scholarly journals Strategizing Public Sector Hospitals In Megacity Karachi: A Case Study On Gender Based Healthcare Facility Selection Criteria And Concerns (From Demand And Supply Perspective)

2019 ◽  
Vol 19 (1) ◽  
pp. 179-196
Author(s):  
Shamaila Burney ◽  
Khalid Mahmood Iraqi
Keyword(s):  
Public Sector ◽  
Selection Criteria ◽  
Healthcare Facility ◽  
Health Care Facilities ◽  
Public Hospitals ◽  
Public Healthcare ◽  
Demand And Supply ◽  
Healthcare Facilities ◽  
The Public

Karachi is the most populous city in Pakistan and it plays an important role in urban demography of Pakistan. It is growing rapidly, as every fifth urban citizen lives here. This urbanization creates serious challenges for all sectors of Karachi. Especially the health sector, from demand and supply view point is facing serious challenges in terms of non-availability of qualified doctors, specifically female doctors, medicines, latest equipment, poor infrastructure, and patient’s queues belonging to other rural areas because of the lack of quality healthcare facilities, makes the public hospitals crowded and overburdened. Like all over Pakistan, public sector hospitals are very much neglected in Karachi also and needs special consideration. The focus should be on developing patient oriented supply chains for efficient patient’s care and healthcare facilities. Moreover, the case study of Qatar hospital a part of our basic research study also highlighted the depriving condition for women patients’ in Emergency Department, because only male doctors are there but female doctors are not available. Although we observed that the gender wise daily patient flow was consist of 65% females, whereas only 35% male patients. The study suggests that there is an urgent need of women doctors and paramedics staff in the public sector hospitals of suburbs of Karachi. This paper presents a synoptic view of concerns of the residents of Karachi, and identification of their selection criteria of health care facilities. The study also aimed to provide solutions and recommendations for the improvement of these facilities. Cross sectional questionnaire and random sampling with two stage clusters sampling was used to record the responses of 1991 households, 46% respondents were female and 54% were male. Among the total of 11127 respondents, only 580, (5.2 %) sought treatment in public health hospitals and, 2440 (21.9 %) visited private hospitals. Research results shows that Cost is the only significant factor because of which people opt for treatment at public healthcare facility.

scholarly journals The impacts of motivation, personal traits of managers and management education on the performances of public healthcare facilities

2016 ◽  
Vol 73 (9) ◽  
pp. 831-837
Author(s):  
Nevena Karanovic ◽  
Sanja Stosic
Keyword(s):  
Public Sector ◽  
Personal Development ◽  
Formal Education ◽  
Management Education ◽  
Public Hospitals ◽  
Public Healthcare ◽  
Healthcare Facilities ◽  
The Public ◽  
Health Technologies ◽  
The Impact

Background/Aim. Exposed to increasing needs of users for better and faster services, more medications and innovative health technologies, managers of healthcare services in the public sector need motivation, permanent updating of information and constant personal development. The aim of this paper was to evaluate, on the basis of experienced healthcare managers, the impact of their motivation, selected character traits, managerial skills and formal education in management on healthcare facilities performances in the public sector. Methods. For the purposes of this study, 97 experienced managers from public hospitals and primary health centers in Serbia answered to 30 questions on the motivation of managers, essential skills for successful management and formal education in management in health facilities. The obtained data about their motivation, governing experience, personal skills and formal education in management were systematized and processed by the Statistical Package for Social Sciences (SPSS). Healthcare facilities performances were expressed by the healthcare facilities ranks in the official annual rankings according to the quality improvement, conducted by the Institute of Public Health of Serbia. Pearson's or Spearman's correlation coefficients were used for proving the potential impact of selected factors on performances of healthcare facilities. Results. This study confirmed the association between the healthcare facilities ranks and managers' abilities to organize the working process (t = -2.453; p = 0.018); expressed high managers? motivation (?S = 0.206; p = 0.048) and the length of governing experience (r = -0.198; p = 0.043). Within a 3-year follow-up, this study also confirmed a positive correlation between annual ranks of healthcare facilities and managers quality management courses (?S = -0.238; p = 0.017) and managers education in human resources management (?S = -0.234; p = 0.027). Conclusion. In addition to management education, permanent personal development and higher motivation of managers have positive influence on healthcare performances.

scholarly journals Publicly funded interfacility ambulance transfers for surgical and obstetrical conditions: A cross sectional analysis in an urban middle-income country setting

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241553
Author(s):  
Paul Truche ◽  
Rachel E. NeMoyer ◽  
Sara Patiño-Franco ◽  
Juan P. Herrera-Escobar ◽  
Myerlandi Torres ◽  
...  
Keyword(s):  
Surgical Care ◽  
Healthcare Facility ◽  
Public Hospitals ◽  
Public Healthcare ◽  
Publicly Funded ◽  
Cross Sectional ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Timely Access ◽  
Surgical Conditions

Introduction Interfacility transfers may reflect a time delay of definitive surgical care, but few studies have examined the prevalence of interfacility transfers in the urban low- and middle-income (LMIC) setting. The aim of this study was to determine the number of interfacility transfers required for surgical and obstetric conditions in an urban MIC setting to better understand access to definitive surgical care among LMIC patients. Methods A retrospective analysis of public interfacility transfer records was conducted from April 2015 to April 2016 in Cali, Colombia. Data were obtained from the single municipal ambulance agency providing publicly funded ambulance transfers in the city. Interfacility transfers were defined as any patient transfer between two healthcare facilities. We identified the number of transfers for patients with surgical conditions and categorized transfers based on patient ICD-9-CM codes. We compared surgical transfers from public vs. private healthcare facilities by condition type (surgical, obstetric, nonsurgical), transferring physician specialty, and transfer acuity (code blue, emergent, urgent and nonurgent) using logistic regression. Results 31,659 patient transports occurred over the 13-month study period. 22250 (70.2%) of all transfers were interfacility transfers and 7777 (35%) of transfers were for patients with surgical conditions with an additional 2,244 (10.3%) for obstetric conditions. 49% (8660/17675) of interfacility transfers from public hospitals were for surgical and obstetric conditions vs 32% (1466/4580) for private facilities (P<0.001). The most common surgical conditions requiring interfacility transfer were fractures (1,227, 5.4%), appendicitis (913, 4.1%), wounds (871, 3.9%), abdominal pain (818, 3.6%), trauma (652, 2.9%), and acute abdomen (271, 1.2%). Conclusion Surgical and obstetric conditions account for nearly half of all urban interfacility ambulance transfers. The most common reasons for transfer are basic surgical conditions with public healthcare facilities transferring a greater proportion of patient with surgical conditions than private facilities. Timely access to an initial healthcare facility may not be a reliable surrogate of definitive surgical care given the substantial need for interfacility transfers.

Differences In Treatment and Diagnostic Patterns In Private Vs Public Sectors For Deletion 5Q Myelodysplastic Syndromes (MDS) In Mexico: Results From A Physician Survey

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5593-5593
Author(s):  
Michelle Ann Soriano ◽  
Roberto Ovilla ◽  
Maria Guadalupe Rodríguez-González ◽  
Renée Arnold ◽  
Dalia Mahmoud
Keyword(s):  
Bone Marrow ◽  
Public Sector ◽  
Public Hospitals ◽  
Diagnosis And Treatment ◽  
Disease Stage ◽  
Medical Attention ◽  
Public Healthcare ◽  
Rapid Progression ◽  
The Public ◽  
Patient Profile

Abstract Objective Deletion of the long arm of chromosome 5 (5q) is the most common chromosomal abnormality seen in MDS; however, there is little information about treatment and diagnostic patterns, especially in Latin America.  This study aimed to understand the real-life approach to diagnosis and treatment of MDS del(5q) in Mexico in 2012. Methods Overall clinical practice was investigated through a physician face-to-face survey.  Eligible participants were 10 hematologists and/or hemato-oncologists with at least 5 years experience treating patients with MDS and practicing in one of 5 major public hospitals in Mexico City (IMSS, ISSSTE or MoH) and/or two private hospitals (Español and Angeles Lomas).  The interview covered 6 sections: (1) physician´s point of view about the disease and MDS and/or del(5q) patient profile; (2) diagnosis; (3) treatment patterns, including country-specific barriers for each; (4) patient access to appropriate drug treatment, (5) knowledge and perception about innovative drugs such as lenalidomide; and (6) areas of opportunity in diagnosis and/or treatment. Results Physicians described patient flow for most in the public sector as starting at Family Medicine Units and second level hospitals, which tend to basic health issues; eventually most are referred to a hematologist in third-level high-specialty hospitals.  In private practice about 60% first contact a general physician and all eventually get referred to a specialist; the other 40% go directly to a hematologist.  Furthermore, ∼80% who start treatment in the private setting eventually switch to public healthcare since MDS treatment is for life and cost is of great concern.  Even though interviewed physicians have a clear sense about MDS diagnosis, they all agree that there is a lack of information about the disease within the medical community, which complicates even further the diagnosis and early patient referral.  Eight out of 10 doctors recognized del(5q) as a low-risk disease; the rest considered it as having rapid progression to leukemia, which is a misconception. In practice, 9 out of 10 said MDS is usually diagnosed by exclusion; however, all agreed that del(5q) abnormality diagnosis needs to be identified through karyotyping.  All physicians agree that most patients seek medical attention due to fatigue and constant bleeding and receive treatment for anemia prior to reaching a specialist; however, in the public sector they tend to arrive in a more advanced disease stage.  Research indicated that the tests to detect MDS are fully covered by the public health system, however, not for detecting del(5q) subtype.  In the public sector CBC or blood smear (US$20-30 out-of-pocket) and bone marrow aspiration or biopsy are free of charge (US$300-400 out-of-pocket).  Conversely, karyotyping for MDS is only covered by the second largest provider (ISSSTE, covering 9% of the population) and FISH testing is rarely done overall; however, for both, most of the time they are paid out-of-pocket (US$200-500). Treatment preferences and duration vary greatly, mainly because of drug availability, physician disease expertise and patients’ willingness to pay out-of-pocket for appropriate testing/drugs. Physicians acknowledge lenalidomide as the best treatment option for del(5q) MDS (some are already using lenalidomide for myeloma); however, due to its high cost and restricted availability in the public sector, they use whatever is readily available.  Thalidomide is usually used in 1st line treatment, cyclosporine and prednisone as 2nd line and hypomethylating drugs, such as azacitadine, or bone marrow transplant as 3rd line.  Additionally, due to misdiagnosis and/or co-morbidities, patients are treated with erythropoietin (anemia), GCSF (leucopenia), platelet agonists (thrombocytopenia), and iron chelators (iron excess due to transfusions). Conclusion Most physicians conclude that in order to have appropriate del(5q) MDS diagnosis and treatment there is a clear opportunity to increase continuous medical education on the disease as well as training to spur more highly qualified geneticists.  Moreover, there is a need to have more reference centers and genetic testing laboratories and greater availability of del(5q) karyotype testing in the public sector. Finally, results from this research indicates that improving access to novel drugs, such as lenalidomide, will expand the treatment options available for del(5q) MDS in Mexico. Disclosures: No relevant conflicts of interest to declare.

Reforming Public Healthcare in the Republic of Ireland with Information Systems

2011 ◽  
pp. 1151-1171
Author(s):  
David Sammon ◽  
Frederic Adam
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Public Healthcare ◽  
The Public ◽  
The Republic ◽  
Returns On Investment ◽  
Substantial Change ◽  
Is Projects ◽  
Causes Of Failure

The need for reforming public healthcare towards greater efficiency and measurable returns on investment has been felt by governments in many countries. In Ireland, this led to the PPARS project, which sought to implement SAP across all public healthcare sites. This project, however, was unsuccessful and led to a parliamentary inquiry. To understand why the PPARS project failed, we carried out an extensive case study of the project and compared our findings to the implementation of JD Edwards in a multinational in the private sector. Our study reveals that despite specific circumstances in the public sector that contributed to the failure of the ERP project, the primary causes of failure result from a lack of understanding of what ERP involves and a failure to prepare adequately, which can be found in any organisation, public or private. This leads to significant lessons for ERP implementations and IS projects involving substantial change.

Precarious Employment in the Public Sector

2017 ◽  
Author(s):  
Michal Tabibian-Mizrahi
Keyword(s):  
Public Sector ◽  
Civil Service ◽  
The State ◽  
Public Hospitals ◽  
Hiring Practices ◽  
Organizational Practices ◽  
Precarious Employment ◽  
The Public ◽  
Gradual Process

This case study of precarious employment in public hospitals shows that the adoption of neoliberal practices was a gradual process whose roots can be traced to earlier decades. Innovative and even revolutionary changes in civil service hiring practices emerged in the early 1960s, gathering momentum in the subsequent decade. In this domain, at least, neoliberal practices preceded the neoliberal ideological shift, and helped pave the way for the latter’s assimilation. At the same time, being conferred with significance and legitimacy assisted the further growth of precarity in the public sector. This dialectic of ideas and organizational practices constituted an important mechanism entrenching neoliberal modes of employment within the state.

Vocational rehabilitation for young stroke survivors in gauteng public healthcare: Perceptions from occupational therapist1

Work ◽  
2021 ◽  
pp. 1-17
Author(s):  
Greea Dreyer ◽  
Matty van Niekerk
Keyword(s):  
South Africa ◽  
Public Sector ◽  
Focus Groups ◽  
Work Ability ◽  
Financial Burden ◽  
Occupational Therapists ◽  
Public Hospitals ◽  
Public Healthcare ◽  
Stroke Survivors ◽  
The Public

BACKGROUND: The prevalence of working-aged stroke survivors is increasing yearly. Stroke is an expensive disease, causing financial burden to the government, the family and caregivers of the patient, thus making it imperative for working-aged stroke survivors to work to remain financially independent. Survivors’ need to work necessitates occupational therapists to shift their focus from basic activities of daily living, to rehabilitating work. OBJECTIVES: This study aimed to determine the perceptions of occupational therapists working with younger stroke survivors in public hospitals and clinics in Gauteng South Africa, about rehabilitating working-aged stroke survivors’ work ability. METHODS: Ethical clearance was obtained. A qualitative research design was used to obtain narrative, descriptive data from six focus groups. Therapists from public healthcare settings, who had more than six months’ experience and had worked in neurological rehabilitation within the six months preceding the focus group, were invited to participate. Focus groups were audio recorded and transcribed. Inductive content analysis was used to identify themes and categories. RESULTS: Few participants are involved in rehabilitating younger stroke survivors’ work ability or facilitating return to work (RTW). The study identified perceived barriers and enablers to rendering OT services that meet working-aged stroke survivors’ needs. CONCLUSIONS: Despite enabling employment equity laws in South Africa, OTs working in the public sector appear to experience a sense of futility when trying to rehabilitate young stoke survivors to RTW. Fragmentation of the public sector and limited resources impede successful RTW for working-aged stroke survivors. Survivors’ employment status and motivation to RTW facilitated rehabilitating work ability.

scholarly journals Evaluation of Energy Consumption in German Hospitals: Benchmarking in the Public Sector

Energies ◽  
2018 ◽  
Vol 11 (9) ◽  
pp. 2279 ◽  
Author(s):  
Alfonso González González ◽  
Justo García-Sanz-Calcedo ◽  
David Rodríguez Salgado
Keyword(s):  
Energy Consumption ◽  
Public Sector ◽  
Gross Domestic Product ◽  
Surface Area ◽  
Geographic Location ◽  
Weather Conditions ◽  
Public Hospitals ◽  
Healthcare Facilities ◽  
The Public ◽  
Bed Numbers

The use of benchmarking in the management of healthcare facilities enables immediate comparison between hospitals. Benchmarking allows ascertaining their expected energy consumption and estimating the possible savings margin. In the 2005–2015 period, 90 EU Eco-Audits of 23 public hospitals in Germany were studied to analyze the energy consumption related with weather conditions, built surface area, gross domestic product (GDP), geographic location (GL), bed numbers, and employee numbers. The results reveal that the average annual energy consumption of a hospital under normal conditions, both climatic and operational, is 0.27 MWh/m2, 14.37 MWh/worker, and 23.41 MWh/bed. The indicator dependent on the number of beds proved to be the most suitable as a reference to quantify the energy consumption of a hospital.

scholarly journals Detailed cost of robotic-assisted surgery in the Australian public health sector: from implementation to a multi-specialty caseload

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kate McBride ◽  
Daniel Steffens ◽  
Christina Stanislaus ◽  
Michael Solomon ◽  
Teresa Anderson ◽  
...  
Keyword(s):  
Public Sector ◽  
Health Sector ◽  
Public Hospitals ◽  
Fixed Costs ◽  
Tertiary Referral Hospital ◽  
Robotic Assisted ◽  
The Public ◽  
Robotic Assisted Surgery ◽  
Specific Implementation ◽  
Theatre Utilisation

Abstract Background A barrier to the uptake of robotic-assisted surgery (RAS) continues to be the perceived high costs. A lack of detailed costing information has made it difficult for public hospitals in particular to determine whether use of the technology is justified. This study aims to provide a detailed description of the patient episode costs and the contribution of RAS specific costs for multiple specialties in the public sector. Methods A retrospective descriptive costing review of all RAS cases undertaken at a large public tertiary referral hospital in Sydney, Australia from August 2016 to December 2018 was completed. This included RAS cases within benign gynaecology, cardiothoracic, colorectal and urology, with the total costs described utilizing various inpatient costing data, and RAS specific implementation, maintenance and consumable costs. Results Of 211 RAS patients, substantial variation was found between specialties with the overall median cost per patient being $19,269 (Interquartile range (IQR): $15,445 to $32,199). The RAS specific costs were $8828 (46%) made up of fixed costs including $4691 (24%) implementation and $2290 (12%) maintenance, both of which are volume dependent; and $1848 (10%) RAS consumable costs. This was in the context of 37% robotic theatre utilisation. Conclusions There is considerable variation across surgical specialties for the cost of RAS. It is important to highlight the different cost components and drivers associated with a RAS program including its dependence on volume and how it fits within funding systems in the public sector.

scholarly journals DEEP SCOPE: A Framework for Safe Healthcare Design

2021 ◽  
Vol 18 (15) ◽  
pp. 7780
Author(s):  
Ellen Taylor ◽  
Sue Hignett
Keyword(s):  
Human Factor ◽  
Healthcare Facility ◽  
Built Environments ◽  
Facility Design ◽  
Healthcare Facilities ◽  
Healthcare Design ◽  
Accident Causation ◽  
Healthcare Facility Design

Thinking in patient safety has evolved over time from more simplistic accident causation models to more robust frameworks of work system design. Throughout this evolution, less consideration has been given to the role of the built environment in supporting safety. The aim of this paper is to theoretically explore how we think about harm as a systems problem by mitigating the risk of adverse events through proactive healthcare facility design. We review the evolution of thinking in safety as a safety science. Using falls as a case study topic, we use a previously published model (SCOPE: Safety as Complexity of the Organization, People, and Environment) to develop an expanded framework. The resulting theoretical model and matrix, DEEP SCOPE (DEsigning with Ergonomic Principles), provide a way to synthesize design interventions into a systems-based model for healthcare facility design using human factors/ergonomics (HF/E) design principles. The DEEP SCOPE matrix is proposed to highlight the design of safe healthcare facilities as an ergonomic problem of design that fits the environment to the user by understanding built environments that support the “human” factor.

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