Private Hospital Patients Research Articles

ASSESSMENT OF WHO/INRUD CORE DRUG USE INDICATORS AT PUBLIC AND PRIVATE HEALTHCARE CENTRES IN LAHORE, PAKISTAN: A MULTICENTRE CROSS-SECTIONAL STUDY

Background: A key element of the pharmaceutical care plan is the appropriate use of medications. Objectives: Using the WHO/INRUD core drug use indicators, this study sought to evaluate medication usage trends at both public and private healthcare centres in the Lahore district of the Punjab province of Pakistan. Methodology: A cross-sectional and descriptive study design was adopted. For data collection, 399 prescriptions (199 prescriptions from public and 200 prescriptions from private healthcare facilities) were systematically sampled written from February to July 2022. To evaluate the prescription indicator, patient-care and facility-specific indicators, patients randomly selected from both public and private hospitals were examined and interviewed. For each of the WHO/INRUD indicators, we considered ideal criteria that have been published. Results: The average number of medicines prescribed each encounter was reported to be 6.26% in public hospitals and 4.14% in private hospitals among the prescribing indicators, generic medication, antibiotics, and the number of times patients received injections were prescribed, respectively, in 54%, 84%, and 89% of public hospitals and 19%, 61.7%, and 78% of private hospitals. In the public and private sectors, respectively, 71% and 97% of prescription drugs were from the list of essential drugs. The average consultation time was found to be 2.1 minutes in public hospitals and 3.2 minutes in private hospitals, while the average dispensing time was reported to be 37 seconds in public hospitals and 39 seconds in private hospitals. Of the total prescribed medicines, 84% and 97 % were dispensed in public and private hospitals respectively and the percent medicine adequately labelled was 100% in both healthcare facilities. Regarding patient awareness, 69% of patients in private hospitals and 42.5% of patients in public hospitals were aware of the proper dosage, frequency, and duration of the medications that were prescribed. In terms of facility-specific data, both public and private hospitals had 100% availability of the EDL copy and 82% stock of the important medications, respectively. Conclusion: Irrational use of drugs was observed in both public and private healthcare facilities. WHO/INRUD proposed 12 key initiatives to encourage rational use of medications must be put into practice as a result of present study.

Prevalence and comparison of psychological trauma and stressors in functional seizure patients from a public and private hospital.

To date not much is known about the differences, if any, between patients with functional seizures (FS) from different socioeconomic backgrounds. We sought to compare the psychological stress and trauma profiles of patients with FS from a private and public hospital in Cape Town, South Africa. Only video-electroencephalography-confirmed patients with FS were eligible for the study. In this retrospective case-control study we collected data on self-reported demographic and psychological stressor/trauma variables using digital patient records starting with the earliest available digital patient record for each hospital. A total of 321 patients from a private hospital and 68 patients from a public hospital were included in the study. Most factors showed no significant differences. However, public hospital patients had higher odds of being older (p=0.002), almost nine times the odds of reporting physical violence by an intimate partner (aOR=8.65, 95% CI [1.70, 44.08]), more than eight times the odds of reporting psychological stress in the form of death and/or sickness in the family (aOR=8.56, 95% CI [1.81, 40.41]) and almost three times the odds for other general psychosocial stressors (aOR=2.82, 95% CI [1.08, 7.42]) compared to those attending the private hospital. They also had half the odds of being female compared to the private hospital patients (aOR=0.47, 95% CI [0.23, 0.95]) and 93% fewer odds of reporting coming from an abusive home (aOR=0.07, 95% CI [0.01, 0.52]). History and psychological trauma and stressor profiles showed many similarities between the public and private hospital groups; however, some differences were noted and could benefit further exploration and consideration in therapeutic and diagnostic contexts.

Evaluation of Patients Satisfaction Level and Quality of Life (QOL) Receiving Physical Therapy Care for Musculoskeletal Disorders in Public and Private Hospitals

Patients’ satisfaction is the experience of an attitude and effective response that is related to beliefs that the physiotherapy service provided to patient must have adequate component and dimension. Objective: To measure the satisfaction level and quality of life of patients in both public and private hospitals of Faisalabad. Methods: It was a comparative cross-sectional study with sample size of 278. A simple random sampling technique was used to collect data from patients receiving physical therapy care in both the public and private sectors. The outcome measures of the study were the multidimensional "Queen Mary's Satisfaction Survey" and the "SF-36 Questionnaire" to check level of satisfaction and overall QOL. The collected data were then analyzed by SPSS version-22. Results: About 6.5% patients from government and 35% from private hospitals were highly satisfied from the physiotherapy services.46% patients from government and 64% from private reported to have an excellent quality of life. Independent t-test revealed that p value was less than 0.05 for both satisfaction level and quality of life in patients receiving physiotherapy from private and government sectors of Faisalabad. Conclusions: A significant difference was found between quality of life and satisfaction level of patients receiving physiotherapy from private and government hospitals of Faisalabad. Patients of private hospital reported higher level of satisfaction and QOL as compared to the government hospitals.

تأثير تجربة تعديل الخدمة على تغيير نيات المرضى وتناقل الكلام الإيجابي في المستشفيات الخاصة في الكويت: تأثير التزام المريض كمتغير وسيط

Objectives: Touchpoints of the service recovery experience in private hospitals in Kuwait were identified and validated. Then, a research model was developed to study the effect of service recovery experience on patient’s switching intentions and positive word of mouth with patient commitment as a mediator. Method: Service recovery touchpoints of patient experience were identified by focus group and a sample of private hospital patients in Kuwait was recruited using a snowballing sampling procedure with an online-survey platform. The proposed research model was validated via two-stage structural equation modeling in AMOS 27 statistical software. Path analysis examined the mediating effects of patient commitment in the examined relationships. A sample of 171 patients in private hospitals in Kuwait was recruited for the exploratory factor analysis [EFA] and a separate sample of 976 patients was recruited for the confirmatory factor analysis [CFA]. Results: The findings confirmed a significant direct effect of service recovery experience on patients’ positive word of mouth and a significant indirect effect through patient commitment as a mediator. On contrary, service recovery experience was related to patients’ switching intentions only through the indirect link of patient commitment, which provided support for the full mediation model. Conclusion: Private hospitals should pay much attention to service recovery experience and allocate resources across critical touchpoints to enhance patient relationship.

Identifying the Use of Indonesian Nursing Diagnosis Standards In COVID-19 Patients In Malang Private Hospital

This study aimed to determine the number and name of the diagnoses that often appear in COVID-19 patients in 2020-2022 at RIC-19, one of the private hospitals in Malang, as seen from medical records. The method used was a descriptive retrospective with a quantitative approach. This study used secondary data in the form of medical records of patients diagnosed with COVID-19 in private hospitals in Malang from March 2020 to March 2022. The results found that there were eight nursing diagnoses including hyperthermia, ineffective airway clearance, impaired gas exchange, acute pain, diarrhoea, risk of ineffective cerebral perfusion, nausea, and risk of nutritional deficits. The nursing diagnoses that often appear in COVID-19 patients in private hospitals in Malang are the same as the results of the study according to Hidayati et al. (2022) which states that the nursing diagnosis “cleansing ineffective airway” is the most dominant. However, these results do not include the signs and symptoms of minor and major patients in detail. The findings above illustrate that the documentation of nursing care by nurses is still not optimal, not structured assessment of initial nursing performed by the nurse on duty affects the implementation of nursing care. This can be an input for hospitals to continue to improve quality in documenting nursing care in the future.
 Keywords: Standard Indonesian Nursing Diagnosis; COVID-19; Nursing care

Experiences of nurses regarding challenges faced while dealing with psychiatric patients in both public and private tertiary care hospitals of Karachi, Pakistan.

To explore the challenges of mental health nurses in dealing with psychiatric patients. The qualitative, descriptive, phenomenological study was conducted at three public and private psychiatric setups in Karachi from August 13 to October 30, 2018, and comprised mental health nurses having a minimum 6-month experience of working in a psychiatric ward. Data was collected using focus group discussion using a semi-structured interview guide. The proceedings were transcribed, translated and analysed using thematic analysis, leading to the formation of themes, categories and sub-categories. Of the 15 nurses with mean age 25±1.95 years, 5(33.3%) were from the public sector and 10(66.6%) were associated with private-sector institutions. Besides, 7(46.6%) nurses had work experience up to 5 years. There were three sessions of focus group discussion; 1(33.3%) of public-sector nurses and 2(66.6%) of priver-sector nurses. Each session had 5(33.3%) participants. Post-transcription feedback was provided by 8(53%) nurses. There were 4 themes; lack of resources, safety-related challenges, lack of staff capacity building, and lack of support. The themes overall had 14 categories and 7 sub-categories. The nurses exposed to patient aggression should be provided debriefing sessions to deal with possible burnout.

Performance of Covid-19 Waste Management at Health Service Facilities in North Toraja Regency

Community health centers are the frontliners of healthcare services which in its activities produces medical waste and non-medical waste both in solid and liquid form. This waste needs to be managed in accordance with existing regulations where environmental management must be carried out systematically and sustainably. Regarding the management of Covid-19 medical waste in the health facilities of North Toraja Regency, this study aims to determine the management process, management constraints and compare the management of wastewater and hazardous and toxic solid medical waste generated from handling Covid-19 patients at hospitals and health centers in Toraja Regency. North. The research method used is descriptive research method with case study design. Data collection techniques are carried out by observations, interviews, and documentation of secondary data. The results show that the management of hazardous and toxic solid medical waste water and waste for Covid-19 patients in private hospitals leaves the processing to third parties and government hospitals destroy solid hazardous medical waste with incinerators, while at community health center the wastewater is directly discharged into water bodies and medical hazardous waste. handed over to a third party. The process of treating waste water and hazardous and toxic solid medical waste for Covid-19 patients at the health facilities of North Toraja Regency has not been in accordance with the guidelines issued by the Indonesian Ministry of Health. The main obstacle in processing solid medical waste water and hazardous waste for Covid-19 patients at the health facilities of North Toraja Regency is the lacking of operational costs and delays in disbursing operational costs. Government-owned hospitals were found to be slow to comply the Covid-19 Health Facilities Waste Management Guidelines issued by the Ministry of Health of the Republic of Indonesia.

Health Care Disparities in Transsphenoidal Surgery for Pituitary Tumors: An Experience from Neighboring Urban Public and Private Hospitals.

Objectives Few studies have assessed the role of socioeconomic health care disparities in skull base pathologies. We compared the clinical history and outcomes of pituitary tumors at private and public hospitals to delineate whether health care disparities exist in pituitary tumor surgery. Methods We reviewed the records of patients who underwent transsphenoidal pituitary tumor resection at NYU Langone Health and Bellevue Hospital. Seventy-two consecutive patients were identified from each hospital. The primary outcome was time-to-surgery from initial recommendation. Secondary outcomes included postoperative diabetes insipidus, cerebrospinal fluid (CSF) leak, and gross total resection. Results Of 144 patients, 23 (32%) public hospital patients and 24 (33%) private hospital patients had functional adenomas ( p = 0.29). Mean ages for public and private hospital patients were 46.5 and 51.1 years, respectively ( p = 0.06). Private hospital patients more often identified as white ( p < 0.001), spoke English ( p < 0.001), and had private insurance ( p < 0.001). The average time-to-surgery for public and private hospital patients were 46.2 and 34.8 days, respectively ( p = 0.39). No statistically significant differences were found in symptom duration, tumor size, reoperation, CSF leak, or postoperative length of stay; however, public hospital patients more frequently required emergency surgery ( p = 0.03), developed transient diabetes insipidus ( p = 0.02), and underwent subtotal resection ( p = 0.04). Conclusion Significant socioeconomic differences exist among patients undergoing pituitary surgery at our institution's hospitals. Public hospital patients more often required emergency surgery, developed diabetes insipidus, and underwent subtotal tumor resection. Identifying these differences is an imperative initial step in improving the care of our patients.

A nationwide study of patients operated for cervical degenerative disorders in public and private hospitals

During the last decades, there has been an increase in the rate of surgery for degenerative disorders of the cervical spine and in the use of supplementary private health insurance. Still, there is limited knowledge about the differences in characteristics of patients operated in public and private hospitals. Therefore, we aimed at comparing sociodemographic-, clinical- and patient management data on patients operated for degenerative cervical radiculopathy and degenerative cervical myelopathy in public and private hospitals in Norway. This was a cross-sectional study on patients in the Norwegian Registry for Spine Surgery operated for degenerative cervical radiculopathy and degenerative cervical myelopathy between January 2012 and December 2020. At admission for surgery, we assessed disability by the following patient reported outcome measures (PROMs): neck disability index (NDI), EuroQol-5D (EQ-5D) and numerical rating scales for neck pain (NRS-NP) and arm pain (NRS-AP). Among 9161 patients, 7344 (80.2%) procedures were performed in public hospitals and 1817 (19.8%) in private hospitals. Mean age was 52.1 years in public hospitals and 49.7 years in private hospitals (P < 0.001). More women were operated in public hospitals (47.9%) than in private hospitals (31.6%) (P < 0.001). A larger proportion of patients in private hospitals had high education (≥ 4 years of college or university) (42.9% vs 35.6%, P < 0.001). Patients in public hospitals had worse disease-specific health problems than those in private hospitals: unadjusted NDI mean difference was 5.2 (95% CI 4.4 – 6.0; P < 0.001) and adjusted NDI mean difference was 3.4 (95% CI 2.5 – 4.2; P < 0.001), and they also had longer duration of symptoms (P < 0.001). Duration of surgery (mean difference 29 minutes, 95% CI 27.1 – 30.7; P < 0.001) and length of hospital stay (mean difference 2 days, 95% CI 2.3 – 2.4; P < 0.001) were longer in public hospitals. In conclusion, patients operated for degenerative cervical spine in private hospitals were healthier, younger, better educated and more often men. They also had less and shorter duration of symptoms and seemed to be managed more efficiently. Our findings indicate that access to cervical spine surgery in private hospitals could be skewed in favour of patients with higher socioeconomic status.

A comparative study to assess the quality of nursing care rendered by staff nurses and the level of satisfaction perceived by patients in selected wards of selected government and private hospitals of Srinagar, Kashmir

The objectives of the study were to assess the quality of nursing care rendered by staff nurses in medical and surgical wards of government and private hospitals, to compare the quality of nursing care rendered by staff nurses in medical and surgical wards of government and private Hospitals, to find association between quality of nursing care rendered by staff nurses and selected demographic variables, to assess the level of satisfaction perceived by patients in medical and surgical wards of government and private hospitals, to compare the level of satisfaction perceived by patients in medical and surgical wards of government and private hospitals, to find association between level of satisfaction perceived by patients and selected demographic variables.Quantitative research approach and (descriptive comparative) research design was used. Tools used for data collection comprised of a structured observation checklist to assess quality of nursing care and a structured patient satisfaction questionnaire for assessment of patient satisfaction. Convenient sampling was adopted to select the 60 staff nurses, 30 from each hospital and 60 patients, 30 from each hospital. The study was conducted at a government (SMHS) hospital and a private (Noorah) Hospital, Srinagar.Data was analyzed and interpreted using both descriptive and inferential statistics. The findings showed that better quality of nursing care was rendered by staff nurses in private than in the government hospital. In government hospital, the areas in which staff nurses rendered good quality of care were nurse’s communication and behavior and patient safety, average quality in areas of documentation and environment and poor quality in the area of general nursing care. In case of private hospital, good quality of nursing care was rendered under the areas environment, patient safety, nurse’s communication and behavior and average quality of nursing care was rendered in the area documentation. No significant association was found between the quality of nursing care and selected demographic variables viz. age, educational qualification and years of work experience in both hospitals. A significant association was found between the level of satisfaction perceived by patients and age and marital status, and no significant association with gender, days of stay in the hospital and history of previous hospitalization in the government hospital. On average, in the government hospital, patients were satisfied with nurse’s communication and behavior and were dissatisfied with general nursing care and care facilities in the ward. In private hospital, no significant association was found between the level of satisfaction perceived by patients and demographic variables viz. age, gender, marital status, days of stay in the hospital and history of previous hospitalization. In the private hospital, on average the patients were satisfied with the general nursing care and nurse’s communication and behavior but were dissatisfied with care facilities in the ward.The study concluded that better quality of nursing care is rendered by staff nurses in private hospital than in government hospital. The level of satisfaction perceived by patients in private hospitals is better in private hospital than in government hospital.

SURGICAL SITE INFECTIONS: PREVALENCE, ASSOCIATED FACTORS AND ANTIMICROBIAL SUSCEPTIBILITY PATTERNS OF THE BACTERIAL ISOLATES AMONG POSTOPERATIVE PATIENTS IN SANA’A, YEMEN

Background: Surgical site infections (SSIs) are infections that occur one month after a surgical operation or one year after implant surgery and a surgical procedure, either at the injury site or near the injury site. Despite SSIs are still a major problem causing increased morbidity and mortality globally, especially in developing countries, there is a dearth of information in Yemen. Objective: This study was aimed to assess the prevalence of SSIs, associated factors and antimicrobial susceptibility patterns of the bacterial isolates among post-operative patients in public and private hospitals in Sana’a, Yemen. Methods: This is a cross-sectional study carried out on 309 postoperative patients, aged one year and over that underwent surgery in selected public and private hospitals between January 2019 and January 2020 in Sana’a. Patients’ demographic and clinical information were assessed using an interviewer-administered, pretested, structured questionnaire. Wound swabs and aspirates were collected, placed in Stuart transport media and transferred to the Bacteriology Department of the National Center for Public Health Laboratories in Sana’a for bacterial isolation, identification and antimicrobial susceptibility testing.. Results: The mean age of postoperative patients was 34.0±18.3 (SD) years, age group 25-34 years was 93 (30.1%), and females were 105 (33.8%). Total 309 postoperative patients, 98 (31.7%) presented with SSI. Having postoperative antibiotics (OR=7.0, 95%CI: 4.1-12.0), dirty surgical wound (OR=10.5, 95%CI: 5.0-21.9), emergency surgery (OR=3.1, 95%CI: 1.8-5.1), amputation (OR=2.5, 95%CI: 1.1-5.7), excision (OR=2.2, 95%CI: 1.2-4.0), hospital stay &gt; two weeks (OR=5.2, 95%CI: 2.3-11.1) and having diabetes mellitus (OR=2.2, 95%CI: 1.1-4.7) were factors significantly associated with SSIs. Conclusion: This study shows a significant proportion of SSIs among patients in Sana’a, Yemen. Being a female, having a dirty surgical wound, amputation, excision, long hospital stays, diabetes mellitus, and emergency surgery appears to be the major factors associated with SSIs. The most common SSI bacterial etiology is S. aureus, sensitive to vancomycin and rifampicin. Peer Review History: Received: 10 May 2022; Revised: 12 June; Accepted: 30 June, Available online: 15 July 2022 Academic Editor: Prof. Dr. Gorkem Dulger, Duzce University, Turkey, gorkemdulger@yandex.com UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewers: Dr. Bountain Welcome Tebeda,Chemical Pathology Department, Federal Medical Centre, Yenagoa, Nigeria. bountaintebeda@yahoo.com Dr. Esther Marguerite Chase DJANGA, Faculty of Medicine and Biomedical Sciences. Department of Public Health. University of Yaoundé I, Cameroon. e.djanga@yahoo.com Similar Articles: EFFECT OF MOST COMMON ANTIBIOTICS AGAINST BACTERIA ISOLATED FROM SURGICAL WOUNDS IN ADEN GOVERNORATE HOSPITALS, YEMEN PREVALENCE OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) AND ANTIMICROBIAL SUSCEPTIBILITY PATTERNS AT A PRIVATE HOSPITAL IN SANA'A, YEMEN

Effect of relationship marketing on hospital loyalty: the mediating role of patient satisfaction

PurposeThis study aims to reveal the mediating role of patient satisfaction on the impact of relationship marketing on hospital loyalty.Design/methodology/approachThe scale questionnaires used in the study was the Relationship Marketing, Hospital Loyalty and the Patient Satisfaction Scale. The population of the study is made up of the patients who received in-hospital services in private hospitals operating in Kocaeli province. The field study was conducted between August 1 and October 31, 2019. After determining the sample size, the study was conducted on 401 patients in private hospitals primarily using the purposive sampling method. Descriptive statistics, correlation analysis and statistical package for the social sciences Process Macro were used to analyze the data.FindingsAccording to the findings of this study, patient satisfaction has an effect on hospital loyalty. Relationship marketing has an impact on hospital loyalty, and this effect is further enhanced by patient satisfaction. In other words, patient satisfaction has a mediating role in the impact of relationship marketing on hospital loyalty. Relationship marketing plays an important role in creating hospital loyalty and patient satisfaction. For this reason, it is recommended that health institutions adopt relationship marketing practices. Hospital loyalty and patient satisfaction will be ensured through relationship marketing. This will allow the health-care institution to continue to exist and to be more advantageous than other institutions.Originality/valueThe uniqueness of the paper lies not only in the only regression findings but also in the methodology used to capture the impact of the lagged effect of marketing relationships on hospital loyalty. Specifically, a regression model is based on both direct and indirect effects.

Impact of Patient Communication Preferences on the Patient Trust in Physicians: A Cross-Sectional Study in Iranian Outpatient's Clinics.

There are widely emerging concerns that patient confidence in physicians is diminishing as physician–patient communication is threatened globally. This study aimed to assess patient communication preferences and their impact on patient trust in physicians. A cross-sectional study was conducted among outpatient clinics of 2 public and private hospitals in Tabriz, Iran. A total of 704 patients were selected conveniently. Of the 704 patients, 6.39% had low trust, 36.79% moderate trust, 35.37% had a high trust, and 21.45% had blind trust in physicians. Overall patient communication preference score was more in a private clinic rather than a public one (P = .008). Patients of private hospitals and those who were living in rural areas have been shown to have more trust in physicians. Patients’ trust in physicians showed a significant association with patient communication preference (B = 0.58; 95% CI: 0.53-0.63, P < .001).

Evaluation on public and private health care delivery in COVID19

Background: In Korea, there are two healthcare delivery sectors: public and private. The purpose of this study is to compare public and private healthcare delivery in the context of COVID-19 and evaluate healthcare delivery to patients with medical benefits.Methods: Data from the Korea Centersfor Disease Control and Prevention (KCDC), the Health Insurance Reviewand Assessment Service claimdata, and the Ministry ofHealth andWelfarewere analyzed fromJanuary 2020 to February 2021.Results: During the observation period, the cumulative number of patients with the most severe cases was 1,566, and the proportion of inpatients with the most severe cases by healthcare facilities types were: 44.2% (692 patients) in regional public hospitals, 8.9% (140 patients) in national university hospitals, and 22.9% (358 patients) in other types of public hospitals, and 24.0% (376 patients) of private hospitals. The proportion of patients receiving medical benefits by health care institutions was 13.9% in regional public hospitals, 6.7% in national university hospitals, and 7.1% in other public hospitals.Conclusions: The debate about the roles and functions of public and private hospitalsis ongoing. Ratherthan classifying according to the establishment entity, it is necessary to seek ways to achieve the ultimate goal of the medical system, which isto protect people’slives and promote health.

An integrative model of patients\u2019 perceived value of healthcare service quality in North Cyprus

BackgroundImproving healthcare quality has become an essential objective for all health institutions worldwide to address the need to improve services, manage costs and satisfy patient expectations about the quality of care. As health is one of the leading service sectors of the North Cyprus economy, analysing patients’ perceived value of healthcare service quality is crucial. In this research, a comparative analysis of existing models revealed affordability, acceptability and accessibility as the leading modern service quality indicators affecting patients’ perceived value of healthcare service quality. The quality of services is a leading factor impacting business competition and retention dictated by the current market. This study aimed to investigate the factors that influence patient perceptions of healthcare service quality in North Cyprus.MethodsA self-administered questionnaire was carried out among 388 patients of public and private hospitals in North Cyprus, and the data were analysed using partial least squares-structural equation modelling.ResultsEmpirical results highlight that the acceptability of healthcare services is a prerequisite for perceiving a high value of service quality. The affordability and accessibility of services, respectively, were less effective. Results concerning mediating effects confirm that acceptability could fully mediate the relationship between affordability and perceived value and could partially mediate the impact of accessibility on the perceived quality of healthcare services.ConclusionThis study contributes to healthcare theory and practice by developing a conceptual framework to provide policymakers and managers with a practical understanding of factors that affect healthcare service quality.

Investigating the Outcomes of an Asthma Educational Program and Useful Influence in Public Policy.

The study was conducted to evaluate the effectiveness of an asthma educational program for asthma control, asthma self-management, asthma knowledge, and patient activation. The study analyzes different demographic variables with the purpose of investigating which asthma patients performed better than others. Based on these demographic characteristics, the study provides several recommendations for various stakeholders. The study is based on a positivist approach since its purpose is to investigate the consequences of an asthma educational program with a view to generalizing the results to a larger population. The study targets public and private hospitals which have applied the asthma educational program in collaboration with the Saudi Initiative for Asthma (SINA). Multiple questionnaires were deployed 263 valid responses were received from patients of public and private hospitals using online and offline data collection method. Several parametric and non-parametric tests were carried out in terms of data analysis. The results reveal that patients in the intervention group obtained high scores and were therefore more knowledgeable and able to control their asthma compared to the control group. Overall, patients in the intervention group performed better in terms of asthma control, asthma self-management and knowledge and awareness. There was a high level of patient activation in this group. In the context of demographic features, it was found that patients who are married and are undergraduate degree holders in employment scored high compared to patients who were young, single, post-graduate degree holders that were mainly self-employed. The results of this study can guide policy makers, SINA authorities, and hospitals as to which demographic category of asthma patients require immediate attention. The significance of asthma educational programmes has increased especially through social media platforms as the number of adult patients continues to increase day by day.

Depression, Anxiety and Stress Levels among Chronic Disease Patients During COVID-19 Pandemic in Dessie Town Hospitals, Ethiopia

Introduction: Coronavirus disease 2019 was first detected in China in December 2019. In Ethiopia, depression, anxiety, and stress levels of chronic disease patients were not known during COVID-19. Thus, this study aimed to assess depression, anxiety, and stress levels of chronic disease patients in government and private hospitals of Dessie town during COVID-19. Methods: Hospital-based cross-sectional study design was used. The Depression Anxiety and Stress Scale-21 was used to measure depression, anxiety, and stress of chronic disease patients during the current pandemic. Both binary and multivariate logistic regression analyses were performed to identify factors, and a significant association was declared at p-value &lt; 0.05 in multivariate analysis. Results and Discussion: The overall anxiety, depression, and stress level were 19.9%, 21.5%, and 17.7%, respectively. In multivariate analysis, older age, female gender, urban residency, duration of living with chronic diseases, and presence of comorbidities were associated with depression of chronic disease patients during the pandemic at p-value &lt;0.05. Age, female gender, presence of comorbidities, and no social support were associated with anxiety. Urban residency, use of hand sanitizer, those who had respiratory manifestations, and travel history in the last two weeks were significantly associated with stress levels. Conclusion: A significant number of chronic disease patients had depression, anxiety, and stress during the COVID-19 pandemic. Therefore, governmental and non-governmental organizations, health professionals, media, and hospital administrators should be involved to decrease the depression, anxiety, and stress of chronic disease patients during the pandemic. Moreover, we encourage researchers to conduct comparative longitudinal studies to assess depression, anxiety, and stress levels of chronic disease patients before and after the onset of the COVID-19 pandemic.

Main factors affecting perceived quality in healthcare: a patient perspective approach

PurposeDelivering patient-centered healthcare is now seen as one of the basic requirements of good quality care. In this research, the impact of the perceived quality of three experiential dimensions (Physical Environment, Empowerment and Dignity and Patient–Doctor Relationship) on patient's Experiential Satisfaction is assessed.Design/methodology/approach259 structured interviews were performed with patients in private and public hospitals across Italy. The research methodology is based in testing mediation and moderation effects of the selected variables.FindingsThe study shows that: perceived quality of Physical Environment has a positive impact on patient's Experiential Satisfaction; perceived quality of Empowerment and Dignity and perceived quality of Patient–Doctor Relationship mediate this relationship reinforcing the role of Physical Environment on Experiential Satisfaction; educational level is a moderator in the relationship between perceived quality of Patient–Doctor Relationship and overall Satisfaction: more educated patients pay more attention to relational items. Subjective Health Frailty is a moderator in all the tested relationships with Experiential Satisfaction: patients who perceive their health as frail are more reactive to the quality of the above-mentioned variables.Originality/valuePhysical Environment items are enablers of both Empowerment and Dignity and Patient–Doctor Relationship and these variables must be addressed all together in order to improve the value proposition provided to patients. Designing a hospital, beyond technical requirements that modern medicine demands and functional relationships between different medical departments, means dealing with issues like the anxiety of the patient, the stressful working environment for the hospital staff and the need to build a sustainable and healing building.

Short- and Long-Term Outcomes After Transcatheter Aortic Valve Implantation in Public and Private Hospital Settings: A Propensity-Matched Analysis

To compare short- and long-term outcomes after transcatheter aortic valve implantation (TAVI) in the public and private hospital setting. Propensity-matched, retrospective analysis of a prospective registry. Patients with severe aortic stenosis who underwent TAVI at a tertiary public hospital (n=507) and an experienced private hospital (n=436). The primary endpoint was all-cause mortality. Patients that underwent TAVI in the public hospital were younger than patients in the private hospital (82±8 years vs 84±6 years, p<0.001), with lower estimated short-term mortality risk (Society of Thoracic Surgeons Predicted Risk of Mortality [STS-PROM] score >4.0%: 43% vs 56%, p<0.001). There was no difference between public and private hospitals in 30-day mortality (1.5% vs 1.2%, p=1.0), and the rate of complications was similar. Long-term survival was similar in propensity-matched public (n=344) and private (n=344) patient cohorts. The 1-year, 2-year, 5-year and 7-year survival rates were 95%, 90%, 67% and 47% in public patients, and 92%, 86%, 67% and 51% in private patients (p=0.94). In multivariable analysis, the hospital setting was not a predictor of mortality. Despite increased age and predicted mortality in private hospital patients, short- and long-term outcomes after TAVI were comparable between public and private hospital settings. This study demonstrates the feasibility of performing TAVI in a private hospital with a dedicated and experienced team and questions the current restricted access to TAVI in the private sector.

Nurses' Caring Behavior in Hospital: A Literature Review

The review was carried out using the PRISMA and PICO methods based on the search results of the BMC, IJCS, IJRPH, Science Direct and Wiley Online databases, with the keyword Caring and Nursing Service and the results obtained were 1216 articles. After screening the articles based in inclusion and exclusion criteria, for total 7 articles included in this review study. The patients were generally satisfied with the caring behavior of the nurses in the hospital, but the level of satisfaction of patients in private hospitals was higher than patients in public hospitals. Nurse caring behavior is the most important services for hospital, especially in government hospitals. Good nurse behavior has a positive effect on patient satisfaction and care in each hospital. Based on the research results, nurses have to apply caring behavior sufficiently to patients related to basic human needs