scholarly journals The hospital management practices in Chinese county hospitals and its association with quality of care, efficiency and finance

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yidan Zhu ◽  
Yifei Zhao ◽  
Lixia Dou ◽  
Ruya Guo ◽  
Xuefei Gu ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Performance Appraisal ◽  
Management Practices ◽  
Rating Scale ◽  
Management Practice ◽  
Statistical Significance ◽  
Hospital Management ◽  
Care Quality ◽  
Cross Sectional

Abstract Background County hospitals as the backbone of the China’s healthcare system are providing services for over 70% of the total population. However, the hospital management practice (HMP) and its links with quality of care, efficiency and finance in these hospitals are unknown. Methods We did two cross-sectional surveys of HMP in 2013 and 2015 among 101 county hospitals across rural China. Three managing roles (hospital director, director of medical affairs office and director of cardiology) and a cardiologist were invited to the surveys. A novel HMP rating scale, with 100 as full score, was used to measure the HMP in 17 indicators under four dimensions (target, operation, performance, and talent management) for each hospital. We analyzed the association of HMP score with variables on quality of care, efficiency and finance using linear mixed models with and without adjustment for potential confounders. Findings A total of 95 hospitals participated in at least one survey and were included in the analysis. The overall mean HMP score varied dramatically across the hospitals and 84% of them scored less than 60. The dimension mean HMP score was 38.6 (target), 56.4 (operation), 53.2 (performance) and 55.7 (talent), respectively. The pattern of indicator mean HMP score, however, was almost identical between hospitals with high and low overall HMP score, showing the same ‘strength’ (staff satisfaction, staff performance appraisal, ‘hard wares’, patient-centered services, etc.) and ‘weakness’ (target balance, target setting, continuous quality improvement, penalties on staff with dissatisfied performance, etc.). The associations of overall mean HMP score with quality of care and efficiency variables and cost per hospitalization was not statistically significant. The statistical significance in the association with hospital annual total income disappeared after adjusting for region, teaching status, number of competitors, number of staff and number of beds in use. Conclusion The HMP in Chinese county hospitals scores low in general and was not significantly associated with hospital care quality, efficiency and finance. The current healthcare reform in China should address the micro level issues in hospital management practices.

Residential Care in Hospital and in the Community – Quality of Care and Quality of Life

1996 ◽  
Vol 168 (4) ◽  
pp. 448-456 ◽  
Author(s):  
Geoff Shepherd ◽  
Matt Muijen ◽  
Rachel Dean ◽  
Margaret Cooney
Keyword(s):  
Quality Of Life ◽  
Quality Of Care ◽  
Management Practices ◽  
Housing Association ◽  
Cross Sectional ◽  
Living Situation ◽  
Internal Management ◽  
External Management ◽  
Hospital Wards

BackgroundThe reduction of beds in long-stay hospitals has led to concerns over the quality of care offered to the remaining residents as well as that provided in the community. This study seeks to compare the quality of care and quality of life (reported satisfaction) from residents in both types of setting.MethodA cross-sectional comparison was made of community residential homes and hospital wards drawn randomly from lists provided by local authorities in the outer London area. Samples were drawn from all the main provider types (local authority, housing association, private and joint NHS/voluntary sector). Measures were taken of the quality of the physical environment, staff and resident characteristics, external management arrangements and internal management regimes, resident satisfaction and staff stress. Direct observations were also made of the amount and quality of staff-resident interactions.ResultsIn general, the most disabled residents were found to be still living in hospital in the worst conditions and receiving the poorest quality of care. Although there were some problems with missing data, hospital residents also seemed most dissatisfied with their living situation. There were few differences between community providers regarding either the quality of care provided or the levels of reported satisfaction. Quality of care in the community homes seemed to be much more determined by the personality and orientation of project leaders.ConclusionsPurchasers and providers still need to give attention to the problems of selectively discharging the most able residents to the community, leaving the most disabled being looked after in progressively deteriorating conditions. All residential providers need to review their internal management practices and try to ensure that residents are offered, as far as possible, the opportunity to make basic choices about where and how they will live. Staff training and quality assurance practices need to be reviewed in order to improve the direct quality of care offered to the most disabled individuals.

Nurse Staffing, Missed care, Quality of Care and Adverse Events: A Cross Sectional Study

2021 ◽  
Author(s):  
Apiradee Nantsupawat ◽  
Lusine Poghosyan ◽  
Orn‐Anong Wichaikhum ◽  
Wipada Kunaviktikul ◽  
Yaxuan Fang ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Adverse Events ◽  
Nurse Staffing ◽  
Cross Sectional Study ◽  
Care Quality ◽  
Sectional Study ◽  
Cross Sectional ◽  
Missed Care

scholarly journals The Relationships Between Patient Experience and Quality and Utilization of Primary Care Services

2020 ◽  
Vol 7 (6) ◽  
pp. 1678-1684
Author(s):  
Jaya Aysola ◽  
Chang Xu ◽  
Hairong Huo ◽  
Rachel M Werner
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Patient Experience ◽  
Smoking Status ◽  
Care Quality ◽  
Cross Sectional ◽  
Process Measures ◽  
Care Services ◽  
Patient Reported

We lack knowledge on how patient-reported experience relates to both quality of care services and visit attendance in the primary care setting. Therefore, in a cross-sectional analysis of 8355 primary care patients from 22 primary care practices, we examined the associations between visit-triggered patient-reported experience measures and both (1) quality of care measures and (2) number of missed primary care appointment (no shows). Our independent variables included both overall patient experience and its subdomains. Our outcomes included the following measures: smoking cessation discussion, diabetes eye examination referral, mammography, colonoscopy screening, current smoking status (nonsmoker vs smoker), diabetes control Hemoglobin A1c (HbA1c [<8]), blood pressure control, cholesterol control Low Density Lipoprotein (LDL) among patients with diabetes (LDL < 100), and visit no shows 2 and 5 years after the index visit that triggered the completed patient-experience survey. We found that patient experience, while an important stand-alone metric of care quality, may not relate to clinical outcomes or process measures in the outpatient setting. However, patient-reported experiences with their primary care provider appear to influence their future visit attendance.

scholarly journals Client perceived quality of postnatal care following a normal delivery provided by public sector specialized care institutions in Sri Lanka: A cross sectional study

2019 ◽  
Author(s):  
Sashimali Wickramasinghe ◽  
Wasantha Gunathunga ◽  
Nilmini Hemachandra
Keyword(s):  
Quality Of Care ◽  
Sri Lanka ◽  
Postnatal Care ◽  
Current Data ◽  
Care Quality ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Normal Delivery ◽  
Interpersonal Care

Abstract Background Majority of the maternal and neonatal adverse events take place during the postnatal period. Provision of high-quality care during this period can minimize these events. Assessment of mothers’ perceptions of the quality of care received by them provides valuable feedback to improve the care and ultimately outcomes. Methods A cross sectional survey was conducted in specialized institutions of Colombo district, Sri Lanka, to assess the maternal perceptions of the quality of regular postnatal care and its correlations, using an interviewer administered questionnaire. Descriptive statistics were used to assess the perceptions and multivariate analysis was conducted to assess the significant correlates of positive perceptions. Results The median score obtained for the questionnaire was 108, (96-114). The median scores of the technical care and information domain, interpersonal care domain and ward facilities and cleanliness domain were 43 (38-45), 33 (30-35) and 32 (28-35) respectively. Attending teaching/ specialized hospitals (1.6, p<0.001), 20-35 age group (aOR=1.8, p=0.024), and services such as initiation of breast feeding within one hour of delivery (2.1, p=0.009), pain relief during episiotomy suturing (2.2, p<0.001), practicing KMC (1.4, p=0.035), receiving health advices by doctors or midwives (2.1, p<0.001) were significant correlates of positive perceptions. Conclusions Majority of mothers had favourable perceptions of the quality of care received by them. However, the ward facilities and environment domain has obtained lower ratings compared to technical and interpersonal care domains. Several services were significantly associated with favourable perceptions. Authorities should consider these findings when attempting to improve care quality. Further, this assessment should be carried out regularly to obtain more current data.

scholarly journals Client perceived quality of the postnatal care provided by public sector specialized care institutions following a normal vaginal delivery in Sri Lanka: A cross sectional study

2019 ◽  
Author(s):  
Sashimali Wickramasinghe ◽  
Wasantha Gunathunga ◽  
Nilmini Hemachandra
Keyword(s):  
Quality Of Care ◽  
Sri Lanka ◽  
Postnatal Care ◽  
Care Quality ◽  
Normal Vaginal Delivery ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Interpersonal Care ◽  
Information Domain

Abstract Background: Majority of the maternal and neonatal adverse events take place during the postnatal period. Provision of high-quality care during this period can minimize these events. Assessment of mothers’ perceptions of the quality of care received by them provides valuable feedback to improve the care and ultimately outcomes. Methods: A cross sectional survey was conducted in specialized institutions of Colombo district, Sri Lanka, to assess the maternal perceptions of the quality of regular postnatal care and its correlations, using an interviewer administered questionnaire. The questionnaire contained 23 items distributed under three main domains: technical and information domain, interpersonal care domain and ward facilities and cleanliness domain. Each item was given a score from 1 to 5 and total scores were calculated for the total questionnaire and for each domain. Descriptive statistics were used to assess the perceptions and multivariate analysis was conducted to assess the significant correlates of positive perceptions. Results: The median score obtained for the questionnaire was 108, (Inter Quartile Range 96-114). The median scores of the technical care and information domain, interpersonal care domain and ward facilities and cleanliness domain were 43 (IQR 38-45), 33 (IQR 30-35) and 32 (IQR 28-35) respectively. Attending teaching/ specialized hospitals (1.6, p<0.001), 20-35 age group (aOR=1.8, p=0.024), and services such as initiation of breast feeding within one hour of delivery (2.1, p=0.009), pain relief during episiotomy suturing (2.2, p<0.001), practicing Kangaroo Mother Care (1.4, p=0.035), receiving health advices by doctors or midwives (2.1, p<0.001) were significant correlates of positive perceptions. Conclusions: Majority of mothers had favourable perceptions of the quality of care received by them. However, the ward facilities and environment domain has obtained lower ratings compared to technical and interpersonal care domains. Several services were significantly associated with favourable perceptions. Authorities should consider these findings when attempting to improve care quality. Further, this assessment should be carried out regularly to obtain more current data. Key words: Client perceptions, Postnatal care, Quality of care, Client perceived care, institutional postnatal care

scholarly journals Client perceived quality of the postnatal care provided by public sector specialized care institutions following a normal vaginal delivery in Sri Lanka: a cross sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sashimali Anuradha Wickramasinghe ◽  
Moraendage Wasantha Gunathunga ◽  
Dewabandu Kumarathungalage Nilmini Hemachandra
Keyword(s):  
Quality Of Care ◽  
Sri Lanka ◽  
Postnatal Care ◽  
Care Quality ◽  
Normal Vaginal Delivery ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Interpersonal Care ◽  
Information Domain

Abstract Background Majority of the maternal and neonatal adverse events take place during the postnatal period. Provision of high-quality care during this period can minimize these events. Assessment of mothers’ perceptions of the quality of care received by them provides valuable feedback to improve the care and ultimately outcomes. Methods A cross sectional survey was conducted in specialized institutions of Colombo district, Sri Lanka, to assess the maternal perceptions of the quality of regular postnatal care and its correlations, using an interviewer administered questionnaire. The questionnaire contained 23 items distributed under three main domains: technical and information domain, interpersonal care domain and ward facilities and cleanliness domain. Each item was given a score from 1 to 5 and total scores were calculated for the total questionnaire and for each domain. Descriptive statistics were used to assess the perceptions and multivariate analysis was conducted to assess the significant correlates of positive perceptions. Results The median score obtained for the questionnaire was 108, (Inter Quartile Range 96–114). The median scores of the technical care and information domain, interpersonal care domain and ward facilities and cleanliness domain were 43 (IQR 38–45), 33 (IQR 30–35) and 32 (IQR 28–35) respectively. Attending teaching/ specialized hospitals (aOR=1.6, p < 0.001), 20–35 age group (1.8, p = 0.024), and services such as initiation of breast feeding within 1 h of delivery (2.1, p = 0.009), pain relief during episiotomy suturing (2.2, p < 0.001), practicing Kangaroo Mother Care (1.4, p = 0.035), receiving health advices by doctors or midwives (2.1, p < 0.001) were significant correlates of positive perceptions. Conclusions Majority of mothers had favourable perceptions of the quality of care received by them. However, the ward facilities and environment domain has obtained lower ratings compared to technical and interpersonal care domains. Several services were significantly associated with favourable perceptions. Authorities should consider these findings when attempting to improve care quality. Further, this assessment should be carried out regularly to obtain more current data.

scholarly journals Client perceived quality of postnatal care following a normal delivery provided by public sector specialized care institutions in Sri Lanka: A cross sectional study

2019 ◽  
Author(s):  
Sashimali Wickramasinghe ◽  
Wasantha Gunathunga ◽  
Nilmini Hemachandra
Keyword(s):  
Quality Of Care ◽  
Sri Lanka ◽  
Postnatal Care ◽  
Care Quality ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Normal Delivery ◽  
Interpersonal Care ◽  
Information Domain

Abstract Background: Majority of the maternal and neonatal adverse events take place during the postnatal period. Provision of high-quality care during this period can minimize these events. Assessment of mothers’ perceptions of the quality of care received by them provides valuable feedback to improve the care and ultimately outcomes. Methods: A cross sectional survey was conducted in specialized institutions of Colombo district, Sri Lanka, to assess the maternal perceptions of the quality of regular postnatal care and its correlations, using an interviewer administered questionnaire. The questionnaire contained 23 items distributed under three main domains: technical and information domain, interpersonal care domain and ward facilities and cleanliness domain. Each item was given a score from 1 to 5 and total scores were calculated for the total questionnaire and for each domain. Descriptive statistics were used to assess the perceptions and multivariate analysis was conducted to assess the significant correlates of positive perceptions. Results: The median score obtained for the questionnaire was 108, (Inter Quartile Range 96-114). The median scores of the technical care and information domain, interpersonal care domain and ward facilities and cleanliness domain were 43 (IQR 38-45), 33 (IQR 30-35) and 32 (IQR 28-35) respectively. Attending teaching/ specialized hospitals (1.6, p<0.001), 20-35 age group (aOR=1.8, p=0.024), and services such as initiation of breast feeding within one hour of delivery (2.1, p=0.009), pain relief during episiotomy suturing (2.2, p<0.001), practicing Kangaroo Mother Care (1.4, p=0.035), receiving health advices by doctors or midwives (2.1, p<0.001) were significant correlates of positive perceptions. Conclusions: Majority of mothers had favourable perceptions of the quality of care received by them. However, the ward facilities and environment domain has obtained lower ratings compared to technical and interpersonal care domains. Several services were significantly associated with favourable perceptions. Authorities should consider these findings when attempting to improve care quality. Further, this assessment should be carried out regularly to obtain more current data. Key words: Client perceptions, Postnatal care, Quality of care, Client perceived care, institutional postnatal care

scholarly journals A CROSS SECTIONAL STUDY TO MEASURE PATIENTS' PERCEPTION OF QUALITY OF NURSING CARE AT MEDICAL WARDS

2014 ◽  
Vol 04 (01) ◽  
pp. 021-023
Author(s):  
Tamilselvi A. ◽  
Rajee Reghunath
Keyword(s):  
Quality Of Care ◽  
Nursing Education ◽  
Nursing Care ◽  
Skill Training ◽  
Care Quality ◽  
Cross Sectional ◽  
Perception Of Quality ◽  
Medical Wards ◽  
Quality Of Nursing

Abstract:Traditionally quality of care has been measured against expectations of health professionals and standards rather than being grounded in the perspectives of patients. The most important aspect on which patients' perspective on quality of care depends is “nursing care” because nurses are involved in every aspect of patients' care in hospital. Thus, it is important to measure patients' perception of quality of nursing care in medical wards. A cross sectional descriptive study design was used and total of 50 patients recruited for the study by using purposive sampling technique. Patients' satisfaction with nursing care quality (PSNCQQ) questionnaire was used to measure the patients' perception of quality of nursing care after obtaining reliability. The results revealed that 34% of patients were between the age group of 21-40 years and half of them were males. The total mean score of patients' perception of quality of nursing care was 64.8 with standard deviation of (+) or (-) 13.2 and 40 patients' (80%) perceived overall aspect of quality of nursing care. There were 19 (38%) perceived low quality in the dimensions of providing information and skill and competency. This was supported by the results of the study revealed that almost 1/3 patients (31.6%) perceived that nurses did not offer adequate “explanation and information” about their treatment in hospital and home care and follow up advice. Thus, it was concluded that nurses need to improve their skill and competency and update their knowledge by attending continuing nursing education program and skill training workshops

ASSECSSING MOCA TEST IN SUBACUTE STROKE PATIENTS AND COMPARE MOCA VERSUS MMSE

2016 ◽  
pp. 120-127
Author(s):  
Dinh Toan Nguyen
Keyword(s):  
Human Life ◽  
Statistical Significance ◽  
High Sensitivity ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Female Age ◽  
Subacute Stroke ◽  
Duration Of Illness ◽  
Dsm Iv

Background: Dementia after stroke, particularly subacute period is often overlooked. Today the quality of human life is increasingly high, finding scales that have high value for detection of dementia in patients with stroke is increasingly interested. MoCA test is high sensitivity with mild dementia and identify more abnormalities of awareness caused by vascular, but MoCA have not been studied much in Vietnam. Objective: Assessing MoCA test in subacute stroke patients and compare MoCA versus MMSE in these patients. Subjects: 90 patients with subacute stroke period, these people are being treated at Department of cardiovascular internal medicine at Hue Central Hospital, from 7/2014 - 7/2015. Methods: cross-sectional description and analysis. Results: The mean age is 65.57 ± 13.38, accounting for 54.4% male and 45.6% female. Age, duration of illness has weak correlation with MoCA. The risk factors: hypertension, stroke ischemic transient, alcoholism, smoking, heart disease, diabetes, dyslipidemia related no statistical significance with MoCA. The proportion of dementia in subacute stroke according MoCA is 82.2%. The concordance between MoCA and MMSE was good (kappa = 0.684). Using DSM-IV criteria as the gold standard we found MoCA more valuable in the dementia diagnosis than MMSE (AUC 0.864 versus 0.774, p <0.05). Conclusion: The rate of dementia in stroke subacute period according MoCA is quite high. MoCA is valuable than MMSE in detecting dementia in patients with stroke subacute period, this scale is short, easy to implement so should put into using widely in clinical practice. Key words: MoCA test, subacute stroke, dementia

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