scholarly journals Incidence of Medical Malpractice Lawsuits and Its Relationship to the Growth of Private Hospitals

2020 ◽  
Author(s):  
Yu Sun ◽  
Gordon G. Liu ◽  
Mengxiao Wang ◽  
Sijia Liu
Keyword(s):  
Health Care ◽  
Medical Malpractice ◽  
Fixed Effects ◽  
Negative Binomial ◽  
Public Hospitals ◽  
Health Care Market ◽  
Private Hospitals ◽  
Outpatient Visits ◽  
Province Level ◽  
Health Statistic

Abstract BackgroundDoctor-patient relationship has become an intense concern in public health in recent years. Medical malpractice lawsuits have presented an increasing trend over past decade. This study aims to describe distributions of medical malpractice lawsuits across different provinces and to investigate its relationship to the growth of private hospitals.MethodsData was drawn from China Judgments Online, the China Health Statistic Yearbooks and China Statistical Yearbooks between January 1, 2010 to December 31, 2016. Private hospitals expansion was measured by the number and proportion of private hospitals, the ratio of outpatient visits from private to public hospitals and the ratio of discharges from private to public hospitals. Fixed-effects negative binomial regressions were utilized to estimate the association between the growth of private hospitals and the number of medical malpractice lawsuits.ResultsIn total, we identified a total of 18220 lawsuits relevant to medical malpractices across China between 2010 and 2016. The regression results revealed that more private hospitals, larger proportion of private hospitals and higher ratio of discharges from private to public hospitals were significantly associated with fewer medical malpractice lawsuits. An increase of 100 private hospitals in health care market was associated with a decrease in the number of medical malpractice lawsuits by 21%. The ratio of outpatient visits from private to public hospitals was not significantly associated with the number of malpractice lawsuits. ConclusionsThere was great disparities of incidences of medical malpractice lawsuits across different provinces. Greater expansion of private hospitals was associated with fewer medical malpractice lawsuits at province level. This negative association indicated that more private hospitals in health care market might provide more incentives for hospitals to contain the incidences of medical malpractice cases.

scholarly journals An analysis of medical malpractice lawsuits and its relationship to the growth of private hospitals

2020 ◽  
Author(s):  
Yu Sun ◽  
Gordon G. Liu ◽  
Mengxiao Wang ◽  
Sijia Liu
Keyword(s):  
Health Care ◽  
Medical Malpractice ◽  
Fixed Effects ◽  
Negative Binomial ◽  
Public Hospitals ◽  
Health Care Market ◽  
Private Hospitals ◽  
Outpatient Visits ◽  
Province Level ◽  
Health Statistic

Abstract Background Doctor-patient relationship has become an intense concern in public health in recent years. Medical malpractice lawsuits have presented an increasing trend over past decade. This study aims to describe distributions of medical malpractice lawsuits across different provinces and to investigate its relationship to the growth of private hospitals.Methods Data was drawn from China Judgments Online, the China Health Statistic Yearbooks and China Statistical Yearbooks between January 1, 2010 to December 31, 2016. Private hospitals expansion was measured by the number and proportion of private hospitals, the ratio of outpatient visits from private to public hospitals and the ratio of discharges from private to public hospitals. Fixed-effects negative binomial regressions were utilized to estimate the association between the growth of private hospitals and the number of medical malpractice lawsuits.Results In total, we identified a total of 18220 lawsuits relevant to medical malpractices across China between 2010 and 2016. The regression results revealed that more private hospitals, larger proportion of private hospitals and higher ratio of discharges from private to public hospitals were significantly associated with fewer medical malpractice lawsuits. An increase of 100 private hospitals in health care market was associated with a decrease in the number of medical malpractice lawsuits by 21%. The ratio of outpatient visits from private to public hospitals was not significantly associated with the number of malpractice lawsuits.Conclusions There was great disparities of incidences of medical malpractice lawsuits across different provinces. Greater expansion of private hospitals was associated with fewer medical malpractice lawsuits at province level. This negative association indicated that more private hospitals in health care market might provide more incentives for hospitals to contain the incidences of medical malpractice cases.

Healthcare Cost and Patient Satisfaction: A Comparative Analysis Between Public and Private Hospitals in Bangladesh

2021 ◽  
Author(s):  
Farhana Begum ◽  
Jamaliah Said ◽  
Syed Zabid Hossain ◽  
Mohammad Jahid Hasan ◽  
Normah Binti
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Comparative Analysis ◽  
Healthcare Cost ◽  
Health Care Facilities ◽  
Public Hospitals ◽  
Satisfaction Level ◽  
Private Hospitals ◽  
Public And Private ◽  
Female Ratio

Abstract Background and objective: Patient satisfaction and its relation with healthcare cost in Bangladesh remains unknown. The objective of the study was to perform a comparative analysis of satisfaction of patients in relation with healthcare cost in public and private healthcare settings in Bangladesh.Methods: This cross-sectional study was conducted at two public and two private hospitals in Dhaka city, Bangladesh. A total of 1120 respondents were included by purposive sampling. Data collection was performed with a semi-structured questionnaire. The level of satisfaction was assessed by a 5-point Likert scale. Expenditure details during hospital stay were also recorded. Informed consent was obtained, and study procedures were conducted according to the Declaration of Helsinki. SPSS 23 was used for statical test. Results: The mean age of the respondents was 50.10±21.13 (SD) years, with a male-female ratio of 1.14:1. The majority were from urban areas. The average health-care cost of patients in both the conservative and operative groups was statistically significantly higher in private hospitals than in public hospitals (p<0.001). The overall satisfaction level was higher among the patients who received care from private settings than the public (p<0.001). However, taking health care in private hospitals rather than public hospitals was independently associated with patient satisfaction when adjusted for other factors (age, sex, economic status, treatment type, duration of hospital stays, treatment outcome, and total expense).Conclusion: Despite higher expenses, the overall satisfaction level was significantly better in private health-care facilities. These findings need to be explored in further large multicenter studies.

scholarly journals PERANAN SERVICE QUALITY TERHADAP PATIENT REVISIT INTENTION MELALUI PATIENT SATISFACTION PADA RUMAH SAKIT UMUM DAN RUMAH SAKIT SWASTA TIPE B

2008 ◽  
Vol 1 (1) ◽  
pp. 49
Author(s):  
Febry Adhiana
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Service Quality ◽  
Health Care Professionals ◽  
Public Hospitals ◽  
Human Beings ◽  
Private Hospitals ◽  
Public And Private ◽  
Revisit Intention ◽  
Public And Private Hospitals

<p>Backg of nd: the increasing of awareness in health care by Indonesian people especially in Jakart Healthcare that health care professionals are highly dependent on each other to provide and coordi ate services of high value for human beings. Patients usually prefer to go to private hospitals hoping tc receive high service quality. But in fact, public hospitals have a good quality service also becau e ft is supported by the government.<br />Object ve to compare service quality, patient satisfaction and patient revisit intention of public and privatE hospitals.<br />Resea h design: this research applies to public and private hospitals in Jakarta and questionnaires were s read away to 97 respondents or patients from some public and private hospitals in Jakarta by usi g purpose sampling.<br />Findin s: There are no differences between private and public hospitals in service quality, patient satisf Um and patient revisit intention. Finally the implications of the results are highlighted for health :are managers.</p>

scholarly journals Did the universal zero-markup drug policy lower healthcare expenditures? Evidence from Changde, China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zixuan Peng ◽  
Chaohong Zhan ◽  
Xiaomeng Ma ◽  
Honghui Yao ◽  
Xu Chen ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Drug Policy ◽  
Negative Binomial ◽  
Public Hospitals ◽  
Hunan Province ◽  
Healthcare Expenditures ◽  
Discharge Data ◽  
Outpatient Visits ◽  
Drug Expenditures ◽  
Outpatient Drug

Abstract Background The zero-markup drug policy (also known as the universal zero-markup drug policy (UZMDP)) was implemented in stages beginning with primary healthcare facilities in 2009 and eventually encompassing city public hospitals in 2016. This policy has been a central pillar of Chinese health reforms. While the literature has examined the impacts of this policy on healthcare utilization and expenditures, a more comprehensive and detailed assessment is warranted. The purpose of this paper is to explore the impacts of the UZMDP on inpatient and outpatient visits as well as on both aggregate healthcare expenditures and its various components (including drug, diagnosis, laboratory, and medical consumables expenditures). Methods A pre-post design was applied to a dataset extracted from the Changde Municipal Human Resource and Social Security Bureau comprising discharge data on 27,246 inpatients and encounter data on 48,282 outpatients in Changde city, Hunan province, China. The pre-UZMDP period for the city public hospitals was defined as the period from October 2015 to September 2016, while the post-UZMDP period was defined as the period from October 2016 to September 2017. Difference-in-Difference negative binomial and Tobit regression models were employed to evaluate the impacts of the UZMDP on healthcare utilization and expenditures, respectively. Results Four key findings flow from our assessment of the impacts of the UZMDP: first, outpatient and inpatient visits increased by 8.89 % and 9.39 %, respectively; second, average annual inpatient and outpatient drug expenditures fell by 4,349.00 CNY and 1,262.00 CNY, respectively; third, average annual expenditures on other categories of healthcare expenditures increased by 2,500.83 CNY, 417.10 CNY, 122.98 CNY, and 143.50 CNY for aggregate inpatient, inpatient diagnosis, inpatient laboratory, and outpatient medical consumables expenditures, respectively; and fourth, men and older individuals tended to have more inpatient and outpatient visits than their counterparts. Conclusions Although the UZMDP was effective in reducing both inpatient and outpatient drug expenditures, it led to a sharp rise in other expenditure categories. Policy decision makers are advised to undertake efforts to contain the growth in total healthcare expenditures, in general, as well as to evaluate the offsetting effects of the policy on non-drug components of care.

scholarly journals SARS-COV-2 Seroprevalence among Health Care Workers in Private and Public Hospitals in Tehran, Iran

2021 ◽  
Author(s):  
Maryam Darvishian ◽  
Maryam Sharafkhah ◽  
Zahra Mohammadi ◽  
Khosro Sadeghniiat-haghighi ◽  
Alireza Abdollahi ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Test Performance ◽  
Elisa Test ◽  
Public Hospitals ◽  
Private Hospitals ◽  
Public And Private ◽  
Care Workers ◽  
Private And Public ◽  
Public And Private Hospitals

Abstract BackgroundEstimating the prevalence of SARS-COV-2 antibody seropositivity among health care workers (HCWs) is crucial. In this study the seroprevalence of anti-SARS-COV-2 antibodies among HCWs of five hospitals of Tehran-Iran with high COVID-9 patient’s referrals was assessed.MethodsHCWs from public and private hospitals were included and were asked questions on their demographic characteristics, medical history, hospital role and usage of personal protective equipment (PPE). Seroprevalence was estimated on the basis of ELISA test results (IgG and IgM antibodies in blood samples) and adjusted for test performance.ResultsAmong the 2065 participants, 88.4% and 11.6% HCWs were recruited from the public and private hospitals, respectively. The overall test-performance adjusted seroprevalence estimate among HCWs was 22.6 (95% CI 20.2-25.1) and it was higher in private hospitals (37.0%; 95% CI 28.6-46.2) than public hospitals (20.7%; 95% CI 18.2-23.3). PPE usage was significantly higher among HCWs of public versus private hospitals (66.5% vs. 20.0%). Test-adjusted seroprevalence estimates were highest among assistant nurses and nurses, and lowest among janitor/superintendent categories. ConclusionsSeroprevalence of SARS-COV-2 among HCWs depends on hospital type, hospital department, and hospital role. The PPE usage was especially suboptimal among HCWs in private hospitals. Continued effort in access to adequate PPE is warranted.

scholarly journals Riscos legais litigiosos na assistência à saúde

2019 ◽  
Vol 13 ◽  
Author(s):  
Regina Ribeiro Parizi Carvalho ◽  
Welington Cardoso de Oliveira Cadidé
Keyword(s):  
Health Care ◽  
Outpatient Service ◽  
Care Patient ◽  
Public Hospitals ◽  
Private Hospitals ◽  
Legal Risks ◽  
Court Proceedings ◽  
Quantitative Descriptive ◽  
Collection Form

Objetivo: analisar as demandas judiciais que envolveram riscos legais ou jurídicos litigiosos na assistência à saúde. Método: trata-se de um estudo quantitativo, descritivo, retrospectivo. Pesquisaram-se 1.138 processos válidos do universo de 1.599. Utilizou-se ficha de coleta de dados assim como a planilha Excel para organizaão e análise dos processos judiciais, frequência e razão nos hospitais públicos, privados e filantrópicos. Resultados: revelou-se ocorrência maior da razão de processos nos hospitais privados (8,06). Apresentou-se o risco erro médico com maior concentração (58,1%) nos hospitais privados (65,6%), no serviço ambulatorial (65,0%) e na área cirúrgica (58,9%).  Conclusão: destaca-se que os riscos legais litigiosos na assistência foram mais frequentes nos hospitais privados. Mostrou-se a assistência prestada em hospitais públicos com qualidade, sendo os resultados conclusivos e reveladores, entretanto, é importante ampliar esse tipo de estudo para melhor caracterização do perfil do risco diante do tipo de serviço e da clientela, gerando parâmetro para a avaliação da qualidade da assistência prestada em todo o território nacional. Descritores: Risco; Responsabilidade Legal; Responsabilidade Civil; Assistência à Saúde; Segurança do Paciente; Judicialização da Saúde.AbstractObjective: to analyze the lawsuits that involved legal or litigious legal risks in health care. Method: this is a quantitative, descriptive, retrospective study. 1,138 valid processes from the universe of 1,599 were searched. Data collection form was used as well as Excel spreadsheet for the organization and analysis of court proceedings, frequency and reason in public, private and philanthropic hospitals. Results: a higher occurrence of the ratio of processes in private hospitals was found (8.06). The risk of medical error was higher (58.1%) in private hospitals (65.6%), outpatient service (65.0%) and surgical area (58.9%). Conclusion: It is noteworthy that the litigious legal risks in care were more frequent in private hospitals. The assistance provided in quality public hospitals has been shown, and the results are conclusive and revealing. However, it is important to expand this type of study to better characterize the risk profile regarding the type of service and the clientele, generating a parameter for the evaluation of quality of care provided throughout the national territory. Descriptors: Risk; Liability, Legal; Responsabilidad Civil; Delivery of Health Care; Patient Safety; Health's Judicialization.ResumenObjetivo: analizar las demandas judiciales que involucraron riesgos legales o litigiosos en la atención médica. Método: este es un estudio cuantitativo, descriptivo, retrospectivo. Se buscaron 1.138 procesos válidos del universo de 1.599. Se utilizó el formulario de recopilación de datos, así como una hoja de cálculo Excel para la organización y el análisis de los procedimientos judiciales, la frecuencia y la razón en hospitales públicos, privados y filantrópicos. Resultados: se encontró una mayor incidencia de la proporción de procesos en hospitales privados (8.06). El riesgo de error médico fue mayor (58.1%) en hospitales privados (65.6%), servicio ambulatorio (65.0%) y área quirúrgica (58.9%). Conclusión: cabe destacar que los riesgos legales litigiosos en la atención fueron más frecuentes en los hospitales privados. Se ha demostrado la asistencia brindada en hospitales públicos de calidad y los resultados son concluyentes y reveladores. Sin embargo, es importante ampliar este tipo de estudio para caracterizar mejor el perfil de riesgo con respecto al tipo de servicio y la clientela, generando un parámetro para la evaluación de calidad de la atención prestada en todo el territorio nacional. Descriptores: Riesgo; Responsabilidad Legal; Responsabilidad Civil; Prestación de Atención de Salud; Seguridad del Paciente; Judicialización de la Salud.

scholarly journals Demand for Public Health Care in Pakistan

2009 ◽  
Vol 48 (2) ◽  
pp. 141-153 ◽  
Author(s):  
Ather H. Akbari ◽  
Wimal Rankaduwa ◽  
Adiqa K. Kiani
Keyword(s):  
Public Health ◽  
Health Care ◽  
Care Quality ◽  
Health Care Facilities ◽  
Public Hospitals ◽  
Demand Model ◽  
Outpatient Visits ◽  
Care Facilities ◽  
Government Hospitals ◽  
Per Capita

A health care demand model is estimated for each province in Pakistan to explain the outpatient visits to government hospitals over the period 1989-2006. The explanatory variables include the number of government hospitals per capita, doctors’ fee per visit at a private clinic, income per capita, the average price of medicine and the number of outpatient visits per capita in the previous period. All variables are significant determinants of the demand for health care in at least one province but their signs, magnitudes and the levels of significance vary. These variations may be attributed to cultural, social and religious factors that vary across provinces. Variations in health care quality offered at public hospitals may also be a factor. These factors and improved accessibility of health care facilities should be the focus of public policy aimed at increasing the usage of public sector health care facilities in Pakistan. JEL classification: I110, I180, O150 Keywords: Health Care, Hospitals, Human Resources, Policy, Public Health

Public Hospitals in China

2016 ◽  
pp. 1296-1315
Author(s):  
Donghai Wei ◽  
Louis Rubino
Keyword(s):  
Health Care ◽  
Health Care Reform ◽  
Essential Medicine ◽  
Universal Coverage ◽  
Health Care Facilities ◽  
Public Hospitals ◽  
Private Hospitals ◽  
The Public ◽  
Reform Plan ◽  
Health Care Leaders

China has had some initial success in its current health care reform efforts. Five areas of reform have been targeted and include providing universal coverage, equitable access to basic health insurance, establishing an essential medicine system, and improving primary health care facilities. The last area, the reform of the public hospitals, remains the most difficult to reform. General guidelines have been established by the national government and movement is being taken to delegate authority to local units for implementation. The aim of this paper is to compare China's formal government sponsored health care reform plan for public hospitals to the acknowledgement and acceptance by a sample of health care leaders in Guangzhou. Challenges are strong and include cost accountability, doctor training, employee empowerment, improprieties, and the influence of private hospitals. Based on this qualitative research, conclusions and recommendations are made by the authors as to what is necessary to have effective pubic hospital reform in China.

scholarly journals Public and private hospitals – different opportunities for nurses (Bulgaria, Pleven, 2016-2018)

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Grancharova ◽  
S t Dulgerova ◽  
S Aleksandrova-Yankulovska
Keyword(s):  
Health Care ◽  
Lifelong Learning ◽  
Statistical Significance ◽  
Age Distribution ◽  
Public Hospitals ◽  
High Quality ◽  
Quality Health Care ◽  
Private Hospitals ◽  
Public And Private ◽  
Public And Private Hospitals

Abstract Background The freedom of private initiative is one of the basic principles of Bulgarian health reform. Since 2000 to 2018 the private hospitals increased over 6 times and hospital beds - over 40 times. The total number of nurses decreased by 3%. Nurses/physicians ratio dropped to 1.03:1. Private hospitals with better facilities and higher payment attract great proportion of nursing graduates. Public hospitals cannot compete and often fall in financial crisis and lack of human resources. We aimed to analyse the opportunities, motivating and demotivating factors for nurses in public and private hospital settings for lifelong learning (LLL). Methods The study included a sample of 573 nurses (448 in public and 125 in private hospitals). By anonymous self-administered questionnaire we collected and compared information about opportunities, motivation and obstacles for LLL in different hospital settings using parametric and non-parametric tests (t-test, chi-square) and correlation coefficients (Phi, Kramer, contingency coefficient). The accepted level of statistical significance was p &lt; 0.05. Data processing was performed by IBM SPSS v.24. Results Great discrepancy was found in age distribution: in private hospitals 52,8% were below 40 years while in public hospitals 69,2% - over 40 years (p &lt; 0.001). Significant differences were observed in motivation for LLL: in public hospitals 46.4% ranked “better payment” compared to 36.8% in private hospitals; “career development” took 31.2% in private hospitals and 24.1% in public hospitals (p &lt; 0.05). Financial problems were the biggest obstacle in public hospitals (49,8%) and substantially lower (33.6%) in private hospitals (p &lt; 0.01). Prevailing form of LLL in public hospitals was on-site training. Conclusions Our results underlined the significant differences in nursing profile, opportunities and motivation for LLL in public and private hospitals. Public hospitals do not provide equal prerequisites for nurses' professional development. Key messages Lifelong learning is irreversible prerequisite for provision of high quality and safety health care. Nurses in public and private hospitals should have equal opportunities to participate in LLL. Public hospitals need substantial investments to provide better opportunities and to attract younger nursing generations able to respond to increasing requirements for high quality health care.

scholarly journals THE IMPACT OF HEALTH SUBSIDY ON HEALTH CARE UTILIZATION IN INDONESIA

2021 ◽  
Vol 3 (2) ◽  
pp. 16-37
Author(s):  
Renosa Tosca Zamaro
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Insurance Premium ◽  
Health Care Facilities ◽  
Public Hospitals ◽  
Care Utilization ◽  
Poor People ◽  
Outpatient Visits ◽  
Care Facilities ◽  
The Impact

Equal opportunity and access to health care services regardless of one’s socio-economic background is important for health equity. To achieve this, the Indonesian government introduced a national health insurance program named Jaminan Kesehatan Nasional in 2014 and provided insurance premium subsidies for poor people. The current study evaluates the health subsidy policy’s impact on the utilization of different kinds of health care facilities, both public and private. Two waves of Indonesian socio-economic surveys, namely 2013 and 2018, and two analysis methods, namely logistic regression, and difference-in-differences, were applied in this study. The results show that in first-level health care facilities, the health subsidy improves the probability of outpatient visits in public health centers and polyclinics but decreases the probability of outpatient visits in medical practices. Then, in secondary-level health care facilities, the health subsidy was found to increase the likelihood of outpatient visits in public hospitals; however, it lowers the probability of outpatient visits in private hospitals.

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