Physicians In Private Hospitals Research Articles

Physicians' Knowledge of the Effect of Insurance Status on Clinical Decision Making in Saudi Arabia

Background: Generally, decisions related to healthcare issues should be only made according to the clinical criteria. However, in clinical decision-making, there is mutual information sharing, in which health providers share the benefits and adverse effects of potential treatment with their patients, and patients share their values and lifestyle preference with their physicians. The clinical decision is affected by factors either related to patients or physicians; the factors related to patients include socio-economic status. Health insurance reduces the costs of medication and hospitalization of patients, and this allows patients to obtain better medical care while treating various diseases. Therefore, clinical decisions can be affected by the insurance status of patients. Aim: To describe the physicians' knowledge regarding the impact of the insurance status of patients on clinical decision-making. Methods: The study was cross-sectional that was enrolled physicians in private hospitals and clinics. The study was conducted via an online questionnaire that investigated the demographics of physicians and their knowledge. SPSS version 22 was used to analyze the collected data; a P-value≤0.05 was significant. Results: There were 401 physicians who participated in this study; 75.3% were males, 42.9% were consultants, 76.3% were non-Saudi physicians, and 72.1% were working in the private sector. The mean ±SD of the knowledge score was 18.89±4.9. The mean score of knowledge was significantly affected by nationality (P˂0.001) and type of practice (P=0.012). Conclusion: Physicians had inadequate knowledge regarding the impact of health insurance on clinical decision-making. The nationality and type of facility affected the level of physicians‘ knowledge.

Comparison of stress levels between physicians working in public and private hospitals in Johor, Malaysia.

ObjectivesPhysicians are known to experience a high level of stress due to the profession itself, as well as due to factors related to the workplace, patient care, and work-life balance. Owing to the nature of public and private hospitals in Malaysia, physicians working in different settings are expected to have different levels of stress. However, there is no study to validate this assumption. The present study aimed to compare stress levels between physicians working in public and private hospitals in the state of Johor, Malaysia.MethodsParticipants were selected via stratified sampling. Participants completed an online questionnaire comprising demographic details and the Health Professional Stress Inventory. Scores on each domain and the aggregate scores were compared between physicians in public and private hospitals using a univariate analysis adjusted for potential confounders.ResultsThe overall stress level between physicians in public and private hospitals was similar. However, physicians in private hospitals experienced a higher stress level related to patient care responsibilities and professional uncertainty as compared to those in public hospitals.ConclusionPhysicians from private hospitals experience stress in different aspects of their profession as compared to physicians in public hospitals, especially with reference to patient care and career uncertainty. Measures should be taken to relieve the stress of physicians and thus improve their wellbeing.

Real-World Multiple Myeloma Treatment Pattern In Morocco: Evidence From Patient Chart Audit

Understanding symptomatic multiple myeloma (MM) patient management, treatment patterns and outcomes in real-world practice in Morocco. Data were collected through a cross-sectional phase (X) and retrospective (R) patient chart review (Aug/16–Oct/16) by oncologists, hematologists and internists managing >10 symptomatic MM patients during the last three months and responsible for treatment initiation. The X-phase collected treatment for MM patients seen during a 4 week time-frame, physicians’ perception on MM drugs accessibility and guidelines use. The R-phase recorded disease characteristics, including treatment response and duration. Analyses were descriptive. 4 physicians in public hospital, 2 physicians in Cancer Center and 14 physicians in private hospitals participated in recruiting MM patients in both study phases. All of them, perceive full access to MM therapies and they were mainly using NCCN/ASH and ASCO guidelines for treatment decision-making. In the X-phase, a total of 237 patients were enrolled, 68% were currently undergoing treatment, of which 93% were on 1L treatment. Across all lines, thalidomide-based regimen was mainly used (72% in 1L, 60% in second-line [2L], 100% from third-line onwards [3L+]), while bortezomib-based regimen and lenalidomide-based regimen were used only in 1L (9% and 1% respectively). 95% of patients having completed a 1L were SCT eligible. In the R-Phase, a total of 200 patients were included. Physician-assessed depth of response decreased across lines: 20% patients achieved at least a very good partial response (VGPR) in 1L, while 7% and 17% achieved at least a VGPR in 2L and 3L, respectively. Average length of therapy was 6.2 months in 1L, 5.9 and 6.2 in 2L and 3L, respectively. Despite the average time of treatment duration, low response rates from 1L onwards suggest a need for more effective therapies in Morocco to support patients in achieving better and sustained responses across all lines.

Facility evaluation of resigned hospital physicians:managerial implications for hospital physician manpower.

Introduction:Turnover of physicians might be responsible for reducing patients’ trust and affecting hospital performance. This study aimed to understand physicians’ psychological status regarding their hospital work environment and the resources of independent practitioners.Method:This was a cross-sectional study with 774 physicians who had resigned from hospitals and were now practicing privately in clinics in Taichung City as its study population. A mail survey with a multidimensional questionnaire was sent to each subject.Results:This study revealed that older physicians were less satisfied regarding the work environment in their respective former hospitals. Male physicians were found to be more satisfied with the tangible resources of their hospitals. Internal medicine physicians were found to be less satisfied overall with the intangible resources. Gynecologists and pediatricians were found to be more satisfied with their hospital environments. The physicians who worked long hours per week reported that they were less satisfied with their job content. The physicians who had opportunities to learn advanced skills and enhance their knowledge were more satisfied with their hospital environment, tangible resources, and intangible resources. In addition, physicians in private hospitals were found to be more satisfied with their job content, but they were less satisfied with work motivation and retention and intangible resources. In addition, physicians who worked in hospitals located in Taichung city reported that they were less satisfied with their tangible resources than the physicians working in hospitals outside of the city.Conclusion:This study focused on the satisfaction of physicians who had already left their respective hospitals instead of current retained physicians. From this study, it is our recommendation that hospital managers should pay closer attention to the real needs and expectations of the physicians they employ, and managers should consider adjusting their managerial perspectives when establishing new human resources policies or making decisions.

Nonmedical use of sedatives in urban Bengaluru.

Background:Nonmedical sedative use is emerging as a serious problem in India. However, there is paucity of literature on the patterns of use in the population.Aim:The aim of the present analysis was to explore sedative use patterns in an urban metropolis.Materials and Methods:Data for the present analysis come from the parent study on nonmedical prescription drug use in Bengaluru, India. Participants (n = 717) were recruited using a mall-intercept approach, wherein they were intercepted in five randomly selected shopping malls, and administered an interview on their use of prescription drugs.Results:Past 12-month nonmedical sedative use was reported by 12%, benzodiazepines being the commonest. Reasons cited for nonmedical use included “sleeplessness, pain relief, stress.” A majority (73%) reported sedative use “in ways other than as prescribed,” compared to “use without prescription” (27%). All prescriptions were issued by general physicians in private hospitals. About 11% among those who used “in ways other than as prescribed,” and 100% of nonprescribed users, reported irregular use (skipping doses/stopping/restarting).Among those who used “in ways other than prescribed,” pharmacy stores were the source of obtaining the sedatives. Among “nonprescribed users,” family/friends were the main source. Three-percent reported using sedatives and alcohol together in the same use episode. In multivariate logistic regression analyses, nonmedical sedative use was significantly associated with graduation-level education or above (adjusted odds ratio [aOR]: 2.53, 95% confidence interval [CI]: 1.30-4.91), and married status (aOR: 2.32, 95% CI: 1.04-5.18).Conclusions:Findings underscore the need for considering various contextual factors in tailoring preventive interventions for reducing nonmedical sedative use.

The growth of private hospitals and their health workforce in China: a comparison with public hospitals

China significantly opened its healthcare market through a series of market-opening policies in 2000-1. This study aims to explore the direct consequences of these policies-the growth of private hospitals, their workforce characteristics compared with public hospitals in China and the source of their healthcare workforce. First, we performed a segmented regression analysis of a longitudinal data series of the number of hospitals in China between 1990 and 2009 to examine the before and after effects of the market-opening policy on private hospitals. Then, to highlight the workforce differences between private and public hospitals, provincial survey data collected in 2009 were compared with data from a second database collected in 2002 to detect the mobility of medical staff from the public to the private hospitals. The number of private hospitals rapidly increased after 2001, and the yearly growth rate increased from 19 to 205, represented primarily by an increase in specialty hospitals. Approximately 22.03% of the physicians in private hospitals are over the age of 60, whereas this proportion in public hospitals is only 2.97%. In 2008, at least 4.1% of the staff working in private hospitals had previously worked in local public hospitals in 2001. The broad expansion of private hospitals since 2001 is most likely the result of an unbiased market policy environment for private hospitals. Moreover, specific features of the hospital-physician relationship in China may account for the unbalanced age distribution feature among doctors and the mobility of the healthcare workforce in private hospitals.

Vital Signs: Physicians in Private Hospitals and Practices Earned Over $78 per hour

Vital Signs: Physicians in Private Hospitals and Practices Earned Over $78 per hour

Vital Signs: Physicians in Private Hospitals and Practices Earned Over $78 per hour

Vital Signs: Physicians in Private Hospitals and Practices Earned Over $78 per hour

Vital Signs: Physicians in Private Hospitals and Practices Earned Over $78 per hour

Vital Signs: Physicians in Private Hospitals and Practices Earned Over $78 per hour