Hospital efficiency and patient satisfaction

2003 ◽  
Vol 16 (1) ◽  
pp. 24-38 ◽  
Author(s):  
G. H. Pink ◽  
M. A. Murray ◽  
I. McKillop
Keyword(s):  
Patient Satisfaction ◽  
Religious Affiliation ◽  
Cost Model ◽  
Hospital Efficiency ◽  
Small Hospital ◽  
Hospital Size ◽  
Patient Dissatisfaction ◽  
Teaching Status ◽  
Underlying Causes ◽  
Using Data

The objective of this study was to investigate the relationship between efficiency and patient satisfaction for a sample of general, acute care hospitals in Ontario, Canada. A measure of patient satisfaction at the hospital level was constructed using data from a province-wide survey of patients in mid-1999. A measure of efficiency was constructed using data from a cost model used by the Ontario Ministry of Health, the primary funder of hospitals in Ontario. In accordance with previous studies, the model also included measures of hospital size, teaching status and rural location. Based on the results of this study, at a 95% confidence level, there does appear to be evidence to suggest that an inverse relationship between hospital efficiency and patient satisfaction exists. However, the magnitude of the effect appears to be small. Hospital size and teaching status also appear to affect satisfaction, with lower satisfaction scores reported among non-teaching and larger hospitals. This study did not find any evidence to suggest that hospital location (rural versus urban) or religious affiliation contributed to reports of patient satisfaction in any way not explained by the other measures included in the study. The findings imply that low patient satisfaction cannot be explained by excessive management concentration on efficiency. Managers should analyse some of the underlying causes of patient dissatisfaction before reconfiguring resources. It may be beneficial in larger hospitals to study the aspects of care that patients have reported they prefer in small hospitals.

scholarly journals Assessment of technical efficiency of public hospitals in Turkey

2019 ◽  
Vol 30 (2) ◽  
pp. 230-235 ◽  
Author(s):  
Aziz Küçük ◽  
Volkan Soner Özsoy ◽  
Dursun Balkan
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Comprehensive Evaluation ◽  
Efficiency Score ◽  
Hospital Efficiency ◽  
Public Hospitals ◽  
Hospital Size ◽  
Geographical Regions ◽  
Using Data ◽  
The Impact

Abstract Background Turkish public hospitals have been subjected to health care reform because of increasing cost pressure, inequities in access to health care, poor quality of care and limited patient responsiveness in the last three decades. This study investigates the impact of recent hospital reforms on the efficiency of public hospitals. Methods The study provides a comprehensive evaluation of the efficiency of Turkish hospitals by using Data Envelopment Analysis (DEA). The estimation of efficiency of 669 public hospitals of Turkey is performed by an output-oriented model of DEA under the assumption of variable return-to-scale by using data collected from the Ministry of Health (MoH) over the period 2013–17. Results The average efficiency score is equal to 0.83 for all MoH hospitals. Considering the hospital type, the efficiency scores of training and research hospitals are higher than those of the general and branch hospitals. In addition, considering the hospital size, huge-scale hospitals have the highest efficiency score in all years. Moreover, overcrowded regions such as Marmara and South-eastern Anatolia regions had higher efficiency scores than other geographical regions. Conclusions The results indicate that recent health reforms did not significantly enhance hospital efficiency. Thus, policymakers and managers should take the necessary precautions to increase hospital efficiency.

Complications of Asian Double Eyelid Surgery: Prevention and Management

2020 ◽  
Vol 36 (05) ◽  
pp. 592-601
Author(s):  
Stephanie Ming Young ◽  
Yoon-Duck Kim
Keyword(s):  
East Asian ◽  
Eyelid Surgery ◽  
Patient Dissatisfaction ◽  
Optimal Outcomes ◽  
Asian Populations ◽  
Underlying Causes ◽  
Double Eyelid

AbstractDouble eyelid surgery remains one of the most popular aesthetic surgeries, especially among East Asian populations. Complications related to double eyelid surgery can be divided into various categories: (1) patient dissatisfaction, (2) problems with the eyelid crease, (3) problems with the eyelid height, (4) suture-related complications, and (5) complications related to eyelid surgery in general. As with all eyelid surgeries, it is important to understand and appreciate the normal and abnormal function and anatomy of the Asian eyelid to reduce the risk of complications. It is also important to recognize the various complications and their underlying causes so that the surgeon can confidently revise the surgery to achieve optimal outcomes.

scholarly journals Association of Receipt of Antibiotics with Patient Satisfaction for Caregivers of Children Presenting to Urgent-Care Settings

2020 ◽  
Vol 41 (S1) ◽  
pp. s134-s135
Author(s):  
Diane Liu ◽  
NORA FINO ◽  
Benjamin Haaland ◽  
Adam Hersh ◽  
Emily Thorell ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Otitis Media ◽  
Respiratory Infections ◽  
Otitis Media With Effusion ◽  
Multivariable Analysis ◽  
Acute Otitis Media ◽  
Skewed Distribution ◽  
Urgent Care ◽  
Provider Type ◽  
Patient Dissatisfaction

Background: The Press Ganey (PG) Medical Practice Survey is a commonly used questionnaire for measuring patient experience in healthcare. Our objective was to evaluate the PG surveys completed by caregivers of children presenting for urgent care evaluation of acute respiratory infections (ARIs) to determine any correlation with receipt of antibiotics during their visit. Methods: We evaluated responses to the PG urgent-care surveys for encounters of children <18 years presenting with ARIs (ie, sinusitis, bronchitis, pharyngitis, upper respiratory infection, acute otitis media, or serous otitis media with effusion) within 9 University of Utah urgent-care centers. Scores could range from 0 to 100. Because the distributions of scores followed right- skewed distribution with a high ceiling effect, we defined scores as dissatisfied with their care (≤25th percentile) and satisfied with their care (scores >25th percentile). Univariate and multivariable generalized mixed-effects logistic regression was used to assess correlates of patient dissatisfaction. Random intercepts were included for each provider to account for correlation within the same provider. Separate models were used for each PG component score. Multivariable models adjusted for receipt of antibiotics, age, gender, race, ethnicity, and provider type. Results: Overall, 388 of 520 responses (74.6%) indicated satisfaction and 132 responses (25.4%) indicated dissatisfaction. Among patients who did not receive antibiotics, 87 of 284 responses (30.6%) indicated dissatisfaction versus 45 of 236 (19.1%) who did receive antibiotics. Among patients who were dissatisfied with their clinician, raw clinician PG scores were higher among patients who received antibiotics (mean, 64.5; standard deviation [SD], 16.9) versus those who did not receive antibiotics (mean, 54.7; SD, 24.4; P = .015) (Table 1). In a multivariable analysis, receipt of antibiotics was associated with a reduction in patient dissatisfaction overall (odds ratio, 0.55; 95% CI, 0.36–0.85). Conclusions: Overall, most responses for patients seen for ARIs in pediatric urgent care were satisfied. However, a significantly higher proportion of responses for patients who did not receive antibiotics were dissatisfied than for those patients who received antibiotics. Antibiotic stewardship strategies to communicate appropriate prescribing while preserving patient satisfaction are needed in pediatric urgent-care settings.Funding: NoneDisclosures: None

Pain associated with cemented and uncemented long-stemmed tibial components in revision total knee arthroplasty

2021 ◽  
Vol 103-B (6 Supple A) ◽  
pp. 165-170
Author(s):  
Darin J. Larson ◽  
John H. Rosenberg ◽  
Maxwell A. Lawlor ◽  
Kevin L. Garvin ◽  
Curtis W. Hartman ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Postoperative Pain ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Stem Length ◽  
Exact Test ◽  
Patient Dissatisfaction ◽  
Total Knee ◽  
Revision Tka

Aims Stemmed tibial components are frequently used in revision total knee arthroplasty (TKA). The purpose of this study was to evaluate patient satisfaction, overall pain, and diaphyseal tibial pain in patients who underwent revision TKA with cemented or uncemented stemmed tibial components. Methods This is a retrospective cohort study involving 110 patients with revision TKA with cemented versus uncemented stemmed tibial components. Patients who underwent revision TKA with stemmed tibial components over a 15-year period at a single institution with at least two-year follow-up were assessed. Pain was evaluated through postal surveys. There were 63 patients with cemented tibial stems and 47 with uncemented stems. Radiographs and Knee Society Scores were used to evaluate for objective findings associated with pain or patient dissatisfaction. Postal surveys were analyzed using Fisher’s exact test and the independent-samples t-test. Logistic regression was used to adjust for age, sex, and preoperative bone loss. Results No statistically significant differences in stem length, operative side, or indications for revision were found between the two cohorts. Tibial pain at the end of the stem was present in 25.3% (16/63) of cemented stems and 25.5% (12/47) of uncemented stems (p = 1.000); 74.6% (47/63) of cemented patients and 78.7% (37/47) of uncemented patients were satisfied following revision TKA (p = 0.657). Conclusion There were no differences in patient satisfaction, overall pain, and diaphyseal tibial pain in cemented and uncemented stemmed tibial components in revision TKA. Patient factors, rather than implant selection and surgical technique, likely play a large role in the presence of postoperative pain. Stemmed tibial components have been shown to be a possible source of pain in revision TKA. There is no difference in patient satisfaction or postoperative pain with cemented or uncemented stemmed tibial components in revision TKA. Cite this article: Bone Joint J 2021;103-B(6 Supple A):165–170.

Religion and Happiness

2012 ◽  
Author(s):  
Michael Hout ◽  
Andrew Greeley
Keyword(s):  
United States ◽  
Religious Affiliation ◽  
General Social Survey ◽  
The United States ◽  
Religious Groups ◽  
Social Survey ◽  
Religious Rituals ◽  
Religious Services ◽  
Using Data ◽  
International Social

This chapter discusses the link between happiness and religion. It draws on meaning-and-belonging theory to deduce that a religious affiliation heightens happiness through participation in collective religious rituals. Attendance and engagement appear key: a merely nominal religious affiliation makes people little happier. Notably, two religious foundations of happiness—affiliation with organized religious groups and attendance at services—have fallen. Softened religious engagement, then, may contribute to the slight downturn in general happiness. In fact, steady happiness is reported among those who participate frequently in religious services, but falling levels among those who are less involved. The chapter also considers the association between religion and happiness outside the United States using data from the International Social Survey Program, an international collaborative survey to which the General Social Survey contributes the American data.

Gender and Computing at University in the UK

2009 ◽  
pp. 1583-1590
Author(s):  
Ruth Woodfield
Keyword(s):  
Information Technology ◽  
Computer Science ◽  
Educational Level ◽  
The Us ◽  
Underlying Causes ◽  
The Subject ◽  
Using Data ◽  
Women's Role ◽  
The Uk ◽  
Educational Field

In the late 1970s, women’s progress and participation in the more traditional scientific and technical fields, such as physics and engineering, was slow, prompting many feminist commentators to conclude that these areas had developed a nearunshakeable masculine bias. Although clearly rooted in the domains of science and technology, the advent of the computer was initially seen to challenge this perspective. It was a novel kind of artefact, a machine that was the subject of its own newly created field: “computer science” (Poster, 1990, p. 147). The fact that it was not quite subsumed within either of its parent realms led commentators to argue that computer science was also somewhat ambiguously positioned in relation to their identity as masculine. As such, it was claimed that its future trajectory as equally masculine could not be assumed, and the field of computing might offer fewer obstacles and more opportunities for women than they had experienced before. Early predictions of how women’s role in relation to information technology would develop were consequently often highly optimistic in tone. Computing was hailed as “sex-blind and colour-blind” (Williams, Cited in Griffths 1988, p. 145; see also Zientara, 1987) in support of a belief that women would freely enter the educational field, and subsequently the profession, as the 1980s advanced. During this decade, however, it became increasingly difficult to deny that this optimism was misplaced. The numbers of females undertaking undergraduate courses in the computer sciences stabilised at just over a fifth of each cohort through the 1980s and 1990s, and they were less likely to take them in the more prestigious or researchbased universities (Woodfield, 2000). Tracy Camp’s landmark article “The Incredible Shrinking Pipeline” (1997), using data up to 1994, plotted the fall-off of women in computer science between one educational level and the next in the US. It noted that “a critical point” was the drop-off before bachelor-level study—critical because the loss of women was dramatic, but also because a degree in computer science is often seen as one of the best preparatory qualifications for working within a professional IT role1. The main aim of this article is to examine how the situation has developed since 1994, and within the UK context. It will also consider its potential underlying causes, and possible routes to improvement.

Gender and Computing at University in the UK

2011 ◽  
pp. 365-371
Author(s):  
Ruth Woodfield
Keyword(s):  
Information Technology ◽  
Computer Science ◽  
Educational Level ◽  
The Us ◽  
Underlying Causes ◽  
The Subject ◽  
Using Data ◽  
Women's Role ◽  
The Uk ◽  
Educational Field

In the late 1970s, women’s progress and participation in the more traditional scientific and technical fields, such as physics and engineering, was slow, prompting many feminist commentators to conclude that these areas had developed a near-unshakeable masculine bias. Although clearly rooted in the domains of science and technology, the advent of the computer was initially seen to challenge this perspective. It was a novel kind of artefact, a machine that was the subject of its own newly created field: “computer science” (Poster, 1990, p. 147). The fact that it was not quite subsumed within either of its parent realms led commentators to argue that computer science was also somewhat ambiguously positioned in relation to their identity as masculine. As such, it was claimed that its future trajectory as equally masculine could not be assumed, and the field of computing might offer fewer obstacles and more opportunities for women than they had experienced before. Early predictions of how women’s role in relation to information technology would develop were consequently often highly optimistic in tone. Computing was hailed as “sex-blind and colour-blind” (Williams, Cited in Griffths 1988, p. 145; see also Zientara, 1987) in support of a belief that women would freely enter the educational field, and subsequently the profession, as the 1980s advanced. During this decade, however, it became increasingly difficult to deny that this optimism was misplaced. The numbers of females undertaking undergraduate courses in the computer sciences stabilised at just over a fifth of each cohort through the 1980s and 1990s, and they were less likely to take them in the more prestigious or research-based universities (Woodfield, 2000). Tracy Camp’s landmark article “The Incredible Shrinking Pipeline” (1997), using data up to 1994, plotted the fall-off of women in computer science between one educational level and the next in the US. It noted that “a critical point” was the drop-off before bachelor-level study—critical because the loss of women was dramatic, but also because a degree in computer science is often seen as one of the best preparatory qualifications for working within a professional IT role1. The main aim of this article is to examine how the situation has developed since 1994, and within the UK context. It will also consider its potential underlying causes, and possible routes to improvement.

scholarly journals HIV Testing and Referral to Care in U.S. Hospitals Prior to 2006: Results from a National Survey

2009 ◽  
Vol 124 (3) ◽  
pp. 400-408 ◽  
Author(s):  
Gretchen Williams Torres ◽  
Juliet Yonek ◽  
Jeremy Pickreign ◽  
Heidi Whitmore ◽  
Romana Hasnain-Wynia
Keyword(s):  
Hiv Testing ◽  
Clinical Symptoms ◽  
Geographic Location ◽  
Routine Screening ◽  
Behavioral Risk ◽  
Hospital Inpatient ◽  
Current Recommendation ◽  
Public Health Action ◽  
Hospital Size ◽  
Teaching Status

Objectives. We sought to provide a benchmark for human immunodeficiency virus (HIV) testing availability and practices in U.S. hospitals prior to the Centers for Disease Control and Prevention's (CDC's) 2006 revised recommendations. Methods. We conducted a survey of nonfederal general hospitals in the U.S. in 2004. Chi-square tests detected significant associations with hospital characteristics. Questionnaires were completed electronically via a secure Internet site or on paper. Nonresponse analysis was conducted and data were weighted to adjust for nonresponse. Results. HIV testing (on the basis of clinical symptoms or behavioral risk factors) was available in more than half of hospital inpatient units (62%), employee health departments (58%), and emergency departments (57%). Twenty-three percent offered routine screening (testing for people in a defined population regardless of clinical symptoms or behavioral risk), most commonly in labor and delivery. Teaching status, region, size, and type of metropolitan area were associated with the availability of HIV testing and routine screening ( p<0.01). Hospitals used a variety of methods to link patients to care: referral to a hospital-based clinic (36%); on-site, same-day evaluation (35%); and referral to an unaffiliated HIV or community clinic (42%). Conclusions. Hospitals offered HIV testing on the basis of clinical suspicion or risk, but were far from meeting CDC's current recommendation to routinely test all patients aged 13 to 64. Hospital size, teaching status, and geographic location were associated with HIV testing availability and testing practices. Our understanding of current practice identifies opportunities for public health action at the practitioner, organization, and systems levels.

Designated Stroke Center Status and Hospital Characteristics as Predictors of In-Hospital Mortality among Hemorrhagic Stroke Patients in New York, 2008-2012

2016 ◽  
Vol 43 (1-2) ◽  
pp. 43-53 ◽  
Author(s):  
Hajere J. Gatollari ◽  
Anna Colello ◽  
Bonnie Eisenberg ◽  
Ian Brissette ◽  
Jorge Luna ◽  
...  
Keyword(s):  
New York ◽  
Ischemic Stroke ◽  
Hospital Mortality ◽  
Hemorrhagic Stroke ◽  
New York State ◽  
Hospital Level ◽  
Stroke Patients ◽  
Hospital Size ◽  
Teaching Status ◽  
Hospital Characteristics

Background: Although designated stroke centers (DSCs) improve the quality of care and clinical outcomes for ischemic stroke patients, less is known about the benefits of DSCs for patients with intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH). Hypothesis: Compared to non-DSCs, hospitals with the DSC status have lower in-hospital mortality rates for hemorrhagic stroke patients. We believed these effects would sustain over a period of time after adjusting for hospital-level characteristics, including hospital size, urban location, and teaching status. Methods and Results: We evaluated ICH (International Classification of Diseases, Ninth Revision; ICD-9: 431) and SAH (ICD-9: 430) hospitalizations documented in the 2008-2012 New York State Department of Health Statewide Planning and Research Cooperative System inpatient sample database. Generalized estimating equation logistic regression was used to evaluate the association between DSC status and in-hospital mortality. We calculated ORs and 95% CIs adjusted for clustering of patients within facilities, other hospital characteristics, and individual level characteristics. Planned secondary analyses explored other hospital characteristics associated with in-hospital mortality. In 6,352 ICH and 3,369 SAH patients in the study sample, in-hospital mortality was higher among those with ICH compared to SAH (23.7 vs. 18.5%). Unadjusted analyses revealed that DSC status was related with reduced mortality for both ICH (OR 0.7, 95% CI 0.5-0.8) and SAH patients (OR 0.4, 95% CI 0.3-0.7). DSC remained a significant predictor of lower in-hospital mortality for SAH patients (OR 0.6, 95% CI 0.3-0.9) but not for ICH patients (OR 0.8, 95% CI 0.6-1.0) after adjusting for patient demographic characteristics, comorbidities, hospital size, teaching status and location. Conclusions: Admission to a DSC was independently associated with reduced in-hospital mortality for SAH patients but not for those with ICH. Other patient and hospital characteristics may explain the benefits of DSC status on outcomes after ICH. For conditions with clear treatments such as ischemic stroke and SAH, being treated in a DSC improves outcomes, but this trend was not observed in those with strokes, in those who did not have clear treatment guidelines. Identifying hospital-level factors associated with ICH and SAH represents a means to identify and improve gaps in stroke systems of care.

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