2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kate McBride ◽  
Daniel Steffens ◽  
Christina Stanislaus ◽  
Michael Solomon ◽  
Teresa Anderson ◽  
...  

Abstract Background A barrier to the uptake of robotic-assisted surgery (RAS) continues to be the perceived high costs. A lack of detailed costing information has made it difficult for public hospitals in particular to determine whether use of the technology is justified. This study aims to provide a detailed description of the patient episode costs and the contribution of RAS specific costs for multiple specialties in the public sector. Methods A retrospective descriptive costing review of all RAS cases undertaken at a large public tertiary referral hospital in Sydney, Australia from August 2016 to December 2018 was completed. This included RAS cases within benign gynaecology, cardiothoracic, colorectal and urology, with the total costs described utilizing various inpatient costing data, and RAS specific implementation, maintenance and consumable costs. Results Of 211 RAS patients, substantial variation was found between specialties with the overall median cost per patient being $19,269 (Interquartile range (IQR): $15,445 to $32,199). The RAS specific costs were $8828 (46%) made up of fixed costs including $4691 (24%) implementation and $2290 (12%) maintenance, both of which are volume dependent; and $1848 (10%) RAS consumable costs. This was in the context of 37% robotic theatre utilisation. Conclusions There is considerable variation across surgical specialties for the cost of RAS. It is important to highlight the different cost components and drivers associated with a RAS program including its dependence on volume and how it fits within funding systems in the public sector.


Author(s):  
Beniamino Schiavone ◽  
Andrea Vitale ◽  
Mena Gallo ◽  
Gianlucasalvatore Russo ◽  
Domenico Ponticelli ◽  
...  

Background: Facebook is the most popular social network across the world and also allows users access to health information. Our study presents an overview of the official Facebook profiles of hospitals in Italy (n = 1351) and how much they are used. Methods: All hospitals were surveyed on the number of Facebook posts in May (post-lockdown) and October (second pandemic wave) 2020. The number of followers, the creation date of the official page, and the frequency of publication—that is, the average number of days between two subsequent posts—were determined. Results: In Italy, only 28% (n = 379) of the hospitals had official Facebook pages, of which 20.6% (n = 78) were public hospitals, and 79.4% (n = 301) were private hospitals. Of the hospitals with Facebook pages, 49.1% used them every week, and public hospitals published more often. Conclusions: Despite the differences between regions and types of management, the number of hospitals in Italy that use Facebook as a tool for the public dissemination of health information is still low. Hospitals should adopt an effective communication strategy using social networks to improve the quality of health care.


Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 693
Author(s):  
Aravinthan Kadravello ◽  
Seng-Beng Tan ◽  
Gwo-Fuang Ho ◽  
Ranjit Kaur ◽  
Cheng-Har Yip

Background and Objective: Despite the increasing treatment options for patients with metastatic breast cancer (MBC), unmet needs remain common, especially in low and middle-income countries where resources are limited and MBC patients face many challenges. They often join support groups to cope with their unmet needs. Currently, many MBC patients connect with each other via online support group in view of the constant availability of support and rapid information exchange. The objective of this study is to determine the unmet needs of women with MBC from an online support group. Material and Methods: Messages in an online support group of twenty-two MBC patients over a period of three years from August 2016 till August 2019 were thematically analyzed. Results: Three themes were generated, (1) unmet information needs (2) unmet financial needs (3) unmet support needs. Women needed information on side effects of treatment, new treatment options and availability of clinical trials. Although Malaysia has universal health care coverage, access to treatment remains a major challenge. When treatment was not available in the public hospitals, or waiting lists were too long, women were forced to seek treatment in private hospitals, incurring financial catastrophe. Insufficient private insurance and inadequate social security payments force many women to consider stopping treatment. Women felt that they were not getting support from their clinicians in the public sector, who were quick to stop active treatment and advise palliation. On the other hand, clinicians in the private sector advise expensive treatment beyond the financial capability of the patients. Women with families also face the challenge of managing their family and household in addition to coping with their illness. Conclusions: There is a need for healthcare professionals, policy makers, and civil society to better address the needs of MBC patients through patient-centered, multidisciplinary and multi-organizational collaboration.


2020 ◽  
Vol 23 ◽  
pp. S697
Author(s):  
C. Bouchand ◽  
V. Siorat ◽  
A. Degrassat Theas ◽  
O. Parent de Curzon ◽  
P. Paubel

Author(s):  
Shanshan Liu ◽  
Jiaoling Huang ◽  
Yanting Li ◽  
Jincheng Fan ◽  
Hong Liang ◽  
...  

The public hospital reform has lasted 5 years in China; however, the operation development status and trends of public hospitals have not been systematically evaluated in Pudong New District. We first applied the technology of longitudinal index to assess the development of public hospitals there. The quantitative data were mainly gathered by taking health statistics database from 2009 to 2014. The results showed that overall operating index presented a down-up trend, with the highest point in 2014 and the lowest point in 2012. Overall operating index, development foundation index, and management condition index were found to be statistically different ( P = .010, P = .016, P = .031) in different years, whereas the service operation index and financial risk index were not so ( P = .543, P = .228). Moreover, the results demonstrated that no obvious difference was observed in the overall operating index between the general and specialized hospitals ( P = .327), which was the same in the 4 first-class indexes. However, there were statistical differences in the overall operating index and development foundation index among these 5 years ( P = .018, P = .036), but none in the service operation index, management condition index, and financial risk index ( P = .503, P = .062, P = .177). No interaction effects were discovered between year and hospital categories in the current study ( P = .673, P = .375, P = .885, P = .152, P = .288).


Curationis ◽  
2002 ◽  
Vol 25 (4) ◽  
Author(s):  
L. Cilliers ◽  
F.P. Retief

The evolution of the hospital is traced from its onset in ancient Mesopotamia towards the end of the 2nd millennium to the end of the Middle Ages. Reference is made to institutionalised health care facilities in India as early as the 5th century BC, and with the spread of Buddhism to the east, to nursing facilities, the nature and function of which are not known to us, in Sri Lanka, China and South East Asia. Special attention is paid to the situation in the Graeco-Roman era: one would expect to find the origin of the hospital in the modem sense of the word in Greece, the birthplace of rational medicine in the 4th century BC, but the Hippocratic doctors paid house-calls, and the temples of Asclepius were visited for incubation sleep and magico-religious treatment. In Roman times the military and slave hospitals which existed since the 1st century AD, were built for a specialized group and not for the public, and were therefore also not precursors of the modem hospital. It is to the Christians that one must turn for the origin of the modem hospital. Hospices, initially built to shelter pilgrims and messengers between various bishops, were under Christian control developed into hospitals in the modem sense of the word. In Rome itself, the first hospital was built in the 4th century AD by a wealthy penitent widow, Fabiola. In the early Middle Ages (6th to 10th century), under the influence of the Benedictine Order, an infirmary became an established part of every monastery. During the late Middle Ages (beyond the 10th century) monastic infirmaries continued to expand, but public hospitals were also opened, financed by city authorities, the church and private sources. Specialized institutions, like leper houses, also originated at this time. During the Golden Age of Islam the Muslim world was clearly more advanced than its Christian counterpart with magnificent hospitals in various countries.


2021 ◽  
Vol 5 (2) ◽  

Introduction: The objective of this study was to evaluate the practice of hand hygiene in the maternities of the public hospitals of Lubumbashi. Method and techniques: We carried out a cross-sectional descriptive study in which the population consisted on the one hand of the technical rooms of the maternity hospitals and the operating rooms for cesarean sections and on the other hand the nurses responsible for these maternities. The observation technique using an observation guide of the WHO model allowed us to collect the data. Results: Hand hygiene was not properly carried out in the maternity wards of Lubumbashi's public hospitals. Most of the prerequisites before hand washing and hydro-alcoholic hand rubbing were not respected, the prerequisites for surgical hand washing were observed only at 21.4%:e wearing of short-sleeved clothing (43.0%),absence of jewelry (78.6%), short nails without varnish and false nails (50.0%). In the absence of hydroalcoholic solution (SHA) (71.4%) for the friction, they used denatured alcohol (28.6%). The duration of soaping and friction was in an interval between 11 to 20 seconds or 42.9% and that of hygienic hand washing was observed at 28.6%. The duration of surgical and antiseptic hand washing was 21 to 40 seconds to 35.7%. Only 21.4% of the departments surveyed had used the broad-spectrum antiseptic foaming solution, no structure had a sterile disposable brush for hygienic and surgical hand washing, 2/14 departments surveyed had sterile disposable towels, the water used had not undergone bacteriological control and only one service, ie 7.1%, which had non-manually operated bins. Conclusion: Hand hygiene is not properly carried out in maternity hospitals in Lubumbashi's public hospitals, due to a lack of equipment and knowledge on this practice, equipment must be provided and staff trained in hand hygiene.


Author(s):  
Alireza Jabbari ◽  
Nasrin Shaarbafchi Zadeh ◽  
Behrooz Maddahian

Introduction: Performance-based payment is a payment model that attempts to reward the measured dimensions of performance and encourages health service providers to achieve predetermined goals by financial incentives. This study aimed to identify executive challenges of performance-based payment from medical and educational hospitals managers’ perspective and offering solutions in Isfahan 2018. Methods: This study was a qualitative study. Semi structured interviews were used to collect data. The research population was 11 people (the managers of educational and medical hospitals in Isfahan) who were selected purposefully. All interviews were recorded and then written on a paper. The duration of the interviews varied between 45 to 60 minutes. The data were analyzed using MAXQDA120 software and based on thematic analysis. Results: In this study, , regarding executive challenges, seven themes and fifteen sub-themes were obtained, including the weakness of the performance-based payment project, weakness in education and educational support, low employee participation, weakness of information and communication technology, weakness of laws and regulations, unfavorable economic conditions of the public sector, and special conditions governing public hospitals.   Conclusion: performance-based payment, if implemented correctly, can lead to the improvement of quantitative and qualitative indicators related to employees’ performance. Correct implementation requires identifying challenges and obstacles and then corrective actions. This study was able to identify and present some of the operational challenges of the performance-based payment from the viewpoint of hospital managers.


Author(s):  
Şirin Özkan ◽  
Mert Uydacı

INTRODUCTION: The aim of this study is to examine the requirement and distribution of nurse workforce based on workload in public hospitals. METHODS: The number of nurses required in intensive care unit, all inpatient services, emergency room, operating room and dialysis units of the hospitals affiliated to the Ministry of Health in Kocaeli was calculated based on the workload by applying the Workload Indicators of Staffing Need (WISN) method. RESULTS: When the nurses were compared based on the inter-hospital workload ratio in the province, it was found that the number of nurses in the hospitals A, B, C, D, G, H and I was inadequate, the average workload was 0.73 and the number of nurses should be increased by 27% throughout the province. It was determined that the nurses having the highest workload ratio were inpatient service nurses in hospital with A rate of 0.49 and hospital in C with 0.53 rate. In addition, although the total number of nurses in E and F hospitals is sufficient, the units within the hospital are unevenly distributed according to the workload of the nurse workforce. DISCUSSION AND CONCLUSION: It was determined that the number of nurses in the hospitals was insufficient and the workload distribution between the hospitals and within the hospital was unbalanced. The unbalanced distribution of nurse workforce throughout the province causes labour inefficiency, decreases the quality of patient care and causes health inequalities. The study results could set an example of practice that would provide support for health and nursing managers in planning and managing healthcare human resources more effectively.


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