Development Of Health Services Research Articles

Analysis of health knowledge awareness and influencing factors of permanent residents in Songshan Lake Science and Technology Industrial Park, Dongguan City

Objective: To understand the health knowledge awareness and influencing factors of permanent residents in Songshan Lake Science and Technology Industrial Park, Dongguan City, and to provide a data basis for the development of health education and public health services in the region. Methods: A multi-stage stratified sampling method was used to select 1,000 permanent residents from 13 residential areas in the region as survey subjects. Basic demographic information and health knowledge awareness were obtained through questionnaires, and statistical analysis was conducted on the data. Results: The health knowledge awareness rate of permanent residents in the region is relatively low, with the highest rate being the dangers of smoking in pregnant women, with the correct answer rate reaching 87.1%. Correct use of antibiotics, transmission routes of AIDS, salt intake standards and hypertension diagnostic standards have correct answer rates between 40% and 55%. The three knowledge points of risk factors for hypertension, diabetes and cerebrovascular disease had the lowest correct answers. Respondents with higher education levels know more health knowledge. Conclusion:The awareness rate of health knowledge is very low, which is not suitable for the current economic development and population quality. Health education and publicity should be strengthened for groups with low awareness and knowledge content.

Exploring the foundations of a digital health information service for patients with inflammatory bowel disease: a mixed method study in Gravitate-Health

BackgroundProviding relevant digital health information of high quality may promote treatment adherence and self-management for patients with inflammatory bowel disease. The development of digital health services is optimised by considering end users’ needs.AimTo identify key aspects required for digital promotion of inflammatory bowel disease patients’ self-management by exploring their health information needs and the preferences of both patients and healthcare professionals in relation to the digital provision of inflammatory bowel disease health services.MethodsData from an audit of 1,481 electronic health record summaries from an inflammatory bowel disease help line, 17 semi-structured interviews with inflammatory bowel disease patients and 2 focus group interviews with 11 healthcare professionals were analysed.ResultsPatients primarily contacted the hospital due to concerns about symptoms, examinations and tests, and medicines. Their concerns appeared to vary according to diagnosis, gender, age and disease duration. The interviews identified two overarching themes: (1) the available health information and patients’ health information needs, and (2) whishes, thoughts and preferences for a digital solution in IBD care with relevant and individualised information.ConclusionsThe findings delineate key aspects for developing a suitable digital health information service. Patients seek information from healthcare professionals about treatment; however, in a digital solution, they want access to relevant and practical information about the disease, treatment and self-management. Both patients and healthcare professionals saw opportunities for increasing health data availability to patients. However, healthcare professionals expressed concerns about adapting, maintaining and ensuring the relevance of patient health information without increasing their workload and, thus, reducing quality of care.

Health effect of public sports services and public health services: empirical evidence from China.

There is no clear explanation for the extraordinary rebound in China's population mortality over the past decade. This paper utilizes panel data from 31 Chinese provinces from 2010 to 2020 to determine the distinct impacts of public sports services (PSS), public health services (PMS), and their interaction on population mortality. Empirical results show that public sports services significantly reduce mortality. Every unit increase in public sports services reduces mortality by about 2.3%. It is characterized by delayed realization. Public health services were surprisingly associated with a rebound in mortality. Further studies found strong health effect from interaction of public sports and health services. The effect was significantly strengthened in areas with fewer extreme temperatures or developed economy. The findings have important policy implications for the high-quality development of public sports and health services. It also emphasizes integration of sports and medicine and mitigates health risks associated with extreme temperatures.

The Collaboration of Private Hospitals with the Public Health Service: The Case of La Rioja, Spain (1986-2019).

In Spain, the public National Health Service provides care to Spaniards and other residents and is tailored for a decentralized state of autonomies. Each Autonomous Community has legislative capacity in its organization and management. We study the case of the collaboration between private hospitals and the public health service in La Rioja, an Autonomous Community of Spain located in the North of the Iberian Peninsula, due to the importance that this relationship has in health systems, in general. We applied the case study method as a methodological tool in a long-term local study. The interpretation was carried out within a national context, which allows us to understand its meaning and the historical keys to hospital development in this region. Primary sources have been reviewed (mainly reports, catalogs, and censuses of hospitals from the Ministry of Health and the Government of La Rioja) and other secondary sources, located in archives, libraries, Institute of Rioja Studies, and Department of Health. The hospital system in La Rioja was characterized by a predominance of public beds compared with private ones, although there has been a growing trend in the number of private beds from 2013 onwards due to the incorporation of health and social care convalescent hospitals (two). La Rioja has been promoting public-private collaboration (seen as a strategic alliance) and focusing on agreements in the socio-health space, particularly using the management service agreement and the concession of work formulas. The development of the public health service in La Rioja, from 1986 to 2019, has been determined by a progressive lower dependence on specialized hospitals from other health services of neighboring Autonomous Communities and by a mixed public-private hospital system.

Proposed System of Integrated Geriatric and Disability Care Services in Sri Lanka (A Concept Note)

The global landscape is witnessing a significant transformation marked by a rapid increase in the aging population, driven by epidemiological and demographic transitions. Sri Lanka, like many other countries, is experiencing a significant demographic shift with an increase of older population. Notably, Sri Lanka stands out in South Asia, with 12.3% of its population aged 60 or older, the highest proportion in the region. Similar to other countries Sri Lanka also experiencing the increasing of elderly population. Sri Lanka is not geared to cater the elderly population and their needs as well as related health conditions, hence; it is the need in the current context. Objective of this paper is to propose a service delivery framework for elderly and related health care to the Sri Lankan health system based on the current findings. Methodology used are a desk reviews and key informant interviews to gather current data on elderly care and develop the model based on these findings. The development of geriatric health services in Sri Lanka is crucial to ensure that the growing elderly population receives the care and support they need to age healthily and maintain their quality of life. By addressing the unique healthcare challenges faced by the elderly, we can enhance the overall health and well-being of the elderly population in the nation.

PERLINDUNGAN TERHADAP PERKEMBANGAN LAYANAN KESEHATAN BERBASIS KECERDASAN BUATAN (ARTIFICIAL INTELLIGENCE) DI INDONESIA

Artificial Intelligence-based (AI) Health Service is a solution to the limited number and distribution of doctors in Indonesia. However, the use of AI technology also presents several challenges. This research used a normative juridical approach to analyse protection regarding the development of AI-based technology-based health services in Indonesia. The analysis shows that challenges to utilizing AI in healthcare include bias, protection of personal data and risk of malpractice. As a system that has no moral values, doctors is expected to be wiser in operating it. To ensure the delivery of quality AI-based health services, patients, doctors, service providers and the government need to understand and carry out their respective roles collaboratively.

Spiritual and Community-Based Mental Health Services for Children with Special Needs in Islamic Boarding School

This study focuses on enhancing the care and educational support for children with special needs, particularly in rural areas where their families often lack adequate support. Recognizing the vital roles of communities and governments, the research seeks to create an inclusive education and mental health service model that incorporates spirituality and community engagement. A qualitative research method was used to achieve this, involving 19 managers and caregivers of children with special needs. Through interviews, participant observations, and three focus group discussions, data were collected using the free association technique and analyzed via thematic analysis. This analysis highlighted four key themes: the development of spiritual and community-based mental health services, the application of these approaches in service delivery, the care strategies for children with special needs, and the evaluation methods and psychological interventions rooted in indigenous psychology. The goal is to establish a mental health service model for rural settings that can be adapted for broader application in other regions.

Supporting newly qualified pharmacists in transitioning to independent practice: a qualitative analysis of the role of supervision

Abstract Introduction Newly qualified pharmacists (NQPs) face a demanding and challenging work environment during their transition to independent practice.[1,2] They also face challenges related to the changing nature of pharmacy practice, with pharmacists playing an increasingly important clinical role in patient care, which can be daunting for NQPs. Supporting NQPs during this transition period is essential for ensuring the sustainable development of health services. In 2021, Health Education England introduced the Newly Qualified Pharmacist Pathway, which included access to the Royal Pharmaceutical Society (RPS) e-Portfolio, formal learning of clinical and other skills, and access to educational supervision. The learning programmes were delivered by different providers in different settings/sectors. In hospitals, the Pathway was intended to complement existing programmes. Those in community pharmacy, general practice, community health services, health and justice, and care homes had access to a 12-month structured programme. Aim To discuss how supervision works and its contribution to supporting NQPs during their transition to independent practice. Methods Semi-structured qualitative interviews with NQPs (n=7) and supervisors (n=14). Email invitations were sent via learning providers. Participants were selected to capture NQPs and supervisors from various learning programmes and settings/sectors. Interviews were analysed thematically. Results The transition to independent practitioners meant NQPs were required to work with a high degree of autonomy in their practice. Yet, NQPs reported a lack of confidence in this. Supervisors reported that being an independent practitioner also meant that NQPs needed to be accountable for their decisions, learn to prioritise in a high-pressure environment, lead more experienced colleagues and manage a team. Supervision was an important part of the Pathway. Both NQPs and supervisors reported that supervisors provided NQPs with guidance, support, and feedback during their transition period. Supervisors added that they conducted learning needs assessments to foster a learner-centred approach that aided NQPs in expanding their skills and knowledge. They also supported NQPs in developing reflective practice as part of their professional development and progression to advanced practice. How supervision was conducted in practice varied across different settings/sectors. NQPs and hospital supervisors described that NQPs had a clinical work-based supervisor and an educational supervisor. In community pharmacies where NQPs often lacked access to support and structured learning opportunities, NQPs and supervisors claimed that remote educational supervision offered through the Pathway provided a support system for NQPs who would otherwise have been without any support structure. Conclusion Our study highlights that both NQPs and supervisors noted the importance of the support provided by educational supervisors to address learning/support needs in the early year of practice. However, the extent to which NQPs received what they needed varied widely. This support will likely become increasingly important from 2026, when pharmacists will require support as they become independent prescribers. We need to develop processes and infrastructure to ensure high-quality supervision is available to NQPs in all settings/sectors. The strength of the study lies in the in-depth interviews that provided rich and insightful data, effectively addressing the limitation posed by the relatively small number of participating NQPs.

Best practice transfer by public health nurses in Japan: actual conditions and related factors

BackgroundThe workload of public health nurses (PHNs) working for local governments has been increasing as health issues become more diverse and complicated. Even amidst the ongoing administrative and fiscal reforms, there is an urgent need to ensure how effectively and efficiently public health nurses can practice in health service development. The objective of this research was to clarify the actual conditions of best practice transfer (BPT) and its related factors.MethodsAn anonymous postal and self-administered questionnaire survey was conducted among PHNs working at 334 sites, including the local government offices and health centers across Japan, and analysed mainly through logistic regression analysis.ResultsOne hundred eighty-five of the 334 institutions (55.4%) agreed to participate, and of the 966 questionnaire forms distributed, 709 forms (73.4%) were collected, of which 702 responses (72.7%) were valid. Although less than half (43.2%) have experience in BPT in health service development, more than 80% are willing to perform going forward. Significant factors for both the group with experience in BPT and the group with willingness to perform include an organizational culture that promotes BPT, as well as multiple elements of the workplace environment and facilitating factors related to knowledge and learning. The experienced group recognised the needs for criteria to evaluate the adaptability of best practice, while the willing group, to evaluate the quality of practice.ConclusionsThrough a nationwide survey, this research elucidated for the first time the actual conditions of BPT by PHNs in Japan and related factors. The results indicated the importance of developing a system to promote BPT at the workplace level, also highlighted the importance for practitioners and experts, including researchers, to work together to develop practical guidelines to ensure evidence-based practices. Urgent actions are needed for the national and local governments to develop a system to promote BPT from diverse perspectives, building on the findings of this research.

How internet healthcare information overflow affects farmers' healthcare consumption: insights from China.

In the context of the deep coupling and synergistic development of digital villages and healthy villages, the development of China's rural society harbors a huge potential for medical and healthcare consumption. On the basis of theoretical research, a framework was constructed to analyze the influence mechanism of farmers' medical and healthcare consumption in the context of Internet medical information overflow, and empirically examines the research and analysis framework by using the 2020 China Household Tracking Survey data with the OLS model, mediation effect model, and instrumental variable method. It is found that Internet medical information spillover has a "crowding-in effect" on farmers' healthcare consumption; Medical attendance behavior, economic capital utilize the intermediary effect between Internet medical information spillover and farmers' healthcare consumption. And there is age group heterogeneity in the effect of Internet medical information spillover on farmers' healthcare consumption, The ability of rural middle-aged and old-aged groups to recognize new things such as Internet medical information needs to be improved, so the overflow of Internet medical information will induce rural middle-aged and old-aged groups to generate a certain amount of medical and health care consumption. However, the impact on healthcare consumption is not sensitive to the youth cohort group. The sinking of Internet medical resources should be accelerated in the future to promote the high-quality development of rural medical and health services, at the same time the "Internet + healthcare services" should be optimized to promote scientific and rational stratification of farmers' access to healthcare, and economic capital for farmers' access to health care should be improved in order to alleviate the burden of health care, etc.

A pilot study: Exploring suicidal ideation among non-offending adults with sexual attraction to minors, through their online forum posts

Summary An emerging field of research seeks to understand the experiences of non-offending adults who experience sexual attraction towards children. Research indicates that this largely hidden population can experience significant mental ill health and suicidal ideation, yet are reluctant to seek professional mental health support. Furthermore, mental ill health has been identified as a factor that can increase the likelihood of offending. This study, undertaken by a social work practitioner researcher, aimed to assist in understanding suicidality factors within this population, and to identify how statutory mental health services could be developed for this client group, thus contributing to child protection and suicide prevention agendas. A qualitative analysis was undertaken of data gathered from an online forum used by adults who have sexual attraction towards children, and are committed to non-offending. The data related to forum members’ experiences of suicidality, and key themes were identified through thematic analysis. Findings The study found that a pattern of suicidal ideation commonly appears to manifest and identified risk and protective factors that can influence suicidality. The benefits of peer support and the strengths and limitations of professional support were also identified. Applications The findings from this study contribute to an improved understanding of this client group for mental health practitioners. The findings also lay the foundation for further investigations, to inform the development of mental health services to facilitate improved outcomes for this client group, and for child protection.

The Application and Ethical Issues of Digital Mental Health Services

The widespread popularity of digital technology has brought about significant changes in the treatment of mental health problems. Traditional mental health services can no longer meet the needs of society for mental health, and digital mental health services are developing vigorously. Digital mental health services have shown significant advantages in rapid diagnosis, improving mental health, and improving mental service efficiency. This article outlines the development and application of mental health services so far. On the basis of describing the various uses of digital psychological intervention measures, it focuses on the ethical issues faced by the current application of digital mental health services, such as privacy and data security caused by Big data, potential ethical risks caused by digital technology, insufficient clinical verification, imperfect market regulations and professional threats to psychological workers. To ensure the rational and compliant use of digital technology in the field of mental health, this article discusses the ethical problem- solving directions of current digital mental health services from three levels: technical policies, ethical norms and systems, and social individuals, in order to promote the integration of digital technology and mental health services and improve the quality and efficiency of digital mental health services.

It takes it out of the textbook: Benefits of and barriers to expert by experience involvement in pre-registration mental health nursing education.

Nurse academics teaching mental health nursing have generally favourable views about the importance of expert by experience involvement. Nurse academics experience significant barriers in supporting the implementation of academic positions for experts by experience, particularly in obtaining funding. The experts by experience could contribute to mental health nursing education does not appear to be clearly understood by nurse academics. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health services aspire to adopt a recovery-oriented approach to practice. Involving experts by experience in mental health nursing education can facilitate increased understanding and appreciation of recovery-oriented practice. Nurse academics could play an important role in supporting the implementation of experts by experience positions in nursing academia. To do so, they require an understanding of the benefits of EBE involvement in academia and the barriers that can be encountered when attempting to facilitate the implementation of such positions. Experts by experience contribute unique expertise, essential to the development of quality mental health services. Conveying this expertise through the educating the future nursing workforce in mental health is essential. INTRODUCTION: Involving service users in mental health nursing education is ad hoc and minimal, despite growing evidence of its benefits. Insights and experiences of nurse academics teaching mental health to pre-registration students have been underrepresented in the research to date. To seek insights and experiences of nurse academics involved in designing and delivering pre-registration mental health nursing education in Australian universities regarding involving service users in mental health nursing education. A descriptive qualitative study involving 19 nurse academics from 13 Australian universities, involved in pre-registration mental health nursing education. Data were analysed thematically. Participants reported minimal service user involvement. Most sought an increase and identified barriers. Data analysis resulted in five identified themes: (1) value-rich, (2) resource-poor, (3) imperfect processes, (4) 'part, but not all' and (5) unrecognised worth. Increasing meaningful involvement of service-users in mental health nursing education requires support and investment from multiple stakeholders. Nurse academics are crucial stakeholders in understanding the unique expertise service users bring. Service users being central to all aspects of mental health services requires their active participation in the education of health professionals. Nurse academics have an important role in realising this goal.

Reconceptualizing transnational knowledge transfer in mental health services: Reflection upon the postcolonial era

Knowledge transfer in global mental health services has long been depicted from Western perspectives. This article destabilizes this discourse through a conceptual model that integrates the top-down approach (macro postcolonial context, meso transnational knowledge transfer and micro mental health programmes) and the bottom-up approach (the roles of transcreation in reconfiguring micro mental health intervention, meso mental health services integration and macro policy advocacy and reform). This article raises social workers’ awareness of ongoing development of mental health services from a decolonizing perspective, and guides social work research and practice to continue the decolonization of global mental health services.

Community-based rehabilitation services implemented by multidisciplinary teams among adults with stroke: a scoping review with a focus on Chinese experience

BackgroundDespite the growing interest in hospital rehabilitation services for communities, studies on existing community-based rehabilitation (CBR) services remain scarce owing to limitations in the development of community health services and regional cultural diversity. As a guaranteed measure for ensuring the quality of rehabilitation services and achieving the desired service outcomes, clear roles and responsibilities in multidisciplinary teams and effective service delivery are particularly important.ObjectiveThis scoping review aimed to determine the scope of community stroke rehabilitation programs involving existing multidisciplinary teams and to analyze the implementation content and implementers’ functional roles to provide guidance for future CBR programs.MethodsThe scoping review design followed the methodology of the Joanna Briggs Institute and was based on the normative scoping review framework proposed by Arksey and O’Malley. The comprehensive CBR framework was proposed by World Health Organization-guided data charting and analysis.ResultsOf the 22,849 identified citations, 74 studies were included, consisting of 6,809 patients with stroke and 49 primary caregivers, most of whom were from China. The most common working mode in CBR programs was a dual approach involving both healthcare professionals in medical institutions and community healthcare professionals. The number of programs in each discipline was in the following descending order: nursing, medical care, rehabilitation, psychology, nutrition, and public health. Among these, multidisciplinary teams comprising medical, nursing, and rehabilitation disciplines were the most common, with a total of 29 programs. Disciplinary members were mainly responsible for implementing their respective disciplinary content, with physicians providing guidance for the programs. More than 82.4% of the studies reported 2–4 intervention strategies. The intervention forms of rehabilitation content were the most diverse, whereas preventive interventions were more homogeneous than others. Physical function and socio-psychological measurements were the most commonly reported outcomes.ConclusionCBR services implemented by multidisciplinary teams can effectively achieve functional and emotional improvement in patients with stroke, and nurses are the most involved in implementation, especially in community settings. The results further emphasize the importance of strengthening the exploration of nurses’ maximum potential to implement CBR plans in future practice.Trial registrationThe registration information for this scoping review can be found at osf.io/pv7tg.

Patient and public involvementin the development of health services: Engagement of underserved populations in a quality improvement programme for inflammatory bowel disease using a community-based participatory approach.

Involving people with lived experience is fundamental to healthcare development and delivery. This is especially true for inflammatory bowel disease (IBD) services, where holistic and personalised models of care are becoming increasingly important. There is, however, a significant lack of representation of underserved and diverse groups in IBD research, and there are significant barriers to healthcare access and utilisation among minority groups in IBD. IBD centres need to be aware of these experiences to address barriers via service changes, improve interactions with local communities and promote meaningful engagement for improved health outcomes. A pragmatic community-based approach was taken to engage with leaders and members of underserved groups across 11 workshops representing Roma, Afro-Caribbean, people of African descent and the wider black, Asian and minority ethnic (BAME) communities, Muslim women, refugee community members, deprived areas of South Yorkshire, LGBTQ+ and deaf populations. Thematic analysis of field notes identified patterns of attention across the community groups and where improvements to services were most frequently suggested. Findings demonstrated several barriers experienced to healthcare access and utilisation, including language accessibility, staff attitudes and awareness, mental health and stigma, continuity of support, and practical factors such as ease of service use and safe spaces. These barriers acted as a lever to co-producing service changes that are responsive to the health and social care needs of these groups. Engaging with people from a range of communities is imperative for ensuring that service improvements in IBD are accessible and representative of individual needs and values. Local community leaders and members of community groups actively participated in the co-design and development of improvements to the IBDservice for a local hospital. Their contributions further informed a pilot process for quality improvement programmes in IBD centres.

Intellectual disability healthcare in Australia: Progress, challenges, and future directions

AbstractPeople with intellectual disability experience some of the greatest health disparities in Australia. Individuals are expected to access mainstream health services that are ill equipped to meet their needs. The Australian government has made recent commitments to improve the healthcare of people with intellectual disability. This article describes the Australian health system and how it responds to the needs of people with intellectual disability. It draws on examples of advances in policy, inclusion, and service development, achieved through concrete and persistent systemic advocacy, to discuss emerging evidence on the delivery of healthcare to people with intellectual disability in Australia. The article also highlights immediate priorities including increasing the uptake of health assessments, building the capacity of our health workforce, and responding to the needs of people with intellectual disability in COVID‐19 outbreaks or other natural disasters. Intellectual disability healthcare is at a dynamic point in Australia with commitment and funding from government to lead to change. It is critical that momentum in health services development is maintained to enable improved health outcomes for people with intellectual disability.

Student Health Services at Historically Black Colleges and Universities and Predominantly Black Institutions in the United States.

Student health services are associated with improved health outcomes and academic success, particularly among under-resourced college populations. This study compared student health services at Historically Black Colleges and Universities (HBCUs) and Predominantly Black Institutions (PBIs) and identified factors associated with the availability of comprehensive health services (CHS). We conducted a secondary analysis of 2022 data from the Integrated Postsecondary Education Data System (IPEDS), the Minority Serving Institutions (MSIs) Directory, and the websites of HBCUs and PBIs (n=167). Bivariate and multivariate logistic regression analyses were undertaken to identify institutional variables associated with providing CHS. Institutional variables included college type (public vs. private), MSI category (HBCU vs. PBI), undergraduate enrollment, location, and proportion of Pell grant recipients. Approximately 13% of HBCUs and 26% of PBIs offered no student health services; 65% of HBCUs and 39% of PBIs offered on-campus CHS with prescribing providers. Four-year HBCUs were five times more likely than 4-year PBIs to have CHS (p=0.014). Institutions with more Pell Grant recipients were less likely to offer CHS. Access to health care is an important social determinant of health, academic persistence, and achievement for college students. HBCUs were significantly more likely than PBIs to offer CHS. HBCUs are more likely than PBIs to have resources from federal funding, donors, and endowments that may support the development of student health centers and services. Increased funding for PBI health centers could improve access and promote health equity among the most vulnerable student populations.

What Women Want: Mental Health in the Context of Violence Against Women in Sri Lanka-A Qualitative Study of Priorities and Capacities for Care.

Insufficient evidence guides mental health service development for survivors of violence against women in Sri Lanka. Provider and survivor perspectives on (1) what constitutes mental health, (2) quality of care, and (3) priority areas and stakeholders for intervention were identified through framework analysis of 53 in-depth interviews. Desired care is chiefly psychosocial-not psychological-prioritizing socioeconomic, parenting, and safe environment needs in non-clinical community settings. Our evidence points strongly to the need to strengthen non-mental health community-based providers as "first contacts" and reassessment of health system-centric interventions which neglect preferred community responses and more holistic approaches accounting for women's full circumstances.

Comparative Analysis Of Service Quality On Patient Satisfaction Levels In Government And Private Hospitals In Medan City In 2022

This study compares service quality to patient satisfaction in government and private hospitals in Medan City in 2022. This study used a survey method using a questionnaire as a data collection instrument. The research respondents were patients who used government and private hospital services. The data collected includes service quality dimensions, such as tangibles, reliability, responsiveness, assurance, and empathy. In addition, the data also consists of the level of patient satisfaction with the services provided by the hospital. Comparative analysis of service quality and patient satisfaction levels was carried out using appropriate statistical techniques, such as testing the difference between two groups of hospitals (government vs. private) using appropriate statistical tests. The results of this analysis will provide an understanding of the differences in service quality between government and private hospitals, as well as the related level of patient satisfaction. This research is expected to contribute to the development and improvement of health services in hospitals, especially in the city of Medan. The results of this study can also be input for hospital management to improve service quality and patient satisfaction. Thus, hospitals can provide better services and meet patient expectations to enhance the reputation and competitiveness of both government and private hospitals in Medan City. Especially in the city of Medan. The results of this study can also be input for hospital management to improve service quality and patient satisfaction. Thus, hospitals can provide better services and meet patient expectations to enhance the reputation and competitiveness of both government and private hospitals in Medan City. Especially in the city of Medan. The results of this study can also be input for hospital management to improve service quality and patient satisfaction. Thus, hospitals can provide better services and meet patient expectations to enhance the reputation and competitiveness of both government and private hospitals in Medan City.