Private Health Care Institutions Research Articles

TOOLKIT FOR PROMOTING THE SYSTEMIC DEVELOPMENT OF HEALTH CARE INSTITUTIONS AT THE LOCAL LEVEL

In the study, attention is updated to the problem of stimulating the development of small entrepreneurship at the local level and simultaneously improving the system of providing social services to the local population, in particular medical care. It was emphasized that stimulating the development of small business entities and also the medical sector in rural and remote areas is a very difficult task that requires identification in the implementation of specific tools and the involvement of sufficient resources for such purposes. It has been proven that this is why research in this field is always unique and has a high theoretical, methodological and applied value. The purpose of the study is to improve the theoretical, methodological and applied principles of forming policy tools for supporting and stimulating the development of small entrepreneurship in the medical field at the local level. It is shown that the decentralization reform, which is being implemented with permanent success in Ukraine, has largely shifted from the central to the local level the issue of management and financial and resource provision of local social and economic development. These issues become particularly acute in the field of medicine, and often local self-government bodies are objectively unable to solve these extremely difficult tasks on their own. It is necessary to use non-traditional methods and approaches. One of these can be the stimulation of private business in the form of small private health care institutions that provide a wide range of diagnostic and preventive medical services to the population. It was concluded that the policy of local self-government bodies in terms of promoting the development of small business initiatives in the field of providing medical services to the population should be broad in nature, in particular aimed at the general socio-economic development of small towns and surrounding rural areas. Conceptually, the principles of such a policy can be implemented in the following directions: development of production factors; creation and improvement of small business support infrastructure; formation of solvent demand due to increased employment and incomes of the population; development of priority sectors of the economy; increasing the efficiency of small enterprises in the medical field.

REAL CLINICAL PRACTICE OF TREATMENT OF CARDIAC ARRHYTHMIAS IN LOCOMOTIVE CREW WORKERS

Cardiac arrhythmias create prerequisites for the occurrence of sudden cardiac death in the workplace, which poses a threat to the safety of train traffic. A targeted examination of locomotive crew workers (LCW) includes the diagnosis of cardiac arrhythmias for effective and safe pharmacotherapy. A retrospective analysis of 100 medical histories of machinists and assistant machinists hospitalized in the cardiology department of the Private healthcare institution "Clinical Hospital "Russian Railways-medicine" Voronezh", who have the following types of cardiac arrhythmias: supraventricular extrasystole (single 94%, paired 20%), single ventricular extrasystole 51%, paroxysmal form of atrial fibrillation 2%, conduction disorder 6%. According to the results of the examination, a group of LCW with prognostically unfavorable cardiac arrhythmias (32%) was identified, who underwent pharmacotherapy, including beta-blockers, antiarrhythmic drugs of class IC and class III. The choice of medications for pharmacotherapy in outpatient settings took into account the impact on professionally important functions according to the established List of "Medicines and traffic safety" (ed. from 2016). At discharge, 25% of patients were recommended nebivolol, which LCW could take in conditions of professional activity. Pharmacotherapy of drivers on an outpatient basis was continued with etacizine (3%), allapinine (2%), amiodarone (1%) with suspension from work for the period of taking the drug.

Managerial Aspect of Private Health Care Institutions in the Republic of Croatia at the Time of COVID-19 Pandemic

Managerial economics, with its specificity, provides a special insight into the management of private health care institutions. According to the sources of the Financial Agency (FINA) and the national classification of activities (8622 and 8610), the observed industry in the Republic of Croatia in 2020 contains 675 entities, out of which 9 are in special private hospitals (8610), and others are in specialist medical practice (8622). The effectiveness of managers in conditions of uncertainty and increased risk is reflected in the availability of information and their experience in similar situations. Precisely the lack of information that was present at the time of the COVID-19 pandemic indicates the effective strategic thinking of managers (owners) of the observed institutions who responded in a timely manner to market needs in these conditions. In doing so, they acted as a substitute for specialist health care because it was not able to provide adequate service to the required extent. Key words: managerial economics, private health care, COVID-19 pandemic, company, market structure

Comparative Analysis of ETL Tools in Big Data Analytics

Massive amounts of data are being generated these days all around the world. The majority of social networking platforms, ecommerce sites, the public and private sectors, healthcare institutions, cloud networks, and various servers are all generating immense amount of data. Collected data from various sites could be in a structured or unstructured format. Extract Transform Load (ETL) is a crucial component of the growing demand for quicker business decisions aimed at many contemporary applications. Due to the volume and speed of data, real-time ETL is built on the foundation of multi-source, unstructured data stream extraction and transformation employing disc data in dispersed environments. The entire procedure is pipelined while processing so that the final resultant data can provide some essential and useful conclusions to work on. Some analytical findings are once again helpful in making decisions. However, the produced results may differ in some numbers, graphs, and figures in many circumstances. This occurs as a result of the usage of some unrealistic tools for big data processing. This paper proposed several methods and appropriate ETL (extract, transform, and load) tools for the big data processing, which may result in appropriate analytics and conclusions from the data.

The empirical relationship between transformational leadership and job attitudes: mediating role of psychological capital – a study of healthcare in India

PurposeThe goal of this research is to investigate the association between transformational leadership style, psychological capital and job attitude (job satisfaction and organization commitment). Transformational leadership's effects on these job attitudes were also analysed in terms of the mediating effects of psychological capital.Design/methodology/approachThe authors received 296 authentic questionnaires from the para-medical staff working in different public and private healthcare institutes in Jammu and Kashmir, India, and these were then analysed by using SEM with SPSS 25.0 and AMOS 19.FindingsResults implied that transformational leadership increased the levels of employees' job attitudes. The results further displayed that transformational leadership and psychological capital in the workplace are positively associated. The results also showed that psychological capital was positively linked with job attitudes. Moreover, psychological capital serves as a mediating construct between transformational leadership and job attitudes.Practical implicationsThe outcomes of this research will help in comprehending the significance of transformational leadership and psychological capital. Further, these research findings affirm the effectiveness of transformational leadership and psychological capital in forecasting positive job attitudes in the Indian work context. The administrators and policymakers in the healthcare sector can implement these concepts to reduce negative job outcomes.Originality/valueThis study expanded on Deci et al.’s (2017) existing self-determination theory model by incorporating leadership style and psychological capital as workplace context and autonomous intrinsic factors, respectively, into the self-determination theory model to study work behaviours of job satisfaction and commitment. This study contributes to existing self-determination theory knowledge by proposing and testing psychological capital as a mechanism for determining the effect of transformational leadership on job attitudes (job satisfaction and organizational commitment).

Faktori koji utiču na razvoj dobrovoljnog zdravstvenog osiguranja u Republici Srbiji

Voluntary health insurance enables a higher level of healthcare services for users and provision of healthcare services not included in the compulsory health insurance system. One of the main advantages of further development and growth of voluntary health insurance in the Republic of Serbia is a significant reduction of expenses of citizens in the entire healthcare system. A key argument in favour of voluntary health insurance is that, in the context of limited public resources for healthcare, it can advance healthcare policy goals by easing fiscal pressure on the healthcare sector. The situation and trends in the real sector influence development of the insurance sector. In order to improve voluntary health insurance, it is necessary to establish cooperation within compulsory and voluntary health insurance, work on connecting state and private healthcare institutions, provide better promotion of services and influence the increase in health literacy of citizens. Better connection of private and public healthcare institutions, compulsory and voluntary health insurance, better promotion of service packages, better information provided to citizens about this type of health insurance, as well as increasing the standard of living, influence development of the basic factors of voluntary health insurance.

A comparison of patients’ satisfaction treated at public and private healthcare institutions under the health scheme using the HEALTHQUAL model

Abstract BACKGROUND: Patient satisfaction and patient outcomes are two elements that influence the quality of healthcare. Based on four dimensions—environment, empathy, efficiency, and effectiveness—the HEALTHQUAL scale is used to measure patient satisfaction with the quality of care. The current study sought to compare patients’ satisfaction with treatment at public and private healthcare institutions under the health scheme using the HEALTHQUAL model. MATERIALS AND METHODS: A hospital-based descriptive cross-sectional study of 96 study participants was conducted to assess the level of satisfaction perceived by patients admitted to government and private healthcare institutes in the Malda district from August 2022 to September 2022 under the health scheme. Participants were chosen at random from one government and two private hospitals. The hospitals were chosen using a lottery method and a probability proportion to the number of bed sizes. Every single participant was interviewed using a structured questionnaire, and data were analyzed using the Statistical Package for Social Sciences software version 23. RESULT: Overall healthcare service quality practices in public hospitals are low, according to 71% of participants, with a mean of 3.50 and a standard deviation of 0.55. On the other hand, in private hospitals, 60% of participants rated service quality practices as high, with a mean of 4.59) and a standard deviation of 0.34. CONCLUSION: The findings indicate that perceived overall patient satisfaction in public hospitals was low. In contrast, perceived overall patient satisfaction was higher in private hospitals. It is recommended that hospital administrators and policymakers must put focus on patients to close service quality gaps, increase service quality, and enhance patient care.

МЕДИЧНІ ТА РЕАБІЛІТАЦІЙНІ ЗАКЛАДИ ЯК СУБ’ЄКТИ ПРАВА

The legal position of institutions in the field of health care and rehabilitation was studied. The main trends of reforming the sphere of functioning of health care institutions are defined, their main types, organizational and legal forms and forms of ownership are characterized. The peculiarities of the activity of state health care institutions, which are business entities belonging to the state sector of the economy and the management of such institutions is carried out exclusively by the state in accordance with the principles of domestic and foreign policy, are considered. The procedure for the formation and operation of communal enterprises that carry out their activities on a non-commercial basis is analyzed, that is, medical institutions that work as communal non-commercial enterprises independently carry out their economic activities, which are aimed at achieving relevant economic, social and other results and without the goal of making a profit. It is noted that the network of state and communal health care institutions is formed taking into account the development plans of hospital districts, the needs of the population in medical care, the need to ensure the proper quality of such care, timeliness, accessibility for citizens, effective use of material, labor and financial resources. It was noted that private health care institutions are not limited in the choice of organizational and legal form. Key words: medical institution, rehabilitation care institution, hospital district, state medical institution, communal medical institution, private medical institution, state medical institution.

The cost-benefit approach to an optimal charging scheme for an embryo storage service

Cryostorage of human embryos produced during the course of in vitro fertilization (IVF) treatment is an important issue for hospitals, governments and individuals who are facing fertility challenges. Embryo cryostorage is giving rise to increasing economic, ethical and legal concerns due to the increasing holding and operational costs of storage, the rise in the number of unused embryos, and the absence of economic incentives for hospitals to provide free cryostorage services. These issues may reduce the availability of storage services and encourage individuals to seek embryo donations from abroad with attendant medical risks and the possibility of illegal transactions. Given that both public and private healthcare institutions are increasingly motivated by economic factors, increasing the economic incentive to offer cryostorage has the potential to increase the provision of storage facilities. This paper proposes a nonlinear programming model to enable a hospital or other service provider to determine the optimal price it should charge for storage. The suggested pricing policy comprises three components; however, our analysis shows that an optimal solution can only include a maximum of two of these components. Finally, the paper introduces a numerical example as well as a real-data comparison among several providers to demonstrate the applicability and value of the proposed model.

НОРМАТИВНО-ПРАВОВЕ ЗАБЕЗПЕЧЕННЯ УПРАВЛІННЯ ГОСПОДАРСЬКОЮ ДІЯЛЬНІСТЮ ЗАКЛАДІВ ОХОРОНИ ЗДОРОВ’Я

The purpose of the article is the analysis and systematization of the current regulatory and legal framework, which regulates the economic activity of health care facilities in order to determine approaches to its improvement. The relevance of the normative and legal regulation of the management of the activities of health care institutions has been determined. Problems of a medical and economic nature are outlined, the solution of which should be aimed at the management process of health care. The conceptual principles of the state-legal regulation of the activity of health care facilities (purpose of the task, objects, subjects, methods) have been defined. The goal of regulatory and legal support for the management of health care activities has been established, which consists in ensuring the full coherence of all internal processes related to the impact on material, labor and financial resources for the implementation of economic activities aimed at achieving the goals and performance of tasks by the health care institution. The levels of regulatory and legal support for the management of health care activities are highlighted. The types of health care facilities were analyzed according to different forms of ownership (state, communal, private, mixed) and organizational and legal forms (state or state and communal or communal non-commercial enterprises) in accordance with the norms of the Civil Code of Ukraine and the Economic Code of Ukraine. The requirements established for institutions in order to obtain a license for medical practice are highlighted. It is pointed out the need for accreditation of health care facilities in accordance with their established criteria. The norms of the Tax Code of Ukraine regarding the taxation of state and private health care facilities have been analyzed. The conditions of taxation in the simplified and general form for private health care institutions are determined. Deficiencies in regulatory and legal support, which hinder the effective operation of health care facilities, have been identified. Separate areas of medical law have been identified, which should be amended and improved, which will have a positive impact on the activities of health care facilities as a whole.

Collaborative Shift-Scheduling and Perceived Procedural Justice as Predictors of Clinical Decision-Making in Managed Care Practice among Selected Samples of Health Workers in the Federal Capital Territory (FCT), Abuja, Nigeria

This study examined the roles of collaborative shiftwork schedule and procedural justice as predictors of clinical decision-making in managed care practice among a selected sample of health workers in Abuja, Nigeria. The study was survey design conducted among 197 healthcare workers were selected using convenient sample from public and private healthcare institutions in Abuja. The Bergen Shift Work Sleep Questionnaire (BSWSQ) developed by Flo et al. (2012) was used to assess shiftwork collaborative scheduling. Procedural justice was measured using the Procedural Justice Scale (OJS) developed by Niehoff and Moorman (1993). While The Clinical Decision-Making Survey (CDMS) developed by Ferrell et al. (1991) was used to measure clinical decision-making. The result revealed that shiftwork did show significant relationship with clinical decision-making among psychiatric nurses [r (197) = .451, p <. 01]. Results from the multiple regression showed that procedural justice significantly predicted clinical decision-making among healthcare workers [? = .331, p <0.01]. The result of this study suggest that healthcare workers who engage in shift-schedule with a high perception of procedural justice have higher propensity to provide enhanced clinical decision-making at the workplace. The Nigerian healthcare reforms and policies should be reviewed, specifying issues relating to collaborative shiftwork for healthcare workers.

Experiences and perceptions of COVID-19 infection and vaccination among Palestinian refugees in Jerash camp and Jordanian citizens: a comparative cross-sectional study by face-to-face interviews

BackgroundDuring the COVID-19 vaccination, the access to vaccines has been unequal among countries and individuals, for example low-income countries displayed significant low levels of vaccination. Furthermore, most refugees are living in developing low-income countries which struggling to access the essential health-care services including vaccination. Thus, the objective of this study was to assess the experiences and perceptions of COVID-19 infection and vaccination among Palestine refugees in Jerash camp compared to resident Jordanian citizens.MethodsA face-to-face interview-based comparative cross-sectional study was carried out among Palestine refugees in Jerash camp located in northern Jordan and Jordanian citizens from different cities in Jordan from October, 2021 to March, 2022. A Chi-square test was used to determine the differences in the experiences and perceptions of COVID-19 infection and vaccination between Palestinian refugees and resident Jordanian citizens. Logistic regression analysis was performed to predict factors associated with the beliefs, barriers and hesitancy towards COVID-19 vaccines.ResultsThe total number of participants was 992, with 501 (50.5%) Palestinian refugees and 491 (49.5%) Jordanian citizens. Most participants (64.1%) who have never been tested for COVID-19 were from the refugees (P < 0.001), whereas about 80.3% of the participants tested for COVID-19 at private healthcare institutions were citizens (P < 0.001). While 70.0% of the participants who tested positive for COVID-19 (n = 303) were from the refugees (P < 0.001). Compared to the citizens, the refugees had significantly lower levels of beliefs about the safety (P = 0.008) and efficiency (P < 0.001) of COVID-19 vaccines. They also had lower rates of vaccine hesitancy (P = 0.002) and vaccine uptake (P < 0.001), and a higher rate of facing difficulties during registration for COVID-19 vaccination (P < 0.001). Furthermore, refugees have more negative attitudes toward the importance and implementation of COVID-19 precautionary activities, including wearing face masks, practicing social distancing and following proper prevention hygiene compared to citizens (P < 0.001). The regression analysis showed that gender (P < 0.001), age (P < 0.001) and level of education (P = 0.001) were significantly associated with COVID-19 vaccine hesitancy. Also, being a refugee (P < 0.001) and being a male (P = 0.012) were significantly associated with facing more difficulties upon the registration to receive a COVID-19 vaccine.ConclusionsThis study showed that, compared to citizens, refugees had lower attitudes and practices toward COVID-19 infection and vaccination. They also had and a lower rate of COVID-19 vaccine hesitancy and uptake with limited access to vaccines. Government sectors and non-government organizations should implement policies and regulations to raise the awareness of refugees towards COVID-19 infection, testing, preventive measures, and the safety and efficacy of vaccines.

Complications in urological surgery. The urologist as a player in risk management

The first part of this article deals with accreditation of the quality of the professional practice of urologists and medical teams working in public or private health care institutions. This is a voluntary national risk management process based on the reporting and analysis of medical risk events and the development and implementation of recommendations. The fundamental objective of the system is to reduce the frequency and severity of adverse events associated with care for the patient. The second part aims to describe the mechanisms and management of surgical complications. The perception of complications by the urologist is discussed, as it may be distorted by cognitive biases leading to inappropriate actions. Two important points were also emphasized: communication with the patient following an injury, therapeutic hazard or complication following an error, and proper maintenance of the medical record. A joint effort to cultivate a culture of safety and quality in urological surgical practice should be encouraged. Collective actions by urologists in the future should help to maintain a proactive attitude:-generalization of quality accreditation of urologic physicians' professional practice;-national registry: which has demonstrated its advantages in the world of aeronautics;-creation of a specific module "Management of complications in urology" in teaching (ECU) and continuing education (SUC, website);-creation of an AFU "Complications" Committee;-management of social networks.

Problems of ensuring the quality of dental care (based on a sociological survey of dentists)

Annotation. The low level of dental health of the population of Ukraine determines the relevance of the problem of finding opportunities to improve the quality of dental care. One of the modern methods of monitoring the quality of medical care is sociological research. The purpose of the study: to analyze the problems of providing quality dental care based on the results of a sociological survey of dentists. The sociological study covered two qualitatively and quantitatively representative samples, the first of which included 259 dentists from public health institutions, and the second – 109 dentists from private dental institutions in Kyiv. Statistical processing of sociological research materials involved the use of methods of statistical grouping, tabulation, analysis of absolute and relative distribution series, assessment of the statistical reliability of the difference in sociological survey results (according to the Pearson χ2 test). The results of the sociological study showed significant differences in the resource and process components of quality assurance of dental care in public and private health care institutions. According to dentists from public institutions, there is a need to ensure legal and financial independence and stability of institutions (77.6±2.6%), it is necessary to update medical equipment, materials, tools (87.6±2.0%), ensuring patient satisfaction (71.0±2.8%) and improving the quality of dental care (57.5±3.1%). The current management system of municipal dental institutions and its management staff do not have the economic levers to improve the quality of dental care and do not implement effective measures to ensure it in a market economy. Solving the problem of providing the population of Ukraine with affordable and high-quality dental care requires the development of new organizational mechanisms for managing the quality of dental care in public health institutions.

Orthopaedic and trauma surgery in France: Do patterns differ across healthcare institution types (public community, public university, private not-for-profit, and private for-profit)?

BackgroundNo studies have evaluated, to our knowledge, potential differences in practices in France according to type of healthcare institution, i.e., university public hospital, community public hospital, or private hospital with or without participation in the public healthcare system. The objectives of this study of the exhaustive information collected in the French hospital-admission database were to: (1) describe the numbers of the main procedures performed in France by orthopaedic and trauma surgeons in each type of institution and each subspecialty; and (2) to determine whether the pattern of procedures differed according to the type of healthcare institution. HypothesisDifferences in surgical practice patterns exist across healthcare institution types and according to the nature of the procedures. Patients and methodsA retrospective observational nationwide study was performed using the exhaustive French hospital database. All surgical procedures done in 2019 for orthopaedic and trauma indications were collected. We then classified the procedures according to the most common diagnoses by distinguishing procedures on the hip, knee, shoulder, hand, spine, ankle, and foot, as well as paediatric and traumatology procedures. ResultsProcedures performed more often in private institutions included those on the hip (93,225 [64.3%] of 144,919), knee (223,542 [75.5%] of 296,255), shoulder (103,923 [76.6%] of 300,577), hand (408,035 [77.6%] of 525,534), spine (for degenerative disease, 27,001 [71.2%] of 37,915), and ankle and foot (75,392 [77.1%] of 105,720). In contrast, of the 19,157 (80.3%) of the 23,848 paediatric procedures and 203,090 (67.7%) of the 300,065 traumatology procedures were done in public institutions. For all eight comparisons, the difference between public and private institutions was statistically significant. The overall trend was towards public university hospitals performing more paediatric and trauma procedures and more complex surgeries such as those required by multiple traumatic injuries. DiscussionOur study provides accurate numbers of surgical procedures done in public and private healthcare institutions in France in 2019. We found major differences not only across categories and specialties but also within specialties depending on the type of procedure. Orthopaedic surgical activity shows a marked imbalance in France between public and private institutions. Further research would be needed to identify the causes. Level of evidenceIV, retrospective observational epidemiological study.

IMPACT OF LEADERSHIP STYLES ON EMPLOYEE BEHAVIOR IN HEALTHCARE INSTITUTIONS DURING THE COVID-19

The COVID-19 pandemic that hit the world during 2019 has set an enormous challenge for the healthcare industry in B&amp;H as well as for the entire world. The Healthcare industry was forced to find new strategies overnight to survive. This study aims to investigate the impact of transactional and transformational leadership styles on employees’ intention to stay in mediating the role of affective commitment in healthcare organizations in B&amp;H during the COVID-19. This research has high implications for decreasing turnover in workplaces and increasing organizational commitment by contributing high commitment to the employees that will be more motivated and perform better. The data of the study were analyzed using SPSS (v20) software packages and mediation tests were applied, using 178 sample data from private healthcare institutions in B&amp;H. The results indicate that effective commitment mediates the connection between transformational and transactional leadership and turnover intention.

Corruption, public trust and medical autonomy in the public health sector of Montenegro: Taking stock of the COVID-19 influence.

In this paper, we analyze the influence of corruption perception, experiences of corruptive behavior, and healthcare autonomy on the public trust in Montenegrin healthcare, by surveying the general population before and after the global COVID-19 pandemic. By providing a quasi-replication of a previous empirical study of corruption and trust in the Croatian public healthcare sector, we introduce the COVID-19 pandemic as a new research context. Before the pandemic, we found a consistent and significant negative influence of the corruptive practices and the generally perceived level of corruption (corruption salience) on the trust in public healthcare. The emergence of COVID-19 had mixed effects: while there is a slightly higher effect of corruption salience to the preference of public healthcare, corruptive experiences still matter but are tolerated much higher than before the pandemic. Public assessment of the autonomy of the health system increases preference for public healthcare, both before and after the pandemic, although the emergence of COVID-19 somewhat lowers this effect. The obtained results point to the most significant challenges of the ‘post-COVID-19’ social context to public health policymaking and management of public healthcare institutions. These include focusing the public healthcare reforms on corruption, reducing waiting times for different diagnostics and medical procedures in the public healthcare system, and regulating the ‘dual practice’ (simultaneous work in public and private healthcare institutions).

Healthcare in Malta

Malta is an island state located in the Mediterranean Sea and a former British colony. Malta gained independence only in 1964, and 10 years later received the status of a parliamentary republic. The population of Malta is a little over 440 thousand people, and the country has the status of the most sparsely populated EU member state. Every fifth Maltese living on the island is an emigrant; the emigration of pensioners from the UK is especially popular here. Life expectancy for men in Malta is 79.6 years, for women 84.3 years. The state guarantees the provision of medical care for all segments of the population. The annual expenditure on health needs exceeds 10%; the financing of the medical sector is carried out through taxes and weekly insurance premiums, which are paid by both employers and employees themselves. To obtain medical ser vices, one can apply to both public and private healthcare institutions. In order to receive medical care foreigners who are not EU citizens have to purchase a private health insurance policy. Malta is a popular destination for medical tourism, as the quality of provided medical services meets European standards, while prices are about a third lower than in European countries.

(Dis)trust in doctors and public and private healthcare institutions in the Western Balkans.

IntroductionConsidering the geopolitical changes in the six Western Balkan countries—Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia and Serbia—over the last three decades, particularly as it concerns the progress and changes in the healthcare systems, we argue that there is a need for a detailed analysis of people's trust in those healthcare systems and healthcare providers.MethodsIn this cross‐sectional, intercountry study, we examine the trust trends of Western Balkans citizens in medical doctors and public and private healthcare institutions from 25 July 2021 to 30 October 2021, with 3789 participants using a self‐reported questionnaire, and Google Forms. Snowball sampling is used to collect data from six Western Balkans countries: Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia and Serbia.FindingsThe primary findings of our study show that citizens in the Western Balkans have a low level of trust in their healthcare system (X̄ = 4.3/10). Medical doctors working in private healthcare institutions, on the other hand, are afforded a higher level of trust (X̄ = 6.6/10) than those working in public healthcare institutions (X̄ = 5.7/10). In the event that they or their family members need to visit a health institution, half of the study participants would choose private healthcare institutions over public ones. We found a statistically significant difference between countries on the mean points from the questions concerning one's trust in the healthcare system, private healthcare institutions and medical doctors working in public and private sectors (p < .05).ConclusionDespite its limitations, this study is the first cross‐sectional research on the ‘trust interface’ among western Balkan citizens, revealing that they have low trust in their healthcare systems.Public ContributionThe information in this manuscript was gathered on the level of 3789 citizens from six Western Balkan countries. Before we began collecting data, we conducted a piloting procedure with 40 citizens who were clients of health institutions to validate the data collection questionnaire.

Determinants of Work-Related Stress Among Nurses Working in Private and Public Hospitals in Dessie City, 2021: Comparative Cross-Sectional Study.

BackgroundGlobally, work-related stress had a significant impact on health-care providers. Private and public health-care institutions are considered intensive work areas for work-related stress. In Ethiopia, most studies were focused on only public hospitals. However, this study aimed to include private and public hospitals.MethodsA hospital-based comparative cross-sectional study was conducted among 304 nurses working in public and private hospitals from 8 April to 7 May 2021. A simple random sampling technique was used to select nurses, and the data were collected using a standardized self-administered questionnaire. Data were entered into Epidata version 4.6.1 and then exported to SPSS version 26 for analysis. Descriptive statistics, bivariable and multivariable binary logistic regression were applied. The final multivariate regression declared significant determinants at a p-value <0.05 and a 95% confidence interval with an adjusted odds ratio (AOR) to reveal the strength of associated variables.ResultsIn this study, the overall magnitude of work-related stress among nurses was 48.4% (95% CI: 42.4–54.6) (51.6% among public hospitals and 46.4% for private hospitals). Bachelor nurses (AOR=0.32,95% CI:0.13,0.76), working in operation room (AOR=7.89, 95% CI:1.46,9.60) and job dissatisfaction (AOR=4.95, 95% CI: 1.94,2.61) were determinants of work-stress in private hospitals whereas being female (AOR = 3.15, 95% CI: 1.43, 6.92), working experience 5 to 10 years (AOR=0.42, 95% CI: 0.18, 0.97), having degree and above (AOR = 0.41, 95% CI: 0.17, 0.99) and working in intensive care unit (AOR = 6.48, 95% CI:1.49, 8.18) were determinants of work-related stress in public hospitals.ConclusionThe overall magnitude of work-related stress among nurses in Dessie city was almost half. In contrast, more work-related stress among nurses working in public hospitals than in private hospitals. Sex, operating (working) unit, working experience, and type of institution were work-related stress determinants in public and private hospitals. Hence, reducing workload and providing stress management training is crucial to reducing work-related stress among nurses.