ABSTRACT
Resumen Este artículo identifica y analiza la relación entre la sustentabilidad financiera y la excelencia de la atención hospitalaria de la salud pública chilena. Los datos se obtienen directamente del Cuadro de Mando Integral de los 57 hospitales chilenos de mayor complejidad. Se realiza un análisis univariado, para determinar el comportamiento tendencial de los indicadores que componen las estrategias de sustentabilidad financiera y excelencia de la atención; luego un análisis bivariado para establecer asociaciones entre indicadores y variables relevantes, y analizar el funcionamiento de los establecimientos; y finalmente un análisis multivariado, donde se utiliza la técnica de análisis factorial confirmatoria. Demuestra que existe una relación negativa entre los resultados de ambas estrategias en estudio, por lo que se concluye que mejoras en los resultados de la sustentabilidad financiera no se traducen directamente en los resultados de excelencia de la atención hospitalaria, ya que no existe una canalización efectiva entre ambas estrategias.
Abstract Objective: To determine. This article identifies and analyzes the relationship between financial sustainability and the excellence of hospital care in Chilean public health. The data is obtained directly from the Balanced Scorecard of the 57 most complex Chilean hospitals. A univariate analysis is carried out to determine the trend behavior of the indicators that make up the strategies of financial sustainability and excellence of care; then a bivariate analysis to establish associations between indicators and relevant variables, and analyze the operation of the establishments; and finally a multivariate analysis, where the technique of confirmatory factor analysis is used. It shows that there is a negative relationship between the results of both strategies under study, so it is concluded that improvements in the results of financial sustainability do not translate directly into the results of excellence in hospital care, since there is no effective channeling between both strategies.
Subject(s)
Quality of Health Care/organization & administration , Health Care Reform/economics , Development Indicators , Hospital Care/economics , Management Indicators/policies , Chile , Public HealthABSTRACT
Study design: This is a cross-sectional study which reports the development and pilot of a digital mobile partograph application in 5 primary healthcare centers of North Karnataka, India. Background: The DAKSH is a tablet-based application designed to improve care for women in the intrapartum period by addressing the issue related to paper partograph usage. Application is designed to provide real-time labor monitoring, basic decision making support by alerts and better record-keeping. The primary objective of the study was to evaluate the feasibility and acceptability of mobile partograph in low resource primary healthcare centers. Methods: The digital partograph was introduced at 5 primary healthcare centers in North Karnataka, India. Following 2 days of training, remote monitoring was done through a dashboard and a bi-monthly evaluation visit was conducted. Results were analyzed in terms of quantitative analysis (data filled into the application was compared against hospital records) and qualitative analysis (during each bi-monthly visit staff nurses were interviewed). Results: A total of 10 staff nurses from these healthcare centers used the application to monitor 424 pregnancies for a period of 10-months. During this period the hospital observed around 463 childbirths and out of which 91.56% (n=424) were recorded into the application. Conclusion: This shows good acceptability of application among staff nurses. Plotting of partograph, auditory reminders to monitor labour vitals were helpful.
ABSTRACT
Background: During the past decade, significance and impacts of low level of health literacy on individuals' health status has been greatly noticed. This study was conducted with the aim of determining the relation between health literacy with promoting behaviors in health ambassadors of Kazeroon city healthcare centers. Methods: This study was descriptive – analytical and of cross-sectional type. The research sampling method was multi-stage method. Samples were selected from three urban healthcare centers and three rural health care centers and from each center respectively two bases and two health houses were randomly selected. In the present study, two questionnaires of health literacy and standard questionnaire (HpLp-II) was used. Pearson correlation test, independent t-test and bilateral variance analysis were used for data analysis. Results: 528 health ambassadors completed the questionnaires that from them 79.85 were woman and 20.20% man. The results of the present study showed that there is a significant relation and positive correlation between health literacy rate of ambassadors and general behaviors promoting health and its components like liability, physical activity and nutrition habits (P<0.05). Conclusion: The results of the present study showed that increasing of ambassadors health literacy is effective in increasing their health promoting behaviors and it is recommended that in future with effective interventions, besides promoting health literacy of people in various fields, increase their cooperation and participation for self-care and doing health promoting behaviors
ABSTRACT
A cross-sectional study with a descriptive and an analytical component was conducted to describe and analyze the incidence of anti-tuberculosis adverse drug effects and its reporting rate at Hospital Parmenio Piñero CeSACs [Centros de Salud y Acción Comunitaria (Community Healthcare Centers)] between 2007 and 2014, as well as the knowledge and attitudes of primary care physicians regarding the pharmacovigilance system. The clinical and socio-demographic variables of patients diagnosed with tuberculosis were analyzed based on statistical records and the assessment of medical records. These records were compared with the reports made to the Program of the City of Buenos Aires. Primary care physicians were interviewed. Five hundred and sixty-two cases of tuberculosis were evaluated. Two hundred and forty-two adverse effects were documented in 109 patients (19%). Of these, 39% were hepatic, 36% were gastrointestinal, and 29% were hematological. Adverse effects were mild in 63% of the patients, moderate in 28% and severe in 8%. Treatment had to be discontinued in 7% of the cases. Seven cases (19%) required hospitalization and two patients passed away (0.36%). Being unemployed [OR: 3.26 (1.29-8.25)], being of Bolivian nationality [OR: 2.98 (1.32-3.28)] or having a comorbidity [OR: 3.06 (1.84-5.08)] was associated with a higher risk of exhibiting adverse effects. Twenty-nine percent of the physicians surveyed mentioned they had reported an adverse effect. The adverse effects found were not reported to the Tuberculosis Program. It is essential to handle the information associated with the adverse effects of tuberculostatic drugs more efficiently.
Subject(s)
Tuberculosis , PharmacovigilanceABSTRACT
Objective Measure the variation trend and the problems of bed allocation and its equity at primary medical institutions and provide theoretical basis for optimizing the policy of health resources allocation for the government.Methods Analysis of the distribution and equity of the inpatient beds at primary medical institutions in terms of geographical area by means of the survey of regular overall statistics forms and the methods of Gini coefficient and Theil index.Results From 2009 to 2012,the number increase of beds at such institutions geographically was 7.72%,while that in eastern,central and western regions of China were respectively 5.35%, 3.97% and 27.88%.The number increase at community healthcare centers was 46.58%,while that in eastern,central and western regions of the country were respectively 18.09%,29.57%和 81.53%.The number increase at township hospitals was 2.33%,while that in eastern,central and western regions were respectively - 3.83%,- 0.43% and 22%.The Gini coefficient of bed allocation at such institutions was beyond 0.6,while that in eastern, central and western regions were respectively under 0.3,0.3-0.4 and 0.6 above.The Gini coefficient of bed allocation at community healthcare centers fell from above 0.4 to under 0.4.The Gini coefficient in the western regions increased from 0.3-0.4 to over 0.4.The variation trend of township hospitals was similar with the overall conditions at such institutions.The intra-regional Theil indexes and their contribution rates of bed allocation at such institutions were higher than those of inter-regional. Conclusions The overall variation trend of bed allocation at such institutions was on the rise,yet its variation trend of equity remains unchanged.The bed allocation and its equity at such institutions were higher than those at township hospitals.The growth rate in western regions was the highest,but the absolute number was the lowest.Moreover,the equity of bed allocation in such regions was not only the lowest,but also was found rising.The influence of bed allocation in intra-region terms was large,while its equity was not only lower but falling as well.
ABSTRACT
OBJETIVO: Determinar a relação da síndrome metabólica (SM) com o nível socioeconómico, hábitos comportamentais, condições de saúde, antecedentes familiares de morbidades e áreas de residência. MÉTODOS: Trata-se de um estudo de corte transversal. A amostra aleatória foi constituída por usuários de duas Unidades Básicas de Saúde da cidade de São Paulo - Jardim Comercial (UBS1) e Jardim Germânia (UBS2) -, totalizando 452. Para o diagnóstico de SM utilizou-se o critério do Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (NCEP-ATP III). Na avaliação antropométrica foram aferidas medidas de peso, estatura, circunferências abdominal e do quadril. Foi utilizado questionário geral para obtenção de dados sociodemográficos, socioeconómicos, antecedentes familiares e pessoais de morbidades, hábitos comportamentais como tabagismo, etilismo e nível de atividade física. Foi estabelecida associação entre as variáveis explicativas de interesse e SM, empregando-se a regressão logística multivariada. RESULTADOS: Na UBS1, o percentual de SM foi de 56,1 por cento e na UBS2, de 34,0 por cento. Houve associação direta e significativa entre SM e idade, sexo feminino, cor, tabagismo, etilismo, nível de atividade física, estresse e antecedentes familiares de doença cardíaca e de diabetes mellitus. A escolaridade apresentou associação inversa: morar no bairro de menor nível socioeconómico aumentou a chance de SM. CONCLUSÃO: Os resultados sugerem que as morbidades que compõem a SM são um grave problema de saúde pública nessa população.
OBJECTIVE: To determine the relationship between metabolic syndrome (MS) and socioeconomiclevel, life style, health status, family history of morbidity, and residence areas. METHODS: This is a cross-sectional cohort study. The random sample consisted of users of two primary health care units (Unidades Básicas de Saúde - UBSs) in the city of São Paulo - Jardim Comercial (UBS1), and Jardim Germânia (UBS2), a total of 452 subjects. The NCEP ATP IIIcriterion was used to diagnose MS. Weight, height, abdominal and hip circumferences were measured for the anthropometric evaluation. A general questionnaire was used to obtain sociodemographicand socioeconomic data; family history; medical history; behavioral habitssuch as smoking, drinking, and physical activity. Multivariate logistic regression was used to establish the association between explanatory variables of interest and MS. RESULTS: At UBS1, MS percentage was 56.1 percent; at UBS2, 34.0 percent. There was a direct and significant association between MS and age, female gender, race, smoking, drinking, physical activity level, stress, and family history of heart disease and diabetes mellitus. Education level showed an inverse association. Subjects living in a lower socioeconomic level neighborhood had a higher MS risk. CONCLUSION: The results suggest that the morbidities that compose MS are a serious publichealth problem in that population.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Metabolic Syndrome/epidemiology , Primary Health Care , Body Weights and Measures , Brazil/epidemiology , Cross-Sectional Studies , Educational Status , Metabolic Syndrome/etiology , National Health Programs , Prevalence , Risk Factors , Sex Distribution , Socioeconomic Factors , Urban HealthABSTRACT
Objective: Explore approaches to strengthening the ethical research on nursing management at grass-roots healthcare centers,to regulate the nursing care at grass-roots healthcare centers.Methods: Regulations,procedures and technology criteria are formulated based on the status quo and practical problems of grass-roots healthcare centers.Results: It is an effective way to improve the quality of hospital medical service by enhancing nursing management.Conclusion: It is necessary for enhancing overall nursing quality to take full advantage of nursing management skills,and improve nursing quality and management effect.
ABSTRACT
Community participation in the rural healthcare service is still necessary under existing Chinese social conditions to achieve the goal of providing general rural public with safe,effective,convenient and inexpensive medical and healthcare services,as is declared in the 17th national people's committee report.The property rights system reform in rural healthcare centers is a reflection of community participation,and related problems in its participation process should be handled by steering the rudder of fairness when the Government applies its functions.The ultimate goal of rural healthcare property rights reform is to achieve the healthcare fairness for every rural individual,and thus right of each participator and fairness in the reform should be ensured.