Assessment Of Healthcare Services Research Articles

An Assessment of Healthcare Services in Jordanian Public Hospitals from the Perspective of COVID-19 Patients in the Aftermath of COVID-19

Hospitals faced many challenges during the COVID-19 pandemic when it came to providing healthcare to patients. These obstacles included limited bed availability, shortages of medical equipment and staff, insufficient drug supply, inadequate physical facilities, and a lack of healthy environments. As the pandemic continues into its third year, it has become clear that viruses could remain a permanent part of our lives, leading to a rise in the demand for healthcare services. With this in mind, a study was conducted to investigate the impact of different healthcare service dimensions provided by public hospitals in Jordan on patient satisfaction. The research revealed that reliability, assurance, and responsiveness are the most critical dimensions for patient satisfaction, followed by tangibility and empathy. In addition, the study discovered healthcare service characteristics positively affected patient satisfaction according to the patient's age, gender, and place of treatment. In addition, the study discovered healthcare service dimensions positively affected patient satisfaction according to the patient's age, gender, and place of treatment. In order to improve and manage the healthcare services offered to patients, the study advises public hospital administrators to identify the significance of healthcare service dimensions. Administrators should pay close attention to the dimensions of tangibility and empathy, which are strong yet good, and take into account patient demographic disparities.

Assessment of Healthcare Services using Models Based on Support Vector Machines

This article presents a case study that provides assessment of access to the Irish healthcare system and the services it provides. We explore factors related to unmet heath care needs using recent survey data. Our approach is based on using support vector machines for building predictive models that analyse and measure those factors. The proposed methodology is novel for the domain. Following the behavioural model for access to medical care, we group factors into three categories: predisposing, enabling, and needs, and analyse each group. Experimental results show and measure the primary causes of imbalances and inequalities of treatment in the Irish healthcare system today.

The ICF Classification as a Simple Tool to Aid in the Assessment of Healthcare Services in a Non-COVID-19 Hospital during the COVID-19 Pandemic.

The COVID-19 pandemic has had a significant impact on the operation of medical facilities. In this period, they have seen increased absence of medical staff from work, a decrease in the number of hospitalizations and in the value of healthcare services provided. We assess the impact of this pandemic on the operation of a non-COVID-19 orthopedic and rehabilitation hospital using International Classification of Functioning, Disability and Health (ICF) categories. The authors analyzed these parameters in relation to the operation of a non-COVID-19 orthopedic, rehabilitation and rheumatological hospital in Q1 2020 compared to Q1 2019. For the analysis, the categories and qualifiers of the ICF were used, allowing for a simple and easily readable data analysis. In March 2020, in comparison to March 2019, the average working time of medical workers (p < 0.001) and the number of hospitalizations (p < 0.034) decreased significantly. In April 2020, compared to April 2019, the average working time of medical workers (<0.001) and the number of hospitalizations (0.002) also decreased significantly. In addition, in April 2020, the percentage value of the contracted services provided decreased significantly (p = 0.017), which was not observed in March of that year. The COVID-19 pandemic has affected the operation of a non-COVID-19 hospital, causing an increase in staff absences from work, a decrease in the number of hospitalizations and a decrease in the value of the revenue generated from health services provided. The ICF is a useful tool for the evaluation of a hospital’s healthcare services.

Evaluation of the Patients’ Satisfaction with Psychiatric Health Care Services with an Adapted PIPEQ-OS Tool

Abstract Until now, the assessment of health care services provided by psychiatric institutions in Latvia has not been carried out and questionnaires to provide assessment from the patient’s perspective have not been adapted. For this study, a questionnaire that has been validated and successfully employed for several years in Norway was chosen to assess patients’ experience and in a psychiatric inpatient setting. The aim of the study was to determine patients’ satisfaction with the quality of mental health care services in Latvia in the subacute inpatient psychiatric ward in Rīga, adapting during this process the PIPEQ-OS (Psychiatric Inpatient Patient Experience Questionnaire) tool in Latvia. The pilot quantitative study was conducted from June 2016 till February 2017. In the study, an anonymous patient self-assessment questionnaire PIPEQ-OS containing 21 questions was used. During the adaptation process, the questionnaire was translated from English into Latvian and Russian and backwards. The quality and compliance of the translation was subsequently tested in cognitive interviews. During the study, 297 patients were discharged from the unit, and 231 of them completed the questionnaire. 12% of the completed questionnaires were not included in data processing due to being incorrectly filled in. Cognitive interviews with 20 patients were carried out; the average length of an interview was 15 minutes. Overall, the translation of the questionnaire proved to be relevant to the research theme. The subsequent factor analysis revealed three significant factors that reached the Cronbach’s alpha index of 0.7. Further studies using socio-demographic data and based on various inpatient units as well as the comparison of satisfaction indicators across different diagnostic groups are needed.

Assessment of health care services for people with stoma: a multicase study

Objective: to evaluate the health care services of people with stoma. Methods:a multi-case study that analyzed the implementation of five regional services. Three components were defined, namely Service management, Clinical care and Educational assistance. The degree of implementation set by a score system was classified as complete, satisfactory, poor, not implemented. Results:a service was evaluated with “completely implemented” and another as “not implemented”. The best components evaluated were Clinical Care and Service Management; the one that obtained lower assessment was Educational assistance. Structural limitations included a lack of complete health staff and lack of clinical and organizational protocols. In the Process, there was a shortage of consultations carried out by the team, formation of support groups and health education. Conclusion:the regional services surveyed are not adequate to subsidize planning, monitoring and services to people with stoma, as they present structural and procedural problems that interfere with the quality of care.

Assessment of health care services on crop farmers’ activities in Oke-Ero Local Government Area of Kwara State, Nigeria

The study assessed the healthcare services on crop farmers’ activity in Oke-Ero Local Government area of Kwara State, Nigeria. A two-stage sampling techniques was used to select one hundred and sixty (160) respondents. Data were collected with questionnaire and analysed using both descriptive and inferential statistics. The findings revealed that about (30.0%) of the respondents age were greater than sixty (&gt;60) years while 54.4% and 40.0% were male and had no formal education respectively. Also, Malaria (Mean=1.86), cough (Mean=1.39) and headache (Mean=1.38) were most experienced sickness among the farmers. Yearly, 48% of the respondents received treatments on malaria, 2.5% of the respondents received treatments on Dysentery while 88.8% and 92.5% received treatments on skin rashes and ante-natal care respectively from healthcare centre. Findings revealed that most (66.8%) of the respondents patronized modern healthcare services, 18.8% patronized Traditional healthcare centre while only 14.4% of the respondents patronized others healthcare services. However, lack of fund, distance from healthcare centers, insufficient healthcare practitioners and religious belief were some of the constraints to good healthcare. It is concluded that, malaria was the most common sickness experienced by the farmers and they usually received healthcare services mainly on malaria and child delivery. It is therefore recommended that, healthcare services centers should be made accessible and closer to farmers in the rural areas through ministry of health in conjunction with agricultural development programme.Keywords: Assessment, Health Care Services, Crop Farmers, Activities, Kwara State

Overall satisfaction of health care users with the quality of and access to health care services: a cross-sectional study in six Central and Eastern European countries.

BackgroundThe measurement of consumer satisfaction is an essential part of the assessment of health care services in terms of service quality and health care system responsiveness. Studies across Europe have described various strategies health care users employ to secure services with good quality and quick access. In Central and Eastern European countries, such strategies also include informal payments to health care providers. This paper analyzes the satisfaction of health care users with the quality of and access to health care services. The study focuses on six Central and Eastern European countries (Bulgaria, Hungary, Lithuania, Poland, Romania and Ukraine).MethodsWe use data on past experience with health care use collected in 2010 through uniform national surveys in these countries. Based on these data, we carry out a multi-country analysis to investigate factors associated with the satisfaction of health care users in the six countries.ResultsThe results indicate that about 10-14 % of the service users are not satisfied with the quality of, or access to health care services they used in the preceding year. However, significant differences across countries and services are observed, e.g. the highest level of dissatisfaction with access to outpatient services (16.4 %) is observed among patients in Lithuania, while in Poland, the level of dissatisfaction with quality of outpatient and inpatient services are much lower than dissatisfaction with access. The study also analyses the association of users’ satisfaction with factors such as making informal payments, inability to pay and relative importance of service attributes stated by the service users.ConclusionsThese multi-country findings provide evidence for health policy making in the Central and Eastern European countries. Although the average rates of satisfactions per country are relatively high, the results suggest that there is ample room for improvements. Specifically, many service-users still report dissatisfaction especially those who pay informally and those unable to pay. The high shares of informal payments and inability of users to deal with the health expenditures lead to doubts about the fairness of the health care provision in Central and Eastern Europe. There is an urgent need for policy makers in the region to not only acknowledge but also to effectively address this key problem.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1585-1) contains supplementary material, which is available to authorized users.

Evaluation of Mackey Childbirth Satisfaction Rating Scale in Iran: What Are the Psychometric Properties?

BackgroundWith the integration of the evaluation of patient satisfaction in the overall assessment of healthcare services, authorities can be assured about the alignment of these services with patient needs and the suitability of care provided at the local level.ObjectivesThis study was conducted in 2013 in Zahedan, Iran, in order to assess the psychometric properties of the Iranian version of the mackey childbirth satisfaction rating scale (MCSRS).Patients and MethodsFor this study, a methodological design was used. After translating the MCSRS and confirming its initial validity, the questionnaires were distributed among women with uncomplicated pregnancies and no prior history of cesarean section. The participants had given birth to healthy, full-term, singletons (with cephalic presentation) via normal vaginal delivery at hospitals within the past six months. Cronbach’s alpha and test-retest (via the intraclass correlation coefficient) were applied to analyze the internal consistency and reliability of the scale. Moreover, the validity of the scale was tested via exploratory factor analysis, confirmatory factor analysis, and convergent validity.ResultsThe MCSRS consists of six subscales. Through the process of validation, two partner-related items (“partner” subscale) of the scale were excluded due to cultural barriers and hospital policies. Cronbach’s alpha for the total scale was 0.78. It ranged between 0.70 and 0.86 for five subscales, and was 0.31 for the “baby” subscale. Factor analysis confirmed the subscales of “nurse,” “physician,” and “baby,” which were identified in the original scale. However, in the translated version, the “self” subscale was divided into two separate dimensions. The six subscales explained 70.37% of the variance. Confirmatory factor analysis indicated a good fitness for the new model. Convergent validity showed a significant correlation between the MCSRS and the SERVQUAL scale (r = 0.72, P < 0.001). Moreover, the Farsi version of the MCSRS showed excellent repeatability (r = 0.81 - 0.96 for individual subscales and r = 0.96 for the entire scale).ConclusionsThe study findings indicated the Farsi version of the MCSRS is a reliable and valid instrument. However, according to the reliability assessment and factor analysis, the “baby” and “self” subscales need further revisions.

Understanding patient satisfaction in a hospital emergency department

The field of health marketing has been witnessing the growing importance of concerns for patient satisfaction and assessment of health care services. This paper reports a prospective study which has been conducted in order to understand satisfaction in a hospital emergency department (ED). A questionnaire was applied to a sample of patients leaving the emergency department of a public hospital and correlation analysis is used to assess the proposed hypotheses. Results show that satisfaction rates with the service as a whole are lower than satisfaction with the core health service. Patients consider “technical quality of health care”, “interpersonal behaviour”, and “waiting time” as the most important dimensions of service. Moreover, the variable “waiting time” is inversely associated to the ED patients’ satisfaction and “interpersonal behaviour” and “communication between clinicians and patients” influence positively patient satisfaction. These results contribute to a clearer view of which dimensions impact patients’ satisfaction thus contributing to understand how to improve healthcare services in EDs.

ANALISIS SIKAP PENILAIAN PASIEN TENTANG JASA PELAYANAN KESEHATAN

The study, entitled "Analysis of Patients About Attitude Assessment in Health Care Services Medical Center Health Care and Rehabilitation Center (PPKR) BSMI Prambanan Klaten" which aims to determine how attitudes outpatient assessment of health services provided by the Center for Health Services and Medical Center Rehabilitation (PPKR) BSMI Prambanan Klaten that includes, facilities, workforce and location.In this study, researchers used a test tool attidude towar object or model of Fishbein attitude to answer the hypothesis. The hypothesis that the attitude of the patient assessment of health care services that includes, facilities, workforce and location in the Medical Center Health Care and Rehabilitation Center (PPKR) BSMI Prambanan Klaten is positive, it is true and acceptable. Because after tested the hypothesis is proven, based on the patient's attitude about the assessment interval services Polyclinics Health Care and Rehabilitation Center (PPKR) BSMI Prambanan Klaten covering factors, facilities, workforce and location of 64.44 and enter the positive interval is 54.78 &lt;x &lt;67.66, mean attitude positive patient assessment of services provided Polyclinics Health Care and Rehabilitation Center (PPKR) BSMI Prambanan Klaten.

Neoadjuvant Treatment of Rectal Carcinoma: Assessment of Health Care Services by Physicians and Lay Persons

Because of demographic changes, an increase in malignant diseases can be expected in the coming decades. Colorectal cancer has become the second most common form of cancer in both sexes. Standards for the diagnosis and treatment of colorectal cancer have changed considerably during the last decade, for example, the number of examined lymph nodes and routine total mesorectal excision. Multimodal treatment strategies such as neoadjuvant radiotherapy or radio-chemotherapy should further improve prognosis. Preoperative therapy reduces the local recurrence rate by half but also causes considerable long-term morbidity without influencing the prognosis. There is a variety of data sets, some of which focus on recurrence rates and prognosis, and some of which focus on quality-of-life issues. This complex situation creates difficulties in making treatment decisions for both experts and, to a greater degree, patients and lay persons. Therefore, we completed a project to summarize and present the data from several clinical trials in a way that lay persons can also understand the most important aspects, thus enhancing patient involvement in the decision-making process. The final presentation for the patients was based on published data from five major prospective, randomized, double-arm, multicentric studies on neoadjuvant treatment of rectal cancer with long-term follow-up. The target population consisted of patients who were to undergo surgery for rectal cancer, either with or without additional neoadjuvant radiotherapy or radio-chemotherapy. End points were postoperative and total mortality, rates of local relapses, and distant metastases, as well as long-term morbidity, such as frequency of fecal incontinence, cardiovascular diseases, disturbance of sexual functions, and secondary cancers resulting from radiotherapy. A detailed summary of the long-term morbidity was published separately. The summarized data of the five studies and the side effects reported for each study (summarized in Kornmann and HenneBruns) were presented in a graphical form consisting of four squares (quadrants) as shown in Figure 1. The two quadrants on the left side showed the results of treatment with preoperative radiation and the two quadrants on the right side showed the results of treatment without preoperative radiation. The two upper quadrants displayed the results that were reported in the initial publication for mortality and recurrences. The two lower quadrants showed the results for longterm morbidity, generally reported as separate publications (summarized in Kornmann and Henne-Bruns). Each of the end points was displayed in a different color. The graphically displayed results of the five studies were presented as POWERPoint presentation or colored tables to different groups of test persons. An example of a colored table is shown in Figure 1. The first group of test persons consisted of German lay persons (n 59). The second group consisted of 20 Brazilian guests of the Brazil Center Baden-Wurttemberg. Eighteen physicians participating in a seminar during the 8th Annual Convention of the German Network of Evidence-Based Medicine in Berlin, Germany, in March 2007, constituted the third group. The fourth group consisted of participants at the Congress of Health Networkers—principally health insurance managers, employees in hospital administration, and employees of the pharmaceutical industry (n 34). The fifth group consisted of 21 persons affiliated with health care politics. In the first group, the participants were requested to vote on the treatment options in the five studies after a 20-minute introduction to the topic of rectal cancer. This introduction gave a brief overview about the anatomy, pathogenesis, treatment options, possible side effects, and life with cancer recurrence. After this introduction, the participants had the chance to discuss and ask questions before voting. Each study was then presented as an animated POWERPoint slide (Fig 1). The test persons had to vote for their preferred approach, surgery with (A) or without (B) neoadjuvant treatment, immediately after the presentation of the summarized data of each study. Only the five tables with the two different therapeutic concepts were shown to the second to fifth test groups. The 152 test persons made a total of 760 decisions, of which 86% (minimum, 73%; maximum, 93%) would choose not to receive neoadjuvant therapy. In only one of the five studies, a 10% survival benefit in favor of the radiotherapy group had been reported. Nevertheless, only 24% of all participants in this study preferred the treatment with preoperative radiation. When summarizing and presenting the data, we realized the difficulties in understanding the details and reported differences in the various studies. Preparing such a presentation involves considerable time and effort, because the necessary information had to be extracted and summarized from different publications with different subgroup analyses (eg, patients who underwent R0 resection or long-term survivors). JOURNAL OF CLINICAL ONCOLOGY COMMENTS AND CONTROVERSIES VOLUME 26 NUMBER 30 OCTOBER 2

Vergleichende Bewertung von Gesundheitsleistungen durch Laien am Beispiel der Therapie des Rektumkarzinoms

Multimodal treatment strategies make the assessment of health care services very difficult even for experts and almost impossible for lay persons. The aim of this project was to present complex data from scientific publications in a simplified way so that all essential information is preserved, but still assessable by lay persons and to compare their assessments with the recommendations of experts. Using the surgical treatment of rectal cancer with or without preoperative radiation as an example, the aims of treatment as well as the "outcomes" (actually intended study endpoints) and "outputs" (surrogate parameters) were defined, identified and presented graphically for five key studies of neoadjuvant treatment. German lay persons (n = 59) favoured in the majority of the cases (93 %) surgical treatment without preoperative radiation. Lay persons assessed the results in a similar manner to other groups (physicians, health care workers, and health care politicians) and lay persons of other cultural backgrounds. Altogether, the participants (n = 152) favoured surgical treatment without preoperative therapy in 86 % of the cases (653 of 760). This lay assessment did not correlate with the assessments and recommendations of the scientific societies responsible for the guidelines. Complex scientific results can be prepared in such a way that their assessment by lay persons is feasible. Lay persons orientate their assessment according to the outcomes, while the recommendations of the guidelines are more directed by the outputs. These different viewpoints should be taken more into consideration for the development of guidelines than they are now.

Vergleichende Bewertung von Gesundheitsleistungen durch Laien am Beispiel der Therapie des Rektumkarzinoms

Ziel der Untersuchung: Multimodale Therapiekonzepte machen die Bewertung von Gesundheitsleistungen selbst für Experten immer schwieriger und für Laien nahezu unmöglich. Ziel dieses Projektes war zu klären, ob Patienten bei komplexen Problemen ähnlich wie Experten entscheiden. Dazu waren komplexe Daten aus wissenschaftlichen Publikationen so vereinfacht darzustellen, dass zwar alle wesentlichen Informationen enthalten blieben, diese aber von Laien bewertet werden konnten. Basismethodik: Am Beispiel der operativen Therapie des Rektumkarzinoms mit und ohne Vorbestrahlung wurden die Ziele der Therapie, nämlich die „Outcomes” (tatsächlich angestrebte Endpunkte) und „Outputs” (Surrogat- oder Stellvertreter-Parameter) definiert, identifiziert und grafisch für fünf Schlüsselstudien zur neoadjuvanten Therapie dargestellt. Ergebnisse: Deutsche Laien (n = 59) bevorzugten in der Mehrzahl (93 ) die Operation ohne Vorbestrahlung. Laien bewerteten die Ergebnisse jedoch ähnlich wie andere befragte Gruppen (Mediziner, Gesundheitsnetzwerker, Gesundheitspolitiker) und Laien aus einem anderen Kulturkreis. Alle Befragten (n = 152) entschieden sich in 86 der Fälle (653 von 760) für die Operation ohne Vorbestrahlung. Die Bewertung der Laien stimmte mit den Empfehlungen der wissenschaftlichen Fachgesellschaften und der Leitlinien nicht überein. Schlussfolgerungen: Komplexe wissenschaftliche Daten können so aufbereitet werden, dass deren Bewertung durch Laien möglich ist. Laien scheinen ihre Bewertung an den „Outcomes” zu orientieren, während sich die Empfehlungen in den Leitlinien mehr an „Outputs” orientieren. Diese unterschiedlichen Sichtweisen sollten bei der Gestaltung von Leitlinien mehr als bisher berücksichtigt werden.

Setting national priorities for quality assessment of health care services in Korea

To identify target services and determine national priorities among those services identified for a national quality assessment program of the Health Insurance Review Agency (HIRA) in Korea. Target services were identified from published sources addressing quality problems, various quality-monitoring programs in other countries, suggestions from 26 medical specialty associations in Korea, and frequently reported consumer claims. Three steps were involved in the prioritization decision: (i) development of a set of priority criteria; (ii) expert panel survey to evaluate the extent to which individual services satisfy each of the priority criteria and to calculate mean priority ratings for individual services; and (iii) formation of four levels of priority groups-top, high-middle, middle, and low-according to the allocated priority ratings. Five priority criteria were selected: "burden of the condition", "seriousness of the quality problem", "interest and demand of society", "acceptability", and "the feasibility of quality assessment". Among the 57 services identified as targets for the national quality assessment program, 10 were selected as having a top priority for quality assessment because of their high feasibility rating. These are: cardiac surgery; cataract surgery; tonsillectomy; appendectomy; tooth extraction; usage of albumin/globulin products; treatments for hypertension, pneumonia, and acute upper respiratory infection; and services provided by clinical laboratory centers. The priority services identified from the studies will assist the HIRA in selecting target services and implementing the national assessment program.

Regional Mapping of Incidence Rates Using Spatial Bayesian Models

This study takes a statistical-modeling point of view to the assessment of health care services and procedures. The emphasis is on small-area prediction of incidence rates from spatially contiguous regions, although suitable modifications can also give doctor-level predictions. The main idea is to recognize the individuality of each region through a spatial Bayesian model for incidence rates. A noise component, because of location error and measurement error, is filtered out using empirical Bayes methods. The resulting smoothed predictors of incidence rates provide an accurate picture of the health care service or procedure under investigation.