State-owned Hospitals Research Articles (Page 3)

Ownership and hospital behaviour: Employment and local unemployment

This study retrospectively analyzed antimicrobial prescription and concomitant economic outcomes in 28 Chinese state-owned hospitals before and after the intervention introduced by the Action Plan. The outcomes of national intervention were evaluated by analyzing statistics collected before and after the Action Plan which came into effect as of July 1, 2011. The fourth quarters of 2010 and 2011 were set as the baseline and intervention periods, respectively. The percentage of patients receiving antimicrobial prescription, the intensity of antimicrobials prescribed, economic indexes related to antimicrobial prescribing, and antimicrobial prophylaxis in clean surgical procedures were investigated, respectively. First, during the intervention period, the percentage of patients receiving antimicrobial treatment dropped to 15.6% and 49.1% in outpatient and inpatient settings, respectively. The intensity of antimicrobial prescribed decreased to 50.29 DDD (defined daily dose) in outpatient setting. The defined daily doses (DDDs) per thousand patients per day decreased to 12914.33 DDDs in outpatient settings. The results were statistically significant as compared to those in the baseline period (P<0.001). Second, the expenses on antimicrobials significantly decreased (P<0.001). Finally, the percentage of patients receiving antimicrobial prophylaxis for clean surgical procedures decreased to 48.94% (P<0.001), while the infection rates did not differ significantly (P=0.581). This multi-center study suggests that the Action Plan launched by China’s government proved effective in state-owned medical institutions in promoting rational antimicrobial prescription.

Hospital competitive intensity and perioperative outcomes following lumbar spinal fusion

Background: Human Immunodeficiency Virus (HIV) has been transmitted all over the world and attack people including pregnant women and their fetus. HIV-AIDS has become the main cause of maternal death. The transmission is started from Africa to Indonesia, specifically to Papua Island. In Papua, HIV is a serious threat for pregnant women’s life because of its fast transmission, even faster from other regions in Indonesia. Until present, there has no research about HIV transmission on pregnant women in Papua Island.Objective: To conduct analysis on risk factors related to HIV transmission on pregnant women in Papua Island.Method: Cross sectional continued with retrospective cohort. Data was taken from medical record of all patients delivering in eight state-owned hospitals in Papua and West Papua provinces started from 1 January 2013 to 31 December 2013. Inclusion criteria were all pregnant women who delivered vaginally or by caesarean sections with HIV and non HIV diagnosis and had complete medical record data. Data being taken included mother’s age when delivered the baby, mother’s education, parents’ social economic status, mother’s ethnicity, parents’ domicile, prematurity and infant’s birth weight. The two research groups were HIV (+) and HIV (-) groups. Data were statistically analyzed using Pearson Chi Square for univarian and logistic regression for multivarian.Result and Discussion: In Papua island, prevalence of pregnant women with HIV was 15.3%, and mostly occurred in reproductive age ( 85.1%). The main transmission source was heterosexual (100%). Univarian analysis found that mothers’s age &lt;20 years old when delivered the baby increase 1.12 times compared to &gt; 20 years old but it’s statistically insignificant (p=0.53). Mothers education &lt; 9 years increases the risk of HIV 1.4 times compared to mother’s education &gt; 9 years (p=0.01). The husband’s low socioeconomic status increase the risk of 5.51 times compared with husband’s high socioeconomic status (p&lt;0.01). The wife’s low socioeconomic status increase the risk of 1.22 times, in which statistically insignificant (p=0.14). Native Papuanese pregnant women has significantly 3.05 times higher risk for HIV transmission compared to non Papuanese (p&lt;0.01). Pregnant women’s domicile in villages increase the transmission significantly 2.21 times compared to cities’ domiciles (p&lt;0.00). Premature delivery increased HIV transmission by 1.7 times (p&lt;0.01). Low infant body weight increased the transmission by 1.64 times significantly (p&lt;0.01). Multivarian analysis showed that husband’s low socioeconomic status, Papuanese ethnicity and domicile in villages are the most dominant factors influencing HIV transmission on pregnant women in Papua Island.Conclusion: Varied risk factors on HIV transmission resulted in the occurrence of HIV (+) cases in Papua Island, while the most dominant factors are husband with low socioeconomic status, Papua ethnicity and domicile in villages. Keywords: HIV, risk factors, birthing mothers, Papua Island.

We suggest that healthcare organizations (HCOs) develop a hybrid identity that can be described in a typology made up of four identities: janusian, anomic, agent, and steward. These hybrid identity types result from the combination of two seemingly incompatible identities: utilitarian or business oriented versus normative or community care oriented. We also posit that the perception of HCOs’ identity is related with members’ patient-focused behaviour and organizational identification. To explore these possibilities, we surveyed a sample of 732 members from three very different HCOs: a non-profit mental health provider, a haemodialysis for-profit company, and a state-owned acute hospital. Results show that our typology of HCOs’ identity discriminates between organizations, between occupations and, more importantly, that patient-focused behaviours and organizational identification are higher when members perceive their organizations as janusian, i.e. rate their organizations high in both utilitarian and normative identities, orientations that do not usually go together. Implications for the management of janusian HCO are discussed.

Objetivo: Avaliar itens de segurança na cirurgia cardíaca em pacientes de um hospital público. Método: Estudo descritivo e transversal. A coletade dados, desenvolvida em 2012, foi realizada em uma instituição hospitalar pública estadual, onde foram observadas 30 cirurgias cardíacas por meio deum roteiro embasado nas 3 fases do checklist de cirurgia segura da Organização Mundial da Saúde (OMS), com alternativas descritas como “em conformidade”e “em não conformidade”. Resultados: Os resultados de não conformidade corresponderam a 56% dos casos antes da indução anestésica,57% antes do procedimento e 75% na saída da sala de cirurgia. Conclusão: O checklist da OMS se faz necessário, porém, o treinamento profissional e aeducação permanente constituem a linha mestra para a formação de uma equipe de saúde crítica e consciente do seu papel na segurança dos pacientes.

Previous studies only focused on antecedent factors of transfer of training and only a few of them focused on the consequence factors. The main objectives of this research were to examine the antecedents and consequence of transfer of training. The antecedent factors consist of individual characteristics, training design, and organizational environment. The consequence factor is individual performance. Since the previous studies used transfer of training as unidimensional construct, this research used multidimensional construct consist of knowledge sharing, training retention and training generalization. Survey with questionnaire is used as design research method. The respondents are employee who worked in state-owned hospitals (N=202). Multiple regressions was used to examine the hypothesis. The result showed that individual performance was determined by training transfer consists of three factors such as knowledge sharing, training retention, and training generalization. Training of transfer itself was determined by some factors such as individual characteristics (i.e. self-efficacy and learning orientation), training design (trainer and training material), and organizational environment (organizational support, supervisor support and peer support). Specific for organizational support, it’s only had significant effect on training retention but not on knowledge sharing and training generalization. Since transfer of training has important effect on individual performance, organization must consider the three antecedent factors.

In the context of healthcare reforms in post-socialist Serbia, this research analyses the reconfiguration of acute care hospitals from the aspect of the spatial distribution of hospital beds among and within state-owned hospitals. The research builds a relationship between the macro or national level and the micro or hospital level of the spatial distribution of hospital beds. The aim of the study is to point out that a high level of efficiency in hospital functionality is difficult to achieve within the current hospital network and architectural-urban patterns of hospitals, and to draw attention to the necessity of a strategically planned hospital spatial reconfiguration, conducted simultaneously with other segments of the healthcare system reform. The research analyses published and unpublished data presented in tables and diagrams. The theoretical platform of the research covers earlier discussions of the Yugoslav healthcare system, its post-socialist reforms and the experiences of developed countries. The results show that the hospital bed distribution has not undergone significant changes, while the hospital spatial reconfiguration has either not been carried out at all or, if it has, only on a small scale. All this has contributed to overall inadequate, inflexible, inefficient, defragmented and unequal bed distribution. Copyright © 2016 John Wiley & Sons, Ltd.

In this case study, based on six criteria, four Chinese hospitals were chosen from a national sample to showcase, through content analysis and in-depth interviews, the best practices of serving patients online. The extensive findings have addressed the following three questions: what these hospitals have in common in their Web development, what problems and challenges they are facing, and how they have excelled in serving their patients online. The study concludes that, like larger hospitals, smaller hospitals can also excel in creating an outstanding Web site to serve their patients so long as they truly care about their patients, have a clear vision, and strong expertise in IT development. The study also concludes that Chinese private hospitals can learn from these state-owned hospitals in establishing a good reputation through professional and responsible interaction with patients. The four hospital studied may shed light on the Web development in many other Chinese hospitals that are going through the same healthcare new media adoption. The findings from this study can also help Chinese hospitals form their visions in serving patients online.

This study aims to find out how Chinese hospitals have used online videos as marketing and patient education tools. The findings from this study can help Chinese hospital administrators better understand how to best take advantage of the up-to-date online video delivery technology to conduct contemporary marketing and efficiently help their patients. Based on a systematic probability sample of 2385 Chinese hospitals, the authors conducted a content analysis of Chinese hospital websites in early 2013. The study found that 42% of Chinese hospitals had a website, only 21.8% of these websites contained video(s), and 44.3% of the these video websites carried only one video. The videos were mainly used to provide patient education (27.7%) and to promote a hospital (23.1%). Overall, private hospitals used more videos than state-owned hospitals especially for advertising and promotion, but hospital ranking did not exert much influence. The study concludes that Chinese hospitals need to learn how to turn videos into an integral part of their marketing strategy so as to create both conceptually and technologically user-centric websites to serve themselves and, more importantly, to serve their patients.

Raman spectroscopy as an ex vivo noninvasive approach to distinguish complete and incomplete spermatogenesis within human seminiferous tubules

BackgroundThe overall expenditure on pharmaceuticals in hospitals is rising. It is important to use tendering processes to obtain lower prices. At the same time, drug shortages are an increasing challenge...

Attitude and orientation of doctors to the doctor-patient relationship has a direct influence on delivery of high quality health- care. No study to the knowledge of these researchers has so far examined the practice orientation of doctors in Nigeria to this phenomenon. The aims of this study were to determine the orientation of Kano doctors to the practice of doctor-patient relationship and physicians' related-factors. Participants were doctors working in four major hospitals (i.e., two federal-owned and two state-owned) servicing Kano State and its environs. The Patient-Practitioner Orientation Scale (PPOS) and a socio-demographic questionnaire were completed by the 214 participants. The PPOS has 18 items and measures three parameters of a total score and two dimension of "sharing" and "caring". The mean age of participants was 31.72 years (standard deviation = 0.87), with 22% being females, 40.7% have been practicing for ≥ 6 years and about two-third working in federal-owned health institution. The Cronbach's alpha of total PPOS scores was 0.733 and that of two sub-scale scores of "sharing" and "caring" were 0.659 and 0.546 respectively. Most of the doctors' orientation (92.5%) was towards doctor-centered (i.e., paternalistic) care, majority (75.2%) upheld the view of not sharing much information and control with patients, and showing little interest in psychosocial concerns of patients (i.e., 'caring'=93.0%). Respondents' characteristics that were significantly associated with high doctor 'caring' relationship orientation were being ≥ 30-year-old and practicing for ≥ 6 years. Working in State-owned hospitals was also significantly associated with high doctor "sharing" orientation. This paper demonstrated why patient-centered medical interviewing should be given top priority in medical training in Nigeria, and particularly for federal health institutions saddled with production of new doctors and further training for practicing doctors.

BackgroundThis is an interventional study, since a training has been given, performed in order to investigate whether training has significant impact on knowledge levels of healthcare managers (head-nurses, assistant head nurses, hospital managers and deputy managers) regarding bio-medical waste management.MethodsThe study was conducted on 240 volunteers during June – August 2010 in 12 hospitals serving in Istanbul (private, public, university, training-research hospitals and other healthcare institutions). A survey form prepared by the project guidance team was applied to the participants through the internet before and after the training courses. The training program was composed of 40 hours of theory and 16 hours of practice sessions taught by persons known to have expertise in their fields. Methods used in the analysis of the data chi-square and t-tests in dependent groups.Results67.5% (162) of participants were female. 42.5% (102) are working in private, and 21.7% in state-owned hospitals. 50.4% are head-nurses, and 18.3% are hospital managers.A statistically significant difference was found among those who had received medical waste management training (preliminary test and final test) and others who had not (p<0.01). It was observed that information levels of all healthcare managers who had received training on waste management had risen at the completion of that training session.ConclusionOn the subject of waste management, to have trained healthcare employees who are responsible for the safe disposal of wastes in hospitals is both a necessity for the safety of patients and important for its contribution to the economy of the country.

BackgroundEffective human resources management plays a vital role in the success of health-care sector reform. Leaders are selected for their clinical expertise and not their management skills, which is often the case at the middle-management level. The purpose of this study was to examine the situation in some fields that involve working with people in health-care organizations at middle-management level.MethodsThe study included eight state-owned hospitals in Slovenia. A cross-sectional study included 119 middle managers and 778 employees. Quota sampling was used for the subgroups. Structured survey questionnaires were administered to leaders and employees, each consisting of 24 statements in four content sets evaluated on a 5-point Likert-type scale. Respondents were also asked about the type and number of training or education programmes they had participated in over the last three years. Descriptive statistics, two-way analysis of variance, Pearson’s correlation coefficient and multiple linear regression were used. The study was conducted from March to December 2008.ResultsStatistically significant differences were established between leaders and employees in all content sets; no significant differences were found when comparing health-care providers and health-administration workers. Employment position was found to be a significant predictor for employee development (β = 0.273, P < 0.001), the leader–employee relationship (β = 0.291, P < 0.001) and organizational motivation (β = 0.258, P < 0.001). Area of work (β = 0.113, P = 0.010) and employment position (β = 0.389, P < 0.001) were significant predictors for personal involvement. Level of education correlated negatively with total scores for organizational motivation: respondents with a higher level of education were rated with a lower score (β = -0.117, P = 0.024). Health-care providers participate in management programmes less frequently than do health-administration workers.ConclusionEmployee participation in change-implementation processes was low, as was awareness of the importance of employee development. Education of employees in Slovenian hospitals for leadership roles is still not perceived as a necessary investment for improving work processes. Hospitals are state owned and a national strategy should be developed on how to improve leadership and management in Slovenian hospitals.

Facing the new problems under the background of new era,with the establishment of the market economy of our country and the improvment of the medical health system,how to solve medical health problems,how to strengthen the modernization management of state-owned hospital,and how to improve their comprehensive strength become the focus of the health research.With the internal and external environment analysis and the strategic management theory,this paper puts forward the development strategy and the support system of the children's hospital of Chongqing Medical University. Key words: Medical industry; Development strategy; Strength; weakness; opportunities; threaten analysis; Support system

Surgical-site infections (SSIs) give rise to significant demands on the health systems as well as economic and social sequelae for patients. This article describes an audit for infection control developed in a surgical unit of a tertiary care setting in Gujarat state, India that was scaled-up to all state-owned hospitals in the district. A retrospective baseline assessment of surgical infection rates in a general surgical unit revealed an infection rate of 30%. An audit was implemented based on guidelines for SSI prevention published by the Centres of Disease Control. Surveillance and hospital epidemiology were established and practice reforms implemented. Monthly and annual meetings to review implementation were held. After 12 months, an 88% decrease in the infection rate in the surgical unit was demonstrated. Thereafter, the process was replicated across the surgical department and for all cases undergoing surgery. After 12 months, a 67% reduction in the infection rate was detected. The process has since been applied across the state. A locally owned and team-led process embedded within routine working conditions can challenge widely held perceptions, inform low-cost and no-cost remedial actions, and improve cultures of practice, quality of care and health outcomes. As urban populations grow, methods that are capable of continuously identifying, and responding to, problems and sustaining quality of care in facilities are necessary. SSIs may be largely preventable. With careful implementation, audit has the potential to be a major contributor to their reduction.

To understand the prevalence of workplace violence of the state-owned hospitals and private hospitals and to compare the characteristics of them in Tangshan city. Cluster sampling method were used to investigate the three state-owned hospitals and five private hospitals， medical staff who suffer violence in the workplace from April 2008 to April 2009 in Tangshan city. The incidence rate of workplace violence in state-owned hospitals(62.98%) was higher than private hospitals（13.55％）. The type of the violence is mainly psychological violence both in state-owned hospitals and private hospitals. And state-owned hospitals’ incidence of psychological violence (46.48％) was higher than private hospitals（13.55％）. Both state-owned hospitals and private hospitals， the violence mainly occurred during daytime hours. Violence of state-owned hospital most occurred in wards（47.92%）， while private hospitals most occurred in medical rooms（32.35%）. The most important reasons for workplace violence in State-owned hospitals and private hospitals were the perpetrators of alcohol (42.81%) and patients without improvement or self-opinion that there is no improvement（57.35％）, respectively. Private Hospitals’ incidence of workplace violence is lower than the state-owned hospitals’ in Tangshan city， According to the characteristics of various hospitals， we should implement interventions to reduce the incidence of violence in the hospital.

Willingness to pay for three hypothetical malaria vaccines in Nigeria

The reform of Portuguese public hospitals can be described as an evolution by “waves”. A first “wave” took place in 2002, when 34 public hospitals were transformed into State-owned hospital enterprises (SA hospitals). Subsequently, in January 2006, the SA hospitals and some of the traditional public administration hospitals (SPA hospitals) were changed into public business enterprises (EPE hospitals). That was the second “wave” that is the stage we are at pre- sent. A possible third “wave” can be related with the possibility of conversion of the EPE hospitals into State Hospital Foundations (SHF). This paper tries to identify if this new management model has more capacity to influence positively values such as efficiency, equity, quality, governance, empowerment and accountability than the previous existing model. For this purpose it was developed a strategic analysis including an evaluation of some internationals experi- ences, and also a SWOT analysis was performed. The authors conclude that the introduction of SHF model is a very plausible alternative. The model of governance can make the difference and promote its implementation. Due to the participative management model, the process of accountability can be more “visible” and the regulatory process of this management model seems to be more effective.