Prediction of the financial performance of Ontario hospitals: A Test of Environmental Determinist and Adaptationist Perspectives

1996 ◽  
Vol 9 (3) ◽  
pp. 137-155 ◽  
Author(s):  
L. Narine ◽  
G. Pink ◽  
P. Leatt
Keyword(s):  
Environmental Factors ◽  
Financial Performance ◽  
Financial Distress ◽  
Cross Validation ◽  
Structural Characteristics ◽  
Public Hospitals ◽  
Cross Sectional ◽  
Policy Makers ◽  
Hospital Size ◽  
Hospital Managers

While other industries for many years have been concerned with the problem of financial distress, it is only recently that this issue has become a matter of interest to hospital managers, policy makers, and the general public. However, the determinants of hospital financial performance are neither well studied nor understood. The objectives of this study were to identify factors that affect the financial performance of Ontario hospitals and to construct a model that could be used to predict financial performance in the future. A number of organization and environmental factors that could influence financial performance were postulated and then tested for their statistical impact and predictive ability. Cross-sectional data over the 3-year-period 1986–1988 for 223 Ontario public hospitals were used. The first 2 years of data served as a derivation sample for hypothesis testing and development of a predictive model. The third year of data was used as a holdout sample for cross validation. Information on the variables investigated came from secondary sources, in particular Statistics Canada's Annual Hospital Returns. Univariate analyses revealed distressed hospitals were more likely to earn more revenues from non-government sources, to be non-teaching institutions and have longer chronic lengths of stay, and to be found in areas with higher per capita incomes, number of females in the population, physician supply, and area wage rates. A five variable prediction model was developed which accounted for 25% of the variance in financial performance in the derivation sample and on cross validation dropped to 21%. The model identified greater hospital size, older plants, higher technological complexity, more intensive care services, and location in areas with more females to be significant predictors of financial distress. Overall, environmental factors (community and structural characteristics) were more important in influencing financial performance. The implication for hospital managers is to underscore that an important dimension of successful leadership requires they remain outwardly focused and involved in managing the external environment. For policy makers the need is to develop funding formulae which encourage efficiency and are also responsive to differences in community and structural characteristics across hospitals.

scholarly journals The Competency Movement in Public Hospitals: Analysing the Competencies of Hospital Executive Managers

2021 ◽  
pp. 22-43
Author(s):  
Mehtap ÇAKMAK BARSBAY ◽  
Mustafa Kemal ÖKTEM
Keyword(s):  
Assessment Tool ◽  
Management Training ◽  
Healthcare Management ◽  
Public Hospitals ◽  
Public Healthcare ◽  
Healthcare Organizations ◽  
Self Assessment ◽  
Cross Sectional ◽  
Hospital Managers ◽  
Executive Managers

"Our primary aim was to provide a quantitative snapshot relying on a self-assessment tool developed for the local healthcare environment and formal tasks for top-level executive hospital managers of public healthcare organizations. We used a cross-sectional and descriptive mixed study design that targeted the nationwide population of 701 top-level managers in public hospitals in 2015 in Turkey. As the first step, position description content analysis was conducted based on document analysis to explore their legal tasks and statements, and the job requirements for an executive management position in public hospitals. Second, before designing the data-collection instrument, we conducted four meetings and group discussions with several hospital managers – with and without medical backgrounds – and five academics who were part of healthcare management and public administration departments. Lastly, we built upon past efforts and the literature, and constructed a questionnaire. The managers are fully responsible for the healthcare quality, medical, nursing, administrative issues and financial performance of the facility. The participants perceived that they were competent in most of the competencies. The participants’ mean total competency score was 81%, and the competency gap between the required and current competency levels differed from 13% to 22%. This research provides deep insight into the competencies perceived by hospital executive managers in a developing country context. Our results have several practical implications for both healthcare policymakers and new executive hospital managers. There is an urgent need for follow-up self-assessment for competencies and ongoing management training programs."

scholarly journals What Ibero-American hospitals do when things go wrong? A cross-sectional international study

2020 ◽  
Vol 32 (5) ◽  
pp. 313-318
Author(s):  
José Joaquín Mira ◽  
Irene Carrillo ◽  
Ezequiel García-Elorrio ◽  
Daniela Campos D E Andrade-Lourenção ◽  
Patricia Campos Pavan-Baptista ◽  
...  
Keyword(s):  
Action Plan ◽  
International Study ◽  
Public Hospitals ◽  
Future Research ◽  
Strategic Action ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Private Hospitals ◽  
Hospital Managers ◽  
Depth Analysis

Abstract Objective To know what hospital managers and safety leaders in Ibero-American countries are doing to respond effectively to the occurrence of adverse events (AEs) with serious consequences for patients. Design Cross-sectional international study. Setting Public and private hospitals in Ibero-American countries (Argentina, Brazil, Chile, Colombia, Mexico, Peru, Portugal and Spain). Participants A convenience sample of hospital managers and safety leaders from eight Ibero-American countries. A minimum of 25 managers/leaders from each country were surveyed. Interventions A selection of 37 actions for the effective management of AEs was explored. These were related to the safety culture, existence of a crisis plan, communication and transparency processes with the patients and their families, attention to second victims and institutional communication. Main Outcome Measure Degree of implementation of the actions studied. Results A total of 190 managers/leaders from 126 (66.3%) public hospitals and 64 (33.7%) private hospitals participated. Reporting systems, in-depth analysis of incidents and non-punitive approaches were the most implemented interventions, while patient information and care for second victims after an AE were the least frequent interventions. Conclusions The majority of these hospitals have not protocolized how to act after an AE. For this reason, it is urgent to develop and apply a strategic action plan to respond to this imperative safety challenge. This is the first study to identify areas of work and future research questions in Ibero-American countries.

TO EVALUATE THE PERFORMANCE OF A TEACHING HOSPITAL BY COMBINING THE HOSPITAL INDICES USING THE PABON LOSSO MODEL DURING THE SURVEILLANCE BY AUTHORITIES:HAWTHORNE EFFECT

2021 ◽  
pp. 75-77
Author(s):  
C. Narender Kumar
Keyword(s):  
Teaching Hospital ◽  
Public Hospital ◽  
Quality Care ◽  
Hospital Performance ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Hawthorne Effect ◽  
Cross Sectional ◽  
Policy Makers ◽  
The Public

BACKGROUND:The patients' health care choice is diverting from the private health provider to the public hospital due to introduction of various schemes and incentives by the policy makers. The limited resources are posing a challenge to the hospital administrator in escalating demands, diversity and complexity of diseases of patients. The hospital performance enhances steadily by the monitoring authorities' surveillance. It is an effective method for improving quality care in the public hospital. The Hawthorne effect is a term referring to the tendency of people to work harder and increases in effectiveness of organization when they are being observed. OBJECTIVES: 1. To assess the performance of a teaching hospital during surveillance by calculating the hospital indices, using the Pabon Losso Model. 2. To evaluate whether the Hawthorne effect is the cause of the increase in the effectiveness of hospital. MATERIALS AND METHODS: The study was a prospective and record based cross-sectional study and conducted at Government teaching hospital over a period of 18 months. RESULTS: st A total of 18 months period census report was recorded from January 2016 to June 2017and hospital indices were estimated. The 1 phase of surveillance (January- 2016 to May -2016), where immense supervision was present, with performance feed- back, BOR was 88.65, nd ALOS was 3.932, BTR was 7.074 and BTI was 0.54, 2 phase of surveillance which was intensied with communication and committee meetings rd (June-2016 to October- 2016), BOR was 95.59, ALOS was 3.49, BTR was 7.03 and BTI was 0.886, 3 phase weaning period, where a little th supervision (November -2016 to February-2017) BOR was 87.8, ALOS was 4.1, BTR was 6.413 and BTI was 0.5725 and 4 phase self sustain stage or no observations phase, BOR was 92.6, ALOS was 3.47, BTR was 6.547 and BTI was 0.28. CONCLUSION: The surveillance of higher authorities over the hospital had increased the performance. Hospital efciency is reected by increased hospital indices. The cause and effect is the “Hawthorne effect”. Therefore it is concluded that the surveillance increases the performance and efciency of the public hospitals.

scholarly journals Patient Satisfaction with Rural Medical Services: A Cross-Sectional Survey in 11 Western Provinces in China

2019 ◽  
Vol 16 (20) ◽  
pp. 3968 ◽  
Author(s):  
Jinlin Liu ◽  
Ying Mao
Keyword(s):  
Patient Satisfaction ◽  
Medical Services ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Policy Makers ◽  
Hospital Managers ◽  
Health Related ◽  
The Mean ◽  
Trust In Physicians ◽  
Shed Light

Rural medical services play an important role in protecting and promoting the health of the rural population; however, patient satisfaction with rural medical services has been understudied in China. A better understanding of the actual situation and the determinants involved will provide evidence for health-related policy makers and hospital managers to further improve rural medical services. A total of 9811 patients (5208 outpatients and 4603 inpatients) were included in this study from a cross-sectional survey conducted in rural hospitals from 11 western provinces in China. Three in five patients (including outpatients and inpatients) were satisfied with rural medical services. The mean overall satisfaction scores were 3.61 ± 0.857 and 3.80 ± 0.829 (out of a maximum of 5) for rural outpatients and inpatients, respectively. The most satisfying domains for outpatients and inpatients were medical service attitude and illness explanation, and waiting time and medical expenses were the domains that outpatients and inpatients were least satisfied with. Satisfaction with medical technology (OR: 1.73; 95% CI: 1.57–1.92) and satisfaction with trust in physicians (OR: 2.05; 95% CI: 1.85–2.28) were identified as the strongest predictors of outpatients’ and inpatients’ overall satisfaction with rural medical services, respectively. This study might shed light on rural medical services management in China.

scholarly journals Case for hospital nurse-to-patient ratio legislation in Queensland, Australia, hospitals: an observational study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036264 ◽  
Author(s):  
Matthew D McHugh ◽  
Linda H Aiken ◽  
Carol Windsor ◽  
Clint Douglas ◽  
Patsy Yates
Keyword(s):  
Quality Of Care ◽  
Emotional Exhaustion ◽  
Nurse Staffing ◽  
Patient Characteristics ◽  
Public Hospitals ◽  
Job Dissatisfaction ◽  
Additional Patient ◽  
Cross Sectional ◽  
Hospital Size

ObjectivesTo determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio legislation targeting medical-surgical wards, and if so, the extent to which nurse staffing variation was associated with poor outcomes for patients and nurses.DesignAnalysis of cross-sectional data derived from nurse surveys linked with admitted patient outcomes data.SettingPublic hospitals in Queensland.Participants4372 medical-surgical nurses and 146 456 patients in 68 public hospitals.Main outcome measures30-day mortality, quality and safety indicators, nurse outcomes including emotional exhaustion and job dissatisfaction.ResultsMedical-surgical nurse-to-patient ratios before implementation of ratio legislation varied significantly across hospitals (mean 5.52 patients per nurse; SD=2.03). After accounting for patient characteristics and hospital size, each additional patient per nurse was associated with 12% higher odds of 30-day mortality (OR=1.12; 95% CI 1.01 to 1.26). Each additional patient per nurse was associated with poorer outcomes for nurses including 15% higher odds of emotional exhaustion (OR=1.15; 95% CI 1.07 to 1.23) and 14% higher odds of job dissatisfaction (OR=1.14; 95% CI 1.02 to 1.28), as well as higher odds of concerns about quality of care (OR=1.12; 95% CI 1.01 to 1.25) and patient safety (OR=1.32; 95% CI 1.11 to 1.57).ConclusionsBefore ratios were implemented, nurse staffing varied considerably across Queensland hospital medical-surgical wards and higher nurse workloads were associated with patient mortality, low quality of care, nurse emotional exhaustion and job dissatisfaction. The considerable variation across hospitals and the link with outcomes suggests that taking action to improve staffing levels was prudent.

scholarly journals Assessing the use of Hospital Information Systems (HIS) to support decision-making: A cross-sectional study in public hospitals in ​​Huila, sanitary region of southern Angola.

2021 ◽  
Author(s):  
Tomas Hambili Sanjuluca ◽  
Ricardo Cruz Correia ◽  
Anabela Antunes de Almeida
Keyword(s):  
Decision Making ◽  
Information Systems ◽  
Cross Sectional Study ◽  
Hospital Information Systems ◽  
Public Hospitals ◽  
No Production ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hospital Managers ◽  
Support Decision Making

Abstract Background Some previous studies have reported that hospital medical assistance in Angola lacks efficiency. There is no production of information on health financing or even health spending that could help monitor equity. Hospital information systems (HIS) could be relevant tools to inform hospital managers, supporting better management decisions in healthcare and, consequently, increasing efficiency. Nonetheless, the effective use of these systems by hospital managers to support decision-making in Angola is unknown. This study aimed to analyze the use of HIS as a tool to support decision-making by hospital managers in Huila, Angola. Methods This is a descriptive–cross-sectional study that was inducted between July and September 2017 in seven hospitals in Huila Province, Angola, specifically in Lubango and Matala cities. Each hospital board included four to six managers (e.g., general, clinical, administrative, nursing, diagnostic and therapeutic, and teaching and training managers). Thirty-six members of the hospital boards filled on a self-questionnaire that consisted of twenty questions based on the following issues: characterization of the interviewee's profile; availability of information in the institution; quality and usefulness of the available operational information and satisfaction with the existing HIS. Perform data analysis with IBM SPSS Statistics, version 21.0 Results At least ⅔ of the participants reported being unsatisfied or relatively satisfied with each of the HIS-specific features that were assessed. More than 50%have rarely or never used the health information system to support decision-making, and 47.2% have never noted audits performed in their institution. Only 25% of the participants considered that the HIS stored information was satisfactory to calculate the rate of service indicators. Conclusion Our study showed that most hospital managers don’t use hospital information systems as tools to support management-related decision-making in Angola. Improving the Hospital information systems, ability to compute adequate indicators, and providing training on HIS usage to hospital managers could be targets of future interventions to support better management-related decision-making in Angolan healthcare.

scholarly journals Financial Performance of Public Hospitals: A Cross-Sectional Study among Polish Providers

2020 ◽  
Vol 17 (7) ◽  
pp. 2188 ◽  
Author(s):  
Katarzyna Dubas-Jakóbczyk ◽  
Ewa Kocot ◽  
Anna Kozieł
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Financial Performance ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Legal Form

There is growing evidence of a positive association between health care providers’ financial standing and the quality of care. In Poland, the instable financial situation and growing debt of public hospitals has been a source of concern for more than two decades now. The objectives of this paper were to compare the financial performance of public hospitals in Poland, depending on the ownership and organizational form; and analyze whether there is an association between financial performance and the chosen variables. We conducted a cross sectional study covering the whole population of public hospitals operating in 2018. The total number of included units was 805. The hospitals’ financial outcomes were measured by several variables; Spearman’s rank correlation was calculated, and a multivariable logistic regression model was performed. In 2018, the majority of public hospitals in Poland (52%) generated a gross loss, while 40% hospitals had overdue liabilities. There were statistically significant differences between hospital groups, with university hospitals and those owned by counties (local hospitals) being in the most disadvantageous situation. Additionally, corporatized public hospitals performed worse than those functioning in the classic legal form of independent health care units. Urgent actions are needed to measure and monitor the potential impact of financial performance on the quality of care.

scholarly journals Green Growth, Green Technology, and Environmental Health: Evidence From High-GDP Countries

2022 ◽  
Vol 9 ◽  
Author(s):  
Zahid Hussain ◽  
Bilal Mehmood ◽  
Muhammad Kaleem Khan ◽  
Raymondo Sandra Marcelline Tsimisaraka
Keyword(s):  
Energy Consumption ◽  
Environmental Factors ◽  
Nonlinear Effects ◽  
Green Technology ◽  
Green Growth ◽  
Cross Sectional ◽  
Policy Makers ◽  
Linear Effect ◽  
Growth Energy ◽  
Econometric Approach

Green growth is an exceptional strategy for sustainable development. It provides a pathway to combat environmental issues and the use of natural resources. This study investigates the effects of green technology and environmental factors on green growth in high-gross domestic product (GDP) countries from 2000 to 2020. In addition, it also probes the linear and nonlinear effects of GDP on green growth. To do so, we employ an advanced econometric approach, e.g., a cross-sectional autoregressive distributed lags estimator for long and short runs. The outcomes demonstrate that the linear effect of GDP is positive for green growth. On the contrary, the nonlinear effect of GDP has a negative magnitude for green growth. Besides, green technology substantially increases green growth. Energy consumption is found to be an important influencer, and it decreases green growth. Environmental factors such as emissions, according to the findings, also reduce green growth in the sample countries. It is worth noting that the joint effects of energy consumption and emissions deteriorate green growth in countries. Based on empirical findings, for policy makers, this study suggests that high-GDP countries should manage their economic and environmental activities in order to increase the amount of green growth that may protect the ecological environment.

scholarly journals Financial performance of public hospitals: a cross-sectional study among Polish providers

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Dubas-Jakóbczyk ◽  
E Kocot ◽  
A Kozieł
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Financial Performance ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Sectional Study ◽  
Cross Sectional ◽  
Financial Situation ◽  
Research Institutes

Abstract Background there is growing evidence of a positive association between health care providers' financial standing and the quality of care. In Poland, the instable financial situation and growing debt of public hospitals has been a source of concern for more than two decades now. The objectives were: (1) to compare the financial performance of public hospitals, depending on the ownership and organizational form; (2) to analyze whether there is an association between financial performance and the chosen variables (e.g., total assets, revenues). Methods we conducted a cross sectional study covering the whole population of public hospitals operating in 2018. The total number of included units was 805 (659 classic public hospitals, 17 research institutes and 129 corporatized). The hospitals' financial outcomes were measured by several variables and compared between the hospital groups; Spearman's rank correlation was calculated and a multivariable logistic regression model was performed. Results in 2018, the majority of public hospitals in Poland (52%) generated a gross loss, while 40% hospitals had overdue liabilities. There were statistically significant differences between hospital groups, with university hospitals and those owned by counties (local hospitals) being in the most disadvantageous situation. Also, corporatized public hospitals performed worse than those functioning in the classic legal form of independent health care units. All three variables which can be used as proxy indicators of hospital size (total assets, revenues or costs) were positively correlated with the value of overdue liabilities and the debt ratio, and negatively correlated with the gross profit margin. Conclusions there is high diversity in public hospital financial standing in Poland, with numerous units facing liquidity problems in 2018. Urgent actions are needed to measure and monitor the potential impact of financial performance on the quality of care. Key messages The instable financial situation and growing debt of public hospitals in Poland has been a source of concern for more than two decades now. In 2018, local hospitals owned by counties as well as highly-specialized university clinics and research institutes were in the most disadvantageous financial situation.

scholarly journals Predictors of Women’s Satisfaction with Hospital-Based Intrapartum Care in Asmara Public Hospitals, Eritrea

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Meron Mehari Kifle ◽  
Filmon Abraham Ghirmai ◽  
Soliana Amanuel Berhe ◽  
Winta Sium Tesfay ◽  
Yodit Teklemariam Weldegebriel ◽  
...  
Keyword(s):  
Service Providers ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Health Providers ◽  
Intrapartum Care ◽  
Chi Square ◽  
Cross Sectional ◽  
Policy Makers ◽  
Maternity Hospitals ◽  
The Difference

Background. Exploring patient satisfaction contributes to provide quality maternity care, but there is paucity of epidemiologic data in Eritrea. Objectives. To determine the predictors of women's satisfaction with intrapartum care in Asmara public maternity hospitals in Eritrea. Methods. A cross-sectional study among 771 mothers who gave birth in three public Hospitals. Chi-square tests were done to analyze the difference in proportion and logistic regression to assess the predictors of satisfaction with intrapartum care. Results. Overall, only 20.8% of the participants were satisfied with intrapartum service. The key predictors of satisfaction with intrapartum care were provision of clean bed and beddings (AOR = 18.87, 2.33–15.75), privacy during examinations (AOR = 10.22, 4.86–21.48), using understandable language (AOR = 8.72, 3.57–21.27), showing how to summon for help (AOR = 8.16, 4.30–15.48), showing baby immediately after birth (AOR = 8.14, 2.87–23.07), control of the delivery room (AOR = 6.86, 2.65–17.75), receiving back massage (AOR = 6.43, 3.23–12.81), toilet access and cleanliness (AOR = 6.09, 3.25–11.42), availability of chairs for relatives (AOR = 5.96, 3.14–11.30), allowing parents to stay during labour (AOR = 3.52, 1.299–9.56), and request for permission before any procedure (AOR = 2.39, 1.28–4.46). Conclusion. To increase satisfaction with intrapartum care, maternity service providers need to address the general maternity ward cleanliness, improve the quality of physical facilities, and sensitize health providers for better communication with clients. Policy makers need to adopt strategies that ensure more women involvement in decision making and consideration of privacy and reassurance needs during the whole delivery process.

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