费缴纳,标准以5~8元为宜;住院药事服务费可在患者住院押金(预交款)里按每人日直接扣除或依报销比例自动结算,标准可参考门诊.在政府补偿机制到位的情况下,公立医院增设药事服务费是可行的.%OBJECTIVE: To provide reference for additional establishment of pharmaceutical services fee in public hospitals in China. METHODS: Through considering about the definition and character of pharmaceutical services fee, the program, way and standard of pharmaceutical service fee charge were analyzed on the basis of local economic and consumption level. RESULTS & CONCLUSIONS: With reasonable fee-collecting program, pharmaceutical service fee should be collected for once when patients got to the pharmacy to get medicine. Every patient should pay for out-patient pharmaceutical service along with medical costs after diagnosis. Suitable pharmaceutical service fee should range from 5 yuan to 8 yuan. Inpatient pharmaceutical service fee can be paid autonomously by taking away from inpatient deposit (down payment) directly by per capita or reimbursement ratio. The standard of inpatient pharmaceutical service fee refers to out-patient department. When government compensation mechanisms have been put in the right place, additional establishment of pharmaceutical service fee in public hospital is feasible.

  16. 42 CFR 409.26 - Transfer agreement hospital services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Transfer agreement hospital services. 409.26... SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.26 Transfer agreement...) of this chapter for the transfer of patients and exchange of medical records; or (2) A hospital that...

  17. Hospitals look to hospitality service firms to meet TQM goals.

    Science.gov (United States)

    Hard, R

    1992-05-20

    Hospitals that hire contract service firms to manage one or all aspects of their hospitality service departments increasingly expect those firms to help meet total quality management goals as well as offer the more traditional cost reduction, quality improvement and specialized expertise, finds the 1992 Hospital Contract Services Survey conducted by Hospitals.

  18. 42 CFR 419.21 - Hospital outpatient services subject to the outpatient prospective payment system.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Hospital outpatient services subject to the... FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES Categories of Hospitals and Services Subject to and Excluded From the Hospital Outpatient Prospective Payment System § 419.21 Hospital outpatient services...

  19. 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)

  20. The Cost of Health Service Waste Management of (HSWM: A Case Study of Intensive Care Unit of Infectious Diseases at a Public Hospital in São Paulo.

    Directory of Open Access Journals (Sweden)

    Chennyfer Dobbins Paes da Rosa

    2015-08-01

    Full Text Available The Health Service Waste Management is a set of technical and legal procedures for waste management in any type of health facilities. It is known about the limited resources, so reducing environmental costs can contribute to the management of hospital costs. The objective was to estimate the cost of the phases of HSWM to the Intensive Care Unit for public service. Data collecting was done through a script of questions and observations on site at the Emilio Ribas Infectious Diseases Institute in Sao Paulo. The ABC costing method was used. The most costly step was wrapping (40.68%, followed by segregation (40.17%, which is justified by both being associated with health workers’ salaries. The daily cost of the management of health care waste from segregation to final disposal in the ICU was R$ 4,288.81 a day, being R$ 314.80/bed-patient/day. To know the cost of an activity allows for the analysis of strategies for price negotiation. Health care waste is little remembered when pricing a daily ICU, many managers believe this value to be irrelevant; but< if not measured, it may bring losses to the institution.

  1. Depository Libraries and Public Services.

    Science.gov (United States)

    Kessler, Ridley

    1998-01-01

    Discusses the Wright State University (Ohio) Library policy directive on customer service, and suggests this document as a model to follow in setting up service standards or guidelines for depository-library services. Draft-depository library public-service guidelines for government information in electronic format are appended. (JAK)

  2. 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.

  3. 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.

  4. 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.

  5. Public Foundations of Service Design

    DEFF Research Database (Denmark)

    Junginger, Sabine

    2012-01-01

    , where services do not affect a select target market but thousands, if not millions of people. This chapter looks into the role and challenges of the Australian Service Delivery Reform in re-envisioning the ways in which the Australian government goes about developing products and services for Australian......This chapter looks into the developments of service design in the public sector. It shows how Service Design emerged and continues to evolve in Australia, where the practices involving the design of services are deeply rooted in human-centred design principles and where these practices have begun...... to influence many areas of government, ranging from public management to social policies. For researchers of Service Design, the Australian efforts present an opportunity to situate the design of services theoretically and practically in an area, where the development of services is not an option but a mandate...

  6. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Nursing and related services, medical social... Inpatient Hospital Services and Inpatient Critical Access Hospital Services § 409.12 Nursing and related... (b) of this section, Medicare pays for nursing and related services, use of hospital or...

  7. 42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

    Science.gov (United States)

    2010-10-01

    ... furnished by a hospital with a swing-bed approval. ... 42 Public Health 4 2010-10-01 2010-10-01 false Inpatient hospital services, other than services in...: GENERAL PROVISIONS Definitions § 440.10 Inpatient hospital services, other than services in an institution...

  8. 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.

  9. 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.

  10. 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

  11. Public Values and Public Service Motivation

    DEFF Research Database (Denmark)

    Andersen, Lotte Bøgh; Beck Jørgensen, Torben; Kjeldsen, Anne Mette

    2013-01-01

    The literatures on public values (PV) and public service motivation (PSM) both address whether public service delivery is driven by something more than self-interest. They have developed separately, although they can benefit from insights developed by the other, and this article discusses...... conceptual and empirical relationships between them. Based on a survey of 501 public managers, we find that PSM and PV are associated empirically, but not in a manner allowing total integration. The conceptual discussion reveals how the two concepts cannot be totally separated, as values can be motivating...... and motivation is often oriented toward something desirable (e.g., values). This suggests that neither total separation nor integration is a fruitful strategy. Given that the concepts are related, the literatures may benefit from more awareness of the conceptual overlaps and differences....

  12. CONSUMER'S SATISFACTION MEASUREMENT IN PUBLIC HOSPITALS

    Directory of Open Access Journals (Sweden)

    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.

  13. Survey of the functioning conditions of public hospital radiodiagnosis services in Rio de Janeiro State; Levantamento das condicoes de funcionamento dos servicos de radiodiagnostico dos hospitais publicos do Estado do Rio de Janeiro

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Marcos O.; Azevedo, Ana C.P. [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil). Dept. de Radiologia]. E-mail: marcao@ufrj.br; anacecilia@hucff.ufrj.br

    2001-07-01

    This work aims to make a survey of the conditions of quality control of the Services of Radiodiagnostic of some public and/or University Hospitals in Rio de Janeiro. This survey consisted of the accomplishment of some quality control tests required by Brazilian legislation. Besides the improvement in the quality of these Services, cost reduction is another factor that motivated this work. The implantation of a Quality Assurance Program is also discussed. It includes the procedures of quality control that need be implemented in each of the hospitals. (author)

  14. Hizmet Kalitesi - Müşteri Memnuniyeti İlişkisinin Hastane Türlerine Göre Karşılaştırılması : Devlet, Özel ve Üniversite Hastaneleri Uygulaması = An Analysis of the Relationship Between Service Quality and Customer Satisfaction According to Type of Health Services Provider : An Application at Public, Private and University Hospitals

    Directory of Open Access Journals (Sweden)

    Teoman DUMAN

    2006-06-01

    Full Text Available Current study attempted to identify dimensions of hospital service quality and analyzed relationships between service quality dimensions and overall patient satisfaction within different hospital service provider categories. The research was conducted with 225 patients at public, university and private hospitals in two southern metropolis of Turkey. Patients' service quality perceptions were measured with four factors; services before the treatment, physician services, care for private needs-laboratory services and perceptions about physical environment. First factor analysis and variance analysis was conducted. Then it was followed by regression analyses. Multiple regression analyses revealed that services before the treatment and perceptions about physical environment were significant determiners of overall patient satisfaction at public hospitals whereas physician services, care for private needs-laboratory services and perceptions about physical environment were significant indicators of overall patient satisfaction at university hospitals. As for private hospitals, all four factors show significant relationships with overall patient satisfaction.

  15. 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.

  16. Public Foundations of Service Design

    DEFF Research Database (Denmark)

    Junginger, Sabine

    2012-01-01

    This chapter looks into the developments of service design in the public sector. It shows how Service Design emerged and continues to evolve in Australia, where the practices involving the design of services are deeply rooted in human-centred design principles and where these practices have begun...... citizens and residents. It points to the need for Service Design to position itself in the public contexts of policy-making and policy implementation and to understand its role in contributing to social justice, social inclusion and social coherence....

  17. Service, Public Work, and Respectful Public Citizens

    Science.gov (United States)

    Youniss, James

    2011-01-01

    Encouragement of service as public work is one strategy higher education can use in fulfilling its civic mission to socialize society's future leaders. The diversity of American higher education includes large land grant state universities, small liberal arts colleges, religiously sponsored institutions, and local community colleges. This array…

  18. The service of public services performance measurement

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang

    2014-01-01

    Nowadays, states spend more attention, time and money on performance measurement and evaluation in the public sector than ever before (OECD, 1996; Power, 1997; van Thiel et al., 2002). Result-based management is the talk of the day at all levels of the public sector; at local, regional, national...... explosion” and “the audit society” to describe this development.  Some criticize this development. Thus, a number of critiques which suggest that public service performance measurement may in fact have no significant impact or even lead to negative effects on performance. Powers (1997, 2003) have argued...... middle- and upper-level officials, create massive paperwork, and produce major unintended effects.” Critics also argue that performance measures stifles innovation by rewarding conformity rather than risk-taking (fx. van Thiel et al., 2002). Thus, the scholarly discourse on public services performance...

  19. The service of public services performance measurement

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang

    2014-01-01

    that performance measurement serves as “rituals of verification” which promotes the interests of political masters and their mistresses rather than public service. Another area of concern is the cost of performance measurement. Hood & Peters (2004:278) note that performance measurement is likely to “distract...... the actual impact, the costs and unintended consequences associated with performance measurement. This paper identifies the main rationales and rationalities in the scholarly discourse on public services performance measurement. It concludes with some suggestions on how to deal with the many rationales......Nowadays, states spend more attention, time and money on performance measurement and evaluation in the public sector than ever before (OECD, 1996; Power, 1997; van Thiel et al., 2002). Result-based management is the talk of the day at all levels of the public sector; at local, regional, national...

  20. Le Contrat de service public.

    OpenAIRE

    2009-01-01

    La Banque de France est concernée par le développement et la compétitivité des territoires, par l’amélioration de l’accès et de la qualité des services offerts aux publics, thèmes au coeur du Contrat de service public conclu, depuis 2003, avec l’État.

  1. 公立医院客户服务部建设的探索——华山医院东院客户服务部六年实践总结%An exploration of the construction of the customer service department in a public hospital: 6-year experience of Customer Service Department in East Branch, Huashan Hospital

    Institute of Scientific and Technical Information of China (English)

    蔡丽莉

    2012-01-01

    在医院内建立一个功能完整的客户服务部是目前公立医院的创新举措,它整合了医院内除医疗护理外所有的行政事务类服务和管理,树立了一个用对客服务的理念向医院客户传递服务信息建立良好的公共关系的形象.通过与院内外各部门的协调和合作完成部门各岗位的工作运转,在建立一个服务高端人群的医疗模式的同时为病人提供方便、及时、高效、温馨的人性化服务.六年来,华山东院在这方面进行了尝试探索,创建了医院的客户服务工作模式.%The establishment of a functional Customer Service Department is creative and integrated of current public hospitals. It doesn' t only integrate all the service and management in the hospital administration except for nursing, but also conveys a customer-oriented motto to the patients in order to establish a good characteristic of the public relationship. This department works by the coordination with internal and external departments of the hospital. While endeavoring to build a new medical pattern of high-end service, our department has sustained to provide the patients with convenient, prompt, efficient, considerate and personal service as well. We have been exploring in the past 6 years and established the pattern of customer service in the public hospital.

  2. Public Goods and State Services

    Directory of Open Access Journals (Sweden)

    Ignatova T.V.

    2015-09-01

    Full Text Available The article argues that state services are classified into two groups depending on the level of market mechanism use: public services and private services. These services have different characteristics: individual choice of consumption, type and quality of goods, financing, institutional regulation, decision-making subject, external effects, opportunity of effects control. The mechanism of public state services regulation is based on the influence on formal institutes, while the mechanism of private state services regulation is based on informal institutes. Joint mechanism of both types of state services provision includes the procedures of standartization and regulatory activity implying the provision of services by “one stop” principle and minimization of consumer - agent contacts. The optimization of services rendering process and their quality improvement are ensured by administrative regulations which establish strict standards of public service provided by the bodies of executive power and subordinate organizations The means of institutional regulation allow inclusion of market elements but on the condition of state control that ensures stimulation of public institutes. During the process of market institutes initialization in the sphere of state services rendering to government bodies, it is necessary to consider their dependence on marginal profits of one or another institute. In the long-term prospect those institutes got a foothold in the market that strengthen and encompass marginal effect for all individuals under the growth of individuals who observe the rules and restrictions. The activities organized by these institutes deserve positive response on behalf of the majority of individuals and, therefore there is no need in enforcement and violence in order to keep rules and restrictions. In the sphere of state and municipal services we can find the example of services provided in the scope of free contraction, in particular the

  3. 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

  4. 42 CFR 410.28 - Hospital or CAH diagnostic services furnished to outpatients: Conditions.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Hospital or CAH diagnostic services furnished to... Medical and Other Health Services § 410.28 Hospital or CAH diagnostic services furnished to outpatients: Conditions. (a) Medicare Part B pays for hospital or CAH diagnostic services furnished to outpatients...

  5. Inefficiencies in public environmental services

    NARCIS (Netherlands)

    de Jong, R.; Nentjes, A.; Wiersma, D.

    The paper discusses efficiency issues in the public provision of environmental services, in particular waste water treatment. It is shown that in the face of increasing, respectively decreasing returns to scale the zero profit constraint of a cost minimizing public firm induces underinvestment,

  6. Inefficiencies in public environmental services

    NARCIS (Netherlands)

    de Jong, R.; Nentjes, A.; Wiersma, D.

    2000-01-01

    The paper discusses efficiency issues in the public provision of environmental services, in particular waste water treatment. It is shown that in the face of increasing, respectively decreasing returns to scale the zero profit constraint of a cost minimizing public firm induces underinvestment, resp

  7. 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.

  8. Contracting for Public Services

    DEFF Research Database (Denmark)

    Greve, Carsten

    strategic purchasing understanding markets communicating the contracting decision designing and drafting the contract the role of the consumer the regulation of service provision Illustrated throughout with practitioner case-studies from a range of OECD countries, this book presents an important new......Insightful and comprehensive and covering new subjects like globalization and IT, this text, international in its approach, provides a thorough introduction to the key phases of the contracting process and the skills required by managers in its implementation. These include: policy for contracting...

  9. The Spirit of Public Service

    DEFF Research Database (Denmark)

    Hassall Thomsen, Line Hassall; Willig, Ida

    on cultural production and news work. Through fieldwork and interviews with Danish and British reporters/editors from DR 1, TV 2, BBC 1 and ITV we identify three components of a strong public service spirit present in the journalist’s understanding of the self: mass audience orientation, democratic......Research on public service broadcasting tends to highlight norms and values at the strategic level. This paper explores ‘public service’ as an institutional logic guiding the everyday practice of journalists. The theoretical framework draws on Pierre Bourdieus’ field theory and recent works...... responsibility and unbiased reporting. These three components can be found in both British and Danish newsrooms suggesting a trans-national, institutional spirit of public service. At the same time, the three components are interpreted differently from newsroom to newsroom suggesting different practices...

  10. When public service drama travels

    DEFF Research Database (Denmark)

    Jensen, Pia Majbritt; Nielsen, Jakob Isak; Waade, Anne Marit

    2016-01-01

    This article provides a detailed analysis of how the Danish public service broadcaster DR employs external funding for its drama productions. This investigation is carried out in order to discuss the schisms involved when a public service broadcaster – whose traditional obligations arguably pertain...... the last 15 years, our empirical data also show significant new patterns in production culture and international market orientation within DR. Interestingly, however, our study demonstrates the distinctive contribution that precisely DR’s public service remit has made to the quality of its drama...... assessed on the basis of existing theory and expert interviews conducted with significant industry professionals at DR’s Drama Division, DR Sales, German public broadcaster ZDF’s commercial sales arm ZDF Enterprises, and independent Danish production companies Nimbus Film and Miso Film. Specific cases...

  11. 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.

  12. 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. 

  13. [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.

  14. The service of public services performance management

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang

    . Performance measures are rational tools, part of the rational panoply of effective management and organizational functioning. Their recommendation lies in their rationality. The literature suggests three main theoretical perspectives on the purpose of performance measurement of public services. One...... as compensating for the absence of effective competition in supply markets. Thus, according to this view, because dissatisfied service users are unable to go elsewhere and taxpayers cannot act like shareholders to keep in efficient providers in check, the role of performance measurement is to manage supply...... the existence of significant concern about the actual impact, the costs and unintended consequences associated with performance measurement.  Performance measurement and management have been part of the political agenda within the public sphere since their adoption in the post-Second World War period...

  15. When public service drama travels

    DEFF Research Database (Denmark)

    Jensen, Pia Majbritt; Waade, Anne Marit

    This paper will investigate how and to what extent the Danish public service broadcaster DR employs external funding for its drama productions. This investigation is carried out in order to discuss the schisms involved when a public service broadcaster – whose traditional obligations arguably...... such as canned programme export revenues, co-productions, pre-sale and format sale. We therefore believe it is relevant to explore how and to what extent DR makes use of external funding for its drama productions in order to discuss potential advantages and disadvantages in doing so for a public service...... pertain to the national sphere – becomes a player in the international market for television content and, as a consequence, partly reliant on international funding through either co-productions, canned programming export revenues, pre-sale or format sale. DR’s drama productions such as The Killing...

  16. Government Public Service Advertising Design

    Directory of Open Access Journals (Sweden)

    Agus Ganjar Runtiko

    2013-07-01

    Full Text Available Public service advertising is one of the government strategies to promote the development program. At the national level, the government prefers television as a medium for advertising. As for the local level, the government usually tend to choose lower-cost ads. In Banyumas, many public service announcements using outdoor media such as billboards, banners, or posters. Characteristics of outdoor media that promotes design in attracting the attention of an audience became a challenge for designers. On the other hand, the messages also require the space in public service announcements. This study wants to know about how the execution of the design of outdoor advertising services in the community in efforts to combine the design with a message to be delivered. The study, sought to examine aspects of the design using the composition interpretation methods and verbal composition of outdoor advertising with discourse analysis methods.This research concludes that the government public service announcements desain still needs to be improved according to the rules of visual communication design.

  17. 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.

  18. 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.

  19. PUBLIC FINANCING OF HEALTHCARE SERVICES

    Directory of Open Access Journals (Sweden)

    Agnieszka Bem

    2013-10-01

    Full Text Available Healthcare in Poland is mainly financed by public sector entities, among them the National Health Fund (NFZ, state budget and local government budgets. The task of the National Health Fund, as the main payer in the system, is chiefly currently financing the services. The state budget plays a complementary role in the system, and finances selected groups of services, health insurance premiums and investments in healthcare infrastructure. The basic role of the local governments is to ensure access to the services, mostly by performing ownership functions towards healthcare institutions.

  20. 38 CFR 17.52 - Hospital care and medical services in non-VA facilities.

    Science.gov (United States)

    2010-07-01

    ... or equipped to perform, and transfer to a public or private hospital which has the necessary staff or... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Hospital care and medical... VETERANS AFFAIRS MEDICAL Use of Public Or Private Hospitals § 17.52 Hospital care and medical services in...

  1. 42 CFR 424.122 - Conditions for payment for emergency inpatient hospital services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Conditions for payment for emergency inpatient hospital services. 424.122 Section 424.122 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... hospital services, the beneficiary was— (1) In the United States; or (2) In Canada traveling between Alaska...

  2. 42 CFR 403.321 - State systems for hospital outpatient services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false State systems for hospital outpatient services. 403.321 Section 403.321 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Control Systems § 403.321 State systems for hospital outpatient services. CMS may approve a...

  3. No Previous Public Services Required

    Science.gov (United States)

    Taylor, Kelley R.

    2009-01-01

    In 2007, the Supreme Court heard a case that involved the question of whether a school district could be required to reimburse parents who unilaterally placed their child in private school when the child had not previously received special education and related services in a public institution ("Board of Education v. Tom F."). The…

  4. Algorithms and Public Service Media

    DEFF Research Database (Denmark)

    Sørensen, Jannick Kirk; Hutchinson, Jonathon

    2017-01-01

    When Public Service Media (PSM) organisations introduce algorithmic recommender systems to suggest media content to users, fundamental values of PSM are challenged. Beyond being confronted with ubiquitous computer ethics problems of causality and transparency, also the identity of PSM as curator...

  5. 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.

  6. Service quality for facilities management in hospitals

    CERN Document Server

    Sui Pheng, Low

    2016-01-01

    This book examines the Facilities Management (FM) of hospitals and healthcare facilities, which are among the most complex, costly and challenging kind of buildings to manage. It presents and evaluates the FM service quality standards in Singapore’s hospitals from the patient’s perspective, and provides recommendations on how to successfully improve FM service quality and achieve higher patient satisfaction. The book also features valuable supplementary materials, including a checklist of 32 key factors for successful facilities management and another checklist of 24 service attributes for hospitals to achieve desirable service quality in connection with facilities management. The book adopts a unique approach of combining service quality and quality theory to provide a more holistic view of how FM service quality can be achieved in hospitals. It also integrates three instruments, namely the SERVQUAL model, the Kano model and the QFD model to yield empirical results from surveys for implementation in hosp...

  7. 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

  8. 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

  9. Evaluation of service quality of hospital outpatient department services.

    Science.gov (United States)

    Chakravarty, Abhijit

    2011-07-01

    It has become essential for hospital managers to understand and measure consumer perspectives and service quality gaps, so that any perceived gap in delivery of service is identified and suitably addressed. A study was conducted at a peripheral service hospital to ascertain any service gap between consumer expectations and perceptions in respect of the hospital outpatient department (OPD) services. A cross-sectional study was conducted using SERVQUAL as the survey instrument, the instrument being validated for use in the hospital environment. Consumer ratings across 22 items of the survey instrument were collected in paired expectation and perception scores and then service quality gaps were identified and statistically analysed. Service quality gaps were identified to exist across all the five dimensions of the survey instrument, with statistically significant gaps across the dimensions of 'tangibles' and 'responsiveness.' The quality gaps were further validated by a total unweighted SERVQUAL score of (-) 1.63. The study concludes that significant service quality gaps existed in the delivery of the hospital OPD services, which need to be addressed by focused improvement efforts by the hospital management.

  10. Public Service Motivation and Paternalism

    DEFF Research Database (Denmark)

    Holm Pedersen, Lene; Qvistgaard, Lars

    holds a potential to improve public service provision (Belle, 2013, Andersen et al., 2014), it also has dark sides (Van Loon et al., 2015, forthcoming). The aim of this paper is to analyze and discuss how one type of public service motivated individuals (paternalistic knights) and constitute a problem...... of democratic accountability. The setting of this discussion is unusual for the PSM literature, and takes PSM into the analysis and discussion of motivation and paternalism in trade unions. This setting is relevant and interesting as the election of representatives is based on elections, and hence trade unions...... are democratic organizations, but they are also organizations which frequently are critiqued for paternalism. More specifically the research question is how the motivation of the elected representatives is associated to their paternalistic orientation in negotiations on performance pay? The central independent...

  11. Obesity, hospital services use and costs

    DEFF Research Database (Denmark)

    Folmann, Nana Bro; Bossen, Kristine Skovgaard; Willaing, Ingrid

    2007-01-01

    OBJECTIVE: To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts--number of inpatient admissions, number of outpatient visits, and number of emergency department visits--based on anthropometric measurements of waist circumference (WC.......5-24.9 kg/m2 were defined as normal weight. Individuals with BMI costs were obtained from The National Patient...... Registry and DRG. Analyses were performed using two-part models and Poisson regression. Outcome variables were costs and hospital contacts. RESULTS: This study has demonstrated that obese individuals have a greater use of hospital services and greater hospital costs compared with normal weight individuals...

  12. Impact mechanism of the reimbursement system reform on service provision behavior of public hospitals%补偿机制改革对公立医院服务提供行为作用机制研究

    Institute of Scientific and Technical Information of China (English)

    代涛

    2015-01-01

    简要回顾了我国公立医院补偿机制改革历程和目前改革的主要内容,重点分析了医疗服务价格调整及政府专项拨款等改革措施对公立医院服务提供行为的作用机制。结果发现,在现阶段公立医院自主化经营背景下,医疗服务价格调整的补偿方式可激励医院增加医疗服务提供数量;政府拨款的补偿方式会使医院减少服务提供数量,并在一定程度上抑制药品销售数量;在两项改革措施的综合作用下,医院更愿意通过增加医疗服务提供数量,以补偿取消药品加成所减少的收入。据此,对公立医院补偿机制改革提出政策建议。%This study reviewed the history and major issues of the reimbursement system reform on public hospitals in China,and analyzed the impact mechanism of specific reform approaches including price adjustment of health service and government special appropriation on the health care services provided by hospitals using qualitative analysis methods.This study has the following findings:if the public hospital is allowed to operate independently,the compensation by health service price adjustment will encourage hospitals to increase their service provision;the compensation method of government special appropriation will decrease the amount of service,and probably cut back the amount of drugs sold;with both reforms combined,hospitals will be encouraged to increase their medical service provision to make up for the revenue lost caused by canceling drug mark-ups.Finally,there were several policy suggestions.

  13. SERVICE MARKETING MIX OF INDIAN HOSPITALS: A CRITICAL REVIEW

    Directory of Open Access Journals (Sweden)

    Dharmesh, MOTWANI

    2014-07-01

    Full Text Available Sreenivas, Srinivasarao and Srinivasa (2013 said that “The health care market has become consumer centered and expecting high quality care at a reasonable price. The mushroomed development of corporate hospitals in India, competition is also bringing massive changes in industry structure. In this context, hospital services’ marketing is slowly and surely coming of age and is being woven into the fabric of hospitals planning and public relations programmes.” The essence of any marketing activity is marketing mix, and the central theme of the present paper revolves around the contemporary service marketing mix offered by Indian hospitals. In this paper author has critically reviewed 51 papers to describe elements of hospital service marketing mix; product, price, place, promotion, people, process and physical evidence.

  14. The Motivational Bases of Public Service.

    Science.gov (United States)

    Perry, James L.; Wise, Lois Recascino

    1990-01-01

    Suggests that, although a crisis in government service is widely recognized, understanding the motives of public servants and the way to stimulate public service motivation are at a preliminary stage. (Author)

  15. eServices for Hospital Equipment

    NARCIS (Netherlands)

    De Jonge, M.; Van der Linden, W.P.M.; Willems, H.X.

    2007-01-01

    In this paper we explore the idea that by combining different sources of information in a hospital environment, valuable e-services canbe developed that may help in reducing cost and improving quality of service. Companies, like Philips Medical Systems, may have a compe-titive advantage, because the

  16. 32 CFR 728.54 - U.S. Public Health Service (USPHS), other than members of the uniformed services.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false U.S. Public Health Service (USPHS), other than... FACILITIES Beneficiaries of Other Federal Agencies § 728.54 U.S. Public Health Service (USPHS), other than... 43 (Contract Health Service Purchase Order for Hospital Services Rendered) or HRSA form 64...

  17. Developing satellite communications for public service: Prospects in four service areas

    Science.gov (United States)

    1977-01-01

    The Public Service Satellite Consortium evaluated prospects for satellite telecommunications in four areas of the public service: the U.S. health care system, elementary and secondary education, American libraries, and that sector of the public service which is concerned with the provision of continuing education to health professionals. Three important conclusions were reached. First, throughout the public service there are three recurring needs: improved access, cost containment, and maintenance of quality. Appropriate application of communication satellite systems could ameliorate each of these concerns. Second, there appears to be an enormous latent demand for data communication services throughout the public service. The potential demand in 1982 to support requirements in hospital administration, library services and other information-retrieval activities, equipment maintenance, and environmental monitoring may be in excess of $300 million a year. Third, administrative applications of data communication networks show particular promise, especially in rural areas.

  18. 42 CFR 482.2 - Provision of emergency services by nonparticipating hospitals.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Provision of emergency services by nonparticipating... General Provisions § 482.2 Provision of emergency services by nonparticipating hospitals. (a) The services..., nevertheless, be reimbursed under the program if— (1) The services are emergency services; and (2)...

  19. 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.

  20. The current situation of basic public health services of 59 township hospitals in Sichuan prov-ince%四川省59家乡镇卫生院基本公共卫生服务现况分析

    Institute of Scientific and Technical Information of China (English)

    郑兰; 曹强; 蔡力; 刘洲; 廖菁; 韩亮; 王海江; 杨荣芳; 武文博; 雍正平

    2014-01-01

    Objective To understand the current situation of the public health services of township hospitals in Sichuan prov -ince.Methods Stratified sampling method was choose to extract 59 township hospitals through questionnaire .ANOVA was used to compare.Results Workload of public health services was increasing year by year .Differences in rates of cumulative filing of residents'health records ,filing of electronic documents ,filing of old people more than 65-year-old,and chronic disease management were statisti-cally significant in different years ( P<0.05 ) .Workload of the public health services in class I region was significantly higher than that in class II and III regions .By using analysis of variance ,all indexes of the public health service were significantly different ( P<0.05 ) except card number of pregnant women and rate of electronic document filing .Conclusion The basic public health services in each township health center of Sichuan province have been improved since the new medical reform .However ,there are differences among the areas.In order to provide references to improve township public health service ,opinions and suggestions should be put forward for differ-ent health service items ,so that the majority of rural residents will enjoy a better public health service .%目的:了解四川省乡镇卫生院的部分基本公共卫生服务项目的现况。方法采用分层抽样的方法,抽取59家乡镇卫生院进行问卷调查,并运用方差分析方法对公共卫生服务情况进行分析比较。结果乡镇卫生院各项公共卫生服务工作量逐年升高,其中居民健康档案累计建档率、电子建档率、65岁以上老人建档率和慢性病健康管理率在不同年份间总体上差异有统计学意义( P<0.05);一类地区的各项公共卫生服务量明显高于二类地区和三类地区,经方差分析,除孕产妇建卡人次和电子建档率两指标差别无统计学意义外,其他项服

  1. Measuring patient-perceived hospital service quality: a conceptual framework.

    Science.gov (United States)

    Pai, Yogesh P; Chary, Satyanarayana T

    2016-04-18

    Purpose - Although measuring healthcare service quality is not a new phenomenon, the instruments used to measure are timeworn. With the shift in focus to patient centric processes in hospitals and recognizing healthcare to be different compared to other services, service quality measurement needs to be tuned specifically to healthcare. The purpose of this paper is to design a conceptual framework for measuring patient perceived hospital service quality (HSQ), based on existing service quality literature. Design/methodology/approach - Using HSQ theories, expanding existing healthcare service models and literature, a conceptual framework is proposed to measure HSQ. The paper outlines patient perceived service quality dimensions. Findings - An instrument for measuring HSQ dimensions is developed and compared with other service quality measuring instruments. The latest dimensions are in line with previous studies, but a relationship dimension is added. Practical implications - The framework empowers managers to assess healthcare quality in corporate, public and teaching hospitals. Originality/value - The paper helps academics and practitioners to assess HSQ from a patient perspective.

  2. [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.

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

    Directory of Open Access Journals (Sweden)

    C. Selebi

    2007-09-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  5. 75 FR 68799 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Science.gov (United States)

    2010-11-09

    ... Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for CY 2011 AGENCY: Centers... inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services... (c) $141.50 for the 21st through 100th day of extended care services in a skilled nursing facility...

  6. Water Service Areas - Public Water Supplier's (PWS) Service Areas

    Data.gov (United States)

    NSGIC Education | GIS Inventory — Boundaries of current public water supplier's (PWS) service areas. This data set contains the present service area boundary of the water system and does not contain...

  7. Water Service Areas - Public Water Supplier's (PWS) Service Areas

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — Boundaries of current public water supplier's (PWS) service areas. This data set contains the present service area boundary of the water system and does not contain...

  8. Readmissions at a public safety net hospital.

    Directory of Open Access Journals (Sweden)

    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.

  9. New challenges for public services social dialogue

    DEFF Research Database (Denmark)

    Hansen, Nana Wesley; Mailand, Mikkel

    2015-01-01

    This is the national report on Denmark to the country comparative project New Challenges for Public Services: Integrating Service User and Workforce In-volvement to Support Responsive Public Services in Tough Times. The project examines service user involvement and how it is related to tradi......-tional forms of social dialogue in five European countries. Furthermore, the project examines how employers and trade unions are responding to recent de-velopments in the countries....

  10. 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.

  11. 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...

  12. 42 CFR 410.66 - Emergency outpatient services furnished by a nonparticipating hospital and services furnished in...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Emergency outpatient services furnished by a... SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.66 Emergency outpatient... for payment of emergency inpatient services furnished by a nonparticipating U.S. hospital and...

  13. METHODOLOGY OF PUBLIC TRANSPORT SERVICE QUALITY

    Directory of Open Access Journals (Sweden)

    Olga Saginova

    2016-01-01

    Full Text Available The paper analysis approaches to establishing a system of indicators for public transport service quality in Moscow using customers’ expectations and current characteristics of transportation service. The topic is relevant due to using a new model of transportation service in Moscow involving private transportation companies, which requires establishing uniform service quality standards. Object of research. Public transport service quality Objectives. Using modern marketing concepts and customer oriented approach to service quality assessment develop a comprehensive methodology of managing public transport service quality. Methods. The paper uses Russian and foreign research publications in service quality assessment as well as results of research project by a team of scientists from Plekhanov Russian University of Economics. Methods of comparative research, netnography and marketing research (focus groups and survey methods were used. Results. After analyzing the public transportation problems in the megapolis, current transportation policy and survey of foreign experience, transportation service standards of EC, USA and CIS, a structure and method of establishing a self-regulated system of improving transportation service quality was developed basing on a marketing approach. Conclusions/relevance. The developed methodology of establishing a self-regulating system of improving the transportation service quality is based on a marketing approach, and the structure of a system of indicators to assess the service quality, basic indicators of expected and perceived quality of transportation service.

  14. 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...

  15. Promoting and tracking the use of hospital library web services by outside entities.

    Science.gov (United States)

    Leman, Hope

    2010-04-01

    This column describes a process that can be used to market a hospital library Web service for use by external entities and monitor its use by the worldwide audience (e.g., medical, academic and public libraries, offices of research administration). Included are concrete suggestions to help hospital librarians in their efforts to encourage adoption of their Web service by other institutions.

  16. LIFENET hospitals (India): developing new services' case study.

    Science.gov (United States)

    Rahman, Zillur; Qureshi, M N

    2008-01-01

    Indian healthcare is in the process of offering a plethora of services to customers hailing largely from India and from neighboring countries. The Indian hospital sector consists of private "nursing homes" and government and charitable missionary hospitals. Government and missionary hospitals determine their charges according to patients' income levels and treat poor patients freely. Nursing homes charged higher, market-determined rates. They offer services in just a few medical specialties, owned and operated by physicians who worked with them. Nursing homes cannot afford the latest medical technology, but they provide more intimate settings than government hospitals. This case study aims to demonstrate the various strategic options available to a for-profit hospital, in an emerging economy with a burgeoning middle-class population and how it can choose which services that it can best offer to its target population. Diagnosing and treating complex ailments in nursing homes could be a time-consuming and expensive proposition as visits to several nursing homes with different specialties may be necessary. This paper demonstrates how an hospital can develop new customer-oriented services and eliminate the hassle for patients needing to run around different healthcare outlets even for minor ailments. The paper finds that large government hospitals generally have better facilities than nursing homes, but they were widely believed to provide poor-quality care. They failed to keep up with advanced equipment, train their technicians adequately and did not publicize their capabilities to doctors who might refer patients. Many missionary and charitable hospitals were undercapitalized and did not offer all services. These conditions left an unsatisfied demand for high-quality medical care. In 1983, LIFENET opened in Madras, becoming the first comprehensive, for-profit hospital in India. LIFENET, invested in a cardiology laboratory and clinics with capacity to diagnose heart

  17. Reform of Public Hospitals and the Joint Reform of Medical Insurance, Pharmacy Purchase Regime and Medical Service Provision%公立医院改革与三医联动

    Institute of Scientific and Technical Information of China (English)

    王震

    2016-01-01

    The Joint reform of Medical Insurance, Pharmacy Purchase Regime and Medical Service Provision has been issued in recent years to advance the reform of public hospitals, which has become the key task of medical reform in China. However, the aim of the joint reform is to form an independent, mutually restricting, balanced and eff ective competitive mechanism among diff erent sectors rather than merging them as one government department, and to form a resource allocation mechanism adapting to current socialist market economic system. It should avoid that medical insurance becoming a tool of cost reimbursement for public hospitals; but from the point of de-bureaucratic reform of public hospitals, we should promote establishing a health-insurance-physicians system and separating the payment of pharmacy from medical service, to achieve the general goal of three sectors joint-acting in medical system reform.%公立医院改革是当前医改的关键。“三医”联动助推公立医院改革不等于医保、医药和医疗三个部门之间的行政化合并,而是要各司其职,形成相互制约、平衡的有序竞争机制,形成与社会主义市场经济体制相适应的资源配置机制。从这个角度看,“三医”联动要避免诸如医保成为公立医院“成本补偿”渠道等重新行政化、计划化的思路,而是要从推动公立医院去行政化改革的角度,加快推进医保医师制度,推进医疗服务与医药的分开支付,实现符合医改总目标的“三医”联动新机制。

  18. Changes in service availability in california hospitals, 1995 to 2002.

    Science.gov (United States)

    Kirby, Paul B; Spetz, Joanne; Maiuro, Lisa; Scheffler, Richard M

    2006-01-01

    Hospitals face serious financial challenges in the current healthcare marketplace. In response to these challenges, they may alter their service offerings, eliminating services that are perceived as money-losing or adding new services in areas where profitability is expected to be greater. Although research has examined hospital closures, the more subtle phenomenon of hospital service changes has not been systematically studied. This issue is important because different types of hospital service changes could have different effects on hospital financial viability: extensive service closures could contribute to a downward spiral leading to hospital closure, whereas adding new services might help improve a hospital's finances. This article' examines changes in hospital service availability in California general acute care hospitals between 1995 and 2002. Our major findings indicate that many California hospitals made changes in their service offerings during the study period, although few made extensive changes. Altogether, about half of the hospitals in our study population either closed or opened at least one service. Nearly one-fourth of the hospitals in our study population closed one or more services, whereas just under one-third opened one or more new services. However, the vast majority of the hospitals that closed or added a service made only one or two such changes. In addition, few hospitals both closed and opened services. The service closed most frequently was normal newborn labor and delivery (obstetrics), whereas inpatient rehabilitation was the most frequently opened service. Hospitals that made the most service changes tended to be small, rural, and financially troubled at the start of the study period. Among this group of hospitals, service closures were associated with continued financial deterioration, whereas new service openings were associated with improvements in key financial ratios.

  19. [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

  20. Artificial Intelligence and Public Healthcare Service Innovation

    DEFF Research Database (Denmark)

    Sun, Tara Qian; Medaglia, Rony

    Public healthcare ecosystems are complex networks of diverse actors that are subject to pressures to innovate, also a result of technological advancements. Artificial Intelligence (AI), in particular, has the potential to transform the way hospitals, doctors, patients, government agencies...

  1. Preliminary results of a program of quality assurance applied to the image service of a public hospital; Resultados preliminares de um programa de garantia de qualidade aplicado ao servico de imagem de um hospital publico

    Energy Technology Data Exchange (ETDEWEB)

    Almeida, Claudio Domingues de; Ferreira, Rubemar de Souza; Marechal, Maria Helena H. [Instituto de Radioprotecao e Dosimetria (IRD), Rio de Janeiro, RJ (Brazil); Milano, Nelly Ester [Hospital Municipal Cardoso Fontes, Rio de Janeiro, RJ (Brazil). Setor de Imagem

    2001-07-01

    Overall quality in radiological protection and medical image depend largely on keeping certain safety standards and technical procedures in good levels. In this way, in June 1998, the Ministry of Health published the document 453 - Guidelines of Radiological Protection to Medical and Dental Practices, defining different levels of actions and responsibility for radiological installation where the critical starting point was the necessity of a previous quality assurance program (QAP) into the radiological service. Preliminary results of a QAP realized in the Department of Radiology of a high complexity Hospital in Rio de Janeiro has showed that, although the importance of 453 Regulation be recognized, there is a few motivation for implementing it. Besides, during 1999 it was possible to identify film losses of 14,9 % related only to the repetition of exposures in the patients, reflecting in terms of cost about U$ 100,000 a year. Results suggest that losses of 64% of total film are due to under or over exposures and 15% are due to inadequate positioning of either film or patient, evidencing the need for training the technical and medical staff . (author)

  2. Public service improvement with user-centric service composition

    NARCIS (Netherlands)

    Hoppen dos Santos, Joni; Ferreira Pires, Luis; Goncalves da Silva, Eduardo; Iacob, Maria Eugenia; Janssen, M.; Macintosh, A.; Scholl, H.J.; Tambouris, E.; Wimmer, M.A.; de Bruijn, H.; Tan, Y.H

    2011-01-01

    In recent years, public organisations have been challenged to offer electronic services. This has caused a proliferation of disconnected web sites or web portals, often reflecting the internal structures (departments or sections) of these organizations. This paper shows that electronic public servic

  3. 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.

  4. 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.

  5. Management Methods of Decentralized Public Services

    Directory of Open Access Journals (Sweden)

    BILOUSEAC Irina Adriana

    2013-05-01

    Full Text Available The purpose of the article, having as theme the typology of public services management and the implications on decentralization, is the foundation of theoretical concepts, but also the analysis from a practical point of view of both types of management applied in the management of public services in Romania and of the effects they cause on the Romanian public administration capacity to provide efficient public services. Although the users of decentralized public services don’t have the possibility of choosing the service provider, the analysis of the management methods is important, because depending on the type of management chosen there are advantages and disadvantages for the local community. It has to be analyzed for each particularly case which type of management leads to a greater satisfaction of a social need appeared.

  6. Quality and public transport service contracts

    OpenAIRE

    Gatta, Valerio; Marcucci, Edoardo

    2007-01-01

    Public authorities and transport operators are both involved in the provision of public transport services. There is a contrast between the social goals of the former and the private ones of the latter. Regulation plays an important role especially failing competition. Service contracts are the natural method to set bilateral After a brief description of the most important regulatory procedures, we focus our attention on the quality framework in service contracts. In recent years the inclusio...

  7. A survey of hospital outpatient services for chronic diseases in ...

    African Journals Online (AJOL)

    A survey of hospital outpatient services for chronic diseases in Gauteng. ... in particular aspects of the organisation of services, and indirect indicators of patient care. Design ... Management guidelines were used for all conditions in 5 hospitals.

  8. Model construction of nursing service satisfaction in hospitalized tumor patients

    OpenAIRE

    Chen, Yongyi; LIU, JINGSHI; Xiao, Shuiyuan; Liu, Xiangyu; Tang, Xinhui; Zhou, Yujuan

    2014-01-01

    This study aims to construct a satisfaction model on nursing service in hospitalized tumor patients. Using questionnaires, data about hospitalized tumor patients’ expectation, quality perception and satisfaction of hospital nursing service were obtained. A satisfaction model of nursing service in hospitalized tumor patients was established through empirical study and by structural equation method. This model was suitable for tumor specialized hospital, with reliability and validity. Patient s...

  9. Users’ expectations of public library services

    Directory of Open Access Journals (Sweden)

    Tanja Borko

    2006-01-01

    Full Text Available Public libraries are used by a wide range of users. Therefore they should offer as many different services as possible. The proper introduction of library services to the users can be monitored by measuring their expectations. The article represents the services, which public libraries should offer to their users, definition of the expectation and which factors influence forming the expectations. 60 users were interviewed in two public libraries. The purpose of research was to find out how expectation differs from public library service offer. The results show that most users expect traditional library services such as free access to books, loaning books, giving information over the phone, reading rooms and inter-library loan; furthermore, most users expect library consultancy and advisory services, access to the Internet, public library website, on-line library catalog and services for the youngest members of the library. Fewer users expect guided tour of the library and information on cultural events in the city. Very few users expect modern services, such as provision of electronic publications, courses or lectures for using the Internet and other electronic sources, special courses, such as how to write a scientific research, and services for leisure and recreation, such as organized trips, and fun activities, such as arranging flowers, painting, sawing, etc.

  10. The role of public relations for image creating in health services: a sample patient satisfaction survey.

    Science.gov (United States)

    Kirdar, YalçIn

    2007-01-01

    This study discusses the role of public relations for image creating in health services. Hospitals require public relations activities to distinguish them from competitors, provide bidirectional communication between the society and the hospital, and assist to create of a strong hospital image and culture. A satisfaction survey was conducted on 264 patients who have received health services at Maltepe University Hospital. The research focused on how the Hospital's examination, care, catering and physical services; doctor and nurse politeness towards patients and patient relatives, their attitudes and behaviors; examination, check-in, bedding and discharge operations; public relations activities in and out of the hospital were perceived. Another subject of the study was the degree of recommendation of patients who have been served by the hospital's health services to prospective patients seeking treatment.

  11. Service dogs, psychiatric hospitalization, and the ADA.

    Science.gov (United States)

    Muramatsu, Russ S; Thomas, Kelly Jones; Leong, Stephanie L; Ragukonis, Frank

    2015-01-01

    A service dog is defined as "any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability." Some psychiatric patients may depend on a service dog for day-to-day functioning. The Americans with Disabilities Act (ADA) established certain rights and responsibilities for individuals with disabilities and health care providers. Psychiatric hospitalization of a patient with a service dog may pose a problem and involves balancing the requirement to provide safe and appropriate psychiatric care with the rights of individuals with disabilities. This Open Forum examines issues that arise in such circumstances, reviews the literature, and provides a foundation for the development of policies and procedures.

  12. Evaluation of hospital service level agreements.

    Science.gov (United States)

    Berbée, Rieneke G; Gemmel, Paul; Droesbeke, Brenda; Casteleyn, Hugo; Vandaele, Darline

    2009-01-01

    The purpose of the paper is to evaluate the development and use of service level agreements (SLAs) in a Belgian hospital from a client's point of view. The paper is based on a theoretical framework indicating the variables that influence the relationship between the use of a specific governance mechanisms and performance, a new instrument was developed and applied on a convenience sample of 107 SLA clients from a Belgian hospital. SLAs are useful for hospitals, as they improve people's insight into processes, stimulate people to think about performance measurement and, in some cases, also lead to improved services. The main advantages of SLAs do not really lie in improved relationships and better fits with clients' needs, but in improved process mapping and improved performance measurement. The questionnaire from this research study proves to be a useful and reliable instrument for evaluating internal SLAs from a client's point of view. The results of this study are limited, as they are only based on one Belgian institution. Other limitations include the posttest-only research design and the unequal distribution of the respondents over the different SLAs. Recommendations for future research include applying the questionnaire in other Belgian hospitals and in settings where both a pretest and posttest can be conducted. As far as known, no other studies have yet evaluated the effectiveness of SLAs in the healthcare sector. While a fairly-substantial amount of scientific literature deals with SLAs in the world of ICT, this literature is often very specific and cannot always be applied to other service sectors.

  13. 42 CFR 93.220 - Public Health Service or PHS.

    Science.gov (United States)

    2010-10-01

    ... RESEARCH MISCONDUCT Definitions § 93.220 Public Health Service or PHS. Public Health Service or PHS means... 42 Public Health 1 2010-10-01 2010-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...

  14. Arm's length delegation of public services

    DEFF Research Database (Denmark)

    Bennedsen, Morten; Schultz, Christian

    2011-01-01

    Delegation is a key feature of political decision making: Mayors or prime ministers delegate to subordinates, voters delegate to elected representatives. We analyze the effect of political delegation on public service provision and the choice between private or public providers when contracts are...... position vis a vis a private firm with market power. In general, these effects imply that delegation improves public service provision.......Delegation is a key feature of political decision making: Mayors or prime ministers delegate to subordinates, voters delegate to elected representatives. We analyze the effect of political delegation on public service provision and the choice between private or public providers when contracts...... are incomplete and incentives therefore distorted. We identify two important effects: The incentive effect increases the incentive part of service providers' remuneration and delegation may therefore be a substitute for an explicit complete incentive contract. The bargaining effect improves the bargaining...

  15. Public policy alienation of public service workers: A conceptual framework

    NARCIS (Netherlands)

    L.G. Tummers (Lars); V.J.J.M. Bekkers (Victor); A.J. Steijn (Bram)

    2007-01-01

    textabstractThis paper theoretically examines identification problems with the implementation of public policies. When these identification problems occur, they might have significant impacts. For instance, the quality of the interaction between service workers and clients influence the effectivenes

  16. Hospitality and service: leading real change.

    Science.gov (United States)

    Kerfoot, Karlene M

    2009-01-01

    A patient's decision to recommend a health care organization and the patient's loyalty scores are largely determined by the interaction patients and their families have with the nurses. Hospitality is how the delivery of that product makes the person feel and is a dialogue that requires the server to be "on the guest's side" throughout the experience. The challenge for health care is to help our patients and their families transcend the usual routine care of our health care world and to experience an emotional connection that provides that sense of affiliation and emotional kinship with the organization and the staff. Moving from the service mindset in health care to the hospitality mindset that engages people positively and emotionally is what healing is all about.

  17. 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.

  18. Participation & Co-Design in Public Services

    DEFF Research Database (Denmark)

    Giordano, Fanny Barbara

    administrations are unable to provide valid answers to emerging everyday problems. Theses opportunities and challenges are related to the role designers could take to help generating new kinds of public services. Services that are sustainable, that take into account the technological innovations but most...... importantly that are informed by the real needs of their users (citizens). How design may contribute to build capacity and bridge relations between citizens and public service providers?......This poster is part of an early investigation of a PhD-study in Service Design that started in February 2017. The poster identifies challenges and opportunities emerging from a gap between citizen’s needs and public offering to address such needs. Citizens often organize themselves when public...

  19. 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

  20. Public service i netværkssamfundet

    DEFF Research Database (Denmark)

    Mortensen, Frands

    Analyser af digitaliseringens betydning for radio, TV og Internet, og især for konsekvenserne for levering af Public Service Broadcasting. En særlig del omhandler EU's betydning for udviklingen af statsstøtte til PSB.......Analyser af digitaliseringens betydning for radio, TV og Internet, og især for konsekvenserne for levering af Public Service Broadcasting. En særlig del omhandler EU's betydning for udviklingen af statsstøtte til PSB....

  1. 42 CFR 409.68 - Guarantee of payment for inpatient hospital or inpatient CAH services furnished before...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Guarantee of payment for inpatient hospital or inpatient CAH services furnished before notification of exhaustion of benefits. 409.68 Section 409.68 Public... HOSPITAL INSURANCE BENEFITS Scope of Hospital Insurance Benefits § 409.68 Guarantee of payment...

  2. 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

  3. 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.

  4. Arm's Length Provision of Public Services

    DEFF Research Database (Denmark)

    Bennedsen, Morten; Schultz, Christian

    We analyze the economic consequences of strategic delegation of the right to decide between public or private provision of governmental service and/or the authority to negotiate and renegotiate with the chosen service provider. Our model encompass both bureaucratic delegation from a government...

  5. Public Service Guidelines in an Electronic Environment.

    Science.gov (United States)

    Barkley, Daniel C.

    1998-01-01

    In today's electronic environment, government information librarians face new challenges, especially in the arena of quality public-service provision. Given the lack of clear guidelines that Federal Depository Library Program participants follow, and based upon suggested guidelines of reference-oriented literature, a new set of public services…

  6. 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.

  7. 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.

  8. Computerized system for hospital engineering service management

    Energy Technology Data Exchange (ETDEWEB)

    Centeno, C A; Gonzalez, E A; Cagnolo, F J; Olmos, C E [Clinical Engineering Group, National Technological University, Cordoba Regional Faculty, Maestro M Lopez St and Cruz Roja Argentina St, Cordoba (Argentina)

    2007-11-15

    When a Hospital Engineering Service (HES) is implemented within a health care environment, the idea is to improve service conditions and costs as well as to provide timely responses to equipment preventive maintenance and infrastructure requirements. An HES must, within the shortest possible period of time, meet the above requirements at the cost necessary to provide the service quality sought. In many cases there is a lack of minimal materials and staff who are qualified to attain the objectives that have been set. Therefore, external assistance becomes necessary. In this context, actions are often taken which, because they are not recorded, cannot be assessed in order to evaluate the HES. Since all action taken is appraised from the purely economic point of view, in the final analysis the contributions from staff remain invisible. This situation works against the possibility of quantifying the convenience of possessing an internal HES. The software support system we have developed here is oriented toward providing all the necessary data to address this issue.

  9. 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.

  10. Psychology in the public service.

    Science.gov (United States)

    Zimbardo, Philip G

    2002-01-01

    Philip G. Zimbardo outlines the challenges and opportunities he faces as the American Psychological Association's (APA's) 110th president. This article expands on remarks made in his introduction to Patrick H. DeLeon's presidential address at the APA's 2001 annual convention in San Francisco, California. Appearing now, mid-term in his presidency, that vision is a working blueprint of his activities and what he hopes to accomplish in his remaining tenure: enhancing psychologists' pride in psychology; developing more productive relationships with all media as gatekeepers to the public; publishing the standard high school psychology textbook; developing a compendium of all psychological research that illustrates how psychologists have made a significant difference in improving various aspects of the quality of life of individuals, groups, communities, and the United States; and encouraging greater unity of purpose and respect among psychologists across their many diverse domains and specialties.

  11. 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.

  12. Performance Management Compared across Public Services

    DEFF Research Database (Denmark)

    Bjørnholt, Bente; Agger Nielsen, Jeppe; Lindholst, Christian

    on extent literature we expect performance management systems to be operationalized more tightly, freed from definitional conflicts and with more rigorous and quantitative measures in areas with low governance complexity (technical services) while performance management systems will appear with opposite...... service areas and draw lessons from these differences. On this backdrop this paper investigates theoretical assumptions on performance management systems through a cross-comparison of two public service areas (technical and social services) which differ in theoretically important dimensions. Drawing...... characteristics in areas with high governance complexity (social service). We find that the performance management systems unexpectedly converged in characteristics across the two service areas, and even appeared with more rigid monitoring and control functions in social services compared to newer developments...

  13. Performance Based Supplementary Payment Systems in Istanbul Public Hospitals

    Directory of Open Access Journals (Sweden)

    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

  14. Public Service In Service Soil Certificate In The Sorong City

    Directory of Open Access Journals (Sweden)

    Muhammad Ridha

    2015-03-01

    Full Text Available ABSTRACT One of the goals of decentralization in 2004 that the decentralization of Local Government authorities undergo a process of empowerment the ability of initiative creativity encouraged so that the capacity to address domestic problems getting stronger This opens opportunities made possible since the enactment and implementation of the Law on Local Government that Act No. 32 of 2004. The problem is formulated in this study is how the public service in the administration of land titles in Sorong city . This study used a qualitative approach that is descriptive analysis. This study seeks to describe and interpret what is can about the condition or existing relationship opinion growing ongoing process result or effect that occurs or emerging trend.Basic techniques of data collection used is interview observation and documentation. Interviews were used in the form of nonstandard or unstructured done without preparation of a list of questions that tight but based on the interview guide focused on research. Data analysis techniques in this study using a qualitative analysis of the interaction model proposed by Miles and Huberman. The results showed that public service obtaining certificates of land that occurred in Sorong city land office applied based counter system to provide services that are easy for the public applicants for all service activities through mechanisms that have been specified for ease of service. But it must be admitted that there are services that have not been fully optimized in accordance with the procedures of service. Counter parties in implementing the maintenance service is not in accordance with SOP according to the stages of eligibility has been determined. Service activities implemented by the land office by the applicant community feedback or service activities is not optimal because they are less efficient service activities tend to be economical because the service is not simple and not timely completion

  15. [Development and application of hospital customer service center platform].

    Science.gov (United States)

    Chen, Minya; Zheng, Konglin; Xia, Yong

    2012-01-01

    This paper introduces the construction and application of the platform of client service center in the general hospital and discusses how to provide patients with an entire service including service before clinic, on clinic and after clinic. It can also provide references for a new service mode for clinic service.

  16. [Terrorism, public health and health services].

    Science.gov (United States)

    Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge

    2009-01-01

    Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.

  17. Regulative Aspects of Public Services in Slovenia

    Directory of Open Access Journals (Sweden)

    Mik STRMECKI

    2006-06-01

    Full Text Available The main points tackled in this paper are the evolution of regulation of public services and the way in which they are provided in Slovenia from the advent of the so-called transition period up to the present. The importance of this sort of regulation is to create a level playing field between the private and public sectors to function to their utmost mutual advantage and at the same time safeguarding the public interest. The paper further addresses also the objectives of regulation in this field such as promoting healthy competition, the creation of a level playing field for competition to play itself out properly and in congruity with the law and also in such a way as to prevent unjustified profiteering, monopolistic abuses etc. The paper also touched upon the functional characteristics of the regulating authority, appointment procedures, funding and the regulatory process. The focus of the paper is on the public service delivery landscape in our country: the direct provision by the central government or local government and the indirect service delivery, which has numerous sub-forms such as public companies, concessionary public service and publicprivate partnerships.

  18. Model construction of nursing service satisfaction in hospitalized tumor patients.

    Science.gov (United States)

    Chen, Yongyi; Liu, Jingshi; Xiao, Shuiyuan; Liu, Xiangyu; Tang, Xinhui; Zhou, Yujuan

    2014-01-01

    This study aims to construct a satisfaction model on nursing service in hospitalized tumor patients. Using questionnaires, data about hospitalized tumor patients' expectation, quality perception and satisfaction of hospital nursing service were obtained. A satisfaction model of nursing service in hospitalized tumor patients was established through empirical study and by structural equation method. This model was suitable for tumor specialized hospital, with reliability and validity. Patient satisfaction was significantly affected by quality perception and patient expectation. Patient satisfaction and patient loyalty was also affected by disease pressure. Hospital brand was positively correlated with patient satisfaction and patient loyalty, negatively correlated with patient complaint. Patient satisfaction was positively correlated with patient loyalty, patient complaints, and quality perception, and negatively correlated with disease pressure and patient expectation. The satisfaction model on nursing service in hospitalized tumor patients fits well. By this model, the quality of hospital nursing care may be improved.

  19. 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.

  20. Attitude of Supervisors of Yazd Educational Hospitals towards the Role of Personnel Element on the Market Share of Hospital Services

    Directory of Open Access Journals (Sweden)

    Mohammad Zare Zadeh

    2013-07-01

    Full Text Available Introduction: Quality of services extremely depends on how personnel have contact and interaction with the clients. Moreover, the personnel’s attitudes and their behaviors with the clients significantly affect clients’ perception of quality of services and consequently influence their satisfaction as well as their absorption to the services of an institution. This study intends to investigate the supervisor’s attitude towards the effect of persons or the personal element (as one of the elements of the service marketing mix on choosing the hospital by the patients and their companions. Materials and Methods: This cross-sectional descriptive study conducted in the winter of 2012. The study participant involved 35 supervisors in Yazd educational hospitals of Shahid Sadoughi University of Medical Sciences; Shahid Rahnemoun and Afshar. The research data were gleaned via a researcher-made questionnaire on factors of the marketing mix which its validity and reliability were confirmed. Data analysis was performed using SPSS software. Results: Results revealed that supervisor’s belief in the increasing of market share of a hospital services in public hospitals are consist of: 1-Physical evidence 2- Service or product 3- People or persons 4- Efficiency and quality 5- Process 6- Distribution 7-Promotion or propagation and 8- Price. Therefore, the significance of the personnel role in absorption of a definite patient involves the third element in choosing the hospital by the patients. Conclusion: Based on this study, since the third factor in clients’ (patients, etc. choices of hospital are the personnel and persons who provide services, it is confirmed that in service-based organizations like hospitals, the most important elements of quality of services in retaining and absorbing new clients and surviving the organization are the personnel activities who has been connected with organization clients. Moreover, it is regarded as a vital factor in

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

    Directory of Open Access Journals (Sweden)

    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.

  2. User innovation in public service broadcasts

    DEFF Research Database (Denmark)

    Khajeheian, Datis; Tadayoni, Reza

    2016-01-01

    This research aims to understand how public service media can encourage media entrepreneurship in the society to enrich user innovations as a source of ideas, products, contents, talent and creativity. The assumption is that media entrepreneurs turn users into sources of external creativity...... and develop user innovations into professional content. This study follows a qualitative approach with a document study of Denmark's public service broadcast and two interviews. Findings indicate that the commitment to quality and professional content prevents managers of PSBs from outsourcing...... their production to media entrepreneurs, but they trust large media companies as external producers. This research contributes to the field by proposing that public service media can foster media entrepreneurship in a society indirectly and by creating demand for external sources of creativity. Large media...

  3. 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.

  4. Design Competences to Support Participatory Public Services

    DEFF Research Database (Denmark)

    Giordano, Fanny Barbara

    2017-01-01

    This paper is an early investigation of a PhD-study that started in February 2017. The paper identifies challenges emerging from a gap between citizens’ needs and public offering to address such needs. Citizens often organize themselves when public administrations are unable to provide valid...... answers to unsolved and shared everyday problems. In this context designers should support and facilitate bottom up approaches that could address these challenges by the creation of new public services that are informed by the real needs of their users (the citizens). How can designers support...... the spontaneous creations of services by citizens? How might designers build platforms that could support interactions between citizens and public organizations on a large scale? In this paper I will refer to the Open4Citizens (O4C) research project as an exemplary playground to build co-design tools...

  5. 42 CFR 413.122 - Payment for hospital outpatient radiology services and other diagnostic procedures.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for hospital outpatient radiology services... radiology services and other diagnostic procedures. (a) Basis and purpose. (1) This section implements section 1833(n) of the Act and establishes the method for determining Medicare payments for radiology...

  6. Hippi Care Hospital: Towards Proactive Business Processes in Emergency Room Services. Teaching Case

    Science.gov (United States)

    Tan, Kar Way; Shankararaman, Venky

    2014-01-01

    It was 2:35 am on a Saturday morning. Wiki Lim, process specialist from the Process Innovation Centre (PIC) of Hippi Care Hospital (HCH), desperately doodling on her notepad for ideas to improve service delivery at HCH's Emergency Department (ED). HCH has committed to the public that its ED would meet the service quality criterion of serving 90%…

  7. Secure Electronic Cards in Public Services

    Directory of Open Access Journals (Sweden)

    Cristian TOMA

    2008-01-01

    Full Text Available The paper presents the electronic wallet solution implemented within a GSM SIM technology for accessing public services. The solution is implemented in the medical field to provide information on the patient’s medical history and payment for private medical services. The security issue is a very important one as the patient’s history is confidential and the payment has to be safe.

  8. Medicaid program; clarification of outpatient hospital facility (including outpatient hospital clinic) services definition. Final rule.

    Science.gov (United States)

    2008-11-07

    Outpatient hospital services are a mandatory part of the standard Medicaid benefit package. This final rule aligns the Medicaid definition of outpatient hospital services more closely to the Medicare definition in order to: Improve the functionality of the applicable upper payment limits (which are based on a comparison to Medicare payments for the same services), provide more transparency in determining available hospital coverage in any State, and generally clarify the scope of services for which Federal financial participation (FFP) is available under the outpatient hospital services benefit category.

  9. Work engagement in the public service context

    DEFF Research Database (Denmark)

    Noesgaard, Mette Strange; Hansen, Jesper Rosenberg

    2016-01-01

    Work engagement has increasingly captured the attention of researchers and practitioners due to its positive impact on employee level outcomes and overall organizational performance (e.g. Bakker and Bal, 2010, Hallberg and Schaufeli, 2006). Therefore, several studies have been conducted in variou...... investigates the role of public service motivation (PSM) in relation to engagement and how it may be used to enhance engagement in a challenging public context characterized by high levels of emotional labor, control and increasing demands for efficiency....

  10. 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

  11. 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

  12. 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.

  13. Unit cost of medical services at different hospitals in India.

    Directory of Open Access Journals (Sweden)

    Susmita Chatterjee

    Full Text Available Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010-11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital to Rs. 2,213 (private hospital (USD 1 = INR 52. The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country's hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising

  14. Customer Relationship Management and Hospital Service Quality in ...

    African Journals Online (AJOL)

    Customer Relationship Management and Hospital Service Quality in Nigeria. ... Relationship Management can be employed to bring about improve health service quality in Nigeria. ... EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  15. Factor Analysis 01- Healthcare Service Quality In Medan Government Hospital

    OpenAIRE

    Lubis, Arlina Nurbaity; Lumbanraja, Prihatin; Lubis, Rahmawaty; Hasibuan, Beby Kendida

    2016-01-01

    Service sector increases rapidly especially in Indonesia. This can be seen from the distribution of the percentage of Product Domestic Bruto (PDB) based on job vacancy showing that the service sector contribution approaches 50%. One of the service/care industries with rapid growth is healthcare service. It can be seen from the government plan year 2015-2016 to do healthcare reinforcement. Generally, healthcare is identically related to hospital. A hospital is a professional healthcare institu...

  16. Governance and innovation in public sector services

    DEFF Research Database (Denmark)

    Scupola, Ada; Zanfei, Antonello

    2016-01-01

    This paper examines the co-evolution of public governance and innovation, and proposes an adaptation of Hartley's model to take into consideration such co-evolution. This model is then applied to a longitudinal case study of the digitalization of Roskilde University Library. The theoretical...... and empirical analysis yields four main results. First, it is shown that the transition from a New Public Management approach towards a Networked Governance mode implies a greater distribution of knowledge and innovation across different organisational levels within public administrations. Interactions between...... such organisational levels crucially affect the development of new public services. Second, a more articulated view of users in public sector innovation is developed. It is argued that: (i) users play distinct roles at different stages in innovation processes, with relatively greater involvement in minor incremental...

  17. 41 CFR 101-5.307 - Public Health Service.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the...

  18. Message Effects of Public Service Advertising.

    Science.gov (United States)

    Lynn, Jerry R.

    Public service advertisements, disseminated via the mass media, have been credited with "positive attitudinal effects" in past research, but only certain kinds of such advertisements are really effective. Of the types of appeals used in television commercials--informative, emotional, "establishment" (or status quo), and…

  19. Prosocial behavior and public service motivation

    NARCIS (Netherlands)

    Esteve, M.; Urbig, D.; van Witteloostuijn, Arjen; Boyne, George

    Although research on public service motivation (PSM) is vast, there is little evidence regarding the effects of PSM on observable behavior. This article contributes to our understanding of the behavioral implications of PSM by investigating whether PSM is associated with prosocial behavior.

  20. Managerial challenges in public service contracting

    DEFF Research Database (Denmark)

    Lindholst, Andrej Christian; Bogetoft, Peter

    2011-01-01

    , themes and questions for research in public service contracting. We identify and exemplify the framework by combining insights from different theoretical perspectives with empirical evidence through an iterative process. The evidence is educed as a set of observed and self-reported stories in a cross...

  1. Energy efficiency public service advertising campaign

    Energy Technology Data Exchange (ETDEWEB)

    Gibson-Grant, Amanda [Advertising Council, New York, NY (United States)

    2015-06-12

    The Advertising Council (“the Ad Council”) and The United States Department of Energy (DOE) created and launched a national public service advertising campaign designed to promote energy efficiency. The objective of the Energy Efficiency campaign was to redefine how consumers approach energy efficiency by showing that saving energy can save homeowners money.

  2. Communication Satellites: Experimental & Operational, Commercial & Public Service.

    Science.gov (United States)

    Development Communication Report, 1979

    1979-01-01

    The title reflects the first and major article in an issue of this newsletter devoted entirely to communication satellites. This series of articles on the potential and applications of communication satellites in development projects is concerned with their development for commercial and public service, development in the Pacific region, SPACECOM…

  3. Public Service Employment as Macroeconomic Policy.

    Science.gov (United States)

    Baily, Martin N.; Solow, Robert M.

    1979-01-01

    Authors assert that public service employment (PSE) is one form of macroeconomic policy and compare PSE to tax reduction, federal subsidies, and other forms. They propose a design for an ongoing federal employment program and conclude that a PSE program aimed at the structurally unemployed creates more jobs per GNP dollar than other policies. (SK)

  4. Prosocial behavior and public service motivation

    NARCIS (Netherlands)

    Esteve, M.; Urbig, D.; van Witteloostuijn, Arjen; Boyne, George

    2016-01-01

    Although research on public service motivation (PSM) is vast, there is little evidence regarding the effects of PSM on observable behavior. This article contributes to our understanding of the behavioral implications of PSM by investigating whether PSM is associated with prosocial behavior. Moreover

  5. Public Employment Services and European Law

    DEFF Research Database (Denmark)

    Freedland, Mark; Craig, Paul; Jacqueson, Catherine

    jobformidling i EU: institutioner, aktiviteter og regulering - økonomisk/social regulering, privat/offentlig aktivitet - EU-ret - komparativ ret: Danmark, Frankrig, England, Tyskland og Italien - EU kompetence, sociale anliggende og offentlige tjenesteydelser - "Public service" modeler i EU - reg...

  6. 公立医院体检服务战略定位:体检消费者分析%Strategic Position of Physical Examination Service in Public Hospitals: Analysis of Physical Examination Consumers

    Institute of Scientific and Technical Information of China (English)

    王前; 许崇伟; 田柯; 曹瑞; 邹俐爱

    2011-01-01

    The paper studies the customer segments, value analysis, and purchase decision research of the local market where the sample public hospital stays to provide support for the strategic positioning study of the sample hospitals.%通过对广州市局部市场进行消费者细分、消费者价值分析和消费者购买决策研究,为范例公立医院体检中心战略定位提供支持.

  7. Effect of Managers on Public Service Performance

    DEFF Research Database (Denmark)

    Mikkelsen, Maria Falk

    This report provides an overview of the PhD dissertation “Effects of Managers on Public Service Performance” carried out at the Department of Political Science, Aarhus University and SFI – The Danish National Centre for Social Research. The dissertation is part of the research project “School...... Management, Teaching, and Student Performance” supported by the Danish Strategic Research Council (now Innovation Fund Denmark) and headed by professor Søren Winter. The dissertation explores the effects of managers on public service performance. By combining theoretical insights and research designs from......? The Interplay between Decentralized Authority and Managerial Factors.” Invited for revise and resubmit [referred to as “Decentralized authority”]. C. Mikkelsen, Maria Falk 2015, “Trade-offs or Superman(agers)? The Effect of Public Managers on Production and Process Performance.” Under review [referred...

  8. Birthing Centers and Hospital Maternity Services

    Science.gov (United States)

    ... What are the hospital's statistics for cesarean sections, episiotomies, and mortality? (Keep in mind, though, that these ... What are the center's statistics for hospital transfers, episiotomies, and mortality? What procedures are followed after your ...

  9. Influence of Public Relations and Reference Services on Academic ...

    African Journals Online (AJOL)

    Keywords: Academic Library, library services, Public relations, Reference Services ... reference services as the direct personal help given by librarian to a ... helps make management aware of public opinion and .... information centre. If local ...

  10. 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.

  11. 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

  12. Arm's Length Provision of Public Services

    DEFF Research Database (Denmark)

    Bennedsen, Morten; Schultz, Christian

    to a privatization agency and electoral delegation from voters to a government. We identify two powerfull effects of delegation when contracts are incomplete: The incentive effect increases the incentive part of service providers' remuneration and we show that strategic delegation may substitute formal incentive...... contracts. The bargaining effect improves the bargaining position vis a vis a private firm with market power and leads to a lower price for the service......We analyze the economic consequences of strategic delegation of the right to decide between public or private provision of governmental service and/or the authority to negotiate and renegotiate with the chosen service provider. Our model encompass both bureaucratic delegation from a government...

  13. 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...

  14. 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.

  15. Patients' satisfaction of service quality in Saudi hospitals: a SERVQUAL analysis.

    Science.gov (United States)

    Al-Borie, Hussein M; Damanhouri, Amal M Sheikh

    2013-01-01

    Saudi Arabian hospital performance, vis-á-vis patient satisfaction with service provision, has emerged as a key policy and planning concern. Keeping in view public and private hospital service quality, this article seeks to provide guidelines to the on-going Saudi Arabian health service reorganization, which emphasizes decentralization, bed-capacity expansion, research-based policymaking and initiatives in the health insurance sector. The article outlines an empirical study that compares patient satisfaction with service quality in Saudi Arabian public and private sector hospitals. The authors employ a stratified random sample (1,000 inpatients) from five Saudi Arabian public and five private hospitals. Data were collected through questionnaire using the SERVQUAL scale. For reducing the language bias the questionnaire was translated into Arabic. The response rate was 74.9 percent. Data were analyzed using SPSS and appropriate descriptive and inferential statistical techniques. Cronbach's alpha for five service-quality dimensions (tangibles, reliability, responsiveness, safety and empathy) were high and the SERVQUAL instrument proved to be reliable, valid and appropriate. The results showed that sex, education, income and occupation were statistically significant in influencing inpatients' satisfaction, and all the null hypotheses were rejected. Only inpatient age was not significant. The study highlights service quality influence in the design of broader healthcare strategies for Saudi Arabian public and private hospitals. It demands that management researchers and analysts must identify regional service quality consistencies and related inpatient demographic indicators. The study offers some insights into, and guidance for, hospital quality assurance in Saudi Arabia in general and the urban hospital setting in the Middle-East in particular.

  16. 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

  17. '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

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

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. Obesity, hospital services use and costs

    DEFF Research Database (Denmark)

    Folmann, Nana Bro; Bossen, Kristine Skovgaard; Willaing, Ingrid;

    2007-01-01

    To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts--number of inpatient admissions, number of outpatient visits, and number of emergency department visits--based on anthropometric measurements of waist circumference (WC) and info......To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts--number of inpatient admissions, number of outpatient visits, and number of emergency department visits--based on anthropometric measurements of waist circumference (WC...

  3. Activating the Forces of Public Service Motivation

    DEFF Research Database (Denmark)

    Pedersen, Mogens Jin

    2015-01-01

    resource that is present in the work environment. Using a randomized survey experiment with 528 law students, this article shows how low-intensity treatments may activate PSM and how the effect of PSM activation efforts compares with efforts to activate another, less self-determined type of motivation......Employees with higher public service motivation (PSM) are likely to perform better in public service jobs. However, research on how practitioners may capitalize on this knowledge is sparse. This article expands the understanding of how to activate employee PSM, which is understood as a human...... (relating to the need for feelings of self-importance). The findings are robust and suggest that low-intensity efforts to activate PSM have a positive effect on an individual's behavioral inclinations. However, efforts toward the activation of motivation relating to feelings of self-importance appear...

  4. Public Service Broadcasters and User Profiles

    DEFF Research Database (Denmark)

    Sørensen, Jannick Kirk

    2007-01-01

    Public Service Broadcasters in northern Europe have – in different paces and with different activities – since long been delivering media content to listeners and viewers not only by broadcast but also ‘on demand’. With this pull-based distribution, and with PSBs fighting for marked shares...... on commercial conditions, it is tempting to ask if PSBs should, like their commercial competitors, strive for a more personalised media delivery enabled by user profiles. Information on users’ preferences and interests could be collected by the PSB either indirectly or directly when a program is retrieved on...... as ‘recommender services’, and embedded in the overarching concept of ‘Customer Relation Management’ (CRM). On the other hand it is often stressed that it is the duty of PSB to serve the whole society, not only a few ‘star customers’ – as expressed in PSB remits and in so called ‘public service contracts...

  5. [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.

  6. Factor selection for service quality evaluation: a hospital case study.

    Science.gov (United States)

    Ameryoun, Ahmad; Najafi, Seyedvahid; Nejati-Zarnaqi, Bayram; Khalilifar, Seyed Omid; Ajam, Mahdi; Ansarimoghadam, Ahmad

    2017-02-13

    Purpose The purpose of this paper is to develop a systematic approach to predict service quality dimension's influence on service quality using a novel analysis based on data envelopment and SERVQUAL. Design/methodology/approach To assess hospital service quality in Tehran, expectation and perception of those who received the services were evaluated using SERVQUAL. The hospital service quality dimensions were found by exploratory factor analysis (EFA). To compare customer expectation and perception, perceived service quality index (PSQI) was measured using a new method based on common weights. A novel sensitivity approach was used to test the service quality factor's impact on the PSQI. Findings A new service quality dimension named "trust in services" was found using EFA, which is not an original SERVQUAL factor. The approach was applied to assess the hospital's service quality. Since the PSQI value was 0.76 it showed that improvements are needed to meet customer expectations. The results showed the factor order that affect PSQI. "Trust in services" has the strongest influence on PSQI followed by "tangibles," "assurance," "empathy," and "responsiveness," respectively. Practical implications This work gives managers insight into service quality by following a systematic method; i.e., measuring perceived service quality from the customer viewpoint and service factors' impact on customer perception. Originality/value The procedure helps managers to select the required service quality dimensions which need improvement and predict their effects on customer perception.

  7. [nutritional Education In Public Health Services].

    OpenAIRE

    Boog, M.C.

    2015-01-01

    The purpose of this study was to discuss the implementation of nutritional education in public health services from the perspective of health professionals (physicians and nurses) working in them. The study was conducted in the Municipality of Campinas, São Paulo State, Brazil, from October 1993 to July 1995, using action-based research methodology. The results describe the construction of nutritional knowledge in training and professional institutions; behavior towards food-related problems ...

  8. 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.

  9. Managerial challenges in public service contracting

    DEFF Research Database (Denmark)

    Lindholst, Andrej Christian; Bogetoft, Peter

    2011-01-01

    In this article, we address a series of interrelated issues in the managerial challenge of public service contracting. This is done by prompting ten issues within four objectives and highlighting their relevance and potential interrelatedness in effective contract management. In contrast to preva......In this article, we address a series of interrelated issues in the managerial challenge of public service contracting. This is done by prompting ten issues within four objectives and highlighting their relevance and potential interrelatedness in effective contract management. In contrast...... to prevalent piecemeal and theoretically one-dimensional approaches, the objectives and issues constitute a holistic framework that advances a comprehensive and pragmatic understanding of contracting processes. We hope that the framework merits further in-depth exploration that may generate new insights......, themes and questions for research in public service contracting. We identify and exemplify the framework by combining insights from different theoretical perspectives with empirical evidence through an iterative process. The evidence is educed as a set of observed and self-reported stories in a cross...

  10. Combating unethical publications with plagiarism detection services

    Science.gov (United States)

    Garner, H.R.

    2010-01-01

    About 3,000 new citations that are highly similar to citations in previously published manuscripts that appear each year in the biomedical literature (Medline) alone. This underscores the importance for the opportunity for editors and reviewers to have detection system to identify highly similar text in submitted manuscripts so that they can then review them for novelty. New software-based services, both commercial and free, provide this capability. The availability of such tools provides both a way to intercept suspect manuscripts and serve as a deterrent. Unfortunately, the capabilities of these services vary considerably, mainly as a consequence of the availability and completeness of the literature bases to which new queries are compared. Most of the commercial software has been designed for detection of plagiarism in high school and college papers, however, there is at least one fee-based service (CrossRef) and one free service (etblast.org) which are designed to target the needs of the biomedical publication industry. Information on these various services, examples of the type of operability and output, and things that need to be considered by publishers, editors and reviewers before selecting and using these services is provided. PMID:21194644

  11. Who wants to deliver public service? Do institutional antecedents of public service motivation provide an answer?

    NARCIS (Netherlands)

    Vandenabeele, W.V.

    2011-01-01

    Public service motivation has rapidly become one of the important concepts in contemporary public administration research. However, until now, research has mainly focused on its measurement and its consequences, whereas relatively ignoring its origins. This study investigates where the antecedents o

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

    Directory of Open Access Journals (Sweden)

    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.

  13. 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.

  14. [Analysis of the technical efficiency of hospitals in the Spanish National Health Service].

    Science.gov (United States)

    Pérez-Romero, Carmen; Ortega-Díaz, M Isabel; Ocaña-Riola, Ricardo; Martín-Martín, José Jesús

    To analyse the technical efficiency and productivity of general hospitals in the Spanish National Health Service (NHS) (2010-2012) and identify explanatory hospital and regional variables. 230 NHS hospitals were analysed by data envelopment analysis for overall, technical and scale efficiency, and Malmquist index. The robustness of the analysis is contrasted with alternative input-output models. A fixed effects multilevel cross-sectional linear model was used to analyse the explanatory efficiency variables. The average rate of overall technical efficiency (OTE) was 0.736 in 2012; there was considerable variability by region. Malmquist index (2010-2012) is 1.013. A 23% variability in OTE is attributable to the region in question. Statistically significant exogenous variables (residents per 100 physicians, aging index, average annual income per household, essential public service expenditure and public health expenditure per capita) explain 42% of the OTE variability between hospitals and 64% between regions. The number of residents showed a statistically significant relationship. As regards regions, there is a statistically significant direct linear association between OTE and annual income per capita and essential public service expenditure, and an indirect association with the aging index and annual public health expenditure per capita. The significant room for improvement in the efficiency of hospitals is conditioned by region-specific characteristics, specifically aging, wealth and the public expenditure policies of each one. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Advanced services in hospital logistics in the German health service sector

    National Research Council Canada - National Science Library

    Kriegel, Johannes; Jehle, Franziska; Dieck, Marcel; Mallory, Patricia

    2013-01-01

    ...: What are the developmental options to expand the current capabilities of the hospital contract logistics service providers on the basis of the priorities of the decision-makers in the German hospital sector...

  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. 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.

  18. Assessing Community-Based Injury Prevention Services in U.S. Children's Hospitals

    Directory of Open Access Journals (Sweden)

    Nancy L. Weaver

    2014-10-01

    Full Text Available Objective: Not-for-profit hospitals are required to meet federal reporting requirements detailing their community benefit activities, which support their tax-exempt status. Children's hospitals have long provided community injury prevention (IP programming and thus can inform public health outreach work in other areas. This work describes IP programming as a community service offered by children's hospitals in the U.S. Methods: The IP specialist at 232 US-based member institutions of the Children's Hospital Association were invited to complete an assessment of their hospital's IP outreach programming. Results: 47.7 percent of hospitals request financial data from IP programming for tax reporting purposes. Almost all offer injury prevention (IP services; the majority are in the community (60.3% and 34.5% are hospital-based. Most IP units are independent (60.3% and 71.8% are responsible for their own budgets. Conclusions: By integrating dissemination and implementation sciences and community health needs assessments, these findings can help advance community services provided by hospitals to impact public health.

  19. 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...

  20. 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.

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  3. Climate services to improve public health.

    Science.gov (United States)

    Jancloes, Michel; Thomson, Madeleine; Costa, María Mánez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary

    2014-04-25

    A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4-6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers.

  4. 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

  5. How Source Affects Response to Public Service Advertising.

    Science.gov (United States)

    Lynn, Jerry R.; And Others

    1978-01-01

    Reports that public service advertising attributed to the Advertising Council elicited higher message ratings than did public service advertising attributed to a commercial source, a noncommercial source, or no source; however, it produced the lowest behavioral responses. (GT)

  6. Professional norms, public service motivation and economic incentives

    DEFF Research Database (Denmark)

    Andersen, Lotte Bøgh

    2007-01-01

    The theories of professions, public service motivation, and economic incentives explain the behaviour of the producers of publicly financed services differently. They emphasize professional norms, sector, and economic incentives, respectively. The few existing attempts to integrate these theories...

  7. Health science library and information services in the hospital.

    Science.gov (United States)

    Wakeley, P J; Marshall, S B; Foster, E C

    1985-01-01

    In an increasingly information-based society, hospitals need a variety of information for multiple purposes--direct patient care, staff development and training, continuing education, patient and community education, and administrative decision support. Health science library and information services play a key role in providing broad-based information support within the hospital. This guide identifies resources that will help administrators plan information services that are appropriate to their needs.

  8. Usability in Public Services and Border Control

    Science.gov (United States)

    Pirelli, Giuliano

    The paper starts with a brief overview of the scale of disability and associated challenges and puts them in the context of the public policy on disability. It then analyses the usability challenges in public services and border control, including the issues of accessibility, safety and communication. These need to be addressed in future policy proposals, to provide the best assistance by new technologies to elderly people and people with disabilities, avoiding creating new barriers due to incorrect or incomplete initial conception. With increasing flux of novel security technology in mass transportation systems, and particularly the use of biometric identification in airports, the challenge of usability is recognized. This paper analyses these issues in the context of users with disability in an idealized process of Simplifying Passenger Travel (SPT).

  9. 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.

  10. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Science.gov (United States)

    2010-10-01

    ... furnished to beneficiaries in teaching hospitals. 415.162 Section 415.162 Public Health CENTERS FOR MEDICARE... BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.162 Determining payment for physician...

  11. 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

  12. 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.

  13. 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

  14. 19 CFR 4.70 - Public Health Service requirements.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Public Health Service requirements. 4.70 Section 4... THE TREASURY VESSELS IN FOREIGN AND DOMESTIC TRADES Foreign Clearances § 4.70 Public Health Service... Public Health Service....

  15. 38 CFR 3.753 - Public Health Service.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Public Health Service. 3... Pension, Compensation, and Dependency and Indemnity Compensation Retirement § 3.753 Public Health Service... of the Public Health Service, who was receiving disability compensation on December 31, 1956,...

  16. Equidad de género en la adherencia al tratamiento de adicciones: Representaciones y prácticas de profesionales y pacientes en un servicio de internación de un hospital público Gender equity within adherence to treatment of addictions: Social representations and practices of professionals and patients in an inpatient service of a public hospital

    Directory of Open Access Journals (Sweden)

    Vanesa Jeifetz

    2010-12-01

    Full Text Available El objetivo central de este proyecto1 es explorar la equidad de género relativa a la adherencia al tratamiento en un servicio de internación de un hospital público, que atiende pacientes adictos/as a las drogas, así como identificar los modos en los cuales las diferencias entre los géneros se transforman en inequidad en salud. El propósito del proyecto es contribuir en el avance de la equidad de género en el tratamiento de las adicciones a las drogas, visibilizando las inequidades que se presenten, asi como las necesidades en la atención y los modos de enfermar de cada género. Del mismo modo, promoviendo la inclusión de la perspectiva de género en las prácticas de los profesionales, en aras de mejorar los modelos de atención. Se trata de una investigación de carácter exploratorio-descriptivo, en la que se utiliza metodología cualitativa para la recolección y el análisis de la información.The central objective of this project is to explore gender equity in adherence to treatment of an inpatient service of a public hospital, which serves patients addicted to drugs and to identify ways in which gender differences are transformed into health inequities. The project aim's is to contribute to gender equity in the treatment of addictions to drugs, make visible inequities that arise, promote the inclusion of gender in the practices of professionals and manifest the needs and modes of each gender in pursuit of improved models of care. It is an exploratory and descriptive research, which used qualitative methodology to collect and analyze information.

  17. A Public Service-Dominant Logic for the Executive Education of Public Managers

    Science.gov (United States)

    Hiedemann, Alexander M.; Nasi, Greta; Saporito, Raffaella

    2017-01-01

    Building on the concept of Public Service-Dominant Logic (PSDL), this article aims to apply the public service-dominant logic to executive education. We argue that fit-for-purpose and effective executive master programs for public managers (EMPA) need to be designed from a public service perspective. Framing executive education as a service…

  18. US Forest Service Public Land Survey System Sections

    Data.gov (United States)

    US Forest Service, Department of Agriculture — A map service on the www depicting areas defined by the Public Lands Survey System Grid. Normally, 36 sections make up a township. Sections cover US Forest Service...

  19. MANAGING OPERATIONS IMPROVEMENT IN ROMANIAN PUBLIC SERVICES

    Directory of Open Access Journals (Sweden)

    BALOI IONUT-COSMIN

    2015-07-01

    Full Text Available This paper aims to develop a pleading for the transfer of best practices to improving the operational activity in the Romanian public institutions. The practice of implementation demonstrates that the perception of many executives in the Romanian private enterprises regarding the set of tools to improve processes and assimilation of lean philosophy is not a very favorable and encouraging one. It can be said that only some large enterprises had successfully introduced in their daily practice and organization the improvement principles, the operational optimization and the elimination of waste sources. In the SMEs, and especially in the services the experiences are isolated, but they have demonstrated the usefulness (the frequency of saving goals indicate, indeed, the need for proliferation of continuous improvement principles. Regarding the public organizations, the implementation of the new management system of designing and operating the current practices is pretty unknown, accepted at declarative level, but becomes, when is planned and implemented rather a burden on managers who should take on this challenge. Both in public management and private management, today the focus is on people and relationships (processes and projects, starting of course with the work organization. The good practices successfully proved in the private management in the recent decades are transferred today to public institutions; and the Romanian public organizations tend to adapt, also in terms of processes optimization. The study aims to analyze the functioning of the hypothetical management system of processes improvements, respectively the applying of lean tools and principles within the public Romanian institution. They are treated some dysfunctions observed within the process of understanding the utility aspects and throughout the assuming of operational improvement goals within these organizations. The qualitative observations, the critical interpretations and

  20. 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

  1. 基于非线性回归模型公立医院产权制度演化对医疗服务产出影响研究%Analysis on the Effects of Public Hospital Poverty System Evolution on the Medical Service Output Based on Non-liner Regression Model

    Institute of Scientific and Technical Information of China (English)

    李习平

    2014-01-01

    Objective: To discuss the effects of public hospitals’ marketization poverty reform and nationalization poverty reform on medical service output in public hospitals, trying to provide experimental references for public hospital reform in China. Methods:Based on the non-liner regression expand model, calculation analysis method and Eviews 7.0 Software were used to introduce nationalization degree and marketization degree into proving the effects of public hospital equity system evolution on the medical service output. Results:Based on the analysis of single factor, it is known that:the government’s input limit on public hospitals increased by 1%, while the medical service output in public hospitals increased by 2.97%. The rate of individual payment in total medical cost increased by 1%, while the medical service output in public hospitals decreased by 2.08%, the rate of individual expenditure in total medical cost increased by 1% while the output of public hospitals decreased by 2.21%. Conclusion: There is a positive correlation between nationalization and output in public hospitals, while the marketization rate has negative correlation with the output. The current public hospital poverty system has limited the contribution of health technical staffs on the medical output in public hospitals, which leads to the multiple practices of medical technical staffs. Because of the undefined poverty demarcation, the hospital managers could not put the centralized limited government resources into the medical service field with pure public product value. The over operation in medical service field with competitive private product value leads to the private product value showed in the proportion in medical service, which results in “expensive and difficult to visit the doctor”.%目的:探讨公立医院市场化产权改革与国有化产权改革对公立医院医疗服务产出的影响,试图为我国公立医院改革提供经验佐证;方法:基于非线

  2. Service Robots for Hospitals: A Case Study of Transportation Tasks in a Hospital

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan; Fan, Zhun; Dawids, Steen

    2009-01-01

    In this paper, the need for automated transportation systems for hospitals is investigated. Among other alternatives, mobile robots stand out as the most prominent means of automation of transportation tasks in hospitals. Existing transportation routines of a hospital are analyzed in order...... to verify the need for automation and identify possible areas of improvement. The analysis shows that most of the existing transportation is carried out manually, and hospitals can greatly benefit from automated transportation. Based on the results of the analysis, three alternatives are derived...... for implementing mobile service robots for transportation tasks in hospitals....

  3. Language Services In Hospitals Vary By Ownership And Location.

    Science.gov (United States)

    Schiaffino, Melody K; Nara, Atsushi; Mao, Liang

    2016-08-01

    Twenty-four million people in the United States have limited English proficiency. They experience barriers to health care because of their inability to communicate effectively with providers. Hospitals are required to provide language services that reflect the needs of people in their communities, but these services are not available systematically.

  4. 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.

  5. Service quality of private hospitals: The Iranian Patients' perspective

    Directory of Open Access Journals (Sweden)

    Zarei Asghar

    2012-02-01

    Full Text Available Abstract Background Highly competitive market in the private hospital industry has caused increasing pressure on them to provide services with higher quality. The aim of this study was to determine the different dimensions of the service quality in the private hospitals of Iran and evaluating the service quality from the patients' perspective. Methods A cross-sectional study was conducted between October and November 2010 in Tehran, Iran. The study sample was composed of 983 patients randomly selected from 8 private general hospitals. The study questionnaire was the SERVQUAL questionnaire, consisting of 21 items in service quality dimensions. Results The result of factor analysis revealed 3 factors, explaining 69% of the total variance. The total mean score of patients' expectation and perception was 4.91(SD = 0.2 and 4.02(SD = 0.6, respectively. The highest expectation and perception related to the tangibles dimension and the lowest expectation and perception related to the empathy dimension. The differences between perception and expectation were significant (p Conclusion The results showed that SERVQUAL is a valid, reliable, and flexible instrument to monitor and measure the quality of the services in private hospitals of Iran. Our findings clarified the importance of creating a strong relationship between patients and the hospital practitioners/personnel and the need for hospital staff to be responsive, credible, and empathetic when dealing with patients.

  6. Embedded ubiquitous services on hospital information systems.

    Science.gov (United States)

    Kuroda, Tomohiro; Sasaki, Hiroshi; Suenaga, Takatoshi; Masuda, Yasushi; Yasumuro, Yoshihiro; Hori, Kenta; Ohboshi, Naoki; Takemura, Tadamasa; Chihara, Kunihiro; Yoshihara, Hiroyuki

    2012-11-01

    A Hospital Information Systems (HIS) have turned a hospital into a gigantic computer with huge computational power, huge storage and wired/wireless local area network. On the other hand, a modern medical device, such as echograph, is a computer system with several functional units connected by an internal network named a bus. Therefore, we can embed such a medical device into the HIS by simply replacing the bus with the local area network. This paper designed and developed two embedded systems, a ubiquitous echograph system and a networked digital camera. Evaluations of the developed systems clearly show that the proposed approach, embedding existing clinical systems into HIS, drastically changes productivity in the clinical field. Once a clinical system becomes a pluggable unit for a gigantic computer system, HIS, the combination of multiple embedded systems with application software designed under deep consideration about clinical processes may lead to the emergence of disruptive innovation in the clinical field.

  7. Effects of fiscal retrenchment on public mental health services for the chronic mentally ill.

    Science.gov (United States)

    Surber, R W; Shumway, M; Shadoan, R; Hargreaves, W A

    1986-01-01

    In reviewing the public mental health services of 11 California counties during a period of fiscal retrenchment, we found several common trends: a greater focus on the severely mentally disabled; an increase in utilization of hospital-based care, residential treatment, day treatment, and case management services; and a decrease in the capacity of traditional outpatient services. Although the severely mentally disabled are receiving a higher priority for service, the findings imply that these service systems continue to inadequately address the need for long-term maintenance and supportive services to this population.

  8. Adapting the SERVQUAL scale to hospital services: an empirical investigation.

    Science.gov (United States)

    Babakus, E; Mangold, W G

    1992-02-01

    Defining and measuring the quality of service has been a major challenge for health care marketers. A comprehensive service quality measurement scale (SERVQUAL) is empirically evaluated for its potential usefulness in a hospital service environment. Active participation by hospital management helped to address practical and user-related aspects of the assessment. The completed expectations and perceptions scales met various criteria for reliability and validity. Suggestions are provided for the managerial use of the scale, and a number of future research issues are identified.

  9. 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...

  10. Hospital and corporate information services: introducing a new column.

    Science.gov (United States)

    Jajko, P

    1992-01-01

    Successful hospital and corporate libraries offer customized resources and services to meet the needs of their dynamic organizations. Concepts such as customer-driven, service-oriented and value-added are central to these libraries. Serving decision makers and integrating the library into the decision-making process of the organization is critical. Future articles in this new column will further explore the underlying philosophies and the specialized resources and services that characterize these libraries.

  11. 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.

  12. 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.

  13. OPTIMIZING PUBLIC SERVICE THROUGH E-GOV SERVICES (THE CASE OF PUBLIC SERVICE IN SOUTH JAKARTA MUNICIPALITY

    Directory of Open Access Journals (Sweden)

    Florentina Ratih Wulandari

    2012-08-01

    Full Text Available The development of information technology and public administration paradigms that emphasize services for the benefit of society has affected the strategic efforts of e-Gov in Indonesia. For that, there is a need to create qualified, competitive, effective and efficient of the public services. Indonesia’s E-Gov Policy has been applying principles of good governance and information technology to serve and interact with the community. Some local governments, including South Jakarta Municipality has been implementing e-Gov to optimize public service. e-Gov in South Jakarta Municipality is reflected on the implementation of a management information technology to improve services to the community by creating a web site, namely http://selatan.jakarta.go.id/. The information presented in South Jakarta Municipality website includes tourism, local regulations, and other information of Municipality of South Jakarta.

  14. MEMBANGUN SERVICE QUALITY UNTUK MENCAPAI KEPUASAN KONSUMEN DI INDUSTRI HOSPITALITY

    Directory of Open Access Journals (Sweden)

    Sienny Thio

    2001-01-01

    Full Text Available Service quality is necessary especially in the hospitality industry, remembering that consumers have expectations that must be fulfilled and satisfied. Consumers often expect to get maximal service from the service providers and wish to be treated professionally and as a unique individual. This paper seeks to give a further idea about service quality which can be developed and done by service providers with the hope of fulfilling consumer expectations and finally to satisfy all consumers, both internal and external to the company. Abstract in Bahasa Indonesia : Service Quality sangat dibutuhkan terutama di industri hospitality mengingat konsumen yang mempunyai ekspektasi yang selalu ingin dipenuhi dan dipuaskan. Konsumen selalu mengharapkan untuk mendapatkan service yang maksimal dari para penyedia jasa dalam hal ingin diperlakukan secara professional, dan diperlakukan sebagai individu yang unik. Tulisan ini dimaksudkan untuk memberikan gambaran yang lebih jauh mengenai service quality yang dapat dibangun dan dilakukan oleh para penyedia jasa yang diharapkan dapat memenuhi ekspektasi dari konsumen yang pada akhirnya dapat memuaskan eksternal konsumen maupun internal konsumen. Kata kunci: hospitality, service quality, ekspektasi, kepuasan, penyedia jasa.

  15. 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.

  16. 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.

  17. [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.

  18. Public Service Broadcasters and User Profiles

    DEFF Research Database (Denmark)

    Sørensen, Jannick Kirk

    2007-01-01

    on commercial conditions, it is tempting to ask if PSBs should, like their commercial competitors, strive for a more personalised media delivery enabled by user profiles. Information on users’ preferences and interests could be collected by the PSB either indirectly or directly when a program is retrieved on......Demand or a PSB website is visited. By collecting this information PSBs could start to recommend media content in a personalised manner responding to the interests and media usage patterns of the individual user. These methods and techniques are known from commercial web as personalisation, e.g. applied...... as ‘recommender services’, and embedded in the overarching concept of ‘Customer Relation Management’ (CRM). On the other hand it is often stressed that it is the duty of PSB to serve the whole society, not only a few ‘star customers’ – as expressed in PSB remits and in so called ‘public service contracts...

  19. 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.

  20. Costing hospital surgery services: the method matters.

    Directory of Open Access Journals (Sweden)

    Gregoire Mercier

    Full Text Available BACKGROUND: Accurate hospital costs are required for policy-makers, hospital managers and clinicians to improve efficiency and transparency. However, different methods are used to allocate direct costs, and their agreement is poorly understood. The aim of this study was to assess the agreement between bottom-up and top-down unit costs of a large sample of surgical operations in a French tertiary centre. METHODS: Two thousand one hundred and thirty consecutive procedures performed between January and October 2010 were analysed. Top-down costs were based on pre-determined weights, while bottom-up costs were calculated through an activity-based costing (ABC model. The agreement was assessed using correlation coefficients and the Bland and Altman method. Variables associated with the difference between methods were identified with bivariate and multivariate linear regressions. RESULTS: The correlation coefficient amounted to 0.73 (95%CI: 0.72; 0.76. The overall agreement between methods was poor. In a multivariate analysis, the cost difference was independently associated with age (Beta = -2.4; p = 0.02, ASA score (Beta = 76.3; p<0.001, RCI (Beta = 5.5; p<0.001, staffing level (Beta = 437.0; p<0.001 and intervention duration (Beta = -10.5; p<0.001. CONCLUSIONS: The ability of the current method to provide relevant information to managers, clinicians and payers is questionable. As in other European countries, a shift towards time-driven activity-based costing should be advocated.

  1. The Effect of Hospital Service Quality on Patient's Trust.

    Science.gov (United States)

    Zarei, Ehsan; Daneshkohan, Abbas; Khabiri, Roghayeh; Arab, Mohammad

    2015-01-01

    The trust is meant the belief of the patient to the practitioner or the hospital based on the concept that the care provider seeks the best for the patient and will provide the suitable care and treatment for him/her. One of the main determinants of patient's trust is the service quality. This study aimed to examine the effect of quality of services provided in private hospitals on the patient's trust. In this descriptive cross-sectional study, 969 patients were selected using the consecutive method from eight private general hospitals of Tehran, Iran, in 2010. Data were collected through a questionnaire containing 20 items (14 items for quality, 6 items for trust) and its validity and reliability were confirmed. Data were analyzed using descriptive statistics and multivariate regression. The mean score of patients' perception of trust was 3.80 and 4.01 for service quality. Approximately 38% of the variance in patient trust was explained by service quality dimensions. Quality of interaction and process (P quality of the environment had no significant effect on the patients' degree of trust. The interaction quality and process quality were the key determinants of patient's trust in the private hospitals of Tehran. To enhance the patients' trust, quality improvement efforts should focus on service delivery aspects such as scheduling, timely and accurate doing of the service, and strengthening the interpersonal aspects of care and communication skills of doctors, nurses and staff.

  2. Histories of Public Service Broadcasters on the Web

    DEFF Research Database (Denmark)

    This edited volume details multiple and dynamic histories of relations between public service broadcasters and the World Wide Web. What does it mean to be a national broadcaster in a global communications environment? What are the commercial and public service pressures that were brought to bear...... when public service broadcasters implemented web services? How did “one- to-many” broadcasters adapt to the “many-to-many” medium of the internet? The thematic or- ganisation of this collection addresses such major issues, while each chapter offers a particular historical account of relations between...... public service broadcasters and the World Wide Web....

  3. 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

  4. Identifying key hospital service quality factors in online health communities.

    Science.gov (United States)

    Jung, Yuchul; Hur, Cinyoung; Jung, Dain; Kim, Minki

    2015-04-07

    The volume of health-related user-created content, especially hospital-related questions and answers in online health communities, has rapidly increased. Patients and caregivers participate in online community activities to share their experiences, exchange information, and ask about recommended or discredited hospitals. However, there is little research on how to identify hospital service quality automatically from the online communities. In the past, in-depth analysis of hospitals has used random sampling surveys. However, such surveys are becoming impractical owing to the rapidly increasing volume of online data and the diverse analysis requirements of related stakeholders. As a solution for utilizing large-scale health-related information, we propose a novel approach to identify hospital service quality factors and overtime trends automatically from online health communities, especially hospital-related questions and answers. We defined social media-based key quality factors for hospitals. In addition, we developed text mining techniques to detect such factors that frequently occur in online health communities. After detecting these factors that represent qualitative aspects of hospitals, we applied a sentiment analysis to recognize the types of recommendations in messages posted within online health communities. Korea's two biggest online portals were used to test the effectiveness of detection of social media-based key quality factors for hospitals. To evaluate the proposed text mining techniques, we performed manual evaluations on the extraction and classification results, such as hospital name, service quality factors, and recommendation types using a random sample of messages (ie, 5.44% (9450/173,748) of the total messages). Service quality factor detection and hospital name extraction achieved average F1 scores of 91% and 78%, respectively. In terms of recommendation classification, performance (ie, precision) is 78% on average. Extraction and

  5. APPLICATION OF VSM IN A PUBLIC BRAZILIAN HOSPITAL

    Directory of Open Access Journals (Sweden)

    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.

  6. 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.

  7. 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.

  8. Providing Support Services in Selected Decentral¬ized Hospital

    Directory of Open Access Journals (Sweden)

    R Hafezi

    2009-03-01

    Full Text Available "nBackground: Upon the implementation of the plans of the selected hospitals in Paragraph (C Article [88] of the Law of the Fourth Development Plan, the amount of assessment relative to the execution of each of the Paragraphs related to the direc­tives or guidelines of the mode of managing these hospitals is compulsory. The present article has made efforts to assess the imple­mentation basis of Paragraph [9] of the above-mentioned directives and a survey of conditions as to the performance of the support services in these hospitals."nMethods: This study rested on the performance of 14 supporting activities of 18 selected decentralized hospitals that took place in 2007. Data were collected from questionnaire that had 6 parts about support services and how they were done in each hospital. Then the data were analyzed with Excel software."nResults: In hospitals 35. 60 % of the activities are performed by the contractor. The materials utilized in activities are 10. 34 per­cent, equipping is 26. 48% and equipment repair is 31. 47% of the cases are secured by the contractor. Results pertaining to the survey of manpower engaged in activities show that 62. 71% of the manpower engaged has an intermediate level of educa­tion and the relative average of manpower active in such work as of functional beds can be stated as 0.64, likewise, the average satisfaction rate of the services rendered was 71%."nConclusion: A strategy leading to a decrease of incumbency and an elevation in the support service quality can bring about an increment in the quality of support services being presently rendered in hospitals which could prove effective.

  9. 29 CFR 4.120 - Contracts for public utility services.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Contracts for public utility services. 4.120 Section 4.120... McNamara-O'Hara Service Contract Act Specific Exclusions § 4.120 Contracts for public utility... utility services, including electric light and power, water, steam, and gas.” This exemption is...

  10. 34 CFR 685.219 - Public Service Loan Forgiveness Program.

    Science.gov (United States)

    2010-07-01

    ... organization that is publicly funded and whose principal activities pertain to crime prevention, control or reduction of crime, or the enforcement of criminal law. Military service, for uniformed members of the U.S... are defined by the Bureau of Labor Statistics), public education, public library services,...

  11. 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.

  12. Towards best practice in acute stroke care in Ghana: a survey of hospital services.

    Science.gov (United States)

    Baatiema, Leonard; Otim, Michael; Mnatzaganian, George; Aikins, Ama De-Graft; Coombes, Judith; Somerset, Shawn

    2017-02-02

    Stroke and other non-communicable diseases are important emerging public health concerns in sub-Saharan Africa where stroke-related mortality and morbidity are higher compared to other parts of the world. Despite the availability of evidence-based acute stroke interventions globally, uptake in low-middle income countries (LMIC) such as Ghana is uncertain. This study aimed to identify and evaluate available acute stroke services in Ghana and the extent to which these services align with global best practice. A multi-site, hospital-based survey was conducted in 11 major referral hospitals (regional and tertiary - teaching hospitals) in Ghana from November 2015 to April 2016. Respondents included neurologists, physician specialists and medical officers (general physicians). A pre-tested, structured questionnaire was used to gather data on available hospital-based acute stroke services in the study sites, using The World Stroke Organisation Global Stroke Services Guideline as a reference for global standards. Availability of evidence-based services for acute stroke care in the study hospitals were varied and limited. The results showed one tertiary-teaching hospital had a stroke unit. However, thrombolytic therapy (thrombolysis) using recombinant tissue plasminogen activator for acute ischemic stroke care was not available in any of the study hospitals. Aspirin therapy was administered in all the 11 study hospitals. Although eight study sites reported having a brain computed tomographic (CT) scan, only 7 (63.6%) were functional at the time of the study. Magnetic resonance imaging (MRI scan) services were also limited to only 4 (36.4%) hospitals (only functional in three). Acute stroke care by specialists, especially neurologists, was found in 36.4% (4) of the study hospitals whilst none of the study hospitals had an occupational or a speech pathologist to support in the provision of acute stroke care. This study confirms previous reports of limited and variable

  13. Evolution of a youth work service in hospital.

    Science.gov (United States)

    Hilton, Donna; Jepson, Shelley

    2012-07-01

    Youth workers are based predominantly in the community and use a range of informal educational activities to help young people between the ages of 11 and 25 cultivate their personal and social development. The supraregional paediatric nephrology unit at Nottingham City Hospital successfully evaluated the role of a youth worker, funded by a national renal charity, and secured long-term funding for the post in 2000 (Hilton et al 2004, Watson 2004). This article describes the evolution of the youth service over a decade, following the amalgamation of two children's units into one site and the creation of a unified youth service for the Nottingham Children's Hospital in 2008.

  14. The seven common pitfalls of customer service in hospitals.

    Science.gov (United States)

    Domingo, Rene T

    2015-01-01

    Operating simultaneously like a repair shop, prison, and hotel, hospitals are prone to seven common pitfalls in customer service. Patient care is often fragmented, inscrutable, inflexible, insensitive, reactive, myopic, and unsafe. Hospitals are vying to be more high-tech, rather than high-touch even though staff engagement with patients rather than facilities and equipment strongly influence patient satisfaction. Unless processes, policies, and people are made customer-centered, the high quality of the hospital's human and hardware resources will not translate into high patient satisfaction and patient loyalty.

  15. [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.

  16. Investigation of conflict management among nurses in public hospitals

    Directory of Open Access Journals (Sweden)

    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.

  17. 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.

  18. The impact of lean management components on improved quality of public hospitals in Kohgiluyeh and Boyerahmad and Bushehr provinces

    Directory of Open Access Journals (Sweden)

    Lida Gholizadeh

    2016-07-01

    Full Text Available The objective of this study was to investigate the impact of lean management components on improved service quality in public hospitals of Kohgiluyeh and Boyerahmad and Bushehr provinces. Fifty thousand employees of public hospitals of Kohkiloyeh-Boyer Ahmad and Bushehr provinces were selected using single-stage random cluster sampling method. Then, a researcher-made questionnaire was used to respond all employees of these hospitals. Structural equation modeling was used to analyze data. Structural equation modeling analyses confirmed the match between research model and experimental data. The results showed that the standard coefficient of all paths of communicative, processes, management, technology, structure, and human components of lean management to improved quality is significant. This means that all components of lean management have a direct impact on improved quality. Lean management leads to improved quality of services in public hospitals of Kohgiluyeh and Boyerahmad and Bushehr provinces.

  19. 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.

  20. Predictors of Language Service Availability in U.S. Hospitals

    Directory of Open Access Journals (Sweden)

    Melody K. Schiaffino

    2014-10-01

    Full Text Available Background Hispanics comprise 17% of the total U.S. population, surpassing African-Americans as the largest minority group. Linguistically, almost 60 million people speak a language other than English. This language diversity can create barriers and additional burden and risk when seeking health services. Patients with Limited English Proficiency (LEP for example, have been shown to experience a disproportionate risk of poor health outcomes, making the provision of Language Services (LS in healthcare facilities critical. Research on the determinants of LS adoption has focused more on overall cultural competence and internal managerial decision-making than on measuring LS adoption as a process outcome influenced by contextual or external factors. The current investigation examines the relationship between state policy, service area factors, and hospital characteristics on hospital LS adoption. Methods We employ a cross-sectional analysis of survey data from a national sample of hospitals in the American Hospital Association (AHA database for 2011 (N= 4876 to analyze hospital characteristics and outcomes, augmented with additional population data from the American Community Survey (ACS to estimate language diversity in the hospital service area. Additional data from the National Health Law Program (NHeLP facilitated the state level Medicaid reimbursement factor. Results Only 64%of hospitals offered LS. Hospitals that adopted LS were more likely to be not-for-profit, in areas with higher than average language diversity, larger, and urban. Hospitals in above average language diverse counties had more than 2-fold greater odds of adopting LS than less language diverse areas [Adjusted Odds Ratio (AOR: 2.26, P< 0.01]. Further, hospitals with a strategic orientation toward diversity had nearly 2-fold greater odds of adopting LS (AOR: 1.90, P< 0.001. Conclusion Our findings support the importance of structural and contextual factors as they relate to

  1. 42 CFR 413.118 - Payment for facility services related to covered ASC surgical procedures performed in hospitals...

    Science.gov (United States)

    2010-10-01

    ... ASC surgical procedures performed in hospitals on an outpatient basis. 413.118 Section 413.118 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM... PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Specific Categories of Costs §...

  2. 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.

  3. US Forest Service Public Land Survey System Townships

    Data.gov (United States)

    US Forest Service, Department of Agriculture — A map service on the www depicting areas defined by the Public Lands Survey System grid that are referenced by their tier and range numbers, and are normally...

  4. A strategy for building public service motivation research Internationally

    NARCIS (Netherlands)

    Kim, S.; Vandenabeele, W.V.|info:eu-repo/dai/nl/323038816

    2010-01-01

    As public service motivation research grows qualitatively and quantitatively, some scholars question its appropriateness for international applications. This essay sets out a strategy of convergence for international research and measurement approaches. Studies that assess commonalities in public

  5. A strategy for building public service motivation research Internationally

    NARCIS (Netherlands)

    Kim, S.; Vandenabeele, W.V.

    2010-01-01

    As public service motivation research grows qualitatively and quantitatively, some scholars question its appropriateness for international applications. This essay sets out a strategy of convergence for international research and measurement approaches. Studies that assess commonalities in public se

  6. U.S. EPAs Public Geospatial Metadata Service

    Data.gov (United States)

    U.S. Environmental Protection Agency — EPAs public geospatial metadata service provides external parties (Data.gov, GeoPlatform.gov, and the general public) with access to EPA's geospatial metadata...

  7. Government Research Services in the Public Library.

    Science.gov (United States)

    Davidsson, Robert I.

    1997-01-01

    Describes the Government Information Service of Florida's Palm Beach County Library System (PBCLS). Highlights include models for service, the need for specialized government services, costs versus benefits, the Question-Response Service and Government Web site, and keys to success. (AEF)

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Efficiency in health public services provision and market failure

    Directory of Open Access Journals (Sweden)

    Carlos Arturo Meza Carvajalino

    2006-07-01

    Full Text Available This document studies the theoretical foundations, the different controversies regarding the health service and the conceptions adopted from the hypotheses related to the market efficiency in the provision of a public service and the consequent market failures. The author thinks that when the health public service was delegated to the market in Colombia they originated failures in the competition, externalities, preference goods and services, asymmetry and redistribution, among the most relevant ones.

  10. Public policy alienation of public service workers : A conceptual framework

    NARCIS (Netherlands)

    L.G. Tummers (Lars); V.J.J.M. Bekkers (Victor); A.J. Steijn (Bram)

    2007-01-01

    textabstractNowadays, many public professionals face identification problems towards public policies they have to implement; that is, they experience policy alienation. This is troublesome, as for a proper implementation a minimal level of identification with the public policy is required. We use li

  11. 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.

  12. 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

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

    Science.gov (United States)

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

    2017-08-01

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

  14. Service quality of hospital outpatient departments: patients' perspective.

    Science.gov (United States)

    Zarei, Ehsan

    2015-01-01

    Assessment of patient perceptions of health service quality as an important element in quality assessments has attracted much attention in recent years. The purpose of this paper is to assess the service quality of hospital outpatient departments affiliated to Shahid Beheshti University of Medical Sciences from the patients' perspective. This cross-sectional study was conducted in 2014 in Tehran, Iran. The study samples included 500 patients who were selected by multi-stage random sampling from four hospitals. The data collection instrument was a questionnaire consisting of 50 items, and the validity and reliability of the questionnaire were confirmed. For data analysis, exploratory and confirmatory factor analysis, Friedman test, and descriptive statistics were used through LISREL 8.54 and SPSS 18 applications. Eight significant factors were extracted for outpatient service quality, which explained about 67 per cent of the total variance. Physician consultation, information provided to the patient, and the physical environment of the clinic were the three determining factors of the quality of outpatient services. The highest and lowest perceptions were related to physician consultation and perceived waiting time dimension, respectively. The mean score of patients' perception of outpatient service quality was 3.89 (±0.60). About 59.5 per cent of patients assessed the quality of outpatient services as good, 38.2 per cent as moderate, and 2.3 per cent as poor. Practical implications - The instrument developed for this study is valid and reliable, and it can help hospital managers to identify the areas needing improvement and correction. According to the findings of this study, the majority of patients had a positive experience with outpatient departments of teaching hospitals, and the services provided in these centres were of adequate quality, based on patient assessments.

  15. Organization structure and the performance of hospital emergency services.

    Science.gov (United States)

    Georgopoulos, B S

    1985-07-01

    A comparative study of 30 hospital emergency departments (EDs) and nearly 1,500 individuals associated with them was conducted. Data were obtained from institutional records, physicians, patients, and other sources. The object was to investigate the relationship between the organization and performance of these health service systems. The study assessed the quality of medical care, the quality of nursing care, and the economic efficiency of hospital EDs. The results show substantial interinstitutional differences in these criteria. They also show a significant relationship between medical and nursing care, but not between the quality of care and economic efficiency. Differences in ED performance are related to medical staffing patterns, medical teaching affiliation, personnel training, scope of emergency services, number of patient visits processed, and hospital size and complexity. Not all of these variables, however, correlate positively with all three criteria of performance, nor are they equally important to each.

  16. Analysis of HIV / AIDS Patients Service Management in Paniai Hospital, Paniai, Papua

    Directory of Open Access Journals (Sweden)

    Agus Agus

    2017-02-01

    Full Text Available Clinical Voluntary Counseling Testing (VCT was established in 2009 in hospitals Paniai Papua. VCT Clinic Hospital Papua Paniai aims to prevent and break the chain of transmission of HIV, screening and early diagnosis, ongoing counseling, as well as preventing the transmission of HIV infection from mother to child. VCT is also becoming more access to management for people with HIV, either the antiretroviral drugs, prevention and treatment of opportunistic infections, and the treatment of HIV infection holistically. Objective: The identification of patient care management of HIV / AIDS in patient wards of hospitals Paniai Papua Province. Mixed Methods ie qualitative and quantitative research. The quantitative data obtained from medical records of 287 patients with HIV-AIDS hospitalizations in 2014-2016. The qualitative data obtained from interviews with key informants were 13 people selected by purposive sampling and analyzed descriptively. Characteristics of patients with HIV / AIDS are the patients most aged 25-49 years (54%, female gender (56%, high school (26%, not working (54%, risk factors for heterosexual (74%, tuberculosis coinfection (46%, duration of treatment ARV therapy for less than 1 year (57%, non-compliance with taking medication (61.1%, length of stay of 1-5 days (48%, stage III (65%, CD4 <200 mg (55%, the difference in the payment of fees at the rate parties BPJS RS Rp. 764 715 036. Inputs include human resources, facilities, infrastructure in the service of HIV / AIDS patients in hospitals Paniai accordance Hospital classification type D. Sources of funds from DAU (General Allocation Fund, DAK (Special Allocation Fund, Papua Health Card (KPS as well as the Public Service Board (BLUD. Optimal service process is already running with the service flow and SOP examination and treatment of HIV. Output inpatient care including HIV / AIDS patients were optimal given by SPM (Minimum Service Standards Hospital Health Ministerial Decree No

  17. Perceived nursing service quality in a tertiary care hospital, Maldives.

    Science.gov (United States)

    Nashrath, Mariyam; Akkadechanunt, Thitinut; Chontawan, Ratanawadee

    2011-12-01

    The present study explored nurses' and patients' expectations of nursing service quality, their perception of performance of nursing service quality performed by nurses, and compared nursing service quality, as perceived by nurses and patients. The sample consisted of 162 nurses and 383 patients from 11 inpatient wards/units in a tertiary care hospital in the Maldives. Data were collected using the Service Quality scale, and analyzed using descriptive statistics and the Mann-Whitney U-test. The results indicated that the highest expected dimension and perceived dimension for nursing service quality was Reliability. The Responsiveness dimension was the least expected dimension and the lowest performing dimension for nursing service quality as perceived by nurses and patients. There was a statistically significant difference between nursing service quality perceived by nurses and patients. The study results could be used by nurse administrators to develop strategies for improving nursing service quality so that nursing service delivery process can be formulated in such a way as to reduce differences of perception between nurses and patients regarding nursing service quality. © 2011 Blackwell Publishing Asia Pty Ltd.

  18. Hospital volunteerism as human resource solution: Motivation for both volunteers and the public health sector

    Directory of Open Access Journals (Sweden)

    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

  19. Public service announcements: their effect on smoking.

    Science.gov (United States)

    McKinney, R M

    1988-01-01

    , though one would assume that this would initially serve to increase commitment to quit smoking. The applicability of these models to public service announcements are many. It is not enough to make individuals aware of the dangers of smoking but to create an unfavorable image and attitude towards smoking that leads an individual to action.(ABSTRACT TRUNCATED AT 400 WORDS)

  20. 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

  1. 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.

  2. Public Service Motivation as a Predictor of Attraction to the Public Sector

    Science.gov (United States)

    Carpenter, Jacqueline; Doverspike, Dennis; Miguel, Rosanna F.

    2012-01-01

    According to public service motivation theory, individuals with a strong public service orientation are attracted to government jobs. This proposition was investigated in three studies by measuring public sector motivation at a pre-entry level as an individual difference variable affecting perceptions of fit and organizational attraction. Results…

  3. Service Quality Dimensions in Public Library: Nothern Area Experienced

    OpenAIRE

    2011-01-01

    Problem statement: Service quality has emerged as a key strategic issue in management. The service quality assessment tool SERVQUAL was introduced the dimensions of tangibles, reliability, responsiveness and assurance and empathy dimensions of service quality. Approach: The objective of this study is to investigate which service quality dimensions that mostly influenced the service quality in public library in Sungai Petani. The study was conducted among library users and ...

  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

    Directory of Open Access Journals (Sweden)

    Marina Vanzetta

    2014-06-01

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

  6. 7 CFR 8.8 - Use by public informational services.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Use by public informational services. 8.8 Section 8.8 Agriculture Office of the Secretary of Agriculture 4-H CLUB NAME AND EMBLEM § 8.8 Use by public informational services. (a) In any advertisement, display, exhibit, visual and audio-visual material, news...

  7. 75 FR 27348 - Public Health Services Act; Delegation of Authority

    Science.gov (United States)

    2010-05-14

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Public Health Services Act; Delegation of Authority Notice is hereby given that I have delegated to the Director, Office of Public Health...

  8. Public Service Loan Forgiveness. NASFAA Task Force Report

    Science.gov (United States)

    National Association of Student Financial Aid Administrators, 2014

    2014-01-01

    The Public Service Loan Forgiveness (PSLF) program was established in 2007 to encourage student borrowers to work in the public sector. Qualifying borrowers may have their Direct Loans forgiven after 10 years of full-time service in an eligible job. Currently, qualifying employers include federal, state, or local government agencies and tax-exempt…

  9. Past, present, and future of public service motivation research

    NARCIS (Netherlands)

    Vandenabeele, Wouter; Brewer, Gene A.; Ritz, Adrian

    2014-01-01

    This article reviews the evolution of almost 25 years of public service motivation research in order to identify what is necessary to raise future research to a higher level. First, we look at the rise in public service motivation research and try to provide an explanation for the increasing number

  10. Strengthening Public Revenue and Expenditure Management to Enhance Service Delivery

    OpenAIRE

    2013-01-01

    To achieve higher growth and reduce poverty and inequality, Mexico needs to improve public service delivery. Mexico is a middle-income country with continuing high levels of poverty (46.2 percent of the population). To improve public sector service delivery, Mexico needs to ensure sufficient financial and human resources relative to the needs of the population, and effective and efficient ...

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

    Directory of Open Access Journals (Sweden)

    Renata Santos Silva

    2015-03-01

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

  12. Using mass transit public service advertising to market family planning.

    Science.gov (United States)

    Blonna, R; McNally, K; Grasso, C

    1990-03-01

    To increase public awareness of family planning services in New Jersey, the Family Planning Program of the State Department of Health conducted an intermediary marketing campaign using free public service advertising on mass transit. In 1986, the year of the campaign, 237 calls were made to the advertised hotline, resulting in a like number of referrals to family planning service providers. Also, 2664 new patients examined in the state's family planning agencies in 1986 cited exposure to the media campaign as the reason for their visits. The results of the campaign and their implications for other public service agencies are discussed.

  13. 'The hospital was just like a home': self, service and the 'McCord Hospital Family'.

    Science.gov (United States)

    Noble, Vanessa; Parle, Julie

    2014-04-01

    For more than a century, McCord Hospital, a partly private and partly state-subsidised mission hospital has provided affordable health-care services, as well as work and professional training opportunities for thousands of people in Durban, a city on the east coast of South Africa. This article focuses on one important aspect of the hospital's longevity and particular character, or 'organisational culture': the ethos of a 'McCord Family', integral to which were faith and a commitment to service. While recognising that families - including 'hospital families' like that at McCord - are contentious social constructs, with deeply embedded hierarchies and inequalities based on race, class and gender, we also consider however how the notion of 'a McCord family' was experienced and shared in complex ways. Indeed, during the twentieth century, this ethos was avidly promoted by the hospital's founders and managers and by a wide variety of employees and trainees. It also extended to people at a far geographical remove from Durban. Moreover, this ethos became so powerful that many patients felt that it shaped their convalescence experience positively. This article considers how this 'family ethos' was constructed and what made it so attractive to this hospital's staff, trainees and patients. Furthermore, we consider what 'work' it did for this mission hospital, especially in promoting bonds of multi-racial unity in the contexts of segregation and apartheid society. More broadly, it suggests that critical histories of the ways in which individuals, hospitals, faith and 'families' intersect may be of value for the future of hospitals as well as of interest in their past.

  14. Service users' perceptions about their hospital admission elicited by service user-researchers or by clinicians.

    LENUS (Irish Health Repository)

    O'Donoghue, Brian

    2013-05-01

    OBJECTIVE Service users may express positive, ambivalent, or negative views of their hospital admission. The objective of this study was to determine whether the background of the interviewer-service user-researcher or clinician-influences the information elicited. The primary outcome was the level of perceived coercion on admission, and secondary outcomes were perceived pressures on admission, procedural justice, perceived necessity for admission, satisfaction with services, and willingness to consent to participate in the study. METHODS Participants voluntarily and involuntarily admitted to three hospitals in Ireland were randomly allocated to be interviewed at hospital discharge by either a service user-researcher or a clinician. Interviewers used the MacArthur Admission Experience Survey and the Client Satisfaction Questionnaire. RESULTS A total of 161 participants were interviewed. No differences by interviewer status or by admission status (involuntary or voluntary) were found in levels of perceived coercion, perceived pressures, procedural justice, perceived necessity, or satisfaction with services. Service users were more likely to decline to participate if their consent was sought by a service user-researcher (24% versus 8%, p=.003). CONCLUSIONS Most interviewees gave positive accounts of their admission regardless of interviewer status. The findings indicate that clinicians and researchers can be more confident that service users\\' positive accounts of admissions are not attributable to a response bias. Researchers can also feel more confident in directly comparing the results of studies undertaken by clinicians and by service user-researchers.

  15. 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.

  16. 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

  17. Behaviour and action:citizens vs.public services

    OpenAIRE

    Lucica MATEI; Ani MATEI

    2010-01-01

    The paper presents the relation between citizens and public service providers from the view of the applicability of the theory of consumers’ interests and operation of the market mechanisms in the public sector. The roles between the provider and consumer/ user of the service are continuously subject to transformations, determined by the change of systems and mechanisms of public administration. The relations citizen-administration provide the means in order to build the typolo...

  18. The road to success - from high quality public services towards the high-quality public administration

    OpenAIRE

    Mitreva, Elizabeta; Taskov, Nako

    2013-01-01

    There is empirical evidence that various quality improvement programmes in public administration have increased users' satisfaction. Yet, at the same time, mass public surveys indicate a decrease in trust in national government, Parliament and the civil service. This indicates that there is no linear relationship between service quality and trust. The perception of quality come from very specific observations of public services whereas trust refers to the government machinery in general. ...

  19. Clients’ Satisfaction with Anti Retroviral Therapy Services at Hamidia Hospital Bhopal

    Directory of Open Access Journals (Sweden)

    Bhagat Vimal Kishor, Pal D K, Lodha Rama S, Bankwar Vishal

    2011-01-01

    Full Text Available Background: The HIV/AIDS pandemic is a major public health problem with an estimated 33.33 million people living with the virus globally. Free antiretroviral treatment was initiated in India 2004. Patients’ satisfaction is one of the commonly used outcome measures of patient care. Objective: To assess the satisfaction of people living with HIV/AIDS with services provided at anti retroviral therapy Centre Hamidia Hospital Bhopal. Material and Methods: A hospital based cross-sectional study was undertaken from August 2008 to July 2009 on all the registered people living with HIV/AIDS (PLWHA following antiretroviral treatment at Hamidia Hospital Bhopal. Data was collected and by using pre-designed & pre-tested questionnaire and analyzed using Epi-info version 3.5.3. Results: For most of the questions regarding satisfaction on the care services of the center, participants responded positively (excellent & good.The overall mean satisfaction score was “Excellent”. Conclusion: The services of the Center were rated positively (Excellent and above.The hospital management should work to strengthen the clinic services by helping the ART clinic staff to involve patients in the treatment process and recognize their opinions on follow up.

  20. Great Expectations of Public Service Delegation: A systematic review

    NARCIS (Netherlands)

    Overman, S.P.

    2016-01-01

    Politicians use a variety of expectations to justify the delegation of public services to public, semi-public or private organizations. This article reveals expectations of delegation, as well as its correlates. Empirical evidence is drawn from a systematic review of 250 peer-reviewed articles publi

  1. Great Expectations of Public Service Delegation: A Systematic Review

    NARCIS (Netherlands)

    Overman, Sjors

    2016-01-01

    Politicians use a variety of expectations to justify the delegation of public services to public, semi-public or private organizations. This article reveals expectations of delegation, as well as its correlates. Empirical evidence is drawn from a systematic review of 250 peer-reviewed articles publi

  2. The marketing concept of customer value of hospitality service

    Directory of Open Access Journals (Sweden)

    O.V. Gerasimenko

    2015-12-01

    customer’s satisfaction to create an intangible asset of the company is a segment of loyal and regular customers. Secondly, the process of developing marketing actions aimed at creating high customer value hospitality services As the conclusion, understanding the genesis of scientific theories customer value product/service allows to conclude that marketing concept to create customer value is a reason to determine structural elements of hotel services. This phase of the research was based on the fact that a functional feature of the hotel is its service differentiation on the main (accommodation and meals and additional services (range which depends on the category and type of business. Secondly, the formation of hotel services should be interpreted in the format of the production chain. Implementation of the marketing concept of customer value of hotel services in hotel marketing activities aims to maximize the realization of customer’s satisfaction in order to create an intangible asset of the company – a segment of loyal and regular customers.

  3. [Review of legislation regarding clinical research in the Spanish health care system and hospital pharmacy services].

    Science.gov (United States)

    Laguna-Goya, Noa; Serrano, M Antonia; Gómez-Chacón, Cristina

    2009-01-01

    The call for public funding for the Spanish Health Care System clinical research with drugs for human use projects Subprogramme highlights the need for hospital pharmacy services to include the manufacture of investigational drugs which are the subject of a clinical trial, developed by either a researcher or a group of researchers, within its activities. This article discusses the legislation concerning the manufacture of investigational drugs and the requirements that the pharmacy services must meet in order to develop, distribute, or conceal an investigational drug in a clinical trial sponsored by a professional from the SHS.

  4. 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.

  5. Hospitality: transformative service to children, families, and communities.

    Science.gov (United States)

    Melton, Gary B

    2014-11-01

    Hospitality is an ancient moral practice that was deeply embedded in early Judaism, Christianity, and Islam. Hospitality requires acceptance of, service to, and respect for people who lack a place in the community. The contemporary importance of this practice reflects the social disconnection and economic disadvantage of many young parents and the high frequency of separation of young people, including many young parents, from their communities. Such social deterioration substantially increases the risk of child maltreatment. Building on the proposals of the U.S. Advisory Board on Child Abuse and Neglect, Strong Communities for Children demonstrated the effectiveness of community building in reducing such risk. It further suggested the importance of both relying on and learning from hospitable people in strengthening support for children and their parents.

  6. 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.

  7. Service-learning: an integral part of undergraduate public health.

    Science.gov (United States)

    Cashman, Suzanne B; Seifer, Sarena D

    2008-09-01

    In 2003, the Institute of Medicine (IOM) described public health as "an essential part of the training of citizens," a body of knowledge needed to achieve a public health literate citizenry. To achieve that end, the IOM recommended that "all undergraduates should have access to education in public health." Service-learning, a type of experiential learning, is an effective and appropriate vehicle for teaching public health and developing public health literacy. While relatively new to public health, service-learning has its historical roots in undergraduate education and has been shown to enhance students' understanding of course relevance, change student and faculty attitudes, encourage support for community initiatives, and increase student and faculty volunteerism. Grounded in collaborative relationships, service-learning grows from authentic partnerships between communities and educational institutions. Through emphasizing reciprocal learning and reflective practice, service-learning helps students develop skills needed to be effective in working with communities and ultimately achieve social change. With public health's enduring focus on social justice, introducing undergraduate students to public health through the vehicle of service-learning as part of introductory public health core courses or public health electives will help ensure that our young people are able to contribute to developing healthy communities, thus achieving the IOM's vision.

  8. Athletic Trainer Services in Public and Private Secondary Schools.

    Science.gov (United States)

    Pike, Alicia M; Pryor, Riana R; Vandermark, Lesley W; Mazerolle, Stephanie M; Casa, Douglas J

    2017-01-01

     The presence of athletic trainers (ATs) in secondary schools to provide medical care is crucial, especially with the rise in sports participation and resulting high volume of injuries. Previous authors have investigated the level of AT services offered, but the differences in medical care offered between the public and private sectors have not been explored.  To compare the level of AT services in public and private secondary schools.  Concurrent mixed-methods study.  Public and private secondary schools in the United States.  A total of 10 553 secondary schools responded to the survey (8509 public, 2044 private).  School administrators responded to the survey via telephone or e-mail. Descriptive statistics depict national data. Open-ended questions were evaluated through content analysis.  A greater percentage of public secondary schools than private secondary schools hired ATs. Public secondary schools provided a higher percentage of full-time, part-time, and clinic AT services than private secondary schools. Only per diem AT services were more frequent in the private sector. Regardless of the extent of services, reasons for not employing an AT were similar between sectors. Common barriers were budget, school size, and lack of awareness of the role of an AT. Unique to the public sector, remote location was identified as a challenge faced by some administrators.  Both public and private secondary schools lacked ATs, but higher percentages of total AT services and full-time services were available in the public sector. Despite differences in AT services, both settings provided a similar number of student-athletes with access to medical care. Barriers to hiring ATs were comparable between public and private secondary schools; however, remote location was a unique challenge for the public sector.

  9. 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.

  10. Hospital image and the positioning of service centers: an application in market analysis and strategy development.

    Science.gov (United States)

    Smith, S M; Clark, M

    1990-09-01

    The research confirms the coexistence of different images for hospitals, service centers within the same hospitals, and service programs offered by each of the service centers. The images of individual service centers are found not to be tied to the image of the host facility. Further, service centers and host facilities have differential rankings on the same service decision attributes. Managerial recommendations are offered for "image differentiation" between a hospital and its care centers.

  11. Performance management of the public healthcare services in Ireland: a review.

    Science.gov (United States)

    Mesabbah, Mohammed; Arisha, Amr

    2016-01-01

    Performance Management (PM) processes have become a potent part of strategic and service quality decisions in healthcare organisations. In 2005, the management of public healthcare in Ireland was amalgamated into a single integrated management body, named the Health Service Executive (HSE). Since then, the HSE has come up with a range of strategies for healthcare developments and reforms, and has developed a PM system as part of its strategic planning. The purpose of this paper is to review the application of PM in the Irish Healthcare system, with a particular focus on Irish Hospitals and Emergency Services. An extensive review of relevant HSE's publications from 2005 to 2013 is conducted. Studies of the relevant literature related to the application of PM and of international best practices in healthcare performance systems are also presented. PM and performance measurement systems used by the HSE include many performance reports designed to monitor performance trends and strategic goals. Issues in the current PM system include inconsistency of measures and performance reporting, unclear strategy alignment, and deficiencies in reporting (e.g. feedback and corrective actions). Furthermore, PM processes have not been linked adequately into Irish public hospitals' management systems. The HSE delivers several services such as mental health, social inclusion, etc. This study focuses on the HSE's PM framework, with a particular interest in acute hospitals and emergency services. This is the first comprehensive review of Irish healthcare PM since the introduction of the HSE. A critical analysis of the HSE reports identifies the shortcomings in its current PM system.

  12. The Use of Format Adaptation in Danish Public Service Programming

    DEFF Research Database (Denmark)

    Jensen, Pia Majbritt

    2013-01-01

    The article investigates Danish public service broadcasters’ use of format adaptations over a 12-year period in order to examine claims that formats constitute a potential threat to public service broadcasting and the national Danish television industry and culture. The article’s findings, howeve...... service orientation. Instead the article argues, following German sociologist Ulrich Beck, that format adaptation can represent a form of ‘banal transnationalism’, pointing to the fact that the world is no longer exclusively defined by national boundaries.......The article investigates Danish public service broadcasters’ use of format adaptations over a 12-year period in order to examine claims that formats constitute a potential threat to public service broadcasting and the national Danish television industry and culture. The article’s findings, however...

  13. An Analysis of Public Service Structural Imbalances in Rural China

    Institute of Scientific and Technical Information of China (English)

    林万龙

    2008-01-01

    Rectifying the structural imbalance between the provision of and demand for rural public services can effectively boost the efficiency of public funds utilization and the level of public service provision. Based on the findings of a field survey, this article presents a summary of the structural imbalance between the provision of and demand for rural public services. This paper holds that the structural imbalance is primarily reflected in the dislocation between provision and demand, the unsuitable mode of provision, the monolithic provision mechanism, the excessive focus on construction at the expense of governance and the overemphasis of counties and townships at the cost of villages. Such structural imbalance is principally because of the limited financial strength of government at the grass-roots level due to treasury centralization and the over-dependence of public services on special funds allocated by government at or above provincial level.

  14. Electronic Mediated Administration and Public Service Delivery in Nigeria

    Directory of Open Access Journals (Sweden)

    Samuel Oni

    2015-12-01

    Full Text Available The public service of any country is a major pillar in determining the development and stability of such country. This is because the public service is the engine for the processing of the vastly acquired and expanded government responsibilities of executing public policies and projects and rendering essential services to the people. In Nigeria, various governmental regimes have attempted repositioning the public sector for effective and efficient service delivery through various reforms. In spite of all these efforts, the Nigeria Public Service remains inefficient and incapable of delivering its responsibility. This paper adopts descriptive and analytical approach with data collected from secondary sources. By interrogating the exponential growth, usage and acceptance of Information Communication Technology (ICT in Nigeria, it argues for a paradigm shift from the traditional approach to electronic administration to enhance the delivery of public goods and services which are considered necessary for the sustainable development of the country. ICT enabled administration has the potentials of revolutionizing the quality of services delivered to the citizens by ushering in transparency, accountability and efficiency which are the bane of the Nigeria’s public sector.

  15. [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.

  16. The contribution of hospital library information services to clinical care: a study in eight hospitals.

    Science.gov (United States)

    King, D N

    1987-10-01

    Hospital health sciences libraries represent, for the vast majority of health professionals, the most accessible source for library information and services. Most health professionals do not have available the specialized services of a clinical medical librarian, and rely instead upon general information services for their case-related information needs. The ability of the hospital library to meet these needs and the impact of the information on quality patient care have not been previously examined. A study was conducted in eight hospitals in the Chicago area as a quality assurance project. A total of 176 physicians, nurses, and other health professionals requested information from their hospital libraries related to a current case or clinical situation. They then assessed the quality of information received, its cognitive value, its contribution to patient care, and its impact on case management. Nearly two-thirds of the respondents asserted that they would definitely or probably handle their cases differently as a result of the information provided by the library. Almost all rated the libraries' performance and response highly. An overview of the context and purpose of the study, its methods, selected results, limitations, and conclusions are presented here, as is a review of selected earlier research.

  17. Diffusing public sector services through high definition video

    OpenAIRE

    Molnar, Andreea; Weerakkody, Vishanth; El-Haddadeh, Ramzi

    2013-01-01

    The adoption of public services that have been delivered electronically are not necessarily uniformly accepted. This paper argues that the diffusion of high definition video communication as a complimentary mechanism for service delivery could not only alleviate this existing gap in adoption and diffusion of government services but also significantly improve services and save cost for governments. This paper introduces a holistic perspective on how video technology could be integrated in exis...

  18. Comparison of pharmacy services at critical access hospitals and other rural and small hospitals in Illinois.

    Science.gov (United States)

    Crawford, Stephanie Y; Schumock, Glen T; Ursan, Iulia D; Ursan, Julia D; Walton, Surrey M; Donnelly, Andrew J

    2013-08-01

    The results of a survey evaluating pharmacy services and technology use at critical access hospitals (CAHs) and other small and rural hospitals in Illinois are reported. A mail survey was sent to pharmacy directors at 86 CAHs and other rural and small hospitals in Illinois not designated as CAHs. Independent sample t tests and chi-square statistics were used to compare CAHs and non-CAHs in areas such as pharmacy services, staffing, use of technology, and sterile compounding practices. The survey response rate was 46.5%, with usable data received from 40 hospitals. Analysis of the survey data indicated that hospitals designated as CAHs were significantly less likely than non-CAHs to have automatic therapeutic interchange policies (p = 0.012) and more likely to conduct pharmacist-provided educational programs on medication costs for physicians and other health care personnel (p = 0.037). Relative to non-CAHs, CAHs were significantly less likely to have automated dispensing cabinets (p = 0.016) and to out-source the preparation of sterile products to offsite vendors (p = 0.012); pharmacy directors at CAHs were less likely to report the use of technology for remote medication order entry or review (p = 0.038). At both types of facilities, pharmacists typically have both distributive and clinical responsibilities, and patient-specific clinical pharmacy services (e.g., patient education or counseling, other drug therapy monitoring, medication reconciliation, pharmacokinetic consultations) are offered at similar frequencies. A survey of pharmacy departments at small and rural hospitals in Illinois determined that there were more similarities than differences between CAHs and non-CAHs. The survey indicated significant differences in dispensing processes, the use of technology and drug policy tools, and outsourcing of sterile product preparation.

  19. 42 CFR 410.172 - Payment for partial hospitalization services in CMHCs: Conditions.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Payment of SMI Benefits § 410.172 Payment for partial hospitalization services in CMHCs:...

  20. Occupational hazards in a public ambulance service.

    Science.gov (United States)

    Constantin, Brânduşa; Morariu, S; Duma, Olga Odetta

    2013-01-01

    To identify the occupational risks in an ambulance service and to assess their impact on the health of employees. Two marched groups (number, sex, age, length of exposure) from two different work sectors were selected. A 60 item questionnaire was used. The 60 items were grouped into four categories related to work organization, work environment, neuropsychosensorial risk factors and health system and occupational safety-related risk factors and hazards. The data were statistically processed, significant correlations between the risk factors and the associated symptoms being found. Compared to the control group, significantly higher values (pground, carrying weight, vicious postures) were found in ambulance service staff; cervical and lumbar spine problems were the most common complaints of ambulance service staff. The specific risk factors for ambulance service employees directly related to musculoskeletal disorders have been established.

  1. IMPROVING PUBLIC SERVICES THROUGH A ORGANIZATIONAL PERFORMANCE MANAGEMENT

    Directory of Open Access Journals (Sweden)

    IOANA STĂNCESCU

    2010-01-01

    Full Text Available Organizational management, systemic approach, is known more as a system Management, that set of factors such as organizational, methodological information, decisions and relationships between them, as outlined, that will achieve objectives. Fundamental objective of management in public organizations involved in the holders of public office positions and leadership and execution in this area an additional responsibility to manage all types of resources available to the public sector, namely human resources, information, material and financial.Summary of process management is focusing on human coordination of joint work. An important role in this process is modernizing organizational management and quality delivery of public services or the institution's activities, public services more efficient by implementing innovative tools, leading to a government driven process to a results-oriented public service.

  2. [Prevalence of psychiatric disorders in men and women hospitalized in a internal medicine service of a hospital of Santiago, Chile].

    Science.gov (United States)

    Hernández, G; Ibáñez, C; Kimelman, M; Orellana, G; Montino, O; Núñez, C

    2001-11-01

    Mental disorders may interfere, aggravate or mimic medical conditions. To study the prevalence of psychiatric disorders among patients hospitalized in a medical ward of a general hospital. A structured interview for DSM-III, devised for "non patients", was applied to 203 men and 203 women, aged 11 to 90 years old, hospitalized in an internal medicine service of a public hospital. Thirty four psychiatric conditions that can be discriminated with the instrument and others that complied with DSM-III criteria, were investigated. There was a 60% prevalence of mental disorders among men (alcohol dependency in 26%, delirium or dementia in 10.8%, anxiety disorders in 10.4%, major depression in 7.8% and adaptation disorders in 3%). Among women, the prevalence of mental disorders was 65% (major depression in 23.2%, anxiety disorders in 14.3%, adaptation disorders in 8.4%, dementia in 5.6%, delirium in 3% and alcohol dependency in 2.5%). Most conditions were of moderate or mild intensity. Two or more conditions coexisted in 40% of cases. Only in 8% of these subjects, a psychiatric consultation was requested. There is a high frequency of psychiatric disorders among medical patients. These must be adequately diagnosed and treated.

  3. Problems of Public Service Reforming at the Present Stage

    Directory of Open Access Journals (Sweden)

    Arzamet M. Kamkiya

    2015-09-01

    Full Text Available In the present article author investigates problems of public service reforming at the present stage. In the research author notes that the centuries-old history of the state construction proved that any civilized state can't effectively function without highly professional device of public service, and effective public service serves as a key factor of durability of the government, her authority. In the conclusion author notes that during new state construction in Russia it is necessary to adopt federal laws which would regulate not only separate aspects, but also all process of legal support of professional activity on realization of powers of government bodies.

  4. Service Quality Of Diagnostic Fine Needle Aspiration Cytology In A Tertiary Care Hospital Of Lahore (Process Measure As Patient's Perspective).

    Science.gov (United States)

    Rizvi, Zainab; Usmani, Rabia Arshed; Rizvi, Amna; Wazir, Salim; Zahra, Taskeen; Rasool, Hafza

    2017-01-01

    Quality of any service is the most important aspect for the manufacturer as well as the consumer. The primary objective of any nation's health system is to provide supreme quality health care services to its patients. The objective of this study was to assess the quality of diagnostic fine needle aspiration cytology service in a tertiary care hospital. As Patient's perspectives provide valuable information on quality of process, therefore, patient's perception in terms of satisfaction with the service was measured. In this cross sectional analytical study, 291 patients undergoing fine needle aspiration cytology in Mayo Hospital were selected by systematic sampling technique. Information regarding satisfaction of patients with four dimensions of service quality process, namely "procedure, sterilization, conduct and competency of doctor" was collected through interview on questionnaire. The questionnaire was developed on SERVQUAL model, a measurement tool, for quality assessment of services provided to patients. All items were assessed on 2- point likert scale (0=dissatisfied, 1=satisfied). Frequencies and percentages of satisfied and dissatisfied patients were recorded for each item and all items in each dimension were scored. If the percentage of sum of all item scores of a dimension was ≥60, the dimension was 'good quality'. Whereas quality' dimension. Data was analysed using epi-info-3.5.1. Fisher test was applied to check statistical significance. (p-value service quality process, Procedure (48.8%), Sterilization (51.5%) and practitioner conduct (50.9%) were perceived as 'poor' by the patients. Only practitioner competency (67.4%) was perceived as 'good'. Comparison of dimensions of service quality scoring with overall level of patient satisfaction revealed that all 4 dimensions were significantly related to patient dissatisfaction (pservice quality of therapeutic and diagnostic procedures in public hospitals should be routinely monitored from the patients

  5. The Relationship Between Population Size and Contracting Out Public Services

    DEFF Research Database (Denmark)

    Foged, Søren Kjær

    2015-01-01

    What is the causal relationship between population size and the contracting out of public service delivery in local governments? The size of the population of a given municipality has long been thought to be an important driver of contracting out public service delivery, which theoretically....../contracting out relationship. Results show that the relationship differs across policy sectors: It is negative for services with high fixed costs, presumably due to scale economies, and is positive for services that are difficult to measure, probably due to more administrative and technical capacity in larger...

  6. 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."

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. An Analysis of Business Models in Public Service Platforms

    DEFF Research Database (Denmark)

    Ranerup, Agneta; Zinner Henriksen, Helle; Hedman, Jonas

    2016-01-01

    Public Service Platforms (PSPs) are a new type of technology platform. They are based in the philosophy of New Public Management (NPM) and support public services for citizens in quasi-markets. This article increases our understanding of the business models behind these PSPs in terms of their Value...... Propositions, structures, networks, and financing. We interviewed representatives from 14 PSP providers in four public sectors in Sweden: education, healthcare, elder care, and public pensions. We identified a “Traditional view” with its focus on public agencies and neutral information and an “Emerging view......” that includes dialogues, user evaluations, long-term perspectives on choice, promotion of the ideal of choice, and self-promotion by public agencies. The article contributes to research with its empirical example of the digitalization of NPM and the underlying business logic of PSPs....

  12. 杭州市公立医院非技术性住院服务质量持续改进路径研究%A Study on the Continuant Improvement Route of the Non-technical In-patient Service Quality of Hangzhou Public Hospitals

    Institute of Scientific and Technical Information of China (English)

    王淑翠; 褚红女; 黄银芳

    2015-01-01

    以杭州市某公立医院为研究对象,运用 SERVQUAL改良量表测量患者期望与实际感受之间是否存在差距。结合患者的具体调查结果,发现目前该公立医院住院服务质量存在的各条目和各维度的差距状况,并分析和讨论关键差距及原因,提出医院管理工作的改进建议。%The paper took one public hospital of Hangzhou as an example and used varies of methods in the re-search. We viewed the in-patient service quality as the research obj ect,measured the hospital’s service quality and calculated the gap between the expectations and the actual situation based on the improved SERVQUAL scale. Then the reasons were analyzed through the service quality gap model and management suggestions were put forward.

  13. 26 CFR 31.3121(b)(13)-1 - Services of student nurse or hospital intern.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 15 2010-04-01 2010-04-01 false Services of student nurse or hospital intern... 1954) General Provisions § 31.3121(b)(13)-1 Services of student nurse or hospital intern. (a) Services... before 1966 as an intern (as distinguished from a resident doctor), in the employ of a hospital are...

  14. The inpatient costs and hospital service use associated with invasive meningococcal disease in South Australian children.

    Science.gov (United States)

    Wang, Bing; Haji Ali Afzali, Hossein; Marshall, Helen

    2014-08-20

    Invasive meningococcal disease (IMD) remains a serious public health concern due to a sustained high case fatality rate and morbidity in survivors. This study aimed to estimate the hospital service costs associated with IMD and variables associated with the highest costs in Australian children admitted to a tertiary paediatric hospital. Clinical details were obtained from medical records and associated inpatient costs were collected and inflated to 2011 Australian dollars using the medical and hospital services component of the Australian Consumer Price Index. Both unadjusted and adjusted analyses were undertaken. Multivariate regression models were used to adjust for potential covariates and determine independent predictors of high costs and increased length of hospital stay. Of 109 children hospitalised with IMD between May 2000 and April 2011, the majority were caused by serogroup B (70.6%). Presence of sequelae, serogroup B infection, male gender, infants less than one year of age, and previous medical diagnosis were associated with higher inpatient costs and length of stay (LOS) in hospital (pcosts and LOS during the IMD related readmissions for patients with sequelae (passociated long-term sequelae result in high health care costs, which should be considered in meningococcal B vaccine funding considerations. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. 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. ...

  16. New hospital telemedicine services: potential market for a nighttime telehospitalist service.

    Science.gov (United States)

    Sanders, Richard B; Simpson, Kit N; Kazley, Abby S; Giarrizzi, Dana P

    2014-10-01

    A critical shortage in the supply of physicians in the United States has necessitated innovative approaches to physician service delivery. Telemedicine is a viable service delivery model for a variety of physician and health services. Telemedicine is most effective when applied where physician resources are scarce, patient care is time sensitive, and service volume may be distributed across a network. Shortages in critical care and neurology specialists have led to the use of tele-intensive care unit and telestroke services in hospital settings. These hospital-based telemedicine services have gained acceptance and recommendation. Hospitalist staffing shortages may provide an opportunity to apply similar telemedicine models to hospitalist medicine. This study assesses the potential market for a nighttime telehospitalist service. An analysis of the Florida state hospital discharge dataset investigated the potential market for a new nighttime telehospitalist service. Admissions were filtered and stratified for common hospitalist metrics, time of day, and age of patients. Admissions were further expressed by hour of day and location. Nineteen percent of common hospitalist admissions occurred between 7:00 p.m. and 7:00 a.m., with a range of 17%-27% or 0.23-10.09 admissions per night per facility. Eighty percent of admissions occurred prior to midnight. Nonrural facilities averaged 6.69 hospitalist admissions per night, whereas rural facilities averaged 1.35 admissions per night. The low volume of nighttime admissions indicates an opportunity to leverage a telehospitalist physician service to deliver inpatient medical admission services across a network. Lower volumes of nighttime admissions in rural facilities may indicate a market for telehospitalist solutions to address the dilemma of hospitalist staffing shortages.

  17. 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.

  18. 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.

  19. The current situation in the public and private hospitals in Greece

    OpenAIRE

    E Iakovidou; Maria Maniou

    2009-01-01

    The fundamental concept of the policy of the health-care sector, is the creation of a modern System of Health, in which the protection of health and not only the management of illness will come first and it will be ensured that all the citizens will have the same access in the health serviced of high quality.Aim: The purpose of the present study was to evaluate the public and private hospitals in Greece.Conclusively: There is necessity and it is important to evaluate proposals and solutions f...

  20. Methods employed by public libraries in providing services to ...

    African Journals Online (AJOL)

    Methods employed by public libraries in providing services to people living with HIV and AIDS in Benue ... Log in or Register to get access to full text downloads. ... and poster in meeting health information needs of PLWHA in Benue State.

  1. A Liquid work-life under public service contracting

    DEFF Research Database (Denmark)

    Lindholst, Christian

    A part of the reality behind public service contracting in Denmark as well as in many other countries is that a growing number of people are employed in uncertain and temporary conditions and relations in what can be characterized as ‘liquidized’ work-lives. This reality and its consequences...... of staffs’ work-life under public service contracting. The paper relies empirically on focus group interviews in two cases of staff transfers in public service contracting with different levels of liquefaction. it is found that staff transfer is a composite experience for staff with differential outcomes...... for staff, however, are only poorly understood in current theory and research on public service contracting through partial concepts and a tendency to focus merely on negative outcomes. Against this shortfall, the aim in this paper is to build a conceptually and empirically richer and more authentic account...

  2. The Marketing of Public Library Services.

    Science.gov (United States)

    Dragon, Andrea C.

    1983-01-01

    Defines the concept of marketing and relates models involving the exchanges and transactions of markets and charities to services offered by libraries. Market segmentation, understanding the behavior of markets, competition, and movement toward a market-oriented library are highlighted. Nineteen references are cited. (EJS)

  3. Service reliability and urban public transport design

    NARCIS (Netherlands)

    Van Oort, N.

    2011-01-01

    The last few decades have shown a substantial increase in personal mobility. Urban traffic and transport volumes have been increasing for years. However, the share of public transport in this mobility growth did not change much and still remains rather limited. To ensure the accessibility and liveab

  4. Public Service Provision in Clientelistic Political Settlements

    DEFF Research Database (Denmark)

    Whitfield, Lindsay; Hirvi, Marja

    2015-01-01

    's public water utility. It argues that, in order to understand why private-sector participation succeeds or fails and why similar arrangements have different outcomes across developing countries, we need to examine the effects of the informal institutional context, particularly the country...

  5. Governance and Innovation in Public sector Services

    DEFF Research Database (Denmark)

    Scupola, Ada; Zanfei, Antonello

    2015-01-01

    Based on a longitudinal case study of virtual library development, we highlight three important aspects that characterize the links between governance and innovation in public sector innovation. First, the examined case shows that the organizational complexities have increased in the transition f...

  6. Governance and Innovation in Public sector Services

    DEFF Research Database (Denmark)

    Scupola, Ada; Zanfei, Antonello

    2015-01-01

    Based on a longitudinal case study of virtual library development, we highlight three important aspects that characterize the links between governance and innovation in public sector innovation. First, the examined case shows that the organizational complexities have increased in the transition...

  7. Governance and Innovation in Public sector Services

    DEFF Research Database (Denmark)

    Scupola, Ada; Zanfei, Antonello

    2015-01-01

    from what could be considered as a spurious New Public Management approach, which incorporates elements of the traditional hierarchical model and elements of market-like competition, towards a “networked model” implying more emphasis on bottom-up decision making and a greater involvement of end users...

  8. Service reliability and urban public transport design

    NARCIS (Netherlands)

    Van Oort, N.

    2011-01-01

    The last few decades have shown a substantial increase in personal mobility. Urban traffic and transport volumes have been increasing for years. However, the share of public transport in this mobility growth did not change much and still remains rather limited. To ensure the accessibility and

  9. Service reliability and urban public transport design

    NARCIS (Netherlands)

    Van Oort, N.

    2011-01-01

    The last few decades have shown a substantial increase in personal mobility. Urban traffic and transport volumes have been increasing for years. However, the share of public transport in this mobility growth did not change much and still remains rather limited. To ensure the accessibility and liveab

  10. The Paediatric Ambulatory Consulting Service (PACS) program: a role for family pediatricians in the hospital emergency rooms.

    Science.gov (United States)

    Nigri, Luigi; Piazzolla, Ruggiero; Pettoello-Mantovani, Massimo; Giardino, Ida; Abbinante, Micaela; Gorgoni, Giovanni

    2016-02-25

    This paper describes the Paediatric Ambulatory Consulting Service (PACS) project, developed by ASL-BT (Azienda Sanitaria Locale, Barletta-Andria-Trani), an Italian regional Public Health Centers network, in response to the current global situation of economic distress.PACS consist in integrating existing public health care services that are independently provided by hospitals and the Primary Care Paediatrics network. It has been developed with the aim to establish innovative yet efficient managerial solutions able to rationalize the resources not weakening the quality of services provided to the population.

  11. Communication and Ethical Behavior in the Public Service

    OpenAIRE

    Arta Musaraj; Julejda Gerxhi

    2010-01-01

    Setting up public administration which operates effectively and taking over responsibilities, both crucial on the point of view of the democracy indicators, requires great effort from all social stake holders in setting up and maintaining a public service organization. This notion implies the setting in function of the instruments and procedures that prevent undesirable behavior and provide encouragement of good behavior among operators of those services. While doing this, communication as a ...

  12. Public service providers and users in the information society

    Directory of Open Access Journals (Sweden)

    Bernt Krohn Solvang

    2015-03-01

    Full Text Available The issue to be discussed in this article is to what extent does ICT create new challenges for the relationship between public service providers and users? It is important to recognize the concept of social capital because the concept is vital to the understanding of access to the information society and efficient functioning of government in its service to citizens. In this way we see social capital as a mediating “institution” between public authorities and the citizens (users.

  13. 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.

  14. Adequacy of public maternal care services in Brazil

    OpenAIRE

    2016-01-01

    Abstract Background In Brazil, hospital childbirth care is available to all, but differences in access and quality of care result in inequalities of maternal health. The objective of this study is to assess the infrastructure and staffing of publicly financed labor and birth care in Brazil and its adequacy according to clinical and obstetric conditions potentially associated with obstetric emergencies. Methods Nationwide cross-sectional hospital-based study “Birth in Brazil: national survey i...

  15. Submerged discontent and patterns of accommodation: a case study of doctors' pay in two public hospitals in China.

    Science.gov (United States)

    Cao, Xuebing

    2014-01-01

    The article evaluates submerged discontent among Chinese public hospital doctors (Note1) regarding their pay and patterns of accommodation, including doctors' responses through formal and informal actions in the context of health service marketization. On the basis of a case study of two public hospitals, the article illustrates the dynamical impact of marketization on Chinese doctors' pay-related dissatisfaction and health service employment relationship. Because of the authoritarian management and compliant trade unions, the conflict between doctors and hospitals is unable to be accommodated through collective methods. Instead, doctors' discontent is often channelled through informal, individual and subtle activities. Meanwhile, doctors' professional society is gradually influential, showing its potential of developing doctors' group identity and protecting members' interests in future.

  16. Manchester Protocol at a school hospital emergency service

    Directory of Open Access Journals (Sweden)

    Mayara Raphaela Morais Rezende

    2016-01-01

    Full Text Available Objective: to analyze the flow of directing patients triaged by the Manchester Protocol in the emergency service of a school hospital. Methods: a retrospective, descriptive and documentary study using triage records. The sample was composed of 364 records that were analyzed through descriptive statistics, using simple and relative frequencies and measures of central tendency. Results: the most frequent complaints were those related to the musculoskeletal system (26.1% and gastrointestinal system (15.1%. The highest demand was for general practice (47.5%. The most frequent risk classification was green (78.3%. Most of the individuals studied received hospital discharge (92.6%. Conclusion: the results suggest that urgency and emergency units are being sought to solve problems that could be solved by primary care units.

  17. QUALITY GROWTH AND EVALUATION OF PERFORMANCE OF LOCAL PUBLIC SERVICES

    Directory of Open Access Journals (Sweden)

    Remus Gherman

    2015-05-01

    Full Text Available Public sector reform aims to increase performance by improving its efficiency and effectiveness by improving the quality of services provided by public service in order to maximize individual welfare of citizens. The purpose of reform is to improve public services because they have to deal with uncertainties and rapid changes that take place in the internal environmental and external pressures. Public administration, in quality of service provider must make a series of efforts to ensure that citizens know their rights and public services on witch they can benefit taking into account the simplification of service delivery, a high quality of its, new administrative procedures for allocating resources in a transparent way and informing the citizens of standards of services and of the methods of compensation in case if the provided quality is different from that promised. Most important is the fact that the local government must realize that effectiveness involves defining objectives that must be achieved simultaneously with the estimation of the results obtained.

  18. Identifying Student Traits and Motives to Service-Learn: Public Service Orientation among New College Freshmen

    Science.gov (United States)

    Christensen, Robert K.; Stritch, Justin M.; Kellough, J. Edward; Brewer, Gene A.

    2015-01-01

    Among college students, public service motives influence choice of major or job. Although the link between public service motives and prosocial behavior has been established among working adults, researchers have not adequately examined how these motives affect the reported behavior of precareer students. In this article, the authors explored how…

  19. ATTITUDES OF VEGETABLE FARMERS TOWARDS PUBLIC AGRICULTURAL EXTENSION SERVICES

    Directory of Open Access Journals (Sweden)

    Tala Qtaishat

    2012-01-01

    Full Text Available Among vegetable farmers in Jordan, there are conflicting attitudes towards the extension activities provided by the public sector. Some farmers accept and adopt the recommendations of these activities; on the other hand, some people are not satisfied and consider these activities a waste of time for both the farmers and the government. This situation has serious impacts on the quality, duration and efficiency of the extension activities provided by government related agencies. Also, the situation will end in providing low-quality agricultural extension services to the farmers or providing these services in a non-productive manner. The actual attitudes of vegetable farmers towards Public Agricultural Extension Services (PAES in the Dear Alla Area of Jordan were investigated in this study. A total of 80 vegetable farmers were selected for the study. A questionnaire consisting of two main parts was used for data collection; the first part was related to personal and socio-economic characteristics of the sample individuals. The second part was related to extension activities. A five-point Likert-type scale was used as an instrument to gather primary data. The farmers rated their attitudes toward Public Agricultural Extension Services (PAES through 10 statements related carefully to the Public Agricultural Extension Services. Data analysis was done in two sections, consisting of data description and data inferential analysis. The results of the study revealed that the farmers’ overall attitude towards the public agricultural extension activities was negative. The farmers’ attitudes according to age, experience, educational level and frequency and type of contact with public extension services were also negative. The negative attitude of the participant farmers towards the Public Agricultural Extension Services means that the farmers were not satisfied with these services. Identifying the sources and types of public extension programs, the

  20. Effect of Managers on Public Service Performance

    DEFF Research Database (Denmark)

    Mikkelsen, Maria Falk

    and society as a whole (Esping-Andersen 2002; Grossman 2006; Heckman, Lochner, and Todd 2006). Teaching quality and school performance have attracted much academic as well as political attention and debate in recent decades. Particularly in Denmark, which for a number of years has been among the OECD...... countries spending most on education (OECD 2014a), while still performing at the OECD average in PISA tests and on equity measures (OECD 2014b). Studying ways of improving school performance is therefore important in its own right. Another advantage of using Danish schools as the setting......? Analyzing the Impact of Managers on Organizational Performance in Public and Private Organizations” Working paper [referred to as “Public vs. private”]....

  1. Proposing a competitive intelligence (CI framework for Public Service departments to enhance service delivery

    Directory of Open Access Journals (Sweden)

    Nisha Sewdass

    2012-02-01

    Full Text Available Background: The aim of public service departments in South Africa is to improve service delivery through the transformation and improvement of human resources and the improvement of service delivery practices. Furthermore, it is important for the public service sector in South Africa to improve the quality of its service delivery, not only by comparing its performance with other sectors within South Africa but also by positioning itself amongst the best in the world. This can be achieved by benchmarking with other global industries and by implementing the most recent competitive intelligence strategies, tools and techniques. The environment of the public service organisations consists of competitive forces that impact the functioning of these organisations.Objectives: This article focuses on proposing competitive intelligence-related strategies, tools and techniques for gathering and analysing information in the public service departments in South Africa in order to enhance service delivery.Method: The study was qualitative in nature and was divided into two components, namely, (1 theoretical – through an extensive review of the literature and (2 empirical – an ethnographic study at the chosen public service department, the Department of Home Affairs (DHA. Ethnographic interviews with management-level staff, focus groups and document analysis were used to obtain adequate information to determine the current state of public service delivery in South Africa.Results: The results of the study was the development of a new competitive intelligencerelated framework for gathering and analysing information, and it represents a formal and systematic process of informing managers in public service departments about critical issues that these departments face or are likely to experience in future.Conclusion: The strategic planning tools and techniques of this framework will fill the gap that exists in public service departments. Once this framework has

  2. Assessment and Availability of Trauma Care Services in a District Hospital of South India; A Field Observational Study

    Directory of Open Access Journals (Sweden)

    Pallavi Sarji Uthkarsh

    2016-04-01

    Full Text Available Objective: To assess the availability of trauma care services in a district referral hospital of Southern India. Methods: This was a cross-sectional study being performed during 2013 in a tertiary healthcare centre in Southern Indian. A detailed assessment of trauma care services was done in a 400 bed speciality hospital which is an apex referral hospital in the public health system using a check list based on WHO guidelines for evaluation of essential trauma care services, along with in-depth interviews of hospital stake holders and key informants. Results: The hospital had physical infrastructure in terms of emergency room, inpatient wards, operation theatres, intensive care unit and blood bank facilities. The recently constructed designated building for trauma care services was not operational and existing facilities were used beyond capacity. A designated trauma team was lacking and speciality services for managing polytrauma were deficient and thus, existing personnel were performing multiple tasks. Neurosurgeons and rehabilitative nursing staff were unavailable, and a radiographer was not available on a 24/7 basis. Existing nursing personnel had not received any formal training in trauma care and standard operating protocols were not available for trauma care. Resources for acute resuscitation were partially adequate. The hospital lacked adequate resources to manage head, abdomen, chest and spine injuries, and most of the polytrauma cases were referred to nearby city hospitals. Conclusion: District hospital, the only referral hospital in public health system for trauma victims of that region, had inadequate resources to manage trauma victims, which was probably responsible for delay in trauma care, improper referrals, high cost of care and poor outcomes.

  3. Reinventing public service broadcasting in Europe: prospects, promises and problems

    NARCIS (Netherlands)

    Bardoel, J.L.H.; d'Haenens, L.S.J.

    2008-01-01

    New information technologies, liberalizing policies and rapidly changing societies – from mono- to multicultural – entail serious consequences for the prospects of European public service broadcasters in a network society. The European concept of PSB as a comprehensive and universal service is chall

  4. Perspectives on Library Public Services from Four Leaders

    Science.gov (United States)

    Dallis, Diane

    2017-01-01

    This article explores and examines the state of library services through interviewing a small group of directors, associate deans, and associate university librarians of public services and identifying common themes and insightful views on this area of librarianship. The participants respond to the same set of questions that cover topics including…

  5. Bare Bones Young Adult Services: Tips for Public Library Generalists.

    Science.gov (United States)

    Vaillancourt, Renee J.

    This book is a hands-on guide to the philosophy and practice of young adult services in the public libraries. The following chapters are included: (1) "Young Adult Services Philosophy," including reasons to serve teens, why teens are the way they are, who serves young adults, and how to interact with teens; (2) "Youth Participation," including…

  6. Communication and service platform for public safety personnel

    NARCIS (Netherlands)

    Schmidt, J.R.

    2005-01-01

    This paper describes a communication and service platform for public safety personnel. The platform demonstrates just in time provisioning of data and scalable communication services and operates in a heterogeneous network environment with high survivability. As an example use case the design is

  7. Measuring Electronic Services in Public Libraries: Issues and Recommendations.

    Science.gov (United States)

    Bertot, John Carlo; McClure, Charles R.

    1998-01-01

    Public library services are being modified or changed by the Internet. Questions about how to evaluate and measure electronic services have become increasingly important. This article presents an analysis of some ways to create, define, and institute electronic network measures. (Author/AEF)

  8. The Development of Behaviorally Based Public School Consultation Services

    Science.gov (United States)

    Putnam, Robert F.; Handler, Marcie W.; Rey, Jannette; McCarty, Joseph

    2005-01-01

    This article describes the development of behavioral school care consultation services to public schools within a not-for-profit community behavioral health organization. An overview of the process of behavior consultation is presented. A description of the growth of behavioral school consultation services is outlined in regard to (a) the types of…

  9. 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.

  10. 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.

  11. A strategy for building public service motivation research internationally

    NARCIS (Netherlands)

    Kim, Sangmook; Vandenabeele, W.V.

    2009-01-01

    As the scholarly research on public service motivation (PSM) has grown and the geographic scope of the research has expanded, there is growing concern about whether the conceptual composition and dimensionalities of PSM are appropriate for explaining and predicting public service–related behavior in

  12. Building trust through public service co-production

    NARCIS (Netherlands)

    Fledderus, J.

    2015-01-01

    - PURPOSE – Co-production of public service delivery is believed to foster trust among users, but little empirical work is devoted to this assumption. Public sector organizations have therefore little knowledge about the conditions that determine whether co-production leads to trust. The paper aims

  13. Public Service Motivation and Socialization in Graduate Education

    Science.gov (United States)

    Bright, Leonard

    2016-01-01

    The purpose of this study is to explore the extent to which the characteristics of public administration degree programs are related to public service motivation (PSM) using a higher education socialization framework. Using a sample of approximately 500 students enrolled in 26 Master's degree programs across the country, this study confirms that…

  14. Public Service Motivation and Socialization in Graduate Education

    Science.gov (United States)

    Bright, Leonard

    2016-01-01

    The purpose of this study is to explore the extent to which the characteristics of public administration degree programs are related to public service motivation (PSM) using a higher education socialization framework. Using a sample of approximately 500 students enrolled in 26 Master's degree programs across the country, this study confirms that…

  15. A strategy for building public service motivation research internationally

    NARCIS (Netherlands)

    Kim, Sangmook; Vandenabeele, W.V.

    2009-01-01

    As the scholarly research on public service motivation (PSM) has grown and the geographic scope of the research has expanded, there is growing concern about whether the conceptual composition and dimensionalities of PSM are appropriate for explaining and predicting public service–related behavior in

  16. Privatization and 'Agentification' of Public Services Delivery in Africa ...

    African Journals Online (AJOL)

    seriane.camara

    2009-05-14

    May 14, 2009 ... Council for the Development of Social Science Research in Africa, 2008 .... between public and private sector organizations in public services delivery .... assets. Land survey. Municipal land. Sanitation. Town cleaning .... depending on circumstance and may include executive share ..... DOL Contract No.

  17. 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

  18. [Outsourcing: theory and practice at a clinical hospital in Szczecin exemplified by medical waste transport and treatment service].

    Science.gov (United States)

    Kotlega, Dariusz; Nowacki, Przemysław; Lewiński, Dariusz; Chmurowicz, Ryszard; Ciećwiez, Sylwester

    2011-01-01

    Outsourcing proves to be a useful tool in the difficult process of improving the financial result of hospitals. Outsourcing means separation of some functions and services in one entity and their transfer to another. The aim of this study was to analyze the use of outsourcing at the Second Independent Public University Hospital of the Pomeranian Medical University (SPSK 2 PUM) in Szczecin. We studied the transport and treatment of medical waste. Outsourcing of waste treatment services led to financial savings. The cost of treatment of one kilogram of waste by an external company was PLN 2.53. The same service provided by the hospital would cost approximately PLN 7 per kilogram. Appropriate attention should be paid to the quality of services. It seems useful to have appropriate tools for quality control and monitoring. SPSK 2 PUM can serve as a good example of effective use of outsourcing.

  19. EpiAssist: Service-learning in public health education.

    Science.gov (United States)

    Horney, Jennifer A; Bamrara, Sanjana; Macik, Maria Lazo; Shehane, Melissa

    2016-01-01

    Although public health degree programs typically require practica and other field experiences, service-learning courses, with a focus on civic engagement and the application of classroom learning in real world settings, can go beyond these requirements and provide benefits to students and community-based practice partners. The goal of this paper is to assess potential benefits of service-learning programs for both graduate-level public health students and state and local public health agency partners. EpiAssist is a new service-learning program developed at the School of Public Health of the Texas A and M University Health Science Center, USA, in January 2015. EpiAssist was integrated into a new course, Methods in Field Epidemiology. The integration of service-learning was guided by a partnership with the Texas A and M Center for Teaching Excellence. State, regional, and local public health partners requested EpiAssist via email or telephone. A listserv was used to recruit student volunteers to meet requests. 54 of 86 registered EpiAssist students (63%) participated in at least one of ten service-learning and three training activities between January and June, 2015. Service-learning activities included questionnaire development, in-person and telephone data collection, and data analysis. Training topics for students included the Epi Info™ software, community assessment and communicable disease reporting. Students and partner organizations provided generally positive assessments of this service learning program through an online evaluation. Service-learning provides students with enhanced classroom learning through applied public health experience in state, regional and local health departments. These experiences provide both needed surge capacity to public health departments and valuable hands-on field experience to students.

  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. 26 CFR 31.3306(c)(13)-1 - Services of student nurse or hospital intern.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 15 2010-04-01 2010-04-01 false Services of student nurse or hospital intern...) § 31.3306(c)(13)-1 Services of student nurse or hospital intern. (a) Services performed as a student...' training school is chartered or approved pursuant to State law. (b) Services performed as an intern (as...

  3. 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

  4. PERIODIC TIMETABLE OPTIMIZATION IN THE PUBLIC ROAD TRANSPORT SERVICES

    OpenAIRE

    Béla Illés; Richárd Ladányi; György Sárközi3

    2009-01-01

    A prospering transport system is an important precondition for a modern society, for economic growth, employment and welfare. Concerning the development in rural areas an easy access to the infrastructures is essential. Making regional accessibility better is not only investing in the rolling fleets of public transport but also optimizing public transport networks. Changes in the elements and connections of transport networks have an influence on the quality and price of public services offer...

  5. [Worker's health & outsourcing: worker's profile in a hospital cleaning service].

    Science.gov (United States)

    Chillida, Manuela de Santana Pi; Cocco, Maria Inês Monteiro

    2004-01-01

    In the last two decades, service outsourcing has reduced companies' costs by the rationalization of their actions and the exploration of precarious work relations. This research aimed to outline the profile of outsourced workers in the cleaning service of a university hospital, identify their points of view about the health-illness process and future plans. This is a descriptive study from a quantitative approach, involving a random sample with 50 cleaning workers. Most of them started to work early, 74% were women and education level was low. In 36% of the cases, physicians diagnosed some kind of illness. In the analyzed period, 84% of the interviewees had realized medical consultations, resulting in an average of 3.6 consultations per worker, 56% of which involved general clinicians. Data analysis allowed for the identification of these professionals' perspectives in relation to the health/illness process and their future.

  6. Investigating Public Facility Characteristics from a Spatial Interaction Perspective: A Case Study of Beijing Hospitals Using Taxi Data

    Directory of Open Access Journals (Sweden)

    Xiaoqing Kong

    2017-02-01

    Full Text Available Services provided by public facilities are essential to people’s lives and are closely associated with human mobility. Traditionally, public facility access characteristics, such as accessibility, equity issues and service areas, are investigated mainly based on static data (census data, travel surveys and particular records, such as medical records. Currently, the advent of big data offers an unprecedented opportunity to obtain large-scale human mobility data, which can be used to study the characteristics of public facilities from the spatial interaction perspective. Intuitively, spatial interaction characteristics and service areas of different types and sizes of public facilities are different, but how different remains an open question, so we, in turn, examine this question. Based on spatial interaction, we classify public facilities and explore the differences in facilities. In the research, based on spatial interaction extracted from taxi data, we introduce an unsupervised classification method to classify 78 hospitals in 6 districts of Beijing, and the results better reflect the type of hospital. The findings are of great significance for optimizing the spatial configuration of medical facilities or other types of public facilities, allocating public resources reasonably and relieving traffic pressure.

  7. 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.

  8. Change of public transport services for CERN

    CERN Multimedia

    From 9 December onwards, the Number 9 bus, which used to run from Petit-Bel-Air all the way through to CERN, will terminate at Cornavin. With the first stretch of the new Cornavin-Meyrin-CERN tram route now in service, trams 14 and 16 will run from Cornavin to Avanchet (next to the Balexert shopping centre). During construction of the section through to Meyrin and CERN, two new bus services will be available from Avanchet, the 55 to Meyrin Village and the 56 to CERN. The Y bus route has been modified between Blandonnet and the Hôpital de la Tour: buses will no longer transit via Meyrin-Village but via the Meyrin-Satigny business park. The Y bus route has also been extended from Blandonnet to Avanchet so as to establish a connection with the tram routes 14 and 16. To get to CERN from Cornavin station during this period, you should therefore take a number 14 or 16 tram and then a number 56 bus. For further information: www.tpg.ch

  9. Exploring New Service Models: Can Consolidating Public Service Points Improve Response to Customer Needs?

    Science.gov (United States)

    Flanagan, Pat; Horowitz, Lisa R.

    2000-01-01

    Describes an experimental integrated service point that combines the desks and staff who perform reference and circulation at one of Massachusetts Institute of Technology's libraries. Considers whether this service model can consolidate public service points to improve response to customer needs; discusses performance measurement; and offers…

  10. 76 FR 5375 - Public Availability of General Services Administration FY 2010 Service Contract Inventory

    Science.gov (United States)

    2011-01-31

    ... ADMINISTRATION Public Availability of General Services Administration FY 2010 Service Contract Inventory AGENCY: Office of Acquisition Policy; General Services Administration (GSA). ACTION: Notice. SUMMARY: This notice... Consolidated Appropriations Act of 2010 (Pub. L. 111-117), GSA is publishing this notice to advise the...

  11. On innovation patterns and value-tensions in public services

    DEFF Research Database (Denmark)

    Fuglsang, Lars; Rønning, Rolf

    2015-01-01

    to the possibility of intertwined innovation patterns. Focusing public sector services, this paper agues that intertwined innovation patterns emerge within public services as a response to value-tensions. Values can be defined as measures for beneficial behaviour that guide innovation. Value-tensions in public......In the innovation studies literature, innovation patterns have been described, such as science based and practice based innovation, that varies amongst industrial sectors. As a consequence, firms become distinguished with respect to their typical innovation pattern. Less attention has been paid...... services include tensions between the political, economic, communal, aesthetic and intellectual values. The contribution of the paper to service innovation research is the emphasis on the concept of intertwined innovation patterns, such as the intertwinement of science driven and task driven innovation...

  12. Institutional public private partnerships for core health services: evidence from Italy.

    Science.gov (United States)

    Cappellaro, Giulia; Longo, Francesco

    2011-04-19

    Public-private partnerships (PPPs) are potential instruments to enable private collaboration in the health sector. Despite theoretical debate, empirical analyses have thus far tended to focus on the contractual or project dimension, overlooking institutional PPPs, i.e., formal legal entities run by proper corporate-governance mechanisms and jointly owned by public and private parties for the provision of public-health goods. This work aims to fill this gap by carrying out a comparative analysis of the reasons for the adoption of institutional PPPs and the governance and managerial features necessary to establish them as appropriate arrangements for public-health services provisions. A qualitative analysis is carried out on experiences of institutional PPPs within the Italian National Health Service (Sistema Sanitario Nazionale, SSN). The research question is addressed through a contextual and comparative embedded case study design, assuming the entire population of PPPs (4) currently in force in one Italian region as the unit of analysis: (i) a rehabilitation hospital, (ii), an orthopaedic-centre, (iii) a primary care and ambulatory services facility, and (iv) a health- and social-care facility. Internal validity is guaranteed by the triangulation of sources in the data collection phase, which included archival and interview data. Four governance and managerial issues were found to be critical in determining the positive performance of the case examined: (i) a strategic market orientation to a specialised service area with sufficient potential demand, (ii) the allocation of public capital assets and the consistent financial involvement of the private partner, (iii) the adoption of private administrative procedures in a regulated setting while guaranteeing the respect of public administration principles, and (iv) clear regulation of the workforce to align the contracts with the organisational culture. Findings suggests that institutional PPPs enable national health

  13. Institutional public private partnerships for core health services: evidence from Italy

    Directory of Open Access Journals (Sweden)

    Longo Francesco

    2011-04-01

    Full Text Available Abstract Background Public-private partnerships (PPPs are potential instruments to enable private collaboration in the health sector. Despite theoretical debate, empirical analyses have thus far tended to focus on the contractual or project dimension, overlooking institutional PPPs, i.e., formal legal entities run by proper corporate-governance mechanisms and jointly owned by public and private parties for the provision of public-health goods. This work aims to fill this gap by carrying out a comparative analysis of the reasons for the adoption of institutional PPPs and the governance and managerial features necessary to establish them as appropriate arrangements for public-health services provisions. Methods A qualitative analysis is carried out on experiences of institutional PPPs within the Italian National Health Service (Sistema Sanitario Nazionale, SSN. The research question is addressed through a contextual and comparative embedded case study design, assuming the entire population of PPPs (4 currently in force in one Italian region as the unit of analysis: (i a rehabilitation hospital, (ii, an orthopaedic-centre, (iii a primary care and ambulatory services facility, and (iv a health- and social-care facility. Internal validity is guaranteed by the triangulation of sources in the data collection phase, which included archival and interview data. Results Four governance and managerial issues were found to be critical in determining the positive performance of the case examined: (i a strategic market orientation to a specialised service area with sufficient potential demand, (ii the allocation of public capital assets and the consistent financial involvement of the private partner, (iii the adoption of private administrative procedures in a regulated setting while guaranteeing the respect of public administration principles, and (iv clear regulation of the workforce to align the contracts with the organisational culture. Conclusions Findings

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

    Directory of Open Access Journals (Sweden)

    Onalenna Seitio-Kgokgwe

    2014-09-01

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

  15. Costs of publicly provided maternity services in Rosario, Argentina

    Directory of Open Access Journals (Sweden)

    Borghi Josephine

    2003-01-01

    Full Text Available OBJECTIVE: This study estimates the costs of maternal health services in Rosario, Argentina. MATERIAL AND METHODS: The provider costs (US$ 1999 of antenatal care, a normal vaginal delivery and a caesarean section, were evaluated retrospectively in two municipal hospitals. The cost of an antenatal visit was evaluated in two health centres and the patient costs associated with the visit were evaluated in a hospital and a health centre. RESULTS: The average cost per hospital day is $114.62. The average cost of a caesarean section ($525.57 is five times greater than that of a normal vaginal delivery ($105.61. A normal delivery costs less at the general hospital and a c-section less at the maternity hospital. The average cost of an antenatal visit is $31.10. The provider cost is lower at the health centre than at the hospital. Personnel accounted for 72-94% of the total cost and drugs and medical supplies between 4-26%. On average, an antenatal visit costs women $4.70. Direct costs are minimal compared to indirect costs of travel and waiting time. CONCLUSIONS: These results suggest the potential for increasing the efficiency of resource use by promoting antenatal care visits at the primary level. Women could also benefit from reduced travel and waiting time. Similar benefits could accrue to the provider by encouraging normal delivery at general hospitals, and complicated deliveries at specialised maternity hospitals.

  16. Academic-Hospital Partnership: Conducting a Community Health Needs Assessment as a Service Learning Project.

    Science.gov (United States)

    Krumwiede, Kelly A; Van Gelderen, Stacey A; Krumwiede, Norma K

    2015-01-01

    The purposes of this service learning project were to trial nursing student application of the Community-Based Collaborative Action Research (CBCAR) framework while conducting a community health needs assessment and to assess the effectiveness of the CBCAR framework in providing real-world learning opportunities for enhancing baccalaureate nursing students' public health knowledge. In this case study analysis, the CBCAR framework linked service learning and community health needs assessment with public health nursing core competencies. Fifteen nursing students partnered with collaborative members. Student observational field notes and narrative reflections were analyzed qualitatively for fidelity to the CBCAR framework and to evaluate student public health knowledge. Students successfully employed the CBCAR framework in collaboration with the critical access hospital and community stakeholders to design and conduct the community health needs assessment. Service learning themes were real-world solutions, professional development, community collaboration, and making a difference. Students developed skills in six of the eight domains of the Quad Council's core competencies for public health nurses. Community-Based Collaborative Action Research facilitates collaborative partnerships and relationships throughout the research process. Students benefited by applying what they have learned from their education to a real community who lacks resources. © 2014 Wiley Periodicals, Inc.

  17. The Funding of Public Service Media

    DEFF Research Database (Denmark)

    Lowe, Gregory F.; Berg, Christian E.

    2013-01-01

    the complexion of media systems in the 21st century as a consequence of greater instability and higher uncertainty. A model describes 4 modes of funding for media and assesses operational implications for each. This work elaborates on earlier research questioning the premise that big, rich countries are suitable...... funding public broadcasting is not only about funding; it is about wider issues only partly rooted in the current economic malaise. An underlying dynamic is keyed to the digitalization of the media system at large, co-related with growing complexity in media competition, fuelling debate over......, for consideration of implications in how media are understood and organized and the purposes for which media are mandated...

  18. Pour un puissant service public international

    CERN Multimedia

    Staff Association

    2012-01-01

    Les différentes organisations internationales et européennes basées en Europe emploient des dizaines de milliers de fonctionnaires publics internationaux et européens. Les membres du personnel de ces organisations sont soumis à divers régimes de droit juridique et doivent faire appel contre les décisions administratives avant d’aller aux différents tribunaux administratifs internationaux (e.g. TAOIT, TANU, TFPU, TAOCDE). CERN, une des organisations les plus importantes, se doit d’être à l’affut des derniers développements dans ce domaine. L’Association du personnel a donc envoyé des représentants à un colloque sur « les évolutions de la protection juridictionnelle des fonctionnaires internationaux et européens » qui a eu lieu au Luxembourg le 1 et 2 avril 2011. Nous n&rsqu...

  19. Whose social capital matters? The case of U.S. urban public hospital closures and conversions to private ownership.

    Science.gov (United States)

    Ko, Michelle; Derose, Kathryn Pitkin; Needleman, Jack; Ponce, Ninez A

    2014-08-01

    Prior literature on social capital and health has predominantly focused on health outcomes and individual access to healthcare services. It is not known to what degree, if any, community social capital influences the performance or behaviors of public hospitals, a key source of healthcare for disadvantaged communities in the United States. In this study we developed measures of community bridging social capital - horizontal social networks between heterogeneous groups of similar social position - and linking social capital - vertical networks across the status hierarchy - relevant to public hospitals. We examined associations between social capital, and U.S. urban public hospital closures and conversions to private ownership from 1987 to 2007. We found that higher voting participation was associated with a greater hazard of public hospital closure over time (p business, professional and political organizations per 10,000 residents was associated a greater hazard of conversion (p social capital were not associated with either outcome. Taken together, our findings suggest that, at least historically, horizontal forms of social capital among more privileged groups (e.g., business, professional, and political associations) bear influence on public hospital outcomes. Specific efforts to increase engagement of disadvantaged groups and connect them with decision-makers may be needed to fully realize the potential of linking social capital to influence local healthcare policy promoting social protection.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Building Sustainable Capacity for Cardiovascular Care at a Public Hospital in Western Kenya.

    Science.gov (United States)

    Binanay, Cynthia A; Akwanalo, Constantine O; Aruasa, Wilson; Barasa, Felix A; Corey, G Ralph; Crowe, Susie; Esamai, Fabian; Einterz, Robert; Foster, Michael C; Gardner, Adrian; Kibosia, John; Kimaiyo, Sylvester; Koech, Myra; Korir, Belinda; Lawrence, John E; Lukas, Stephanie; Manji, Imran; Maritim, Peris; Ogaro, Francis; Park, Peter; Pastakia, Sonak D; Sugut, Wilson; Vedanthan, Rajesh; Yanoh, Reuben; Velazquez, Eric J; Bloomfield, Gerald S

    2015-12-08

    Cardiovascular disease deaths are increasing in low- and middle-income countries and are exacerbated by health care systems that are ill-equipped to manage chronic diseases. Global health partnerships, which have stemmed the tide of infectious diseases in low- and middle-income countries, can be similarly applied to address cardiovascular diseases. In this review, we present the experiences of an academic partnership between North American and Kenyan medical centers to improve cardiovascular health in a national public referral hospital. We highlight our stepwise approach to developing sustainable cardiovascular services using the health system strengthening World Health Organization Framework for Action. The building blocks of this framework (leadership and governance, health workforce, health service delivery, health financing, access to essential medicines, and health information system) guided our comprehensive and sustainable approach to delivering subspecialty care in a resource-limited setting. Our experiences may guide the development of similar collaborations in other settings.

  2. Socioeconomic status and utilization of amblyopia services at a tertiary pediatric hospital in Canada.

    Science.gov (United States)

    Sharma, Abhishek; Wong, Agnes M F; Colpa, Linda; Chow, Amy H Y; Jin, Ya-Ping

    2016-12-01

    To evaluate whether socioeconomic status is associated with equal utilization of amblyopia services at The Hospital for Sick Children (SickKids), a pediatric tertiary hospital in Canada. This is a retrospective, cross-sectional study. The medical records of children aged under 7 years diagnosed with amblyopia at SickKids from 2007 to 2009 were reviewed. Socioeconomic status was derived from patients' residential postal codes through linking with income data in the 2006 Canadian census report. Patients were divided into 5 income quintiles to compare with amblyopia service utilization. The main outcome measure was the observed distribution of amblyopia patients by socioeconomic status versus the expected distribution of 20% for each quintile. The analyses included 336 patients. Children with amblyopia at SickKids were more likely to come from the richest neighbourhood (32.5%), whereas children from each of the 3 lowest quintiles (14.6%-15.5%) were less likely to present at SickKids. These results differed significantly from the expected 20% for each quintile (p hospital, a significant inequality between the lower and higher income quintiles remained for nonmetropolitan Toronto patients, but not for metropolitan Toronto patients. Despite a publicly funded health-care system in Canada, children from lower socioeconomic neighbourhoods in distant areas utilize the amblyopia services in a tertiary pediatric centre less often than those from higher socioeconomic status. Copyright © 2016 Canadian Ophthalmological Society. All rights reserved.

  3. [Fifty years of public service for Quebec community psychiatry services. Part I].

    Science.gov (United States)

    Lesage, Alain

    2015-01-01

    This essay comprises 2 parts. It aims to recognize the public service of psychiatrists of the Département de psychiatrie de l'Université de Montréal who served at the provincial level of the Ministry of Health and Social Services for deinstitutionalisation of policies and organisation of services, at the service of people with severe mental disorders. First with Dr. Camille Laurin post-face of the 1962 book Les fous crient au secours! (Mentally ill patients cry for help); then the insight on the latest phase of differentiated specialised clinics by Dr. Denis Lazure, who participated in 1962 to the Bédard, Lazure, Roberts commission that launched community psychiatry, but who will also be Social Affairs Minister in the late '70 s; Dr. Arthur Amyot will sail through the budgetary issues when in the beginning of the '80s the mental health directorate was under Social Affairs; Dr. Luc Blanchet will be associated to a rich production of interdisciplinary reports by the advisory Mental Health Committee until its dismissal in 2003; and finally, Dr. André Delorme, who probably has the record of longevity at the head of the mental health directorate, transferred in 2003 under the deputy minister for medical and university affairs.The essay will propose since the beginning a grid or referential of four health services analysis. First; the arguments for community care by British and Italian psychiatrists and researchers, Thornicroft and Tansella. Second; system issues of mental health reforms proposed by Canadian psychiatric nurse and researcher Paula Goering. Third; the model of socio-political regulation of health system proposed by the Université de Montréal' health administration researcher Dr. André-Pierre Contandriopoulos; and Fourth; the structural tension between the medical and social sector signaled by the American medical sociologist, Leutz.The same phases of deinstitutionalization in other countries as UK, took place as followed: a) the asylum phase

  4. [Indices of public health services and resource allocation from the Health Ministry of Chile].

    Science.gov (United States)

    Salinas, Hugo; Erazo, Marcia; Reyes, Alvaro; Carmona, Sergio; Veloz, Patricio; Bocaz, Francisca; Silva, Paulina; Carvajal, Rodrigo

    2004-12-01

    Chile has a National Health Services System, formed by 29 Health Services. An efficient resource distribution among this services is crucial for an efficient health care delivery. To obtain indices from the Chilean Public Health Services, that could improve allocation of resources. Information from the Chilean Public Health Services, corresponding to activities during 2001 budgetary period, was collected. This is the latest complete and official information for the totality of Health Services in the country. Seventeen variables generated or monitored by the Instituto Nacional de Estadísticas (INE), the Ministerio de Salud (MINSAL), the Ministerio de Hacienda, the Ministerio de Planificación y Cooperación (MIDEPLAN) and the Fondo Nacional de Salud (FONASA) were studied. The Main Components Analysis (ACP) was used, obtained from the R correlation matrix. The first two main components were selected, with an accumulated percentage of explained variability of 63.05%. The first component is related to the population assigned to each Health Service. This corresponds to the number of people needed to treat in the hospitals of these Services and their answer to this demand, justified by the expenses in which each Health Service incurs. There is an inverse relation of the first component with health indicators, measured by burden of disease and death. The second main component would represent the social and economic characteristics of the population, poor and very poor populations and public health insurance beneficiaries, to take care of in each Health Service. Health indicators in each Health Service are not considered a priority for resource distribution among Health Services in the country. The transference is done considering the indices contained in the two main components defined.

  5. Service Quality Dimensions in Public Library: Nothern Area Experienced

    Directory of Open Access Journals (Sweden)

    Zaherawati Zakaria

    2011-01-01

    Full Text Available Problem statement: Service quality has emerged as a key strategic issue in management. The service quality assessment tool SERVQUAL was introduced the dimensions of tangibles, reliability, responsiveness and assurance and empathy dimensions of service quality. Approach: The objective of this study is to investigate which service quality dimensions that mostly influenced the service quality in public library in Sungai Petani. The study was conducted among library users and the information was gathered via questionnaires which consisted of structured questions. In this study, simple random sampling was used where only 132 respondents were selected. The discussion methods are using the Descriptive Statistic and Multiple Regressions used to analyze the result of this study. Results: The findings indicated that all three hypotheses which are tangible dimension, reliability dimension and responsiveness dimension was accepted by the researchers. Based on the finding, the reliability dimension is a significant with service quality in public library Sungai Petani which is mostly influenced user’s in using the services. However the researchers recommend that the management of public library Sungai Petani needs to focus on several services that needs further improvement such as the Online Public Access Catalogue (OPAC and welcoming atmosphere is important part of providing excellent services towards modern library service. Conclusion: In future research, the library’s management should take an effort to create the pleasant surroundings to encourage the widest possible segment of the population to use the library and to regard it as an essential part of community life and more ‘user friendly’ with the customers.

  6. Inequity in Hospitalization Care: A Study on Utilization of Healthcare Services in West Bengal, India

    Directory of Open Access Journals (Sweden)

    Montu Bose

    2015-01-01

    Full Text Available Background Out of eight commonly agreed Millennium Development Goals (MDG, six are related to the attainment of Universal Health Coverage (UHC throughout the globe. This universalization of health status suggests policies to narrow the gap in access and benefit sharing between different socially and economically underprivileged classes with that of the better placed ones and a consequent expansion of subsidized healthcare appears to be a common feature for most of the developing nations. The National Health Policy in India (2002 suggests expansion of market-based care for the affording class and subsidized care for the deserving class of the society. So, the benefit distribution of this limited public support in health sector is important to examine to study the welfare consequences of the policy. This paper examines the nature of utilizationto inpatient care by different socio-economic groups across regions and gender in West Bengal (WB, India. The benefit incidence of public subsidies across these socio-economic groups has also been verified for different types of services like medicines, diagnostics and professional care etc. Methods National Sample Survey Organization (NSSO has collected information on all hospitalized cases (60th round, 2004 with a recall period of 365 days from the sampled households through stratified random sampling technique. The data has been used to assess utilization of healthcare services during hospitalization and the distribution of public subsidies among the patients of different socio-economic background; a Benefit Incidence Analysis (BIA has also been carried out. Results Analysis shows that though the rate of utilization of public hospitals is quite high, other complementary services like medicine, doctor and diagnostic tests are mostly purchased from private market. This leads to high Out-of-Pocket (OOP expenditure. Moreover, BIA reveals that the public subsidies are mostly enjoyed by the relatively better

  7. Role of hospital evaluation in public hospital reform%医院评价在公立医院改革中的作用

    Institute of Scientific and Technical Information of China (English)

    应晓华

    2015-01-01

    Public hospital reform has been the main contents of current China’s health system reform. One of the aims and the difficult point of public hospital reform is to eliminate their“for-profit” motivation.“For-profit”public hospital may result from inadequate reimbursement from government and complicated behavior,which is related to uncertainty and information asymmetry in medical health care. It is necessary to identify the value,cost and reasonability for medical health services in public hospitals from social perspective through hospital evaluation. In addition,it is also suggested that public hospital evaluation concern quality,efficiency,social involvement,and impact of its information openness.%公立医院改革已经成为我国当前卫生体系改革的主要内容,改变其逐利动机是改革的目的与难点,这可能与补偿补助、公立医院行为的复杂性有关,而行为复杂性则缘于医疗服务不确定性与信息不对称。基于社会角度,通过评价明确公立医院服务的价值、成本、合理性等是公立医院改革的前提与基础,评价既要关注整体的质量与效率,也要注重社会团体的参与,以及公开此类信息的作用。

  8. EVALUATION OF THE PARENTERAL NUTRITION SERVICES IN HOSPITAL PULAU PINANG

    Directory of Open Access Journals (Sweden)

    RIYADH AL BATANI

    2006-01-01

    Full Text Available Parenteral nutrition (PN has been practiced in Hospital Pulau Pinang, Malaysia since 1986. However, there is no published data on the cost, complications and outcome of patients receiving PN in this hospital. A retrospective study was carried out to evaluate the cost, complications and outcome of PN. Data were obtained from patient medical records and analysed using SPSS version 11. From 2003 to 2005, 429 PN cases were evaluated. Of the PN cases, 65% were neonates, 28.2% adults and 6.8% paediatric, where 60.8% of patients were male and 38.5% were female. Malay patients constituted 57.3%, Chinese 30.8% and Indian 11.9%. The reasons for PN were feeding intolerence (86.7%, oral intake restrictions (9.3%, poor oral intake (1.4% and others (2.6%. The average cost for PN in a neonate was found to be RM185 ± 69, RM 233 ± 126 for a paediatric patient and RM 235 ± 107 for an adult. PN-associated complications were bacterial sepsis (30.4%, metabolic acidosis (13.0%, catheter dislodgment (8.7%, long line swelling (8.7%, hepatic complication (21.8%, long line blockage (4.4% and catheter-related infection (13.0%. A total of 82.7% of cases tolerated oral nutrition after PN, 7.4% expired, 5.3% developed PN complications and others were discharged, transferred to other ward, transferred to another hospital, or discharged at own risk (0.3%. The study showed a significant difference in the cost of PN in each group of patients (p = 0.002. We concluded that PN services in Hospital Pulau Pinang were associated with low PN-related complications and good outcomes.

  9. Systemic Model for Optimal Regulation in Public Service

    Directory of Open Access Journals (Sweden)

    Lucica Matei

    2006-05-01

    Full Text Available The current paper inscribes within those approaching the issue of public services from the interdisciplinary perspective. Public service development and imposing standards of efficiency and effectiveness, as well as for citizens’ satisfaction bring in front line the systemic modelling and establishing optimal policies for organisation and functioning of public services. The issue under discussion imposes an interface with powerful determinations of social nature. Consequently, the most adequate modelling might be that with a probabilistic and statistic nature. The fundamental idea of this paper, that obviously can be broadly developed, starts with assimilating the way of organisation and functioning of a public service with a waiting thread, to which some hypotheses are associated concerning the order of provision, performance measurement through costs or waiting time in the system etc. We emphasise the openness and dynamics of the public service system, as well as modelling by turning into account the statistic knowledge and researches, and we do not make detailed remarks on the cybernetic characteristics of this system. The optimal adjustment is achieved through analysis on the feedback and its comparison with the current standards or good practices.

  10. 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

  11. 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.

  12. Assessing users satisfaction with service quality in Slovenian public library

    Directory of Open Access Journals (Sweden)

    Igor Podbrežnik

    2016-07-01

    Full Text Available Purpose: A research was made into user satisfaction with regard to the quality of library services in one of the Slovenian public libraries. The aim was to establish the type of service quality level actually expected by the users, and to determine their satisfaction with the current quality level of available library services.Methodology: The research was performed by means of the SERVQUAL measuring tool which was used to determine the size and direction of the gap between the detected and the expected quality of library services among public library users.Results: Different groups of users provide different assessments of specific quality factors, and a library cannot satisfy the expectations of each and every user if most quality factors display discrepancies between the estimated perception and expectations. The users expect more reliable services and more qualified library staff members who would understand and allocate time for each user’s individual needs. The largest discrepancies from the expectations are detected among users in the under-35 age group and among the more experienced and skilled library users. The results of factor analysis confirm the fact that a higher number of quality factors can be explained by three common factors affecting the satisfaction of library users. A strong connection between user satisfaction and their assessment of the integral quality of services and loyalty has been established.Research restrictions: The research results should not be generalised and applied to all Slovenian public libraries since they differ in many important aspects. In addition, a non-random sampling method was used.Research originality/Applicability: The conducted research illustrates the use of a measuring tool that was developed with the aim of determining the satisfaction of users with the quality of library services in Slovenian public libraries. Keywords: public library, user satisfaction, quality of library services, user

  13. Strategic responses to fiscal constraints: a health policy analysis of hospital-based ambulatory physical therapy services in the Greater Toronto Area (GTA).

    Science.gov (United States)

    Landry, Michel D; Verrier, Molly C; Williams, A Paul; Zakus, David; Deber, Raisa B

    2009-01-01

    Ambulatory physical therapy (PT) services in Canada are required to be insured under the Canada Health Act, but only if delivered within hospitals. The present study analyzed strategic responses used by hospitals in the Greater Toronto Area (GTA) to deliver PT services in an environment of fiscal constraint. Key informant interviews (n = 47) were conducted with participants from all hospitals located within the GTA. Two primary strategic responses were identified: (1) "load shedding" through the elimination or reduction of services, and (2) "privatization" through contracting out or creating internal for-profit subsidiary clinics. All hospitals reported reductions in service delivery between 1996 and 2003, and 15.0% (7/47 hospitals) fully eliminated ambulatory services. Although only one of 47 hospitals contracted out services, another 15.0% (7/47) reported that for-profit subsidiary clinics were created within the hospital in order to access other more profitable forms of quasi-public and private funding. Strategic restructuring of services, aimed primarily at cost containment, may have yielded short-term financial savings but has also created a ripple effect across the continuum of care. Moreover, the rise of for-profit subsidiary clinics operating within not-for-profit hospitals has emerged without much public debate and with little research to evaluate its impact.

  14. Handheld Versus Wearable Interaction Design for Professionals - A Case Study of Hospital Service Work

    DEFF Research Database (Denmark)

    Stisen, Allan; Blunck, Henrik; Kjærgaard, Mikkel Baun;

    2014-01-01

    service work. This explorative study was conducted with 4 experienced hospital orderlies who interacted with an application across two wearable concepts, and one handheld smartphone in five scenarios in a hospital environment. The interaction was video recorded with a chest-mounted video afterwards semi...... aspects to aid designers of next generation wearable designs for hospital service work....

  15. Rural hospital ownership: medical service provision, market mix, and spillover effects.

    Science.gov (United States)

    Horwitz, Jill R; Nichols, Austin

    2011-10-01

    To test whether nonprofit, for-profit, or government hospital ownership affects medical service provision in rural hospital markets, either directly or through the spillover effects of ownership mix. Data are from the American Hospital Association, U.S. Census, CMS Healthcare Cost Report Information System and Prospective Payment System Minimum Data File, and primary data collection for geographic coordinates. The sample includes all nonfederal, general medical, and surgical hospitals located outside of metropolitan statistical areas and within the continental United States from 1988 to 2005. We estimate multivariate regression models to examine the effects of (1) hospital ownership and (2) hospital ownership mix within rural hospital markets on profitable versus unprofitable medical service offerings. Rural nonprofit hospitals are more likely than for-profit hospitals to offer unprofitable services, many of which are underprovided services. Nonprofits respond less than for-profits to changes in service profitability. Nonprofits with more for-profit competitors offer more profitable services and fewer unprofitable services than those with fewer for-profit competitors. Rural hospital ownership affects medical service provision at the hospital and market levels. Nonprofit hospital regulation should reflect both the direct and spillover effects of ownership. © Health Research and Educational Trust.

  16. 48 CFR 831.7001-4 - Medical services and hospital care.

    Science.gov (United States)

    2010-10-01

    ... hospital care. 831.7001-4 Section 831.7001-4 Federal Acquisition Regulations System DEPARTMENT OF VETERANS... and Procedures 831.7001-4 Medical services and hospital care. (a) VA may pay the customary student... Government. (b) When the customary student's health fee does not cover medical services or hospital care, but...

  17. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Science.gov (United States)

    2010-01-01

    ....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... assignment, for hospital emergency medical evacuation service helicopter operations unless that assignment... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Helicopter hospital emergency...

  18. The impact of chaplaincy services in selected hospitals in the eastern United States.

    Science.gov (United States)

    Parkum, K H

    1985-09-01

    Surveys a stratified sample of patients in six different hospitals and compares their perceptions of hospital chaplaincy and other pastoral care efforts with related hospital services. Reports the presence of a strong impact of pastoral care services and discusses these findings from the perspective of a theory of expressive and instrumental social orientations as explicated by the sociologist Talcott Parsons.

  19. 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.

  20. Emerging markets for satellite data communications in the public service

    Science.gov (United States)

    Potter, J. G.

    1978-01-01

    The paper discusses some of the current and potential markets for satellite data communications as projected by the Public Service Satellite Consortium (PSSC). Organizations in the public service sector are divided into three categories, depending on their expected benefits and organizational changes due to increased satellite telecommunications use: A - modest institutional adjustments are necessary and significant productivity gains are likely; B - institutional requirements picture is promising, but more information is needed to assess benefits and risk; and C - major institutional adjustments are needed, risks are high but possible benefits are high. These criteria are applied to the U.S. health care system, continuing education, equipment maintenance, libraries, environmental monitoring, and other potential markets. The potential revenues are seen to be significant, but what is needed is a cooperative effort by common carriers and major public service institutions to aggregate the market.

  1. On a hiding to nothing? Assessing the corporate governance of hospital and health services in New Zealand 1993-1998.

    Science.gov (United States)

    Barnett, P; Perkins, R; Powell, M

    2001-01-01

    In New Zealand the governance of public sector hospital and health services has changed significantly over the past decade. For most of the century hospitals had been funded by central government grants but run by locally elected boards. In 1989 a reforming Labour government restructured health services along managerialist lines, including changing governance structures so that some area health board members were government appointments, with the balance elected by the community. More market oriented reform under a new National government abolished this arrangement and introduced (1993) a corporate approach to the management of hospitals and related services. The hospitals were established as limited liability companies under the Companies Act. This was an explicitly corporate model and, although there was some modification of arrangements following the election of a more politically moderate centre-right coalition government in 1996, the corporate model was largely retained. Although significant changes occurred again after the election of a Labour government in 1999, the corporate governance experience in New Zealand health services is one from which lessons can, nevertheless, be learnt. This paper examines aspects of the performance and process of corporate governance arrangements for public sector health services in New Zealand, 1993-1998.

  2. Improving the effectiveness of service delivery in the public healthcare sector: the case of ophthalmology services in Malaysia.

    Science.gov (United States)

    Foo, Chee Yoong; Lim, Ka Keat; Sivasampu, Sheamini; Dahian, Kamilah Binti; Goh, Pik Pin

    2015-08-28

    Rising demand of ophthalmology care is increasingly straining Malaysia's public healthcare sector due to its limited human and financial resources. Improving the effectiveness of ophthalmology service delivery can promote national policy goals of population health improvement and system sustainability. This study examined the performance variation of public ophthalmology service in Malaysia, estimated the potential output gain and investigated several factors that might explain the differential performance. Data for 2011 and 2012 on 36 ophthalmology centres operating in the Ministry of Health hospitals were used in this analysis. We first consulted a panel of ophthalmology service managers to understand the production of ophthalmology services and to verify the production model. We then assessed the relative performance of these centres using Data Envelopment Analysis (DEA). Efficiency scores (ES) were decomposed into technical, scale, and congestion component. Potential increase in service output was estimated. Sensitivity analysis of model changes was performed and stability of the result was assessed using bootstrap approach. Second stage Tobit regression was conducted to determine if hospital type, availability of day services and population characteristics were related to the DEA scores. In 2011, 33% of the ophthalmology centres were found to have ES > 1 (mean ES = 1.10). Potential output gains were 10% (SE ± 2.92), 7.4% (SE ± 2.06), 6.9% (SE ± 1.97) if the centres could overcome their technical, scale and congestion inefficiencies. More centres moved to the performance frontier in 2012 (mean ES = 1.07), with lower potential output gain. The model used has good stability. Robustness checks show that the DEA correctly identified low performing centres. Being in state hospital was significantly associated with better performance. Using DEA to benchmarking service performance of ophthalmology care could provide insights for policy

  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. [Co-payment for public health care services--public opinion survey].

    Science.gov (United States)

    Derkacz, Marek; Chmiel-Perzyńska, Iwona; Buczak-Stec, Elzbieta; Pachuta, Izabela; Kowal, Agnieszka; Grywalska, Ewelina; Pinkowska, Patrycja; Pawlos, Joanna; Bednarczyk, Natalia; Kuszewski, Krzysztof

    2011-01-01

    One of the solutions aimed at improving the functioning of the healthcare system in Poland is to introduce patients' co-payment for public healthcare services. In all countries where the healthcare system is at a high level there already exists a co-payment system and it is regarded by many specialists as a necessary and indispensable condition for the proper functioning of healthcare. The aim of this study was to show respondents' attitudes and opinions regarding the proposal of introduction co-payments as and additional form of financing medical care. The questionnaire survey covered a group of 2,409 persons (50.7% men and 49.3% women). Most respondents, despite the overall rising dissatisfaction with the quality and availability of medical services do not see the need for co-payments. The opinion about the implementation of co-payments. The opinion about the implementation of co-payments depends on many factors, to the most important belong age, education, place of residence and income. More often, the co-payments is in favour of young people in good health condition, who live in big cities, having a university degree and determining their financial situation as good. Before the introduction of co-payment - certain social groups, which would be exempt from additional fees, should be specified. To the highest costs that patients are able to carry belong: paying for a home visit of family doctor or specialist, for surgical procedures, and for complex tests performed during the hospital stay (including computed tomography, magnetic resonance imaging).

  5. 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.

  6. Remodeling of Rural Public Service Supply Mechanism under the Background of New Village Construction

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Under the background of new village construction, the necessity of remodeling the supply mechanism of rural public service is expounded. It is conducive to improving the capability of public service to satisfy farmers’ demand; to constructing a rural diversified public service system and improving the supply efficiency of rural public goods; to realizing the equalization of urban-rural public services to coordinate urban-rural development. Problems in the supply of Chinese rural public services are analyzed:the demand of rural public goods is enormous, governmental fiscal expenditure is insufficient; social organization is imperfect and public service capability is weak; urban-rural gap is large and the supply of pubic service is unequal; the system of rural public service is single and the functions are imperfect; the market degree of rural public service is low and the efficiency needs improving. In view of these problems, the strategies for remodeling the supply mechanism of rural public service are put forward, covering intensifying the input intensity of the government, expanding the coverage of public services; vigorously supporting the development of social organization and improving its capability of public goods; breaking through dual system and realizing the equalization of urban-rural public service; perfecting rural diversified public services and perfecting its public service functions; promoting the market progress of rural public services and improving the efficiency of public service.

  7. 32 CFR 705.37 - Public affairs and public service awards.

    Science.gov (United States)

    2010-07-01

    ... 451.) (d) Chief of Information awards—(1) Certificate of Public Relations Achievement. (i) This... relations achievements which, while not meeting the criteria for public service awards presented by the... review periodicals and broadast air-checks received by the Internal Relations Activity. (B) Nominations...

  8. Public service motivation ad fonts : Personality traits as antecedents to serve the public interest

    NARCIS (Netherlands)

    van Witteloostuijn, Arjen; Esteve, M.; Boyne, G.

    2017-01-01

    Public Service Motivation (PSM) is a topic that has generated considerable interest among Public Administration scholars. Research on PSM has mainly focused on either defining what PSM is and how this construct can be measured or on testing how PSM affects individual and organizational variables. Ho

  9. Public service motivation and job performance of public sector employees in the Netherlands

    NARCIS (Netherlands)

    Leisink, P.L.M.; Steijn, B.

    2009-01-01

    This article contributes in three ways to our understanding of public service motivation (PSM) and its effects. In the first place, it applies an abridged version of Perry's measurement scale in the Dutch public sector. Although the results of the analysis show that PSM is a valid concept in this co

  10. Public service motivation og jobvalg: Serviceproduktion eller serviceregulering?

    DEFF Research Database (Denmark)

    Kjeldsen, Anne Mette

    2012-01-01

    Litteraturen omkring public service motivation har traditionelt fokuseret på, hvad individers motivation betyder for tiltrækning til offentlig eller privat ansættelse, mens betydningen af karakteren af de ydelser, der leveres i de to sektorer, er overset. Gennem spørgeskemaundersøgelser og...... interviews med sidsteårs-socialrådgiverstuderende, der efter endt uddannelse kan beskæftige sig med såvel produktion som regulering af offentlige ydelser i både offentlig og privat regi, undersøger denne artikel derfor sammenhængen mellem public service motivation og jobvalget serviceproduktion eller...

  11. PUBLIC SERVICES AND THE EURO-REGIONAL COOPERATION

    Directory of Open Access Journals (Sweden)

    Badulescu Alina

    2012-07-01

    Full Text Available Besides the goods and private services, covering the specific needs of individual or groups based on specific mechanisms of demand and supply, human needs can be addressed also through public services. They are designed to meet the general interests of members of a community or society at large and established by public authorities, subject to certain fundamental principles of organization and operation, such as: the principle of efficiency, the principle of equity, the principle of continuity, the principle of movability and the principle of decentralization. In the same time, public services involve in many areas of economic and social life is not just a national issue, but also have characteristics and provision ways at international, regional and euro-regional level. This paper underlines the main areas of euro-regional co-operation interest in the public services sectors, such as: the sectors of environment, agriculture and territorial planning, the sectors of transportation, security and telecommunication, the sector of the economy and labour force, the sector of cross-border populations: social protection and public health, the sectors of education, research and culture.

  12. Psychology in the Public Forum : Unity in Service?

    OpenAIRE

    David W., Rackham

    1996-01-01

    While a theoretical and methodological unity is beyond the grasp of contemporary psychology, it could be argued that a unity of purpose might be possible if it is recognized that specialized psychological systems and methods, even if irreconcilable at the moment, have all been tapped to provide some sort of service to the wider community. It might be said, therefore, that a kind of unity in diversity actually exists, this unity being in terms of the public service dimension of the psychologic...

  13. Perceived Organizational Red Tape and Organizational Performance in Public Services

    DEFF Research Database (Denmark)

    Jacobsen, Christian Bøtcher; Jakobsen, Mads Leth

    2017-01-01

    The claim that perceived organizational red tape hampers public services has become a central theme in public administration research. Surprisingly, however, few scholars have empirically examined the impact of perceived red tape on organizational performance. This study empirically analyzes how...... perceived organizational red tape among managers and frontline staff relates to objectively measured performance. The data consists of survey responses from teachers and principals at Danish upper secondary schools combined with grade-level administrative performance data. Based on theories of red tape...

  14. Functions of Relationship Capital in Rural Public Sports Service

    Institute of Scientific and Technical Information of China (English)

    Wanjing; ZHU

    2014-01-01

    The field survey of two natural villages found that the relationship capital plays an important role in rural public sports service benefiting from the rural elite operation mode. However,negative effect brought by the relationship capital should not be neglected,including distorting the social equity,increasing social transaction cost,and weakening the public trust in government. It is a top priority to effectively evade its negative effect and bring into full play huge potential of the relationship capital.

  15. SERVICE QUALITY AND CUSTOMER SATISFACTION IN PUBLIC TRANSPORTS

    Directory of Open Access Journals (Sweden)

    Filipa Fonseca

    2010-06-01

    Full Text Available The objective of the paper is to identify the determinants of service quality as well as its impact on the satisfaction of public transport commuters. The paper explores the relationship between service quality and customer satisfaction in a public transport service taking into account both internal and external perspectives. In order to analyse this relationship, the concepts of service quality, consumer satisfaction and dissatisfaction are assessed. A model of analysis is developed aiming at explaining this relationship and guiding the empirical study. This is based on an exploratory case study of a metro company in Europe. The results of the study put in evidence two key findings. The first is related to the level of service quality in its main dimensions. We conclude that reliability, security, speed, comfort and punctuality are quality dimensions of greater importance for the public transport services. Secondly, the study explores satisfaction and their determinants. Despite literature stipulates the existence of a distinction between the constructs of quality and satisfaction, this study found that the transport company, non-customers and customers clearly do not make such a distinction.

  16. A notion on restructuring the Bali hospitality and service industry by

    African Journals Online (AJOL)

    An essay on Karma Karana: A notion on restructuring the Bali hospitality and service industry by ... Research in Hospitality Management ... Does the money that is generated from tourism really help the people and the island itself to grow?

  17. 26 CFR 1.513-6 - Certain hospital services not unrelated trade or business.

    Science.gov (United States)

    2010-04-01

    ...) The service is provided at a fee not in excess of actual cost, including straight line depreciation... effect on or before April 20, 1983. (b) Hospital defined. As used in this section the word hospital...

  18. Waste management in three public hospitals of Mato Grosso do Sul, Brazil - doi:10.5020/18061230.2010.p221

    Directory of Open Access Journals (Sweden)

    Keila Tivirolli

    2012-01-01

    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.

  19. Mortality outcomes in hospitals with public, private not-for-profit and private for-profit ownership in Chile 2001-2010.

    Science.gov (United States)

    Cid Pedraza, Camilo; Herrera, Cristian A; Prieto Toledo, Lorena; Oyarzún, Felipe

    2015-03-01

    Public, private not-for-profit (PNFP) and private for-profit (PFP) hospitals may have different behaviour and performance in different indicators such as health outcomes, cost-efficiency and quality. Chile has a mixed healthcare system both in financing and service delivery. The public National Health Fund (Fondo Nacional de Salud) covers 76% of the population-poorer and with higher health risks-whereas private health insurers cover 16% of the population-richer and with lower health risks. The aim of the study was to analyse the in-patient mortality outcomes by hospital ownership in Chile. We use hospital discharge data in Chile for the period 2001-10 with a total of 16,205,314 discharges in 20 public, 6 PNFP and 15 PFP hospitals. We analyse in-patient mortality considering all diagnoses and a subsample considering only myocardial infarction and stroke diagnoses. Using a probit regression, we estimate how hospital ownership explains in-patient mortality controlling for other confounding variables like health and socioeconomic status, and hospital characteristics. The discharge condition was reported as death in 3.5% of the public hospitals' discharges, 1.3% in PNFP and 0.7% in PFP. PNFP and PFP hospitals show a lower risk of in-hospital mortality for all diagnoses, myocardial infarction and stroke in comparison with public hospitals. The question about which type of hospital ownership performs better in Chile remains open. Policy decisions regarding health service provision requires more evidence explaining differences by ownership. Better controls for health risk and hospital characteristics are suggested to address these differences in hospital performance. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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