Public Hospital Services Research Articles

Australian hospital staff perceptions of barriers and enablers of domestic and family violence screening and response

BackgroundHospital presentations provide unique opportunities to detect DFV. However, up to 70% of women experiencing Domestic and Family Violence (DFV) go undetected by hospital staff. While routine DFV screening is internationally encouraged, there is still much debate surrounding its implementation. The aim of the study was to determine staff perceptions of barriers and enablers of DFV screening and response.MethodsA cross-sectional survey was conducted at a tertiary level public hospital and health service. Health care staff in allied health, maternity and mental health divisions (n = 615) were invited to participate by email and through team meetings. 172 responses were analysed.ResultsLess than a third of respondents reported routinely asking patients about DFV, with 34.9% reporting they did not have sufficient training to assist with DFV. Increased levels of training were positively correlated with screening practices, preparedness and knowledge. Major barriers were presence of partner and language barriers, while written protocols and supportive work environment were the principal enablers of screening.ConclusionStaff generally believed that routine screening was important and should encompass all forms of abuse. Many felt ill-equipped to ask about or manage disclosure of DFV. More training improves staff capacity for DFV detection and response, and written guidelines should be made available to all staff.

Patient Satisfaction and Hospital Quality of Care Evaluation in Malaysia Using SERVQUAL and Facebook.

Social media sites, dubbed patient online reviews (POR), have been proposed as new methods for assessing patient satisfaction and monitoring quality of care. However, the unstructured nature of POR data derived from social media creates a number of challenges. The objectives of this research were to identify service quality (SERVQUAL) dimensions automatically from hospital Facebook reviews using a machine learning classifier, and to examine their associations with patient dissatisfaction. From January 2017 to December 2019, empirical research was conducted in which POR were gathered from the official Facebook page of Malaysian public hospitals. To find SERVQUAL dimensions in POR, a machine learning topic classification utilising supervised learning was developed, and this study’s objective was established using logistic regression analysis. It was discovered that 73.5% of patients were satisfied with the public hospital service, whereas 26.5% were dissatisfied. SERVQUAL dimensions identified were 13.2% reviews of tangible, 68.9% of reliability, 6.8% of responsiveness, 19.5% of assurance, and 64.3% of empathy. After controlling for hospital variables, all SERVQUAL dimensions except tangible and assurance were shown to be significantly related with patient dissatisfaction (reliability, p < 0.001; responsiveness, p = 0.016; and empathy, p < 0.001). Rural hospitals had a higher probability of patient dissatisfaction (p < 0.001). Therefore, POR, assisted by machine learning technologies, provided a pragmatic and feasible way for capturing patient perceptions of care quality and supplementing conventional patient satisfaction surveys. The findings offer critical information that will assist healthcare authorities in capitalising on POR by monitoring and evaluating the quality of services in real time.

Influence of Organizational Change on Public Health Maternal Health Care Service Delivery in Kitui County (A Survey of Level 4 Hospitals in Kitui County)

The County Governments in Kenya are faced with poor service delivery especially in the provision of maternal health care services. Maternal health care services in public hospitals are not meeting up to the quality standard as outlined by the Ministry of Health in Kenya. The paper sought to determine the influence of leadership and universal health coverage on public health maternal health care in Kitui County. This study was guided by Transformational Leadership Theory and Theory X &amp; Y. The study focused on 11 public hospitals providing maternity services in Kitui County. The target population of the study was 203 health officers that include 26 doctors, 10 specialists, 41 clinical officers and 126 nurses across the 13 level 4 hospitals providing maternity services in Kitui County. Data was collected by use of structured closed ended questionnaire. Data analysis was conducted using SPSS Version 25.0 Software. Pearson Correlation showed that leadership and universal health coverage have a positive correlation with public health maternal health care service delivery. Model summary results indicated that leadership and universal health coverage explain 52.1 percent of public health maternal health care service delivery. Coefficient regression revealed that coefficient of leadership has appositive and significant influence (?=.203, p=.001&lt;0.05) on and public health maternal health care service delivery. It was also found that coefficient of Universal Health Coverage and public health maternal health care service delivery have a positive and significant relationship (?=.662, p=.000&lt;0.05). The study concludes that leadership is one of the key health systems factors affecting the performance of maternal health services at facility level. Conclusion can be made further that universal health coverage improves public health maternal health care service delivery. The study recommends for the need of maternal health care providers to review their leadership guidelines and styles with aim of enhancing quality of leadership in the management of hospitals. Though universal health coverage is on trial, the study recommends for the need to adequately support the implementation of universal health coverage. Keywords: Leadership, UHC, Maternal Health, Care Service Delivery, Kitui County

The utilisation of sexual and reproductive healthcare services by male adolescents in South Africa.

This paper report on a study that was conducted in a selected area in South Africa to investigate male adolescents' utilisation of Sexual and Reproduction Healthcare services. A contextual, explorative and descriptive qualitative design was utilised to conduct the investigation. Twenty male adolescents aged 18-24 years selected by means of purposive (sampling special or unique cases sampling techniques) and snowballing sampling techniques were interviewed by means of semi-structured interviews. Data were analysed using Tesch's approach of qualitative data analysis. The lack of awareness of the services was the most significant hindrance to the utilisation of sexual and reproductive healthcare services by male adolescents. This was linked to differentiated knowledge about the services, poor services in public hospital and clinics, nurses' attitudes and lack of services designed for males. The study therefore recommends the development of strategies to deal with the emerged themes (lack of awareness of the services, differentiated knowledge about the services, poor services in public hospitals and clinics, nurses' attitudes and lack of services designed for males) in order to enhance, increase and improve utilisation of these services by male adolescents for the betterment of their sexual and reproductive health as well as their health in general.

Measuring Quality of Public Hospitals in Croatia Using a Multi-Criteria Approach.

Quality of public hospital services presents one of the most important aspects of public health in general. A significant number of health services are delivered due to public hospitals. Under the World Bank program “Improving Quality and Efficiency of Health Services: Program for Results”, the competent bodies in Croatia aimed to identify the top 40% best-performing public acute hospitals in Croatia, based on a clinical audit in the preceding 12 months. This paper presents how this goal was achieved, using a multi-criteria decision-making (MCDM) approach. A MCDM approach was selected due to the multidimensionality and complexity of healthcare performance and service quality. We aimed to develop a methodology for ranking top-performing hospitals at the national level. We chose the composite indicator methodology, combined with the analytic hierarchy process (AHP) as a tool for determining weights for aggregation of individual indicators. The study looked at three clinical entities: acute myocardial infarction, cerebrovascular insult, and antimicrobial prophylaxis in colorectal surgery. Indicators for each entity were evidence-based, following the national guidelines, but limited by availability of data. The clinical audit and databases of competent administrative bodies were used as sources of data. The problem investigated in this paper has a significant impact at the strategic (national) level. Even though the AHP has already been applied in the public health domain, to the best of our knowledge, this is the first application of the AHP in combination with composite indicators for hospital ranking at a national level. The AHP enabled participation of experts from the audited hospitals in the assessment of indicator weights. Results show that composite indicators can be successfully implemented for acute hospital evaluation using the AHP methodology: (1) the AHP supported a flexible structuring of the problem; (2) the resulting complexity of pairwise comparisons was appropriate for the experts (consistency ratios were under 0.1); (3) using the AHP approach enabled a successful aggregation of different opinions into group priorities; (4) the developed methodology was robust and enabled identifying the top 40% ranking best-performing public acute hospitals in Croatia combining 20 criteria within three entities, based on input from 36 clinical experts. The proposed methodology can be useful to other researchers for assessment of healthcare quality at the strategic level.

Framework for Evaluation of Effectiveness of Integrated Financial Management Information Systems Architecture Implemented in Public Hospitals in Kenya.

Integrated Financial Management Information System (IFMIS), is an enterprise resource planning application that captures all functional processes and relevant financial flows within Public expenditure management. IFMIS is being adopted by the Public hospitals to promote efficiency, effectiveness, accountability, transparency, security of data management and comprehensive reporting. However the Public hospitals are loosing a lot of money through scandals and this has compromised service delivery to the Public. Therefore, the purpose of this study was to investigate the effectiveness of IFMIS as used in Public procurement services in Public Hospitals in Kenya and come up with an enhanced secure technical architecture. The objectives of the study were: to asses the extent to which IFMIS has been implemented in Public procurement services in Public hospitals in Kenya, to evaluate the effectiveness of IFMIS in enforcing logical access and technical controls in Public procurement services in Public Hospitals in Kenya and to develop a framework that will evaluate the effectiveness of IFMIS architecture that is implemented in Public procurement services in Public hospitals in Kenya .The study used mixed method research design targeting users of IFMIS. Stratified sampling was used to select the target population of 132 in 4 hospitals in Kenya. The target population was from 5 homogeneous stratum comprising of 44 Procurement Assistants, 36 Finance Assistants, 12 Audit Assistants, 28 Medical Practioneers and 12 ICT Staff. Proportional allocation method was used to calculate the sample size which was 99 respondents. The data was collected through questionnaires and direct observation. Content validity was done to ascertain the validity of the research instruments. Reliability of the instruments was carried out using test-retest technique. Internal consistence of data was computed using Cronbach Alpha Computation. Analysis of Quantitative and qualitative data was through descriptive and inferential statistics methods and content analysis respectively. The study developed a framework of enhanced technical architecture of IFMIS that would streamline procurement services in Public hospitals and improve provision of quality health care.

The risks and benefits of using social media to engage consumers in service design and quality improvement in Australian public hospitals: findings from an interview study of key stakeholders

BackgroundEngaging consumers - patients, families, carers and community members who are current or potential service users - in the planning, design, delivery, and improvement of health services is a requirement of public hospital accreditation in Australia. There is evidence of social media being used for consumer engagement in hospitals internationally, but in Australia this use is uncommon and stakeholders’ experiences have not been investigated. The aim of the study was to explore the experiences and beliefs of key Australian public hospital stakeholders around using social media as a consumer engagement tool. This article focuses on the study findings relating to methods, risks, and benefits of social media use.MethodsSemi-structured interviews were conducted with Australian public hospital stakeholders in consumer representative, consumer engagement/patient experience, communications or quality improvement roles. Qualitative data were analysed using a deductive content analysis method. An advisory committee of consumer and service provider stakeholders provided input into the design and conduct of this study.ResultsTwenty-six Australian public hospital service providers and consumers were interviewed. Participants described social media being used to: recruit consumers for service design and quality improvement activities; as an online space to conduct consultations or co-design; and, to gather feedback and patient experience data. The risks and benefits discussed by interview participants were grouped into five themes: 1) overcoming barriers to engagement, 2) consumer-initiated engagement; 3) breadth vs depth of engagement, 4) organisational transparency vs control and 5) users causing harm.ConclusionsSocial media can be used to facilitate consumer engagement in hospital service design and quality improvement. However, social media alone is unlikely to solve broader issues commonly experienced within health consumer engagement activities, such as tokenistic engagement methods, and lack of clear processes for integrating consumer and patient feedback into quality improvement activities.

Influence of Organizational Change on Public Health Maternal Health Care Service Delivery in Kitui County (A Survey of Level 4 Hospitals in Kitui County)

The County Governments in Kenya are faced with poor service delivery especially in the provision of maternal health care services. Maternal health care services in public hospitals are not meeting up to the quality standard as outlined by the Ministry of Health in Kenya. The paper sought to determine the influence of leadership and universal health coverage on public health maternal health care in Kitui County. This study was guided by Transformational Leadership Theory and Theory X &amp; Y. The study focused on 11 public hospitals providing maternity services in Kitui County. The target population of the study was 203 health officers that include 26 doctors, 10 specialists, 41 clinical officers and 126 nurses across the 13 level 4 hospitals providing maternity services in Kitui County. Data was collected by use of structured closed ended questionnaire. Data analysis was conducted using SPSS Version 25.0 Software. Pearson Correlation showed that leadership and universal health coverage have a positive correlation with public health maternal health care service delivery. Model summary results indicated that leadership and universal health coverage explain 52.1 percent of public health maternal health care service delivery. Coefficient regression revealed that coefficient of leadership has appositive and significant influence (β=.203, p=.001&lt;0.05) on and public health maternal health care service delivery. It was also found that coefficient of Universal Health Coverage and public health maternal health care service delivery have a positive and significant relationship (β=.662, p=.000&lt;0.05). The study concludes that leadership is one of the key health systems factors affecting the performance of maternal health services at facility level. Conclusion can be made further that universal health coverage improves public health maternal health care service delivery. The study recommends for the need of maternal health care providers to review their leadership guidelines and styles with aim of enhancing quality of leadership in the management of hospitals. Though universal health coverage is on trial, the study recommends for the need to adequately support the implementation of universal health coverage.

The effectiveness of private services in public hospitals: The case of St. Paul Hospital, Addis Ababa, Ethiopia

BackgroundRetention of doctors had been a big challenge for Ethiopian public hospitals. Private wing service in public hospitals was established in Ethiopia in 2009 with major objectives of retaining specialist doctors and improving access to health services. ObjectiveThis study was conducted to assess the effectiveness of the private wing services in St. Paul Hospital. MethodsQualitative and quantitative data were collected in January 2016. Focus group discussions, key informant interviews and documents review were conducted. A total of 37 participants were included in the study. The discussions and interviews were conducted with specialist doctors, nurses, anesthetists and members of the hospital management team. Consent was obtained from all participants before the data collection. All data were transcribed verbatim, typed and stored safely. Then content and thematic analysis was conducted. ResultsMost of the participants agreed that the private wing arrangement had contributed to the motivation and retention of specialist doctors most notably the surgeons in the hospital. The number of specialist doctors in the hospital increased over the 6 years after the establishment of the private wing by 223%. Most participants mentioned that the hospital benefitted from the private wing. The number of major surgeries conducted in the regular service of the hospital increased by four folds over the six years. In the same period, a total of 8,975,967 ETB was generated to the hospital. ConclusionThe private wing in St. Paul hospital was successful as it contributed to the retention and motivation of specialist doctors and improved access to health services. Other public hospitals may consider establishing private wing services.

Essential public healthcare services utilization and excess non-COVID-19 mortality in Greece

ObjectivesEnsuring access to care for all patients—especially those with life-threatening and chronic conditions—during a pandemic is a challenge for all healthcare systems. During the COVID-19 pandemic, many countries faced excess mortality partly attributed to disruptions in essential healthcare services provision. This study aims to estimate the utilization of public primary care and hospital services during the COVID-19 epidemic in Greece and its potential association with excess non-COVID-19 mortality in the country. Study designThis is an observational study. MethodsA retrospective analysis of national secondary utilization and mortality data from multiple official sources, covering the first nine months of the COVID-19 epidemic in Greece (February 26th to November 30th, 2020), was carried out. ResultsUtilization rates of all public healthcare services during the first nine months of the epidemic dropped significantly compared to the average utilization rates of the 2017–19 control period; hospital admissions, hospital surgical procedures, and primary care visits dropped by 17.3% (95% CI: 6.6%–28.0%), 23.1% (95% CI: 7.3%–38.9%), and 24.8% (95% CI: 13.3%–36.3%) respectively. This underutilization of essential public services—mainly due to supply restrictions such as suspension of outpatient care and cancelation of elective surgeries—is most probably related to the 3778 excess non-COVID-19 deaths (representing 62% of all-cause excess deaths) that have been reported during the first 9 months of the epidemic in the country. ConclusionsGreece's healthcare system, deeply wounded by the 2008–18 recession and austerity, was ill-resourced to cope with the challenges of the COVID-19 epidemic. Early and prolonged lockdowns have kept COVID-19 infections and deaths at relatively low levels. However, this “success” seems to have been accomplished at the expense of non-COVID-19 patients. It is important to acknowledge the “hidden epidemic” of unmet non-COVID-19 needs and increased non-COVID-19 deaths in the country and urgently strengthen public healthcare services to address it.

Covid-19 in Rio de Janeiro/Brazil: efforts of hospital pharmacy services

Objective: To investigate the efforts of hospital pharmacy services in Brazilian public hospitals during the coronavirus pandemic. Methods: A cross-sectional study about practical and routine hospital pharmacy services in hospitals in the city of Rio de Janeiro (Brazil) was developed. The online survey consisted of 22 questions (3 multiple choice questions, 14 yes/no questions and 5 open-response questions) and the instrument was applied to 20 frontline pharmacists of 6 different hospitals from September 15th to 30th of 2020. Descriptive analysis was made by means of estimation of proportions. Results: We observed that 12 of the 20 participating pharmacists were trained about the new protocols and practice. Two hospitals have altered their Pharmacy Department, creating two groups: (1) services supply of COVID-19 and (2) services supply for others disease or complications. It was found that 3 of the 6 hospitals implemented an exclusively electronic medical prescription system and all of them used individualized dispensing system. At least one pharmacist of each hospital reported a lack or shortage of one or more drugs used in the COVID-19 treatment. Six main causes of drug scarcity were cited and 5 hospitals pointed two of them: increased cost of drug manufacturing and insufficient quantities of raw materials. In addition, we found out that essential ICU drugs, such as ceftriaxone, azithromycin, fentanyl and midazolam were the most prescribed ones, being cited by 5 hospitals (each one). Conclusion: This study showed that pharmaceutical services from six public hospitals of the city of Rio de Janeiro have been adjusted and redesigned to fight the COVID-19. Furthermore, this work can contribute to a more comprehensive vision of the pharmaceutical community about their challenges in the fight against COVID-19 and to provide positive suggestions for improving pharmacy practices.

Performance Comparison of Public Hospitals Between 2014 and 2018 in Different Regions of Guangdong Province, China, Following 2017 Medical Service Price Reforms.

This study analyzed performance of public hospitals and regional differences in performance following reform of medical service prices in Guangdong province, China. From three cities in four regions, we randomly selected a total of 12 traditional Chinese medicine hospitals and 12 general tertiary hospitals. Six questionnaires were completed by the hospitals, using 2014–2018 internal data. Principal components analysis was used to compare performances of the hospitals and regions following price reform. The extent to which medical service prices were adjusted varied considerable for different procedures in the same region and for the same category of procedures among regions. After reform, compensation for medical services in public hospitals reached the target of 80%, except in the Western region. However, annual growth of costs to patients was generally above 4%; the burden on patients was not alleviated by fee control. Reforms were more effective for comprehensive than Chinese traditional medicine hospitals. Performance scores of general hospitals in the Pearl River Delta, Eastern, Western, and Northern regions were 1.24, 1.16, −0.22, and −1.01, respectively. This is consistent with ranking by level of economic development of each region. The government should implement a regional medical service pricing mechanism. Additionally, comprehensive and traditional Chinese medicine hospitals should each have appropriate pricing policies. Future policies should focus on controlling costs incurred by patients.

Determinants of Preeclampsia among Women Attending Delivery Services in Public Hospitals of Central Tigray, Northern Ethiopia: A Case-Control Study.

Background Preeclampsia occurs in up to 5% of all pregnancies, in 10% of first pregnancies, and 20–25% of women with a history of chronic hypertension. Objective This study aims to assess the determinants of preeclampsia among women attending delivery services in public hospitals of central Tigray, Ethiopia. Methods Hospital-based unmatched case-control study design was conducted. Women diagnosed with preeclampsia were cases, and women who had no preeclampsia were controls admitted to the same hospitals. A systematic sampling technique was used to select study participants for both cases and controls. The data were entered in EPI data 3.1 statistical software and, then, exported to SPSS Version 22 for cleaning and analysis. Results Family history of hypertension (AOR: 2.60; 95% CI: 1.15, 5.92), family history of preeclampsia (AOR: 5.24; 95% CI: 1.85, 14.80), history of diabetes mellitus (AOR: 4.31; 95% CI: 1.66, 11.21), anemia (AOR: 3.23; 95% CI: 1.18, 8.86), history of preeclampsia on prior pregnancy (AOR: 5.55; 95% CI: 1.80, 17.10), primigravida (AOR: 5.41; 95% CI: 2.85, 10.29), drinking alcohol during pregnancy (AOR: 4.06; 95% CI: 2.20, 7.52), and vegetable intake during pregnancy (AOR: 0.39; 95% CI: 0.21, 0.74) were significantly associated with preeclampsia. Conclusion This study concludes that a family history of hypertension and preeclampsia; a history of diabetes mellitus and anemia; and a history of preeclampsia on prior pregnancy, primigravida, and drinking alcohol were found to be risk factors for preeclampsia. However, vegetable intake was found to be a protective factor for the development of preeclampsia.

Constrains for seeking post-abortion care among adolescents and young women in Guangzhou, China: a cross-sectional study

BackgroundIn China, post-abortion care (PAC) services mainly focus on married couples, such that adolescents and unmarried young women have limited access to those services for contraception counseling. The provision of youth-friendly PAC services in public hospitals is a new concept in China. This study examined the magnitude of PAC services utilization as well as factors influencing its uptake among adolescents and young women in Guangzhou, China.MethodsA cross-sectional study was performed from 1st March 2020 to 30th September 2020 using an anonymous self-administered questionnaire among 688 women aged 15–24 years in Tianhe district, Guangzhou. The Multivariate logistic regression was used to determine factors that were significantly associated with the uptake of PAC services.ResultsThe magnitude of PAC services utilization was 35.9% among adolescents and young women in Guangzhou, China. Students were 69.0% significantly less likely to use PAC services compared to women who had no job. Immigrants were 59.0% significantly less likely to use PAC services than their native counterparts. Women who had a feeling of stigma were 70.0% significantly less likely to use PAC services compared to those who did not feel stigmatized.ConclusionsThe study highlights the need to strengthen youth-friendly PAC services provision, and emphasizes the importance of education about both family planning and abortion services among disadvantaged subgroups of women in the study setting.

The implementation of pharmaceutical services in public hospitals in Mexico: an analysis of the legal framework and organizational practice

BackgroundThe implementation of pharmaceutical services in hospitals contributes to the appropriate use of medicines and patient safety. However, the relationship of implementation with the legal framework and organizational practice has not been studied in depth. The objective of this research is to determine the role of these two factors (the legal framework and organizational practice) in the implementation of pharmaceutical services in public hospitals of the Ministry of Health of Mexico.MethodsSemi-structured interviews were conducted with four groups of actors involved. The analysis focused on the legal framework, defined as the rules, laws and regulations, and on organizational practice, defined as the implementation of the legal framework by related individuals, that is, how they put it into practice.ResultsThe main problems identified were the lack of alignment between the rules and the incentives for compliance. Decision-makers identified the lack of managerial capacity in hospitals as the main implementation barrier, while hospital pharmacists pointed to poor regulation and the lack of clarity of the legal framework as the problems to consider.ConclusionsAlthough the legal framework related to hospital pharmaceutical services in Mexico is inadequate, organizational factors (such as adequate skills of professional pharmacists and the support of the hospital director) have facilitated gradual implementation. To improve implementation, priority should be given to evaluation and modification of the current legislation along with the development of an official minimum standard for activities and services in hospital pharmacies.

Client Satisfaction with Prevention of Mother to Child Transmission of HIV Services in Public Hospitals of Hadiya Zone, Southern Ethiopia

Background: Prevention of mother-to-child transmission is a term used to describe a comprehensive package of services intended to reduce the risk of mother-to-child transmission of HIV. The vertical virus transmission from mother to child accounts for more than 90% of pediatric Acquired Immunodeficiency Syndrome. Published studies on the client satisfaction with PMTCT services’ provision in Ethiopia are generally limited. Even fewer studies do examine client satisfaction with the PMTCT services. Therefore, this study is aimed to assess the client satisfaction with Prevention of Mother-to-Child Transmission of HIV services in public hospitals of Hadiya zone, southern Ethiopia 2017. Methods: Institution based cross-sectional study design using quantitative data collection method was conducted in public hospitals from March 01 to April 10, 2017. A total of 423 pregnant women were consecutively interviewed until the required sample was obtained. The data was entered in to Epi-data and analyzed using SPSS. Bivariate and multivariable logistic regression analyses were computed to see the predictors for satisfaction of clients on PMTCT service. Result : About 89.8% clients were satisfied with PMTCT services provided at public hospitals. The client satisfaction with PMTCT services was associated with waiting time [AOR =4.648, 95% CI = (2.183, 9.897)], counseling time [AOR =3.748, 95% CI = (1.645, 8.537)] and counseling given by same counselor before and after HIV test [AOR =0.193, 95%CI: (0.090, 0.412)]. Conclusion : Clients’ satisfaction by PMTCT service is very high. Keywords: HIV, prevention, women, PMTCT. DOI: 10.7176/JHMN/89-02 Publication date: May 31 st 2021

An Analysis of Budget Planning in Public Hospitals in Limpopo Province: South Africa

Budget planning is a challenge regarding the delivery of cost-effective health services in public hospitals. Budget planning is part of broader planning process in the organisations. The purpose of this article is to analyse budget planning in public hospitals in the Limpopo Province of South Africa. The research approach used for the study is quantitative research design. The sample size of 20 public hospitals was drawn from the population of 40 public hospitals. A survey questionnaire was used as the primary data-gathering instrument. The findings of the research show that budget planning is a management challenge for non-finance managers in public hospitals. The result for this is ineffective budget management in public hospitals. The study recommended that non-finance managers be capacitated on the alignment of budget with a strategy to improve budget management in public hospitals.

Factors Affecting Delivery Health Service Satisfaction of Women and Fear of COVID- 19: Implications for Maternal and Child Health in Pakistan.

ObjectiveHigh maternal and neonatal mortality rates in developing regions like Pakistan are linked to low rates of institutional deliveries. One way to improve rates of institutional deliveries is through improving institutional delivery service satisfaction in women. The aim of this research is to identify which factors influence delivery service satisfaction during the period of COVID-19 and which socio-demographic characteristics of women are associated with greater fear of catching COVID-19 during institutional deliveries.MethodsA total of 190 women who had given birth between May to June, 2020, were sampled from two private and two public sector hospitals in Lahore, Pakistan. A standardized tool was modified for use and a combination of descriptive statistics and multivariate regression was applied.ResultsThe results reveal that a majority of women, at 74.7%, are afraid of contracting COVID-19; specifically, women delivering at public hospitals, those who are illiterate or semi-literate, with more than four children, with low household income, and who are unemployed. Regression models are used to identify factors related to higher satisfaction, including the following: (i) pre-delivery care (explanatory power of R2 = 0.651); (ii) during delivery care (R2 = 0.716); (iii) after delivery care for women (R2 = 0.525); and (iv) after delivery care for newborn (R2 = 0.780). The main areas which influence satisfaction include the following: service quality of staff and administration; maintenance of hygiene and sanitation; involvement in decision-making; provision of necessary information; and advice for breastfeeding, immunization and family planning.Conclusions for PracticeBased on our findings, we recommend improved regulation of delivery services in both public and private hospitals and increased protection for disadvantaged women groups to maintain service quality during the pandemic.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10995-021-03140-4.

Persistent and Transient Inefficiency of Australian States and Territories in Providing Public Hospital Services: An Application of Bayesian Stochastic Finite Mixture Frontier Analysis

Current literature on public hospital efficiency in Australia only reveals information on how efficient public hospitals are in the short run. The presence of persistent technical inefficiency arising from long‐term systemic problems and government‐related regulatory constraints does not appear to have been addressed. Using the aggregated hospital panel data for the period 2002–2018 on eight Australian states and territories, this study incorporates the measure of both transient and persistent technical inefficiency while controlling for unobserved heterogeneity to obtain a more precise measure of technical efficiency. This study’s findings estimate the national average transient efficiency to be 0.96. In contrast, the national average persistent efficiency is estimated to be 0.83. Further, Queensland (0.67), Victoria (0.66) and New South Wales (0.60) posted the lowest overall technical efficiency driven by the high level of persistent inefficiency. On the other hand, Northern Territory (0.96), Australian Capital Territory (0.95) and Tasmania (0.95) are the top performers. This study’s findings call on policy‐makers and regulators to disclose hospital‐level data to researchers to gain further insight into the causes of persistence in inefficiency, especially among bigger states, which will help formulate more targeted policy interventions.

Patient satisfaction with in-patient hospital services in Public and Private Hospitals in Borama, Northwest Somalia

Patient satisfaction with in-patient hospital services in Public and Private Hospitals in Borama, Northwest Somalia