Development Path and Urgency of Further Strengthening Construction of Public Hospitals Based on Novel Coronavirus Pneumonia Treatment

During the outbreak of novel coronavirus pneumonia(NCP)in Wuhan,public hospitals have played an important role in intensive care,case guidance and scheme optimization.At the same time,it also faces unprecedented challenges and tests.Based on the treatment of severe patients in Wuhan,combined with the treatment practice in Tongji Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology,this paper puts forward the urgency of further strengthening the construction of public hospitals,discusses the feasible path for promoting the development of public hospitals,so as to meet the growing medical needs of the people,improve the ability to respond to major public health emergencies,and effectively guarantee the safety of people's lives and the promotion of a healthy China construction.

Data Envelopment Analysis on Evaluating the Efficiency of Public Hospitals in Tianjin,China

Public hospitals are the most important components of health systems and account for a large proportion of health resources in China. However, few researches on the efficiency assessment of public hospitals have been conducted in Tianjin, China. On the basis of the data of annual health service report in 2013 from the Ministry of Health, we measured the relative efficiency of the tertiary general public hospitals in Tianjin and estimated the magnitudes of output increase and/or input reduction by using data envelopment analysis to improve hospital efficiency. The main findings of this study indicate that more than half of the sample hospitals operate at a technical and scale efficiency, and the prevalent scale inefficiency is increasing returns to scale. Moreover, it is a prominent issue that health resource constraint and resource waste coexist. Health policy-makers and hospital administrators would need to address these problems by taking comprehensive measures such as optimizing the allocation of health resources, implementing hierarchical diagnosis and treatment, as well as innovating medical-service operating mechanism of public hospital to improve the people's wellbeing.

Investigation of Factors Affecting Preparedness of Reporting Adverse Drug Reactions among Nurses in Public and Private Hospitals in Dar Es Salaam, Tanzania

The current study assessed preparedness among nurses about reporting adverse drug reactions in public and private hospitals. Nurses in hospitals are among health providers very close to patients and are involved in the process of administering medications especially to inpatients. A cross sectional study was conducted among nurses in public and private hospitals in Dar es Salaam city in Tanzania to compare their preparedness on reporting adverse drug reactions (ADRs). A total of 384 nurses were involved in this study, of which 50% were drawn from public hospitals and 50% from private hospitals. Majority of respondents (75.25%) in public and 84.73% in private hospitals said they have not received any training about reporting ADRs. Of the few trained nurses, 85.43% and 96.55%, in public and private hospitals, respectively, said they have been trained in a seminar only once, after they started working as nurses. Respondents in public (19.17%) and private (32.8%) hospitals reported to stock ADRS forms (Yellow cards). Less than 50% of respondents agreed to have access to reference materials such as a text books named “Good Dispensing Practice” and a “List of Registered Medicines”. Further results showed more than two third of all respondents in private (74.25%) and public (73.5%) hospitals reported that lack of training affects the process of reporting ADRs in terms of ability and tendency. In this study we found training, availability of Yellow cards and presence of a focal person are among important contributing factors to preparedness of reporting ADRs among nurses in public and private hospitals.

The Social Determinants of Health and the Role of the Health Care System: A Case Study of the Significance of Good Governance in Public Hospitals in South Africa

Increasingly international and national policies are being directed at actions for the social determinants of health and for an integrated approach to health care provision, not only in terms of institutional cooperation but also stakeholder involvement. A key component of both these policies is the development of good governance principles in all health care agencies and organizations. A neglected dimension in these debates has been the role of the public hospital which remains a vital and expensive dimension of service provision. In a case study of a public hospital in South Africa, this paper charts the readiness of its management principles and activities to provide quality health care linked to population health and to contribute to the non-medical determinant of health. Using Taylor’s principles of good governance, we conclude that there is a mixture of good and not so good governance activity. The paper concludes by examining the external constraints on the public hospital and by providing suggestions for future activities.

Financial Performance of Public Hospitals Revolving Funds Between 2008-2017 in Turkey

In this study,financial position and financial performance of public hospitals(PH)in Turkey were analyzed.Financial statements of 948 public hospitals between 2008 and 2017 were used in analysis.Financial statements were analyzed by ratio analysis technique to analyze the financial status and financial performance of public hospitals.With the Z-score analysis technique,the risk of financial failure of public hospitals was measured.The credibility of public hospitals was measured by the rating analysis technique.It was determined that the accumulated losses in public hospitals lowered the equity below zero,the institutions has trouble with paying debt,and the credit risk of public hospitals is high.

Nurses’ Knowledge, Attitude, and Practice Regarding Personal Protective Equipment for the Prevention of COVID-19 in Public Hospitals Khartoum State Sudan 2022

Since December 2019, there had been a series of unexplained cases of pneumonia reported in Wuhan, China, and on 12 January 2020, the World Health Organization (WHO) named this new virus as the 2019 novel coronavirus (2019-nCoV). The Novel Coronavirus disease (COVID-19) is an emerging, rapidly changing global health challenge affecting all sectors, including the health sector. This study aimed to investigate nurses’ knowledge, attitudes, and practices regarding the prevention and control of COVID-19. Methods: This cross-sectional study was conducted among nurses in three public health hospitals in Khartoum state. A self-administered questionnaire was used. A total of 14 knowledge questions were adopted. There are 5 questions constructed for attitude. A total of 12 practice questions were used. Mean score of knowledge considers as follows when the mean more than 75% considers as good knowledge while this percent uses as good practice and poor practice respectively to analyze the mean score differences of knowledge, attitudes, and practices between the independent variables. Spearman correlation was used to assess the relationship between mean knowledge and attitude scores. Results: Of the 101 nurses approached, a total of 100 nurses responded (99.0% response rate). The mean age of the participants was 27.6 (SD 5.3) years, and the majority of the participants were male (293/434, 67.5%). The mean knowledge score was 1.01 (SD 0.100). The mean attitude score was 10.5 (SD 4.1), and 54.8% (238/434) of the participants had a good attitude toward COVID-19. The mean practice score was 1.4176 (SD 1.4176). There was a negative correlation between knowledge and attitude scores (P < -0.014) and between knowledge and practice scores (P < -0.081). Conclusions: The overall levels of knowledge and practice and attitude were good.

Behavioral Aspects in Obligatory Reports of Public Hospitals in Poland

The health care sector is the most difficult one to manage and control. Special units in this field are public hospitals which are required to prepare a lot of reports to various institutions, including the ownership body. The paper focuses on two issues. The first is the presence of behavioral factors in the reporting of public hospitals in Poland to the ownership bodies. This article aims to indicate the thematic areas of specific reports, most affected by behavioral factors and explain the causes and consequences of their occurrence. The second issue is the analysis of the legal status of obligatory reporting of public hospitals. Participants of the conducted research, due to their specific ownership and political and social position, were public hospitals in Poland. The paper uses the research methods of the meta-analysis of the literature, legal acts in Poland and empirical materials, and also the methods of synthesis, observation, and deduction. Data analysis focused on specific sample of reports issued by Polish public hospitals for their ownership body. The research shows that hospitals draw up a tremendous number of often thematically overlapping and redundant reports addressed to different institutions in different time periods. It is a consequence of legal regulations failing to streamline the reporting of the health care sector institutions, in particular public hospitals. The paper points to the large number of legal instruments that contain imprecise requirements resulting from the complex and obscure forms of control of public funds allocation in this sector. There are many behavioral factors that shape some fields of public hospitals＇ reports, for example, interpersonal relationships, egoism, private financial interests, strengthening of the employment status and professional position, and professional competences. There is considerable freedom in the reporting process fulfilled by public hospitals in Poland for their ownership body. It causes strong consequences, like poor-quality data, duplication of information, and its chaos, as well as high costs of obtaining information. Reporting system of financial and non-financial data of public hospitals in Poland is dysfunctional.

Analysis of the reasons for the bottleneck of public hospitals＇ return to public welfare

At the present stage, the public hospital has not stopped the pace of reform , although they are starting from the interests of the people, but also made some achievements, but there are still many problems in the process of reform. Especially many scholars including the national government for public hospitals return to public welfare, bat in actual operation there are many are contrary to the nature of public welfare, there is an inherent logic contradiction between theory and practice, the public hospital is difficult to return to public welfare. The path of public welfare regression of public hospitals by the layers of obstacles, this article through the literature study, on-the-spot investigation, interview method to study the fundamental crux of the problem, combined with other path synthesis Research has laid a good theoretical foundation for public hospitals to return to public welfare as soon as possible

Bootstrapping Data Envelopment Analysis of Efficiency and Productivity of County Public Hospitals in Eastern, Central, and Western China after the Public Hospital Reform

China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis（DEA） to evaluate the technical efficiency（TE） and productivity of county public hospitals in Eastern, Central, and Western China after the 2012 public hospital reform. Data from 127 county public hospitals（39, 45, and 43 in Eastern, Central, and Western China, respectively） were collected during 2012–2015. Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist. The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal–Wallis H test and Mann–Whitney U test. The average bias-corrected TE values for the four-year period were 0.6442, 0.5785, 0.6099, and 0.6094 in Eastern, Central, and Western China, and the entire country respectively, with average non-technical efficiency, low pure technical efficiency（PTE）, and high scale efficiency found. Productivity increased by 8.12%, 0.25%, 12.11%, and 11.58% in China and its three regions during 2012–2015, and such increase in productivity resulted from progressive technological changes by 16.42%, 6.32%, 21.08%, and 21.42%, respectively. The TE and PTE of the county hospitals significantly differed among the three regions of China. Eastern and Western China showed significantly higher TE and PTE than Central China. More than 60% of county public hospitals in China and its three areas operated at decreasing return scales. There was a considerable space for TE improvement in county hospitals in China and its three regions. During 2012–2015, the hospitals experienced progressive productivity; however, the PTE changed adversely. Moreover, Central China continuously achieved a significantly lower efficiency score than Eastern and Western China. Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county public hospitals in the three areas of China, especially in Central China.

Nurses Perception of Advance Nurse Practitioners Roles in Public Hospitals: A Qualitative Study

Aim: To explore the nurses’ perceptions about the advanced nurses’ practitioner’s role in public hospitals in Saudi Arabia. Background: Advanced nurse practitioners are one of the leading professionals who contribute to health promotion, disease prevention, health counseling and patient education. However, misunderstandings of their roles may have an impact on the performances of the function that limits their access and the use of significant resources that can help patients to obtain treatment. Methods: This is a qualitative exploratory study conducted on nurses working in three public hospitals. Semi-structured interviews were conducted among fourteen nurses between October-January 2020. The three public hospitals were based in Eastern (1) and Central (2) Saudi Arabia regions. Data analysis was conducted through thematic analysis utilizing inductive and deductive coding. Results: The study found that the role of Advanced Practice Nurses will enhance, motivate, and sustain the status of nurses in Saudi Arabia. Findings indicated that advanced practitioners’ educational preparedness, organizational, and contextual factors are important factors that need to be addressed to promote their role and to improve nurse’s perception about the APN role in clinical practice. Conclusion: This research provided new evidence to support the need to raise understanding of the role of advanced nurse practitioners among nurse members, advanced nurses and clinical nurse specialists who wish to enhance quality healthcare delivery and job satisfaction in the Kingdom of Saudi Arabia. Recognizing the factors that comprise the function and status of APNs will assist health-care officials to make informed decisions when designing a national policy and a plan for the implementation and the development of the role of APNs.

Study on the Treatment Strategy of Batches of the Wounded and Partial First-Aid Procedures in Public Emergencies in Tertiary General Hospitals

Objective: The purpose is to formulate treatment strategies of batches of the wounded and partial first-aid procedures, and further improve the emergency rescue capability of hospitals. Methods: This study analyzed the emergency treatment case that we participated in. In this case, we used various means to start the emergency plan, run the emergency procedures, optimize diagnosis, treatment, and rescue procedures, mobilize medical rescue resources, provide a reference for emergency command decisions, formulate a set of coping strategies of tertiary general hospitals on public emergencies. Results: Through the scientific and effective management of our hospital, 20 wounded have been discharged from the hospital and achieved the ideal effect of zero deaths in the hospital. Conclusions: The new mode of first-aid and health emergency management on the scene of modern disaster needs to find ways to minimize the loss of life and property brought by public emergencies, integrate the various sections of modern disaster medicine, integrate a large number of international and domestic basic and clinical research achievements of disaster first-aid, and upgrade to information, digital system.

ICT-Enabled Universal Health Coverage Monitoring and Evaluation in Sub-Saharan Health Facilities： Study in 8 Reference Hospitals of Rwanda, Burundi, the Democratic Republic of Congo and Mali

Abstract： UHC （Universal Health Coverage） is at the center of the Sustainable Development Agenda. In this study, the authors made an evaluation of the indicators allowing quantification of the impact of health coverage schemes on patients, applied in 4 sub-Saharan Africa countries： Rwanda, Burundi, the DRC （Democratic Republic of Congo） and Mall After an analysis of potential health coverage indicators, the most relevant ones were calculated on the basis of patient administrative and health insurance data, collected via OpenClinic GA, an HIMS （health information management system） used in 8 sub-Saharan hospitals during the period 2010-2016. The results show that the PHSC （patient health services coverage） rate is highest （81.5%-92.7%） in the 2 hospitals of Rwanda and in 2 hospitals of Burundi （37.7%-77.7%）. The PHSP （patient health service payment） rate as the proportion of costs paid by the patient versus total health service costs is below the 25% threshold recommended by WHO only for the 2 hospitals in Rwanda. The POOP （patient out-of-pocket） payment is below the threshold of 180USD per patient per year for all hospitals. The HIEXs （health insurance expenditures） are funded by the university private insurance （86% of expenses covered） in 2 university teaching hospitals in DRC, by CBHI （community based health insurance） （69%） in 2 hospitals in Rwanda, by the free care policy （77%） in 2 hospitals in Burundi and by the SHI （social health insurance） （100%） in the 2 hospitals in Mali. PHSC in the 8 reference hospitals reflects the national trend towards UHC in each country. With this study, we demonstrate the possibility to assess the degree of UHC in developing countries, by a methodology based on indicators calculated via information extraction from routine data in electronic health records.

Investigation of the working conditions of nurses in public hospitals on the basis of nurse-friendly hospital criteria

Objective:This descriptive study reveals how nurses working in public hospitals rated their practice environments with respect to nurse-friendly hospital criteria.Methods:This study was conducted on 460 nurses volunteering to participate this study among 735 nurses working in inpatient wards of three public hospitals.Data were collected using a personal information form and the Adapted Nursing Work IndexeRevised.Numbers,percentages,means and standard deviations,t-test and one-way variance analysis were used to evaluate the data.Results:Among the nurse-friendly hospital criteria,‘control of nursing practice’,‘middle management accountability’and‘quality initiatives’had the highest mean scores,and‘competitive wages’had the lowest mean score.The assessments of the nurses presented statistically significant differences with respect to personal and occupational variables.Conclusion:The nurses found most of the nurse-friendly hospital criteria adequate,but they believed that several areas needed improvement.

Cost of Stroke Care at Public Hospitals in Brazzaville and Implication of Third Parties in Stroke Care Expenditure

Background: Among the main challenges of healthcare system throughout the world, there is stroke management. It is important to have data on the in-hospital costs of stroke care to help decision-makers to implement a health insurance system. Objectives: To evaluate the in-hospital costs of stroke care in Brazzaville;to determine the factors influencing the total mean in-hospital cost of stroke care;to identify third parties contributing to stroke care expenditure. Methods: This was a cross-sectional prospective and analytical study. It was carried out at 4 public hospitals in Brazzaville (University Hospital Center, Chinese and Congolese Friendship Hospital, Talanga&#239; Hospital and Makélékélé Hospital), from May to August 2019 (4 months). It focused on patients who had a first episode of stroke confirmed by brain imaging and were at least 18 years old. The bottom-up approach was used to determine the in-hospital costs of stroke care. Results: This study included 109 patients who fulfilled inclusion criteria. Their mean age was 59.2 ± 13.7 years old, with limits of 35 and 90 years old. The total direct in-hospital cost of stroke care was 47,308,330 francs CFA (72,122 euro). The total mean in-hospital cost of stroke care was 1,389,590 francs CFA (2118 euro). The mean cost of intracerebral hemorrhage care was 510,988 francs CFA (779 euro) versus 373,457 francs CFA (569 euro) for cerebral arterial infarction care. The following factors affected the total mean cost of stroke care: type of hospital (p < 0.0001), length of hospital stay (p = 0.001), type of stroke (p = 0.01), stroke severity (p = 0.001) and complications (p = 0.001). The level of contribution to stroke care expenditure covered by third parties was: 78% for patient families;2.8% for community self-help associations. Conclusion: In Congo, the mean in-hospital cost of stroke care is elevated considering the guaranteed minimum wage of 70,000 francs CFA (107 euro). Five factors affect the total mean cost of stroke care. Patient families are the main financial assistance system for stroke care expenditure. To minimize the heavy financial burden induced by stroke on patients, households and families, it is important to implement a health insurance system and strengthen the stroke prevention program.

Consequence and Path Analysis of Balanced Scorecard Usage： Evidence From Chinese Public Hospitals

Based on a questionnaire survey of Chinese public hospitals, this paper explores the consequence and realization path of balanced scorecard （BSC, hereafter） usage. The results show that BSC usage can improve hospital performance remarkably. With the structural equation model analysis, we further find that, this function is realized in an indirect way through the perception of organizational fairness and organizational commitment. The BSC has direct effect to improve the perception of organizational fairness and organizational commitment, which further influence the performance. The results not only complement empirical evidences for BSC usage, but also provide guidance to regulators and hospitals to implement BSC in compensation contract.

Universal precaution practice and barriers to compliance among nurses in Aseer public Hospitals, Saudi Arabia

Background:Studies have shown that for every 100 hospitalized patients at any given time,10 in developing,and 7 in the developed countries would eventually develop at least one episode of healthcare associated infections.This highlights the imperativeness of adherence to Universal Precautions(Ups)for prevention of infections.Proper compliance with standard would lead to a decrease in rate of HAI.Aim:The aim of the study is to determine the perception of nurses toward compliance with universal precautions in Aseer region hospitals,Saudi Arabia and factors that may hinder the nurses from complying with those standards.Methods:A cross sectional study was performed.Data collected using validated questionnaire of universal precautions from convenience sample of 302 respondents’nurses across four public hospitals in Aseer region.Analysis was performed through descriptive statistics and chi square tests of association.Results:The overall compliance toward universal precautions among nurses was high at 88%.The results reveal that all constructs that define the actions of the nurses to have a statistically significant association at 99%with the extent to which nurses utilized the universal precautions.Discussion:The results indicate that nursing staff adhere to the universal precautions for prevention of infection.However,the hospitals should solve the main barriers including lack of personal protective clothing,challenges during emergencies,and lack of training on how to use.

Impact of community public health care on treatment effect,health cognition,and self-management in patients with type 2 diabetes

BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T2DM).Based on conven-tional nursing methods,community home care has important clinical significance in controlling blood sugar and disease progression.AIM To explore the impact of community public health nursing on treatment effect,health cognition,and self-management in patients with T2DM.METHODS One hundred patients with T2DM were selected as the research subjects.The patients were divided into either a conventional nursing group or community nursing(CN)group using the random number table method.The conventional nursing group(50 cases)received routine care,while the CN group(50 cases)received community public health care in addition to routine care as that for the conventional nursing group.The rate of excellent and good blood glucose control,fasting blood glucose before and after care,2-h postprandial blood glucose,health cognition,and self-management ability,and patient satisfaction were compared between the two groups.RESULTS The CN group had a higher rate of excellent blood sugar control than the conventional nursing group(88%vs 70%,P<0.05).Before care,there was no significant difference in fasting blood glucose or 2-h postprandial blood glucose between the two groups of patients(P>0.05).After nursing,fasting blood glucose and 2-h postprandial blood glucose were reduced to varying degrees in both groups,and both blood glucose levels in the CN group were lower than those of the conventional nursing group(P<0.05).Compared with the scores before care,the cognitive level score for diabetes and self-management ability score improved after care in both groups.The cognitive level and self-management ability of patients in the CN group were higher than those of the conventional nursing group(P<0.05).The overall satisfaction of the CN group was better than that of the conventional nursing group(98%vs 86%,P<0.05).CONCLUSION Community public health care based on conventional care of T2DM can achieve better blood sugar control,and improve patients’health cognitive level and self-management ability.

Data Collection and Research on the Vitality of Public Space in Traditional Villages: A Case Study of Cuandixia Village

The optimization and renewal of rural space is the foundation for building livable,business friendly and harmonious countryside.Three types of data on the spatial vitality of traditional villages are collected and analyzed.A street and alley axis map model is established using spatial syntax,and the degree of industry aggregation is quantified using POI data,and the results of syntactic calculation are validated with the help of popular review text preferences.Taking Cuandixia Village as an example,this paper found that its public space nodes have a pattern of one axis and scattered points;the street and alley space is well preserved but slightly lacking in transportation;the user group is single and the form is traditional.This paper could provide corresponding suggestions for stimulating the vitality of public spaces in traditional villages,in order to provide inspiration for the revitalization design of public spaces in traditional villages.

An Assessment of Procurement Risks Management Systems in the Public Sector

Risk management in public procurement is a critical aspect that needs to be addressed in the public sector.Several studies have been conducted to understand the challenges and factors influencing risk management in public procurement.These studies have explored the importance of risk management principles,the role of political influence,and the need for effective risk assessment and anticipation.The research has also highlighted the need for specific risk management mechanisms and tools to be implemented in public procurement processes.Risk management reforms in the public sector are essential but often circumvented due to assorted reasons,such as political influence and the emergence of new risks.The research investigation employs a quantitative research design.A total of 380 questionnaires were recovered from respondents.The study showed that the public sector has a procurement risk management system that is effective,but there may be some areas for improvement in the prequalification process,onboarding process,and support provided to newly onboarded suppliers.Additionally,the public sector used some strategies to mitigate and control contract risks during the procurement process,but there were some areas for improvement in the review and lessons learned process,risk mitigation measures,contract monitoring and performance evaluation mechanisms,and communication and documentation process.Finally,the results suggest that there were constraints placed on the risk management strategies currently utilized by professionals working in the public sector.These constraints include insufficient support and buy-in from senior management and stakeholders,bureaucratic or administrative hurdles,inadequate policies and regulations,insufficient training and skill development opportunities,and insufficient resources.The study highlights the significance of tackling risk management in the realm of public procurement and offers valuable perspectives on avenues for enhancement,obstacles encountered by practitioners,and the necessity of thorough evaluation and revisions.Through the adoption of the suggestions originating from this study,governmental entities can improve their procurement risk management frameworks and guarantee improved adherence to risk management principles.

Principle for the Installation of Accommodation for Sick guards in Public Health Establishments in Brazzaville in the Republic of Congo

The results of scientific studies of human social facts in the field of health show that the management of a patient should involve the patient’s entourage,whatever the status or size of the health establishment.In healthcare establishments in the Congo,the following are recognised as being responsible for medical care:specialist doctors,doctors,midwives,nurses and care assistants.The patient’s family and close friends are responsible for looking after the patient and financing care.The hospital infrastructure does not provide any space for the patient warden who accompany the patient during reception and hospitalisation.This makes Congolese hospitals inefficient for patient care.How can we integrate the function of the Sick guard and the assistance of the family,in order to reduce the mortality rate and repair the harm caused to patients requiring the presence of relatives during their stay in hospital,which is considered to be a dangerous place?This article examines the functional principles for configuring the space that patient warden would occupy in the patient care system.On the basis of a documentary analysis of sociological and architectural studies of existing facilities,this article proposes a typical accommodation model with the spaces needed to ensure the well-being and effectiveness of the patient warden with the patient.These are rooms with minimum space for 2 to 4 individual beds,equipped with toilets and showers.The accommodation has a dining area,kitchen and laundry facilities.In the future,this accommodation will become part of the hospital estate and may be occupied by orderlies and patient warden recruited by the hospital administration.