Quality indicators for mental healthcare in the Danube region: results from a pilot feasibility study.

Quality indicators are vital for monitoring the transformation of institution-based mental health services towards the provision of person-centered mental healthcare. While several mental healthcare quality indicators have been identified as relevant and valid, their actual usability and utility for routine monitoring healthcare quality over time is significantly determined by the availability and trustworthiness of the underlying data. In this feasibility study, quality indicators that have been systematically identified for use in the Danube region countries of Bulgaria, the Czech Republic, Hungary, and Serbia were measured on the basis of existing mental healthcare data in the four countries. Data were collected retrospectively by means of the best available, most standardized, trustworthy, and up-to-date data in each country. Out of 21 proposed quality indicators, 18 could be measured in Hungary, 17 could be measured in Bulgaria and in the Czech Republic, and 8 could be measured in Serbia. The results demonstrate that a majority of quality indicators can be measured in most of the countries by means of already existing data, thereby demonstrating the feasibility of quality measurement and regular quality monitoring. However, data availability and usability are scattered across countries and care sectors, which leads to variations in the quality of the quality indicators themselves. Making the planning and outputs of national mental healthcare reforms more transparent and evidence-based requires (trans-)national standardization of healthcare quality data, their routine availability and standardized assessment, and the regular reporting of quality indicators.

Burnout in Belgrade orthopaedic surgeons and general practitioners, a preliminary report.

BACKGROUND: Burnout syndrome (BOS) is caused both by psychological-emotional and physical stress. It is associated with decreased job performance and low career satisfaction. BOS has a significance influence both to physicians' performance in health care system, and in their private life. Until now, there was no data about this aspect of orthopaedic surgeon condition and health in our community. AIM: To assess the level of the burnout syndrome in orthopaedic surgeons and general practitioners (GPs), and the relations of their demographic features, job characteristics to the burnout syndrome DESIGN: Questionnaire-based survey METHODS: The sample consisted of 30 orthopaedic surgeons from the University Clinical Centre, and 40 GPs from the primary health care centres. The Burnout syndrome was measured by the Maslach Burnout Inventory (MBI). In addition to the MBI, the demographic data were collected and analyzed (age, age of practicing, gender, marital status) in relation to BOS. RESULTS: Both groups expressed moderate to high rate of emotional exhaustion, depersonalization and low personal accomplishment. However, statistical significance between the groups had not been demonstrated. Neither gender nor years of practice or marital status did express statistically significant impact on the BOS items, i.e. they were not predictors of the BOS. Our results showed that about 70% of the physicians were emotionally exhausted considering both groups. On the other hand, orthopaedics demonstrated slightly higher depersonalisation level (55%) than GPs (38%). While GPs expressed lower personal accomplishment (48%) comparing to orthopaedics (29%). DISCUSSION: The obtained MBI scores in this study were similar to those registered in US among residents, but when comparing to physicians in West Europe, which have similar health care system, our results demonstrated higher rates of BOS items. CONCLUSION: The Burnout syndrome represents an important problem for actively practicing physicians. The results of this and other similar studies should be used to evaluate medical training, practice, professional relations and introduce necessary changes.