scholarly journals ACCREDITATION AND HEALTH CARE QUALITY ASSURANCE IN PAKISTAN: A DESK REVIEW

1970 ◽  
Vol 7 (3) ◽  
pp. 174-179 ◽  
Author(s):  
Fauziah Rabbani ◽  
Imran Naeem Abbasi
Keyword(s):  
Health Care ◽  
Quality Assurance ◽  
Quality Of Care ◽  
National Health ◽  
Health Sector ◽  
World Health ◽  
Private Health Sector ◽  
Regulatory Bodies ◽  
Quality In Healthcare

Background: Pakistan has a well-established healthcare system with 70% healthcare needs catered by private health sector. The latter's unregulated and unchecked expansion has resulted in quackery and compromised quality of care. This situation analysis provides a snapshot of health system's quality assurance and accreditation processes. Methods: Two validated questionnaires from World health Organization gauged the current state of health care accreditation and quality of care initiatives in Pakistan. Information was obtained from peer reviewed articles, grey literature, policy documents on government websites and newspapers. Results: Pakistan has a number of regulatory bodies responsible for ensuring quality in healthcare through accreditation and defined standards. National Institute of Health issues updated clinical quality guidelines pertaining to disease epidemics. A national quality policy was also formulated in 2004. However, implementing and ensuring accreditation has been challenging. Though statutory bodies are in place for registering different cadres of healthcare professionals, policies and mechanisms regarding licensure of healthcare establishments are missing. Emergence of national health vision 2012-2020, provincial health sector strategies and healthcare commission acts have focused on regulation of private health sector and accreditation of healthcare establishments. Despite presence of regulatory bodies, there are implementation gaps. Conclusion: This paper highlights some important gaps regarding accreditation and quality in healthcare. Quality assurance should be incorporated into national health policies, programs and strategies. National health policy should include explicit laws concerning quality Indicators and standards for quality in health care. Need to regulate private health sector and ensuring quality in overall healthcare is more than ever.

scholarly journals Patient’s Satisfaction With Quality of Care at a National Health Insurance Clinic at a Tertiary Center, South-South Nigeria

2021 ◽  
Vol 8 ◽  
pp. 237437352098147
Author(s):  
Temitope Esther Olamuyiwa ◽  
Foluke Olukemi Adeniji
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Bivariate Analysis ◽  
P Value ◽  
Tertiary Center

Introduction: Patient satisfaction is a commonly used indicator for measuring the quality of health care. This study assessed patients’ satisfaction with the quality of care at the National Health Insurance Scheme (NHIS) clinic in a tertiary facility. Methods: It was a descriptive cross-sectional study in which 379 systematically selected participants completed an interviewer-administered, semi-structured questionnaire. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 23. Bivariate analysis was performed using Pearson χ2 with a P value set at ≤ .05. Results: The study found out that about half (193, 50.9%) of the respondents were satisfied with the availability of structure. Patients were not satisfied with waiting time in the medical records, account, laboratory, and pharmacy sections. Overall, 286 (75.5%) of the respondents were satisfied with the outcome of health care provided at the NHIS clinic. A statistically significant association ( P = .00) was observed between treatment outcome and patient satisfaction. Conclusion: There is a need to address structural deficiencies and time management at the clinic.

P3415Will less developed countries be capable of giving high-quality universal coverage to cardiovascular disease survivors? Results from a national health survey, Chile ENS 2016–2017

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Margozzini ◽  
A Passi ◽  
M Kruk ◽  
G Danaei
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Health Care ◽  
Quality Of Care ◽  
National Health ◽  
Health Survey ◽  
Universal Coverage ◽  
National Health Survey ◽  
High Quality

Abstract Background Chilean Health System has fully implemented Universal Health Coverage (UHC) for acute cardiovascular events since 2005. Age-adjusted cardiovascular mortality has decreased, but there is limited information about coverage and quality of chronic health care given to cardiovascular disease (CVD) survivors at the national level. Purpose To assess the prevalence and quality of care in Chilean adult CVD survivors. Methods Chilean National Health Survey 2016–2017 (ENS 2016–2017) is a random stratified multistage sample of non-institutionalized population over 14 years (n=6240). Age, education, gender, rural/urban and geographical area weighted prevalence of CVD survivors (self-reported medical diagnosis of myocardial infarction or cerebrovascular attack) were calculated. High quality of care was defined as meeting six criteria simultaneously: under 70mg% LDL- C level, statin use, aspirin use, blood pressure under 130/80 mmHg, HgA1C<7 or 8 (>74-year-old) and non-smoking. Quality of care was explored using multivariate linear and logistic regression adjusting by age, gender, education and year of diagnosis (before or after UHC). Results Weighted national prevalence of CVD survivors in over 20-year-old population was 6.1%. The sample size for the CVD survivor analyses was n=455. 28.7% of CVS had their first event before the year 2005 (n=141). Overall 27.9% had LDL-C under 70mg%, 37.8% used statins, 41.4% used aspirin, 37.8% had controlled blood pressure, 78.3% were non-smokers and 84.3% had good glycemic control. National “high quality of care” prevalence in CVD survivors was 0.3%, 0.4% and 0.1% for men and women respectively. LDL and Blood pressure control prevalence (meet both criteria simultaneously) was 4,4%. In the adjusted multivariate model age was associated to a higher number of quality criteria achievement. Conclusion The number of CVD survivors in Chile is a huge challenge for the health care system. Universal coverage does not guarantee the quality of chronic life long care. Specific surveillance in high-risk population is needed to assess the system's effectiveness and accountability. Acknowledgement/Funding ENS 2016-2017 was funded by the chilean Ministry of Health (MINSAL)

Neoliberal Reforms in Swedish Primary Health Care: For Whom and for What Purpose?

2008 ◽  
Vol 38 (4) ◽  
pp. 697-715 ◽  
Author(s):  
Göran Dahlgren
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Low Income ◽  
Health Sector ◽  
High Income ◽  
Public Hospitals ◽  
Primary Health ◽  
Access And Quality

The conservative government that came to power in Sweden in 2006 has initiated major market-oriented reforms in the health sector. Its first health care policy bill changed the health legislation to make it possible to sell/transfer public hospitals to commercial providers while maintaining public funding. Far-reaching market-oriented primary health care reforms are also initiated, for example in Stockholm County. They are typically presented as “free choice models” in which “the money follows the patient.” The actual and likely effects of these reforms in terms of access and quality of care are discussed in this article. One main finding is that existing social inequities in geographic access to care not only are reinforced but also become very difficult to change by democratic political decisions. Furthermore, dynamic market forces will gradually reduce the quality of care in low-income areas while both access and quality of care will be even better in high-income areas. Public funds are thus transferred from people living in low-income areas to people living in high-income areas, even though the need for good health services is much greater in the low-income areas. Certain policy options for reversing the inverse law of care are also presented.

scholarly journals Quality Compliance in a Remotely Located PHC in India

2021 ◽  
pp. 72-80
Author(s):  
M. R. Roopashree
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Service Quality ◽  
National Health ◽  
National Standards ◽  
Health Care Centre ◽  
Primary Health ◽  
Patient Department

Background: As the rural Indian health care sector is providing patient care to the community at large, evaluating the quality of services gives an insight into the level of care provided. The primary health care chose the audit evaluation voluntarily. Objectives: The aim of the study was to assess the service quality provided in the primary health care Centre. The study was to help understand the skill set requirements in improving the quality of care and to identify the service quality gaps and to provide the best possible solutions for the gap closures by nominating the responsible personnel. Methods: The quality of care was evaluated in three ways: staff interview, record review, and observations conducted. Six departments were chosen for evaluation: the out-patient department, in-patient department, labor room, laboratory, National health programs, and general administration. By a prepared specific checklist comprised of standards and measurable elements, an evaluation was performed. The scoring was provided as 0, 1and 2, which implied noncompliance, partial compliance, and full compliance. Results: As per evaluation, national health program areas scored the least, whereas the inpatient departments scored the highest.  There were multiple gaps in the service provision areas and manpower allocation. The average mean score was 77.48. Conclusion: Keeping the national standards and guidelines, an audit evaluation was performed. Quality has to be imbibed with the optimization of resource allocation and with the mindset to provide the best possible care in the interest of the individual's wellbeing.

scholarly journals Prescription auditing: an important tool for sensitization of resident doctors for rationale prescription and utilization of drug

2019 ◽  
Vol 8 (10) ◽  
pp. 2237
Author(s):  
Archana G. Dhavalshankh ◽  
Vikram A. Rajadnya ◽  
Kedar L. Patil
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Tertiary Care ◽  
Development Project ◽  
The State ◽  
Essential Medicines ◽  
World Health ◽  
Duration Of Treatment ◽  
Improving Health Care

Background: The main objective of the Maharashtra Health Systems Development Project (MHSDP) is to enhance the quality of care by improving health care; in the hospitals, in the state. Improvement in the prescribing practice of resident doctors working in the hospitals is one of the initiatives taken up, to improve the rationalizing service delivery. A prescription audit may become an important tool for sensitizing resident doctors for rational prescription and utilization of drug.Methods: An observational study was carried out during the period of March 2017 to May 2017 in tertiary care teaching hospital, Kolhapur. Total 247 first prescriptions written by resident for in-door-patient department were collected, scrutinized and analysed. Prescriptions were evaluated for completeness of prescription format while legibility was graded. Prescriptions were also analysed as per World Health Organization prescribing indicators.Results: In study 247 prescriptions with 1091 drugs with average 4.42% drugs per prescription, 49.8 % prescriptions wrote the drugs by generic name. We found that 44.1 % prescriptions written with drugs included in essential medicines list while antibiotics prescribed were 27.1%. In prescription format 34% had incorrect dosage, 67% of prescriptions omitted the duration of treatment. Direction for drug use was not mentioned in 25% of prescriptions.  Weight was not mentioned on any prescriptions even for paediatric group.Conclusions: Through prescription auditing, sensitizing resident doctors for rational prescription and utilization of drug can be done to achieve the goal of the MHSDP of enhancing the quality of care by improving health care; in the hospitals, in the state.

Improving Quality of Care through Risk Management Knowledge Transfer and Quality Assurance in Nursing Care

2012 ◽  
pp. 233-241
Author(s):  
Kleopatra Alamantariotou
Keyword(s):  
Health Care ◽  
Risk Management ◽  
Quality Assurance ◽  
Quality Of Care ◽  
Knowledge Transfer ◽  
Nursing Care ◽  
Health Professionals ◽  
Careful Consideration

The purpose of this chapter is to provide innovative knowledge and creative ideas of improving quality of care and to explore how risk management and Knowledge transfer and quality assurance can improve health care. Under careful consideration, our purpose is to summarize which factors improve and promote the quality of care and which factors diminish quality. There are forms of ongoing efforts to make performance better. Quality improvement must be a long-term, continuous effort, reducing errors and providing a safe trust environment for health professionals and patients. After reading this chapter, you should know the answer to these questions: What role can risk management and knowledge transfer play in quality of care? How can risk management and knowledge transfer work together? What are the factors that improve risk management and quality assurance in health care? How does knowledge transfer support, inform, and improve care?

Analyzing Errors in Practice: A Vehicle for Assessing and Enhancing the Quality of Care

1992 ◽  
Vol 8 (1) ◽  
pp. 62-75 ◽  
Author(s):  
Susan S. Deusinger
Keyword(s):  
Health Care ◽  
Quality Assurance ◽  
Quality Of Care ◽  
Physical Therapy ◽  
Patient Care ◽  
Enhance Patient Care

AbstractFailures are inevitable in health care. When failure occurs as a result of practitioner error, quality in patient care may be compromised. This article proposes that analyzing clinical errors may contribute to quality assurance. Examples from physical therapy illustrate how information gained from analyzing errors can enhance patient care.

International differences in the value for money provided by institutions in european countries at different stages of deinstitutionalisation and with different economies

2011 ◽  
Vol 26 (S2) ◽  
pp. 2146-2146
Author(s):  
T.L. Taylor
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
National Health ◽  
Service User ◽  
Multilevel Models ◽  
Health Care Expenditure ◽  
Term Care ◽  
National Health Care ◽  
Service User Experience

BackgroundIndividuals with a diagnosis of schizophrenia or schizoaffective disorder may require longer term care. Due to the complexities of caring for this population and the high resource cost of care, it is important to ensure that mental health services are efficient and effective.AimsThis investigation aims to examine international differences in quality of care and service user experience when compared to national health expenditure and the degree of deinstitutionalisation in 10 countries.MethodsThe quality of care provided in 213 units was measured using the Quality Indicator for Rehabilitative Care (QuIRC). Service users living in these units (N = 1750) were asked to assess the care they received. Multilevel models were used to examine the relationships between quality (QuIRC domain ratings), level of deinstitutionalisation and national health care expenditure. As no formalised assessment of deinstitutionalisation has been published, a quantitative tool was developed and validated. Percentage of gross domestic product spent on health care and per capita total health care spend was taken from World Health Organisation data to assess national health care expenditure.ResultsMultilevel models examining the relationships between deinstitutionalisation levels, health care expenditure, quality and service user experience will be presented. Results were adjusted for unit (type and size) and service user (age, gender and level of functioning) characteristics.ConclusionsRecommendations on the best use of resources within a facility providing longer term care and how best to increase the quality of care provided without additional financial expenditure will be discussed in relation to the results.

scholarly journals Quality of Care and Quality of Life: Convergence or Divergence?

2014 ◽  
Vol 7 ◽  
pp. HSI.S13283 ◽  
Author(s):  
Wadi B. Alonazi ◽  
Shane A. Thomas
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Health Policy ◽  
Quality Of Care ◽  
Effective Treatment ◽  
Well Being ◽  
World Health ◽  
The World ◽  
The Impact

The aim of this study was to explore the impact of quality of care (QoC) on patients’ quality of life (QoL). In a cross-sectional study, two domains of QoC and the World Health Organization Quality of Life-Bref questionnaire were combined to collect data from 1,059 pre-discharge patients in four accredited hospitals (ACCHs) and four non-accredited hospitals (NACCHs) in Saudi Arabia. Health and well-being are often restricted to the characterization of sensory qualities in certain settings such as unrestricted access to healthcare, effective treatment, and social welfare. The patients admitted to tertiary health care facilities are generally able to present themselves with a holistic approach as to how they experience the impact of health policy. The statistical results indicated that patients reported a very limited correlation between QoC and QoL in both settings. The model established a positive, but ultimately weak and insignificant, association between QoC (access and effective treatment) and QoL ( r = 0.349, P = 0.000; r = 0.161, P = 0.000, respectively). Even though the two settings are theoretically different in terms of being able to conceptualize, adopt, and implement QoC, the outcomes from both settings demonstrated insignificant relationships with QoL as the results were quite similar. Though modern medicine has substantially improved QoL around the world, this paper proposes that health accreditation has a very limited impact on improving QoL. This paper raises awareness of this topic with multiple healthcare professionals who are interested in correlating QoC and QoL. Hopefully, it will stimulate further research from other professional groups that have new and different perspectives. Addressing a transitional health care system that is in the process of endorsing accreditation, investigating the experience of tertiary cases, and analyzing deviated data may limit the generalization of this study. Global interest in applying public health policy underlines the impact of such process on patients’ outcomes. As QoC accreditation does not automatically produce improved QoL outcomes, the proposed study encourages further investigation of the value of health accreditation on personal and social well-being.

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