Efficiency Of Health Facilities Research Articles

Pressure and Its Impact on Job Satisfaction and Organizational Performance

This paper explores the complex idea of work pressure among Chinese hospital administrators and how it affects job happiness and overall effectiveness of the organization. Hospital directors confront a wide range of intricate issues within the framework of China’s distinct healthcare system because of their twin responsibilities as administrative and medical leaders. The dimensions of role pressure are examined in this study, which include role gap, role overload, where the workload is excessive, role ambiguity, and the role of conflict. Understanding these aspects is essential to appreciating the effectiveness and well-being of hospital administration. Given that job happiness is a major factor in both employee performance and retention, these pressures have a significant effect on job satisfaction. The study also looks at the wider effects of pressure on organizational performance, which is crucial for the long-term viability and efficiency of healthcare facilities. Through an examination of these facets, the paper illuminates the noteworthy, albeit frequently disregarded, psychological and operational obstacles encountered by hospital administrators in China. This, in turn, offers valuable perspectives on the possibility of policy and administrative changes targeted at augmenting job contentment and organizational results

Pressure and Its Impact on Job Satisfaction and Organizational Performance

This paper explores the complex idea of work pressure among Chinese hospital administrators and how it affects job happiness and overall effectiveness of the organisation. Hospital directors confront a wide range of intricate issues within the framework of China's distinct healthcare system because of their twin responsibilities as administrative and medical leaders. The dimensions of role pressure are examined in this study, which include role gap, role overload, where the workload is excessive, role ambiguity, and the role of conflict. Understanding these aspects is essential to appreciating the effectiveness and well-being of hospital administration. Given that job happiness is a major factor in both employee performance and retention, these pressures have a significant effect on job satisfaction. The study also looks at the wider effects of pressure on organisational performance, which is crucial for the long-term viability and efficiency of healthcare facilities. Through an examination of these facets, the paper illuminates the noteworthy, albeit frequently disregarded, psychological and operational obstacles encountered by hospital administrators in China. This, in turn, offers valuable perspectives on the possibility of policy and administrative changes targeted at augmenting job contentment and organisational results.

Harnessing Information Communication Technology to Promote Healthcare Access by Women Living in Rural Areas : Opportunities and Challenges

In today’s world, Information and Communication Technology (ICT) is the driving force behind all economic, financial, technological and social developments. It is a tool that has reached and impacted individuals, organizations and nations globally. In the last couple of decades, ICT has revolutionized the medical field in a tremendous way. ICTs have impacted healthcare sector through sharing of public health information, diagnosis and treatment, facilitation of collaboration and cooperation among healthcare workers, remote consultation, effective health research, monitoring health incidences and improving overall efficiency of healthcare facilities. In this paper, desktop exploratory study was conducted to find out how ICT can be harnessed to promote healthcare access by women in rural areas considering associated opportunities and challenges. It looks at uptake of ICT in healthcare in developed countries versus developing nations. It concludes by outlining the opportunities and challenges associated with the application and use of ICTs by women living in rural areas.

MEDICAL AND SOCIAL JUSTIFICATION OF THE FINANCIAL AND ECONOMIC CONDITION OF THE «HORODENKA NON-COMMERCIAL CENTER OF PRIMARY MEDICAL CARE» BEFORE AND AFTER THE INTRODUCTION OF THE HOSPITAL DISTRICT

The aim of the work is to identify the peculiarities of medical and social justification of the financial and economic condition of «Horodenka non-commercial center of primary medical care» before and after introduction of a hospital district. To achieve the goal, the following are defined task: to conduct an analysis of the main indicators of «Horodenka non-commercial center of primary medical care»; to determine the problems of inefficient work of the «Horodenka non-commercial center of primary medical care». Materials and methods: When conducting research, they were used general scientific and special methods of research, in particular the system approach and system analysis - to carry out a comprehensive study of the identified objects and systems in their external and internal relationships, as well as determination of approaches to identifying and analyzing problems and developing ways to solve them solution; process approach - for the study of various types of activities in the existing management system of the health care facility before and after implementation of the hospital district; medical and statistical - for statistical processing of received data; analytical methods. Results: The efficiency of health care facilities and the quality of the provided medical services are considered as the main target functions of the health care system. In many countries, programs for ensuring the quality of medical care have been implemented and are operating. The activities of Ukrainian medical institutions and the health care system as a whole are often harshly criticized by patients and the public for the low quality of providing medical services. The quality of medical services, medical care and medical infrastructure definitely depends on the principles of building the Ukrainian medical system and the development of the national economy. Because without a financial basis, it is very difficult to build an effective health care system and ensure proper medical care and the work of all medical institutions. Conclusions: Thus, after the introduction of the hospital district in the «Horodenka non-commercial center of primary medical care», it is proposed to carry out a number of measures to increase the effectiveness of the implementation of financial management. In order to increase the efficiency of management, including financial resources, it is important to improve personnel management. The main emphasis in the management is the formation of the personnel potential of the «Horodenka non-commercial center of primary medical care» the involvement of qualified specialists in the field of medicine, the motivation of various directions for the support and improvement of the qualifications of management personnel. It is also important to use the system of financial planning of a budget institution, to ensure expenses for its life activities. In particular, the main direction of cost control is targeted use of funds, strict control over this use, formation of an effective internal audit system of a medical institution.

Comparison of two home-based polysomnography tools for OSAS diagnosis: a cost-minimization analysis

Abstract Obstructive sleep apnoea syndrome (OSAS) is an underdiagnosed chronic disease with a high prevalence in adults. It is becoming an important social problem since it is associated with a significant adverse impact on quality of life and life expectancy. Overnight polysomnography, performed in a sleep laboratory (LabPSG), is considered the diagnostic standard. Home complete PSG (HoPSG) could represent an alternative to LabPSG for patients who want to avoid the overnight stay at a sleep center. The aim of this study was to assess the economic impact of two alternative HoPSG diagnostic techniques in the diagnosis of OSAS: the standard one versus the telemonitoring approach. The observational study was designed as a cost-minimization analysis adopting a healthcare perspective. The time horizon was 6 months (January 2021 - June 2021), thus no discounting was necessary. Direct medical costs, expressed in 2021 euros, were estimated through a micro-costing method while indirect costs were quantified adopting the Human Capital Approach. To explore the uncertainty of critical parameters, a one-way sensitivity analysis was run. Considering the direct costs, the telemonitoring HoPSG was estimated to cost around €55 less than the standard approach. The cost savings sharply increases taking into account the indirect costs that amounted to €90 million and €365 million for the telemonitoring and the standard approach, respectively. Sensitivity analyses results did not significantly differ from the base-case scenario. The diagnosis of OSAS is presently time-consuming, labor-intensive and costly. The adoption of digital health solutions as telemedicine has the potentiality to ease the diagnosis, to improve the access to health services, to reduce both direct and indirect costs, and to enhance the efficiency of healthcare facilities becoming a crucial tool in addressing the actual public health challenges. Key messages The telemonitoring Home complete polysomnography is cost-saving compared with the standard approach. Telemedicine has the huge potential to overcome public health challenges as increases in chronic disease in an ageing society and the associated burden in healthcare costs.

SOCIAL EFFICIENCY OF CREATING A COMPETITIVE ENVIRONMENT IN THE MARKET OF MEDICAL SERVICES: ECONOMIC AND ENVIRONMENTAL PRINCIPLES

Purpose. The aim of the article is substantiation of the need to increase the competitiveness of health care institutions in the context of the quality of medical services, improving the image of medical institutions of various forms of ownership, strengthening the economic and environmental efficiency of their activities. Methodology of research.The theoretical and methodological basis of writing the article are the fundamental principles of economics, set out in the scientific works of domestic and foreign scientists on economic and environmental efficiency of health care facilities. Methods of analysis, synthesis, induction, deduction were used to solve the tasks set in the research process (to characterize the levels of medical services, to argue the effects of competition in the market of medical services on the quality and availability of medical services, increase economic and environmental efficiency activities of health care institutions). Results. The risks and advantages of forming a competitive environment in the market of medical services, changes in the system of financing the medical industry are studied. The prospects of the level of territorial and financial accessibility of medical services in connection with the creation and operation, along with municipal medical institutions, of private medical institutions are substantiated. Due to the impact of environmental risks on the work of health care facilities, a system of measures to coordinate and control the state of the process of medical waste disposal has been proposed. Originality. The environmental and economic approach to increasing the competitiveness of health care facilities was improved. This approach in contrast to the existing substantiated the need to improve the quality of medical services, forming a positive image of medical institutions of various forms of ownership, strengthening economic performance, conscious management of medical waste raising the level of environmental awareness and responsibility. Practical value. The use of the proposed measures to improve the work with medical waste will reduce the level of environmental pollution, will improve the health of the population of Ukraine. Key words: health care system; medical services market; social and environmental efficiency; medical institutions; competitive environment; mortality rate.

The effect of patient reminders in reducing missed appointment in medical settings: a systematic review

Missed appointments are a problem to healthcare professionals worldwide. There is up to nearly 42% missed appointment rate in medical setting globally. Reducing missed appointment rates improves the efficiency of health services and health outcomes of patients. Missed appointment rates can be reduced by reminding patients about their medical appointments in advance. A simple way of doing this is via electronic notification to the patients´ phones. The aim of this paper is to review the effect of patient reminders in reducing missed appointment rates. The methodology was conducted based on the PRISMA guidelines for systematic reviews. Literature search was conducted extensively using Google Scholar and PubMed databases based on terms such as cell phone reminders, electronic notification reminders, missed appointment rates, clinic attendance and SMS reminders. Geographical and publication biases were assessed. The result of the review showed that 95% studies reviewed reported a positive effect of patient reminders on appointment rates, with an average of 41% reduction in missed appointment rates and 34% increase in clinic attendance rates in all the studies. The review revealed that patient reminders reduce missed appointment rates and improve clinic attendance rates. Multiple reminders produce better outcomes. Reducing missed appointment rates also improve the efficiency of health care facilities.

Improving primary health care facility performance in Ghana: efficiency analysis and fiscal space implications

BackgroundHealth centers in Ghana play an important role in health care delivery especially in deprived communities. They usually serve as the first line of service and meet basic health care needs. Unfortunately, these facilities are faced with inadequate resources. While health policy makers seek to increase resources committed to primary healthcare, it is important to understand the nature of inefficiencies that exist in these facilities. Therefore, the objectives of this study are threefold; (i) estimate efficiency among primary health facilities (health centers), (ii) examine the potential fiscal space from improved efficiency and (iii) investigate the efficiency disparities in public and private facilities.MethodsData was from the 2015 Access Bottlenecks, Cost and Equity (ABCE) project conducted by the Institute for Health Metrics and Evaluation. The Stochastic Frontier Analysis (SFA) was used to estimate efficiency of health facilities. Efficiency scores were then used to compute potential savings from improved efficiency. Outpatient visits was used as output while number of personnel, hospital beds, expenditure on other capital items and administration were used as inputs. Disparities in efficiency between public and private facilities was estimated using the Nopo matching decomposition procedure.ResultsAverage efficiency score across all health centers included in the sample was estimated to be 0.51. Also, average efficiency was estimated to be about 0.65 and 0.50 for private and public facilities, respectively. Significant disparities in efficiency were identified across the various administrative regions. With regards to potential fiscal space, we found that, on average, facilities could save about GH₵11,450.70 (US$7633.80) if efficiency was improved. We also found that fiscal space from efficiency gains varies across rural/urban as well as private/public facilities, if best practices are followed. The matching decomposition showed an efficiency gap of 0.29 between private and public facilities.ConclusionThere is need for primary health facility managers to improve productivity via effective and efficient resource use. Efforts to improve efficiency should focus on training health workers and improving facility environment alongside effective monitoring and evaluation exercises.

Evidence Based Design and healthcare: an unconventional approach to hospital design.

Evidence Based Design (EBD) is a scientific analysis methodology that emphasises the use of data acquired in order to influence the design process in hospitals. It measures the physical and psychological effects of the built environment on its users. EBD uses formularization of hypothesis, testing/analyzing and outcome gathering as a framework. The design practice, in general, has always been based on a combination of legal, technical/ functional/ and aesthetical knowledge. This generalization has been shifted to another level after the implementation of EBD. In the last 30 years many case studies were collected which demonstrate the built environment's impact on users. EBD methodology can be applied to any type of building, but it is particularly used to analyze the efficiency of healthcare facilities. The Goal of this paper is to demonstrate various applications of EBD principles in healthcare buildings through case studies concerning: - reduction of infections - reduction of stress on medical staff - improved patient healing In addition to the analysis of case studies, we will also focus on official EBD researches developed by healthcare designers and professionals as "alternative solutions". These alternative "ad hoc" solutions are developed in order to answer EBD research results. The solutions that are developed from the results can answer the real needs of each hospital and improve best technological practice to reduce infection, stress and improve patient comfort. Abroad the EBD research results are studied and used by many contemporary hospital architects to develop new solutions to meet the specific requirements of any hospital project they are currently designing. This procedure demonstrates that for each outcome and key finding, there is always at least one alternative solution and, therefore, the achievement of a new hypothesis, case studies to test/measure and outcome to gather occurs. This repetitive attitude leads to a "virtuous circle" where the development of new samples produces a double- positive effect in both EBD research (in terms of new case studies to analyze) and in EBD lessons for implementation in various hospitals. Through this paper the authors state that the combined effort is needed by EBD practitioners, healthcare architects and hospital managers for the improvement and diffusion of EBD in healthcare, especially in Italy where this methodology is not widely used.

Locational Efficiency of Healthcare Facilities in Ikot Ekpene Local Government of Akwa-Ibom State: The Role of Geographical Information System (GIS)

Given the effect of locational decisions on access and utilization of healthcare facilities in any society, the current study attempted an evaluation of the locational efficiency of available health facilities in Ikot Ekpene LGA with a view to ascertain the distributional pattern of the health care centers in the study area. It was discovered that health care centers in the area are randomly distributed but moderately concentrated in a few wards leaving more than half the area under-served. Using a WHO population/distance criterion of 1/4km, it is shown that only a small portion of the study area has effective access to healthcare facilities. Potential sites for location of additional health centers were suggested and the capability of Geographical Information System (GIS) in spatial planning and healthcare facility management is demonstrated DOI: 10.5901/jesr.2013.v3n9p93

Location Efficiency of Healthcare Facilities in Ikot Ekpene Local Government of Akwa-Ibom State: The Role of Geographical Information System (GIS)

Given the effect of locational decisions on access and utilization of healthcare facilities in any society, the current study attempted an evaluation of the locational efficiency of available health facilities in Ikot Ekpene LGA with a view to ascertain the distributional pattern of the health care centers in the study area. It was discovered that health care centers in the area are randomly distributed but moderately concentrated in a few wards leaving more than half the area under-served. Using a WHO population/distance criterion of 1/4km, it is shown that only a small portion of the study area has effective access to healthcare facilities. Potential sites for location of additional health centers were suggested and the capability of Geographical Information System (GIS) in spatial planning and healthcare facility management is demonstrated.

Productive efficiency analysis of primary healthcare services in Afghanistan: a DEA study

Very little is known about the productive efficiency of the large scale contracting-out mechanism that delivers basic healthcare services in Afghanistan. This study analyses the relative efficiency of basic package of health services (BPHS) facilities and examines the factors associated with the efficiency of health facilities (HFs) in Afghanistan. Data envelopment analysis (DEA) model is used on the primary data, collected in 2011. Using the DEA scores in a fractional logit regression model, we estimate the effects of exogenous factors on the productive efficiency of the HFs. The level of the HF and the productive efficiency are not linearly related – the lowest level facilities are quite evenly distributed in the range of efficiency scores. This study establishes the need for a better understanding of the HF – specific management processes and the geography specific healthcare demand situation for a better policy decisions in the distribution of HFs for the country.

User Fee Impact on Equitable Access to Care: A Review

Access to care and equity are the two most pertinent issues for policy-makers of the current era. In developing countries, health care is continuously facing budget constraints as central governments’ expenditures do not reach peripheral level of health care. Lack of resources and emphasis on systems’ sustainability has supported the concept of user charges. However, the World Health Organisation (WHO) has recently urged developing countries to not rely on user fee as a source of fund, based on the economic theory that high prices induce negative demand, especially for vulnerable populations, which invariably raises the issue of user fee widening inequity. This article reviews the evidences from low and middle-income countries to analyze various political agendas supporting user fee policies and their impact on health facilities in terms of utilization and availability of resources in view of barriers to access. The evidences highlighted that access to care is largely affected by unavailability of resources in most African countries whereas India grapples continuously with governance issues for improving efficiency of health care facilities. The success of the concept of user fee lies in careful examination of health care system-capacity issues, providing a support mechanism for the vulnerable and restructuring user fee policy around efficiency rather than cost-recovery mechanism.

The efficiency of healthcare facilities providing PET cancer screening in Japan

The number of positron emission tomography (PET) facilities has rapidly increased in Japan in recent years. We assume there has been a downward spiral that low reimbursement prices for PET scans by public health insurance have driven these facilities to provide cancer screening, leading to a decline in efficiency with more cancer screening. The purpose of this study was to confirm this decline and clarify the determinants of efficiency. Questionnaire survey data from 65 facilities that provided PET cancer screening were used. Data envelopment analysis (DEA) was used to measure the efficiency of each facility. Multivariate regression analysis was then performed with each DEA score as a dependent variable, with other potential factors that might affect efficiency as independent variables. We found that from 2004 to 2006 efficiency in PET facilities declined. However, significantly greater efficiency was observed for those facilities that started cancer screening earlier, were located in an area with an aging population, and were clinics and general hospitals. Conversely, significantly lower efficiency was observed for facilities with higher market share and price for PET cancer screening. Our findings on decreasing efficiency imply that reimbursement prices should be raised to halt the downward spiral.

Efficiency of primary care in rural Burkina Faso. A two-stage DEA analysis.

BackgroundProviding health care services in Africa is hampered by severe scarcity of personnel, medical supplies and financial funds. Consequently, managers of health care institutions are called to measure and improve the efficiency of their facilities in order to provide the best possible services with their resources. However, very little is known about the efficiency of health care facilities in Africa and instruments of performance measurement are hardly applied in this context.ObjectiveThis study determines the relative efficiency of primary care facilities in Nouna, a rural health district in Burkina Faso. Furthermore, it analyses the factors influencing the efficiency of these institutions.MethodologyWe apply a two-stage Data Envelopment Analysis (DEA) based on data from a comprehensive provider and household information system. In the first stage, the relative efficiency of each institution is calculated by a traditional DEA model. In the second stage, we identify the reasons for being inefficient by regression technique.ResultsThe DEA projections suggest that inefficiency is mainly a result of poor utilization of health care facilities as they were either too big or the demand was too low. Regression results showed that distance is an important factor influencing the efficiency of a health care institutionConclusionsCompared to the findings of existing one-stage DEA analyses of health facilities in Africa, the share of relatively efficient units is slightly higher. The difference might be explained by a rather homogenous structure of the primary care facilities in the Burkina Faso sample. The study also indicates that improving the accessibility of primary care facilities will have a major impact on the efficiency of these institutions. Thus, health decision-makers are called to overcome the demand-side barriers in accessing health care.

Technical efficiency of peripheral health units in Pujehun district of Sierra Leone: a DEA application

BackgroundThe Data Envelopment Analysis (DEA) method has been fruitfully used in many countries in Asia, Europe and North America to shed light on the efficiency of health facilities and programmes. There is, however, a dearth of such studies in countries in sub-Saharan Africa. Since hospitals and health centres are important instruments in the efforts to scale up pro-poor cost-effective interventions aimed at achieving the United Nations Millennium Development Goals, decision-makers need to ensure that these health facilities provide efficient services. The objective of this study was to measure the technical efficiency (TE) and scale efficiency (SE) of a sample of public peripheral health units (PHUs) in Sierra Leone.MethodsThis study applied the Data Envelopment Analysis approach to investigate the TE and SE among a sample of 37 PHUs in Sierra Leone.ResultsTwenty-two (59%) of the 37 health units analysed were found to be technically inefficient, with an average score of 63% (standard deviation = 18%). On the other hand, 24 (65%) health units were found to be scale inefficient, with an average scale efficiency score of 72% (standard deviation = 17%).ConclusionIt is concluded that with the existing high levels of pure technical and scale inefficiency, scaling up of interventions to achieve both global and regional targets such as the MDG and Abuja health targets becomes far-fetched. In a country with per capita expenditure on health of about US$7, and with only 30% of its population having access to health services, it is demonstrated that efficiency savings can significantly augment the government's initiatives to cater for the unmet health care needs of the population. Therefore, we strongly recommend that Sierra Leone and all other countries in the Region should institutionalise health facility efficiency monitoring at the Ministry of Health headquarter (MoH/HQ) and at each health district headquarter.