Since December 2019, there had been a series of unexplained cases of pneumonia reported in Wuhan, China, and on 12 January 2020, the World Health Organization (WHO) named this new virus as the 2019 novel coronavirus (...Since December 2019, there had been a series of unexplained cases of pneumonia reported in Wuhan, China, and on 12 January 2020, the World Health Organization (WHO) named this new virus as the 2019 novel coronavirus (2019-nCoV). The Novel Coronavirus disease (COVID-19) is an emerging, rapidly changing global health challenge affecting all sectors, including the health sector. This study aimed to investigate nurses’ knowledge, attitudes, and practices regarding the prevention and control of COVID-19. Methods: This cross-sectional study was conducted among nurses in three public health hospitals in Khartoum state. A self-administered questionnaire was used. A total of 14 knowledge questions were adopted. There are 5 questions constructed for attitude. A total of 12 practice questions were used. Mean score of knowledge considers as follows when the mean more than 75% considers as good knowledge while this percent uses as good practice and poor practice respectively to analyze the mean score differences of knowledge, attitudes, and practices between the independent variables. Spearman correlation was used to assess the relationship between mean knowledge and attitude scores. Results: Of the 101 nurses approached, a total of 100 nurses responded (99.0% response rate). The mean age of the participants was 27.6 (SD 5.3) years, and the majority of the participants were male (293/434, 67.5%). The mean knowledge score was 1.01 (SD 0.100). The mean attitude score was 10.5 (SD 4.1), and 54.8% (238/434) of the participants had a good attitude toward COVID-19. The mean practice score was 1.4176 (SD 1.4176). There was a negative correlation between knowledge and attitude scores (P < -0.014) and between knowledge and practice scores (P < -0.081). Conclusions: The overall levels of knowledge and practice and attitude were good.展开更多
The International Healthcare Community recommends that countries do not exceed a 15% rate for cesarean section (CS). Our objective was to determine the prevalence and factors associated with CS at GPHC from July to Se...The International Healthcare Community recommends that countries do not exceed a 15% rate for cesarean section (CS). Our objective was to determine the prevalence and factors associated with CS at GPHC from July to September 2022. Methods: A cross-sectional study was carried out and data were collected from 1296 mothers, who met the inclusion criteria, through face-to-face interviews after obtaining prior informed consent. We performed descriptive analyses both for the outcome and independent variables. Bivariate and multiple logistic regression were used to identify factors associated with CS with a p-value Results: The prevalence of CS at GPHC was 28.9% (95%CI: 26.5-31.5). Factors associated factors with CS were mothers aged 20 to 34 years (AOR: 1.56, 95%CI: 1.02 - 2.39, P = 0.039);mothers who received more than three minimum wages (AOR: 1.95, 95%CI: 1.29 - 2.97, P = 0.002) and who attended prenatal care at both public and private health facilities (AOR: 2.49, 95% CI: 1.19 - 5.22, P = 0.022). Likewise, the highest Odds of CS were observed in mothers with gestational hypertension (AOR: 2.00, 95%CI: 1.35 - 2.96, P Conclusion: The prevalence of CS is higher than the ideal rate recommended by the International Healthcare Community. More studies are needed to understand the reasons for such high prevalence at GPHC.展开更多
During the outbreak of novel coronavirus pneumonia(NCP)in Wuhan,public hospitals have played an important role in intensive care,case guidance and scheme optimization.At the same time,it also faces unprecedented chall...During the outbreak of novel coronavirus pneumonia(NCP)in Wuhan,public hospitals have played an important role in intensive care,case guidance and scheme optimization.At the same time,it also faces unprecedented challenges and tests.Based on the treatment of severe patients in Wuhan,combined with the treatment practice in Tongji Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology,this paper puts forward the urgency of further strengthening the construction of public hospitals,discusses the feasible path for promoting the development of public hospitals,so as to meet the growing medical needs of the people,improve the ability to respond to major public health emergencies,and effectively guarantee the safety of people's lives and the promotion of a healthy China construction.展开更多
China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis(DEA) to evaluate the technical efficiency(TE) and productivity of county public hospitals in Eastern, C...China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis(DEA) to evaluate the technical efficiency(TE) and productivity of county public hospitals in Eastern, Central, and Western China after the 2012 public hospital reform. Data from 127 county public hospitals(39, 45, and 43 in Eastern, Central, and Western China, respectively) were collected during 2012–2015. Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist. The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal–Wallis H test and Mann–Whitney U test. The average bias-corrected TE values for the four-year period were 0.6442, 0.5785, 0.6099, and 0.6094 in Eastern, Central, and Western China, and the entire country respectively, with average non-technical efficiency, low pure technical efficiency(PTE), and high scale efficiency found. Productivity increased by 8.12%, 0.25%, 12.11%, and 11.58% in China and its three regions during 2012–2015, and such increase in productivity resulted from progressive technological changes by 16.42%, 6.32%, 21.08%, and 21.42%, respectively. The TE and PTE of the county hospitals significantly differed among the three regions of China. Eastern and Western China showed significantly higher TE and PTE than Central China. More than 60% of county public hospitals in China and its three areas operated at decreasing return scales. There was a considerable space for TE improvement in county hospitals in China and its three regions. During 2012–2015, the hospitals experienced progressive productivity; however, the PTE changed adversely. Moreover, Central China continuously achieved a significantly lower efficiency score than Eastern and Western China. Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county public hospitals in the three areas of China, especially in Central China.展开更多
Increasingly international and national policies are being directed at actions for the social determinants of health and for an integrated approach to health care provision, not only in terms of institutional cooperat...Increasingly international and national policies are being directed at actions for the social determinants of health and for an integrated approach to health care provision, not only in terms of institutional cooperation but also stakeholder involvement. A key component of both these policies is the development of good governance principles in all health care agencies and organizations. A neglected dimension in these debates has been the role of the public hospital which remains a vital and expensive dimension of service provision. In a case study of a public hospital in South Africa, this paper charts the readiness of its management principles and activities to provide quality health care linked to population health and to contribute to the non-medical determinant of health. Using Taylor’s principles of good governance, we conclude that there is a mixture of good and not so good governance activity. The paper concludes by examining the external constraints on the public hospital and by providing suggestions for future activities.展开更多
Objectives: To assess the nurses’ experiences in service provision a COVID-19 dedicated tertiary public hospital. Materials and Methods: This descriptive cross-sectional study was conducted in one tertiary level publ...Objectives: To assess the nurses’ experiences in service provision a COVID-19 dedicated tertiary public hospital. Materials and Methods: This descriptive cross-sectional study was conducted in one tertiary level public hospital namely Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh from January to December 2021. Data were collected through face-to-face interview using a structured questionnaire containing demographic details and experiences faced by the nurses in service provision during COVID-19. Data was analysed by using SPSS (Statistical Package for Social Science) software version 23. Results: The findings revealed that the mean age of the respondents was 32.35 ± 7.248 years, the minimum age was 23 years and maximum age was 58 years. About half of the respondents 52.1% were in 21 - 30 years. The majorities 89% were female. More than half of the respondents 72.6% were Muslim and 63.83% of respondents have completed Diploma in nursing. About 32.2% respondents were living with senior citizen, 33% respondents were infected by COVID-19, 24.23% respondent mentioned nurse-Patient ratio in general ward was 1:7 and 71.08% mentioned nurse-patient ratio in I.C.U/C.C.U. was 1:3 (December 2021). PPE were available among 88.0% respondents and N95 mask were available among 84.0% respondent. About 34.8% respondents got COVID-19 guideline training and 32.4% got donning and doffing training. More than half of the respondents 76% stated that equipment is adequate, 56.38% respondents mention that insufficient of nurses and 53.7% were mentioned insufficient of subordinate staff. About 22.6% respondents faced social stigma and majorities 96.5% respondents mentioned they got proper family support. There was a significant association found between Professional educational qualification and satisfaction of current designation (p value = 0.001 Conclusion: The most important findings of this study was lack of training, insufficient of manpower especially nurses and subordinate staff, high nurse-patient ratio and fear about personal and family safety. The findings of the study will be helpful for the authority in planning for future course of action.展开更多
Objective:This descriptive study reveals how nurses working in public hospitals rated their practice environments with respect to nurse-friendly hospital criteria.Methods:This study was conducted on 460 nurses volunte...Objective:This descriptive study reveals how nurses working in public hospitals rated their practice environments with respect to nurse-friendly hospital criteria.Methods:This study was conducted on 460 nurses volunteering to participate this study among 735 nurses working in inpatient wards of three public hospitals.Data were collected using a personal information form and the Adapted Nursing Work IndexeRevised.Numbers,percentages,means and standard deviations,t-test and one-way variance analysis were used to evaluate the data.Results:Among the nurse-friendly hospital criteria,‘control of nursing practice’,‘middle management accountability’and‘quality initiatives’had the highest mean scores,and‘competitive wages’had the lowest mean score.The assessments of the nurses presented statistically significant differences with respect to personal and occupational variables.Conclusion:The nurses found most of the nurse-friendly hospital criteria adequate,but they believed that several areas needed improvement.展开更多
Background: Among the main challenges of healthcare system throughout the world, there is stroke management. It is important to have data on the in-hospital costs of stroke care to help decision-makers to implement a ...Background: Among the main challenges of healthcare system throughout the world, there is stroke management. It is important to have data on the in-hospital costs of stroke care to help decision-makers to implement a health insurance system. Objectives: To evaluate the in-hospital costs of stroke care in Brazzaville;to determine the factors influencing the total mean in-hospital cost of stroke care;to identify third parties contributing to stroke care expenditure. Methods: This was a cross-sectional prospective and analytical study. It was carried out at 4 public hospitals in Brazzaville (University Hospital Center, Chinese and Congolese Friendship Hospital, Talangaï Hospital and Makélékélé Hospital), from May to August 2019 (4 months). It focused on patients who had a first episode of stroke confirmed by brain imaging and were at least 18 years old. The bottom-up approach was used to determine the in-hospital costs of stroke care. Results: This study included 109 patients who fulfilled inclusion criteria. Their mean age was 59.2 ± 13.7 years old, with limits of 35 and 90 years old. The total direct in-hospital cost of stroke care was 47,308,330 francs CFA (72,122 euro). The total mean in-hospital cost of stroke care was 1,389,590 francs CFA (2118 euro). The mean cost of intracerebral hemorrhage care was 510,988 francs CFA (779 euro) versus 373,457 francs CFA (569 euro) for cerebral arterial infarction care. The following factors affected the total mean cost of stroke care: type of hospital (p < 0.0001), length of hospital stay (p = 0.001), type of stroke (p = 0.01), stroke severity (p = 0.001) and complications (p = 0.001). The level of contribution to stroke care expenditure covered by third parties was: 78% for patient families;2.8% for community self-help associations. Conclusion: In Congo, the mean in-hospital cost of stroke care is elevated considering the guaranteed minimum wage of 70,000 francs CFA (107 euro). Five factors affect the total mean cost of stroke care. Patient families are the main financial assistance system for stroke care expenditure. To minimize the heavy financial burden induced by stroke on patients, households and families, it is important to implement a health insurance system and strengthen the stroke prevention program.展开更多
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 ...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 magnitudes 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.展开更多
Background: Contact dermatitis is common disease and represents a significant problem in healthcare sector, mainly among nurses. Many studies reported the prevalence of contact dermatitis from different parts of the w...Background: Contact dermatitis is common disease and represents a significant problem in healthcare sector, mainly among nurses. Many studies reported the prevalence of contact dermatitis from different parts of the world. Nevertheless, data about its frequency in Tunisia especially in public hospital seems to be insufficient. This study aims to assess the prevalence of contact dermatitis among nurses working in public hospital and identify risk factors. Patient and Methods: A cross sectional study was conducted among a representative sample of 1278 health professionals working in a public hospital matched by professional status and department. The survey was based on a questionnaire, a specialized examination and patch tests. Results: The prevalence of occupational contact dermatitis was 22% (17.5 - 27.2). The worker profile at risk of contact dermatitis was a female nurse aged 37 years working in a surgical department during 12.7 ± 9.36 years. Hands were damaged in 92.4% of cases and rhythmicity with occupational exposure was reported by 86% of affected individuals. Patch tests using European Standard Battery were performed among 33 workers and revealed a sensitization to an allergen among 26 workers. Patch test using rubber battery (if suspicion of allergic contact dermatitis to gloves) was performed among 29 agents and positive among 12. The analytical study revealed that history of atopy, job tenure, the mean daily number of hand washing, the mean daily number of worn gloves and mean duration of glove wearing were significantly higher in the affected population. Conclusion: Contact dermatitis affects particularly nurses in public hospitals. Its prevention requires a diagnostic approach based on a detailed professional investigation and patch tests.展开更多
In this study,financial position and financial performance of public hospitals(PH)in Turkey were analyzed.Financial statements of 948 public hospitals between 2008 and 2017 were used in analysis.Financial statements w...In this study,financial position and financial performance of public hospitals(PH)in Turkey were analyzed.Financial statements of 948 public hospitals between 2008 and 2017 were used in analysis.Financial statements were analyzed by ratio analysis technique to analyze the financial status and financial performance of public hospitals.With the Z-score analysis technique,the risk of financial failure of public hospitals was measured.The credibility of public hospitals was measured by the rating analysis technique.It was determined that the accumulated losses in public hospitals lowered the equity below zero,the institutions has trouble with paying debt,and the credit risk of public hospitals is high.展开更多
Following the continuous development of our country's economy,the new medical reform of our country is also gradually speeding up.And potential problems existing in public hospital's financial department are b...Following the continuous development of our country's economy,the new medical reform of our country is also gradually speeding up.And potential problems existing in public hospital's financial department are being gradually magnified that has brought new challenge to financial management.The financial staff are studying the problems and trying to solve the problems through their working experiences from long-term practices and on a certain basis.Therefore,in this article,we try to find out the existing problems and to explore efficient solutions to the problems under the background of new medical reform and in the light of the importance of financial management to public hospital's development.The main purpose of this study is to try to solve the existing problems in financial management of public hospital so as to promote perfecting the systems of public medical institutions to get a better development.展开更多
Nursing is a very intense and focused career, so picking the right time and its proper management can help to relieve personal stress, manage tasks properly and achieve patients and organizational outcome. Objective: ...Nursing is a very intense and focused career, so picking the right time and its proper management can help to relieve personal stress, manage tasks properly and achieve patients and organizational outcome. Objective: This study aimed to explore perceived time management skill of the clinical nurses. Methods: This was a descriptive correlational study design using simple random sampling. A total of 77 clinical nurses working in Mugda Medical College Hospital, Dhaka, Bangladesh were selected as study participants. The data were collected through structure questionnaire which consisted of demographic questionnaire and five dimensions of Time Management Skill Questionnaire (TMSQ). Results: The overall mean score of time management skill was 2.63 (SD = 0.28) reflecting a medium level of nurses perceived time management skill. The results also revealed that nurses age (r = 0.39, p = 0.000), monthly income (r = 0.294, p = 0.017) and service experience (r = 0.248, p = 0.030) were statistically significant correlated with nurses’ perceived time management skill. Conclusion: The outcome of this research would add to develop a strategy for nurse administrators to take an initiative for how nurses could improve the time management and utilize their limited time effectively. It specifies that proper time management can influence to provide quality care and achieving organizational goal.展开更多
<strong>Aim:</strong> To explore the nurses’ perceptions about the advanced nurses’ practitioner’s role in public hospitals in Saudi Arabia. <strong>Background:</strong> Advanced nurse pract...<strong>Aim:</strong> To explore the nurses’ perceptions about the advanced nurses’ practitioner’s role in public hospitals in Saudi Arabia. <strong>Background:</strong> Advanced nurse practitioners are one of the leading professionals who contribute to health promotion, disease prevention, health counseling and patient education. However, misunderstandings of their roles may have an impact on the performances of the function that limits their access and the use of significant resources that can help patients to obtain treatment. <strong>Methods: </strong>This is a qualitative exploratory study conducted on nurses working in three public hospitals. Semi-structured interviews were conducted among fourteen nurses between October-January 2020. The three public hospitals were based in Eastern (1) and Central (2) Saudi Arabia regions. Data analysis was conducted through thematic analysis utilizing inductive and deductive coding. <strong>Results:</strong> The study found that the role of Advanced Practice Nurses will enhance, motivate, and sustain the status of nurses in Saudi Arabia. Findings indicated that advanced practitioners’ educational preparedness, organizational, and contextual factors are important factors that need to be addressed to promote their role and to improve nurse’s perception about the APN role in clinical practice. <strong>Conclusion:</strong> This research provided new evidence to support the need to raise understanding of the role of advanced nurse practitioners among nurse members, advanced nurses and clinical nurse specialists who wish to enhance quality healthcare delivery and job satisfaction in the Kingdom of Saudi Arabia. Recognizing the factors that comprise the function and status of APNs will assist health-care officials to make informed decisions when designing a national policy and a plan for the implementation and the development of the role of APNs.展开更多
Background： Nowadays obesity is the world＇s common disease. Bariatric surgery is the only therapy that providessignificant cost savings within Public Health Service, but the lack of diagnostic paths universally acce...Background： Nowadays obesity is the world＇s common disease. Bariatric surgery is the only therapy that providessignificant cost savings within Public Health Service, but the lack of diagnostic paths universally accepted causes enormous waste ofresources and disruptions. Service Mapping is the ideal methodology to describe work＇s organization and to plan a new service model.Methods： The Service Mapping has been used to represent the actual state of the bariatric surgery service and starting from the criticalaspects found, we have developed a desirable state of the service. Results： Experience-based design has given centrality to thebeneficiary, making the bariatric service sensitive to patient＇s needs and expectations. The micro-organization of work has improvedprofessionals＇ integration, avoiding the creation of new operational entities or additional costs. The service has been simplified both forclinicians and hospital managers. The strategic repositioning of the dietician and general practitioner＇s recognition within the bariatricpath allowed us to achieve better clinical outcomes. Conclusions： Service Mapping has highlighted clinicians＇ difficulties in providingthe service, emphasizing the importance of the beneficiary. The iconic representation is a powerful explicit framework, fundamental formanagement purposes, to understand the role of every subject involved in the service, to rationalize work＇s organization, and integratehealthcare activities.展开更多
This study investigates the construction of a health management service mode based on large-scale comprehensive hospitals by analyzing health management service modes at home and abroad,that is,taking the Affiliated H...This study investigates the construction of a health management service mode based on large-scale comprehensive hospitals by analyzing health management service modes at home and abroad,that is,taking the Affiliated Hospital of Chifeng University as an example,establish a health examination hospital,undertake core tasks such as health service operation process,system,monitoring,and system formulation,and take the best medical resources.Attract social medical resources to collaborate and give health service mode of health status monitoring,evaluation,and intervention to health service objects,aided by advanced medical technology.To extend the traditional health management service with the hospital as the protagonist to health management with participation from family and society beyond the hospital,forming a closed-loop,rapid,and efficient health service management system.Thus,through graded quality services,to lessen the difficulties of patients seeing a doctor and to solve the problem of overcrowding and minor ailments in major hospitals.展开更多
文摘Since December 2019, there had been a series of unexplained cases of pneumonia reported in Wuhan, China, and on 12 January 2020, the World Health Organization (WHO) named this new virus as the 2019 novel coronavirus (2019-nCoV). The Novel Coronavirus disease (COVID-19) is an emerging, rapidly changing global health challenge affecting all sectors, including the health sector. This study aimed to investigate nurses’ knowledge, attitudes, and practices regarding the prevention and control of COVID-19. Methods: This cross-sectional study was conducted among nurses in three public health hospitals in Khartoum state. A self-administered questionnaire was used. A total of 14 knowledge questions were adopted. There are 5 questions constructed for attitude. A total of 12 practice questions were used. Mean score of knowledge considers as follows when the mean more than 75% considers as good knowledge while this percent uses as good practice and poor practice respectively to analyze the mean score differences of knowledge, attitudes, and practices between the independent variables. Spearman correlation was used to assess the relationship between mean knowledge and attitude scores. Results: Of the 101 nurses approached, a total of 100 nurses responded (99.0% response rate). The mean age of the participants was 27.6 (SD 5.3) years, and the majority of the participants were male (293/434, 67.5%). The mean knowledge score was 1.01 (SD 0.100). The mean attitude score was 10.5 (SD 4.1), and 54.8% (238/434) of the participants had a good attitude toward COVID-19. The mean practice score was 1.4176 (SD 1.4176). There was a negative correlation between knowledge and attitude scores (P < -0.014) and between knowledge and practice scores (P < -0.081). Conclusions: The overall levels of knowledge and practice and attitude were good.
文摘The International Healthcare Community recommends that countries do not exceed a 15% rate for cesarean section (CS). Our objective was to determine the prevalence and factors associated with CS at GPHC from July to September 2022. Methods: A cross-sectional study was carried out and data were collected from 1296 mothers, who met the inclusion criteria, through face-to-face interviews after obtaining prior informed consent. We performed descriptive analyses both for the outcome and independent variables. Bivariate and multiple logistic regression were used to identify factors associated with CS with a p-value Results: The prevalence of CS at GPHC was 28.9% (95%CI: 26.5-31.5). Factors associated factors with CS were mothers aged 20 to 34 years (AOR: 1.56, 95%CI: 1.02 - 2.39, P = 0.039);mothers who received more than three minimum wages (AOR: 1.95, 95%CI: 1.29 - 2.97, P = 0.002) and who attended prenatal care at both public and private health facilities (AOR: 2.49, 95% CI: 1.19 - 5.22, P = 0.022). Likewise, the highest Odds of CS were observed in mothers with gestational hypertension (AOR: 2.00, 95%CI: 1.35 - 2.96, P Conclusion: The prevalence of CS is higher than the ideal rate recommended by the International Healthcare Community. More studies are needed to understand the reasons for such high prevalence at GPHC.
文摘During the outbreak of novel coronavirus pneumonia(NCP)in Wuhan,public hospitals have played an important role in intensive care,case guidance and scheme optimization.At the same time,it also faces unprecedented challenges and tests.Based on the treatment of severe patients in Wuhan,combined with the treatment practice in Tongji Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology,this paper puts forward the urgency of further strengthening the construction of public hospitals,discusses the feasible path for promoting the development of public hospitals,so as to meet the growing medical needs of the people,improve the ability to respond to major public health emergencies,and effectively guarantee the safety of people's lives and the promotion of a healthy China construction.
基金supported by the National Natural Science Foundation of China(No.71473099)
文摘China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis(DEA) to evaluate the technical efficiency(TE) and productivity of county public hospitals in Eastern, Central, and Western China after the 2012 public hospital reform. Data from 127 county public hospitals(39, 45, and 43 in Eastern, Central, and Western China, respectively) were collected during 2012–2015. Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist. The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal–Wallis H test and Mann–Whitney U test. The average bias-corrected TE values for the four-year period were 0.6442, 0.5785, 0.6099, and 0.6094 in Eastern, Central, and Western China, and the entire country respectively, with average non-technical efficiency, low pure technical efficiency(PTE), and high scale efficiency found. Productivity increased by 8.12%, 0.25%, 12.11%, and 11.58% in China and its three regions during 2012–2015, and such increase in productivity resulted from progressive technological changes by 16.42%, 6.32%, 21.08%, and 21.42%, respectively. The TE and PTE of the county hospitals significantly differed among the three regions of China. Eastern and Western China showed significantly higher TE and PTE than Central China. More than 60% of county public hospitals in China and its three areas operated at decreasing return scales. There was a considerable space for TE improvement in county hospitals in China and its three regions. During 2012–2015, the hospitals experienced progressive productivity; however, the PTE changed adversely. Moreover, Central China continuously achieved a significantly lower efficiency score than Eastern and Western China. Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county public hospitals in the three areas of China, especially in Central China.
文摘Increasingly international and national policies are being directed at actions for the social determinants of health and for an integrated approach to health care provision, not only in terms of institutional cooperation but also stakeholder involvement. A key component of both these policies is the development of good governance principles in all health care agencies and organizations. A neglected dimension in these debates has been the role of the public hospital which remains a vital and expensive dimension of service provision. In a case study of a public hospital in South Africa, this paper charts the readiness of its management principles and activities to provide quality health care linked to population health and to contribute to the non-medical determinant of health. Using Taylor’s principles of good governance, we conclude that there is a mixture of good and not so good governance activity. The paper concludes by examining the external constraints on the public hospital and by providing suggestions for future activities.
文摘Objectives: To assess the nurses’ experiences in service provision a COVID-19 dedicated tertiary public hospital. Materials and Methods: This descriptive cross-sectional study was conducted in one tertiary level public hospital namely Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh from January to December 2021. Data were collected through face-to-face interview using a structured questionnaire containing demographic details and experiences faced by the nurses in service provision during COVID-19. Data was analysed by using SPSS (Statistical Package for Social Science) software version 23. Results: The findings revealed that the mean age of the respondents was 32.35 ± 7.248 years, the minimum age was 23 years and maximum age was 58 years. About half of the respondents 52.1% were in 21 - 30 years. The majorities 89% were female. More than half of the respondents 72.6% were Muslim and 63.83% of respondents have completed Diploma in nursing. About 32.2% respondents were living with senior citizen, 33% respondents were infected by COVID-19, 24.23% respondent mentioned nurse-Patient ratio in general ward was 1:7 and 71.08% mentioned nurse-patient ratio in I.C.U/C.C.U. was 1:3 (December 2021). PPE were available among 88.0% respondents and N95 mask were available among 84.0% respondent. About 34.8% respondents got COVID-19 guideline training and 32.4% got donning and doffing training. More than half of the respondents 76% stated that equipment is adequate, 56.38% respondents mention that insufficient of nurses and 53.7% were mentioned insufficient of subordinate staff. About 22.6% respondents faced social stigma and majorities 96.5% respondents mentioned they got proper family support. There was a significant association found between Professional educational qualification and satisfaction of current designation (p value = 0.001 Conclusion: The most important findings of this study was lack of training, insufficient of manpower especially nurses and subordinate staff, high nurse-patient ratio and fear about personal and family safety. The findings of the study will be helpful for the authority in planning for future course of action.
文摘Objective:This descriptive study reveals how nurses working in public hospitals rated their practice environments with respect to nurse-friendly hospital criteria.Methods:This study was conducted on 460 nurses volunteering to participate this study among 735 nurses working in inpatient wards of three public hospitals.Data were collected using a personal information form and the Adapted Nursing Work IndexeRevised.Numbers,percentages,means and standard deviations,t-test and one-way variance analysis were used to evaluate the data.Results:Among the nurse-friendly hospital criteria,‘control of nursing practice’,‘middle management accountability’and‘quality initiatives’had the highest mean scores,and‘competitive wages’had the lowest mean score.The assessments of the nurses presented statistically significant differences with respect to personal and occupational variables.Conclusion:The nurses found most of the nurse-friendly hospital criteria adequate,but they believed that several areas needed improvement.
文摘Background: Among the main challenges of healthcare system throughout the world, there is stroke management. It is important to have data on the in-hospital costs of stroke care to help decision-makers to implement a health insurance system. Objectives: To evaluate the in-hospital costs of stroke care in Brazzaville;to determine the factors influencing the total mean in-hospital cost of stroke care;to identify third parties contributing to stroke care expenditure. Methods: This was a cross-sectional prospective and analytical study. It was carried out at 4 public hospitals in Brazzaville (University Hospital Center, Chinese and Congolese Friendship Hospital, Talangaï Hospital and Makélékélé Hospital), from May to August 2019 (4 months). It focused on patients who had a first episode of stroke confirmed by brain imaging and were at least 18 years old. The bottom-up approach was used to determine the in-hospital costs of stroke care. Results: This study included 109 patients who fulfilled inclusion criteria. Their mean age was 59.2 ± 13.7 years old, with limits of 35 and 90 years old. The total direct in-hospital cost of stroke care was 47,308,330 francs CFA (72,122 euro). The total mean in-hospital cost of stroke care was 1,389,590 francs CFA (2118 euro). The mean cost of intracerebral hemorrhage care was 510,988 francs CFA (779 euro) versus 373,457 francs CFA (569 euro) for cerebral arterial infarction care. The following factors affected the total mean cost of stroke care: type of hospital (p < 0.0001), length of hospital stay (p = 0.001), type of stroke (p = 0.01), stroke severity (p = 0.001) and complications (p = 0.001). The level of contribution to stroke care expenditure covered by third parties was: 78% for patient families;2.8% for community self-help associations. Conclusion: In Congo, the mean in-hospital cost of stroke care is elevated considering the guaranteed minimum wage of 70,000 francs CFA (107 euro). Five factors affect the total mean cost of stroke care. Patient families are the main financial assistance system for stroke care expenditure. To minimize the heavy financial burden induced by stroke on patients, households and families, it is important to implement a health insurance system and strengthen the stroke prevention program.
文摘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 magnitudes 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.
文摘Background: Contact dermatitis is common disease and represents a significant problem in healthcare sector, mainly among nurses. Many studies reported the prevalence of contact dermatitis from different parts of the world. Nevertheless, data about its frequency in Tunisia especially in public hospital seems to be insufficient. This study aims to assess the prevalence of contact dermatitis among nurses working in public hospital and identify risk factors. Patient and Methods: A cross sectional study was conducted among a representative sample of 1278 health professionals working in a public hospital matched by professional status and department. The survey was based on a questionnaire, a specialized examination and patch tests. Results: The prevalence of occupational contact dermatitis was 22% (17.5 - 27.2). The worker profile at risk of contact dermatitis was a female nurse aged 37 years working in a surgical department during 12.7 ± 9.36 years. Hands were damaged in 92.4% of cases and rhythmicity with occupational exposure was reported by 86% of affected individuals. Patch tests using European Standard Battery were performed among 33 workers and revealed a sensitization to an allergen among 26 workers. Patch test using rubber battery (if suspicion of allergic contact dermatitis to gloves) was performed among 29 agents and positive among 12. The analytical study revealed that history of atopy, job tenure, the mean daily number of hand washing, the mean daily number of worn gloves and mean duration of glove wearing were significantly higher in the affected population. Conclusion: Contact dermatitis affects particularly nurses in public hospitals. Its prevention requires a diagnostic approach based on a detailed professional investigation and patch tests.
文摘In this study,financial position and financial performance of public hospitals(PH)in Turkey were analyzed.Financial statements of 948 public hospitals between 2008 and 2017 were used in analysis.Financial statements were analyzed by ratio analysis technique to analyze the financial status and financial performance of public hospitals.With the Z-score analysis technique,the risk of financial failure of public hospitals was measured.The credibility of public hospitals was measured by the rating analysis technique.It was determined that the accumulated losses in public hospitals lowered the equity below zero,the institutions has trouble with paying debt,and the credit risk of public hospitals is high.
文摘Following the continuous development of our country's economy,the new medical reform of our country is also gradually speeding up.And potential problems existing in public hospital's financial department are being gradually magnified that has brought new challenge to financial management.The financial staff are studying the problems and trying to solve the problems through their working experiences from long-term practices and on a certain basis.Therefore,in this article,we try to find out the existing problems and to explore efficient solutions to the problems under the background of new medical reform and in the light of the importance of financial management to public hospital's development.The main purpose of this study is to try to solve the existing problems in financial management of public hospital so as to promote perfecting the systems of public medical institutions to get a better development.
文摘Nursing is a very intense and focused career, so picking the right time and its proper management can help to relieve personal stress, manage tasks properly and achieve patients and organizational outcome. Objective: This study aimed to explore perceived time management skill of the clinical nurses. Methods: This was a descriptive correlational study design using simple random sampling. A total of 77 clinical nurses working in Mugda Medical College Hospital, Dhaka, Bangladesh were selected as study participants. The data were collected through structure questionnaire which consisted of demographic questionnaire and five dimensions of Time Management Skill Questionnaire (TMSQ). Results: The overall mean score of time management skill was 2.63 (SD = 0.28) reflecting a medium level of nurses perceived time management skill. The results also revealed that nurses age (r = 0.39, p = 0.000), monthly income (r = 0.294, p = 0.017) and service experience (r = 0.248, p = 0.030) were statistically significant correlated with nurses’ perceived time management skill. Conclusion: The outcome of this research would add to develop a strategy for nurse administrators to take an initiative for how nurses could improve the time management and utilize their limited time effectively. It specifies that proper time management can influence to provide quality care and achieving organizational goal.
文摘<strong>Aim:</strong> To explore the nurses’ perceptions about the advanced nurses’ practitioner’s role in public hospitals in Saudi Arabia. <strong>Background:</strong> Advanced nurse practitioners are one of the leading professionals who contribute to health promotion, disease prevention, health counseling and patient education. However, misunderstandings of their roles may have an impact on the performances of the function that limits their access and the use of significant resources that can help patients to obtain treatment. <strong>Methods: </strong>This is a qualitative exploratory study conducted on nurses working in three public hospitals. Semi-structured interviews were conducted among fourteen nurses between October-January 2020. The three public hospitals were based in Eastern (1) and Central (2) Saudi Arabia regions. Data analysis was conducted through thematic analysis utilizing inductive and deductive coding. <strong>Results:</strong> The study found that the role of Advanced Practice Nurses will enhance, motivate, and sustain the status of nurses in Saudi Arabia. Findings indicated that advanced practitioners’ educational preparedness, organizational, and contextual factors are important factors that need to be addressed to promote their role and to improve nurse’s perception about the APN role in clinical practice. <strong>Conclusion:</strong> This research provided new evidence to support the need to raise understanding of the role of advanced nurse practitioners among nurse members, advanced nurses and clinical nurse specialists who wish to enhance quality healthcare delivery and job satisfaction in the Kingdom of Saudi Arabia. Recognizing the factors that comprise the function and status of APNs will assist health-care officials to make informed decisions when designing a national policy and a plan for the implementation and the development of the role of APNs.
文摘Background： Nowadays obesity is the world＇s common disease. Bariatric surgery is the only therapy that providessignificant cost savings within Public Health Service, but the lack of diagnostic paths universally accepted causes enormous waste ofresources and disruptions. Service Mapping is the ideal methodology to describe work＇s organization and to plan a new service model.Methods： The Service Mapping has been used to represent the actual state of the bariatric surgery service and starting from the criticalaspects found, we have developed a desirable state of the service. Results： Experience-based design has given centrality to thebeneficiary, making the bariatric service sensitive to patient＇s needs and expectations. The micro-organization of work has improvedprofessionals＇ integration, avoiding the creation of new operational entities or additional costs. The service has been simplified both forclinicians and hospital managers. The strategic repositioning of the dietician and general practitioner＇s recognition within the bariatricpath allowed us to achieve better clinical outcomes. Conclusions： Service Mapping has highlighted clinicians＇ difficulties in providingthe service, emphasizing the importance of the beneficiary. The iconic representation is a powerful explicit framework, fundamental formanagement purposes, to understand the role of every subject involved in the service, to rationalize work＇s organization, and integratehealthcare activities.
基金The 2021 Chifeng natural science research project“Research on Optimization of health management mode of Chifeng Class 3A general public hospital”(Project number:2021-40)。
文摘This study investigates the construction of a health management service mode based on large-scale comprehensive hospitals by analyzing health management service modes at home and abroad,that is,taking the Affiliated Hospital of Chifeng University as an example,establish a health examination hospital,undertake core tasks such as health service operation process,system,monitoring,and system formulation,and take the best medical resources.Attract social medical resources to collaborate and give health service mode of health status monitoring,evaluation,and intervention to health service objects,aided by advanced medical technology.To extend the traditional health management service with the hospital as the protagonist to health management with participation from family and society beyond the hospital,forming a closed-loop,rapid,and efficient health service management system.Thus,through graded quality services,to lessen the difficulties of patients seeing a doctor and to solve the problem of overcrowding and minor ailments in major hospitals.
