Modelos de medición de la calidad de atención en salud / Health care quality measurement models

Una aproximación para medir el nivel de atención expresada en la calidad de servicio que se presta al paciente en los establecimientos de salud está referida al uso de modelos de medición, que en este artículo se describen desde la propuesta por Donabedian basado en la teoría general de sistemas evaluando estructura, proceso y resultado, pasando a segundo plano la percepción del paciente. Este modelo contrasta con el modelo Nórdico que enfatiza la imagen corporativa, con un balance entre el servicio esperado y la percepción del servicio, basado en el paradigma de la desconfirmación al igual que el modelo presentado por Nguyen. En esta última línea paradigmática se encuentra el modelo más notorio, SERVQUAL que contrasta las expectativas y la precepción del usuario de un servicio identificando brechas en base a las 5 dimensiones propuestas fiabilidad, seguridad, elementos tangibles, capacidad de respuesta, y la empatía, posteriormente basado en este modelo se propone el modelo SERVPERF, basada exclusivamente en la valoración de las percepciones. Posteriormente, se describen el modelo de Desempeño Evaluado que surge como un modelo alternativo al SERVQUAL sustituyendo las expectativas por el concepto de punto ideal; el Modelo Jerárquico Multidimensional que desarrolla una solución tridimensional para completar la modelización de la calidad de servicio. De igual manera el modelo multietapa de valoraciones de la calidad que identifica la disconformidad que existe las expectativas del cliente en relación al servicio y las percepciones de las características por niveles de componente

One approach to measuring the level of care expressed in the quality of service provided to the patient in health facilities is referred to as the use of measurement models described in this paperstarting with the one proposed by Donabedian based on the general theory of systems evaluating structure, process and outcome, with the patient's perception taking second place. In contrast, the Nordic model emphasizes the corporate image, with a balance between the expected service and the perception of the service, based on the paradigm of disconfirmation as well as the model presented by Nguyen. In this paradigmatic line the most notorious model, SERVQUAL, contrasts the expectations and the user's perception of a service identifying gaps based on the 5 proposed dimensions reliability, security, tangible elements, responsiveness, and empathy, later based on this model the SERVPERF model is proposed, based exclusively on the valuation of perceptions. In addition, the Evaluated Performance model, which emerges as an alternative model to SERVQUAL, replaces expectations with the concept of ideal point. And the Multidimensional Hierarchical Model develops a three-dimensional solution to complete the modeling of service quality, as well as the multi-stage model of quality assessments that identifies the non-conformity that exists between customer expectations in relation to the service and the perceptions of the characteristics by component levels

Universiti Sains Malaysia (USM) Pre-clinical Medical Students’ Guidance and Counselling Needs Questionnaire: A Confirmatory Factor Analysis

@#Introduction: The USM Pre-clinical medical students’ guidance and counselling needs questionnaire (USM-MSGCN-Q) is an English-language guidance and counselling needs questionnaire which was developed specifically for pre-clinical medical students. The aim of this study is to highlight the construct validity of USM-MSGCN-Q among pre-clinical medical students. Methods: In June 2017, a cross-sectional study on 208 pre-clinical medical students was conducted in Universiti Sains Malaysia (USM). This self-administered USM-MSGNC-Q consisted of four constructs and 20 items with a 5-point Likert scale within each item. A confirmatory factor analysis was employed to test the hypothesized measurement model. Results: The final measurement model fitted the data well. The four-factor model initially consisted of 20 items however, it was reduced to 18 items with the goodness of fit indices suggesting good model fit (RMSEA 0.89, GFI .915 and ChiSq/df 2.642). Internal consistency reliability (Cronbach’s alpha) was 0.879 for self-leadership skills, 0.929 for communication skills, 0.871 for learning skills, and 0.870 for psychological coping skills. The overall Cronbach’s value was 0.922. Respective composite reliability values were 0.879,0.952,0.879 and 0.835 while the Average Variance Extracted values were 0.729, 0.911, 0.595 and 0.630. Conclusion: This study has confirmed that self-leadership, communication, learning and psychological coping skills were the components of guidance and counselling needs which influences the effectiveness of guidance and counselling sessions with pre-clinical medical students.

Revisión de los criterios para validez convergente estimada a través de la Varianza Media Extraída / Review of the criteria for convergent validity estimated through the Extracted Average Variance

Resumen En el contexto del modelamiento de ecuaciones estructurales se manejan los conceptos de validez convergente y confiabilidad compuesta aplicados a los modelos de medida con ítems congenéricos. Este estudio metodológico tiene como objetivo revisar los puntos de corte estipulados para la Varianza Media Extraída (VME) cuando se usa para establecer la validez convergente de un modelo de medida. Por una parte, se consideró la gran semejanza entre los conceptos de validez convergente y confiabilidad por consistencia interna, al usarse los pesos de medida estandarizados para su estimación. Por otra parte, se analizó la relación entre el número de ítems del factor, la VME y los coeficientes omega y H. A efectos de simplificación, se manejó un peso de medida homogéneo en las demostraciones. Se observó un efecto muy grande del número de ítems, provocando un deterioro en la VME, aun manteniendo constante el mismo nivel de confiabilidad (coeficientes omega y H), y más acusado a mayor nivel de confiabilidad. Se concluye que valores de VME < .50 pueden reflejar niveles aceptables de validez convergente, dependiendo del número de ítems, si incluyen como criterios complementarios: pesos de medida estandarizados ≥ .50 y coeficientes omega y H ≥ .70.

Abstract In the context of the structural equation modeling, the concepts of convergent validity and composite reliability applied to the measurement models with congeneric items are used. This methodological study aims to review the stipulated cut-off points for the Extracted Average Variance (AVE) when it is used to establish the convergent validity of a measurement model. On the one hand, the great similarity between the concepts of convergent validity and internal consistency reliability, when standardized measurement weights are used for their estimation, was considered. On the other hand, the relationships among the number of factor items, the AVE and the omega and H coefficients were analyzed. For simplification purposes, a homogeneous measurement weight was used in the demonstrations. A very large effect of the number of items was observed, causing a deterioration in the AVE, while still maintaining the same level of reliability (omega and H coefficients), and more pronounced at a higher level of reliability. It is concluded that AVE values < .50 may reflect acceptable levels of convergent validity depending on the number of items, if the following criteria are included as complementary criteria: standardized measurement weights ≥ .50, and coefficients omega and H ≥ .70.

Empirical research on the performance appraisal model and implementation framework for administrative departments at public hospitals / 中华医院管理杂志

Efficient measurement of administrative departments at public hospitals is key to performance appraisal for such units. The authors analyzed the current situation and problems of performance management of such departments of public hospitals, and made case studies for the formulating and implementing process of the performance appraisal system.Furthermore, they probed into appraisal methods for these departments and presented a performance appraisal model of " expectation-response" . Combined with the practice of the case hospitals, the authors recommended an annual personalized evaluation indicator system. Based on analysis of the operation process of the case hospitals from 2016 to 2018, namely theory study-practical exploration-experience summary-program readjustment for further practice. These efforts studied the implementation framework of performance management for these departments, summarized the by-stage practice experiences of the appraisal from the " basic version" to " specialized version" . Thus the paper provided references for their performance management of these hospitals.

Thirst as the threshold symptom to prevent worsening heat-related illness

@#Introduction: The heat-related illness (HRI) is a continuum illness ranging from minor health effects to life-threatening medical emergencies when the pathological effects of heat load are not prevented. The aim of this study was to demonstrate the threshold HRI symptom for deciding to take simple preventative actions both by the individual workers and employers.

Empirical research on the performance appraisal model and implementation framework for administrative departments at public hospitals / 中华医院管理杂志

Efficient measurement of administrative departments at public hospitals is key to performance appraisal for such units.The authors analyzed the current situation and problems of performance management of such departments of public hospitals,and made case studies for the formulating and implementing process of the performance appraisal system.Furthermore,they probed into appraisal methods for these departments and presented a performance appraisal model of " expectation-response".Combined with the practice of the case hospitals,the authors recommended an annual personalized evaluation indicator system.Based on analysis of the operation process of the case hospitals from 2016 to 2018,namely theory study-practical exploration-experience summary-program readjustment for further practice.These efforts studied the implementation framework of performance management for these departments,summarized the bystage practice experiences of the appraisal from the "basic version" to "specialized version".Thus the paper provided references for their performance management of these hospitals.

Establishment of a model for measuring the impact of Chinese papers published by class A hospitals / 中华医学图书情报杂志

A model for measuring the impact of Chinese papers published by hospitals in China was established, followed by an analysis of the contribution of the total citations, the number of fund-supported papers, the number of papers published in core journals, the number of papers published in core journals of Chinese Medical Associa-tion to the impact of papers, which showed that these parameters could effectively measure the impact of Chinese papers published by class A hospitals in China.