scholarly journals Retrospective observational study of ethnicity-gender pay gaps among hospital and community health service doctors in England

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e051043
Author(s):  
Carol Woodhams ◽  
Mark Williams ◽  
Jane Dacre ◽  
Ira Parnerkar ◽  
Mukunda Sharma

ObjectivesTo identify differences in average basic pay between groups of National Health Service (NHS) doctors cross-classified by ethnicity and gender. Analyse the extent to which characteristics (grade, specialty, age, hours, etc.) can explain these differences.DesignRetrospective observational study using repeated cross-section design.SettingHospital and Community Health Service (HCHS) in England.ParticipantsAll HCHS doctors in England employed by the NHS between 2016 and 2020 appearing in the Digital Electronic Staff Record dataset (average N=99 953 per year).Main outcome measuresHours-adjusted full-time equivalent pay gaps; given as raw data and further adjusted for demographic, job, and workplace characteristics (such as grade, specialty, age, whether British nationality, region) using multivariable regression and statistical decomposition techniques.ResultsPay gaps relative to white men vary with the ethnicity-gender combination. Indian men slightly out-earn white men and Bangladeshi women have a 40% pay gap. In most cases, pay gaps can largely be explained by characteristics that can be measured, especially grade, with the extent varying by specific ethnicity-gender group. However, a portion of pay gaps cannot be explained by characteristics that can be measured.ConclusionsThis study presents new evidence on ethnicity-gender pay gaps among NHS doctors in England using high quality administrative and payroll data. The findings indicate all ethnicity-gender groups earn less than white men on average, except for Indian men. In some cases, these differences cannot be explained giving rise to discussions about the role of discrimination.

2021 ◽  
Author(s):  
Yun Wei ◽  
Feiyue Wang ◽  
Zhaolu Pan ◽  
Meirong Wang ◽  
Guanghui Jin ◽  
...  

Abstract BackgroundPhysical examination is a central part of consultation. Evidence showed that clinical use of physical examination in hospital has decreased, but little is known about physical examination performed by general practitioners in community health service institutions.ObjectiveThis study aimed to investigate general practitioners’ performance of physical examination in community health service institutions in Beijing.MethodsAn observational study was conducted in 5 community health service institutions in Beijing, China between November 2019 and January 2020. And 11 participated general practitioners were observed for one workday. Information was recorded including patient characteristics, patient reasons for encounter, physical examinations provided by general practitioners, the length of consultation and time spent on specific activities in consultations.ResultsA total of 682 consultations were recorded from 11 general practitioners. Physical examination occurred in 15.8% of the consultations. Among the recorded 126 examinations, most were distributed in “Head, face, and neck examination” (n = 54, 42.9%) and “Cardiovascular examination” (n = 55, 43.7%), and no physical examination was performed on skin, male genitalia, female breasts and genitalia, and neurological systems. A total of 2823 minutes of activities were recorded. general practitioners only spent 3.1% of their time on physical examination, less than the time spent on taking history (18.2%), test (4.9%), diagnosis (22.7%), therapy (38.4%), and health education (8.6%). The mean length of time spent on physical examination portions was 0.8 ± 0.4 minutes.ConclusionPhysical examination was infrequently performed by general practitioners in community health service institutions in Beijing. More time and attention were needed for general practitioners performing a careful and appropriate physical examination in primary care.


2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Yun Wei ◽  
Feiyue Wang ◽  
Zhaolu Pan ◽  
Meirong Wang ◽  
Guanghui Jin ◽  
...  

Abstract Background Physical examination is a core component of consultation. Little is known about the status quo of physical examinations performed by general practitioners in community health service institutions in China. The aim of this study was to investigate general practitioners’ performance of physical examinations in consultations. Methods An observational study was conducted in 5 community health service institutions in Beijing between November 2019 and January 2020. Eleven general practitioners were observed for one workday. Information of consecutive consultations was recorded including patient characteristics, reasons for encounter, physical examinations performed by general practitioners, length of consultation time and time spent on specific activities in consultations. Results A total of 682 consultations of 11 general practitioners were recorded. Physical examinations were performed in 126 consultations (15.8%). Physical examination was more likely to be performed in patients visiting with symptoms (P < 0.001). Majority of the 126 physical examinations were distributed in “Head, face, and neck examination” (n = 54, 42.9%) and “Cardiovascular examination” (n = 55, 43.7%). No physical examination was performed on skin, male genitalia, female breasts and genitalia, and neurological systems. Total 2823 min of activities were observed and recorded. General practitioners only spent 3.1% of the recorded time on physical examination, which was less than the time spent on taking history (18.2%), test (4.9%), diagnosis (22.7%), therapy (38.4%), and health education (8.6%). The average time spent on physical examinations was 0.8±0.4 min per consultation. Conclusion Physical examination was insufficiently performed by general practitioners in community health service institutions in Beijing. More time and commitment should be advocated for improving the quality of physical examinations in primary care.


2017 ◽  
Vol 4 (2) ◽  
pp. 99-104
Author(s):  
Agus Nursikuwagus

Information system at community health center is an information system that has several activities, such as registration, medical record, health care, and reporting.  Day to day operation, community health service, is using process manually. It is cause the stack of service. Sometime, the patient has to wait within several times. For Further, the patient did not know that the queuing is full. In order to help the problem, this paper wants to show about E-Health as service software. The research is completed by conveying the model like UML diagram. The UML diagrams are consisting such as usecase, class, activity, and component. The sequence of system construct is using Prototype Paradigm. The result is the software which has ability to service patient start from registration, medical check, medical prescription, until reporting. As an impact for Community health service is the service more efficiency. The system is able to control the medicine and reporting on day to day operation.   REFERENCES[1] Susanto, Gunawan,” Sistem Informasi Rekam Medis PadaRumah Sakit Umum Daerah (RSUD) Pacitan Berbasis WebBase”. Pacitan. 2012.[2] B, Nugroho, S.H. Fitriasih, B. Widada, “Sistem InformasiRekam Medis Di Puskesmas Masaran I Sragen”. JournalTIKomSiN, vol.5, no.1, p.49-56, 2017.[3] G.G.S. Bagja,” Membangun Sistem Informasi KesehatanPuskesmas Cibaregbeg”, Univ. Komp. Indonesia, 2010.[4] A.M. Herdy, Aulia, M. Amran, D. Novita, “PerancanganSistem Informasi Pelayanan Medis Di Puskesmas SungaiDua”, STMIK MDP. 2014.[5] J. Sundari, “Sistem Informasi Pelayanan Puskesmas BerbasisWeb”, Int.Journal.on Soft.Eng, vol.2, no.1, p.57-62, 2016.[6] R.S. Pressman, Software Engineering A PractitionersApproach. Nineth Edition, Addsion Wesley, 2011.[7] G. Booch, J. Rumbaugh, I. Jacobson, Unified ModelingLanguage User Guide, Addison-Wesley, 1999.[8] I, Daqiqil. (2011, August 2). Framework CodeIgnite. [Online].Available: http://koder.web.id/buku-codeigniter-gratis/


2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Shuang Shao ◽  
Tao Wu ◽  
Aimin Guo ◽  
Guanghui Jin ◽  
Rui Chen ◽  
...  

2020 ◽  
Vol 10 (2) ◽  
pp. 51-55
Author(s):  
Nurhikmah ◽  
Tahir Abdullah ◽  
Stang ◽  
Suriah ◽  
Andi Imam Arundhana ◽  
...  

Objective: This study was to examine the effects of counselling delivered during antenatal care on the knowledge and attitudes of pregnant women about danger signs in pregnancy.Methods: This was a pre-experimental design using one group pre- and post-test only. This study was conducted in Takalar, specifically within Sanrobone Community Health Service working area. Takalar is located in South Sulawesi Province Indonesia and this area is coastal with the majority of people working as a fisherman. Participants of this study were pregnant women living in the villages which are included in the working area of Sanrobone Community Health Service.Results: The study shows that counselling improved knowledge and attitude of pregnant women about danger signs in pregnancy (p=0.011 and p=0.025, respectively). The number of pregnant women with good knowledge and positive attitude increased after the intervention (43.8% vs 93.8%, 62.5% vs 93.8%, respectively).Conclusions: In can be concluded that intervention by means of counselling can improve the knowledge and attitude of pregnant women about danger signs in pregnancy. Therefore, it is important to implement the counselling program delivered by health workers in Community Health Service in order to mitigate the risk of maternal mortality.


2019 ◽  
Author(s):  
Yunque Bo ◽  
Miaojie Qi ◽  
Siyu Liu ◽  
Jiyu Cui ◽  
Youli Han

Abstract Background:Fragmentation of medical care has become one of the main reasons for the inefficiency of medical delivery systems. Vertical integration of medical delivery systems (VIMDS) is a reform direction in the world. Managers’ behavior toward profit distribution is an important factor that influences them to pursue the goal of VIMDS. We conducted a controlled economics experiment to explore decision-making by managers of medical institutions in respect of profits and what influences the distribution mechanism in VIMDS. Methods:Undergraduate and postgraduate Students majoring in health management, and administrative staffs from hospitals were recruited to make choices in the role of directors of institutions. Z-Tree software was used to design the experimental program. 96 subjects participated in the experiment. We gathered 479 valid contracts. Results: 66.39% of the subjects choose flexible contracts. The median of the bidding distribution rate to community health service centers of all auctions was 18.50%. The final distribution rate is about 3 percentage points higher than the bidding distribution rate. The median of the effort level was 9.00. There was a significant correlation between the improvement rate and the choice of effort level (p<0.05) in flexible contracts. Conclusions: The hospital managers have a preference for flexible contracts because of uncertainty in the medical system. Community health service center director may be perfunctory as shading in the integration. Flexible contract and sharing rate beyond participants’ expectation motivate managers to make more cooperative behaviors.


1942 ◽  
Vol 42 (7) ◽  
pp. 847
Author(s):  
Dorothy J. Carter ◽  
Amelia Howe Grant

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