فهرست مطالب

  • Volume:3 Issue: 3, 2014
  • تاریخ انتشار: 1393/09/05
  • تعداد عناوین: 8
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  • Abdullah Sarwar Page 103
    Background And Objectives
    Services quality has become the major concern of policy-makers in the present rapidly growing consumer-oriented health industry. However, there is a major gap in the relevant literature in Malaysia in this particular field. Thus, this research attempted to narrow this gap by conducting a qualitative study to gain insight into quality of healthcare services in the Malaysian private hospitals, as perceived by the patients.
    Methods
    This interview-based study was conducted between November 2013 and January 2014. A sample of fourteen patients was randomly selected for interview, from three major Malaysian private hospitals, including Kuala Lumpur Pantai Hospital, Prince Court Medical Centre, and KPJ Ampang Puteri Specialist Hospital. Interview data were collected using a semi-structured questionnaire designed based on literature review. The major themes of healthcare services quality was extracted by iterative review of the interview transcripts.
    Findings
    Analysis of interview data identified three important aspects of healthcare services quality as perceived by the interviewed patients, including cost and location of services delivery, the quality of patient care, availability of adequate facilities.
    Conclusions
    By identifying major factors of patient satisfaction in the private healthcare sector, this study can guide development of effective strategies leading to a higher quality of health services in Malaysia. The study also sets a baseline for future large-scale studies aimed at improving understanding of patients’ unmet expectations from the health system.
    Keywords: Quality of health services, Patient satisfaction, Private Hospital, Hospital management, Health services delivery
  • Shatavisa Mukherjee, Sukanta Sen, Seshadri Sekhar Chatterjee, Arunava Biswas, Satwika Sinha, Malay Ghosal, Santanu Kumar Tripathi Page 113
    Background And Objectives
    The expanding field of psychopharmacology is constantly seeking new and improved drugs to treat psychiatric disorders. Although psychotropic drugs have had a remarkable impact in psychiatry, their utilization, effectiveness, and side effects in the in clinical practice need continuous study. The present study was thus designed to analyze the pattern of psychotropic drugs prescription in a tertiary care teaching hospital in Eastern India.
    Methods
    A 6-month prospective cross-sectional observational clinical study was carried. The study enrolled a total of 294 cases to investigate the prescribing pattern of psychotropic medications, using a predesigned format.
    Findings
    Major depression was found to be the most common psychiatric disorder encountered (34.69%). The number of psychotropic drugs prescribed per patient averaged 3.39. Anti-anxiety drugs were the most frequently prescribed psychotropic drugs in various psychiatric disorders. Psychotropic fixed dose combinations were present in 18.36% of the prescriptions. A majority (83.09%) of medicines was prescribed by generic names. Psychotropic drugs accounted for 69.2% of drugs prescribed from the hospital drug schedule, of which 60.2% actually dispensed from the hospital drug store free of cost. Utilization of drugs from the national list of essential medicines of India (NLEM 2011) was 45.63%.
    Conclusions
    This study provides a baseline data for carrying out further studies on prescribing pattern in a tertiary care unit which would help for improve psychotropic drugs utilization in mental health facilities.
    Keywords: Prescription, Drug utilization, Psychotropic medications, Tertiary care hospital
  • Koorosh Kamali Page 123
    Background And Objectives
    Responsiveness is one of the hallmarks of high performance health systems. Maintaining the responsiveness of health organizations at high level, require constant assessment of its situation as perceived by the patients. The accumulation of data on patients’ perception of health organizations’ responsiveness can help policy-makers in developing effective relevant strategies. Thus, the aim of this study was to survey the perceived responsiveness of the teaching hospitals of Zanjan City, Iran.
    Methods
    Thiscross-sectional study was carried out at the Zanjan University of Medical Sciences between 2013-2014. A total of 246 inpatients were selected systematically at the time of their discharge. The responsiveness questionnaire recommended by the World Health Organization’s (WHO) was used for the study instrument, which evaluate the responsiveness in terms of dignity, communication, autonomy, confidentiality, prompt attention, quality of basic amenities, choice of provider, and social support. Data were summarized using descriptive statistical methods. T-test and ANOVA was used for comparing the mean values.
    Findings
    More than half of the inpatients rated overall responsiveness as good (58.4%). The confidentiality dimension gained the higher score (82.5%), followed by communication (72.3%), and prompt attention (70.3%). The choice dimension was evaluated as the weakest aspect (22.8%) of the responsiveness. While dignity was perceived to be the most important aspect of responsiveness, confidentiality gained the lowest perceived importance (62%). Old patients expressed a higher evaluation of overall responsiveness and some of its dimensions, including dignity, autonomy, and choice compared with the young patients. In addition, illiterate patients expressed a significantly higher assessment of responsiveness and some of its dimensions, including dignity, autonomy, and communication.
    Conclusions
    Our results ranks the status of different dimensions of responsiveness as perceived by the patients and reveals those areas needing further attention to improve such as social support, autonomy, and choice of provider. The fact the younger and more educated patients expressed lower assessment of responsiveness’s dimensions in, highlights the importance of attention to the specific expectations of these groups and to maintain a high level of responsiveness in the health settings.
    Keywords: Rresponsiveness, Inpatients, Hospital management, Hospital performance, Patient satisfaction, Health system
  • Nahid Hatam, Asiyeh Salehi, Vida Keshtkaran, Parvaneh Heidari Orojloo, Maliheh Ram Page 133
    Background And Objectives
    A career anchors consists of jobs that a person holds in order to achieve a professional goal. Career anchors development management results in job satisfaction, professional commitment, and higher effectiveness. The purpose of this study was to determine different dimensions of career anchors among in the personnel of vice-chancellor offices of Shiraz University of Medical Sciences.
    Methods
    This cross-sectional study was conducted in 2012. The study sample was 236 personnel of the Vice-chancellor offices of Shiraz university of Medical Sciences, selected using ratio estimation method. The 43-item Schein''s career anchors orientation inventory was used as the study instrument. T-test, ANOVA and Spearman coefficient were used for data analysis.
    Findings
    The highest mean score of career anchors was observed in service port (3.28 ± 0.43) and the lowest mean was observed in identity port (2.47 ± 0.5). Significant inverse relationships were found between age and work experience in the innovation port. There was also significant difference between genders in service and security ports.
    Conclusions
    The main career anchor was related to services port, which highlights the importance providing quality health care services to the patients. In order to improve work situation it is recommended to hire well-educated managers for job development and provide educational courses for managers and personnel.
    Keywords: Career anchors, Job Motivation, Job satisfaction
  • Lida Gholizade, Irvan Masoudi*, Mohammad Reza Maleki, Afsoon Aeenparast, Mehdi Barzegar Page 139
    Background And Objectives
    Healthcare human resources management is a challenging and multi-faceted task. Study of the interrelation of various variables affecting the performance of the healthcare workers resources can provide insight into effective management of human resources in the health settings. Hence, this study aimed to explore the relationship between job satisfaction, job motivation and organizational commitment in the healthcare workers.
    Methods
    A sample of 250 healthcare workers was selected from the public hospitals of Boyerahmad Kohkiluyeh Province using cluster sampling method. Job satisfaction was measured by Spector’s job survey, job motivation by Loudahel Kitchener’s survey and organizational commitment by Allen and Meyer’s survey. The relationship between the variables was explored by sstructural equations modeling.
    Results
    Job satisfaction was found to be a significant predictor of job motivation and organizational commitment. In addition, job motivation significantly predicted the organizational commitment.
    Conclusions
    In order to increase organizational commitment of the healthcare workers, the administrators of the healthcare settings should motivate their employees by strategies leading targeting enhancing their satisfaction with job and quality of work life.
    Keywords: Job satisfaction, Job Motivation, Organizational Commitment, Healthcare workers, Healthcare Human Resources, Hospital management
  • Mohammadali Zhiarfar, Seyed Hesam Seyedin, Sogand Tourani, Rahim Khodayari Zarnaq*, Ali Ayoubian Page 145
    Background And Objectives
    Outsourcing healthcare and the associated services is has proven as an effective strategy for enhancing hospital performance and improving quality of services. Despite, the concept is relatively new in Iran, calling for studies investigating different aspects of the issue and its potential benefits. Thus, this study was conducted to explore the impact of outsourcing management of healthcare services on quality of these services in a number of teaching hospitals in Iran.
    Methods
    A sample of 113 managers from six teaching hospitals of Tehran University of Medical Sciences (TUMS) was surveyed. A 14-item researcher-made questionnaire was used to record the perception of hospital managers towards the quality of healthcare services before and after signing management contract. Paired t-test was used to compare the mean values.
    Findings
    The quality of healthcare services after outsourcing was found to be significantly higher (P < 0.05) as perceived by the hospital managers, compared with the period before outsourcing.
    Conclusions
    Our results provide further support for the notion that outsourcing management of healthcare services can lead to an improved quality of these services, thereby higher patient satisfaction and enhanced hospital performance.
    Keywords: Healthcare services, Hospital management, Outsourcing, Health services quality
  • Fateme Sadeghi, Marjan Ghazisaeedi, Reza Safdari, Abdoljalil Kalantarhormozi Page 149
    Fast and holistic access to the patients’ clinical record is a major requirement of modern medical decision support systems (DSS). While electronic health records (EHRs) have replaced the traditional paper-based records in most healthcare organization, the data entry into these systems remains largely manual. Speech recognition technology promises substitution of the more convenient speech-based data entry with currently laborious manual method, in the near future. Developing effective speech recognition systems (SRS) require availability of standardized vocabulary databases. This study was aimed at developing a medical speech recognition database for reconstructive hand surgery based on the Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT). All codes related to hand problems were extracted from ICD-10. A sample of 2051 diagnosis codes was randomly selected from the patients’ records. The operation report paper sheets were transformed to electronic records. For each term, the SNOMED-CT was browsed to find the preferred synonym, using CliniClue® Xplore Software. For some words with several number of synonyms, the preference of reconstructive surgery specialists were asked using a researcher-made questionnaire. Ultimately, the preferred words was substituted throughout each document and used for developing a database of standard nomenclature. The developed database was used in speech-based recording clinical data in reconstructive hand surgery operating room and accuracy of 81% in correct recording of clinical data was observed. Therefore, development of standard medical nomenclature databases can facilitate accurate electronic recording of medical data and reduce the associated labor and cost posed by current manual method.
    Keywords: Clinical Records, Health Electronic Systems, Electronic Health Records, Speech recognition, Database, Software, Medical Informatics, Hand Surgery
  • Edris Hasanpoor, Ali Janati, Abdulla Salehi, Mobin Sokhanvar, Javad Ebrahimzadeh Page 155
    Under the table or informal payments in several middle and low income countries is a serious impediment to health care reform. These payments are effectively a form of systemic corruption. This report shows the efforts of a patient who seek health care for his ankle while being requested to pay under the table in hospital and private clinic. The data were collected by interview and surveying patient documents. Informal payments have adverse impact on access and utilization of health services, efficiency, quality and equity. Informal payments lead to false information about the real costs of disease and the patient share of these costs and consequently wrong government policies. Appropriate deterrent sanctions should be imposed on providers that request for under the table payments, especially in the public sector where the government tries to subsidize healthcare to ensure it is accessible to all, especially the poor.
    Keywords: Under the table payments, Health care system, Health setting, Patient