scholarly journals Surgery in Brazilian Health Care: funding and physician distribution

2017 ◽  
Vol 44 (2) ◽  
pp. 202-207 ◽  
Author(s):  
NIVALDO ALONSO ◽  
BENJAMIN B. MASSENBURG ◽  
RAFAEL GALLI ◽  
LUCAS SOBRADO ◽  
DARIO BIROLINI
Keyword(s):  
Local Population ◽  
Surgical Care ◽  
National Database ◽  
Public Healthcare ◽  
Health Coverage ◽  
Inequality Index ◽  
Public And Private ◽  
Healthcare Facilities ◽  
The Public ◽  
The North

ABSTRACT Objective: to analyze demographic Brazilian medical data from the national public healthcare system (SUS), which provides free universal health coverage for the entire population, and discuss the problems revealed, with particular focus on surgical care. Methods: data was obtained from public healthcare databases including the Medical Demography, the Brazilian Federal Council of Medicine, the Brazilian Institute of Geography and Statistics, and the National Database of Healthcare Establishments. Density and distribution of the medical workforce and healthcare facilities were calculated, and the geographic regions were analyzed using the public private inequality index. Results: Brazil has an average of two physicians for every 1,000 inhabitants, who are unequally distributed throughout the country. There are 22,276 board certified general surgeons in Brazil (11.49 for every 100,000 people). The country currently has 257 medical schools, with 25,159 vacancies for medical students each year, with only around 13,500 vacancies for residency. The public private inequality index is 3.90 for the country, and ranges from 1.63 in the Rio de Janeiro up to 12.06 in Bahia. Conclusions: A significant part of the local population still faces many difficulties in accessing surgical care, particularly in the north and northeast of the country, where there are fewer hospitals and surgeons. Physicians and surgeons are particularly scarce in the public health system nationwide, and better incentives are needed to ensure an equal public and private workforce.

scholarly journals ‘The nurse did not even greet me’: how informed versus non-informed patients evaluate health systems responsiveness in South Africa

2021 ◽  
Vol 6 (4) ◽  
pp. e004360
Author(s):  
Dumisani MacDonald Hompashe ◽  
Ulf-G Gerdtham ◽  
Carmen S Christian ◽  
Anja Smith ◽  
Ronelle Burger
Keyword(s):  
Health Systems ◽  
Primary Healthcare ◽  
Healthcare Workers ◽  
Quality Care ◽  
Public Healthcare ◽  
Health Coverage ◽  
Access To Health Services ◽  
Healthcare Provision ◽  
Healthcare Facilities ◽  
Patients Experience

Introduction Universal Health Coverage is not only about access to health services but also about access to high-quality care, since poor experiences may deter patients from accessing care. Evidence shows that quality of care drives health outcomes, yet little is known about non-clinical dimensions of care, and patients’ experience thereof relative to satisfaction with visits. This paper investigates the role of non-clinical dimensions of care in patient satisfaction. Methods Our study describes the interactions of informed and non-informed patients with primary healthcare workers at 39 public healthcare facilities in two metropolitan centres in two South African provinces. Our analysis included 1357 interactions using standardised patients (for informed patients) and patients’ exit interviews (for non-informed patients). The data were combined for three types of visits: contraception, hypertension and tuberculosis. We describe how satisfaction with care was related to patients’ experiences of non-clinical dimensions. Results We show that when real patients (RPs) reported being satisfied (vs dissatisfied) with a visit, it was associated with a 30% increase in the probability that a patient is greeted at the facilities. Likewise, when the RPs reported being satisfied (vs dissatisfied) with the visit, it was correlated with a 15% increase in the prospect that patients are pleased with healthcare workers’ explanations of health conditions. Conclusion Informed patients are better equipped to assess health-systems responsiveness in healthcare provision. Insights into responsiveness could guide broader efforts aimed at targeted education and empowerment of primary healthcare users to strengthen health systems and shape expectations for appropriate care and conduct.

scholarly journals Public and private sectors collective response to combat COVID-19 in Malaysia

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Ching Siang Tan ◽  
Saim Lokman ◽  
Yao Rao ◽  
Szu Hua Kok ◽  
Long Chiau Ming
Keyword(s):  
Insurance Coverage ◽  
Healthcare Providers ◽  
Screening Tests ◽  
Public Healthcare ◽  
Private Hospitals ◽  
Public And Private ◽  
The Public ◽  
Private Healthcare ◽  
Care Services ◽  
Challenges And Opportunities

AbstractOver the last year, the dangerous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly around the world. Malaysia has not been excluded from this COVID-19 pandemic. The resurgence of COVID-19 cases has overwhelmed the public healthcare system and overloaded the healthcare resources. Ministry of Health (MOH) Malaysia has adopted an Emergency Ordinance (EO) to instruct private hospitals to receive both COVID-19 and non-COVID-19 patients to reduce the strain on public facilities. The treatment of COVID-19 patients at private hospitals could help to boost the bed and critical care occupancy. However, with the absence of insurance coverage because COVID-19 is categorised as pandemic-related diseases, there are some challenges and opportunities posed by the treatment fees management. Another major issue in the collaboration between public and private hospitals is the willingness of private medical consultants to participate in the management of COVID-19 patients, because medical consultants in private hospitals in Malaysia are not hospital employees, but what are termed “private contractors” who provide patient care services to the hospitals. Other collaborative measures with private healthcare providers, e.g. tele-conferencing by private medical clinics to monitor COVID-19 patients and the rollout of national vaccination programme. The public and private healthcare partnership must be enhanced, and continue to find effective ways to collaborate further to combat the pandemic. The MOH, private healthcare sectors and insurance providers need to have a synergistic COVID-19 treatment plans to ensure public as well as insurance policy holders have equal opportunities for COVID-19 screening tests, vaccinations and treatment.

scholarly journals Surgical care in the public health agenda

2017 ◽  
Vol 33 (10) ◽  
Author(s):  
Mário Scheffer ◽  
Saurabh Saluja ◽  
Nivaldo Alonso
Keyword(s):  
Public Health ◽  
Universal Access ◽  
Surgical Care ◽  
Public Health Issue ◽  
Public And Private ◽  
The Public ◽  
Timely Fashion ◽  
Current Article ◽  
Clinical Conditions ◽  
Global Indicators

The current article examines surgical care as a public health issue and a challenge for health systems organization. When surgery fails to take place in timely fashion, treatable clinical conditions can evolve to disability and death. The Lancet Commission on Global Surgery defined indicators for monitoring sustainable universal access to surgical care. Applied to Brazil, the global indicators are satisfactory, but the supply of surgeries in the country is marked by regional and socioeconomic inequalities, as well as between the public and private healthcare sectors.

Baseline assessment of therapeutic injection practices in Pakistan in 2020: a cross-sectional study

2021 ◽  
pp. 16-21
Author(s):  
Syed Sharaf Ali Shah ◽  
Safdar Pasha ◽  
Nikhat Iftikar ◽  
Altaf Ahmed Soomro ◽  
Nazia Farrukh ◽  
...  
Keyword(s):  
Public Sector ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Cross Sectional ◽  
Injection Equipment ◽  
Public And Private ◽  
Healthcare Facilities ◽  
The Public ◽  
Injection Safety

Objective: To assess the magnitude of the problem of injection safety in public and private health facilities in two districts of Sindh and Punjab provinces of Pakistan. Methods: A cross-sectional observational study was conducted between October and December 2020 among public and private health facilities of two districts of Pakistan: Gujarat in Punjab and Larkana in Sindh provinces. A convenient sample size of 60 healthcare facilities (30 from each district) was taken due to time and resource constraint. Six data collection tools were used which included structured observations and interviews with injection prescribers and providers based on WHO Revised Tool C, which were finalised after piloting. Results: Reuse of injection equipment was not observed in any of the 60 health facilities. In exit interviews of 120 patients, it was found that 27 (22.5%) patients reported receiving an injection, while 11 (9.2%) were prescribed intravenous (IV) drips. More injections and drips were prescribed in the private sector (n=15; 25.0%) in comparison with the public sector (n=12; 20.0%). Slightly higher proportion of IV drips were prescribed by the private providers when compared to public sector healthcare providers: 6 (10.0%) vs 5 (8.3%) respectively. Most of the prescribers (n=58; 96.7%) reported that patients who attended public and private health facilities demanded injectable medicines. Used syringes and drips were noted to be visible in open containers and buckets for final disposal in 20 (33.3%) assessed health facilities. Continuou...

scholarly journals Late antique domus in Skelani (Municipium Malvesiatium)

Starinar ◽  
2015 ◽  
pp. 197-220
Author(s):  
Nadezda Gavrilovic-Vitas ◽  
Bojan Popovic
Keyword(s):  
The Other ◽  
Late Antique ◽  
Public And Private ◽  
The Public ◽  
Architectural Elements ◽  
The North ◽  
Wall Heating ◽  
North Western ◽  
Main Entrance ◽  
Archaeological Excavations

During June and July 2014, at the site of Zadruzni Dom in Skelani, archaeological investigations of the late antique building were carried out, whose rooms were first discovered in the course of archaeological excavations in 2008. The building has a rectangular base, of a northeast-southwest orientation, with the discovered part measuring 20.90 x 30.90 m. What is distinguishable within the asymmetrical base is an entrance, along with eleven rooms, two of which have apses, and a peristyle, i.e. an inner courtyard with a roofed corridor surrounding it which connects all the rooms of the building. During the archaeological excavations, entrance thresholds and extremely well preserved mortar floors with mortar skirting were noted in most rooms, along with traces of fresco painting on the walls and mosaic floors, executed in the opus tesselatum technique, observed in several rooms, the peristyle and the encompassing corridor. The discovered mosaic fragments are decorated with geometric motifs in the form of a swastika, a Solomon?s knot, a square, a rhomboid, overlapping circles, etc. and floral motifs of ivy and petals, as well as a double braid motif. Small but, unfortunately, fragmented pieces of a mosaic with a figural representation were discovered in the central part of the peristyle, while the mosaic in room K was decorated with a motif portraying the winged head of Medusa. Two construction phases were noted, an older and a younger, with the walls, which were two Roman feet wide and built from dressed stone, and the older mortar floor belonging to the older construction phase, and the second, younger construction phase comprising mosaics, fresco painting, the younger mortar floor and two furnaces. Contemplating the planimetry of the building, one gets the impression of the rooms being divided between two parts - public and private, whereby the public part of the building would be located near the main entrance hall and would comprise rooms A, B, C, D and F, with mortar floors and traces of fresco painting on the walls. The other, possibly private, part of the building would include five rooms G, H, I, J and K and the inner courtyard. Rooms I, J and K had floor and wall heating, while rooms G and H had an arched apse and possibly functioned as a reception hall and/or a stibadium. The hallway with mosaics, which flanks the inner courtyard, was most likely roofed. Traces of burning in the north-western corridor testify to the destruction of the building in a fire. Based on the architectural elements and the traces of fresco painting and mosaics in the building at the site of Zadruzni Dom in Skelani, it can be deduced that this is a late antique building which can roughly be dated to the period between the end of the 3rd and the mid-4th century AD, and whose lavish decoration implies that it was owned by an affluent resident of Skelani from the aforementioned period.

Evaluation of outpatient satisfaction and service quality of Pakistani healthcare projects

2018 ◽  
Vol 8 (4) ◽  
pp. 462-480 ◽  
Author(s):  
Saad Ahmed Javed ◽  
Sifeng Liu
Keyword(s):  
Service Quality ◽  
Private Sector ◽  
Healthcare Delivery ◽  
Grey System Theory ◽  
Public Healthcare ◽  
Grey System ◽  
Healthcare Delivery System ◽  
Public And Private ◽  
Content Type ◽  
The Public

PurposeThe purpose of this paper is to analyse the relationship between outpatient satisfaction and the five constructs of healthcare projects’ service quality in Pakistan using Deng’s grey incidence analysis (GIA) model, absolute degree GIA model (ADGIA), a novel second synthetic degree GIA (SSDGIA) model and two approaches of decision-making under uncertainty.Design/methodology/approachThe study proposes a new synthetic GIA model and demonstrates its feasibility on data (N=221) collected from both public and private sector healthcare projects of Punjab, the most populous province of Pakistan, using a self-administered questionnaire developed using the original SERVQUAL approach.FindingsThe results of decision analysis approach indicated that outpatients’ satisfaction from the private sector healthcare projects is higher as compared to the public healthcare projects’. The results from the proposed model revealed that tangibility and reliability play an important role in shaping the patient satisfaction in the public and private sectors, respectively.Originality/valueThe study is pioneer in evaluating a healthcare system’s service quality using grey system theory. The study proposes the SSDGIA model as a novel method to evaluate parameters comprehensively based on their mutual association (given by absolute degree of grey incidence) and inter-dependencies (given by Deng’s degree of grey incidence), and tests the new model in the given scenario. The study is novel in terms of its analysis of data and modelling. The study also proposes a comprehensive structure of the healthcare delivery system of Pakistan.

scholarly journals Healthcare in the news media: The privileging of private over public

2017 ◽  
Vol 54 (4) ◽  
pp. 574-590 ◽  
Author(s):  
Sophie Lewis ◽  
Fran Collyer ◽  
Karen Willis ◽  
Kirsten Harley ◽  
Kanchan Marcus ◽  
...  
Keyword(s):  
Private Sector ◽  
Healthcare System ◽  
News Media ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Public And Private ◽  
The Public ◽  
Print News ◽  
Private Healthcare ◽  
Time Period

This article reports on a discourse analysis of the representation of healthcare in the print news media, and the way this representation shapes perspectives of healthcare. We analysed news items from six major Australian newspapers over a three-year time period. We show how various framing devices promote ideas about a crisis in the current public healthcare system, the existence of a precarious balance between the public and private health sectors, and the benefits of private healthcare. We employ Bourdieu’s concepts of field and capital to demonstrate the processes through which these devices are employed to conceal the power relations operating in the healthcare sector, to obscure the identity of those who gain the most from the expansion of private sector medicine, and to indirectly increase health inequalities.

scholarly journals Publicly funded interfacility ambulance transfers for surgical and obstetrical conditions: A cross sectional analysis in an urban middle-income country setting

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241553
Author(s):  
Paul Truche ◽  
Rachel E. NeMoyer ◽  
Sara Patiño-Franco ◽  
Juan P. Herrera-Escobar ◽  
Myerlandi Torres ◽  
...  
Keyword(s):  
Surgical Care ◽  
Healthcare Facility ◽  
Public Hospitals ◽  
Public Healthcare ◽  
Publicly Funded ◽  
Cross Sectional ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Timely Access ◽  
Surgical Conditions

Introduction Interfacility transfers may reflect a time delay of definitive surgical care, but few studies have examined the prevalence of interfacility transfers in the urban low- and middle-income (LMIC) setting. The aim of this study was to determine the number of interfacility transfers required for surgical and obstetric conditions in an urban MIC setting to better understand access to definitive surgical care among LMIC patients. Methods A retrospective analysis of public interfacility transfer records was conducted from April 2015 to April 2016 in Cali, Colombia. Data were obtained from the single municipal ambulance agency providing publicly funded ambulance transfers in the city. Interfacility transfers were defined as any patient transfer between two healthcare facilities. We identified the number of transfers for patients with surgical conditions and categorized transfers based on patient ICD-9-CM codes. We compared surgical transfers from public vs. private healthcare facilities by condition type (surgical, obstetric, nonsurgical), transferring physician specialty, and transfer acuity (code blue, emergent, urgent and nonurgent) using logistic regression. Results 31,659 patient transports occurred over the 13-month study period. 22250 (70.2%) of all transfers were interfacility transfers and 7777 (35%) of transfers were for patients with surgical conditions with an additional 2,244 (10.3%) for obstetric conditions. 49% (8660/17675) of interfacility transfers from public hospitals were for surgical and obstetric conditions vs 32% (1466/4580) for private facilities (P<0.001). The most common surgical conditions requiring interfacility transfer were fractures (1,227, 5.4%), appendicitis (913, 4.1%), wounds (871, 3.9%), abdominal pain (818, 3.6%), trauma (652, 2.9%), and acute abdomen (271, 1.2%). Conclusion Surgical and obstetric conditions account for nearly half of all urban interfacility ambulance transfers. The most common reasons for transfer are basic surgical conditions with public healthcare facilities transferring a greater proportion of patient with surgical conditions than private facilities. Timely access to an initial healthcare facility may not be a reliable surrogate of definitive surgical care given the substantial need for interfacility transfers.

scholarly journals Strategizing Public Sector Hospitals In Megacity Karachi: A Case Study On Gender Based Healthcare Facility Selection Criteria And Concerns (From Demand And Supply Perspective)

2019 ◽  
Vol 19 (1) ◽  
pp. 179-196
Author(s):  
Shamaila Burney ◽  
Khalid Mahmood Iraqi
Keyword(s):  
Public Sector ◽  
Selection Criteria ◽  
Healthcare Facility ◽  
Health Care Facilities ◽  
Public Hospitals ◽  
Public Healthcare ◽  
Demand And Supply ◽  
Healthcare Facilities ◽  
The Public

Karachi is the most populous city in Pakistan and it plays an important role in urban demography of Pakistan. It is growing rapidly, as every fifth urban citizen lives here. This urbanization creates serious challenges for all sectors of Karachi. Especially the health sector, from demand and supply view point is facing serious challenges in terms of non-availability of qualified doctors, specifically female doctors, medicines, latest equipment, poor infrastructure, and patient’s queues belonging to other rural areas because of the lack of quality healthcare facilities, makes the public hospitals crowded and overburdened. Like all over Pakistan, public sector hospitals are very much neglected in Karachi also and needs special consideration. The focus should be on developing patient oriented supply chains for efficient patient’s care and healthcare facilities. Moreover, the case study of Qatar hospital a part of our basic research study also highlighted the depriving condition for women patients’ in Emergency Department, because only male doctors are there but female doctors are not available. Although we observed that the gender wise daily patient flow was consist of 65% females, whereas only 35% male patients. The study suggests that there is an urgent need of women doctors and paramedics staff in the public sector hospitals of suburbs of Karachi. This paper presents a synoptic view of concerns of the residents of Karachi, and identification of their selection criteria of health care facilities. The study also aimed to provide solutions and recommendations for the improvement of these facilities. Cross sectional questionnaire and random sampling with two stage clusters sampling was used to record the responses of 1991 households, 46% respondents were female and 54% were male. Among the total of 11127 respondents, only 580, (5.2 %) sought treatment in public health hospitals and, 2440 (21.9 %) visited private hospitals. Research results shows that Cost is the only significant factor because of which people opt for treatment at public healthcare facility.

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