scholarly journals The subjectively perceived quality of postgraduate medical training in integrative medicine within the public healthcare systems of Germany and Switzerland: the example of anthroposophic hospitals

Author(s):  
Peter Heusser ◽  
Sabine Eberhard ◽  
Bettina Berger ◽  
Johannes Weinzirl ◽  
Pascale Orlow
Author(s):  
Anna Lewandowska ◽  
Grzegorz Rudzki ◽  
Tomasz Lewandowski ◽  
Sławomir Rudzki

(1) Background: As the literature analysis shows, cancer patients experience a variety of different needs. Each patient reacts differently to the hardships of the illness. Assessment of needs allows providing more effective support, relevant to every person’s individual experience, and is necessary for setting priorities for resource allocation, for planning and conducting holistic care, i.e., care designed to improve a patient’s quality of life in a significant way. (2) Patients and Methods: A population survey was conducted between 2018 and 2020. Cancer patients, as well as their caregivers, received an invitation to take part in the research, so their problems and needs could be assessed. (3) Results: The study involved 800 patients, 78% women and 22% men. 66% of the subjects were village residents, while 34%—city residents. The mean age of patients was 62 years, SD = 11.8. The patients received proper treatment within the public healthcare. The surveyed group of caregivers was 88% women and 12% men, 36% village residents and 64% city residents. Subjects were averagely 57 years old, SD 7.8. At the time of diagnosis, the subjects most often felt anxiety, despair, depression, feelings of helplessness (46%, 95% CI: 40–48). During illness and treatment, the subjects most often felt fatigued (79%, 95% CI: 70–80). Analysis of needs showed that 93% (95% CI: 89–97) of patients experienced a certain level of need for help in one or more aspects. (4) Conclusions: Patients diagnosed with cancer have a high level of unmet needs, especially in terms of psychological support and medical information. Their caregivers also experience needs and concerns regarding the disease. Caregivers should be made aware of the health consequences of cancer and consider appropriate supportive care for their loved ones.


2016 ◽  
Vol 30 (1) ◽  
pp. 31-56 ◽  
Author(s):  
Renu Agarwal ◽  
Roy Green ◽  
Neeru Agarwal ◽  
Krithika Randhawa

Purpose – The purpose of this paper is to investigate the quality of management practices of public hospitals in the Australian healthcare system, specifically those in the state-managed health systems of Queensland and New South Wales (NSW). Further, the authors assess the management practices of Queensland and NSW public hospitals jointly and globally benchmark against those in the health systems of seven other countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. Design/methodology/approach – In this study, the authors adapt the unique and globally deployed Bloom et al. (2009) survey instrument that uses a “double blind, double scored” methodology and an interview-based scoring grid to measure and internationally benchmark the management practices in Queensland and NSW public hospitals based on 21 management dimensions across four broad areas of management – operations, performance monitoring, targets and people management. Findings – The findings reveal the areas of strength and potential areas of improvement in the Queensland and NSW Health hospital management practices when compared with public hospitals in seven countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. Together, Queensland and NSW Health hospitals perform best in operations management followed by performance monitoring. While target management presents scope for improvement, people management is the sphere where these Australian hospitals lag the most. Practical implications – This paper is of interest to both hospital administrators and health care policy-makers aiming to lift management quality at the hospital level as well as at the institutional level, as a vehicle to consistently deliver sustainable high-quality health services. Originality/value – This study provides the first internationally comparable robust measure of management capability in Australian public hospitals, where hospitals are run independently by the state-run healthcare systems. Additionally, this research study contributes to the empirical evidence base on the quality of management practices in the Australian public healthcare systems of Queensland and NSW.


Author(s):  
George Kuzycz ◽  

Discussion of observations and interviews as to the state of postgraduate medical education in Ukraine during an informal discussion of author’s time as a U.S. Fulbright Scholar for the 2018-2019 academic years for the project titled Postgraduate Medical Education In Ukraine. The interviews with interns (85); attendings, program directors, hospital administrators (75), several medical students and others were recorded during numerous author’s visits and observations (50) to various Ukrainian hospitals. The conclusions made herein are my own and serve to report my observations on the state and quality of postgraduate medical training in Ukraine, reference to that in the United States and the author’s over 45-year practice as a surgeon in Illinois. This mainly concerns internships in the surgical specialties and subspecialties. Some suggestions as to how to change the system are presented.


2017 ◽  
Vol 5 (1) ◽  
pp. 150
Author(s):  
Samwel J. Kabote

This paper examines the effect of corruption on quality of public health services. Corruption, in Tanzania, is a national concern that upsets public health services. There is a public outcry that corruption is increasing in the public health sector while the government’s effort to combat the phenomenon is unimpressive. This poses worries on the quality of public health services. The current study adopted cross-sectional research design, and a total of 180 respondents were involved in the survey. The Mann Whitney U Test was used to compare differences between perceived quality of health services and respondents’ characteristics. Overall, 87.2% of the respondents perceived low quality of health services, and corruption affected quality of health services to a greater extent. Based on age, employment and wealth status, there was significant difference on reporting perceived quality of health services at 5% and 1% level of significance. In addition, respondents’ sex and employment status showed significant difference in reporting the extent to which corruption affected quality of health services at 5% level of significance. The paper draws out two conclusions: first, the quality of health services was low. Second, corruption exacerbated poor quality of health services. To that effect, interventions to combat corruption in the public health sector are needed so as to improve quality of health services.


2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Felippe Leopoldo Dexheimer Neto ◽  
Regis Goulart Rosa ◽  
Bruno Achutti Duso ◽  
Jaqueline Sanguiogo Haas ◽  
Augusto Savi ◽  
...  

Purpose.The long-term outcomes of patients after discharge from tertiary ICUs as they relate to the public versus private healthcare systems in Brazil have not yet been evaluated.Materials and Methods.A multicenter prospective cohort study was conducted to compare the all-cause mortality and the physical functional status (PFS) 24 months after discharge from the ICU between adult patients treated in the public and private healthcare systems. A propensity score- (PS-) matched comparison of all causes of mortality and PFS 24 months after discharge from the ICU was performed.Results.In total, 928 patients were discharged from the ICU including 172 (18.6%) patients in the public and 756 (81.4%) patients in the private healthcare system. The results of the PS-matched comparison of all-cause mortality revealed higher mortality rates among the patients of the public healthcare system compared to those of the private healthcare system (47.3% versus 27.6%,P=0.003). The comparison of the PS-matched Karnofsky performance and Lawton activities of daily living scores between the ICU survivors of the public and private healthcare systems revealed no significant differences.Conclusions.The patients of private healthcare system exhibited significantly greater survival rates than the patients of the public healthcare system with similar PFS following ICU discharge.


2009 ◽  
pp. 166-177
Author(s):  
Giuliano Mariotti

- Creating order: this is the first step needed to prevent the collapse of the public healthcare system. Clinical priority for the healthcare services is a model to create an explicit order based on patients' needs, to guarantee timely referrals. This supports the idea that, despite the general perception that health care is difficult to access, availability of out-patient diagnostic procedures may be sufficient to meet the requirements of patients with major diagnostic needs. In Italy, the Homogeneous Waiting Groups (Raggruppamenti di attesa omogenei, RAO) model is being applied. It involves all those who are part of the process of providing a referral: the family doctor, the booking service (Cup) and the specialist. The model is based on identifying categories for the access to referrals. These allow the prescribers to establish in advance the length of wait considered adequate for a specific patient. To manage a system as complex as this one, it may be useful the socalled "facilitation" management technique. The aim is to guarantee the ongoing improvement of the quality of services, to make waiting times adequate to the clinical needs of citizens and the patients themselves more satisfied. Our experience encourages us to organise educational initiatives and joint courses for family doctors and specialists to reinforce the former's ability to increase their knowledge of appropriateness. At the same time, the involvement of family doctors and specialists may increase the level of concordance regarding the attribution of priority levels and adherence to guidelines' keywords. This will need to be evaluated as such schemes are adopted more widely.Keywords: appropriateness; clinical priority; primary care; waiting lists; clinical needs.


Author(s):  
Anand Parkash Bansal ◽  
Vishnuprasad Nagadevara

Customer satisfaction and client orientation concepts are needed in all service providing organisations, including those engaged in construction and infrastructure provision within the public sector where the public perception about their services is at its lowest. This study measures the expectations and perceptions of various service elements among clients of Military Engineer Services (MES) in India. Customers’ survey mode was used to measure the expectations, perception, importance and satisfaction. The perceived quality of services provided by this department was measured with SERVQUAL instrument on selected attributes using the Gap approach for identifying priorities. Additionally, this study also examines the influence of demographic characteristics of clients on expectations and perceptions of the clients. The results can be used by similar organisations for cultural and structural change to increase accountability and performance, in which the results indicate that the three most important dimensions in the order of importance among the clients of MES are tangibles, responsiveness and reliability.


2020 ◽  
pp. 33-45
Author(s):  
Christopher McKevitt ◽  
Nina Fudge ◽  
Clémence Pinel

Patients and patient organizations, and other members of the public and communities are widely recognized as important stakeholders in processes through which healthcare systems and services are designed, delivered, and monitored. Their involvement in these processes is promoted not only as a strategy to enhance the quality of systems and services, but also as an act of democratic participation. Yet putting involvement into practice is not straightforward. This chapter outlines the field of involvement in healthcare, focusing on some of the key areas of debate. These include definitions of involvement, the rationales put forward, involvement as represented in policy, and the methods used. The chapter summarizes some current key debates in relation to questions of who is involved, power, and evidence of effectiveness.


2014 ◽  
Vol 11 (3) ◽  
pp. 188-197 ◽  
Author(s):  
Veronica Schoj ◽  
Raul Mejia ◽  
Mariela Alderete ◽  
Celia P. Kaplan ◽  
Lorena Peña ◽  
...  

Background: Physician-implemented interventions for smoking cessation are effective but infrequently used. We evaluated smoking cessation practices among physicians in Argentina.Methods: A self-administered survey of physicians from six clinical systems asked about smoking cessation counselling practices, barriers to tobacco use counselling and perceived quality of training received in smoking cessation practices.Results: Of 254 physicians, 52.3% were women, 11.8% were current smokers and 52% never smoked. Perceived quality of training in tobacco cessation counselling was rated as very good or good by 41.8% and as poor/very poor by 58.2%. Most physicians (90%) reported asking and recording smoking status, 89% advised patients to quit smoking but only 37% asked them to set a quit date and 44% prescribed medications. Multivariate analyses showed that Physicians' perceived quality of their training in smoking cessation methods was associated with greater use of evidence-based cessation interventions. (OR = 6.5; 95% CI = 2.2–19.1); motivating patients to quit (OR: 7.9 CI 3.44–18.5), assisting patients to quit (OR = 9.9; 95% CI = 4.0–24.2) prescribing medications (OR = 9.6; 95% CI = 3.5–26.7), and setting up follow-up (OR = 13.0; 95% CI = 4.4–38.5).Conclusions: Perceived quality of training in smoking cessation was associated with using evidence-based interventions and among physicians from Argentina. Medical training programs should enhance the quality of this curriculum.


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