Inpatient Hospital Services Research Articles

Determinant analysis of Length of Stay (LoS) in Covid-19 isolation room at RSUD Jend. A. Yani Metro City

Background: The increasing incidence of Coronavirus Disease 2019 (COVID-19) in Indonesia affects the need for hospital inpatient services. One of the parameters of service quality and the use of hospital resources is the length of stay (LOS). Objective: To find the determinants of COVID-19 that affect LOS in hospitals. Methods: Retrospective observational data collection using a cross-sectional study design. The sampling method used was total sampling during the January-August 2021 hospitalization period in the Isolation Room of the General Hospital of Jend. A. Yani Metro City. The data used is medical record data. Bivariate analysis uses Chi Square, while multivariate analysis uses Multiple Logistics Regression. Results: The sample consisted of 443 patients who were treated during the period January-August 2021 in the COVID-19 isolation room at RSUD Jend. A. Yani Metro City. The median LOS is 6 days. Multiple logistic regression analysis shows that the determinants of LOS include severity, diabetes mellitus, heart disease, and D-Dimer. Conclusion: Severity, comorbid diabetes mellitus, comorbid heart disease, and D-Dimer value are the determinants of LOS in confirmed COVID-19 patients in the COVID-19 isolation room at General Ahmad Yani Hospital, Lampung Province. Keywords: Determinants, Coronavirus Disease, LOS, hospital

The geography of Medicare's hospital value-based purchasing in relation to market demographics.

To illustrate the association between the sociodemographic characteristics of hospital markets and the geographic patterns of Medicare hospital value-based purchasing (HVBP) scores. This is a secondary analysis of United States hospitals with a HVBP Total Performance Score (TPS) for 2019 in the Centers for Medicare and Medicaid Services (CMS) Hospital Compare database (4/2021 release) and American Community Survey (ACS) data for 2015-2019. This is a cross-sectional study using spatial multivariable autoregressive models with HVBP TPS and component domain scores as dependent variables and hospital market demographics as the independent variables. We calculated hospital market demographics using ZIP code level data from the ACS, weighted the 2019 CMS inpatient Hospital Service Area file. Spatial autoregressive models using eight nearest neighbors with diversity index, race and ethnicity distribution, families in poverty, unemployment, and lack of health insurance among residents ages 19-64 years provided the best model fit. Diversity index had the highest statistically significant contribution to lower TPS (ß=-12.79, p < 0.0001), followed by the percent of the population coded to "non-Hispanic, some other race" (ß=-2.59, p < 0.0023), and the percent of families in poverty (ß=-0.26, p < 0.0001). Percent of the population was non-Hispanic American Indian/Alaskan Native (ß=0.35, p < 0.0001) and percent non-Hispanic Asian (ß=0.12, p < 0.02071) were associated with higher TPS. Lower predicted TPS was observed in large urban cities throughout the US as well as in states throughout the Southeastern US. Similar geographic patterns were observed for the predicted Patient Safety, Person and Community Engagement, and Efficiency and Cost Reduction domain scores but are not for predicted Clinical Outcomes scores. The lower predicted scores seen in cities and in the Southeastern region potentially reflect an inherent-that is, structural-association between market sociodemographics and HVBP scores.

Equivalence of care, confidentiality, and professional independence must underpin the hospital care of individuals experiencing incarceration

We present the reflections of three clinical practitioners on ethical considerations when caring for individuals experiencing incarceration needing in-patient hospital services. We examine the challenges and critical importance of adhering to core principles of medical ethics in such settings. These principles encompass access to a physician, equivalence of care, patient’s consent and confidentiality, preventive healthcare, humanitarian assistance, professional independence, and professional competence. We strongly believe that detained persons have a right to access healthcare services that are equivalent to those available in the general population, including in-patient services. All the other established standards to uphold the health and dignity of people experiencing incarceration should also apply to in-patient care, whether this takes place outside or inside the prison boundaries. Our reflection focuses on the principles of confidentiality, professional independence, and equivalence of care. We argue that the respect for these three principles, although they present specific implementation challenges, is foundational for implementing the other principles. Critically important are respect for the distinct roles and responsibilities of healthcare and security staff as well as transparent and non-hierarchical dialogue between them to ensure optimal health outcomes and functioning of hospital wards while balancing the ongoing tensions between care and control.

Does increasing physician volume in primary healthcare facilities under the hierarchical medical system help reduce hospital service utilisation in China? A fixed-effects analysis using province-level panel data

ObjectiveTo examine whether increases in physician volume in primary healthcare facilities are associated with reduced utilisation of hospital outpatient and inpatient services after China facilitated the establishment of the hierarchical...

Perfomance Analysis of Medical Performance in General Hospital in patient service during Covid-19 Pandemic in Ciamis District and Banjar City

The problem of patient care during the COVID-19 pandemic is a very urgent problem because the handling and management requires dexterity skills and even high medical equipment costs. Therefore, more effective patient care during the COVID-19 pandemic at the Ciamis Regency and Banjar City General Hospitals is a must. This study aims to examine how the performance of medical personnel and medical personnel at the Ciamis Regency and Banjar City General Hospitals in patient care in Ciamis Regency and Banjar City. This research uses qualitative and quantitative research methods and refers to the theory of organizational performance in the public sector including the dimensions; individual performance factors, group performance factors and organizational performance factors. Primary data was obtained by using a questionnaire designed according to the needs of research and observation. Secondary data obtained through the study of documentation. The results of this study indicate that the performance of medical personnel and medical personnel at the Ciamis Regency and Banjar City General Hospitals in patient care during the COVID-19 pandemic in Ciamis Regency and Banjar City has not focused optimally on group performance factors while individual performance factors and organizational performance factors is maximum.

Utilizing the Modified OMP Model for Health Equity in a Family Medicine Residency Clinic

Background Racial and ethnically diverse communities have higher mortality rates from chronic diseases. One approach to address health disparities and systemic racism in health care is through alterations in primary care workforce development via the One-Minute Preceptor (OMP) Teaching Method. The University of North Carolina at Chapel Hill created a modified OMP Model for Health Equity to address racial health disparities while teaching. This quality improvement (QI) project focuses on faculty confidence in discussing racial health disparities with learners using the modified OMP Model. Methods The QI project used a Plan-Do-Study-Act (PDSA) framework. Faculty participated in the Awareness, Reflection/Empowerment, and Action (AREA) survey, to assess level of engagement in addressing health disparities. Family Medicine (FM) residents completed a survey on current precepting practices of ethno-racial health disparities. Faculty were introduced to the modified OMP, followed by a two-month intervention period. Post-intervention surveys assessed the impact and identified faculty development opportunities. The intervention took place within a Family Medicine Residency Program, specifically during outpatient continuity clinics and the inpatient Family Medicine Hospital Service. Results Faculty engagement increased in areas of awareness and action and decreased in reflection/empowerment. Residents reported higher satisfaction with Ethno-Racial health disparities clinical teaching after the intervention. Qualitative data suggests discussions are not occurring as often as residents desire and depend on different factors; race/ethnicity of the patient, clinical situation, social determinants of health impacting care, time, and preceptor. Discussion The modified OMP for Health Equity intervention can be used to increase awareness and promote self-reflection and change. Conclusion The PDSA cycle framework for an intervention can improve faculty engagement addressing Ethnic-Racial health disparities.

Utilizing the Modified OMP Model for Health Equity in a Family Medicine Residency Clinic

Background Racial and ethnically diverse communities have higher mortality rates from chronic diseases. One approach to address health disparities and systemic racism in health care is through alterations in primary care workforce development via the One-Minute Preceptor (OMP) Teaching Method. The University of North Carolina at Chapel Hill created a modified OMP Model for Health Equity to address racial health disparities while teaching. This quality improvement (QI) project focuses on faculty confidence in discussing racial health disparities with learners using the modified OMP Model. Methods The QI project used a Plan-Do-Study-Act (PDSA) framework. Faculty participated in the Awareness, Reflection/Empowerment, and Action (AREA) survey, to assess level of engagement in addressing health disparities. Family Medicine (FM) residents completed a survey on current precepting practices of ethno-racial health disparities. Faculty were introduced to the modified OMP, followed by a two-month intervention period. Post-intervention surveys assessed the impact and identified faculty development opportunities. The intervention took place within a Family Medicine Residency Program, specifically during outpatient continuity clinics and the inpatient Family Medicine Hospital Service. Results Faculty engagement increased in areas of awareness and action and decreased in reflection/empowerment. Residents reported higher satisfaction with Ethno-Racial health disparities clinical teaching after the intervention. Qualitative data suggests discussions are not occurring as often as residents desire and depend on different factors; race/ethnicity of the patient, clinical situation, social determinants of health impacting care, time, and preceptor. Discussion The modified OMP for Health Equity intervention can be used to increase awareness and promote self-reflection and change. Conclusion The PDSA cycle framework for an intervention can improve faculty engagement addressing Ethnic-Racial health disparities.

Hospital Utilization for Coronary Artery Disease, 1997-2014.

Coronary artery disease (CAD) is the leading cause of cardiovascular morbidity, mortality, and healthcare costs in the United States. There are few reports on how public health and payment reforms might have influenced inpatient hospital use among patients with CAD. This study describes trends in hospital discharges, hospital charges, and discharge destinations in a national sample of patients with CAD between 1997 and 2014. This was a longitudinal study with descriptive analysis of the Healthcare Cost and Utilization Project of National Inpatient Sample data. During this study period, the total number of discharges was 1 333 996. Patients with CAD between 65 and 84 years old were among the highest users of inpatient hospital services, followed by those in the 45- to 64-year age group. The death rate increased from 5961 to 7217 per 10 000 patients during this time. The mean charge increased more than 5 times, from $9100 to $49 643. There was a large difference in mean hospital charges in urban ($51 666) and rural ($25 548) locations in 2014. Coronary artery disease patients with private insurance paid more than those with Medicaid and Medicare plans. The discharge to home and healthcare costs increased by 4.1% and 4.8%, respectively. Future researchers should use data sets, such as Medicare claims/Medical Expenditure Panel Study, that can provide comprehensive insights into patient-level factors influencing the use of inpatient care services among patients with CAD. Healthcare providers in posthospital settings should be well skilled in providing advanced cardiac rehabilitation and education to patients with CAD.

Psychiatrist and trainee moral injury during the organisational long COVID of Australian acute psychiatric inpatient services.

This paper provides a commentary on the risk of moral injury amongst psychiatrists and trainees working in the acute psychiatric hospital sector, during the third winter of the COVID-19 pandemic. Moral injuries arise from observing, causing or failing to prevent adverse outcomes that transgress core ethical and moral values. Potentially, morally injurious events (PMIEs) are more prevalent and potent while demand on acute hospitals is heightened with the emergence of highly infectious SARS-CoV-2-Omicron subvariants (BA.4 and BA.5). Acute hospital inpatient services were already facing extraordinary stresses in the context of increasingly depleted infrastructure and staffing related to the pandemic. These stresses have a high potential to be morally injurious. It is essential to immediately fund additional staff and resources and address workplace health and safety, to seek to arrest a spiral of moral injury and burnout amongst psychiatrists and trainees. We discuss recommended support strategies.

Changes in Inpatient Hospital Services During the COVID-19 Pandemic in Thailand: A Descriptive and Costing Study

Background: The COVID-19 pandemic forced policy makers to find solutions to protect hospitals from revenue shortfalls and provide high quality of care for COVID-19 and other patients. In Thailand, hospitals have adjusted the hospital services arrangement to new normal hospital services to prevent the spread of coronavirus while maintaining essential hospital services for non-COVID-19 patients. Objective: To describe the COVID-19 patient flow and estimate the costs of the new normal hospital services implemented in six public hospitals across Thailand. Materials and Methods: The authors conducted a cross-sectional study to describe the COVID-19 patient flow in each participating hospital between January and November 2020, representing the first wave of the COVID-19 outbreak in Thailand. Data were collected from hospital staff interviews, hospital historical budget review, and hospital databases. The hospital costs of the new normal hospital services were estimated using an activity-based costing approach from the provider’s perspective. Results: The COVID-19 patients could access the new normal hospital services through three channels including 1) walk-in, 2) transfer from other hospitals, and 3) active surveillance from communities. The ratio of costs of the new normal hospital services during the COVID-19 outbreak and the normal situation were one to two times and one to five times for patients with mild infection admitted to secondary and tertiary care hospitals, respectively, but one to three times for those with moderate-to-severe infection admitted to tertiary care hospitals. Conclusion: The COVID-19 pandemic imposed additional costs to Thai hospitals. The magnitude of the incremental costs depended on COVID-19 severity and hospital level. Keywords: Cost; COVID-19; Hospital services; New normal; Thailand

CO2 production in waste management during the COVID pandemic in an Italian hospital

Abstract Background Personal protection equipment (PPE) use in hospitals has consistently increased due to the Sars-Cov-2 outbreak, in wards repurposed for Covid-19 patients and wards that kept their usual activity. This increase influenced an environmental emergency in terms of health waste (HW) disposal. This study aims to assess the economic and environmental impact of the increase in HW generated before and during the pandemic in an Italian Hospital. Methods Data from 2016 to 2019 and 2020 to 2021 was retrieved from Risk Management department. Per capita and per days-of-stay waste quantity were calculated for the hospital inpatient wards and medical service areas (anatomical pathology, laboratories, radiology, nuclear medicine). Linear regression models assessed the epidemiological impact of COVID, and LOESS analysis modeled the relationship between infectious HW generation and the percentage of COVID-related inpatient days. Average weight of HW per patient was used to estimate the monetary value of CO2 produced. Results Preliminary results show that the inpatient days related to COVID nonlinearly influenced the infectious HW generated by wards. PPE usage increased in every context, and the proportion of COVID-related bed-days ranged from 2% to 12% in low-incidence months to 17% to 31% during acute phases. Pre-COVID CO2 production weighted 487 kg per patient and cost 1705€ per-capita, whereas during the pandemic it amounted to 768 kg per patient and cost 2688€ per capita which resulted in a significant increase of 983€ per patient. Conclusions In light of the results, HW disposal is an urgent issue that should be addressed by policy makers when implementing new monitoring systems for hospitals. A more adequate disposal of HW could substantially contribute in reducing air pollution and concurrently reduce the economic impact health systems due to the coronavirus pandemic. Key messages

Association between Primary Care Utilization and Emergency Room or Hospital Inpatient Services Utilization among the Middle-Aged and Elderly in a Self-Referral System: Evidence from the China Health and Retirement Longitudinal Study 2011-2018.

With rapid economic growth and aging, hospital inpatient and emergency services utilization has grown rapidly, and has emphasized an urgent requirement to adjust and optimize the structure of health service utilization. Studies have shown that primary care is an effective way to reduce inpatient and emergency room (ER) service utilization. This study aims to examine whether middle-aged and elderly individuals who selected primary care outpatient services in the last month had less ER and hospital inpatient service utilization than those who selected hospitals outpatient services via the self-referral system. Data were obtained from four waves of the nationally representative China Health and Retirement Longitudinal Study (CHARLS). We pooled respondents who had outpatient visits and were aged 45 years and above. We used logistic regressions to explore the association between types of outpatient and ER visits or hospitalization, and then used zero-truncated negative binomial regression to examine the impact of outpatient visit types on the number of hospitalizations and the length of hospitalization days. A trend test was used to explore the trend of outpatient visit types and the ER or hospital inpatient services utilization with the increase in outpatient visits. Among the 7544 respondents in CHARLS, those with primary care outpatient visits were less likely to have ER visits (adjusted OR = 0.141, 95% CI: 0.101–0.194), hospitalization (adjusted OR = 0.623, 95% CI: 0.546–0.711), and had fewer hospitalization days (adjusted IRR = 0.886, 95% CI: 0.81–0.969). The trend test showed that an increase in the number of total outpatient visits was associated with a lower hospitalizations (p = 0.006), but a higher odds of ER visits (p = 0.023). Our findings suggest that policy makers need to adopt systematic policies that focus on restructuring and balancing the structure of resources and service utilization in the three-tier healthcare system.

Preparing for 2023: Guidelines for Hospital Inpatient and Observation Services

This article reviews changes to the Current Procedural Terminology (CPT®) guidelines for initial and subsequent hospital inpatient and observation evaluation and management (E/M) services. Topics covered include the following: Codes reported for E/M services provided to patients in inpatient or observation status Distinguishing initial and subsequent encounters according to CPT guidelines Examples of coding for hospital E/M services, including when E/M services are provided in other settings prior to admission to inpatient or observation status on the same date

S2155 Utilizing the Pure-Vu EVS for Inpatient Colonoscopy for Patients With an LVAD: A Case Report

Introduction: Colonoscopy is considered the standard for colon cancer screening. A key factor in ensuring high quality colonoscopy is adequate colon cleansing. In hospitalized patients, bowel preparation is often challenging and inadequate cleansing is often due to patient’s inability to tolerate the preparation, slow bowel transit in the setting of immobilization and acute illnesses, and the use of motility-altering medications. Poor bowel preparation limits visualization of the colonic mucosa and can lead to incomplete colonoscopies, missed pathology, adverse events, prolonged hospital stays and increased costs. New technologies have been developed to improve bowel preparations intra-procedurally. The Pure-Vu EVS system, which is an over-the-scope irrigation and cleansing device. This case report describes a novel use of the Pure-Vu EVS system to improve inpatient colonoscopy prep. Case Description/Methods: A 58-year-old female with past medical history significant for chronic systolic heart failure, ischemic cardiomyopathy status post Left Ventricular Assist Device (LVAD) one year prior. End stage heart failure patients requiring LVAD placement routinely undergo screening colonoscopy as part of their pre-transplant evaluation, as the presence of colon cancer or advanced neoplasia could preclude heart transplantation. As part of orthotopic heart transplant evaluation she was admitted to the hospital for IV heparin bridging for screening colonoscopy. After admission, the patient was started on standard bowel prep consisting of 4L of Golytely and Dulcolax suppository. Despite completion of prep, she continued to pass sediments and prep was deemed inadequate. The patients LVAD anticoagulation had been held for the procedure and the decision was made to proceed with colonoscopy utilizing the Pure-Vu EVS device. During the procedure the clinical team utilized the Pure-Vu EVS device and performed the procedure with cardiovascular anesthesia. The Pure-Vu EVS system effectively irrigated and suctioned areas of inadequate bowel prep with sediment larger than 3.8 mm, allowing for improved visualization of the colonic mucosa. Discussion: Pure-Vu EVS allowed for us to perform a screening colonoscopy as part of orthotopic heart transplant evaluation in a patient with LVAD admitted a hospital inpatient service for heparin bridge. This case report describes one of the first cases of the utilization of this unique technology in a patient requiring inpatient screening colonoscopy with advanced heart failure.

Service-, needs-, and quality-based hospital capacity planning – The evolution of a revolution in Switzerland

Most developed countries spend a large amount of their health budget on hospital capacities and inpatient services. However, those capacities and services are often not comprehensively planned what leads to vague service delivery steering and non-need driven hospital facilities. Switzerland is different as the planning procedure was completely reformed in 2012 and is further refined in 2021/2022. The Canton of Zurich, the frontrunner in Switzerland, has made a comprehensive update of its hospital capacity planning model for acute, psychiatric, and rehabilitative care. The result of this model is the hospital list. This list includes all hospitals which fulfill predefined quality, efficiency, and need requirements. Hospitals on the list receive a mandate to provide inpatient treatments for specific and selected service groups (n = 196), clustered in three areas (acute care, psychiatry, rehabilitation). The underlying health care policy process is transparent and is characterized by a high participation of all relevant actors. The building blocks of the planning model are a classification system of service groups, different quality and efficiency requirements attached to these groups, and an analysis of current and future need for health care. Hospitals which are willing to perform services must apply and demonstrate that the requirements are fulfilled. The canton then decides needs-based which hospital can deliver which services.

Missed opportunities for hepatitis C treatment at a tertiary care hospital in South Australia.

BACKGROUNDHepatitis C is a global epidemic and an estimated 230 000 Australians were living with chronic hepatitis C in 2016. Through effective public health policy and state commitment, Australia has utilised the advent of direct acting antiviral (DAA) therapy to transform the therapeutic landscape for hepatitis C virus (HCV). However, treatment rates are falling and novel public health approaches are required to maintain momentum for HCV elimination. Contemporary discourse in cascades of care have focused on expanding testing capabilities but less attention has been given to linking previously diagnosed patients back to care. Our simple and focused study rests on the premise that hospital admissions are an excellent opportunity to identify and refer previously diagnosed patients for HCV treatment.AIMTo assess whether inpatients with HCV are appropriately referred on for treatment.METHODSWe conducted a retrospective single centre cohort study that examined all patients with HCV presenting to The Queen Elizabeth Hospital (QEH) inpatient service between January 1 and December 31, 2017. QEH is a tertiary care hospital in South Australia. The main inclusion criteria were patients with active HCV infection who were eligible for DAA therapy. Our study cohort was identified using a comprehensive list of diagnosis based on international classification of diseases-10 AM codes for chronic viral hepatitis. Patients were excluded from the analysis if they had previously received DAA therapy or spontaneously cleared HCV. Patients presenting with decompensated liver cirrhosis or other systemic medical conditions conferring poor short-term prognosis were also excluded from the analysis. The primary outcome of our study was referral of patients for HCV treatment. Secondary outcomes included assessment of factors predicting treatment referral.RESULTSThere were 309 inpatients identified with hepatitis C as a principal or additional diagnosis between January 1 and December 31, 2017. Of these patients, 148 had active HCV infection without prior treatment or spontaneous clearance. Overall, 131 patients were deemed eligible for DAA treatment and included in the main analysis. Mean patient age was 47.75 ± 1.08 years, and 69% of the cohort were male and 13% identified as Aboriginal or Torres Strait Islander. Liver cirrhosis was a complication of hepatitis C in 7% of the study cohort. Only 10 patients were newly diagnosed with HCV infection during the study period with the remainder having been diagnosed prior to the study.CONCLUSIONUnder 25% of hepatitis C patients presenting to an Australian tertiary hospital were appropriately referred for treatment. Advanced age, cirrhosis and admission under medical specialties were predictors of treatment referral.

APA’s Government, Policy, and Advocacy Update (August 2022)

APA’s Government, Policy, and Advocacy Update (August 2022)

Inequality in Private Health Care Expenditures: A 36-Year Trend Study of Iranian Households.

ObjectivesThroughout history, societies have been impacted by inequality. Many studies have been conducted on the topic more broadly, but only a few have investigated inequalities in out-of-pocket health payments (OHP). This study measures OHP inequality trends among the Iranian households.MethodsThis study used data from the Iranian Statistics Center on Iranian household income and expenditures. The analysis included a total of 995 300 households during the 36 years from 1984 to 2019. The Gini coefficient, Atkinson index, and Theil index were calculated for Iranian OHP.ResultsAverage Iranian household OHP increased from 33 US dollar (USD) in 1984 to 47 USD in 2019. During this 36-year span, the average±standard deviation Gini coefficient for OHP was 0.73±0.04, and the Atkinson and Theil indexes were 0.68±0.05 and 1.14±0.29, respectively. The Gini coefficients for the subcategories of OHP of outpatient diagnostic services, medical assistant accessories, hospital inpatient services, and addiction cessation were 0.70, 0.61, 0.84, and 0.64, respectively.ConclusionsIn this study, we scrutinized trends of inequality in the OHP of Iranian households. Inequality in OHP decreased slightly over the past four decades. An analysis of trends among different subgroups revealed that affluent households, such as households with insurance coverage and households in higher income deciles, experienced higher inequality. Therefore, lower inequality in health care expenditures may be related to restricted access to health care services in Iran.

Literature Study Analysis of Daily Inpatient Census Implementation for Reporting of Hospital Inpatient Service Indicators

The implementation of the daily census of hospitalization must be carried out according to procedures properly and correctly so that the data used can be utilized optimally by the hospital. The utilization of this reporting data relates to the mechanism of service procedure flow for the internal and external interests of the hospital. The general objective in this research is to know the implementation of daily inpatient census for reporting of inpatient service indicators incorrect. Method: This research is a literature study with research instruments using google chrome and google scholar. Sample of 6 journals related to the daily census of hospitalizations. The results showed that 6 out of 6 daily census journals of hospitalizations were not in accordance with the procedures both in terms of officers and the implementation of the daily census of hospitalizations. Results: The data sources used in the creation of the daily census of hospitalizations are inpatient register books and medical record documents. The utilization of daily census data of hospitalizations 2 out of 6 journals has utilized daily census data to the maximum because daily census data is used as decision making by hospital management. Conclusions: The advice from this study is that hospitals should create or update fixed procedures and instructions covering all activities of the mechanism for implementing the Daily Census of Hospitalization, and hospitals should hold training or socialization of writing/filling technical instructions and fixed procedures on the Daily Census of Hospitalization.

Patient Satisfaction with Inpatient Hospital Services: A Cross Sectional Survey of Admitted Patients of Combined Military Hospital, Malir Cantt, Karachi

Objective: To assess the level of satisfaction regarding the admission process, treatment process, nursing care and general support services amid patients admitted in various hospital departments.&#x0D; Study Design: Hospital-based cross-sectional survey.&#x0D; Place and Duration of Study: Combined Military Hospital, Malir Cantt, from Oct 2018 to Sep 2019.&#x0D; Methodology: Data was collected from 522 participants. An inpatient feedback form was used to assess satisfaction among admitted patients.&#x0D; Result: Out of 522, 256 (49%) participants ranked health care facilities as excellent and199 (38%) participants ranked health care facilities as good. Out of 53 (10%) participants were satisfied, while only 16 (3%) were discontented with current hospital facilities.&#x0D; Conclusion: This survey has provided deep insight into the contemporary health care services of the hospital. Being a costeffective organization, CMH Malir Cantt has delivered excellent quality care to patients through continuous efforts towards betterment in every discipline deemed to the medical facility.