scholarly journals Exploring Patients’ Experience on Hospital Merger: Have they benefited from Cluster Hospital Initiative in Malaysia?

2020 ◽  
Vol 28 (4) ◽  
Author(s):  
Rui Jie Ng ◽  
Nik Nur Eliza Mohamed ◽  
Ili Liyana Khairul Anuar ◽  
Kun Yun Lee ◽  
Nurul Syarbani Eliana Musa ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Resource Sharing ◽  
Productivity Loss ◽  
Healthcare Services ◽  
Integrated Network ◽  
Hospital Mergers ◽  
Hospital Merger ◽  
Before And After ◽  
Expected Benefits

Cluster Hospital Initiative (CHI) in Malaysia is a hospital merger exercise to establish an integrated network of specialist and non-specialist hospitals. The resource sharing, services realignment, and better care coordination from this integration have been shown to improve operational efficiency and quality of care from the providers’ perspective. However, there are very limited studies which focus on the effects of hospital merger on patients. Therefore, this study aims to explore patients’ and caregivers’ experiences of CHI. A qualitative study using purposive sampling was conducted from July to August 2017 at the three pilot sites. Semi-structured in-depth interviews were conducted with 85 patients and caregivers who received healthcare services before and after CHI. Interviews were audio-recorded and transcribed verbatim. Data were analysed using thematic text analysis. Three main themes transpired from the analysis were changes in healthcare service delivery, time spent on healthcare-related activities, and financial implications. Firstly, participants were generally satisfied with the increased access to specialist services, better quality of care, and upgraded equipment and facilities. Secondly, many participants experienced a shorter waiting time and reduced travelling time after CHI. Thirdly, CHI led to financial savings for the participants in terms of reduced out-of-pocket expenditure and productivity loss. This study demonstrated that the implementation of CHI appeared to be well-received by the patients. The expected benefits brought on by hospital mergers were also acknowledged by the study participants. A follow-up study is recommended due to the short duration of CHI implementation and low awareness about the initiative among patients.

scholarly journals PENERAPAN PRAKTIK KEPERAWATAN BERBASIS BUKTI PURSED LIP BREATHING PADA PASIEN DENGAN PENYAKIT PARU OBSTRUKTIF KRONIK DI RUANG RSU PUSAT PERSAHABATAN JAKARTA

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Seven Sitorus
Keyword(s):  
Quality Of Care ◽  
Pulmonary Disease ◽  
Significant Influence ◽  
Exercise Tolerance ◽  
P Value ◽  
Evidence Based ◽  
Copd Exacerbation ◽  
Before And After ◽  
Evidence Based Nursing

Background: Chronic Obstruction Pulmonary Disease (COPD) is disease characterized by obstruction air flow in the breath not wholly reversible. One treatment can be done on improving exercise tolerance is exercise respiration as pursed lip breathing ( PLB ). Purse lip breathing is a techniques of breathing carried out to expelling air by creating power through  in move closer /pursed lips. Purpose: provide an illustration of the application of the practice of evidence based nursing of pursed lip breathing in patients COPD in RSUP Persahabatan Jakarta. Method:  the implementation of the practice of evidence based nursing pursed lip breathing is applied to 12 people sample ( 10 men and 2 women ) diagnosed with COPD exacerbation. Result: the majority of sex respondents is man as many as 10 ( 83,3 % ) persons and women as many as 2 ( 16,7 % ) a person .mean the age of respondents is 61,5 years ± 10.4 .mean the value of PEF ( Peak Expiratory Flow ), the value of the saturation oxygen , the value of respiratori rate before the intervention in a consecutive manner is 131.6 ±  44.6; 92.1 ± 2.44; 31.5 ±  2 . While value after the intervention is 175.0 ±  60.0; 97,1 ± 1.6; 22,6 ± 1.7 with P value = 0.001, α = 0.05. Conclusions: there are significant influence the application of pursed lip breathing between before and after the intervention in patients COPD. Advice: Intervention evidence based nursing can be applied to all patients COPD so reached the quality of care of nursing based on research

scholarly journals Quality of care for patients with diabetes mellitus type 2 in ‘model practices’ in Slovenia – first results

2016 ◽  
Vol 55 (3) ◽  
pp. 179-184 ◽  
Author(s):  
Davorina Petek ◽  
Mitja Mlakar
Keyword(s):  
Diabetes Mellitus ◽  
Quality Of Care ◽  
Quality Indicators ◽  
Diabetes Mellitus Type 2 ◽  
Process Quality ◽  
Diabetes Mellitus Type ◽  
Before And After ◽  
Patients With Diabetes

Abstract Background A new organisation at the primary level, called model practices, introduces a 0.5 full-time equivalent nurse practitioner as a regular member of the team. Nurse practitioners are in charge of registers of chronic patients, and implement an active approach into medical care. Selected quality indicators define the quality of management. The majority of studies confirm the effectiveness of the extended team in the quality of care, which is similar or improved when compared to care performed by the physician alone. The aim of the study is to compare the quality of management of patients with diabetes mellitus type 2 before and after the introduction of model practices. Methods A cohort retrospective study was based on medical records from three practices. Process quality indicators, such as regularity of HbA1c measurement, blood pressure measurement, foot exam, referral to eye exam, performance of yearly laboratory tests and HbA1c level before and after the introduction of model practices were compared. Results The final sample consisted of 132 patients, whose diabetes care was exclusively performed at the primary care level. The process of care has significantly improved after the delivery of model practices. The most outstanding is the increase of foot exam and HbA1c testing. We could not prove better glycaemic control (p>0.1). Nevertheless, the proposed benchmark for the suggested quality process and outcome indicators were mostly exceeded in this cohort. Conclusion The introduction of a nurse into the team improves the process quality of care. Benchmarks for quality indicators are obtainable. Better outcomes of care need further confirmation.

Telepsychiatry Use in Rural Areas in the United States

2020 ◽  
Vol 13 (4) ◽  
pp. 1-13
Author(s):  
Alberto Coustasse ◽  
Morgan Ruley ◽  
Tonnie C. Mike ◽  
Briana M. Washington ◽  
Anna Robinson
Keyword(s):  
Mental Health ◽  
United States ◽  
Quality Of Care ◽  
Rural Areas ◽  
Care Delivery ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
The United States ◽  
Access And Quality

Rural areas have experienced a higher than average shortage of healthcare professionals. Numerous challenges have limited access to mental health services. Some of these barriers have included transportation, number of providers, poverty, and lack of insurance. Recently, the utilization of telepsychiatry has increased in rural areas. The purpose of this review was to identify and coalesce the benefits of telepsychiatry for adults living in rural communities in the United States to determine if telepsychiatry has improved access and quality of care. The methodology for this study was a literature review that followed a systematic approach. References and sources were written in English and were taken from studies in the United States between 2004 and 2018 to keep this review current. Fifty-nine references were selected from five databases. It was found that several studies supported that telepsychiatry has improved access and quality of care available in rural environments. At the same time, telepsychiatry in mental healthcare has not been utilized as it should in rural adult populations due to lack of access, an overall shortage of providers, and poor distribution of psychiatrists. There are numerous benefits to implementing telepsychiatry in rural areas. While there are still barriers that prevent widespread utilization, telepsychiatry can improve mental health outcomes by linking rural patients to high-quality mental healthcare services that follow evidence-based care and best practices. Telepsychiatry utilization in rural areas in the United States has demonstrated to have a significant ability to transform mental health care delivery and clinician productivity. As technology continues to advance access, telepsychiatry will also advance, making access more readily available.

scholarly journals Overpriced? Are Hospital Prices Associated with the Quality of Care?

Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 135
Author(s):  
Brad Beauvais ◽  
Glen Gilson ◽  
Steve Schwab ◽  
Brittany Jaccaud ◽  
Taylor Pearce ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Clinical Care ◽  
Healthcare Services ◽  
Cost Ratio ◽  
Performance Score ◽  
Significant Positive Association ◽  
The Public ◽  
Total Performance

In most consumer markets, higher prices generally imply increased quality. For example, in the automobile, restaurant, hospitality, and airline industries, higher pricing generally conveys a signal of complexity and superiority of a service or product. However, in the healthcare industry, there is room to challenge the price-quality connection as both health prices and health quality can be difficult to interpret. In the best of circumstances, health care costs, prices, and quality can often be difficult to isolate and measure. Recent efforts by the Trump Administration and the Center for Medicare and Medicaid Services (CMS) have required the pricing of hospital services to be more transparent. Specifically, hospital chargemaster (retail) prices must now be available to the public. However, many continue to question if the pricing of health care services reflects the quality of service delivery. This research focuses on investigating the prices hospitals charge for their services in relation to the costs incurred and the association with the quality of care provided. By analyzing data from a nationwide sample of U.S. hospitals, this study considers the relationship between hospital pricing (as measured by the charge-to-cost ratio) and hospital quality performance as measured by the Value Based Purchasing Total Performance Score (TPS) and its associated sub-domains. Results of the study indicate that hospital prices, as measured by our primary independent variable of interest, the charge-to-cost ratio, are significantly and negatively associated with Total Performance Score, Patient Experience, and the Efficiency and Cost Reduction domains. A marginal statistically significant positive association is shown in the Clinical Care domain. The findings indicate that unlike most other industries, in medicine, higher pricing compared to cost does not necessarily associate with higher quality and, in fact, might indicate the opposite. The results of this study suggest that purchasers of healthcare, at all levels, have justification in challenging the pricing of healthcare services considering the quality scores available in the public domain.

scholarly journals Satisfaction of patients received in emergencies in the department of obstetrics and gynecology at the Yalgado Ouedraogo teaching hospital: comparative study before and after the introduction of free care

2019 ◽  
Vol 8 (8) ◽  
pp. 3259
Author(s):  
Hyacinthe Zamané ◽  
Sibraogo Kiemtoré ◽  
Paul Dantola Kain ◽  
Lydie Zounogo Ouédraogo ◽  
Blandine Bonané Thiéba
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Teaching Hospital ◽  
Health Care Services ◽  
Care Process ◽  
Important Indicator ◽  
Care Services ◽  
Before And After ◽  
Free Care

Background: The quality of care perceived by the users of health care services is an important indicator of the quality of care. The aim of this study was to assess the satisfaction of patients received in obstetric and gynecological emergencies department of Yalgado Ouedraogo Teaching Hospital before and after the introduction of free care.Methods: This was a cross-sectional investigation. Data collection was carried out from February to July 2016, covering the last three months before the start of free care and the first three months of implementation of this free policy in Burkina Faso.Results: A total of 620 patients formed the sample. The reception (p=0.0001), the waiting period (p=0.0001), respect for treatment schedules (p=0.0001), respect for intimacy (p=0.0001), communication between providers and patients (p=0.007), the comfort of the delivery room (p=0.003) and the comfort of the ward room (p=0.002) were more favorably appreciated by patients before the free treatment than during that period. Overall patient satisfaction was better before the effectiveness of free care (p=0.003).Conclusions: The realization of free care process was followed by a lower patient’s satisfaction reflecting an alteration in the quality of health care services. A situational analysis of this free health care process is necessary in order to make corrective measures. Also adequate preventive measures should be adopted before any implementation to a larger scale of this free policy.

Erratum to “Perceived quality of care in pregnancy: Assessment before and after delivery”

2000 ◽  
Vol 91 (2) ◽  
pp. 211
Author(s):  
Rafael Lledó ◽  
Teresa Rodrı́guez ◽  
Antoni Trilla ◽  
Vicens Cararach ◽  
Joseph D. Restuccia ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Perceived Quality ◽  
Perceived Quality Of Care ◽  
Before And After ◽  
In Pregnancy

scholarly journals Perceived Consequences of Healthcare Service Decentralization on Access, Affordability and Quality of Care in Khartoum Locality, Sudan

2020 ◽  
Author(s):  
Bandar Noory ◽  
Sara Hassanein ◽  
Jeffrey Edwards ◽  
Benedikte Victoria Lindskog
Keyword(s):  
Quality Of Care ◽  
Healthcare Providers ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
System Capacity ◽  
Cross Sectional ◽  
Study Results ◽  
Catchment Areas ◽  
The Impact

Abstract Background: Decentralization of healthcare services have been widely utilized, especially in developing countries, to improve the performance of healthcare systems by increasing the access and efficiency of service delivery. Experiences have been variable secondary to disparities in financial and human resources, system capacity and community engagement. Sudan is no exception and understanding the perceived effect of decentralization on access, affordability, and quality of care among stakeholders is crucial.Methods: This was a mixed method, cross-sectional, explorative study that involved 418 household members among catchment areas and 40 healthcare providers of Ibrahim Malik Hospital (IBMH) and Khartoum Teaching Hospital (KTH). Data were collected through a structured survey and in-depth interviews from July-December 2015.Results: Access, affordability and quality of healthcare services were all perceived as worse, compared to before decentralization was implemented. Reported affordability was found to be 53% and 55% before decentralization compared to 24% to 16% after decentralization, within KTH and IBMH catchment areas respectively, (p= 0.01). The quality of healthcare services were reported to have declined from 47% and 38% before decentralization to 38% and 28% after, in KTH and IBMH respectively (p=0.02). Accessibility was found to be more limited, with services being accessible before decentralization approximately 59% and 52% of the time, compared to 41% and 30% after, in KTH and IBMH catchment areas respectively, (p=0.01).Accessibility to healthcare was reported to have decreased secondary to facility closures, reverse transference of services, and low capacity of devolved facilities. Lastly, privatized services were reported as strengthened in response to this decentralization of healthcare. Conclusions: The deterioration of access, affordability and quality of health services was experienced as the predominant perception among stakeholders after decentralization implementation. Our study results suggest there is an urgent need for a review of the current healthcare policies, structure and management within Sudan in order to provide evidence and insights regarding the impact of decentralization.

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