scholarly journals Investing in acute health services: is it time to change the paradigm?

2014 ◽  
Vol 38 (5) ◽  
pp. 533 ◽  
Author(s):  
Rhonda Kerr ◽  
Delia V Hendrie ◽  
Rachael Moorin
Keyword(s):  
Health Services ◽  
Service Delivery ◽  
Capital Investment ◽  
Medical Equipment ◽  
Public Hospital ◽  
Cost Of Capital ◽  
Public Hospitals ◽  
Hospital Services ◽  
The Cost

Objective Capital is an essential enabler of contemporary public hospital services funding hospital buildings, medical equipment, information technology and communications. Capital investment is best understood within the context of the services it is designed and funded to facilitate. The aim of the present study was to explore the information on capital investment in Australian public hospitals and the relationship between investment and acute care service delivery in the context of efficient pricing for hospital services. Methods This paper examines the investment in Australian public hospitals relative to the growth in recurrent hospital costs since 2000–01 drawing from the available data, the grey literature and the reports of six major reviews of hospital services in Australia since 2004. Results Although the average annual capital investment over the decade from 2000–01 represents 7.1% of recurrent expenditure on hospitals, the most recent estimate of the cost of capital consumed delivering services is 9% per annum. Five of six major inquiries into health care delivery required increased capital funding to bring clinical service delivery to an acceptable standard. The sixth inquiry lamented the quality of information on capital for public hospitals. In 2012–13, capital investment was equivalent to 6.2% of recurrent expenditure, 31% lower than the cost of capital consumed in that year. Conclusions Capital is a vital enabler of hospital service delivery and innovation, but there is a poor alignment between the available information on the capital investment in public hospitals and contemporary clinical requirements. The policy to have capital included in activity-based payments for hospital services necessitates an accurate value for capital at the diagnosis-related group (DRG) level relevant to contemporary clinical care, rather than the replacement value of the asset stock. What is known about the topic? Deeble’s comprehensive hospital-based review of capital investment and costs, published in 2002, found that investment averages of between 7.1% and 7.9% of recurrent costs primarily replaced existing assets. In 2009, the Productivity Commission and the National Health and Hospitals Reform Commission (NHHRC) recommended capital, for the replacement of buildings and medical equipment, be included in activity-based funding. However, there have been persistent concerns about the reliability and quality of the information on the value of hospital capital assets. What does this paper add? This is the first paper for over a decade to look at hospital capital costs and investment in terms of the services they support. Although health services seek to reap dividends from technology in health care, this study demonstrates that investment relative to services costs has been below sustainable levels for most of the past 10 years. The study questions the helpfulness of the highly aggregated information on capital for public hospital managers striving to improve on the efficient price for services. What are the implications for practitioners? Using specific and accurate information on capital allocations at the DRG level assists health services managers advance their production functions for the efficient delivery of services.

scholarly journals Is capital investment in Australian hospitals effectively funding patient access to efficient public hospital care?

2018 ◽  
Vol 42 (5) ◽  
pp. 501 ◽  
Author(s):  
Rhonda Kerr ◽  
Delia V. Hendrie
Keyword(s):  
Hospital Care ◽  
Capital Investment ◽  
Cost Of Capital ◽  
Capital Allocation ◽  
Public Hospitals ◽  
Patient Access ◽  
Australian Capital ◽  
Capital Funding ◽  
Efficient Hospital ◽  
The Cost

Objective This study asks ‘Is capital investment in Australian public hospitals effectively funding patient access to efficient hospital care?’ Methods The study drew information from semistructured interviews with senior health infrastructure officials, literature reviews and World Health Organization (WHO) reports. To identify which systems most effectively fund patient access to efficient hospitals, capital allocation systems for 17 Organisation for Economic Cooperation and Development (OECD) countries were assessed. Results Australian government objectives (equitable access to clinically appropriate, efficient, sustainable, innovative, patient-based) for acute health services are not directly addressed within Australian capital allocation systems for hospitals. Instead, Australia retains a prioritised hospital investment system for institutionally based asset replacement and capital planning, aligned with budgetary and political priorities. Australian systems of capital allocation for public hospitals were found not to match health system objectives for allocative, productive and dynamic efficiency. Australia scored below average in funding patient access to efficient hospitals. The OECD countries most effectively funding patient access to efficient hospital care have transitioned to diagnosis-related group (DRG) aligned capital funding. Measures of effective capital allocation for hospitals, patient access and efficiency found mixed government–private–public partnerships performed poorly with inferior access to capital than DRG-aligned systems, with the worst performing systems based on private finance. Conclusion Australian capital allocation systems for hospitals do not meet Australian government standards for the health system. Transition to a diagnosis-based system of capital allocation would align capital allocation with government standards and has been found to improve patient access to efficient hospital care. What is known about the topic? Very little is known about the effectiveness of Australian capital allocation for public hospitals. In Australia, capital is rarely discussed in the context of efficiency, although poor built capital and inappropriate technologies are acknowledged as limitations to improving efficiency. Capital allocated for public hospitals by state and territory is no longer reported by Australian Institute of Health and Welfare due to problems with data reliability. International comparative reviews of capital funding for hospitals have not included Australia. Most comparative efficiency reviews for health avoid considering capital allocation. The national review of hospitals found capital allocation information makes it difficult to determine ’if we have it right’ in terms of investment for health services. Problems with capital allocation systems for public hospitals have been identified within state-based reviews of health service delivery. The Productivity Commission was unable to identify the cost of capital used in treating patients in Australian public hospitals. Instead, building and equipment depreciation plus the user cost of capital (or the cost of using the money invested in the asset) are used to estimate the cost of capital required for patient care, despite concerns about accuracy and comparability. What does this paper add? This is the first study to review capital allocation systems for Australian public hospitals, to evaluate those systems against the contemporary objectives of the health systems and to assess whether prevailing Australian allocation systems deliver funds to facilitate patient access to efficient hospital care. This is the first study to evaluate Australian hospital capital allocation and efficiency. It compares the objectives of the Australian public hospitals system (for universal access to patient-centred, efficient and effective health care) against a range of capital funding mechanisms used in comparable health systems. It is also the first comparative review of international capital funding systems to include Australia. What are the implications for practitioners? Clinical quality and operational efficiency in hospitals require access for all patients to technologically appropriate hospitals. Funding for appropriate public hospital facilities, medical equipment and information and communications technology is not connected to activity-based funding in Australia. This study examines how capital can most effectively be allocated to provide patient access to efficient hospital care for Australian public hospitals. Capital investment for hospitals that is patient based, rather than institutionally focused, aligns with higher efficiency.

scholarly journals The Comprehensive Quality in Health Services by Using Six Sigma

2019 ◽  
Vol 7 (9) ◽  
pp. 83-103
Author(s):  
Amal Yassin
Keyword(s):  
Health Services ◽  
Six Sigma ◽  
Practical Importance ◽  
Hospital Management ◽  
Public Hospitals ◽  
Total Quality ◽  
Government Hospitals ◽  
Intermediate Degree ◽  
High Degree

Abstract The study aimed to know the overall quality of the concept and its importance in providing high-quality health services and the availability of the key factors in the application and services and to take administrative factors, technical and human and financial, which may contribute to the raise if directed properly and have an adult in improving the quality of health services impact. Based on the nature of the study and the objectives it seeks, the analytical descriptive approach was used. It was based on the study of the phenomenon as it exists in reality and it is treated as a precise description and expressed in qualitative and quantitative terms. To analyze the analytical aspects of the research subject and then collect the initial data through the questionnaire as a main tool for research, designed specifically for this purpose, and distributed to government hospitals in Khartoum State, and included the study community department managers and patients in government hospitals in Khartoum state. A random sample was collected (300) department managers and patients from the Khartoum government hospitals. Each individual has the opportunity to be a member of the study sample during the year 2016. The study concluded with a number of results, the most important of which is that the hospital management has the material potential (furniture, equipment, ...) to use the Six Sigma curriculum with an intermediate degree. The hospital management is ready to use the Six Sigma curriculum to a high degree. Six Sigma In the middle level, the hospital management is keen to train the heads of departments to form teams for the process of continuous improvement to a high degree, the hospital administration is continuously improving the purpose of reducing the deviations and errors that occur, the hospital management is ready to provide an information system Its data continuously At, there is the management of the hospital readiness to provide direct contact with an intermediate degree of quality coaches tuning software system. The study presented a number of recommendations, the most important of which is linking the promotion system in the public hospitals in Khartoum state with the quality control program, paying attention to the overall quality and stressing the possibility of using it in hospitals in Khartoum State because of its scientific and practical importance and improving the quality of the services and the operations provided. Keywords: total quality management, health services, competitiveness, sigma six

scholarly journals The Effectiveness of Hospital Accreditation Implementation as a Protection Effort on Patient Information Rights

2018 ◽  
Vol 54 ◽  
pp. 03014
Author(s):  
Anggraeni Endah Kusumaningrum
Keyword(s):  
Improve Patient Safety ◽  
Legal Protection ◽  
Good Health ◽  
Hospital Services ◽  
Hospital Accreditation ◽  
Complex Organization ◽  
Right To Information ◽  
The Right ◽  
The Cost

This paper aims to analyze the effectiveness of the implementation of hospital accreditation in an attempt to provide legal protection of the right information of patients in hospital. The right to information stated on Article 7 and Article 8 of Law No. 36 of 2009 on Health as well as the shortcomings and advantages of health services. Along with the increasing awareness of the community to get good health service, raises the attitude of the critical patient. Patients no longer hesitate to ask the alternative treatment they will receive, whether in accordance with the cost incurred. The hospital is a complex organization because it is capital-intensive, energy, technology and various issues, covering the fields of law, economics, ethics, human rights, technology, and others with different principles and perspectives. The complexity of services in hospitals requires quality assurance and hospital service safety in the form of accreditation. Hospital accreditation is an acknowledgment given by an independent accrediting institution related to the assessment of the fulfillment of quality standards of hospital services on an ongoing basis. Therefore an accredited hospital is expected to effectively improve the quality of its services to their patients. The increased quality of hospital services will certainly improve patient safety and provide protection for patients.

Solid waste management in health services: overview of nurses and technicians

2010 ◽  
Vol 4 (4) ◽  
pp. 1780
Author(s):  
Adriana Gonçalves De Barros ◽  
Adriana Maria Pereira Da Silva ◽  
Luiz Carlos Gomes Costa Júnior ◽  
Viviane Euzébia Pereira Santos ◽  
Caroline Araújo Fonseca
Keyword(s):  
Data Analysis ◽  
Health Services ◽  
Solid Waste ◽  
Public Hospital ◽  
Solid Waste Management ◽  
Nursing Management ◽  
Calidad De Vida ◽  
Raising Awareness ◽  
Nursing Team

ABSTRACT Objective: to analyze how the team describes the Nursing Management of Solid Waste in Health. Methodology: consisted of an exploratory, descriptive, from quantitative approach. The study was conducted with 20 members of Nursing group, 10 nurses and 10 technicians Nursing hospitalization units of a public hospital in Petrolina / PE. The data was collected through a questionnaire with open and closed in november 2009 and data analysis took place with the help of EPI INFO 3.5.1 (august/2008). Results: most health professionals have a distorted view of what is the waste of health services and how to classify them. Conclusion: after data analysis, it is necessary to conduct training with a view to raising awareness among professionals about the proper handling of solid waste, and thus prevent accidents and improve the quality of life of the team and its clients. Descriptors: waste of health services; nursing team; solid residues.RESUMO Objetivo: analisar como a equipe de Enfermagem descreve o Gerenciamento dos Resíduos Sólidos em Saúde (GRSS).  Metodologia: estudo exploratório, descritivo, com abordagem quantitativa. O estudo foi desenvolvido com 20 membros da equipe de Enfermagem, 10 enfermeiras e 10 técnicos de enfermagem das unidades de internação de um hospital público de Petrolina/PE. A coleta de dados ocorreu por meio de um questionário com perguntas abertas e fechadas, durante o mês de novembro de 2009 e a análise dos dados com o auxílio do programa EPI INFO 3.5.1 (agosto/2008). Resultados: revelou-se, após analise dos dados que boa parte dos profissionais de saúde tem visão distorcida do que sejam os Resíduos dos Serviços de Saúde e como classificá-los. Conclusão: torna-se necessário a realização de capacitações com intuito de sensibilizar esses profissionais sobre o manuseio correto de resíduos sólidos, e consequentemente prevenir acidentes e melhorar a qualidade de vida da equipe e de seus clientes. Descritores: resíduos dos serviços de saúde; equipe de enfermagem; resíduos sólidos.RESUMEN Objetivo: analizar cómo el equipo de enfermería se describe el manejo de Residuos Sólidos en la Salud. Metodología: estudio exploratorio, descriptivo, el enfoque cuantitativo. El estudio fue realizado con 20 miembros del personal de enfermería, 10 enfermeras y 10 técnicos de enfermeras de las unidades de hospitalización de un hospital público en Petrolina/PE. Los datos fueron recolectados a través de un cuestionario abierto y cerrado durante el mes de noviembre de 2009 y el análisis de datos se llevó a cabo con la ayuda de Epi Info 3.5.1 (agosto/2008). Resultados mostraron que la mayoría de los profesionales de la salud tienen una visión distorsionada de lo que es el desperdicio de los servicios de salud y cómo clasificarlos. Conclusiones: tras el análisis de datos,  es necesario llevar a cabo la formación con el fin de sensibilizar a los profesionales sobre el manejo adecuado de los residuos sólidos, y así evitar accidentes y mejorar la calidad de vida del equipo y sus clientes. Descriptores: residuos de los servicios de salud, del equipo de enfermería, residuos sólidos, servicios de salud, gestión de riesgos del hospital, la salud ocupacional. 

scholarly journals Current status of quality of care for public hospitals in Korea : Comprehensive comparison with private hospitals

2021 ◽  
Vol 5 (1) ◽  
pp. e10
Author(s):  
Hey Jin Ko ◽  
Eunji Yun ◽  
Boryung Ahn ◽  
Won Mo Jang ◽  
Jin Yong Lee
Keyword(s):  
Quality Of Care ◽  
Quality Evaluation ◽  
Public Hospitals ◽  
Quality Level ◽  
Incentive Scheme ◽  
Hospital Services ◽  
Average Quality ◽  
Private Hospitals ◽  
Comprehensive Comparison

Objective: This ecological study aims to perform a comprehensive comparison and evaluation of the quality of care in public and private hospitals according to hospital type.Methods: Thisstudy compared and analyzed the results of the National Quality Assessment Program (NQAP) of Health Insurance Review and Assessment Service (HIRA) and Incentive Scheme for Quality Evaluation of Hospital Services. The NQAP results published on the HIRA website, as of the end of May 2021, and the internal data of HIRA for the 2020 Incentive Scheme for Quality Evaluation of Hospital Services were used as data collection sources.Results: The NQAP analysisrevealed that the overall average scores were higher for public rather than private hospitals, while the Incentive Scheme for Quality Evaluation of Hospital Services analysis reported that the proportion of higher grades (i.e., grades 1 and 2) was higher in public hospitals. Therefore, it was revealed that public hospital quality levels were notlowerthan that of private hospitals.However, itis necessary to improve the quality levelsin terms ofthe quality distribution.Conclusions: The quality levels of public hospitals are notlowerthan that of private hospitals. However,the high average quality level, we identified certain areas that required improvement in their quality level throughout the distribution. Currently, public hospitals that are particularly located in the lower ranks should strive to achieve the average quality level demonstrated by same level private hospitals, thereby, achieving progressive quality levels and minimizing the between institutions. Thus, furtherresearch should focus on identifying the trends of differencesin quality levels, and they should determine the causes by controlling for the characteristics of medical institutions.

scholarly journals Analysis of Outpatient Service Queue of Public Hospital in Jakarta

2018 ◽  
Vol 248 ◽  
pp. 03006
Author(s):  
M. Dachyar ◽  
Farizal ◽  
M. Mansur Yafi
Keyword(s):  
Health Services ◽  
Business Process ◽  
Public Hospital ◽  
Business Process Reengineering ◽  
Outpatient Service ◽  
Process Reengineering ◽  
Quality Enhancement ◽  
Hospital Services ◽  
Large Cities ◽  
Outpatient Health Services

In recent years Public hospital services are becoming a burden in many large cities. Many patients are needed to be served, but it was constrained by the number of doctors. Even though the resources are limited, the efficiency of public hospital services is important. The patient’s queues can be shortened by service quality enhancement of outpatient. This study has applied Business Process Reengineering (BPR) method to improve the efficiency of public hospital services. Igrafx software is used to visualize the improvement design. The result has suggested a solution to accelerate the outpatient health services of a public hospital in Jakarta.

Issues in Service Delivery for Women Statewide: The Consumer Context

1998 ◽  
Vol 4 (3) ◽  
pp. 72
Author(s):  
Beth Wilson
Keyword(s):  
Health Service ◽  
Health Services ◽  
Service Delivery ◽  
Women's Health ◽  
Service Providers ◽  
Public Hospitals ◽  
Health Complaints ◽  
Resolution Process ◽  
Health Service Providers ◽  
Information Program

This article presents data from two sources. The first set of data comes from complaints received by the Health Services Commissioner (Health Ombudsman) in Victoria from Consumers of Health Services about health service providers. The second set of data has been provided by 92 public hospitals using the health complaints information program. The Health Complaints Resolution Process is described and the data are presented in the hope that they may assist in formulating policies for women's health.

scholarly journals Analysis of quality indexes of the provided health services in public and private services of Angola

2016 ◽  
Vol 26 (2) ◽  
pp. 228
Author(s):  
Maria Teresa Conceição Vicente ◽  
Rodrigo Daminello Raimundo ◽  
Ligia Ajaime Azalis ◽  
Virginia Berlanga Campos Junqueira ◽  
Fernando Luiz Affonso Fonseca
Keyword(s):  
Health Services ◽  
Health Management ◽  
Health Indicators ◽  
Structured Interview ◽  
Public Hospitals ◽  
Public Institution ◽  
Bed Occupancy ◽  
Private Institution ◽  
Public And Private

Introduction: Quality indices are being increasingly used by leaders, managers and health professionals as operational tools to improve processes and reduce costs. Noting that there is a greater tendency of private hospitals operating in the regulatory model for market mechanisms, it is expected that the quality indicators that serve as a reference for monitoring the health management are more critical in public hospitals. Objective: Evaluate the quality of health services provided in public and private service in Angola. Methods: We analyzed 142 patients of a public and a private institutions in Angola in a structured interview on health indicators. The indices were collected according to the process structure components and results. Results: There are 51,453 calls in the public institution, remaining hospitalized a day, an average of 184 patients,  with an annual rate of bed occupancy of 90.84%. 50% of respondents praised the services and 22% complained about the quality of services. He was appointed as the main grounds for complaint the slow service (17%). The private institution received 2,222 patients, with an average of 570 patients. The mean hospital stay was 4.5 days. The average monthly rate of bed occupancy was 59.9%. In assessing the degree of satisfaction of care, regular or bad satisfaction obtained a rate of 60% in the private institution. Conclusion: There was no favorable results for quality in health management both in public service and in private.

scholarly journals Measuring OPD Patient Satisfaction with Different Service Delivery Aspects at Public Hospitals in Pakistan

2019 ◽  
Vol 16 (13) ◽  
pp. 2340 ◽  
Author(s):  
Abid Hussain ◽  
Muhammad Asif ◽  
Arif Jameel ◽  
Jinsoo Hwang
Keyword(s):  
Regression Analysis ◽  
Patient Satisfaction ◽  
Health Services ◽  
Service Delivery ◽  
Waiting Time ◽  
Research Method ◽  
Public Hospitals ◽  
Exploratory Research ◽  
Delivery Of Healthcare ◽  
Confirmatory Factor

The satisfaction of the patient is believed to be one of the preferred results of healthcare, and it is directly connected with the usage of health services. This study aimed to assess how doctor services, nurses’ services, and waiting time predict patient satisfaction (PS) with the service delivery of healthcare in Southern Punjab, Pakistan. The study used an exploratory research method, in which 1000 participants were selected, and used a random technique, in which 850 responses were received. Multiple regression analysis and a confirmatory factor were employed to analyze the collected data. The findings showed that doctor services (β = 0.232; p = 0.01), nurses services (β = 0.256; p = 0.01), and waiting time (β = 0.091; p = 0.03) had positive significant impacts on PS, while registration services (β = 0.028; p = 0.390) had an insignificant association with PS. Hence, a significant gap existed in the registration services that were totally ignored in hospitals of Pakistan which needed proper considerations for improvements.

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