Health workers with good self-perceived competency have lower actual competency levels on HIS in Eastern Ethiopia: A cross-sectional study

Introduction: Utilization of health information is critical to meeting service performance goals and for making informed decisions. However, in resource limited countries, health data is rarely used in decisions around program improvements. This study aimed to assess the determinants of competency levels for health workers who utilized data from health information systems in Eastern Ethiopia. Methods:A cross-sectional study was carried out from April -May 2021 at selected public health facilities in the Dire Dawacityand Harar regions. A total of 129 health professionals were included in the study and simple random sampling techniques were used to select health facilities. Data was collected using face-to-face interviews and competency levels were measured using a tool adapted from the Performance of Routine Information Systems Management (PRISM) framework. STATA version 16 was used for data analysis. A linear regression model was applied to determine the linear relationship between self-perceived competency and the actual competency levels of the healthcare workers.Adjusted beta (ß) along with a 95% confidence interval (CI) was used to measure the strength of the association with a p-value < 0.05. Results:The overall mean for the actual competency levels of health workers who utilized data was 20.45 [95% CI: 16.71, 24.19]. Being head of a hospital/health center (ß: 19.24, 95% CI: 4.42, 34.06), perusing HIS training (ß: 14.38, 95% CI: 6.10, 22.67) and good perceived competency to perform RHIS tasks (ß: -12.96, 95% CI: -25.49, -0.43) were significantly associated with actual competency levels.Conclusion:The Health workers with high perceivedcompetency levels were found to have actual competency levels that were low. Health information systemfocused trainings were found to be positively associated with actual competency levels and being a hospital or health center head was found to be associated negatively to the actual competency levels of health workers. This research has found that providing health information system training for health workers could prove to be beneficial. There is also a need for initiatives aimed at enhancing competency in order to improve the health information systems related competency levels and data use.[Ethiop. J. Health Dev. 2022;36(SI-1)]

Changes in public trust in physicians: empirical evidence from China / 医学前沿

Studies examining the trends in public trust in physicians have provided a considerable amount of valuable policy implications for policymakers compared with cross-sectional studies on this topic in many countries. This study investigated changes in public trust in physicians in China based on two cross-sectional national surveys conducted in 2011 and 2016 and identified the determinants of these changes. The results indicated 83.4% of respondents in 2011 reported trust or strong trust in physicians in China, which decreased to 64.2% by 2016. The results of ordinal logistic regression demonstrated that public trust in physicians in China had decreased significantly from 2011 to 2016 (P< 0.001) after adjusting for other independent variables. Self-reported health status, self-rated happiness, and self-identified social class were all associated positively with public trust in physicians in China. The results also confirmed that decreasing public satisfaction with the most recent treatment experience was the major determinant of decreasing public trust in physicians in China. The findings of this study suggest that decreasing public trust in physicians deserves considerable attention from national policymakers and that improving satisfaction with treatment experiences would be the most effective strategy for enhancing public trust in physicians in China.

Avaliação de Desempenho de Sistemas de Saúde: um modelo de análise / Evaluation of performance of health systems: a model for analysis

Este artigo apresenta uma revisão da Matriz de Dimensões da Avaliação do Sistema de Saúde no Brasil desenvolvida em 2003, e uma atualização conceitual de parte das subdimensões de avaliação do desempenho dos serviços de saúde: efetividade, acesso, eficiência e adequação. Descreve o processo de seleção dos indicadores utilizados e uma síntese dos resultados para cada subdimensão do desempenho. O comportamento dos indicadores utilizados para avaliar o desempenho dos serviços de saúde no Brasil, no que se refere às quatro subdimensões selecionadas, não é uniforme e as melhorias mais acentuadas são observadas naquelas influenciadas pela atuação dos serviços no campo da atenção primária, as melhorias mais significativas foram observadas nas Efetividade e Acesso. Em relação à Eficiência dos serviços de saúde coexistem situações de alta eficiência com outras de baixo desempenho. A atuação dos serviços de saúde na subdimensão Adequação foi pior do que nas demais apresentadas.

This paper presents a review of the Dimension Matrix for Evaluation of the Brazilian Health System that was initially developed in 2003, as well as a conceptual update of some of the sub-dimensions for the evaluation of health service performance, namely effectiveness, access, efficiency and appropriateness of health care. It also describes the indicator selection process as well as the results obtained in each performance dimension. The behavior of the indicators used to assess the performance of health services in Brazil, with respect to each sub-dimension, was not uniform. Areas of marked improvement were found in indicators that are influenced by activities in the field of primary care. The most significant improvements were seen in the sub-dimensions of Effectiveness and Access. With respect to the Efficiency of health services, situations of high efficiency coexist with others with substandard performance. The performance of health services in the sub-dimension of Appropriateness of Health Care was the lowest of all indicators.

Design of Large-scale Clusters PACS / 医疗卫生装备

Obiective To design large-scale clusters PACS. Methods The concept of large-scale clusters PACS was proposed firsdy, which is combined with the corresponding instances analysis on the systemic characteristics pros and cons. The important function of EPR with images in the large-scale clusters PACS and basic design were discussed. The distributed architecture design of medical imaging in large-scale clusters PACS was put forward, and then focuses on the composition and requirements of clinical part, required post-processing application of clinical specialist part and IT support part. Results The domestic application of clinical information system can bring leapfrog development by large-scale clusters PACS. Conclusion The large-scale clusters PACS will have good future prospection of popularization in our country.

Effect of acute hypervolemic hemodilution on the difference between the target and actual measured plasma concentration of propofol during target-controlled infusion / 中华麻醉学杂志

1 000 rnl were randomly divided into 2 groups : AHHD group ( n = 18) and control group ( n = 18). The patients were premedicated with intramuscular atropine 0.007-0.01 mg?kg-1 . Radial artery and right internal jugular vein were cannulated before induction of anesthesia for MAP and CVP monitoring, blood sampling and fluid administration. Anesthesia was induced with TCI of propofol. The target plasma propofol concentration was set at 3 ?g ? ml -1 . When the patients lost consciousness, fentanyl 2 ?g ? kg-1 was given intravenous and tracheal intubation was facilitated by vecuronium 0.1 mg? kg-1 , 10min after intubation additional fentanyl 2 ?g? kg-1 and vecuronium 0.08 mg? kg-1 were given. In AHHD group lactated Ringer's solution 10 ml ? kg-1 was infused over 30 min before TCI propofol was started. 10 min after start of TCI propofol 6% HES 20 ml? kg-1 was infused within 30 min. In control group the patients received only lactated Ringer's solution 10 ml?kg-1 . TCI of propofol was maintained for 1 h. Arterial blood samples were taken before and 2, 5, 10, 20, 30, 40, 50 and 60 min after TCI propofol was started, and at 2.5, 5, 10, 15, 20, 25, 30 min after termination of TCI propofol for determination of blood concentration of propofol by gas-chromatography - mass spectrometry (GC-MS) . The TCI system comprising Graseby 3 500 infusion pump controlled by Stelpump 1.07 software which included Tackley pharmacokinetic parameters. Results In AHHD group Hb was reduced from initial (130? 14)g?L-1 to (90? 15)g?L-1 and Hct from initial 38% ? 3% to 26% ? 4 % at the end of AHHD. The measured blood propofol concentrations were significantly lower in AHHD group than those in control group at the corresponding time points (P

Development of Performance Evaluation Testbed for PACS / 医疗卫生装备

Objective To develop a performance evaluation testbed for PACS.Methods The basic architecture and primary functions of PACS was simulated to test its robustness and effectiveness.Results The testbed could be used in not only the clinical performance evaluation of PACS but also the study,training and teaching of PACS.Conclusion The practicability and reliability of the testbed have been proved through its tryout.