Responsiveness of the health insurance and private systems in Alexandria, Egyptah, Saudi Arabia

Background: Responsiveness to patients is a key indicator for measuring the health system performance with respect to nonhealth aspects. This study aimed to compare responsiveness of the Health Insurance Organization [HIO] with the private healthcare system and also to assess the importance of the different responsiveness domains according to the study population's perspective

Participants and methods: Patients attending both inpatient and outpatient settings of both organizations were interviewed [200 outpatients and 200 inpatients from each selected hospital] using the WHO questionnaire. The questionnaire elicits the ratings of the respondents on their experiences with the healthcare system over the past 12 months in terms of responsiveness domains, respondents' inability to access medical care because of financial barriers, and their ranking of the relative importance of responsiveness domains

Results: Almost twice the number of HIO participants reported poor responsiveness compared with the private organization participants [27.8 vs. 56.8%, respectively]. The outpatient setting scored much favorably compared with the inpatient setting at the HIO [52.3% of respondents reported poor responsiveness in the outpatient setting compared with 76.3% in the inpatient setting]; however, they were comparable in the private setting. Communication, prompt attention, and dignity were the domains most frequently rated as the most important [36.0, 32.0, and 14.7%, respectively]. The type of organization [HIO vs. private organization] and setting of care [inpatient vs. outpatient] were significant predictors of responsiveness score [P<0.001]

Conclusion and recommendations: The overall rating of the patients on responsiveness of the HIO system is low, especially when compared with the private sector. The results emphasize the importance of establishment of systems for monitoring the performance of the providers and discontinuation of the services for the nonperformers

Role of vaginal candidosis in abnormal discharge

255 women were recruited in this study; 225 presented with abnormal vaginal discharge and/or pruritis, burning and dysparuenia, the rest were asymptomatic and clinically free. High vaginal swabs taken and streaked immediately on Sabouraud dextrose agar. Vaginal candidosis ascertained by culture morphology and biochemical tests, was detected in 40.8% of symptomatic cases and in 16.6% of asymptomatic cases, the difference was statistically significant [P < 0.01]. The group of vaginal candidosis did not differ significantly from the whole symptomatic group in age or parity distribution. But they presented more in the luteal phase [66.1%] than in the follicular phase [P < 0.05]. The typical picture of candidal vulvo-vaginitis was detected in only 5.22% of patients. Candida albicans was the commonest species isolated from both symptomatic and asymptomatic cases. Torulopsis glabrata was isolated from 4.3% of symptomataic cases but not from asymptomatic cases