Efficiency Of Healthcare Services Research Articles

Preliminary considerations for electronic medical record (EMR) in the public hospitals of Gandaki province in Nepal

Electronic Medical Record (EMR) is the digital tool to keep records of valuable information on computer or computer-like equipment, regarding health systems, including patient’s records and stock management which can provide real time evidence for better patient record, clinical care and health policy making. As Nepal does not have a national EMR system, and it is a challenge to get real time data, information and evidence required for effective health policy making. With an effective national EMR system in Nepal, the health system can be improved with reliable information of patients for the continuity of clinical care.
 
 There are existing scientific evidence of EMR on the lessons of implementation in Nepal, opportunities for the use of EMR in Malaysia, perspectives of health care workers on EMR after its implementation in Canada, on the development of success measuring tools and the use of questionnaires for the EMR implementation in Canada, best practices, impact of EMR on physician practice, and barriers for EMR implementation.
 
 EMR can improve the quality, effectiveness, transparency and efficiency of healthcare services and its management. Gandaki province is one of seven provinces in Nepal and is exploring ways to implement EMR in all the hospitals operated under the province government. There can be step wise approach to have EMR in all of these hospitals. This can give more strategies for the national EMR system.

Evaluating the Performance of the Health Staff and its Role in Improving the Efficiency of Services

Evaluating the performance of health staff is crucial in healthcare organizations to improve the efficiency of services. This research highlights the significance of performance evaluation and its role in enhancing service efficiency. Evaluating health staff performance helps identify areas for improvement, optimize resource allocation, enhance service quality, promote accountability, and improve teamwork and collaboration. Various evaluation methods such as performance metrics, feedback mechanisms, self-assessment, peer reviews, and goal-setting processes are utilized. By implementing recommendations based on evaluation findings, healthcare organizations can enhance service efficiency and deliver high-quality care. This research aims to evaluate the performance of health staff and investigate its role in improving the efficiency of services within healthcare organizations. The study seeks to assess the effectiveness and productivity of health staff members and examine how their performance impacts the overall efficiency of service delivery. By analyzing the relationship between staff performance and service efficiency, the research aims to identify areas for improvement and develop strategies to optimize the performance of health staff, ultimately enhancing the efficiency of healthcare services

Evaluation of patient transport service in hospitals using process mining methods: Patients' perspective.

Designing healthcare facilities and their processes is a complex task which influences the quality and efficiency of healthcare services. The ongoing demand for healthcare services and cost burdens necessitate the application of analytical methods to enhance the overall service efficiency in hospitals. However, the variability in healthcare processes makes it highly complicated to accomplish this aim. This study addresses the complexity in the patient transport service process at a German hospital, and proposes a method based on process mining to obtain a holistic approach to recognise bottlenecks and main reasons for delays and resulting high costs associated with idle resources. To this aim, the event log data from the patient transport software system is collected and processed to discover the sequences and the timeline of the activities for the different cases of the transport process. The comparison between the actual and planned processes from the data set of the year 2020 shows that, for example, around 36% of the cases were 10 or more minutes delayed. To find delay issues in the process flow and their root causes the data traces of certain routes are intensively assessed. Additionally, the compliance with the predefined Key Performance Indicators concerning travel time and delay thresholds for individual cases was investigated. The efficiency of assignment of the transport requests to the transportation staff are also evaluated which gives useful understanding regarding staffing potential improvements. The research shows that process mining is an efficient method to provide comprehensive knowledge through process models that serve as Interactive Process Indicators and to extract significant transport pathways. It also suggests a more efficient patient transport concept and provides the decision makers with useful managerial insights to come up with efficient patient-centred analysis of transportation services through data from supporting information systems.

Integrating Microfluidics and Electronics in Point-of-Care Diagnostics: Current and Future Challenges.

Point-of-Care (POC) diagnostics have gained increasing attention in recent years due to its numerous advantages over conventional diagnostic approaches. As proven during the recent COVID-19 pandemic, the rapidity and portability of POC testing improves the efficiency of healthcare services and reduces the burden on healthcare providers. There are hundreds of thousands of different applications for POC diagnostics, however, the ultimate requirement for the test is the same: sample-in and result-out. Many technologies have been implemented, such as microfluidics, semiconductors, and nanostructure, to achieve this end. The development of even more powerful POC systems was also enabled by merging multiple technologies into the same system. One successful example is the integration of microfluidics and electronics in POC diagnostics, which has simplified the sample handling process, reduced sample usage, and reduced the cost of the test. This review will analyze the current development of the POC diagnostic systems with the integration of microfluidics and electronics and discuss the future challenges and perspectives that researchers might have.

The impact of human resources for health on the health outcomes of Chinese people

Human resources for health (HRH) is a cornerstone in the medical system. This paper combined data envelopment analysis (DEA) with Tobit regression analysis to evaluate the efficiency of health care services in China over the years between 2007 and 2019. Efficiency was first estimated by using DEA with the choice of inputs and outputs being specific to health care services and residents’ health status. Malmquist index model was selected for estimating the changes in total factor productivity of provinces and exploring whether their performance had improved over the years. Tobit regression model was then employed in which the efficiency score obtained from the DEA computations used as the dependent variable, and HRH was chosen as the independent variables. The results showed that all kinds of health personnel had a significantly positive impact on the efficiency, and more importantly, pharmacists played a critical role in affecting both the provincial and national efficiency. Therefore, the health sector should pay more attention to optimizing allocation of HRH and focusing on professional training of clinical pharmacists.

Management and efficiency of health care services in Haryana

Management and efficiency of health care services in Haryana

Appointment Scheduling Problem under Fairness Policy in Healthcare Services: Fuzzy Ant Lion Optimizer

This study addresses the application of the Integer Linear Programming technique for the patient Appointment Scheduling Problem (ASP). In this research, we propose a Mixed-Integer Linear Programming (MILP) model to formulate the problem and treat patients admitted to hospitals and stay in a queue based on their general health status (urgent or regular patients). Moreover, the ASP has two main objectives that often provide early patient admissions. The first objective is based on fairness policy as an essential factor in the healthcare service to help minimize patient waiting time. The second one is to maximize the efficiency of healthcare services in line with patients’ satisfaction. Moreover, we have addressed the Fuzzy Ant Lion Optimization (FALO) strategy and Non-dominated Sorting Genetic Algorithm II (NSGA-II) are utilized to compare and solve the resulting multi-objective ASP. As the application of the model, fairness policy is analyzed in scenario 1 using FALO, and in scenario 2, NSGA-II is applied. The performances of the solution algorithms are then tested using datasets of a big regional hospital in Shanghai. The outcomes indicate potential advantages of implementing the presented approach. In particular, the suggested FALO increases the fairness and patients’ satisfaction by more than 80% while reducing the waiting times by 50% within the basic appointment scheduling system.

Balance of Public Medical and Health Services and Reform of Medical Institutions Based on 5G Sensor Technology

Since its reform and opening in 1978, China’s economy has grown rapidly and human life and physical well-being have improved significantly. The public health care system is an imperative guarantee of people’s life and physical health. It is necessary to establish a reasonable planning, a reasonable division of labor, and an efficient medical service system to improve the overall efficiency of health care services and ensure the physical health of the people. The balance of public health care services plays a very important role. It plays a very important role in safeguarding people’s basic right to health, regulating social fairness and justice, promoting the sustainable development of medical and health services, and building a harmonious society. Based on 5G sensor technology, this paper combines relevant research on sensor technology at home and abroad and comprehensively uses related theories such as sensing principles and health care services to discuss the internal operation mechanism of China’s public health care service system. It conducts experiments to compare health care services with 5G sensor technology with existing health care service systems. It compares its bed occupancy rates, hospital admissions and discharges, outpatient and emergency department volumes, and average inpatient costs. It studies the impact of 5G sensor technology on public health care services. The experimental results show that after adopting 5G sensor technology, the average bed utilization rate in the H hospital is 88.71%. The total number of hospitalizations was 9.845 million, and the total number of discharges was 8.668 million. The total number of outpatient visits was 44.259 million, and the total emergency department was 7.694 million. The per capita cost of inpatients in H hospital is 15,840 yuan, and the per capita cost of inpatients in W center is 9,661.75 yuan.

Locally weighted factorization machine with fuzzy partition for elderly readmission prediction

The mitigation of preventable readmissions is the key to enhance the quality and efficiency of healthcare services in Hong Kong’s aging society. A general predictor like factorization machine (FM) can efficiently capture non-linear interactions among patient characteristics for readmission prediction. However, FM cannot formulate local patient heterogeneity that commonly exists due to different demographics and hospitalization characteristics. This study proposes a locally weighted factorization machine (WFM) by developing a locally weighting scheme that assigns differentiated weights for training instances in accordance with their local similarities with high-readmission-risk ones. Io account for global heterogeneity among patient groups, we further extend WFM and propose a fuzzy partition enhanced WFM model (i.e., WFMFP), which (I) splits the dataset into multiple training subsets with fuzzy partition approach, (II) fits the WFM model on the basis of each training subset, and (III) combines the sub-prediction WFM models by using Takagi–Sugeno–Kang fuzzy weighting mechanism. We collected a territory-wide cohort with electronic health records in Hong Kong during 2008 to 2017. We demonstrated that the proposed WFMFP model outperforms several baselines, including standard FM, XGBoost, Lightgbm, Catboost, Gradient boosting machine, random forests, SVMs with different kernels, and multilayer perceptron. Comparative analysis results demonstrate the effectiveness of applying the locally weighting notion into FM to improve readmission prediction for clinical resource management.

Intra‐provincial fiscal decentralization, relative wealth, and healthcare efficiency: Empirical evidence from China

AbstractDecentralizing fiscal power to locally elected governments is often regarded as beneficial for public service efficiency. However, questions remain about whether decentralizing fiscal responsibilities work well in countries lacking political decentralization. In China, fiscal decentralization has significantly strengthened the role of local governments in the provision of healthcare services, but evidence of its efficiency effects is scarce. To cast light on this issue, this study investigates the relationship between intra‐provincial fiscal decentralization and the productive efficiency of healthcare services in China. Analysis of panel data for 2006–2017 suggests that expenditure and revenue decentralization from provincial to sub‐provincial governments significantly improves healthcare efficiency. Further analysis suggests that the positive impact of healthcare expenditure decentralization on healthcare efficiency may be stronger in wealthier provinces. These findings have important theoretical and practical implications.

Applications of lean in human resources management in healthcare.

Recent challenges brought by the coronavirus disease-2019 pandemic have underscored the importance of coping with pressures on the workforce in healthcare around the world and have emphasised the continuing need to improve quality and operation efficiency of healthcare services even in such dire circumstances. Over the years, lean thinking has gained recognition in the healthcare industry, where lean has been associated with benefits, such as improved healthcare delivery quality, reduced costs and increased effectiveness of the healthcare delivery processes. Lean thinking has also been analysed in human resources with benefits, such as increased job satisfaction and perceived job autonomy. The current narrative review was planned to analyse and discuss the application and implementation of lean strategies with a particular focus on human resource management in healthcare. The review is complemented by a case study in a private healthcare group in Turkey, aiming to demonstrate in practice the effect of lean strategies on the satisfaction of patients and relatives, the job satisfaction of the employees, and the level of turnover rates within healthcare enterprises.

Visualizing the Invisible: Invisible Waste in Diagnostic Imaging.

There is extensive waste in diagnostic imaging, at the same time as there are long waiting lists. While the problem of waste in diagnostics has been known for a long time, the problem persists. Accordingly, the objective of this study is to investigate various types of waste in imaging and why they are so pervasive and persistent in today’s health services. After a short overview of different conceptions and types of waste in diagnostic imaging (in radiology), we identify two reasons why these types of waste are so difficult to address: (1) they are invisible in the healthcare system and (2) wasteful imaging is driven by strong external forces and internal drivers. Lastly, we present specific measures to address wasteful imaging. Visualizing and identifying the waste in diagnostic imaging and its ingrained drivers is one important way to improve the quality and efficiency of healthcare services.

Efficiency evaluation of healthcare services in China based on stochastic multicriteria acceptability analysis and directional distance function

AbstractEvaluating the efficiency of healthcare services accurately can help in analyzing the rationality of inputs and outputs in such services. Considering the consistency and equity of assessment criteria, this study conducts the stochastic multicriteria acceptability analysis (SMAA‐2) with a directional distance function to evaluate the efficiency of healthcare services in 31 provincial administrative regions of mainland China, as observed in 2018. We use SMAA‐DDF to explore all the projection directions to the efficient frontier instead of a certain projection direction. We measure the maximum and average efficiencies for each of the 31 provincial healthcare services. Our empirical findings show that only seven provinces achieve optimal healthcare service efficiency; the eastern area performed the best, followed by the central, western, and northeast areas. Furthermore, the path along the projection directions is provided to help inefficient provinces improve their efficiency and obtain the best possible positions.

Assessing the financial efficiency of healthcare services and its influencing factors of financial development: fresh evidences from three-stage DEA model based on Chinese provincial level data.

Pediatrics is an integral part of public health services. With the impact of the epidemic and the high-quality transformation of China's development, the contradiction in the supply of pediatric public services has become more prominent. Scientific evaluation of the efficiency and quality of pediatric services, clarifying the redundancy of pediatric input resources and adjusting the construction of pediatric services with the help of influencing factors have become important research topics. This paper uses the three-stage SBM-DEA model to summarize the efficiency of China's pediatric services using panel data from 31 provinces and cities in 2008-2019, taking into account undesired outputs such as doctor-patient disputes. Among them, the evaluation system focuses on the role of financial, capital, and other factors, and the Tobit regression model is used to clarify the degree of influence of various factors. The study found that (1) China's pediatric service supply has the characteristics of geographic heterogeneity. (2) The redundancy of various resource inputs is apparent, and the supporting capacity of financial capital is not significant. (3) The economic, technological, and professional environment helps to digest the redundancy of inputs. (4) Capital, urbanization, education development, and birth rate increase under financial operation will promote the increase of the efficiency of pediatric public services.

A new methodological framework for hazard detection models in health information technology systems

The adoption of health information technology (HIT) has facilitated efforts to increase the quality and efficiency of health care services and decrease health care overhead while simultaneously generating massive amounts of digital information stored in electronic health records (EHRs). However, due to patient safety issues resulting from the use of HIT systems, there is an emerging need to develop and implement hazard detection tools to identify and mitigate risks to patients. This paper presents a new methodological framework to develop hazard detection models and to demonstrate its capability by using the US Department of Veterans Affairs’ (VA) Corporate Data Warehouse, the data repository for the VA’s EHR. The overall purpose of the framework is to provide structure for research and communication about research results. One objective is to decrease the communication barriers between interdisciplinary research stakeholders and to provide structure for detecting hazards and risks to patient safety introduced by HIT systems through errors in the collection, transmission, use, and processing of data in the EHR, as well as potential programming or configuration errors in these HIT systems. A nine-stage framework was created, which comprises programs about feature extraction, detector development, and detector optimization, as well as a support environment for evaluating detector models. The framework forms the foundation for developing hazard detection tools and the foundation for adapting methods to particular HIT systems.

Integrated Healthcare Services for Ageing in Place

This study investigates how healthcare practitioners handle significant circumstancesof providing medical assistance and treatments to patients and what challenges theyface. Drawing on key healthcare stakeholders and mixed smart living methods, wedevelop a guideline service protocol for Internet of Things (IoT) solution to helphealthcare stakeholders in coping with operational difficulties. IoT technology is one ofthe key determinants that empowers healthcare professionals to achieve their tasks,and our goal is to study the functions that provides to local citizens, especially olderpeople, and to evaluate how the functions and platform could assist corporatecompliance policies to increase the efficiency of healthcare service. Our fieldexperiments have indicated a need to educate healthcare users about IoT applicationthat provide advantages in decision making. In addition, our research has explored andevaluated the impacts and factors that influence the development and collaboration byallowing workflows of healthcare stakeholders and by following integrated smart livingplatform and required service protocol.

Kesiapan dan Penerimaan Karyawan terhadap Penerapan Lean Management di Rumah Sakit Bethesda

ABSTRACTIntroductions: Efficiency of health care services at a hospital became one of the solutions amid national health insurance era. Particular method offering the solution is lean management. Bethesda Hospital began implementing lean management in 2019. During the course of the program, readiness and acceptance evaluation at the level of employee never been accomplished. Organizations focused mainly on lean tools and lean techniques tend to allocate minimal measurement on readiness lead to reduced level of sustainability and last for short-term activities. Successful lean management require both preparation and implementation combining on lean readiness and lean acceptance data from the organization. Aim:This study aimed to measure employee readiness and acceptance toward implementation of lean management,and to describe the output of lean implementationMethods: An explanatory research took place in Bethesda Hospital, Yogyakarta. Survey were used to collect quantitative data while the qualitative approach performed through in-depth interviews.Results and Discussion: Lean readiness at Bethesda Hospital were analyzed using fuzzy and Euclidean. The analysis indicate value of 6.08 with HLR 4 distance 2.016 interpreted as "close to ready", therefore Bethesda Hospital is ready to start the lean journey, but is not yet fully ready , as well as continuous improvement.The aspects of readiness that still lack of improvement include supplier and customer involvement in lean, lean sensei in institutions, employee resistance, and reward systems.The highest indicator identified from element 6.4, patient and employee safety, while the lowest indicator originated from element 5.2, supplier involvement and conformity to the institution. Lean acceptance Bethesda Hospital measured through lean maturity present average score level 3, but in operational conditions at the hospital lean maturity is at level 2 where awareness of lean has occurred in general, but the lean approach only occurs in some areas with variability of effectiveness. The aspects of lean that still lack of improvement is the foundation of lean philosophy and a monitoring evaluation system that has not been standardized in all of sections.Conclusion: The lean implementation that has been carried out has provided good output in both financial and non-financial term. Bethesda hospital is considered to have the ability to start a lean journey, but the aspects of readiness that are lacking need to be improved. Bethesda hospital has sufficient level of acceptance to undertake further development of lean implementation.

Anonymous Group-Oriented Time-Bound Key Agreement for Internet of Medical Things in Telemonitoring Using Chaotic Maps

Telemonitoring using the Internet of Medical Things (IoMT) enables the seamless communication of physical signs from patients who do not visit healthcare providers. It, therefore, improves the efficiency of healthcare services and patient comfort the quality of life of patients. While providing many benefits, it is associated with challenges concerning energy consumption, privacy, and security. This work addresses those challenges by presenting a new group-oriented time-bound-authenticated key agreement scheme using extended chaotic maps. It provides details on the importance and contribution of this work, investigates the scheme of Chien, and elucidates its weaknesses. The security of the proposed scheme is analyzed formally using the Burrows-Abadi-Needham logic and informally through informal discussions about security features, possible attacks, and countermeasures. Results of a simulation demonstrate that the proposed scheme has more security functions and is more computationally efficient than other related schemes.

Teleradiology public-private partnerships in Saudi Arabia: a review

Owing to the increasing demand for healthcare driven by population growth, the Kingdom of Saudi Arabia’s (KSA) Ministry of Health (MOH) is actively seeking to improve the quality and efficiency of healthcare services in general and medical imaging services in particular by introducing private sector participation in its first healthcare public-private partnership (PPP) venture for teleradiology. Teleradiology will also benefit the more remote areas of the country that are currently underserved. Through the PPPs, hospitals in the project will have interconnected teleradiography services, ensuring efficiency and cost-effectiveness compared to the current public provision of medical imaging services. This review is based on secondary data collected from various computerized repositories, databases, or search engines encompassing articles, MOH documents, and reports in this regard. This review describes healthcare PPPs and how they will operate teleradiology in the KSA. We further highlight obstacles to the involvement of the private sector in the provision of public teleradiology services.

Demographic Transition and its Impacts on Fiscal Sustainability in East and Southeast Asia

Many economies in East and Southeast Asia are progressing toward becoming aging or aged societies. The impacts of this demographic transition are multifaceted and far-reaching and include declining tax revenues, leading to fiscal imbalances, and possible increases in government expenditures for coping with care expenses and pension schemes. We provide insights into ways to balance fiscal revenue against costly pension and social security systems and increasing healthcare expenditures.Using panel data for 178 countries across 18 years to capture the state of fiscal balance and data on demographic transition, we estimate three models to analyze the relationships between (i) demographic transition and government balance, (ii) demographic transition and government health expenditure, and (iii) demographic transition and government debt. The results first establish that health expenditure is negatively associated with the government balance. Then, for the relationship between demographic transition and health expenditure, old-age dependency and the share of the population aged over 64 shows a significant positive relationship with health expenditure. We find that demographic transition does not have a direct effect on the government balance, but instead has an indirect effect through higher government expenditure. This can be explained by the high costs of treating health conditions related to old age, including chronic illnesses.Our findings provide important implications for fiscal sustainability and necessitate comprehensive reviews of public health spending; healthcare reforms that prioritize accessibility for all and efficiency in healthcare services; and cost-sharing measures to mitigate the age-related fiscal burden. These measures will be particularly important in dealing with the impacts of the coronavirus disease (COVID-19) pandemic, to which the elderly are particularly vulnerable.