Performance Of Health Services Research Articles

Qualidade das práticas de profissionais dos programas de controle de infecção no Brasil: estudo transversal

ABSTRACT Objective To analyze the quality of professional practices in infection control programs regarding structure, process, and outcome. Method This is a quantitative, descriptive, and cross-sectional study carried out in 114 hospital infection control services in the five official regions of Brazil. The data were collected using a structured instrument whose psychometric properties were previously validated. Data treatment was performed by principal component analysis and non-parametric Kruskal-Wallis test. Results The best quality index of infection control programs was attributed to the South region, to hospitals that had 300 beds or more, to those that used the National Healthcare Safety Network criterion for infection surveillance and to places that carried out an active prospective search as their surveillance method. Conclusion and implications for practice: The quality of infection control programs is related to hospital location, size, and infection surveillance method. The creation of a quality index, hitherto unheard of in Brazilian studies, draws attention to the precarious performance of health services.

Ghana health service performance appraisal system: a cross-sectional study on practices and perceptions among employees in the Bono East Region of Ghana, West Africa.

the fulcrum of every organization lies in the productivity of its employees. Consequently, organizations have adopted a policy of fostering an organizational culture that promotes employee development, resulting in the consistent use of performance evaluation systems particularly, performance appraisals (PA). Nonetheless, the issue of concern for several organizations is whether PA will truly be an adequate tool for maximizing employee´s performance. Here is where it becomes important to gauge the perceptions and practices of Ghana Health Service (GHS) employees in the Bono East Region of Ghana, West Africa, towards these performance appraisal systems (PAS). the study used an institutional-based cross-sectional study. Using simple random sampling, 375 health workers were recruited using a structured questionnaire. Data was analyzed using Stata. Bivariate and multivariate logistic regression analysis was performed and p-value less than 0.05 was considered statistical significance. the study revealed that the majority of the respondents (86.7%) had completed the performance appraisal form. Out of which 47.7% complete and submit PA every year, followed by those who complete and submit during promotion time (24.3%), every half year (15.1%) and anytime (12.9%). The key determinants of PA completion include; increasing age (AOR=2.24, 95% CI: 1.08-4.62), male staff (AOR=2.38, 95% CI: 1.16-4.91), permanent GHS employees (AOR=2.9, 95% CI: 1.07-7.86), respondents who had worked for 3 to 7 years (AOR=5.53, 95% CI: 2.48-12.36) and those with over 7 years working experience (AOR=20.80, 95% CI: 5.43-79.74). the study identified that the majority of the respondents completed PA, but quite an encouraging number of them do not complete PA at the required period as expected. Age, male staff, permanent employment, and increasing years of experience were the significant predictors of PA completion. Continuous professional development for GHS staff on PAS is required. The GHS human resource division should organize stakeholders´ engagement with facilities managers and employees on the PAS to inform all managers and employees on what is required from everyone.

The influence of commitment on nurse performance at Bahteramas General Hospital, Southeast Sulawesi Province, Indonesia

The findings in the initial study found that one of the causes of the low performance of health services in hospitals is the lack of commitment of nurses in carrying out their duties during working hours at the hospital. The commitment in question is the willingness and obedience of nurses in carrying out the tasks that are their responsibility. The purpose of this study was to determine the effect of commitment on nurse performance at the Bahteramas General Hospital. The type of research used is quantitative research using a cross sectional study design. The size of the population in this study were 209 people, with a sample size of 138 respondents. As for the method of data collection, it was carried out using interviews and field observations. Implementation Data analysis was carried out using Univariate and Bivariate methods. The results showed that there was an effect of commitment on the performance of nurses at the Bahteramas Regional General Hospital with a p (0.000 <0.05). Conclusion; the commitment variable affects the performance of nurses. Suggestion; The need for education and training on hospital service commitments to increase awareness and willingness of nurses to maintain service commitments.

The influence of supervision on nurse performance at Bahteramas general hospital, southeast Sulawesi Province, Indonesia

The findings in the initial study found that one of the causes of the low performance of health services in hospitals is the lack of supervision of the work of nurses in carrying out office duties during working hours at the hospital. Supervision in question is the supervision activity carried out by the appointed work supervisor, to supervise the implementation of tasks that are the responsibility of the nurse in the hospital. The purpose of this study was to determine the effect of supervision on nurse performance at the Bahteramas General Hospital. The type of research used is quantitative research using a cross sectional study design. The size of the population in this study were 209 people, with a sample size of 138 respondents. As for the method of data collection, it was carried out using interviews and field observations. Implementation Data analysis was carried out using Univariate and Bivariate methods. The results showed that there was an effect of supervision on the performance of nurses at the Bahteramas Regional General Hospital with a p (0.000 <0.05). Conclusion; monitoring variables affect the performance of nurses. Suggestion; The need to increase regular and periodic supervision to ensure that every work that has been done by nurses is in accordance with procedures set by the hospital.

Perbandingan Tingkat Kelelahan Kerja Perawat Antara yang Melayani Pasien COVID-19 dan Non COVID-19 di RSUP Dr Kariadi Semarang

Background: Health services during the COVID-19 pandemic trigger a high risk of fatigue among nurses in all inpatient rooms, especially the isolation rooms for patients with COVID-19. Fatigue can reduce the performance of nurses and health services. Objective: This study compares nurses' work fatigue levels between those who serve in the COVID-19 room and those who serve non-COVID-19 at RSUP Dr. Kariadi Semarang. Methods: A comparative study with consecutive sampling involving 96 nurses (46 COVID-19 ward nurses and 50 non-COVID-19 ward nurses). The survey was conducted by filling out a Subjective self-rating test questionnaire from the Industrial Fatigue Research Committee (IFRC) via a Google form. Analysis of fatigue differences was performed using the Chi-Square test. Result: The mean IFRC score of respondents was 47.19 ± 12.97, while most nurses experienced low levels of fatigue (67.71%, n=65). There was no significant difference in the level of nurse fatigue in the COVID-19 and non-COVID-19 isolation rooms (p = 0.169, x2 = 1.89). Uncomfortable work environment (t = -2.50, p = 0.014), anxiety feeling at work (F = 3.57, p = 0.032), and shift system (t = -2.34, p = 0.018) significantly correlated with the level of nurses' fatigue.Conclusion: The work environment, shift system, and feelings at work can affect nurses' fatigue levels. Therefore, hospital policies and regulations are necessary to reduce work fatigue for health workers

Pengaruh Kompensasi, Kompetensi dan Lingkungan Kerja terhadap Kinerja Pegawai Dinas Kesehatan Provinsi Sumatera Selatan

The pupose of this study to determine the effect of compensation, competence and work environment on employee performance of health service of south Sumatera Province. Associative research is the methodology employed. Utilizing a random selection technique and the Isaac and Michael formulas received from 100 respondents, the study population consisted of 156 employees of health service of south Sumatera Province. Using SPSS 25 Program. Based on the results of the study, it is known that compensation and competence have a significant effect on employee performance, the work environment has no significant effect on employee performance partially. Meanwhile, the variables of compensation, competence and work environment have a significant effect on the performance of health service of south Sumatera Province.

Assessment of Patient Satisfaction with the Standards of Providing Outpatient Medical Record Services Batara Guru Belopa Regional General Hospital Luwu Sulawesi Selatan, Indonesia

Background, Patient satisfaction is a level of feeling that arises as a result of the performance of health services obtained after comparing and feeling services with very high expectations. The objective is a picture of patient satisfaction with the standards for providing outpatient medical record services at the Batara Guru Belopa Luwu Regional General Hospital, South Sulawesi. Method, descriptive with a quantitative approach, the sample technique used is Simple Random Sampling with a sample size in this study of 200 respondents, data collection was carried out with a questionnaire. The results, the results of the consumer satisfaction assessment showed that part of the satisfaction of the service of providing outpatient medical records showed this with the statements of respondents with Responsive according to 64.5%, Assurance according to 70.5%, Tangible according to 65.5%, Empathy according to 69.5% and Realiability corresponding 64.5%. Standard provision of outpatient medical record services with exact assessments of 49.5% and more 50.5%. The discussion is that the provision of outpatient medical record services on the assessment of patient satisfaction is included in the appropriate assessment. Suggestions, to be able to provide patient medical record services, efforts are made to increase cooperation that can be outlined in work procedures.

Patient- and community-centered approaches as the cornerstone of health services evaluation in the 21st century.

This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Mediation Model of Digital Technology Factors Affecting Health Care Service Performance

Healthcare technologies have become a crucial component of healthcare providers' daily operations. Hence, healthcare innovation technologies are being promoted worldwide. Healthcare service technologies are constantly improving necessitates ongoing research to show how these technologies affect healthcare services. Hence, current study investigating the state of innovative digital healthcare service practises in the UAE. It examining the effect of innovative technology on healthcare service performance in the UAE and modelling mediating role of organisational learning capacity in the relationship between innovative technology and healthcare service performance. A structural equation model was developed in SmartPLS software using the data collected of the questionnaire. The model showed that the factors system development, digital services, process integration, and IT base innovations have strong relationship effect to the health care performance. Also, the organisational learning capacity has strong mediation effect on the health services relationship. This research has contributed to current state of literature regarding digital service innovations related to health service performance in the UAE. The results emphasized a critical need for practitioners for promoting developments in digital services impacted the performance of health services.

Freedom of choice and health services’ performance: Evidence from a national health system

Public policies fostering the freedom of choice of provider in the healthcare sector are increasingly common in many countries and regions, where policymakers wish to empower patients and improve health service performance. However, in the literature there is not clear consensus about the impact of expanded patient choice on healthcare quality yet. This study investigates whether increasing patients' freedom of choice influences health system outcomes in terms of various non-clinical aspects of care, a dimension often overlooked by researchers in this field. Our study considers a “natural experiment” that took place within the Spanish National Health System in 2009 under which citizens of the Community (region) of Madrid were allowed to freely choose among any GP and/or specialist in their region. The empirical analysis was conducted by using Spanish microdata for the period 2002–2016 and used synthetic control estimation techniques. The key findings show the reform had a strong and long-lasting impact, reducing average waiting times and increasing patients' satisfaction with the specialist attention received. We did not detect any statistically significant impact of the reform on the other responsiveness domains analysed. Our analysis shows that freedom of choice policies could improve health system performance if they are combined with appropriate economic incentives for health providers.

SISTEM PENGUKURAN KEPUASAN PASIEN TERHADAP PELAYANAN KLINIK NYAI WALIDAH

In the era of globalization, excellent service is the main element in hospitals and health units, including health services provided by clinics. Likewise in the health service industry, such as the Nyai Walidah clinic. Almost all health units are required to provide health services that meet optimal service standards. To be able to gain an advantage in the competition, every company must be able to meet customer satisfaction, with a strategy that is in accordance with the services it offers. As for customer satisfaction, the company can fulfill one of them through the quality of its service. Patients will feel satisfied if the performance of the health services obtained equals or exceeds their expectations. The level of patient satisfaction is very important and is closely related to the level of patient return so that this can be used as an indicator of the quality of health services. Therefore, this study aims to measure patient satisfaction with Nyai Walidah's clinical services using the waterfall method. Which produces a satisfaction measurement system to assess the level of satisfaction of visiting patients and as an evaluation material for the performance of health services so that components can be identified that must be maintained and improved by the Nyai Walidah clinic.

Association between socio-economic deprivation and AHRQ composite indicator during pandemic

Abstract Background The Agency for Healthcare Research and Quality (AHRQ) identifies preventable hospitalizations as proxy of potentially low-quality of care. Previous studies showed as socio-economic status was associated to poor diseases outcomes and to the performance of health services. Recently a particular attention was focused on the effect of the pandemic on this context. The aim of this research is to analyze the association between poor quality of primary care and socio-economic status before and during the pandemic. Methods A retrospective observational study was conducted in Abruzzo Region, Italy. Hospital discharge records (HDR) of two different periods were selected: from April to December for 2019 and 2020. The aggregate Prevention Quality Indicator 90 (PQI-90) has been coded according to the indications of the AHRQ. The Italian socioeconomic deprivation index (DI), divided in quintiles (from 1st less deprived to the 5th most deprived) was attributed to all patient, based on the municipality of residence. A multivariate logistic regression model was performed to evaluate the association between PQI-90 and DI. Results Totally were analyzed 253,063 HDR, of which 14,845 attributable to the PQI-90. By correcting for gender, age and number of comorbidities, the DI was not associated with the PQI-90 during 2019. During 2020 the PQI-90 was associated to 4th DI quintile (aOR 1.19;95%CI 1.09-1.30) and 5th DI quintile (aOR 1.13; 95%CI 1.03-1.23), compared to the 1st quintile. Conclusions The impact of the pandemic on primary care has been substantial. Compared to the pre-pandemic era, during the pandemic, an association between potentially poor quality of care and the most disadvantaged socio-economic areas has been shown in Abruzzo. This evidence must be an interesting starting point for health planning in order to fight against inequalities in health services access. Key messages • The reduction in the primary care quality during pandemic caused potentially preventable hospitalizations and it was associated to socioeconomic deprivation. • The analysis of hospital admission linked to context indicators such as the deprivation index, can be a useful tool for the policy maker in order to reduce healthcare inequalities.

An integrated hospital-district evaluation for communicable diseases in low/middle-income countries

Abstract Background The last two decades saw an extensive effort to design and implement integrated and multidimensional healthcare evaluation systems in high-income countries. However, in low/middle-income countries, few experiences of such systems implementation have been reported in the scientific literature. We developed and piloted an innovative tool to assess the performance of health services provision for communicable diseases in three African countries. Methods A total of 42 indicators, 14 per each communicable disease care pathway (Tuberculosis, Gastroenteritis, and HIV/AIDS), were developed. A sub-set of 23 indicators was included in the evaluation process. The indicators assessed four care phases: prevention, diagnosis, treatment, and outcome. All indicators were calculated for the period 2017-2019, while performance evaluation was performed for 2019. The analysis involved four health districts and their relative hospitals in Ethiopia, Tanzania, and Uganda. Results Substantial variability was observed over time and across the four different districts. In the TB pathway, the majority of indicators scored below the standards and below-average performance was mainly reported for prevention and diagnosis phases. Along the Gastroenteritis pathway, excellent performance was instead evaluated for most indicators and the highest scores were reported in prevention and treatment phases. The HIV/AIDS pathway indicators related to screening and outcome phases were below the average score, while good or excellent performance was registered within the treatment phase. Conclusions The bottom-up approach and stakeholders’ engagement increased local ownership of the process and the likelihood that findings will inform health services performance and quality of care. Despite the intrinsic limitations of data sources, this framework may contribute to promoting good governance, performance evaluation and accountability in settings characterised by multiple healthcare service providers. Key messages • A successful experience in developing and implementing a communicable diseases performance evaluation systems in three sub-Saharan African countries using a bottom-up approach. • The communicable diseases performance evaluation tool helped the data sharing between local healthcare providers and the development of competencies in data collection, analysis and interpretation.

COVID-19 pandemic impact on heart failure epidemiology and outcomes in Poland. National database study

Abstract Background COVID-19 pandemic negatively affected patients' will to seek urgent medical treatment as well as and health service performance. Purpose The aim was to evaluate the impact of COVID-19 pandemic outbreak at the beginning of 2020 on heart failure epidemiology and outcomes in Poland. Methods The study is based on the Nationwide Polish Ministry of Health Registry, an administrative nation-wide database covering all heart failure patients in Poland who were beneficiaries of the public health sector between 2013 and 2021. Results After COVID-19 outbreak in 2020, significantly fewer patients presented to health service due to HF than in previous years (Fig. 1). Compared to 2019, the number of HF hospitalisations declined by 21% and outpatient visits by 10% in 2020. Simultaneously, for the first time in the last decade, the trend in heart failure prevalence went down dropping by 3.7% (Fig. 1). The trend was driven by the greater reduction in ischaemic vs non-ischaemic HF prevalence (4.7% vs 1.3%) The longstanding downtrend in heart failure incidence accelerated markedly in 2020, decreasing by 20% between 2019 and 2020, compared to average fall of 8% in the previous decade (ranging between 4.1–12.9%). Likely, the drop was mainly attributable to the decline in the ischaemic HF incidence (23% vs 15.3% drop in nonischemic HF). The average in-hospital mortality due to HF in 2020 was higher compared to 2019 (12.9% vs 11.02%). As many as 1.18% of patients died on the day of admission in 2020, contrary to 0.94% in 2019 which accounts to 25% increase. Monthly distribution of in-hospital mortality aligned with peaks of COVID-19 waves (Fig. 2). Conclusion The study shows unfavorable changes in HF epidemiology and outcomes due to the pandemic. The drop in prevalence and incidence seems to be associated with lower patient influx to the health service. It is unknown whether patient non-occurrence resulted from patients' actions or preoccupation of the health service with the pandemic. At the same time, a marked rise in in-hospital mortality was noted, with an over 25% increase in the number of deaths on the day of admission that could potentially reflect a more advanced disease state. Funding Acknowledgement Type of funding sources: None.

Israeli COVID lockdowns mildly reduced overall use of preventive health services, but exacerbated some disparities

BackgroundDuring 2020, Israel experienced two COVID-19-related lockdowns that impacted the provision of primary and secondary preventive care.MethodsWe examined the month-by-month performance of selected preventive care services using data from Israel’s national Quality Indicators in Community Healthcare program. Process of care measures included hemoglobin A1c (HbA1c) testing, cholesterol testing, colon cancer screening and mammography. Intermediate outcome measures included low-density lipoprotein control and HbA1c control. Measures were stratified by sex and by area-level socioeconomic position (SEP). Diabetes and mammography are presented in this abstract due to space limitations.ResultsAnnual HbA1c testing among persons with diabetes decreased from 90.9% in 2019 to 88.0% in 2020. Performance of HbA1c tests during lockdown months was as low as half the usual amount. There were compensatory increases in testing during post-lockdown months that did not quite make up for the missed tests. In 2019, 9.0% of Israelis with diabetes had poor glycemic control (HbA1c ≥ 9.0); in 2020, it was 8.8%. In total, 4.5% fewer mammograms were performed in 2020 compared with 2019. Women in the lowest SEP level performed 10.4% fewer mammograms in 2020 than in 2019, while women in the highest SEP level performed 3.1% more mammograms.ConclusionsProlonged COVID lockdowns in 2020 were associated with marked decreases in the performance of preventive health services during those months. Compensatory spikes following the end of lockdowns partly, but did not completely, make up for the missed care. COVID lockdowns may have exacerbated socioeconomic disparities in some preventive health services.

PENGARUH KUALITAS PELAYANAN KEFARMASIAN TERHADAP KEPUASAN PASIEN RAWAT JALAN DI RUMAH SAKIT UMUM DAERAH SUMEDANG TAHUN 2022

Patient satisfaction is the level of patient feelings that arise as a result of the performance of health services obtained after the patient compares with what is felt. Pharmaceutical services that started from drug oriented to patient-oriented with a philosophy of pharmaceutical care (pharmaceutical care), make pharmacists required to provide quality pharmaceutical services this will affect the satisfaction of services received by patients. The problems in the outpatient pharmacy installation at Sumedang Hospital include infrastructure, namely the waiting room is not spacious enough, the availability of drugs, and complaints related to waiting time for drugs. The purpose of this study was to determine the satisfaction of outpatients with the quality of pharmaceutical services and the influence between the quality of pharmaceutical services and satisfaction of outpatients at the pharmaceutical installation of Sumedang Hospital in 2022. Correlation quantitative research with cross-sectional research design. Data collection using questionnaires and interviews with samples taken from as many as 120 respondents with the purposive sampling technique. Assessment of patient satisfaction is measured based on service quality using the Servqual model method with a Likert scale. The statistical test used is the sperm rank test. The results showed that the quality of pharmaceutical services was very good with an average index of 80%, and patient satisfaction was very satisfactory with an average index of 83%. The results of the Spearman rank test show that there is a correlation between the quality of pharmaceutical services and patient satisfaction with an average correlation coefficient of 0.60-1,000, which means that it has a strong correlation.

Electronic medical record use and associated factors among healthcare professionals at public health facilities in Dire Dawa, eastern Ethiopia: A mixed-method study.

Despite the significant benefits of digital health technologies (ITs), developing countries are lagging behind their developed counterparts in the adoption of electronic medical records (EMRs) in a healthcare setting. EMRs have long been considered essential elements in improving the quality of healthcare. However, the rate of utilization of EMRs among healthcare providers still remains low, particularly in developing countries. This study aimed at exploring EMR use and its determinants among healthcare providers at public health facilities in Dire Dawa, eastern Ethiopia. A quantitative cross-sectional study was conducted among 402 health professionals working at public health facilities supplemented with an exploratory qualitative study in Dire Dawa, Ethiopia. Descriptive summary statistics and binary and multivariable logistic regression analysis were used to explore the determinant factors of EMR use, while qualitative data were thematically analyzed. Overall, about a quarter (26.6%) of health professionals were using electronic medical records. A work experience of 6 years or less [adjusted odds ratio (AOR) = 2.23; 95% confidence interval (CI): [1.15-4.31]], a discussion on EMR (AOR = 14.47; 95% CI: [5.58-7.57]), the presence of an EMR manual (AOR = 3.10; 95% CI: [1.28-7.38]), and a positive attitude toward the EMR system (AOR = 11.15; 95% CI: [4.90-25.36]) and service quality (AOR = 8.02; 95% CI: [4.09-15.72]) were independent determinants of EMR use. Poor collaboration among stakeholders and dependence on the software programs of NGOs were the main challenges cited by key informants. The findings of this study indicate that EMR use by health professionals in the study area is very low. Several organizational, technical, and behavioral factors were identified for this low utilization. Therefore, there is a need to leverage EMRs through continuous technical support and commitment to enhance its use, which has the potential to improve health service performance. Developing locally applicable EMR software should be considered.

UPAYA PENINGKATAN KUALITAS KINERJA PELAYANAN KESEHATAN APARATUR SIPIL NEGARA (STUDI IMPLEMENTASI PELAYANAN KESEHATAN DI PUSKESMAS KARANGMALANG KABUPATEN SRAGEN)

This article aims to determine the efforts to improve the quality of ASN health service performance and the obstacles faced in improving the performance of health services at Karangmalang Health Center, Sragen Regency. This article uses a descriptive qualitative empirical research method with a sociological juridical approach. In this research, the writer took the research location in Karangmalang Public Health Center, Sragen Regency. Based on the results of the benchmark research, efforts to improve the quality of ASN health service performance at the Karangmalang Health Center, Sragen Regency are considered good and satisfactory with the observed variables of health service quality dimensions, namely (1) Tangibles (physical evidence), (2) Reliability (reliability), (3) Responsiveness (responsiveness), (4) Assurance (assurance), (5) Empathy (empathy). The quality of ASN services, theoretically there are five factors to measure the quality of health services. There are several weaknesses that need to be addressed and improved in an effort to improve the quality of ASN health service performance at the Karangmalang Health Center, namely: 1. The dimension of responsiveness in health services is good, only a lack of dentists. This is not in accordance with Permenkes Number 75 of 2014, so that the service for patients with toothache is hampered. 2. Limited stock of generic drugs that are affordable by the community. 3. There is no recruitment of co-assistant staff and intensive doctors, but only accepts students from the nursing department.

The CRACK programme: a scientific alliance for bridging healthcare research and public health policies in Italy

Healthcare utilisation databases, and other secondary data sources, have been used with growing frequency to assess health outcomes and healthcare interventions worldwide. Their increased popularity as a research tool is due to their timely availability, the large patient populations covered, low cost, and applicability for studying real-world clinical practice. Despite the need to measure Italian National Health Service performance both at regional and national levels, the wealth of good quality electronic data and the high standards of scientific research in this field, healthcare research and public health policies seem to progress along orthogonal dimensions in Italy. The main barriers to the development of evidence-based public health include the lack of understanding of evidence-based methodologies by policy makers, and of involvement of researchers in the policy process. The CRACK programme was launched by some academics from the Lombardy Region. By extensively using electronically stored data, epidemiologists, biostatisticians, pharmacologists and clinicians applied methods and evidence to several issues of healthcare research. The CRACK programme was based on their intention to remove barriers that thwart the process of bridging methods and findings from scientific journals to public health practice. This paper briefly describes aim, articulation and management of the CRACK programme, and discusses why it might find articulated application in Italy.

Feedback of aggregate patient-reported outcomes (PROs) data to clinicians and hospital end users: findings from an Australian codesign workshop process

ObjectivesPatient-reported outcomes (PROs) are increasingly used to measure the patient’s perspective of their outcomes following healthcare interventions. The aim of this study was to determine the preferred formats for reporting...