scholarly journals Influence of Admission Time on Health Care Quality and Utilization in Patients with Stroke: Analysis for a Possible July Effect and Weekend Effect

2021 ◽  
Vol 18 (23) ◽  
pp. 12362
Author(s):  
Chun-Yi Liu ◽  
Pei-Tseng Kung ◽  
Hui-Yun Chang ◽  
Yueh-Han Hsu ◽  
Wen-Chen Tsai
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Care Quality ◽  
Public Hospitals ◽  
Weekend Effect ◽  
Research Database ◽  
Old Patients ◽  
July Effect ◽  
Initial Hospitalization

(1) Purpose: Undesirable health care outcomes could conceivably increase as a result of the entry of new, less experienced health care personnel into patient care during the month of July (the July effect) or as a result of the less balanced allocation of health care resources on weekends (the weekend effect). Whether these two effects were present in Taiwan’s National Health Insurance (NHI) system was investigated. (2) Methods: The current study data were acquired from the NHI Research Database. The research sample comprised ≥18-year-old patients diagnosed as having a stroke for the first time from 1 January 2006 to 30 September 2012. The mortality rate within 30 days after hospitalization and readmission rate within 14 days after hospital discharge were used as health care quality indicators, whereas health care utilization indicators were the total length and cost of initial hospitalization. (3) Results: The results revealed no sample-wide July effect with regard to the four indicators among patients with stroke. However, an unexpected July effect was present among in-patients in regional and public hospitals, in which the total lengths and costs of initial hospitalization for non-July admissions were higher than those for July admissions. Furthermore, the total hospitalization length for weekend admissions was 1.06–1.07 times higher than that for non-weekend admissions; the total hospitalization length for weekend admissions was also higher than that for weekday admissions during non-July months. Thus, weekend admission did not affect the health care quality of patients with stroke but extended their total hospitalization length. (4) Conclusions: Consistent with the NHI’s general effectiveness in ensuring fair, universally accessible, and high-quality health care services in Taiwan, the health care quality of patients examined in this study did not vary significantly overall between July and non-July months. However, a longer hospitalization length was observed for weekend admissions, possibly due to limitations in personnel and resource allocations during weekends. These results highlight the health care efficiency of hospitals during weekends as an area for further improvement.

scholarly journals A qualitative study of old patients’ experiences of the quality of the health services in hospital and 30 days after hospitalization

2019 ◽  
Author(s):  
Ingvild Lilleheie ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Astrid Bergland
Keyword(s):  
Health Care ◽  
Health Services ◽  
Older People ◽  
Everyday Life ◽  
Health Care Quality ◽  
Care Quality ◽  
World Health ◽  
Old Patients ◽  
The Impact

Abstract Background The number of people aged 80 years and above is projected to triple over the next 30 years. People in this age group normally have at least two chronic conditions (multimorbidity). The impact of multimorbidity is often significantly greater than expected from the sum of the effects of each condition. The World Health Organization has indicated that health care systems must prepare for a change in the focus of clinical care for older people. The WHO defines health care quality as care that is effective, efficient, integrated, patient centered, equitable and safe. The degree to which health care quality can be defined as acceptable is determined by services’ ability to meet the needs of users and adapt to patients’ expectations and perceptions. This study explores experiences of the quality of the health services in hospital and the first 30 days at home after discharge by patients over 80 years of age. Method We took a phenomenological perspective to explore older patients’ subjective experiences and conducted semistructured individual interviews. Eighteen patients (aged from 82 to 100 years) were interviewed twice after discharge from hospital. The interview transcriptions were analyzed thematically. Results The patients found their meetings with the health service to be complex and demanding. They reported attempting to restore a sense of security and meaning in everyday life, balancing their own needs against external requirements. Five overarching themes emerged from the interviews: hospital stay and the person behind the diagnosis, poor communication and coordination, life after discharge, relationship with their next of kin, and organizational and systemic determinants. Conclusion According to the WHO, to deliver quality health care, services must include all six of the dimensions listed above. Our findings show that they do not. Health care focused on measurable values and biomedical inquiries. Few opportunities for participation, scant information and suboptimal care coordination left the patients with a feeling of being in limbo, where they struggled to find balance in their everyday life. Further work must be done to ensure that integrated services are provided without a financial burden, centered on the needs and rights of older people.

scholarly journals Quality indicators of dental health care in Serbia

2019 ◽  
Vol 66 (1) ◽  
pp. 36-42
Author(s):  
Svetlana Jovanović ◽  
Maja Milošević ◽  
Irena Aleksić-Hajduković ◽  
Jelena Mandić
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health System ◽  
Quality Indicators ◽  
Health Care Quality ◽  
Care Quality ◽  
System Quality ◽  
Quality Health Care ◽  
Quality Health

Summary Health care has witnessed considerable progresses toward quality improvement over the past two decades. More precisely, there have been global efforts aimed to improve this aspect of health care along with experts and decision-makers reaching the consensus that quality is one of the most significant dimensions and features of health system. Quality health care implies highly efficient resource use in order to meet patient’s needs in terms of prevention and treatment. Quality health care is provided in a safe way while meeting patients’ expectations and avoiding unnecessary losses. The mission of continuous improvement in quality of care is to achieve safe and reliable health care through mutual efforts of all the key supporters of health system to protect patients’ interests. A systematic approach to measuring the process of care through quality indicators (QIs) poses the greatest challenge to continuous quality improvement in health care. Quality indicators are quantitative indicators used for monitoring and evaluating quality of patient care and treatment, continuous professional development (CPD), maintaining waiting lists, patients and staff satisfaction, and patient safety.

scholarly journals Komunitas Masyarakat Dan Perawatan Kesehatan Dalam Peningkatan Kualitas Hidup

2020 ◽  
Vol 10 (1) ◽  
pp. 11-24
Author(s):  
Agustinus Hermino
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Health Care Quality ◽  
Health Sector ◽  
Well Being ◽  
Individual Variability ◽  
Care Quality ◽  
Global Era ◽  
The Impact

Latar belakang: Seiring dengan perkembangan jaman, dalam beberapa tahun terakhir ini banyak perhatian yang difokuskan pada eksplorasi dampak penyakit fisik dan mental pada kualitas hidup seseorang baik secara individu maupun masyarakat secara keseluruhan. Sifat subyektif dari 'kualitas hidup' individu, merupakan konsep yang dinamis untuk diukur dan didefinisikan, tetapi bahwa secara umum dapat dipandang sebagai konsep multidimensi yang menekankan pada persepsi diri dari keadaan pikiran seseorang saat iniTujuan: penulisan ini bertujuan untuk memberikan pemahaman tentang peran masyarakat dalam memahani pentingnya kesehatan di era global ditinjau dari perspektif akademis. Pada sektor kesehatan pemahaman kesehatan menjadi sangat pentingnya karena akan menunjukkan pada kualitas hidup seseorang, tetapi hal ini tidak cukup secara individu karena diperlukan pemahaman secara menyeluruh terhadap masyarakat tentang makna kesehatan dan perawatan kesehatan.Metode: penulisan ilmiah ini adalah dengan melakukan analisa akademis dari dari berbagai sumber rujukan relevan sehingga menemukan makna teoritis baru dalam rangka menjawab tantangan yang terjadi di masyarakat.Hasil: Berdasarkan berbagai sumber rujukan yang ada, dapat disimpulkan bahwa kesehatan merupakan gaya hidup yang bertujuan untuk mencapai kesejahteraan fisik, emosional, intelektual, spiritual, dan lingkungan. Penggunaan langkah-langkah kesehatan dapat meningkatkan stamina, energi, dan harga diri, kemudian meningkatkan kualitas hidup. Dengan demikian maka konsep kesehatan memungkinkan adanya variabilitas individu. Kesehatan dapat dianggap sebagai keseimbangan aspek fisik, emosional, psikologis, sosial dan spiritual dari kehidupan seseorang. Kata kunci: masyarakat, perawatan kesehatan, kualitas hidup Society Community and Health Care in Improving Quality of LifeAbstract Background: Along with the development of the era, in recent years there has been a lot of attention focused on exploring the impact of physical and mental illness on the quality of life of a person both individually and as a whole. The subjective nature of an individual's 'quality of life' is a dynamic concept to measure and define, but that in general can be seen as a multidimensional concept that emphasizes self-perception of one's current state of mindAim: purpose of this study is to provide an understanding the role of community in understanding the importance of health in the global era from an academic perspective. In the health sector understanding of health is very important because it will show the quality of life of a person, but this is not enough individually because a comprehensive understanding of the meaning of health and health care is needed. Method: The method of scientific writing is to carry out academic analysis from various relevant reference sources, and find new theoretical meanings in order to answer the challenges that occur in society. Keyword: Community, Society,Health Care, Quality oflife Resullt : Based on various academic reference, it can be concluded that health is a lifestyle that aims to achieve physical, emotional, intellectual, spiritual, and environmental well-being. The use of health measures can increase stamina, energy, and self-esteem, then improve the quality of life. Thus the concept of health allows for individual variability. Health can be considered as a balance of physical, emotional, psychological, social and spiritual aspects of one's life. Keywords: community, health care, quality of life 

The essence, content and characteristics of medical services’ quality

2021 ◽  
pp. 40-43
Author(s):  
Constantin Etco ◽  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Care System ◽  
Health Care Quality ◽  
Services Quality ◽  
Care Quality ◽  
Medical Services ◽  
Total Quality ◽  
Care System

One of the priorities of the health care system in Moldova is the medical services’ quality improvement. Th is article presents various defi nitions for health care quality and the principles connected with quality improvement. An important part in this article is allocated to the structure and main principles of total quality management in the health care system. Th is part reveals the problems of the commissions that are studying the quality of medical services in healthcare establishments.

Self-reported patient experience and quality of care among elderly patients with colon cancer.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 33-33 ◽  
Author(s):  
Rebecca A Snyder ◽  
Rebecca Wardrop ◽  
Alexander Mclain ◽  
Alexander A. Parikh ◽  
Anna Cass
Keyword(s):  
Health Care ◽  
Patient Experience ◽  
Cancer Care ◽  
Health Care Quality ◽  
Care Quality ◽  
Stage I ◽  
Stage Iii ◽  
Experience Of Care ◽  
Patient Reported

33 Background: Although studies have identified demographic and clinical factors associated with quality colorectal cancer care, the association between patient-reported experience of care and quality of care is unknown. Our primary aim was to assess the relationship between patient-reported experience of care and receipt of guideline-concordant colon cancer (CC) treatment. Methods: Fee-For-Service Medicare beneficiaries with resected stage I-III CC (2003-2013) were identified in the linked SEER registry and Consumer Assessment of Healthcare Providers and Systems patient experience survey (SEER-CAHPS) dataset. Patient-reported ratings were compared based on receipt of care consistent with recommended treatment guidelines [resection of ≥ 12 lymph nodes (LN) (stage I-III) and receipt of adjuvant chemotherapy (stage III)]. Linear regression was performed to compare mean patient experience scores by receipt of guideline concordant care, adjusting for patient and hospital factors. Results: 1010 patients with stage I-III CC were identified (mean age 76.7, SE 6.9). Of these, 58.4% of stage I (n = 192/329) and 73.4% of stage II (n = 298/406) patients underwent resection of ≥ 12 LN. Among stage III patients, 76.0% (n = 209/275) underwent resection of ≥ 12 LN and 52.4% (n = 144/275) received adjuvant chemotherapy. By multivariable analysis, patient-reported ratings of health care quality, personal and specialty physicians, customer service, physician communication, getting needed care, and getting care quickly were similar among patients who received guideline-concordant treatment compared to those who did not. However, mean ratings of overall health care quality [91.3 (SE 2.0) vs. 82.4 (SE 1.7), p = 0.0004] and getting needed care [92.8 (SE 2.4) vs. 86.8 (SE 2.0), p = 0.047] were higher among stage III patients who received guideline concordant care compared to those who did not. Conclusions: Patient-reported ratings of health care quality and ability to get needed care are associated with guideline concordant cancer care among elderly patients with stage III CC. Further investigation is needed to determine if patient-reported experience correlates with other clinical measures of quality of colorectal cancer care.

Health Care of Latino Children with Autism and Other Developmental Disabilities: Quality of Provider Interaction Mediates Utilization

2012 ◽  
Vol 117 (4) ◽  
pp. 304-315 ◽  
Author(s):  
Susan Parish ◽  
Sandra Magaña ◽  
Roderick Rose ◽  
Maria Timberlake ◽  
Jamie G Swaine
Keyword(s):  
Health Care ◽  
Developmental Disabilities ◽  
Health Care Utilization ◽  
Health Care Quality ◽  
Children With Autism ◽  
Care Quality ◽  
Care Utilization ◽  
Latino Children ◽  
Care Needs

Abstract This study examines access to, utilization of, and quality of health care for Latino children with autism and other developmental disabilities. We analyze data from the National Survey of Children with Special Health Care Needs (N  =  4,414 children with autism and other developmental disabilities). Compared with White children, Latino children with autism and other developmental disabilities had a consistent pattern of worse health care access, utilization, and quality. We then test mediation models to determine if health care quality mediates the relationship between ethnicity and health care utilization disparities. Three of four quality indicators (provider does not spend enough time with child, provider is not culturally sensitive, and provider does not make parent feel like a partner) were significant mediators. These analyses suggest that interventions targeted at improving providers' cultural sensitivity and behavior during the clinical encounter may reduce disparities in the health care utilization of Latino children with autism and other developmental disabilities.

scholarly journals Instrumento norteador para auditoria clínica de protocolos

2021 ◽  
Vol 21 (82) ◽  
Author(s):  
Vitória Régia Dias dos Santos Cavalcante ◽  
Tatiane Santos Da Silva ◽  
Patrícia Gabriela Santana Alvestor ◽  
Sara Diniz Rubinsztejn Azevedo ◽  
Crystiane Aline Alves De Souza ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Audit Quality ◽  
Clinical Audit ◽  
Sao Paulo ◽  
Care Quality ◽  
São Paulo ◽  
Common Structure ◽  
Health Care Quality Indicators

A auditoria clínica envolve um processo de verificação das práticas preconizadas e o cuidado prestado nas instituições de saúde implicando na qualidade do atendimento, neste contexto o trabalho tem como objetivo elaborar um protótipo, avaliar aplicabilidade e oportunidades de melhoria de um instrumento norteador para análise da eficácia da implantação de protocolos. Realizado em hospital pediátrico de ensino de grande porte entre abril e setembro de 2020, no município de São Paulo, através de levantamento bibliográfico e de protocolos institucionais, interações com profissionais da Instituição e um teste-piloto. O instrumento em sua versão validada foi baseado na estrutura comum de seis protocolos, constando de seis critérios correspondentes ao objetivo, abrangência, fluxo de atendimento, condutas adotadas, registros em prontuário e indicadores sendo as informações classificadas em conforme, parcialmente e não conforme. No processo de validação verificou a necessidade de instrumento específico para cada protocolo auditado. O instrumento elaborado atendeu ao objetivo proposto de nortear a prática de auditoria dentro do hospital e demonstrou conseguir em conjunto com específico agregar valor ao atendimento apontando possíveis melhorias.Palavras-chave: Auditoria Clínica; Qualidade da Assistência à Saúde; Indicadores de Qualidade em Assistência à Saúde; Protocolos Clínicos ABSTRACTGuiding instrument for clinical audit of protocolsThe clinical audit involves a process of verifying the recommended practices and the are provided in health institutions, implying in the quality of care, in this context the work aims to develop a prototype, evaluate applicability and opportunities for improvement of a guiding instrument for analyzing the effectiveness the implementation of protocols. Held in a large teaching pediatric hospital between April and September 2020, in the city of São Paulo, through a bibliographic survey and institutional protocols, interactions with professionals of the Institution and a pilot test. The instrument in its validated version was based on the common structure of six protocols, consisting of six criteria corresponding to the objective, scope, service flow, conduct adopted, medical records and indicators being classified as conforming, partially and non-conforming. In the validation process, he verified the need for a specific instrument for each audited protocol. The instrument developed met the proposed objective to guide the audit practice within the hospital and obtain the set with the specific value of adding possible improvements to care.Keywords: Clinical Audit; Quality of Health Care; Quality Indicators, Health Care; Clinical Protocols

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