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

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.

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

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.

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

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Ranjbar ◽  
Mohammad Bazyar ◽  
Hassan Jafari ◽  
Mohsen Pakdaman ◽  
Vahid Pirasteh
Keyword(s):  
Performance Indicators ◽  
Average Length ◽  
Interrupted Time Series ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Cross Sectional ◽  
Average Length Of Stay ◽  
Hospitalization Rates ◽  
Research Findings ◽  
Yazd City

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.

scholarly journals Epidemiological comparison of stroke patients before and after Cincinatti Scale implementation

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.

scholarly journals Noncommunicable Disease Service Utilization among Expatriate Patients in Thailand: An Analysis of Hospital Service Data, 2014–2018

2021 ◽  
Vol 18 (18) ◽  
pp. 9721
Author(s):  
Anon Khunakorncharatphong ◽  
Nareerut Pudpong ◽  
Rapeepong Suphanchaimat ◽  
Sataporn Julchoo ◽  
Mathudara Phaiyarom ◽  
...  
Keyword(s):  
Public Health ◽  
Service Utilization ◽  
Well Being ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Noncommunicable Disease ◽  
Noncommunicable Diseases ◽  
P Value ◽  
Health Coverage ◽  
Cross Sectional

Global morbidity associated with noncommunicable diseases (NCDs) has increased over the years. In Thailand, NCDs are among the most prevalent of all health problems, and affect both Thai citizens and non-Thai residents, such as expatriates. Key barriers to NCD health service utilization among expatriates include cultural and language differences. This study aimed to describe the situation and factors associated with NCD service utilizations among expatriate patients in Thailand. We employed a cross-sectional study design and used the service records of public hospitals from the Ministry of Public Health (MOPH) during the fiscal years 2014–2018. The focus of this study was on expatriates or those who had stayed in Thailand for at least three months. The results showed that, after 2014, there was an increasing trend in NCD service utilizations among expatriate patients for both outpatient (OP) and inpatient (IP) care. For OP care, Cambodia, Laos PDR, Myanmar, and Vietnam (CLMV) expatriates had fewer odds of NCD service utilization, relative to non-CLMV expatriates (p-value < 0.001). For IP care, males tended to have greater odds of NCD service utilization compared with females (AdjOR = 1.35, 95% CI = 1.05–1.74, p-value = 0.019). Increasing age showed a significant association with NCD service utilization. In addition, there was a growing trend of the NCD prevalence amongst expatriate patients. This issue points to a need for prompt public health actions if Thailand aims to have all people on its soil protected with universal health coverage for their well-being, as stipulated in the Sustainable Development Goals. Future studies that aim to collect primary evidence of expatriates at the household level should be conducted. Additional research on other societal factors that may help provide a better insight into access to healthcare for NCDs, such as socioeconomic status, beliefs, and attitudes, should be conducted.

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

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 Salé 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.

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

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.

scholarly journals Burden of out-of-pocket payments among patients with cardiovascular disease in public and private hospitals in Ibadan, South West, Nigeria: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044044
Author(s):  
Folashayo Adeniji
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Financial Burden ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Health Coverage ◽  
Sectional Study ◽  
Cross Sectional ◽  
Out Of Pocket Payments ◽  
Ibadan Nigeria

ObjectiveGiven that the mechanism for financial protection is underdeveloped in Nigeria, out-of-pocket (OOP) payment for treating cardiovascular disease could impose substantial financial burden on individuals and their families. This study estimated the burden of OOP expenditures incurred by a cohort of patients with cardiovascular disease (CVD) in Ibadan, Nigeria.Design and settingsThis study used a descriptive cross-sectional study design. A standardised survey questionnaire originally developed by Initiative for Cardiovascular Health Research in Developing Countries was used to electronically collect data from all the 744 patients with CVD who accessed healthcare between 4 November 2019 and 31 January 2020 in the cardiology departments of private and public hospitals in Ibadan, Nigeria. Baseline characteristics of respondents were presented using percentages and proportions. The OOP payments were reported as means±SDs. Costs/OOP payments were in Nigerian Naira (NGN). The average US dollar to NGN at the time of data collection was ₦362.12 per $1. All quantitative data were analysed using STATA V.15.Outcome measuresThe burden of outpatient, inpatient and rehabilitative care OOP payments.ResultsMajority of the patients with CVD were within the age range of 45–74 years and 68.55% of them were women. The diagnostic conditions reported among patients with CVD were hypertensive heart failure (84.01%), dilated cardiomyopathy (4.44%), ischaemic heart disease (3.9%) and anaemic heart failure (2.15%). Across all the hospital facilities, the annual direct and indirect outpatient costs were ₦421 595.7±₦855 962.0 ($1164.2±$2363.8) and ₦19 146.5±₦53 610.1 ($52.87±$148.05). Similarly, the average direct and indirect OOP payments per hospitalisation across all facilities were ₦182 302.4±₦249 090.4 ($503.43±$687.87) and ₦14 700.8±₦ 69 297.1 ($40.60±$191.37), respectively. The average rehabilitative cost after discharge from index hospitalisation was ₦30 012.0 ($82.88).ConclusionThe burden of OOP payment among patients with CVD is enormous. There is a need to increase efforts to achieve universal health coverage in Nigeria.

scholarly journals Prescribing Patterns of Antibiotics for the Self-Treatment of Travelers’ Diarrhea in Global TravEpiNet, 2009–2018

2020 ◽  
Vol 7 (10) ◽  
Author(s):  
Aditya R Gandhi ◽  
Sowmya R Rao ◽  
Lin H Chen ◽  
Michael D Nelson ◽  
Edward T Ryan ◽  
...  
Keyword(s):  
Interrupted Time Series ◽  
Cross Sectional Study ◽  
The Self ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Cross Sectional ◽  
Empiric Antibiotics ◽  
Before And After ◽  
Time Series Analyses ◽  
Rate Of Decline

Abstract Background International travelers are often prescribed antibiotics for self-treatment of travelers’ diarrhea (TD), but the benefits and risks of antibiotics are debated. We assessed the prescribing patterns of empiric antibiotics for TD in international travelers evaluated at Global TravEpiNet (GTEN) sites (2009–2018). Methods We performed a prospective, multisite cross-sectional study regarding antibiotic prescriptions for the self-treatment of TD at 31 GTEN sites providing pretravel consultations to adult international travelers. We described traveler demographics, itineraries, and antibiotic(s) prescribed. We used multivariable logistic regressions to assess the association of year of consultation with antibiotic prescribing (yes/no) and class (fluoroquinolones vs azithromycin). We performed interrupted time-series analyses to examine differences in prescribing before and after the Food and Drug Administration (FDA) warning on fluoroquinolones (July 2016). Results Antibiotics were not prescribed in 23 096 (22.2%) of 103 843 eligible pretravel GTEN consultations; azithromycin and fluoroquinolones were most frequently prescribed. Antibiotic prescribing declined significantly each year between 2009 and 2018 (odds ratio [OR], 0.84; 95% CI, 0.79–0.89), as did fluoroquinolone prescribing, relative to azithromycin (OR, 0.77; 95% CI, 0.73–0.82). The rate of decline in fluoroquinolone prescribing was significantly greater after the FDA fluoroquinolone warning (15.3%/year) than before (1.1%/year; P &lt; .001). Conclusions Empiric antibiotics for TD were prescribed in &gt;75% of pretravel GTEN consultations, but antibiotic prescribing declined steadily between 2009 and 2018. Fluoroquinolones were less frequently prescribed than azithromycin, especially after the 2016 FDA fluoroquinolone warning. Emphasis on the risks of antibiotics may influence antibiotic prescribing by providers for empiric treatment of TD.

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

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.

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

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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