Private Medical Institutions Research Articles

Chastnye medicinskie instituty i apteki v sibirskoj stolice (vtoraya polovina XIX — nachalo XX v.)

Chastnye medicinskie instituty i apteki v sibirskoj stolice (vtoraya polovina XIX — nachalo XX v.)

The marketing study of medical services market: factors and regional characteristics

The article considers the relevance of marketing research in the field of paid medical services. Due to the fact that the market of paid services in Russia has increased significantly, medical management took neighboring position to medical marketing. The article emphasizes that in Russia annually the number of private medical institutions increases. This trend is directly related to to the fact that free medical care is not always able to provide necessary services vital for the patient. In turn, the existing increased competition pushes private medical institutions to actively fight for the client. The statistical data demonstrates that the loss of five customers per day results in losing of up to two million rubles monthly. It id established that due to increasing numbers of private medical institutions an urgent need for new logistics and marketing research of all medical production arises to have more comprehensive picture of the provision of a paid medical care. It is concluded that reaching these marketing and marketing research tasks determine the new special place of marketing technologies. The marketing in the health care system acts as basic system of principles targeted to creating and studying the demand and supply of medical services. In the health care market, the role of the consumer is played by patients whose needs must be met by medical clinics. The marketing in the health care system is the process of developing and providing medical services. The corresponding data and main conclusions related to provision of paid medical services in the Krasnodar region is presented.

A comparative analysis on human resources among the specialized ophthalmic medical institutions in China

BackgroundThis study compares perspectives on specialized ophthalmic medical institutions, identifies the gaps in property and geographic offerings, and explores the ways that ophthalmic medical institutions can better allocate resources. The results of this research will increase patient’s access to equitable and high-quality ophthalmic care in China.MethodsThe data for this research was gathered from the Survey of China National Eye Care Capacity and Resource for the year 2015. The paper specified the number, professional level of expertise, and educational background of ophthalmic health personnel. The authors of the paper analyzed and compared the differences in ophthalmic care in public vs. private and urban vs. rural regions in China. Descriptive statistics were used.ResultsOf the 395 specialized ophthalmic hospitals surveyed, 332 were private medical institutions (84%), and 63 were public (16%). Of the 26 607 ophthalmic personnel surveyed, working in specialized ophthalmic hospitals, 17 561 were in private hospitals (66%) and 9 046 were in public ones (34%). Furthermore, 22 578 of those personnel worked in urban ophthalmic institutions (85%) and 4 029 worked in rural ones (15%). As for regional differences, 14 090 personnel were located in eastern China (53%), 8 828 in central regions (33%), and 3 689 in the western regions (14%).ConclusionsPublic ophthalmic medical institutions still face challenges in providing equitable and widespread care. The availability of well-staffed health centers varies significantly by region. These variations impact resource allocation and directly lead to inequalities and inaccessibility of health services in certain regions of China.

Convergence Study on the Reliability of Public and Private Medical Institutions in Rural Areas -Mainly 65 years old and older-

Convergence Study on the Reliability of Public and Private Medical Institutions in Rural Areas -Mainly 65 years old and older-

Prevalence and determinants of caesarean section in South and South-East Asian women.

BackgroundCaesarean section is considered a relatively preferable and safe method of delivery as compared to normal delivery. Since the last decade, its prevalence has increased in both developed and developing countries. In the context of developing countries viz., South Asia (the highest populated region) and South-East Asia (the third-highest populated region), where a significant proportion of home deliveries were reported,however, the preference for, caesarean delivery and its associated factors are not well understood.ObjectiveTo study the caesarean delivery in the South and South-East Asian countries and to determine the factors associated with the preference for caesarean delivery.MethodologyDemographic and Health Survey Data on from ever-married women of nine developing countries of South and South-East Asia viz., Vietnam, India, Maldives, Timor-Leste, Nepal, Indonesia, Pakistan, Bangladesh, and Cambodia have been considered. Both bivariate and binary logistic regression models were used to estimate the propensity of a woman undergoing for caesarean delivery and to assess the influence of maternal socioeconomic characteristics towards the preference for caesarean delivery.ResultsObtained results have shown an inclination of caesarean delivery among urban than rural women and are quite conspicuous, but is found to be underestimated mostly among rural women. Caesarean delivery in general is mostly predisposed among women whose baby sizes are either very large or smaller than average, have a higher level of education and place of delivery is private medical institutions. The logistic regression also revealed the influence of maternal socioeconomic characteristics towards the preference for caesarean delivery. Based on nine South and South-East Asian countries an overall C-section prevalence of 13%, but based on institutional births its increase to 19%. The forest plot demonstrated that a significant inclination of C-section among urban than rural regions. In Meta-Analysis, very high and significant heterogeneity among countries is observed, but confirms that in terms of prevalence of C-section all of the countries follow independent pattern.ConclusionStudy of seven urban and four rural regions of nine South and South- East Asian countries showed, a significant inclination towards the caesarean delivery above the more recent outdated WHO recommended an optimal range of 10–15%and are associated maternal socioeconomic characteristics. In order to control unwanted caesarean delivery, the government needs to develop better healthcare infrastructure and along with more antenatal care related schemes to reduce the risks associated with increased caesarean delivery.

Recommendations for improving the hospital’s marketing policy

This article summarizes the arguments and counterarguments within the scientific discussion on improving the marketing policy of the clinic. The purpose of the study is to improve the marketing policy of the clinic. The urgency of solving the scientific problem lies in need to promote medical services, where marketing activities contribute to establishing relations between providers and consumers of medical services. The authors noted that patients have a low level of awareness in medical services, making it difficult to understand the market of medical services. In turn, public and municipal health care facilities have a passive marketing policy that is not competitive enough with private health care facilities. In most cases, state and municipal medical institutions do not use marketing tools to acquaint consumers with the list of available services, do not inform consumers about the expansion of medical services and the benefits of their medical institution. The object of the study was selected health care management. According to the results of empirical analysis of ways to improve the marketing policy of the clinic, it is established that the reform of the medical sector of Ukraine intensifies the processes of competition in the market. The marketing system of Ukrainian health care has no concept of medical care. Instead of that, there is a market element as medical service or health care service provided to the patient by a health care institution or an individual registered according to the law and possessing the medical business license. Besides, the medical services are paid for by the customer, such as patients, various organizations, local authorities, and the government. Thus, public medical institutions faced the need to fight (particularly with private medical institutions) for the consumer and state funding for the package of primary medical services. The study empirically confirms and theoretically proves the existence of competition between private and public medical institutions in the market of medical services. The results of this study can help improve the marketing policy of public and municipal clinics.

Conflict management system in health care

This article provides ways to improve the conflict management system in health care based on analyzing the causes of conflicts in a private medical institution. The authors considered the healthcare delivery process in the triad «health worker – patient – society». The study involved analyzing conflict causes in the health care system in the relationship between «health worker – patient» and «health worker – health worker». To determine the conflict causes in private medical institutions and ways to minimize them, the authors used questionnaire data collection, interviewing technique, data analysis, and graphic approach. The study object is medical staff and patients of SILMED Diagnostic Medical Center in Ukraine. The findings identified the main problems in the organization of the conflict management system. Therefore, the essence of conflict situations arising in a medical institution was determined. The obtained results allowed formulating proposals to improve the conflict management system of the private medical institution. Thus, the authors emphasized that the conflict management system in private medicine should minimize the probability of conflict, focus on the treatment quality and the service price. Besides, it should include the development of moral codes for doctors in private medical institutions. The authors noted that to reduce conflict in the relationship «medical worker – medical worker», conflict prevention is more effective than constructive resolution. Thus, conflict prevention requires less effort, resources, and time for a successful clinic operation. To decrease conflicts in the relationship «health worker – patient», it is essential to make a pact between the patient and private medical institution. It establishes the patient’s relationship with the clinic and is publicly available for customers. In the study, the authors concluded that during the consultation, the healthcare professional should persuade the patient to follow all recommendations for maintaining or improving the patient’s health, requiring, if necessary, evidence from the clinic’s patients to follow the treatment protocol.

Analysis of related factors and disease costs of respiratory infection and environmental pollution in children.

BACKGROUND: In recent years, air pollution and the number of children with respiratory tract infections increased. This also increased the burden related to the treatment of disease, so the government and relevant departments need to strengthen their management.OBJECTIVE: The aim of the present study was to quantitatively analyze the relationship between respiratory infection and air quality in children and gain insight into the burden of related diseases.METHODS: Data regarding outpatient and emergency department visits in children of 14 years or younger in 16 public and private medical institutions were collected for four months. Routine air quality monitoring data in Shanghai from the same period were correlated with these medical data by descriptive statistics, Pearson’s correlation analysis and multivariate linear regression analysis.RESULTS: There was a positive correlation between respiratory tract infections in 73376 children and Air Quality Index (AQI), PM2.5, SO and NO levels. The total medical expense per patient was 80.22 yuan, and the average compensation ratio of medical insurance per patient was 18.95%. The increase in AQI and the concentration of major air pollutants will lead to increased medical treatment for children with respiratory diseases.CONCLUSION: It is suggested that the intensity of air pollution control should be increased, so that the special period of childhood respiratory protection is strengthened. Moreover, child medical insurance coverage should also be moderately increased to safeguard the rights and interests of children’s health.

The Dermlep Study Part 2: Results of a Nation-Wide Survey of Dermatologists' Access to Quality Leprosy Services at their Clinics and Hospitals in India.

Introduction:Dermatologists in India are trained and qualified to treat leprosy and there is evidence to suggest that they are involved in the diagnosis and management of a significant number of leprosy patients in the country. The present study evaluated the access to quality leprosy services at their clinics and hospitals to understand the extent of their role in providing comprehensive care to people affected by leprosy and how it can be organized further.Methods:The DermLep Study was a pan-India questionnaire-based survey carried out to evaluate the role that dermatologists play in leprosy management in the country. It included as part-2 of the survey, 11 questions on the access of the dermatologist to various quality leprosy services available at the clinic or institution including skin smears, skin biopsy, multidrug therapy (MDT) blister packs, basic physiotherapy services, and reporting to the national program (NLEP).Results:The dermatologists who participated in the survey included 101 private practitioners and 100 working in Government or private medical institutions. The key findings of the survey were that 78% of the participating dermatologists still encounter leprosy patients frequently in their clinics; 81.0% of them had access to skin smears; and 93.4% to skin biopsy. The World Health Organization (WHO) MDT regimen was followed by 79.0% of the dermatologists in the study, majority of whom were those working in medical colleges (88%); however overall, 87.4% extended the regimen beyond the fixed duration, mostly on a case to case basis. Thalidomide was available for 61.1% of them to treat type 2 reactions. Basic physiotherapy services were available with 70.2% of dermatologists surveyed; 58.9% dermatologists had access to MCR footwear; and RCS facility access known to 45.5% of them. About 83.5% of the dermatologists working in institutions were reporting their leprosy cases to the NLEP, whereas from a high percentage (71.4%) of dermatologists in private practice, cases were not captured in routine under NLEP.Conclusion:Dermatologists in India have the clinical skill, expertise, and access to most of the basic services, including skin smear and skin biopsy facilities needed to provide comprehensive care to leprosy patients in post-elimination era of integration of leprosy services. While dermatologists are already managing leprosy patients both at medical institutes and private clinics across India, their “structured” involvement at all levels in the national program will facilitate improved reporting and cataloging of cases seen by them. It will also elevate standards of leprosy care; create an effective public-private partnership and disease expertise; and assist develop a comprehensive, patient-tailored approach in the leprosy program in India.

Where Does Indian Medical Education Stand Amidst a Pandemic?

The recent outbreak of COVID-19, declared a pandemic, has affected medical education globally. The scenario is no different for medical students in India as they find themselves at a crossroads in their careers, with clinical and elective postings called off. Missing out on the opportunity to learn from “first-hand” clinical observation stands to threaten the quality of medical education and learning procured by Indian medical students which is extremely essential to deal with the vast patient load that awaits them in their impending future as healthcare professionals. Is the Indian medical education system being able to cope with the challenges imposed by the increasing burden of COVID-19? The authors propose few administrative and on-ground interventions that must seek to work collectively with all government and private medical institutions in order to help students/interns and residents in coping with stress, anxiety or academic losses incurred due to the pandemic.

Study on the Location of Private Clinics Based on K-Means Clustering Method and an Integrated Evaluation Model

Appropriate location is an important prerequisite for the long-term survival and development of private medical institutions. However, in both theory and practice, the issue of location decision-making for private clinics has not been fully studied. We therefore aimed to provide a feasible scheme for the location of new private clinics. This paper combines the k-means clustering method and an integrated 2DULVs (two-dimensional uncertain language variables)-TOPSIS (technique for order preference by similarity to ideal solution)-DSCCR (Dempster-Shafer conjunctive combination rule) model to screen and evaluate all of the areas in the target region for an Internet medical company to set up offline clinics. We first created geographic grids using GIS and collected point of interest (POI) data. We then used the k-means clustering method to obtain 10 suitable grids as alternatives. Last, we established an evaluation index system and used the proposed model to rank them. The results show that grids 178, 179 and 202 are more suitable for the company to establish offline clinics in the expansion of business. The results of this study are also consistent with those of the other three fusion methods. This paper provides a beneficial attempt for private clinics to make location decisions and can be extended to the strategic decision-making of other industries or other issues.

Quality of life of students of a private medical college

Objective:To determine the quality of life of students of a private medical college in Karachi in Pakistan.Methods:This cross sectional study was conducted among 217 medical students of Liaquat College of Medicine and Dentistry, Karachi from June 2017 to March 2018. Students were selected by a stratified sampling method and the World Health Organization Quality of Life BREF Instruments (WHO QOL-BREF) was used for the above-mentioned study. Statistical analysis was performed using SPSS (Statistical Package for Social Sciences) version 21 and Analysis of variance (ANOVA). Independent t-test was used as p <0.05 significant.Results:A total of 250 questionnaires were distributed among 2nd year, 3rd year, 4th year and final year students and the response rate was 86.8%. Among them 48.5% (n=105) students were male and 51.5% (n=112) students were female, while 9.2% (n=20) students were currently ill and the other 90.8% (n=197) were healthy.Conclusion:Medical education influences the quality of life (QOL) of students adversely. Social relationships and environmental domain were satisfactory in private medical institutes whereas physical and psychological progress was low due to academic load which requires improvement either by physical activities such as fitness classes or other extra-curricular activities.

Moments of care: How interpersonal interactions contribute to luxury experiences of healthcare consumers

This study introduces the notion of “moments of care,” which describe short-lived and prosocial interpersonal interactions between healthcare consumers and medical staff, as individually defined luxuries. Findings from 30 phenomenological interviews with patients of a luxury ophthalmic clinic reveal that healthcare consumers experience moments of care through (1) authentic presence, (2) balanced power relationship, and (3) interpersonal synchrony. This study contributes a phenomenological experiential perspective to the growing body of research on unconventional aspects of luxury by showing that experiencing humanity in interpersonal interactions is “true luxury” and surpasses material luxury. The findings provide a valuable source of inspiration for private and public medical institutions as well as for branded service providers.

Professional Quality of Life and Its Association with Work Experience and Income among Healthcare Worker

Objective: The objective of the study is to assess job satisfaction between groups of healthcare workers based on their work experience and monthly salary.Methodology: Healthcare workers (n=81) including clinicians, nurses and medical teachers were recruited from a private medical institute at Lahore. Job Satisfaction Survey (JSS) and Professional Quality of Life (ProQOL) Scale including its component scales of Compassion Satisfaction (CS), Burnout (BO) and Secondary Traumatic Stress (STS) were used to determine aspects of vocational quality of life and satisfaction. Kruskal-Wallis test was used to assess group differences. Spearman correlational analysis was done to assess correlation between income, work experience and job satisfaction.Results: Significantly higher professional satisfaction, lower burnout and stress scores were observed in experienced healthcare workers as compared to less-experienced ones (p value =0.039* for JSS, p value =0.011* for CS, p value =0.055* for BO and p value =0.027* for STS). Significantly higher satisfaction scores were found in workers with higher monthly income as compared to those with lower monthly salary (p value =0.006* for JSS and p value =0.032* for CS). Significant positive correlation was observed between healthcare workers’ job satisfaction and their experience and monthly salary.Conclusion: More experience at work is particularly associated with lower burnout and reduced occupational stress.

The specificity of moral aspects of activity of medical workers in Health Care of Russia

The transformation of values and dissemination of consumerism ideology, associated with active implementation of market mechanisms of functioning in the Russian health care system, significantly affected processes of implementing moral aspects of activities of medical workers. The transition of physician and patient to buying and selling relationships initiated the situation when the life and health maintenance is considered not as an ultimate purpose of medical profession, but as a service supplied for particular fee. Moreover, quality of medical care supplied is considered as directly proportional to its cost. This fact results, from one hand, in corruption in health care system initiated by patients themselves because unofficial fee is significantly lower than the established one. From the other hand, it results in the fact that service supplied to patient for free in state polyclinics is provided untimely and not always is has needed quality due to lacking of necessary resources. As a result, the moral purpose of medical profession becomes minor, yielding to commercial relationships. However, these occurrences do not disprove the fact that the patient, in case of visiting physician, remains completely dependent on one's professionalism and responsibility, despite the abundance of private medical institutions and the formal freedom of choosing type of medical service and medical specialist providing it. The high moral culture was and continue to be an obligatory characteristic of successfulness and professionalism of physician. In the new economic conditions, it can become a competitive advantage, since every patient wishes to see in physician not only competent specialist, but also a person capable to empathize and responsibly treat with responsibility another life that was trusted to him.

Competitiveness of private specialist medical entities in the opinion of service recipients

Abstract Introduction. The phenomenon of competitiveness and pressure of competitors that influence private medical institutions lead to the quest for new solutions on managing and defining determinants, which will provide advance of the institution over competing entities Aim. The purpose of the study was to determine factors influencing competitiveness of a medical institution according to the beneficiaries. Material and methods. The study group comprised 127 patients who used the services of private specialised medical institutions. Results and conclusions. The phenomenon of competitiveness in chosen types of medical services was noticed by 69% (88) of beneficiaries. High quality of services 79% (100), short waiting time for appointments 70% (89) and competitive prices 55% (70) are the main determinants of the competitiveness of those institutions.

Regulating private medical institutions: a case study of China.

The expansion of privatisation in health care has been discussed extensively in most European countries and remains a hot topic nowadays. In China, privatisation results in considerable changes in its health care system, especially accelerating the ever-growing private medical institutions (PMIs). The rapid growth of PMIs raises the question of regulation for the Chinese government. Given the fact that few studies are available on the regulation of PMIs in China, I attempted to fill that gap by discussing the development of PMIs with a special focus on legal-regulatory strategies. After assessing current legal-regulatory strategies concerning PMIs, the paper identifies three major concerns regarding effective legal rules (i.e. weak coherence, inconsistency and legislative vacancy) and three difficult issues regarding government capacity (i.e. the negative effects of decentralised political structure, the low professionalism of bureaucrats and lack of reliability) that impede the well-functioning of regulatory agencies in China. As a plausible response, the paper recommends that the newly drafted basic health law should assign a separate chapter to regulate PMIs and also an independent regulatory body should be established to manage the issues of PMIs in China. Detailed recommendations are the practical implications of ICESCR General Comment No. 14.

Dark sides of self-efficacy and task interdependence: victimization

PurposeThe purpose of this paper is to develop and test theoretical propositions explaining why and under what circumstances highly self-efficacious employees experience victimization at work and how task interdependence leads to the situation that employee victimization emerges.Design/methodology/approachTo test hypotheses, the authors collected the data from four organizations, which are private company, public enterprise, medical institution and government office in Gyungbuk province, South Korea. The final sample for analyses was 209 employees.FindingsContrary to the prediction, high self-efficacy did not show a statistically significant relationship with victimization. However, task interdependence is related to victimization and functions as an important situational contributor to exacerbate highly self-efficacious employees’ victimization.Research limitations/implicationsThe findings have research implications by exploring victimization of the employees with high self-efficacy, which is an underdeveloped area in the victimization literature and showing that task interdependence is the critical factor to trigger and aggravate employee victimization. Despite these implications, this study should be evaluated in light of several limitations such as the data from single source for all variables and the use of cross-sectional data.Practical implicationsManagers need to be aware that highly self-efficacious employees can be vulnerable to victimization at work, where there is high task interdependence. The evidence suggests that managers may take safeguards to deter employee victimization, when tasks are closely related among members.Originality/valueThis paper contributes to expand the understanding of employee victimization by examining the roles of self-efficacy and task interdependence to crystalize antecedents and boundary conditions of victimization at workplace.

Positioning analysis of Shanghai′s tertiary public hospitals in the development of health service industry

In the development of Shanghai′s health services, tertiary public hospitals play an important role, and their positioning deserves in-depth research.The authors sorted out the relevant laws and policies of the state and Shanghai, clarified the relevant policy basis of tertiary public hospitals in the development of health service industry on the premise of public welfare, and proposed the functional orientation of these hospitals in the industry. Their roles include namely, proper provision of special medical services, focused efforts on the transformation of medical scientific and technological achievements, active cooperation with private medical institutions on contract basis, and promotion of the cluster development of health service industry chain.At the same time, the authors put forward policy suggestions to support the development of health industry in Shanghai′s tertiary public hospitals. Key words: Hospitals, public; Benefit; Health services industry; Positioning; Shanghai

THE EVALUATION OF FUNCTIONING OF PRIVATE MEDICAL INSTITUTIONS IN THE REPUBLIC OF TAJIKISTAN

Introduction. The analysis of the problem of functioning of private medical institutions is dictated by a number of circumstances related to dramatic increasing of number of private medical services providers in Tajikistan during last years and also by danger of occurrence of medical practice of improper quality. Material and methods. The study included analysis of functioning of 681 private medical services providers according data of the Service of State Monitoring of Medical Activities and Social Defense of the Ministry of Health and Social Defense of Population of the Republic of Tajikistan. The evaluation of their activities was implemented using questionnaires covering all aspects of private medical institutions. Results. Among total sampling of private medical services providers, 325 (47.7%) are corporate bodies, 55 (8.1%) - branches of institutions of corporate bodies and 301 (44.2%) physical persons. In the private medical sector operate 3666 individuals and out of them 1559 physicians, 1234 paramedical personnel and 873 general service and supportive personnel. The analysis of distribution of private medical services providers according licensed activities established that the highest percentage had multi-field institutions (207 or 30.3%), stomatological services (200 or 29.4%) and ultra-sound diagnostic (88 or 12.9%). According the results of analysis established violations personnel of the Service of State Monitoring of Medical Activities and Social Defense, within the framework of authority, in 567 cases applied penalties and out of them vindictive damages in 43.2% of cases, suspending of illegal private practice in 31.2% of cases, disregard of legal requirements in the area of traditional medicine in 13.6% of cases and temporary suspending of functioning of institution in 11.6% of cases. Conclusion. To ameliorate functioning of private medical institutions of the Republic of Tajikistan a support is needed of further development of normative legal base with simultaneous support of private medical institutions with necessary normative materials. Also increasing of expenses of institutions to clinical security and amelioration of organization and quality of infection control are required.