Large Private Hospital Research Articles

Cautionary lessons from the COVID-19 pandemic: Healthcare systems grappled with the dual responsibility of delivering COVID-19 and non-COVID-19 care.

During the COVID-19 pandemic, hospitals were challenged to provide both COVID-19 and non-COVID treatment. A survey questionnaire was designed and distributed via email to hospitals empanelled under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana(AB-PMJAY), the world's largest National Health Insurance Scheme. Telephonic follow-ups were used to ensure participation in places with inadequate internet. We applied support vector regression to quantify the hospital variables that affected the use vs. non-use of hospital services (Model-1), and factors impacting COVID-19 revenue and staffing levels (Model-2).We quantified the statistical significance of important input variables using Fisher's exact test. The survey, conducted early in the pandemic, included 461 hospitals across 20 states and union territories. Only 55.5% of hospitals were delivering emergency care, 26.7% were doing elective surgery and 36.7% providing obstetric services. Hospitals with adequate supplies of PPE, including N95 masks, and separate facilities designated for COVID-19 patients were more likely to continue providing emergency surgeries and services effectively. Data analysis revealed that large hospitals (> 250 beds) with adequate PPE and dedicated COVID-19 facilities continued both emergency and elective surgeries. Public hospitals were key in pandemic management, large private hospital systems were more likely to conduct non-COVID-19 surgeries, with not-for-profit hospitals performing slightly better. Public and large private not-for-profit hospitals faced fewer staff shortages and revenue declines. In contrast, smaller hospitals (< 50 beds) experienced significant staff attrition due to anxiety, stress and revenue losses. They requested government support for PPE supplies, staff training, testing kits, and special allowances for healthcare workers. The inclusion of COVID-19 coverage under AB-PMJAY improved access to healthcare for critical cases. Maintaining non-COVID-19 care during the pandemic indicates healthcare system resiliency. A state-wide data-driven system for ventilators, beds, and funding support for smaller hospitals, would improve patient care access and collaboration.

The Productivity Spectrum: An Individual-Level Examination of Servers’ Reactions to Workload and Overwork

Purpose: This study explores the diverse reactions of human servers to variations in workload and overwork, focusing on how these stressors influence service time in a call center setting.Study design/methodology/approach: OLS regressions with fixed effects and clustered standard errors were used to analyze the impact of workload and overwork on service time at both aggregate and individual levels.Sample and data: This research utilizes archival data from a call center at a large Kuwaiti private hospital, covering 58,460 calls handled by 23 agents during October 2016.Results: At the aggregate level, workload has a negative effect on service time, indicating a general speedup response, while overwork shows no significant effect. At the individual level, responses vary significantly among agents, with some agents speeding up, others slowing down, and some demonstrating non-linear responses to workload. Overwork responses also vary, with some agents slowing down, others speeding up, and some showing flat responses.Originality/value: This study contributes to the behavioral queuing literature by emphasizing the importance of individual-level analysis in understanding server responses to workload and overwork. The findings reveal that aggregate analyses can mask significant variations in individual behaviors, crucial for optimizing call center performance. By exposing the spectrum of individual reactions, the study provides deeper theoretical and practical insights into the complex dynamics of service time under different work stressors.Research limitations/implications: The findings provide insights for optimizing call center performance, but further research is needed to validate and generalize these findings across different settings and call center environments.

An Audit of PCI Indication at a Large Private Hospital After the Introduction of MBS Appropriate Use Criteria

An Audit of PCI Indication at a Large Private Hospital After the Introduction of MBS Appropriate Use Criteria

Anesthesia for the Patient Undergoing Knee Procedures.

Anesthesia for patients undergoing knee procedures encompasses a large patient population with significant variation in patient age, comorbidities, and type of surgery. In addition, these procedures are performed in vastly different surgical environments, including large academic hospitals, private hospitals, and out-patient surgical centers. These variabilities require a thoughtful and individualized anesthetic approach tailored toward the medical and surgical needs of each patient. This article discusses anesthetic approaches to patients with acute, subacute, and chronic knee-related pathology requiring surgery. We will also review pertinent knee anatomy and innervation and discuss regional nerve blocks and their applications to knee-related surgical procedures.

The relationship between burnout syndrome and emotional intelligence in anesthesiologists during the COVID-19 pandemic: A cross-sectional study

Background Burnout, a type of long-lasting work-related stress, is highly prevalent among health professionals. It includes dimensions of emotional exhaustion, depersonalization and low professional achievement. Emotional intelligence is the ability to accurately perceive, evaluate, and express emotions, to perceive and/or produce feelings that facilitate thought, to understand emotion and acquire emotional knowledge, and to control emotions in order to promote emotional and intellectual growth. Among the extensive literature on burnout, no studies have measured its prevalence among anesthesiologists in Brazil during the COVID-19 pandemic. Studies on the association between emotional intelligence and burnout are also scarce in this population. The aim of this study was to describe the prevalence of burnout in anesthesiologists at a hospital during the COVID-19 pandemic and to assess its association with emotional intelligence. Methods This cross-sectional study was conducted in a large private hospital in southern Brazil. A non-probabilistic convenience sample of anesthesiologists was selected from a hospital's clinical staff. Via Google Forms, participants responded to an anonymous self-applied self-explanatory questionnaire with sections on sociodemographic data, burnout (Maslach Burnout Inventory), and emotional intelligence (Wong and Law's Emotional Intelligence Scale). Descriptive analysis of the variables was performed and the association between burnout and emotional intelligence was evaluated using the Pearson or Spearman correlation coefficient, depending on data distribution. Results A burnout prevalence of 8.1% was found, as well as a strong negative correlation between total burnout scores and emotional intelligence. Conclusions According to the regression analysis, emotional intelligence can be considered an independent factor associated with this outcome.

Lived Experiences of Intensive Care Professional Nurses Caring for COVID-19 Patients in Private Hospitals in Gauteng, South Africa: A Phenomenological Study

Aim. To explore and describe intensive care professional nurses’ experiences caring for COVID-19 patients in private hospitals in Gauteng, South Africa. Introduction. Pandemics are unique forms of disasters characterised by adverse psychological symptoms and behaviours. Literature confirms a globally increased workload during pandemics, causing emotional exhaustion and poor concentration among healthcare workers. Moreover, high mortality rates are mentioned as a cause of moral distress and moral injury to healthcare workers. South Africa was unprepared for the COVID-19 pandemic, as evidenced by overcrowded hospitals, a lack of resources, and high mortality rates. Materials and Methods. A qualitative, phenomenological, exploratory, descriptive, and contextual research design was used. The five largest private hospitals from the same hospital group in Gauteng were chosen as they were admitting many COVID-19 patients. Fifteen participants were selected through purposeful sampling. Semistructured, in-depth, individual interviews were conducted and audio-recorded, and field notes were taken from April 2022 to December 2022. The interviews were transcribed verbatim and analysed using Giorgi’s approach. Results. Three themes emerged: abrupt transition from normality to the COVID-19 pandemic; experienced isolation from family, community, and nursing management; and feelings of satisfaction and gratitude for teamwork and learning. Conclusions. It is essential for nurses’ holistic care to be considered along with patients’ holistic care. The findings in this study could drive healthcare institutions in South Africa to respond to nurses’ health, care, and support needs. Implication for Nursing Management. Nursing management should consider shorter and fewer consecutive workdays for nurses to rest and restore their energy levels. Nurse management should also provide human caring by being visible to the nurses and communicating with them. Holistic self-care practices should be included in nurses’ in-service training programmes.

A transformação digital no gerenciamento do fluxo de leitos nos hospitais

Abstract Purpose: This article aims to identify the benefits and difficulties managers perceive regarding implementing digital transformation (DT) in hospital bed management. Originality/value: The article contributes to academia by analyzing a rele-vant topic, DT of health, that is scarcely explored in the multifactorial perspective of its technological, organizational, and social elements. No similar study was identified with application in a large private hospital located in a developing country. By analyzing managerial perceptions about implementing DT applied to hospital bed management, the study allows a better understanding and potential strengthening of this DT process by the professionals involved, which can contribute to expanding access to hospital care. Design/methodology/approach: A single case study was carried out to investigate the implementation of DT for managing hospital beds in a private general hospital in São Paulo, Brazil. We interviewed 19 managers responsible for hospital bed management. The interviews were analyzed using two methods: content analysis and data mining, and they were classified according to their technological, organizational, and social elements (Reis et al., 2018). Findings: DT’s most cited potential benefits were efficiency gains, real-time information, and employee and patient satisfaction. The main dificulties reported were systems integration, data availability in real-time, instituting new processes, and challenges related to organizational culture and the necessary changes. DT can positively impact bed flow management, but it is crucial to consider the technological, organizational, and social elements involved in its success.

NEONPASS ROOM: UMA FERRAMENTA DE INTERAÇÃO DIGITAL ENTRE PACIENTE, ÁREAS ASSISTENCIAIS E DE GOVERNANÇA HOSPITALAR

ABSTRACT Objective: to report the process of implementing a digital solution for interaction between patients, care and hospital governance areas. Method: this is an experience report on the implementation which took place between the months of August and November in a large private hospital located in the city of São Paulo, Brazil, conducted in two stages: 1) implementation in August 2022; and 2) follow-up lasting 13 weeks, until November 2022. Results: the solution consists of an application developed by a Brazilian startup company which was installed on tablets allowing hospitalized patients to view and make requests for the most diverse areas of care. A total of 496 patients used the Neonpass Room, with their requests addressed directly to the areas of nursing, nutrition, hospitality, cleaning and maintenance. There was a predominance of requests for the nursing team (1029/33.3%), followed by nutrition (973/31.5%), hospitality (763/24.7%), cleaning (167/5.4%) and maintenance (157/5.1%). Conclusion: the Neonpass Room solution has been shown to improve the efficient distribution of requests to the appropriate areas. Unlike traditional call button systems, the digital tool directed demands to nursing and governance areas, with clear specifications.

Evaluation of a chat GPT generated patient information leaflet about laparoscopic cholecystectomy.

Artificial intelligence is increasingly being used in all aspects of life in information compilation and writing, and this includes healthcare. This study aimed to evaluate a Chat GPT generated patient information leaflet (PIL) against a surgeon generated version, in order to explore a potential application of this artificial intelligence language processing model. Cross-sectional study, undertaken May to June 2023, asking two cohorts (patients and doctors) to complete a questionnaire evaluating a Chat GPT generated PIL and a surgeon generated PIL about laparoscopic cholecystectomy. The patients were having laparoscopic cholecystectomy at large private Hospital in Melbourne, Australia, and doctors were recruited from this hospital and a public quaternary hospital in Melbourne, Australia. The study included a convenience sample of 28 patients and 16 doctors. The main outcome measure was a questionnaire (maximum score out of 8) based on validated evaluation instrument for PILs. The study recruited 28 patients and 15 doctors to complete the questionnaire. The Chat GPT and surgeon generated PILs were scored similarly by patients (median 8 for both PIL; mean 7.5 for Chat GPT PIL vs. 7.1 for surgeon PIL). Doctors also scored both versions similarly, with slightly higher scores for Chat GPT over surgeon version (median 7 vs. 6; mean 6.7 vs. 5.6, respectively). The Chat GPT generated PIL was assessed as being as good or slightly better than the surgeon generated version. This study shows that PIL are a feasible application of AI language processing models.

What happened to health labour markets during COVID-19? Insights from the analysis of cross-sectional survey data on the perceptions of medical doctors in Brazil

ObjectivesTo examine physicians’ perceptions of changing employment opportunities in Brazil, and gain an insight into labour markets in low/middle-income countries (LMICs) during the pandemic.Study designDescriptive and inferential analysis of a...

Unintentionally retained foreign objects (URFOs): Adverse events influenced by the pandemic. A case series and literature review

Despite being recognized as a preventable serious adverse event more than a century ago, Unintentionally Retained Foreign Objects (URFOs) continue to occur. They, in fact, remain the second most common Sentinel Event (SE) reported to The Joint Commission (TJC). A large private Hospital, after many years of URFO-free practice, experienced four (4) cases of URFOs during a 12-month period (March 9, 2021–March 4, 2022). Three cases occurred in the Operating Room (OR), and one case occurred in Labor &amp; Delivery. All four cases involved the abdomen. The URFO was a sponge in two cases, a retractor wrapped in a pad in one case, and a surgical specimen in one case. Our review confirmed that the characteristics of our cases were similar to those reported by the Joint Commission. The main contributing factor was the closure of the wound without performing the sponge/instrument count. This safety breach resulted from a combination of factors: the inexperience of the nursing staff caused by a dramatic 40% turnover during the pandemic, the lack of assigned responsibility to perform the counting, and the willingness of the surgeon to skip the count. To address the main factors, we implemented a multipronged approach that includes the following: standardization of the protocols of sponge counting, hand-off with shift change, and of double surgical team involvement; assignment of the counting responsibility to two nurses; and education of the new nurses and of independent practitioners about the OR procedures with monitoring of correct implementation.

Contracting the private health sector in Thailand's Universal Health Coverage.

Private sector plays an import role in health service provision, therefore the engagement of private health facilities is important for ensuring access to health services. In Thailand, two of the three public health insurance schemes, Universal Coverage Scheme and Social Health Insurance, contract with private health facilities to fill gaps of public providers for the provision of health services under Universal Health Coverage. The National Health Security Office (NHSO) and Social Security Office (SSO), which manage the schemes respectively, have designed their own contractual agreements for private facilities. We aim to understand the current situation of contracting private health facilities within UHC of the two purchasing agencies. This qualitative descriptive case study was conducted through document review and in-depth interviews with key informants to understand how they contract private primary care facilities, service types, duration of contract, standard and quality requirement and renewal and termination of contracts. Private providers make a small contribution to the service provision in Thailand as a whole but they are important actors in Bangkok. The current approaches used by two purchasers are not adequate in engaging private sector to fill the gap of public provision in urban cities. One important reason is that large private hospitals do not find public contracts financially attractive. NHSO classifies contracts into 3 categories: main contracting units, primary care units, and referral units; while SSO only contracts main contracting units. Both allows subcontracting by the main contractors. Contractual agreements are effective in ensuring mandatory infrastructure and quality standards. Both purchasers have established technical capacities to enforce quality monitoring and financial compliance although there remains room for improvement especially on identifying fraud and taking legal actions. Contracting private healthcare facilities can fill the gap of public healthcare facilities, especially in urban settings. Purchasers need to balance the right level of incentives and accountability measures to ensure access to quality of care. In contracting private-for-profit providers, strong regulatory enforcement and auditing capacities are necessary. Further studies may explore various aspects contracting outcomes including access, equity, quality and efficiency impacts.

MP07-14 THE ASSOCIATION BETWEEN SOCIOCULTURAL AND PSYCHOSOCIAL FACTORS AND THE SEXUAL FUNCTION OF LATINA WOMEN WITH PELVIC FLOOR DISORDERS

You have accessJournal of UrologyCME1 Apr 2023MP07-14 THE ASSOCIATION BETWEEN SOCIOCULTURAL AND PSYCHOSOCIAL FACTORS AND THE SEXUAL FUNCTION OF LATINA WOMEN WITH PELVIC FLOOR DISORDERS Unwanaobong Nseyo, Nanjun Chen, Madeleine Burg, Claudia Sevilla, Nahid Yousif, Christina Dancz, David Ginsberg, Mariana C. Stern, and Larissa V. Rodriguez Unwanaobong NseyoUnwanaobong Nseyo More articles by this author , Nanjun ChenNanjun Chen More articles by this author , Madeleine BurgMadeleine Burg More articles by this author , Claudia SevillaClaudia Sevilla More articles by this author , Nahid YousifNahid Yousif More articles by this author , Christina DanczChristina Dancz More articles by this author , David GinsbergDavid Ginsberg More articles by this author , Mariana C. SternMariana C. Stern More articles by this author , and Larissa V. RodriguezLarissa V. Rodriguez More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003222.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Female sexual function is impacted by the presence of pelvic floor disorders (PFDs). Racial disparities exist in the relationship between PFDs and sexual function. Little is understood regarding the factors that influence these disparities. We evaluated the demographic, sociocultural, and psychosocial factors, namely stress and discrimination, associated with sexual function among Latina women in a clinical setting. METHODS: We conducted a prospective cross-sectional study of Spanish and English-speaking Latina women with and without PFDs recruited from Urology and Urogynecology clinics at a large private or public hospital. We used validated questionnaires to assess the presence of PFDs, Pelvic Floor Disorders Inventory (PFDI-20), and sexual function, Pelvic Organ Prolapse/Urinary Incontinence Sexual Function questionnaire (PISQ-12). We performed a subset analysis of sexually active women with PFDs. Self-reported psychosocial stress was assessed with the 10-item Perceived Stress Scale (PSS), including protective and negative domains, and the Everyday Discrimination Scale (EDS). We performed linear regression analysis to assess the relationship between PISQ-12 score and demographic, cultural and psychosocial metrics, significant at a value of p-value ≤0.05. RESULTS: Of the 153 total study participants, 53 (34.6 %) completed the PISQ-12 with mean PISQ-12 scores of 29.9 with 8.0, 8.6 and 13.2 on the partner, behavior, and physical domains, respectively. Compared to non-sexually active women, sexually active women were slightly older (50.1 vs 47.9, p=0.34), with significantly worse bowel (27.3 vs 15.2, p=0.005), urinary (67.3 vs 31.8, p<0.001), and prolapse symptoms (45.9 vs 20.8, p<0.001). On linear regression analysis, positive associations were seen with better sexual function and Mexican-American values of familism (p=0.05), respect (p=0.04), religion (p=0.02), and being employed (p=0.05), with a trend towards significance for the PSS negative subscore (p=0.06). A negative correlation was observed for Mainstream values of independence (p=0.05), age (p=0.05). CONCLUSIONS: Among Latina women who presented to clinic for management of their PFDs, better sexual function was more associated with Mexican-American values. The specific domains of the Mexican-American values scale highlight areas of importance for maintaining sexual function despite PFDs for Latina women and suggest sociocultural drivers of disparities in sexual function among racial/ethnic minority women with PFDs. Source of Funding: CTSI Pilot Grant Funding © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e90 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Unwanaobong Nseyo More articles by this author Nanjun Chen More articles by this author Madeleine Burg More articles by this author Claudia Sevilla More articles by this author Nahid Yousif More articles by this author Christina Dancz More articles by this author David Ginsberg More articles by this author Mariana C. Stern More articles by this author Larissa V. Rodriguez More articles by this author Expand All Advertisement PDF downloadLoading ...

Leadership during airway management in the intensive care unit: A video-reflexive ethnography study.

Effective leadership is crucial to team performance within the intensive care unit. This novel study aimed to explore how staff members from an intensive care unit conceptualize leadership and what facilitators and barriers to leadership exist within a simulated workplace. It also aimed to identify factors that intersect with their perceptions of leadership. This study was underpinned by interpretivism, and video-reflexive ethnography was chosen as the methodology for the study. The use of both video recording (to capture the complex interactions occurring in the ICU) and team reflexivity allowed repeated analysis of those interactions by the research team. Purposive sampling was used to recruit participants from an ICU in a large tertiary and private hospital in Australia. Simulation groups were designed to replicate the typical clinical teams involved in airway management within the intensive care unit. Twenty staff participated in the four simulation activities (five staff per simulation group). Each group simulated the intubations of three patients with hypoxia and respiratory distress due to severe COVID-19. All 20 participants who completed the study simulations were invited to attend video-reflexivity sessions with their respective group. Twelve of the 20 participants (60%) from the simulations took part in the reflexive sessions. Video-reflexivity sessions (142 min) were transcribed verbatim. Transcripts were then imported into NVivo software for analysis. The five stages of framework analysis were used to conduct thematic analysis of the video-reflexivity focus group sessions, including the development of a coding framework. All transcripts were coded in NVivo. NVivo queries were conducted to explore patterns in the coding. The following key themes regarding participants' conceptualizations of leadership within the intensive care were identified: (1) leadership is both a group/shared process and individualistic/hierarchical; (2) leadership is communication; and (3) gender is a key leadership dimension. Key facilitators identified were: (1) role allocation; (2) trust, respect and staff familiarity; and (3) the use of checklists. Key barriers identified were: (1) noise and (2) personal protective equipment. The impact of socio-materiality on leadership within the intensive care unit is also identified.

Medical waste management improvement in several private hospitals in Amanat Al-Asimah –Yemen

Handling medical waste presents several environmental challenges in most Yemeni hospitals that need immediate attention before they get out of control. This study aims to assess current practices of medical waste management in some of the major private hospitals in Amanat AlAsimah-Yemen. This study relied on several methods of data collection, visits, observation, and interviews with health cadres, cleaners, and workers in the municipality, with the use of a checklist that contains several questions and then follow-up. The results of the study, which were conducted in the four largest private hospitals in Amanat Al-Asimah, which are the Science and Technology Hospital, Azal Hospital, European Modern Hospital, Dr. Abdul Qader Al Mutawakil Hospital showed that there were no independent and specialized administrative units within the hospitals studied how to manage, follow up on the collection, transport, and disposal of medical waste and the lack of laws and regulations on medical waste management and how to deal with them. Moreover, liquid medical waste is discharged through a sewage network that is treated only from organic matter regardless of harmful chemicals that in turn affect humans, the environment, and agriculture.

Factors influencing decision making to use large private hospitals of Thai patients in Bangkok after COVID-19 outbreak

Factors influencing decision making to use large private hospitals of Thai patients in Bangkok after COVID-19 outbreak

The penetration of financial capital and the growth of private hospital groups in Europe: the case of Spain (1975–2022)

AbstractFrom the last decades of the twentieth century, above all, in the more service-oriented post-industrial economies, and in a context of debilitation of public health systems, health care became exponentially profitable, thereby attracting new types of investors. In fact, this new stage entails moving from the commercialisation of health care to its financialisation; that is, medical care becomes just one more financial asset and its price and quality are quoted on the stock exchange. This study intends to participate in the debate initiated by historians of medicine and economic historians with the aim of tracing capitalist traits and market participation in the evolution of health coverage, a process initially promoted by professional doctors who converted their consulting rooms into small clinics and larger hospital companies and which, over time, saw the incorporation of financial capital. In particular, this paper has two specific objectives for the case of Spain. First, to analyse the relationship of collaboration and/or competition between public and private hospitals under democracy and the factors that have conditioned this relationship. Second, to make an initial contribution towards understanding how, in this context, the large private hospital groups have been created in Spain during this period, especially in recent decades with concentration in the hands of financial capital, originating from both the traditional banking sector and investment funds.

Implementation and Outcomes of a Model of Care for Placenta Accreta Spectrum in a Community-Based Private Practice.

The aim of the study is to describe a model of care and outcomes for placenta accreta spectrum (PAS) implemented in the context of a community based non-academic health system. The program for management of PAS includes a multidisciplinary team approach with protocols for ultrasound assessment, diagnosis, and surgery. The program was implemented in the two largest private hospitals in the Twin Cities, Minnesota, United States. Maternal and fetal outcomes as well as cost were compared for histopathologic confirmed PAS cases before (2007-2014, n = 41) and after (2015-2017, n = 26) implementation of the PAS program. Implementation of the PAS program was associated with ICU admission reductions from 53.7 to 19.2%, p = 0.005; a decrease of 1,682 mL in mean estimated blood loss (EBL) (p = 0.061); a decrease in transfusion from 85.4 to 53.9% (p = 0.005). The PAS program also resulted in a (non-significant) decrease in both surgical complications from 48.8 to 38.5% (p = 0.408) and postoperative complications from 61.0 to 42.3% (p = 0.135). The total cost of care for PAS cases in the 3 years after implementation of the program decreased by 33%. The implementation of a model of care for PAS led by a perinatology practice at a large regional non-academic referral center resulted in reductions of ICU admissions, operating time, transfusion, selected surgical complications, overall postoperative complications, and cost. · Implementation of a PAS care model resulted in reduced ICU admissions from 53.7% to 19.2%.. · Patient safety increased by reducing blood loss, transfusions and postoperative complications.. · This model decreased operating time, as well as total cost of care by 33%..

Reviewing a model of public-private mix employed for tuberculosis control in Pakistan

This narrative review of the public private mix (PPM) TB plan by comprehensively evaluated the performance of this initiative in case reporting, management, treatment outcome, affordability, and accessibility from the district health system data to the TB Control Programs. Comprehensive literature review was done from the peer-reviewed journals; reports including global and national TB control programs along with technical guidelines on PPM were reviewed. This paper focusses on PPM model in the TB case notification since its establishment in Pakistan based on the data reported by national TB control mechanisms by reviewing the involvement of and TB case contribution by private health care providers, active case finding through chest camps, TB case finding through enhanced case findings in large private hospitals, and case finding through lady health workers. PPM is a promising strategy for TB care and control and scaling up of PPM should include financial support in addition to material inputs. Moreover, improving program governance and training for the health care providers with the help of integrated collaborative mechanisms is warranted. There should be a standard reporting system for private practitioners for setting up standard guidelines for the Tuberculosis treatment.

Hypertension screening, prevalence, treatment, and control at a large private hospital in Kampala, Uganda: A retrospective analysis.

Adult hypertension prevalence in Uganda is 27%, but only 8% are aware of their diagnosis, accordingly treatment and control levels are limited. The private sector provides at least half of care nationwide, but little is known about its effectiveness in hypertension control. We analyzed clinical data from 39 235 outpatient visits among 17 777 adult patients from July 2017 to August 2018 at Uganda's largest private hospital. We calculated blood pressure screening rate at every visit, and hypertension prevalence, medication treatment, and control rates among the 5 090 patients with two or more blood pressure checks who received any medications from the hospital's pharmacy. We defined hypertension in this group as 1) an average of two blood pressure measurements at separate consecutive visits, higher than 140 mm Hg systolic or 90 mm Hg diastolic, 2) receipt of any antihypertensive medication, or 3) the use of a hypertension electronic medical record code. We deemed hypertension control as normotensive at the most recent check. 12 821 (72.1%) of patients received at least 1 blood pressure check. Among the 5 090 patients above, 2 121 (41.6%) had hypertension (33.4% age-standardized to a world population standard): 1 915 (37.6%) with elevated blood pressure, and 170 (3.3%) were normotensive but receiving medication. 838 (39.4%) of patients with hypertension received medication at least once. Overall, 18.3% of patients achieved control (27% of treated patients, and 15% of untreated patients). Hypertension is common and incompletely controlled in this Ugandan private-sector population, suggesting several avenues for novel interventions.