Investigating the effect of health transformation plan on the public hospitals performance indicators; a case study from Iran

Abstract Background Health systems need constant changes and reforms in their structure to adapt to changing conditions and meet the needs of society. One of the fundamental changes in the health system of Iran is the health transformation plan (HTP), the effects of which must be examined from different aspects. Therefore, the purpose of this study is to investigate the effect of HTP on the performance indicators of public hospitals in Yazd city, Iran. Methods This cross-sectional study was carried out in all public hospitals in city of Yazd. Six performance indicators were examined monthly and in two time periods of 12 months before and 12 months after the implementation of Health Transformation Plan (HTP). The data was analyzed by SPSS software program version 22, using the paired T-test, and the Interrupted Time Series (ITS) model. Findings Findings showed that the performance indicators of the studied hospitals have improved after the implementation of the HTP. According to the ITS model, the implementation of HTP did not have a significant effect on the level and trend of the bed rotation distance, average length of stay and the ratio of surgical operations to bed indicators. However, it had a statistically significant effect on the level and trend of mortality and hospitalization rates. Moreover, the implementation of HTP had a significant effect on the level of the bed occupancy rate, but did not have a significant effect on the trend of this indicator. Conclusion Based on the research findings, all the selected indicators changed to some extent after the implementation of HTP, which showed the effect of this plan on the performance of hospitals. However, not all indicators were statistically significant as the findings sub-section revealed.

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Effect of Health Transformation Plan on the Public Hospitals Performance Indicators; a case study in Iran

10.21203/rs.3.rs-38410/v1 ◽

2020 ◽

Author(s):

Mohammad Ranjbar ◽

Hassan Jafari ◽

Mohammad Baziyar ◽

Mohsen Pakdaman ◽

Vahid Pirasteh

Keyword(s):

Performance Indicators ◽

Average Length ◽

Interrupted Time Series ◽

Cross Sectional Study ◽

Public Hospitals ◽

Health Coverage ◽

Monthly Basis ◽

Cross Sectional ◽

Average Length Of Stay ◽

Before And After

Abstract Introduction: Health systems need constant changes and reforms in their structure in order to adapt to changing conditions and meet the needs of society. One of the fundamental changes in the health system of Iran is the health transformation plan (HTP), the effects of which must be examined from different aspects. Therefore, the purpose of this study is to investigate the effect of HTP on the performance indicators of public hospitals in the context of Yazd. Methods: The present cross-sectional study was carried out in all public hospitals in Yazd. Six performance indicators were examined on a monthly basis and in two time periods of 12 months before and after the implementation of HTP. Data were analyzed using SPSS software program version 22, the paired T-test and the Interrupted Time Series model. Findings: The implementation of the health transformation plan did not have a significant effect on the bed rotation distance, average length of stay and the ratio of surgical operations to bed indicators (p> 0.05). However, it had a statistically significant effect on the level and trend of mortality and hospitalization rates (p <0.05). Moreover, the implementation of HTP had a significant effect on the level of the bed occupancy indicator (P <0.05), but did not have a significant effect on the trend of this indicator (p> 0.05).Conclusion: Based on the research findings, all the selected indicators changed to some extent after the implementation of HTP, which in a way showed the effect of this plan on the performance of hospitals. Therefore, the continuation of such a plan, provided that sustainable financial resources are planned and human and physical resources are organized properly, can be an important step towards achieving universal health coverage and increasing justice in access to services.

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Effect of Health Transformation Plan on the Public Hospitals Performance Indicators; A Case Study in Iran

10.21203/rs.3.rs-81488/v1 ◽

2020 ◽

Author(s):

Mohammad Ranjbar ◽

Hassan Jafari ◽

Mohammad Baziyar ◽

Mohsen Pakdaman ◽

Vahid Pirasteh

Keyword(s):

Performance Indicators ◽

Average Length ◽

Interrupted Time Series ◽

Cross Sectional Study ◽

Public Hospitals ◽

Health Coverage ◽

Monthly Basis ◽

Cross Sectional ◽

Average Length Of Stay ◽

Before And After

Abstract IntroductionHealth systems need constant changes and reforms in their structure in order to adapt to changing conditions and meet the needs of society. One of the fundamental changes in the health system of Iran is the health transformation plan (HTP), the effects of which must be examined from different aspects. Therefore, the purpose of this study is to investigate the effect of HTP on the performance indicators of public hospitals in the context of Yazd. MethodsThe present cross-sectional study was carried out in all public hospitals in Yazd. Six performance indicators were examined on a monthly basis and in two time periods of 12 months before and after the implementation of HTP. Data were analyzed using SPSS software program version 22, the paired T-test and the Interrupted Time Series model. FindingsThe implementation of the health transformation plan did not have a significant effect on the bed rotation distance, average length of stay and the ratio of surgical operations to bed indicators (p> 0.05). However, it had a statistically significant effect on the level and trend of mortality and hospitalization rates (p <0.05). Moreover, the implementation of HTP had a significant effect on the level of the bed occupancy indicator (P <0.05), but did not have a significant effect on the trend of this indicator (p> 0.05).ConclusionBased on the research findings, all the selected indicators changed to some extent after the implementation of HTP, which in a way showed the effect of this plan on the performance of hospitals. Therefore, the continuation of such a plan, provided that sustainable financial resources are planned and human and physical resources are organized properly, can be an important step towards achieving universal health coverage and increasing justice in access to services.

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SCHIZOPHRENIA AND EPILEPSY: WHAT LINKS BETWEEN? ARRAZI HOSPITAL EXPERIENCE ABOUT 56 CASES

International Journal of Advanced Research ◽

10.21474/ijar01/13263 ◽

2021 ◽

Vol 9 (08) ◽

pp. 293-299

Author(s):

S. Benzahra ◽

◽

A. Karara ◽

H. Nafiaa ◽

A. Ouanass ◽

...

Keyword(s):

Psychotic Disorders ◽

Age Of Onset ◽

Average Length ◽

Cross Sectional Study ◽

Cross Sectional ◽

Average Length Of Stay ◽

Management Algorithm ◽

History Of ◽

Generalized Epilepsy ◽

Patients With Epilepsy

Background: Given the higher incidence of psychotic disorders in patients with epilepsy, several neurologists and psychiatrists have attempted to explain this controversial comorbidity. Thus, several hypotheses have been put forward but no link has been established with certainty until today. Objectives: The aim of our work is to draw up a socio-demographic and psychopathological profile of patients with schizophrenia-epilepsy comorbidity as well as to assess the risk of suicide, the management, the reasons for admission and the length of hospitalization. Methodology: we conducted a retrospective cross-sectional study on medical records of patients with schizophrenia and epilepsy who were hospitalized at the Ar-Razi University Psychiatric Hospital in SalÃ© between January 01, 2017 and March 31, 2021. Results: Our study included 56 patients. The average age was 33 + / - 9.83, 55% male. 50% of patients had attempted suicide in the past and 25% had a history of depressive episode, 41.1% had substance use disorder and 26.8% had a family history of psychosis. 85.7% of our patients developed schizophrenia from pre-existing epilepsy the time to onset of schizophrenia compared to epilepsy was 11.08 years +/- 7.71. The mean age of onset of schizophrenia is 23.3 years with a mean duration of progression of 9.18 years, 55.4% of patients were on monotherapy and 8.9% had resistant schizophrenia on clozapine. The average age of onset of epilepsy is 14.73 years, with generalized epilepsy in 84% of cases. The average length of stay is 42 days. The reasons for admission were as follows: hetero-aggression 78.6%, delusional verbalization 85.7% and suicide attempt 23.2%. The majority of our patients have been treated with atypical antipsychotics: Risperidone 30.4%, Amisulpride 21.4% and Aripiprazole 12.5%. Conclusion: The co-occurrence of schizophrenia epilepsy suggests the existence of possible common etiopathogenic factors. The management of this comorbidity requires a multidisciplinary collaboration between neurologist and psychiatrist, in order to confirm the diagnosis, establish a good therapeutic approach and propose a management algorithm taking into account the two pathologies.

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The epidemiological study of migraine and other headache syndromes in southern Brazil: hospitalizations and average length of stay in 2020.

10.5327/1516-3180.042 ◽

2021 ◽

Author(s):

Júlia Maria Orsini Zava ◽

Tais Lorrane Mendes Silva ◽

Gabriela Biazi Barbosa ◽

Fabio Rosnei da Silva ◽

Gabriela Dias Silva Dutra Macedo

Keyword(s):

Average Length ◽

Length Of Hospital Stay ◽

Epidemiological Survey ◽

Cross Sectional Study ◽

Age Group ◽

Southern Brazil ◽

Cross Sectional ◽

Southern States ◽

Average Length Of Stay ◽

Using Data

Introduction: Migraine is one of the most common headaches and a frequent population complaint, presenting different symptoms and intensities. Objective: The objective is to carry out an epidemiological survey and the average length of hospital stay in the southern states of Brazil. Methodology: This is an epidemiological, descriptive and cross-sectional study. Design and setting: Is a carried out using data collected from DATASUS, during 2020 year in southern Brazil. Results: In the proposed period, there were 2,662 hospitalizations, with the state of PR the largest number (1,760). As for the average hospitalization, the RS stands out with 4 days, SC presents 2.8 and PR with 2.3. Regarding the age group, in PR it is between 40-49 years old, SC between 30-39 and in RS 50-59. As for gender, the prevalence is higher among women, with 63.11% of the total. Conclusion:The data are in agreement with the literature, confirming that women are more affected, being justified by numerous factors, from hormonal variations to different responses to the perception of stress and pain. The high average length of hospitalizations indicates the need to develop policies to discuss the issue, providing adequate prophylaxis and therapy, reducing the number of the cases, the intensity of crises and hospitalizations.

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Epidemiological comparison of stroke patients before and after Cincinatti Scale implementation

10.5327/1516-3180.589 ◽

2021 ◽

Author(s):

Brenda Luiza de Sousa Sanches ◽

Gabriela Malaquias Barreto Gomes ◽

Larissa Melo Targino ◽

Julia do Vale Moura Costa ◽

Thaís Lima Barreto ◽

...

Keyword(s):

Mortality Rate ◽

Average Length ◽

Cerebral Arteries ◽

Cross Sectional Study ◽

Cross Sectional ◽

Average Length Of Stay ◽

Premature Deaths ◽

Before And After ◽

The One ◽

Early Stroke

Introduction: Stroke is an obstruction or rupture of cerebral arteries that leads to brain damage. The Cincinnati Prehospital Stroke Scale (CPSS) aims to identify early stroke signs. Objectives: To epidemiologically compare stroke victims in Brazil before and after CPSS implementation. Design and setting: A cross-sectional study in Brazil. Methods: Data collected was published by the Health Ministry through DATASUS. A ten-year period was selected before and after the Cincinnati Scale (2010) implementation in Brazil. The data collected were mortality rate, lethality and average length of stay. Results: The average stroke mortality rate from 2000 to 2009 was 16.99, while from 2011 to 2020 it was 15.10, representing a 12,5% reduction. However, comparing these same periods, the average lethality rate increased by 4.92%. The median of stay averages before the implementation of the CPSS is 7.15 days, whereas the one afterwards is 7.45. Conclusions: The CPSS aims to identify stroke by evaluating weakness, speech and facial drop. A significant reduction in mortality has been noted since the implementation of the protocol, which may suggest its effectiveness in early stroke detection. Before the scale, the treatment was possibly late, leading to worse prognosis. Thus, the average stay increase between the evaluated periods could be explained by premature deaths.

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Intrabases divergences in the mHealth era: a drug interaction investigation in an infectious-diseases hospital setting

Research Society and Development ◽

10.33448/rsd-v10i14.17156 ◽

2021 ◽

Vol 10 (14) ◽

pp. e559101417156

Author(s):

Roberta Souza ◽

Pedro Ivo da Silva ◽

Paulo César Cascao ◽

Clarissa Alencar Sousa ◽

Angela Ferreira Lopes

Keyword(s):

Drug Interaction ◽

Average Length ◽

Anatomical Therapeutic Chemical ◽

Hospital Setting ◽

Cross Sectional Study ◽

Healthcare Applications ◽

Cross Sectional ◽

Average Length Of Stay ◽

Reference Hospital ◽

Aid Decision

Introduction: Information on potential drug interactions (PDI) are obtained from databases available on the web or through mobile healthcare applications (mHealth), and can prevent unfavorable clinical outcomes for patients. This study compared PDI information available in Micromedex® drug interaction checker, its web version and its mHealth app. Method: A cross-sectional study realized based on a retrospective review of drug prescriptions in a reference hospital in infectology in the Midwest Region of Brazil, 2018. We selected all prescriptions containing two or more drugs. Drugs were classified according to the first level of the Anatomical Therapeutic Chemical (ATC) classification, according to the route of administration and the number of drugs prescribed. PDIs were classified according to the severity system and four-level evidence classification system. Results: This study selected 72 patients, predominantly male, median age of 38 years, average length of stay of 15.8 days, and most diagnosed with HIV/AIDS. The most frequently prescribed anatomical groups according to ATC were digestive system and metabolism (22.1%) and general anti-infectives for systemic use (21.6%). The average number of drugs per prescription was 10.8 (SD±6.7). The Micromedex® mHealth app found 381 PDIs while its web version detected 502 PDIs, with an average of 5.3 and 7.0 and frequency of 61.1% and 72.2%, respectively. According to the severity classification in mHealth and web versions, the following stood out, respectively: 221 and 321 severe; 139 and 149 moderate. The majority (>65%) of identified PDIs had their documentation classified as reasonable. Conclusion: Digital tools although they aid decision-making, are not unanimous and consistent in detecting such interactions.

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Performance Indicators of Hospitals Affiliated to Iran University of Medical Sciences and Comparing them with Performance Indicators of Ministry of Health and Medical Education

Quarterly Journal of Management Strategies in Health System ◽

10.18502/mshsj.v4i4.2487 ◽

2020 ◽

Author(s):

Nader Tavakoli ◽

Aziz Rezapour ◽

Arsalan Gholami Somarin ◽

Hossein Ameri ◽

Reza Mohammadi ◽

...

Keyword(s):

Medical Education ◽

Performance Indicators ◽

Average Length ◽

Hospital Performance ◽

National Standards ◽

Medical Sciences ◽

Ministry Of Health ◽

Cross Sectional ◽

Average Hospital ◽

Average Length Of Stay

Background: Hospital indicators are among the most important factors in hospital performance. The aim of this study was to measure the performance of hospitals covered by Iran University of Medical Sciences and to compare them with the national indicators. Methods: In the present cross-sectional descriptive study, performance indicators of all hospitals covered by Iran University of Medical Sciences were compared descriptively in 2018-2019. Data were collected from the Medical Record of treatment deputy of Iran University of Medical Sciences. The collected information was analyzed using descriptive tools, Excel software, and the Ministry of Health and Medical Education standard index tables. Results: The average bed occupancy index, average hospital stay index, and patient registration ratio per bed were 69.17, 4.30, and 75.18 in the hospitals covered by Iran University of Medical Sciences in 2018-2019, respectively. These rates show average, undesirable, and desirable status by national standards, respectively. Conclusion: Given that the average length of stay indicator was at an inappropriate level in this study, hospital authorities are recommended to take the necessary measures to identify the reasons and improve the hospital performance in this regard.

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Constrains for seeking post-abortion care among adolescents and young women in Guangzhou, China: a cross-sectional study

BMC Health Services Research ◽

10.1186/s12913-021-06263-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yiding Wang ◽

Jinzhi Liu ◽

Ribo Xiong ◽

Yan Liu

Keyword(s):

Young Women ◽

Cross Sectional Study ◽

Public Hospitals ◽

Sectional Study ◽

Cross Sectional ◽

Services Utilization ◽

Abortion Care ◽

Post Abortion Care ◽

Post Abortion ◽

Youth Friendly

Abstract Background In China, post-abortion care (PAC) services mainly focus on married couples, such that adolescents and unmarried young womenhave limited access to those services for contraception counseling. The provision of youth-friendly PAC services in public hospitals is a new concept in China. This study examined the magnitude of PAC services utilization as well as factors influencing it’s uptake among adolescents and young women in Guangzhou, China. Methods A cross-sectional study was performed from 1st March 2020 to 30th September 2020 using anonymous self-administered questionnaire among 688 women aged 15–24 years in Tianhe district, Guangzhou. The Multivariate logistic regression was used to determine factors that were significantly associated with the uptake of PAC services. Results The magnitude of PAC services utilization was 35.9% among adolescents and young women in Guangzhou, China. Students were 69.0% significantly less likely to use PAC services compared to women who had no job. Immigrants were 59.0% significantly less likely to use PAC services than their native counterparts. Women who had a feeling of stigma were 70.0% significantly less likely to use PAC services compared to those who did not feel stigmatized. Conclusions The study highlights the need to strengthen youth-friendly PAC services provision, and emphasizes the importance of education about both family planning and abortion services among disadvantaged sub-groups of women in the study setting.

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The Prevalence of Necrotizing Enterocolitis and Associated Factors Among Enteral Fed Preterm and Low Birth Weight Neonates Admitted in Selected Public Hospitals in Addis Ababa, Ethiopia: A Cross-sectional Study

Global Pediatric Health ◽

10.1177/2333794x211019695 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2110196

Author(s):

Sitotaw Molla Mekonnen ◽

Daniel Mengistu Bekele ◽

Fikrtemariam Abebe Fenta ◽

Addisu Dabi Wake

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Necrotizing Enterocolitis ◽

Gestational Age ◽

Associated Factors ◽

Addis Ababa ◽

Cross Sectional Study ◽

Public Hospitals ◽

Sectional Study ◽

Cross Sectional

Necrotizing enterocolitis (NEC) remains to be the most critical and frequent gastrointestinal disorder understood in neonatal intensive care units (NICU). The presented study was intended to assess the prevalence of NEC and associated factors among enteral Fed preterm and low birth weight neonates. Institution based retrospective cross-sectional study was conducted on 350 enteral Fed preterm and low birth weight neonates who were admitted at selected public hospitals of Addis Ababa from March 25/2020 to May 10/2020. The data were collected through neonates’ medical record chart review. A total of 350 participants were enrolled in to the study with the response rate of 99.43%. One hundred eighty-four (52.6%) of them were male. The majority 123 (35.1%) of them were (32 + 1 to 34) weeks gestational age. The prevalence of NEC was (25.4%) (n = 89, [95% CI; 21.1, 30.0]). Being ≤28 weeks gestational age (AOR = 3.94, 95% CI [2.67, 9.97]), being (28 + 1 to 32 weeks) gestational age (AOR = 3.65, 95% CI [2.21, 8.31]), birth weight of 1000 to 1499 g (AOR = 2.29, 95% CI [1.22, 4.33]), APGAR score ≤3 (AOR = 2.34, 95% CI [1.32, 4.16]), prolonged labor (AOR = 2.21, 95% CI [1.35, 6.38]), maternal chronic disease particularly hypertension (AOR = 3.2, 95% CI [1.70, 5.90]), chorioamnionitis (AOR = 4.8, 95% CI [3.9, 13]), failure to breath/resuscitated (AOR = 2.1, 95% CI [1.7, 4.4]), CPAP ventilation (AOR = 3.7, 95% CI [1.50, 12.70]), mixed milk (AOR = 3.58, 95% CI [2.16, 9.32]) were factors significantly associated with NEC. Finally, the prevalence of NEC in the study area was high. So that, initiating the programs that could minimize this problem is required to avoid the substantial morbidity and mortality associated with NEC.

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