scholarly journals An empirical analysis of Unit costs of public hospitals in Jordan

2020 ◽  
Author(s):  
Eman A Hammad ◽  
Ibrahim Alabbadi ◽  
Fardos Taissir ◽  
Malek Hajjwi ◽  
Nathir M. Obeidat ◽  
...  
Keyword(s):  
Unit Cost ◽  
Healthcare Delivery ◽  
Public Hospitals ◽  
Hospital Services ◽  
Middle Income ◽  
Complex Needs ◽  
Political Conflicts ◽  
Unit Costs ◽  
Low Middle Income Countries ◽  
And Performance

Abstract Background: Public providers in low-middle income countries face enormous pressures to meet complex needs of its population. This study aimed to benchmark unit costs of hospital services in public providers in Jordan to provide useful insight and readings of healthcare delivery and sustainability. Methods: Unit costs of hospital services per admission, inpatient days, outpatient visits, emergency visits and surgical operations were estimated using standard average costing method. Unit costs per inpatient days was estimated relevant to nine specialities, staff and selected medical services too. Unit costs were estimated in Jordanian Dinars (exchange rate= US$1.41). Results: Average unit cost per admission was 782.3 JDs (U$1101.8), per inpatient day was 236.6 JDs (U$ 333.2), per bed day was 172.9 JDs (U$244.9), per outpatient visit was 58.4 JDs (U$ 82.3), per operation was 449.6 JDs (U$ 633.2) and per emergency room visit was 31.8 JDs (U$44.8). ICU/CCU and OB/GYN presented the highest unit costs per inpatient days across providers; U$532.9 and U$510.7 respectively. Unit costs varied depending on service utilization, type of service and organizational outset. Conclusions: Countries in areas of political conflicts face enormous fiscal constraints, health policy makers, managers and stakeholders ought to understand these challenges and foster use of value based budgeting and performance analysis.

scholarly journals Models of care for chronic conditions in low/middle-income countries: a ‘best fit’ framework synthesis

2018 ◽  
Vol 3 (6) ◽  
pp. e001077 ◽  
Author(s):  
Dorothy Lall ◽  
Nora Engel ◽  
Narayanan Devadasan ◽  
Klasien Horstman ◽  
Bart Criel
Keyword(s):  
Primary Care ◽  
Chronic Conditions ◽  
Quality Care ◽  
Healthcare Delivery ◽  
Essential Medicines ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Best Fit ◽  
Best Fit Framework Synthesis

Management of chronic conditions is a challenge for healthcare delivery systems world over and especially for low/middle-income countries (LMIC). Redesigning primary care to deliver quality care for chronic conditions is a need of the hour. However, much of the literature is from the experience of high-income countries. We conducted a synthesis of qualitative findings regarding care for chronic conditions at primary care facilities in LMICs. The themes identified were used to adapt the existing chronic care model (CCM) for application in an LMIC using the ‘best fit’ framework synthesis methodology. Primary qualitative research studies were systematically searched and coded using themes of the CCM. The results that could not be coded were thematically analysed to generate themes to enrich the model. Search strategy keywords were: primary health care, diabetes mellitus type 2, hypertension, chronic disease, developing countries, low, middle-income countries and LMIC country names as classified by the World Bank. The search yielded 404 articles, 338 were excluded after reviewing abstracts. Further, 42 articles were excluded based on criteria. Twenty-four studies were included for analysis. All themes of the CCM, identified a priori, were represented in primary studies. Four additional themes for the model were identified: a focus on the quality of communication between health professionals and patients, availability of essential medicines, diagnostics and trained personnel at decentralised levels of healthcare, and mechanisms for coordination between healthcare providers. We recommend including these in the CCM to make it relevant for application in an LMIC.

Costs of district hospitals in South Africa

2005 ◽  
Vol 16 (4) ◽  
pp. 431-440
Author(s):  
Abiodun Olukoga ◽  
Geoff Harris
Keyword(s):  
South Africa ◽  
Average Length ◽  
Unit Cost ◽  
Hospital Costs ◽  
Indirect Costs ◽  
Public Hospitals ◽  
Vulnerable Groups ◽  
District Health ◽  
Unit Costs ◽  
District Hospitals

The district hospitals are an integral part of the district health system (DHS) in South Africa fulfilling several important functions. Using data obtained from relevant published reports. The district hospital costs were allocated using the ‘ingredients approach’ that combined a top-down method and step-down sequence. The costs in the treatment of patients were grouped into six cost centres: buildings, drugs, equipment, materials, personnel and utilities. The unit costs were broadly grouped into two categories using the hospital departments (fixed and variable costs) and input use (direct and indirect costs). More than 30% of the total public expenditure on hospitals in the country was on district hospitals between 1996/97 and 1998/99. They had more beds per population (1.08/1000) than other public hospitals. The bed occupancy rates in these hospitals were generally very low varying between 57% and 75%. The average length of stay (ALOS) was within acceptable range in the hospital except in Osindisweni hospital. Personnel costs were more than 70% and drugs only 3% to 6% of the total costs. McCord hospital was the most expensive using total and unit costs. Harrismith hospital had the lowest total costs and Osindisweni hospital the lowest unit cost. Most of the costs were fixed or direct costs in all the hospitals. There is the need for the adoption of measures to ensure that the hospitals are efficiently run while maintaining access for vulnerable groups.

scholarly journals What If All Patients with Breast Cancer in Malaysia Have Access to the Best Available Care: How Many Deaths Are Avoidable?

2017 ◽  
Vol 9 (8) ◽  
pp. 32 ◽  
Author(s):  
G. F. Ho ◽  
N. A. Taib ◽  
R. K. Pritam Singh ◽  
C. H. Yip ◽  
M. M. Abdullah ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Care ◽  
Safety Net ◽  
Public Hospitals ◽  
Sensitivity Analyses ◽  
Term Survival ◽  
Middle Income ◽  
Avoidable Deaths ◽  
Low Middle Income Countries ◽  
Under Performing

BACKGROUND: Cancer is a leading cause of death in the world and the fourth leading cause in Malaysia. A widening disparity in cancer burden has emerged between high and low-middle income countries. A similar disparity due to differential access to cancer care between affluent and deprived groups is likely to exist within developing country too. We assess this inequality by estimating the number of deaths due to cancer that would be avoidable if all patients had access to the best available care in Malaysia, a high middle income country.METHODS: The number of avoidable deaths is the difference between the number of deaths estimated by GLOBOCAN12 for Malaysia (which is consistent with published estimates on cancer survival), and the expected number of deaths if all patients with Breast Cancer (BC) had experienced the age-ethnic-stage specific survival outcomes observed in a leading private cancer centre in Malaysia. Data on age-ethnic-stage composition of the general BC population were from local cancer registry and public hospitals providing safety net cancer services.FINDINGS: Of the 2312 excess deaths due to BC, 2048 (88%) were avoidable. Of these avoidable deaths, 1167 (57%) were attributable to late stage presentation while 881 (43%) were due to lack of access to optimal treatment. Sensitivity analyses however show that the 88% avoidable deaths may be as low as 50%, taking into account differences in socio-economic status, over-diagnosis and lack of very long term survival data.INTERPRETATION: The huge number of avoidable deaths highlights the high cancer mortality rate among the deprived and the vast disparity in access to cancer care between the rich and poor within Malaysia, which mirrors the global cancer divide between rich and poor countries.Cancer care system that deliver such disastrous and inequitable outcomes is clearly under-performing. It is in urgent need of reform.

scholarly journals Inequalities in health: the role of health insurance in Nigeria

2015 ◽  
Author(s):  
Amanda Chukwudozie
Keyword(s):  
Health Insurance ◽  
Driving Forces ◽  
Healthcare Delivery ◽  
Health Financing ◽  
Public Health Issue ◽  
Middle Income ◽  
Insurance Cover ◽  
Disease Rates ◽  
Low Middle Income Countries

Health financing is a core necessity for sustainable healthcare delivery. Access inequalities due to financial restrictions in low-middle income countries, and in Africa especially, significantly affect disease rates and health statistics in these regions. This paper focuses on the role of a national health insurance cover as a funding medium in Nigeria, highlighting the theoretical premise of health insurance, its driving forces, key benefits and key limitations particular to the country under scrutiny. Emphasis is laid on its overall effect on the pressing public health issue of health inequality.

scholarly journals Implementation of a Multimodal Multicentre Hand Hygiene Study: Evidence From Bangladesh Hospitals

2019 ◽  
Vol 11 (11) ◽  
pp. 73
Author(s):  
Lutfe Ara ◽  
Monisha Datta Trisha ◽  
Md. Ehsanul Haque Tamal ◽  
Noor Kutubul Alam Siddiquee ◽  
SM Niaz Mowla ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Infection Control ◽  
Performance Feedback ◽  
Public Hospitals ◽  
Observational Assessment ◽  
Middle Income ◽  
Before And After ◽  
Quasi Experimental ◽  
Hygiene Compliance ◽  
And Performance

INTRODUCTION: Hand hygiene (HH), one of the most important preventive measures of Healthcare-associated infections (HCAIs), is often neglected by healthcare workers (HCWs) in low and middle-income countries (LMICs). PURPOSE: The purpose of the study is to assess the role of a multimodal intervention (MMI) for enhancing hand hygiene compliance (HHC) of HCWs in a resource-limited setting. METHODOLOGY: A pretest-posttest quasi-experimental study was conducted in five hospitals of Bangladesh where 984 HCWs (342 physicians and 642 nurses) were selected purposively. Using a structured checklist, a direct observational assessment was carried out on HCWs’ HHC both before and after the intervention. The MMI provided to HCWs comprised of: (i) system change, (ii) educational intervention, (iii) visual reminders, (iv) monitoring and performance feedback and (v) formation of infection control committees. RESULTS: Following intervention, overall HH compliance before and after patient contact significantly increased (p<0.00) to 50.1% and 57.2% respectively across all hospitals, professional categories and activities. Nurses were more compliant to HH than physicians (OR = 1.1, 95% CI: 1.0-1.3, P < 0.01) after patient contacts. However, both groups showed equal HHC (OR = 1, CI: 0.9-1.1, P = 0.72) before patient contacts. HCWs of private hospitals were 1.5 times more compliant to HHC than that of public hospitals. CONCLUSIONS: This study denotes that despite national policies on hand hygiene in Bangladesh, HCW’s compliance to HH is poor. Study findings also illustrate that a multimodal HH program resulted in significant improvement in HCWs’ HHC that deserves the potentials to assist the advancement of infection control practices targeting reduction of HCAIs.

The Impact of Covid 19 on Pregnant Women and Child Health

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1367-1373
Author(s):  
Nikhil Sanjay Mujbaile ◽  
Smita Damke
Keyword(s):  
Social Issues ◽  
Middle Income ◽  
Web Based ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
The Social ◽  
Social Separation ◽  
The Impact ◽  
And Child Health ◽  
General Wellbeing

The Covid illness (COVID-19) pandemic has spread rapidly all through the world and has had a drawn-out impact. The Pandemic has done incredible damage to society and made genuine mental injury to numerous individuals. Mental emergencies frequently cause youngsters to deliver sentiments of relinquishment, despondency, insufficiency, and fatigue and even raise the danger of self-destruction. Youngsters with psychological instabilities are particularly powerless during the isolate and colonial removing period. Convenient and proper assurances are expected to forestall the event of mental and social issues. The rising advanced applications and wellbeing administrations, for example, telehealth, web-based media, versatile wellbeing, and far off intuitive online instruction can connect the social separation and backing mental and conduct wellbeing for youngsters. Because of the mental advancement qualities of youngsters, this investigation additionally outlines intercessions on the mental effect of the COVID-19 Pandemic. Further difficulties in Low Middle-Income Countries incorporate the failure to actualize successful general wellbeing estimates, for example, social separating, hand cleanliness, definitive distinguishing proof of contaminated individuals with self-disconnection and widespread utilization of covers The aberrant impacts of the Pandemic on youngster wellbeing are of extensive concern, including expanding neediness levels, upset tutoring, absence of admittance to the class taking care of plans, decreased admittance to wellbeing offices and breaks in inoculation and other kid wellbeing programs. Kept tutoring is critical for kids in Low Middle-Income Countries. Arrangement of safe situations is mainly testing in packed asset obliged schools. 

Risk Factors of Mortality Among Patients with Stroke in Low Middle-Income Countries:  A Series of 180 Patients

2020 ◽  
Author(s):  
Larrey Kamabu ◽  
Hervé Monka Lekuya ◽  
Bienvenu Muhindo Kasusula ◽  
Nicole Kavugho Mutimani ◽  
Louange Maha Kathaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries

scholarly journals Effective coverage and budget implications of skill-mix change to improve neonatal nursing care: an explorative simulation study in Kenya

2019 ◽  
Vol 4 (6) ◽  
pp. e001817 ◽  
Author(s):  
Apostolos Tsiachristas ◽  
David Gathara ◽  
Jalemba Aluvaala ◽  
Timothy Chege ◽  
Edwine Barasa ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Neonatal Mortality ◽  
Nursing Care ◽  
Public Hospitals ◽  
Sensitivity Analyses ◽  
Full Time ◽  
Skill Mix ◽  
Neonatal Nursing ◽  
Low Middle Income Countries

IntroductionNeonatal mortality is an urgent policy priority to improve global population health and reduce health inequality. As health systems in Kenya and elsewhere seek to tackle increased neonatal mortality by improving the quality of care, one option is to train and employ neonatal healthcare assistants (NHCAs) to support professional nurses by taking up low-skill tasks.MethodsMonte-Carlo simulation was performed to estimate the potential impact of introducing NHCAs in neonatal nursing care in four public hospitals in Nairobi on effectively treated newborns and staff costs over a period of 10 years. The simulation was informed by data from 3 workshops with >10 stakeholders each, hospital records and scientific literature. Two univariate sensitivity analyses were performed to further address uncertainty.ResultsStakeholders perceived that 49% of a nurse full-time equivalent could be safely delegated to NHCAs in standard care, 31% in intermediate care and 20% in intensive care. A skill-mix with nurses and NHCAs would require ~2.6 billionKenyan Shillings (KES) (US$26 million) to provide quality care to 58% of all newborns in need (ie, current level of coverage in Nairobi) over a period of 10 years. This skill-mix configuration would require ~6 billion KES (US$61 million) to provide quality of care to almost all newborns in need over 10 years.ConclusionChanging skill-mix in hospital care by introducing NHCAs may be an affordable way to reduce neonatal mortality in low/middle-income countries. This option should be considered in ongoing policy discussions and supported by further evidence.

scholarly journals Triaging and adaptations of surveillance of cancer services in the COVID pandemic

2020 ◽  
pp. 1-3
Author(s):  
Shirley Lewis ◽  
Lavanya Gurram ◽  
Umesh Velu ◽  
Krishna Sharan
Keyword(s):  
Cancer Patients ◽  
Clinical Examination ◽  
Cancer Care ◽  
Middle Income ◽  
Face To Face ◽  
Middle Income Countries ◽  
Cancer Services ◽  
Low Middle Income Countries

Abstract Introduction: Coronavirus disease (COVID-19) has significantly challenged the access to cancer care and follow-up for a patient with cancer. Methods: Based on published literature and our experiences, it is reasonable to presume that clinical examination and follow-up visits have been significantly curtailed worldwide in order to adhere to the new norms during the pandemic. Although telephonic and telemedicine consultations may help bridge a few gaps, completely dispensing with in-person consultation has its challenges, especially in low middle-income countries. Telephonic consultations could facilitate triaging of ambulatory cancer patients and allocation of face-to-face consultations for high priority patients. Conclusions: We propose a telephonic consultation-based triaging approach for ambulatory cancer patients in order to identify those needing in-hospital consultations.

Sign in / Sign up

Export Citation Format

Share Document