scholarly journals Managerial Perspectives on Integration of Complementary and Alternative Medicine Services into the Ghanaian Public Healthcare System: An Exploratory Study

Author(s):  
Maame Yaa Pomaa Nhyira Essel ◽  
Samuel Amon ◽  
Samuel Agyei Agyemang ◽  
Moses Aikins

Abstract Background This study explores healthcare managers’ perspective of integration of CAM service into Ledzorkuku Krowor Municipal (LEKMA) Hospital in Ghana. Methods A questionnaire on CAM services integration was constructed and distributed to all 9 healthcare managers at the Ledzorkuku Krowor Municipal (LEKMA) Hospital.Results The level of integration of CAM services into the health care system was good. The overall self-reported depth of integration was found to be good (2.23), the self-reported extent of was 100% and perceived scope of integration was classified as excellent (90.1%). The drivers of integration process were made up of 7 (19.1%) of the elements of integration functions (47) assessed. Conclusion The drivers of integration were mainly the elements of integration functions of patient satisfaction, right of patients to use other services, interpersonal systems, monitoring and supervision systems, nature of working relationship among staff, reporting, and financial management.

2021 ◽  
Vol 8 ◽  
pp. 237437352199884
Author(s):  
Marian A O Cohen ◽  
Jim McQuaid ◽  
Ruth Remington

Much has been written about the patient experience, but there is little information about experiences of providers as patients. Since lay patients and providers have differing perspectives and expectations, it is important to identify those elements shared by those in each group and those that diverge. This study identified experiences of nurses as being a patient or a family caregiver of a patient as well as identified assessments of the healthcare system by nurses. An exploratory study using a self-administered electronic questionnaire with a group of registered nurses was conducted. Assessments of the system by responders were positive when addressing quality of care, interactions among healthcare personnel, and interactions with patients. However, when discussing their experiences as patient, nurses reported they encountered problems with coordination of care, responses of medical personnel, attention to details of care, and responses to their attempts to become more involved. Results confirm issues raised by patients who are not medical experts in patient satisfaction studies. Adding a professional perspective highlights where problems with the healthcare system lie.


2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 192-192
Author(s):  
Doreen Anuli Ezeife ◽  
Joshua Morganstein ◽  
Sally C Lau ◽  
Lisa Le ◽  
David Cella ◽  
...  

192 Background: Financial distress has been established as a clinically relevant patient-reported outcome (PRO) associated with worse mortality and quality of life, but remains under-recognized by health care providers. Our goal was to define factors associated with financial toxicity (FT) in a public healthcare system. Methods: Patients with advanced lung cancer were recruited from outpatient clinics at the Princess Margaret Cancer Centre (Toronto, Canada). FT was measured with the validated Comprehensive Score for Financial Toxicity (COST) instrument, a 12-item survey scored from 0-44 with lower scores reflecting worse financial well-being. Data on patient and treatment characteristics, total out-of-pocket costs (OOP) and extended insurance coverage (EIC) were collected. Multivariable logistic regression models were fit for COST score and each variable, to determine factors associated with greater FT (COST < 21). Results: Of 251 patients approached, 200 (80%) participated. Median age of the cohort was 65 years; 56% were female, 64% immigrants and 77% employed or on pension. Median total OOP while on treatment ranged between $1000-5000 CAD. Median COST score was 21 (range 0-44). FT was associated with age, with patients < 65 years reporting greater FT than older patients (COST 18.0 vs. 24.0, p < 0.0001). In multivariable logistic regression analysis, younger age was associated with greater FT, when adjusting for income, employment status, OOP and EIC (OR 3.6, [95% CI, 1.5-9.1]; p < 0.0001). Total OOP > $1000 and EIC also were associated with greater FT (adjusted OR 5.0 [95% CI, 2.0-12.1] and 3.7 [95% CI, 1.5-9.1], respectively). Conclusions: Age is significantly associated with FT in the Canadian (Ontario) public healthcare system, with younger lung cancer patients reporting greater financial distress. This study highlights priority patient populations where FT should be routinely assessed and appropriate resources for support offered.


2018 ◽  
Vol 13 (2) ◽  
pp. 9-28
Author(s):  
Sindhu Joseph

Medical tourism based on transnational journeys for health care, cure, and well-being is being widely discussed in the literature. As a fast-developing phenomenon, there are different views and perspectives on the concerns of medical tourists and various impacts created in destination areas. This paper critically observes the exertions of medical tourism on destination areas in the light of economic and socio-cultural influences. This paper tries to bring out the muddles of the phenomenon based on empirical research. The paper suggests that the socio-cultural impact of medical tourism on the health care of the poor local people must be viewed seriously and calls for rigid and efficient legislation from the authorities to enable and strengthen the public healthcare system.


2021 ◽  
Vol 6 (6) ◽  
pp. e004707
Author(s):  
Mark W Moses ◽  
Julius Korir ◽  
Wu Zeng ◽  
Anita Musiega ◽  
Joyce Oyasi ◽  
...  

IntroductionA well performing public healthcare system is necessary for Kenya to continue progress towards universal health coverage (UHC). Identifying actionable measures to improve the performance of the public healthcare system is critical to progress towards UHC. We aimed to measure and compare the performance of Kenya’s public healthcare system at the county level and explore remediable drivers of poor healthcare system performance.MethodsUsing administrative data from fiscal year 2014/2015 through fiscal year 2017/2018, we measured the technical efficiency of 47 county-level public healthcare systems in Kenya using stochastic frontier analysis. We then regressed the technical efficiency measure against a set of explanatory variables to examine drivers of efficiency. Additionally, in selected counties, we analysed surveys and focus group discussions to qualitatively understand factors affecting performance.ResultsThe median technical efficiency of county public healthcare systems was 84% in fiscal year 2017/2018 (with an IQR of 79% to 90%). Across the four fiscal years of data, 27 out of the 47 Kenyan counties had a declining technical efficiency score. Our regression analysis indicated that impediments to the flow of funding—measured by the budget absorption rate which is the ratio between funds spent and funds released—were significantly related to poor healthcare system performance. Our analysis of interviews and surveys yielded a similar conclusion as nearly 50% of respondents indicated issues stemming from poor budget absorption were significant drivers of poor healthcare system performance.ConclusionPublic healthcare systems at the county-level in Kenya general performed well; however, addressing delays in the flow of funding is a concrete step to improve healthcare system performance. As Kenya—and other countries—provides additional funding to meet their UHC goals, establishing a strong and robust public financial management system is critical to ensure that the benefits of UHC are realised.


Author(s):  
Narcis Copca ◽  
Constanta Mihaescu-Pintia

Abstract Work motivation and satisfaction are core performance factors, of a broad complexity in healthcare. In spite of all economic, political, administrative, regulatory or bureaucratic adversities, there are public Romanian hospitals striving to perform at European level. Medical personnel dissatisfaction, and shortage due to migration are significant challenges for managers. Methodology: the main research question is whether motivation is a key factor in a public Romanian hospital oriented to clinical excellence, reflected by retention of medical staff and their professional satisfaction, and also perceived by their patients. Purpose: to analyze importance and level of job satisfaction of hospital personnel in relation with other motivation components given the rough environment of Romanian public healthcare system, and its reflection on patient satisfaction. The paper is based on two studies: professional satisfaction survey conducted among all 350 employees of the Clinical Hospital “St. Maria” Bucharest accredited for liver transplantation and achieving great clinical performance, based on a 21-questions semi-structured questionnaire. Second, a patient satisfaction survey conducted on a sample of 75 patients randomly selected from all 5 hospital departments, out of an average of approximately 230 patients per week, by applying on discharge day a questionnaire of 30 questions. Results: Great majority of our personnel appreciated as appropriate: their working conditions, communication and relationship with hierarchic boss and with hospital management team. 84.6% of medical and 90.5% of nonmedical personnel declared to be professionally very satisfied and satisfied in this hospital. Patient satisfaction analysis indicated that almost all respondents were informed by medical personnel about their conditions and rights, receiving explanations about treatment; 90% considered care received at a very good quality, except for food; 90.2% of respondents rated as very good the personnel kindness, availability, communication, information and care; 67,2% of patients stated as very satisfied and 23% satisfied with the medical care received, and all respondents would choose this hospital again if needed and even would recommend it to others. Conclusion: Anticipating their needs and motivating hospital personnel to achieve high performance is of great importance for managers and employees, by focusing on people and using appropriate tools even when no direct financial incentives are possible. Professional satisfaction has to be periodically measured, correlated with patient surveys and followed by specific actions for improvement and kept high, thus allowing climbing up to the best hospitals in Bucharest, despite significant challenges within Romanian public healthcare system. Our analysis showed the importance of job motivation and satisfaction in public hospitals, despite the rough environment, and reflection of work satisfaction on employees-patients relationship in terms of availability, communication, providing information and feedback, care, and choice/preference for future services. Thus, our research objectives were fulfilled.


2021 ◽  
Author(s):  
MD. SHAHJALAL ◽  
Jeffrey Gow ◽  
Md. Ashfikur Rahman ◽  
Md. Jakir Hossain ◽  
Md. Nafiul Alam Khan ◽  
...  

Abstract Background Complementary and alternative medicine (CAM) has played an important role in providing universal access to essential health care services globally. Conventional medicine (CM) driven health care practices are well-developed in Bangladesh; however, millions of people utilise CAM-based healthcare services for specific health conditions or health benefits due to high out-of-pocket payment (74%) in Bangladesh, while the global average is only 32%. Lack of evidence exists about the perception and utilisation of CAM in Bangladesh. This study aimed to estimate the prevalence correlates of the perception and utilisation of CAM among patients who received health care at a tertiary hospital, Bangladesh. MethodsThis study comprised a cross-sectional study with 1,183 individuals from the cross-sectional survey among patients who received health care from Government Unani and Ayurvedic Medical College Hospital in Dhaka, Bangladesh. Logistic regression analyses were employed to estimate the adjusted effect of independent factors on CAM health care services utilisation. Results Thirty-three percent of patients utilised CAM health care services, while 67% of patients sought conventional treatment before turning to CAM. CAM health care utilisation was significantly associated with young adult patients aged 26 to 45 years (AOR=6.26, 95% CI:3.24-12.07), patients without education (AOR=2.99, 1.81-4.93), and being married (AOR=1.79, 1.08-2.97). The apparent effectiveness, lower side effects, adequate patient satisfaction, and recommendations from others were the most prevalent reasons for using CAM.ConclusionCM plays a dominant role in health care provision in Bangladesh, with high-level patient satisfaction and health benefits. These results could be valuable for health policymakers as they explore prospects for integrating CAM and conventional medical services.


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