Quality Of Healthcare Services Research Articles

Postpartum length of hospital stay among obstetric patients in Ibadan, Nigeria

BackgroundPostpartum Length of hospital stay (PLOHS) is an essential indicator of the quality of maternal and perinatal healthcare services. Identifying the factors associated with PLOHS will inform targeted interventions to reduce unnecessary hospitalisations and improve patient outcomes after childbirth. Therefore, we assessed the length of hospital stay after birth and the associated factors in Ibadan, Nigeria.MethodsWe used the Ibadan Pregnancy Cohort Study (IbPCS) data, and examined the 1057 women who had information on PLOHS the mode of delivery [spontaneous vagina delivery (SVD) or caesarean section (C/S)]. The outcome variable was PLOHS, which was described as the time interval between the delivery of the infant and discharge from the health facility. PLOHS was prolonged if > 24 h for SVD and > 96 h for C/S, but normal if otherwise. Data were analysed using descriptive statistics, a chi-square test, and modified Poisson regression. The prevalence-risk ratio (PR) and 95% confidence interval (CI) are presented at the 5% significance level.ResultsThe mean maternal age was (30.0 ± 5.2) years. Overall, the mean PLOHS for the study population was 2.6 (95% CI: 2.4–2.7) days. The average PLOHS for women who had vaginal deliveries was 1.7 (95%CI: 1.5–1.9) days, whereas those who had caesarean deliveries had an average LOHS of 4.4 (95%CI: 4.1–4.6) days. About a third had prolonged PLOHS: SVD 229 (32.1%) and C/S 108 (31.5%). Factors associated with prolonged PLOHS with SVD, were high income (aPR = 1.77; CI: 1.13, 2.79), frequent ANC visits (> 4) (aPR = 2.26; CI: 1.32, 3.87), and antenatal admission: (aPR = 1.88; CI: 1.15, 3.07). For C/S: maternal age > 35 years (aPR = 1.59; CI: 1.02, 2.47) and hypertensive disease in pregnancy (aPR = 0.61 ; CI: 0.38, 0.99) were associated with prolonged PLOHS.ConclusionThe prolonged postpartum length of hospital stay was common among our study participants occurring in about a third of the women irrespective of the mode of delivery. Maternal income, advanced maternal age, ANC related issues were predisposing factors for prolonged LOHS. Further research is required to examine providers’ perspectives on PLOHS among obstetric patients in our setting.

Design of a Booking Management System, with Responsive Design Web Appointments, to Reduce Time and Improve the Quality of Health Care Services

Technology is playing an important role, especially in the current need for technological solutions focused on the health sector. There is currently much room for improvement, for example: reducing the long waiting time for patients to book an appointment according to availability in the specialty and doctor. However, there are still health centers that lack technological solutions focused on this, because most of the population does not yet have the knowledge of technology. Given this, and taking into account the needs of users with low knowledge of ICT and contribute to the health sector, will be launched the design and development of a specialized responsive website for the management of medical appointments that will solve in part the order and time of attention of each appointment requested, whose purpose is to improve the quality of care of public health services.

Enablers and barriers to primary health care access for Indigenous adolescents: a systematic review and meta-aggregation of studies across Australia, Canada, New Zealand, and USA

BackgroundIndigenous adolescents access primary health care services at lower rates, despite their greater health needs and experience of disadvantage. This systematic review identifies the enablers and barriers to primary health care access for Indigenous adolescents to inform service and policy improvements.MethodsWe systematically searched databases for publications reporting enablers or barriers to primary health care access for Indigenous adolescents from the perspective of adolescents, their parents and health care providers, and included studies focused on Indigenous adolescents aged 10–24 years from Australia, Canada, New Zealand, and United States of America. Results were analyzed against the WHO Global standards for quality health-care services for adolescents. An additional ninth standard was added which focused on cultural safety.ResultsA total of 41 studies were included. More barriers were identified than enablers, and against the WHO Global standards most enablers and barriers related to supply factors – providers’ competencies, appropriate package of services, and cultural safety. Providers who built trust, respect, and relationships; appropriate package of service; and culturally safe environments and care were enablers to care reported by adolescents, and health care providers and parents. Embarrassment, shame, or fear; a lack of culturally appropriate services; and privacy and confidentiality were common barriers identified by both adolescent and health care providers and parents. Cultural safety was identified as a key issue among Indigenous adolescents. Enablers and barriers related to cultural safety included culturally appropriate services, culturally safe environment and care, traditional and cultural practices, cultural protocols, Indigenous health care providers, cultural training for health care providers, and colonization, intergenerational trauma, and racism. Nine recommendations were identified which aim to address the enablers and barriers associated with primary health care access for Indigenous adolescents.ConclusionThis review provides important evidence to inform how services, organizations and governments can create accessible primary health care services that specifically meet the needs of Indigenous adolescents. We identify nine recommendations for improving the accessibility of primary health care services for Indigenous adolescents.

Pharmaceutical sector: Packaging requirement in serialization

Access to healthcare is a fundamental right for every individual, and it is the responsibility of governments to ensure the provision of quality healthcare services and infrastructure to their citizens. Over the past few decades, both governments and the healthcare industry have been grappling with the challenge of minimizing the adverse effects on public health caused by counterfeit medicines. According to the World Health Organization, approximately four out of ten medicines in developing and impoverished countries are either fake or potentially adulterated, leading to significant economic losses and reducing funds allocated for research and development (R&D) by organizations. Preventing counterfeit medicines from entering the supply chain poses a significant challenge for governments and regulatory authorities. Consequently, there is a concerted effort to establish stringent guidelines aimed at thwarting criminals and counterfeiters from infiltrating markets with fake medications. The healthcare industry recognizes the necessity for strict regulations and secure technologies to ensure the provision of safe and authentic drugs to patients. In the United States, the FDA has outlined a ten-year roadmap to implement drug traceability measures. Additionally, the Healthcare Distribution Alliance (HDA) has mandated the inclusion of multiple barcodes and human-readable data in product packaging hierarchy. Furthermore, the FDA is actively engaged in a pilot project with leading pharmaceutical manufacturers and wholesalers to explore the utilization of blockchain technology within an interoperable digital network for securing the transfer of digital traceability data among authorized trading partners.

Service quality attributes on customers’ perceived value and behavioral intention of district health centres: a moderating effect of health-care subsidy

Purpose This study aims to explore the influence of health-care service quality on customers’ perceived value, satisfaction, effectiveness and behavioural intention concerning district health centres (DHCs) in Hong Kong. This research also intends to assess customers’ perception of the subsidy scheme and its influence on the relationships amongst the aforementioned constructs. Design/methodology/approach The convenience and snowball sampling approaches were adopted, and the self-administered questionnaire was sent to 309 customers of DHCs. Findings Service quality attributes in terms of staffing and procedures positively increased customers’ perceived value and staffing, procedures and operations. Physical facilities positively promoted customers’ satisfaction, consequently improving DHCs’ effectiveness and behavioural intention. However, core treatments and services of DHCs did not impact customers’ perceived value and satisfaction. Furthermore, customers receiving subsidies exhibited a more positive perception than those without subsidies. Practical implications Health-care organisations are advised to strategically allocate resources (staffing, facilities and procedures and operations management) to optimise overall performance outcomes. DHC operators could reinforce the core services of DHCs and health-care voucher subsidies to local citizens so as to enhance the effectiveness of DHCs and behavioural intention of customers. Originality/value This study integrates the input–process–output approach in measuring the effectiveness of and customers’ behavioural intention towards newly established DHCs.

The Impact of Strategic Decisions of Employee Training and Development on Organisational Goals and the Quality of Healthcare Services in Saudi Arabia

The Impact of Strategic Decisions of Employee Training and Development on Organisational Goals and the Quality of Healthcare Services in Saudi Arabia

Accessibility and availability of maternal and reproductive health care services: ensuring health equity among rural women in Southern India

IntroductionThe health of women is of particular concern because they often have greater health needs than men and many women still lack access to quality healthcare services, preventing their ability to attain the best possible level of health. Hence, this study aimed to assess the accessibility and availability of health services among rural women.MethodsA household survey was conducted by using a multi-stage sample with 407 married women aged 18–45 years, having at least one child and living in Tiruchirappalli District, Tamil Nadu were recruited for this study. A semi-structured questionnaire was used to collect data about the demographic status, and accessibility and availability of health services.ResultsOf the 407 respondents, 70% were aged between 26 and 40 years, 73% were working as farmers and labourers and 77% were living in nuclear families. 71% of them had enjoyed hospital facilities near their residence and 83% of the hospitals were run by the government. In village health nurse service (VHN), 34% of the respondents had received all services from VHN and 86% did not face any kind of gender inequality and almost all of them were satisfied with the service provided by the VHN. Almost all the respondents (98%) were satisfied with the availability of health services and 92% of them benefited from the government scheme related to childbirth.ConclusionThis study showed that overall, the women were satisfied with the availability of healthcare services and reproductive health services. Moreover, almost all of them benefited from the government scheme related to childbirth.

Spherical Fuzzy Multicriteria Decision Making for Evaluating Healthcare Service Quality of Hospitals During the Global Pandemic

AbstractThis study identifies hospitals in Iran that have demonstrated exceptional performance in service quality during the COVID-19 pandemic based on the proposed integrated multicriteria decision-making (MCDM) process. Although the coronavirus has been eradicated in most countries, occasional outbreaks of COVID-19 variants have occurred, affecting many individuals, particularly in Iran. The pandemic caused an influx of hospital visits, with people seeking treatment for various illnesses. However, the abrupt onset of the pandemic and its global impact challenged hospitals’ ability to provide timely care, leading to a noticeable decline in service quality. Identifying the top-performing hospitals is crucial for benchmarking and enhancing healthcare quality. To assess hospital service quality, the study employed a customized SERVQUAL model, which helped identify key factors that served as criteria and subcriteria for the evaluation process. The priority weights of these factors were then obtained using the spherical fuzzy analytic hierarchy process. For each SERVQUAL criterion, the hospitals were evaluated using the spherical fuzzy weighted aggregated sum product assessment method, resulting in respective rankings of the hospitals. Finally, an integrated Borda−Copeland method was utilized to generate the aggregate evaluation ranking, a feature that serves as an important departure from the literature. The contribution of this work lies in developing an integrated approach that intends to serve as a benchmark not only for hospitals in different countries but also for those confronting similar challenges and offers guidance for seeking insights from top-performing hospitals in comparable situations.

Subjective items to be considered in lipoabdominoplasty procedures under epidural anesthesia to increase their satisfaction

Background: Patient satisfaction is increasingly recognized as a vital indicator of healthcare service quality. It aids in identifying healthcare system shortcomings and improving patient trust. Factors influencing patient satisfaction during anesthesia services have been studied globally, but there is a lack of research in the context of lipoabdominoplasty under combined lumbar spinal-epidural anesthesia (CLSEA). Objective: To evaluates patient satisfaction with lipoabdominoplasty under CLSEA, focusing on various intraoperative factors that may affect satisfaction. Patients and Methods: This prospective observational cross-sectional study included adult patients undergoing lipoabdominoplasty under CLSEA without complications. Patients completed a structured questionnaire assessing satisfaction with intraoperative care. The questionnaire addressed factors related to the information provided, decision-making involvement, physical comfort, emotional support, and respect for patient values. Results: The questionnaire encompassed three types of questions: anesthesia quality, factors causing intraoperative annoyance, and patient-team interaction. The majority of patients found epidural anesthesia favorable. Factors causing moderate annoyance included surgery duration, stress, fixed position, feeling cold, and shivering. Patients reported low annoyance with factors like team discussions, anxiety, surgical light, dizziness, thirst, itching, nausea, vomiting, noise, pain, and dyspnea. Patients generally had a high rate of good reactions toward the surgical team, but less than 50% requested more respect and thorough medication information. Conclusion: This study offers insights into patient satisfaction with lipoabdominoplasty under CLSEA, shedding light on factors affecting their experiences. The findings underline the importance of addressing patient concerns and expectations to enhance overall satisfaction and quality of care.

Pattern of Ultrasonographic Prescriptions and Findings in Rural Northern India: A Mixed Methods Study

Abstract Background: Ultrasonography (USG) is used extensively across countries to diagnose and manage diseases. However, the existing USG services must be utilised rationally and effectively. Aim: Understanding the pattern of USG prescriptions and findings is important for improving the quality of healthcare services delivered by any healthcare system. Patients and Methods: A mixed methods study was conducted at a rural sub-district hospital in northern India to assess the pattern and completeness of prescriptions and USG findings and explore the patient and doctor-related factors influencing the USG prescription practices. Results: Of the 505 patients studied, 324 (64.2%) were females. The median age was 32 years (interquartile range: 24–45 years). The availability of complete medical history and clinical examination recording was 471 (85.7%) and 145 (28.7%), respectively. The indication for USG was mentioned in 436 (86.3%) prescriptions. Of the total, 251 (49.7%) had abnormal ultrasound findings. The abnormal finding was significantly high amongst patients (a) aged 45–59 years (P = 0.015) and (b) referred from surgery, paediatrics and other outpatient departments (P = 0.001) after adjustment to other factors. Patient-related factors such as non-harmfulness, free availability, reassurance of normality and health system/provider-level factors such as absence or low awareness of guidelines and changed clinical practice were the reasons for the current pattern of USG prescriptions. Conclusion: Although the medical history is better recorded, the incomplete recording of clinical examination needs improvement. Placing a guideline for prescribing USG, imposing nominal user fees and patient education and counselling can be tested for effectively utilising the USG services. Further, tracking the change in clinical management following the USG in Indian setting is the need of the hour.

Patient satisfaction with pharmaceutical services at primary healthcare centers under the Palestinian Ministry of Health

BackgroundThe measurement of patient satisfaction is a vital metric that enhances stakeholders to take proactive steps in improving the quality of healthcare services within medical care systems. This study assessed patient satisfaction receiving pharmaceutical services from primary health care centers in the Palestinian Ministry of Health (PMoH) governorate directorates in the West Bank.MethodsA total of 938 patients, all aged 18 years or older, completed a self-administered questionnaire. The assessment of general satisfaction was based on selected questions. Analyses were conducted to explore demographic characteristics. Mean and standard deviation (S.D.) were reported. Likert method was used to average scale satisfaction. To examine statistically significant differences, Chi-square analysis and binary logistic analysis were employed.Results56.8% of the survey respondents were women, 57.2% were 40 years or older, and 63.2% had graduated from high school. The general satisfaction score averaged 4.10 ± 0.77 indicating good satisfaction. Patients were satisfied with interpersonal relationships, with a mean score of 4.19 ± 0.70. However, satisfaction with therapy management was lower, with a mean score of 3.99 ± 0.77 indicating moderate satisfaction. A significant factor can affect patient’s satisfaction such as the location of the pharmacy (OR = 1.720, P = 0.012), the waiting area (OR = 1.671, P = 0.002) and the cleanness of pharmacy (OR = 2.307, P = 0.001).ConclusionThis study underlines the main components of patient satisfaction who receive pharmaceutical services in PMoH. It is highly recommended that PMoH must address patient dissatisfaction points in a total quality management plan.

Allocation of Resources Efficiently in Tactile Ethernet PON’s - Healthcare

Efficient resource allocation plays a critical role in enhancing network performance within healthcare environments. This study focuses on resource allocation within Tactile Ethernet Passive Optical Networks (PONs) specifically designed for healthcare applications. Our investigation delves into the unique challenges and requirements posed by healthcare Local Area Networks (LANs), which encompass the imperative for secure and dependable data transmission, as well as the seamless integration of medical devices and tactile communication capabilities. Drawing upon a thorough review of existing literature and empirical analysis, this paper proposes novel strategies for the efficient distribution of resources within Tactile Ethernet PONs to address the diverse needs of healthcare networks. We explore innovative approaches to integrate tactile feedback seamlessly into network infrastructure, aiming to enhance user experience and streamline interaction with medical devices. Moreover, we examine the broader implications of efficient resource allocation in terms of its potential to elevate patient care standards, improve operational efficiency, and fortify data security and privacy protocols within healthcare settings. The insights gleaned from this research contribute to the ongoing endeavors aimed at optimizing network performance and enhancing usability across healthcare LANs, ultimately striving to elevate the quality of healthcare services delivered. Keywords- Tactile Ethernet, Passive Optical Network, Network Optimization.

Impact Assessment of Patient Experience Capacity-Building Program Using Kirkpatrick Model for Program Evaluation at a Regional Healthcare System

ABSTRACT Introduction The patient experience (PX) is central to improving the quality of healthcare services. We launched a PX capacity- and capability-building program at the Armed Forces Hospitals Taif Region, which is integral to our regional healthcare cluster transformation plans and is an initial step toward developing a culture of improvement in human experience in healthcare. Methods A multidisciplinary PX committee recruited five frontline interprofessional PX heads, one from each of our regional healthcare hospitals. The Kirkpatrick model for program evaluation was used to assess the impact on four key levels: reaction, learning, behavior, and results. A pre-program competency assessment was conducted to evaluate the level of expertise across various PX competencies, and a program curriculum was developed accordingly. Participants underwent an intensive workshop-based PX capacity-building training program. A post-program competency assessment was performed along with a post-program survey. The PX-related activities led by interprofessional frontline PX heads at their respective hospitals’ post-programs were tracked. The impact on the regional PX mean score across various settings, including inpatient, outpatient, and emergency settings, was measured using Press Ganey PX surveys. Our work is reported in accordance with the SQUIRE-EDU guidelines of the EQUATOR network. Results The PX capacity-building program led to a significant improvement in participants’ expertise across various PX competencies. Significant improvements beyond the strategic targets were observed in the PX mean score in inpatient departments pre-program (83.31) vs. post-program (86.34), with a p-value of < 0.001 across the regional healthcare system. Conclusion The PX capacity-building program is a first step toward major cultural change amid the healthcare cluster transformation in our regional healthcare system. The Kirkpatrick model helps evaluate the impact of PX capacity- and capability-building training programs comprehensively through an organizational approach. Sustainable improvements in PX over a long period through a capacity-building program alone remain challenging.

Patients' subjective well-being: Determinants and its usage as a metric of healthcare service quality.

It is commonly suggested that patients' subjective well-being (SWB) can be affected by pre-treatment conditions and treatment experiences, and hence SWB can be used to measure and improve healthcare quality. With data collected in a hospital in the UK (N = 446), we investigated the determinants of patients' SWB and evaluated its use in healthcare research. Our findings showed strong relationships between pre-treatment conditions and patients' SWB: anxiety and depression negatively predicted SWB across all three domains, mobility positively predicted the life satisfaction and happiness domains, while the ability to self care and pain and discomfort also predicted SWB in some domains. In contrast, patients' satisfaction with the treatment only played minor roles in determining SWB, much less so the characteristics of their nurses. The general lack of associations between treatment experiences and patient's SWB highlighted the challenges of using SWB to measure healthcare quality and inform policy making.

Predictive Factors of Cancer Patients' Satisfaction with Quality of Healthcare Services Received at the Middle Euphrates Cancer Center, Al-Najaf Al Ashraf, Iraq

Predictive Factors of Cancer Patients' Satisfaction with Quality of Healthcare Services Received at the Middle Euphrates Cancer Center, Al-Najaf Al Ashraf, Iraq

A Study Of Importance Of Branding In Healthcare Service Quality Dimensions In Healthcare Sector

A Study Of Importance Of Branding In Healthcare Service Quality Dimensions In Healthcare Sector

Design of a Booking Management System, with Responsive Design Web Appointments, to Reduce Time and Improve the Quality of Health Care Services

Technology is playing an important role, especially in the current need for technological solutions focused on the health sector. There is currently much room for improvement, for example: reducing the long waiting time for patients to book an appointment according to availability in the specialty and doctor. However, there are still health centers that lack technological solutions focused on this, because most of the population does not yet have the knowledge of technology. Given this, and taking into account the needs of users with low knowledge of ICT and contribute to the health sector, will be launched the design and development of a specialized responsive website for the management of medical appointments that will solve in part the order and time of attention of each appointment requested, whose purpose is to improve the quality of care of public health services

Factors Influencing Postnatal Care Utilization Among Women in Sub-Saharan Africa: A Scoping Review

BACKGROUND:Considerable progress has been made globally in improving maternal and child health. However, Sub-Saharan Africa (SSA) and South Asia together accounted for 86% of all maternal deaths in the world during the 2000–2017 period. It is estimated that more than 60% of global maternal deaths occur during the postnatal period. The utilization of postnatal care (PNC) services remains low in SSA. This scoping review aimed to determine factors that influence PNC utilization among women in SSA.METHODS:Peer-reviewed articles published in English from 2018 to 2023 were searched from Google Scholar, ScienceDirect, MEDLINE, African Journals Online, SCOPUS, and PubMed databases. Two authors independently screened the articles and extracted the data.RESULTS:Thirty-nine articles were included in this review. Thirty-three of the studies were of a quantitative cross-sectional study design, four were mixed-methods, and two were qualitative studies. The review identified several enablers and barriers to PNC utilization among women, which were categorized into individual, community-level, and healthcare system factors. Some of the individual factors included the place of residence, marital status of the woman, employment status, educational level of both the woman and her partner, and household income. Health system factors included accessibility of healthcare facilities, availability of resources, and the quality of healthcare.CONCLUSION:To improve PNC utilization in SSA, several strategies should be implemented. These strategies should address issues such as women’s empowerment, accessibility of healthcare facilities, the quality of healthcare services, and healthcare services financing.

Exploring Iot Embedded Systems Along the Line of Identity Access Management for Enhanced Health Data Security

A. Overview of IoT Embedded Systems The pervasiveness of Internet of Things (IoT) embedded systems in the digital era has significantly transformed numerous industries, including healthcare. These interconnected devices, capable of collecting, transmitting, and analyzing data, offer immense potential to improve healthcare service efficiency, accessibility, and quality. However, the escalating volume of sensitive health data being generated and exchanged necessitates the implementation of robust security measures. A critical element in this regard is Identity and Access Management (IAM), which governs the control of user identities and their access privileges within a specific system [1].

EXAMINING THE FINANCIAL RISK MANAGEMENT OF DONOR FUNDS: CASE OF MINISTRY OF HEALTH IN ZAMBIA

<p>This study examines the financial risk management of donor funds using the Ministry of Health (MOH) in Zambia as a case study. The study employs an exploratory case study methodology on a sample of 224 MOH employees. Zambia, being a developing country, significantly relies on donor funds to support its healthcare sector. Prudent management of donor funds is crucial for the sustained delivery of quality healthcare services. However, there has been concerns regarding the financial risk management practices at the MOH in the efficient utilization and accountability of donor funds. From the literature review, it seems no study has been done regarding the financial risk management of donor funds focusing on the MOH in Zambia. Therefore, this study fills this gap. The study findings seem to show evidence of the misappropriation of donor funds exhibited by misallocation of donor funds to unplanned projects or activities. The misappropriations of donor funds seem to be amplified by a lack of strategic planning, lack of coordination, and the absence of effective monitoring and evaluation systems. Additionally, fraud and corruption posed significant risks to donor funds at MOH. Therefore, to mitigate the risks, the study recommends that robust anti-misappropriation measures, enforcement of due diligence on implementing partners, a thorough review of procurement processes, and regular monitoring and evaluation of donor-funded projects be strengthened at the MOH in Zambia. Whistleblower protection and reporting mechanisms should be promoted to help detect and deter fraudulent activities at this Ministry.</p><p><strong> </strong></p><p><strong>JEL:</strong> H51, I18, O23</p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0787/a.php" alt="Hit counter" /></p>