Assessment of Satisfaction in the Reception and Emergency Department of a Health Center

Introduction The main objective of any healthcare establishment must be to ensure the quality of patient care and customer satisfaction. It is necessary to regularly assess patient satisfaction. The aim of this study was to assess the level of satisfaction of customers aged over 18 years attending the emergency department of the health center. Methodology This was a descriptive and analytical cross-sectional study of patients aged 18 years and over, who attended the Samu Municipal emergency department between 02 and 30 May 2023. The satisfaction index was determined using the adapted 2009 SAPHORA-MCO questionnaire and the Likert satisfaction scale. Results A total of 400 patients were surveyed. The average age was 35 years, with a standard deviation of 14.7. Of those surveyed, 51% were women, 87% were educated, 50% lived in Grand Yoff and 59.5% were unemployed. Satisfaction levels linked to perception of the cost of care (72%), waiting time (64.3%), information given to patients (69.1%) and pain management (74 .5%) are fair. On the other hand, the levels of satisfaction linked to administrative procedures (82.5%), staff attitudes towards patients (84%), staff availability (86.4%), patient privacy (89.2%), general atmosphere (87.2%), staff competence (87.3%), and the effectiveness of care (89.4%) were satisfactory. The average waiting time was 38 minutes. However, 32% of patients waited less than 30 minutes and 92% less than an hour. The satisfaction index linked to administration and reception was 72.9% and 79.85%, respectively. The satisfaction index linked to the administration and technical quality of care is equal to 85.8% and 83.7%, respectively. The overall satisfaction index is equal to 80.6%;the level of satisfaction of users of the health structure is satisfactory. Conclusion Patient satisfaction is an essential part of quality care. Patient satisfaction must be based on effective communication from the healthcare team and the creation of a patient-caregiver relationship.

Review of Two Years of Surgical Activities of the General Surgery Department of the Reference Health Center of Commune I of Bamako Mali

The objectives of this work were to evaluate the surgical activities carried out in the general surgery department of the Reference Health Center of Commune I of Bamako, to describe the sociodemographic characteristics of the operated patients, to determine the main pathologies encountered and to evaluate qualitatively the result of the treatment. In order to improve performance, and the quality of care, and to identify common pathologies in the surgical department, we undertook a retrospective study on surgical activities from January 2009 to December 2010. At the end of this study, out of 474 men and 187 women (equal sex ratio 2.53);we were able to determine the frequency of surgical pathologies. Farmers, housewives and pupils/students were the most represented with 25.9% respectively;20% and 13.3%. The most frequently observed pathologies were wall hernia (44.8%), prostate adenoma (12%) and acute appendicitis (10.5%). The average length of hospitalization was 3.43 days. Infectious complications affected 25 patients (3.8% of cases) and a death rate of 0.45% (i.e. 3 patients). The average cost of care was 53,500 FCFA. Indeed, the reality of surgical practice in health centers was not the same because of the level of skills of practicing surgeons.

Contraceptive Experiences of Women of Procreation Age Who Attended Two HealthCenters in the City of Abidjan (Cote d’Ivoire)

Introduction: Maternal mortality, which is estimated at 614 deaths per 100,000 births in Côte d’Ivoire, is associated with a low national contraceptive prevalence rate of 13.9%. In this study, we are interested in the contraceptive experiences of women who attend health centers to estimate their rate of contraceptive use and to assess the factors involved in the use of modern contraceptive methods among women of childbearing age who are exposed to the risk of pregnancy. Method: A descriptive cross-sectional study was conducted from December 2018 to September 2019 among 423 women, who attended two health centers in Abidjan. A bivariate analysis identified factors associated with contraceptive use by these women. A descriptive analysis determined the means for the quantitative variables and the frequencies and percentages of qualitative variables. Interpretation of results was based on significance (α = 5%, 95% CI). Results: Contraceptive prevalence was 37%. There was a significant relationship between contraceptive use and the socio-demographic and reproductive characteristics of women (p Conclusion: Women who were over 35 years age, uneducated, primary school graduates, housewives, unemployed, in the informal sector, Muslims, nulliparous, and lacking information and decision-making power were less likely to use modern contraceptive methods. They are the target population for strategic interventions to improve contraceptive prevalence.

Veterans utilizing a federally qualified health center: a clinical snapshot

Dear Editor,Te Veterans Health Administration(VHA)provides healthcare for over 9 million enrolled veterans with approximately 2.7 million of those residing in rural areas[1].Te MISSION Act of 2018 emphasizes VHA collaboration with Federally Qualifed Healthcare Centers(FQHC)to serve rural residing veterans and nearly all existing collaborations involve arrangement of payment for community-based care by VHA to FQHCs.Unfortunately,there is a paucity of descriptive clinical data on existing cross-system collaborations which may help characterize these veterans and aid understanding of conditions for which they may receive treatment across systems.Such data has implications for workforce training,development,and resource allocation[2].Te objective of this report is to describe diferent clinical profles between two mutually exclusive samples:veterans engaged in FQHC only use,and VHA-enrolled veterans engaged in dual VHA and FQHC use.

The Level of Knowledge, Behaviors, and Attitudes on Rational Use of Drugs of Patients Who Applied to the Family Health Center in Istanbul, Türkiye: A Cross-Sectional Study

Background: This study, it was aimed to determine the level of knowledge, attitudes, and behaviors of patients who applied to a family health center about the rational use of drugs. Irrational use of drugs is a major problem worldwide. WHO reports that half of the patients do not use their drugs correctly. Methods: This cross-sectional study was conducted between 1 October 2017 and 30 November 2018 at Istanbul Fatih Family Health Center No 7. The sample size was determined as 301 people selected by systematic sampling method from patients aged 18 and older. Results: The mean age of the participants was 53.8% ± 16.8%, 59.8% were female, 62.5% were married, and 52.5% were primary school graduates. 63.9% of the participants knew the names of the drugs they used, and 79.9% of them knew the indication for use. 89% of individuals check the expiry date of the drugs before using them, and 83.1% read the drug prospectus. 84% of the participants support the prohibition of using over-the-counter drugs. Conclusion: The level of knowledge of the participants about the rational use of drugs is above the societal average. However, some issues need more awareness. The high level of rational use of drugs awareness of physicians and pharmacists will also strengthen the rational use of drugs and indirectly increase the awareness of the public.

Assessment of Breast Cancer Prevention Practices among Women Attending Primary Health Care in Abha City, Aseer Region, Saudi Arabia

Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices.

Analysis of good practice of Public Health Emergency Operations Centers

Objective: To study the public health Emergency Operations Centers(EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Command Center in Chinese National Health and Family Planning Commission. Methods: Literature review was conducted to explore the EOCs of selected countries. Results: The study focused on EOC function, organizational structure, human resources and information management. The selected EOCs had the basic EOC functions of coordinating and commanding as well as the public health related functions such as monitoring the situation, risk assessment, and epidemiological briefings. The organizational structures of the EOCs were standardized, scalable and flexible. Incident Command System was the widely applied organizational structure with a strong preference. The EOCs were managed by a unit of emergency management during routine time and surge staff were engaged upon emergencies. The selected EOCs had clear information management framework including information collection, assessment and dissemination. Conclusions: The performance of National Health Emergency Response Command Center can be improved by learning from the good practice of the selected EOCs, including setting clear functions, standardizing the organizational structure, enhancing the human resource capacity and strengthening information management.

U. S. Academic Medical Centers Under the Managed Health Care Environment

This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U. S. health care system through their missions of conducting cutting-edge biomedical researeh, pursuing clinical and technological innovations, Providing state-of-the-art medical care and producing highly qUalified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical sciTo survive the threats of managed care in the health care environment, acadendc medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 1h8 CEOs in all the academic medical centers in the U. S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.

An Efficiency Assessment of Tuberculosis Treatment on Health Centers: A Data Envelopment Analysis Approach

This study utilized Data Envelopment Analysis (DEA) in assessing the efficiency of health center in tuberculosis (TB) treatment. Assessing the efficiency of health center treating TB is a vital and sensitive topic, because there is a cumulative amount of public funds devoted to healthcare. In this research, a DEA model has been correlated to evaluate and assess the efficiency of 17 health centers. The researchers selected the health budget and the number of health workers as input variables likewise, the number of people served, number of TB patients served, and TB patients treated (%) as output variables. Based on the result of the study, only five (5) health centers out of seventeen (17) have 100% efficiencies throughout the 2 years period. It is recommended that other health centers should learn from their efficient peers recognized by the DEA model so as to increase the overall performance of the healthcare system. Likewise, health centers should integrate Health Information Technology to deliver healthier care for their patients.

Practical Experience of Establishing German Standard Level 1 Perinatal Center in Chongqing Health Care for Women and Children

Germany,as a western developed country,has an advanced medical level,especially in the health care of very immature premature infants.We trace the medical history of perinatology to understand the development of perinatal centers in Germany.After analyzing the classification and function,hierarchical management and quality control systems of German perinatal centers,we established a German standard level 1 perinatal center in the Chongqing Health Center for Women and Children(CHCWC).During more than two years of practice,we changed concepts,continuously updated clinical knowledge and skills,developed a series o f high-quality work processes and supervision systems and introduced advanced medical equipment.We believe that the experience of establishing a German standard level 1 perinatal center and perinatal center network in Chongqing is worthy of being promoted to the Chinese maternal and child health care system.

Leveraging the Public Health Emergency Operation Center (PHEOC)for pandemic response: opportunities and challenges

Public Health Emergency Operation Center (PHEOC) was conceptualized and established for coordinatinginformation and resources towards goal-oriented response in large scale public health emergency. Yet, theactivities undertaken by PHEOCs and their intended goals have not been fully optimized in current scenario.This paper revisited the collective efforts invested in PHEOC conceptualization and development, identified theopportunities and challenges in compliance with standards and framework, demonstrated the accountabilityof PHEOC network, thereby promoted best practice guidance for global public health emergency preparednessand response. This review will help navigate emergency response complexities leveraging PHEOC partnershipsand advance the ability to detect and respond to public health emergencies in low resource settings. The reviewshows that the information on how to adapt best practice guidance to local circumstances could incentivizethe full implementation of prevention, early detection and response to outbreaks. Identifying and correctingdeficiencies in effectiveness evaluation will provide the basis for continuous PHEOC improvement. With thegradually reopening economies and public services in some countries, there is an urgent need to emphasize andvalidate the collective efforts undertaken by PHEOCs for tackling the COVID-19 pandemic.

How to allocate public health manpower in township health centers in China scientifically and reasonably

INTRODUCTION The global health issue is not a shortage of capital or technology, but a shortage of health manpower. Health human resource （HHR）, an important component of health resources, determines the quantity, quality and effectiveness of health service, thus greatly impacting on health service to the citizens.

Analysis of Inpatient Bed Allocation Equity and Utilization in the City Community Health Service Center of China

The objective of this study was to examine the inpatient bed （IB） allocation equity and utilization in Chinese city commtmity health service centers （CHSCs）. The data were derived from the Baseline Survey of National City Community Health Service System Building Project, which was conducted in 1917 CHSCs in 28 cities in 2007. The IB allocation was analyzed in terms oflB alloca- tion quantity and distribution equity, and the IB utilization was analyzed by the IB utilization rate and average length of stay of the CHSC inpatients. The results showed that 49.3% of the CHSCs were equipped with IB; averagely, there were 45 IBs per CHSC, 0.94 IBs per 1000 people, and 0.38 nurses and 0.57 doctors per IB; the IB Gini coefficient was 0.32; the IB utilization rate was 40.06%; and the average length of stay of inpatients was 12.24 days. The conclusions were that IB allocation among the population was equitable, but the number of nurse per IB was not up to the national standard; and the CHSC IB utilization was low as a whole, thus inpatient service was not the main health service for Chinese CHSCs.

Approach to perinatal mental health and child abuse prevention in Japanese prefectural health centers

The aim of this study was to conduct a nationwide survey in Japan of prefectural health centers, which were responsible for providing guidance to municipalities. The survey was performed in order to clarify the following issues: 1) the current level of support provided by prefectural centers for pre-and post-natal mental health;2) the structures in place for providing consultation services for an “unwanted pregnancy” and the support available for high-risk cases;and 3) the advice available on postpartum maternal psychological screening, and interpretation of results of such screening. Questionnaires were sent by post to 394 prefectural health centers, of which 277 (70.3%) responded. A total of 32% of prefectural health centers confirmed that they had offered support to high-risk cases during pregnancy, and 72% had offered support post-partum. Regarding offering support to high-risk mothers, those prefectural health centers that did provide consultation services (n = 59) reported providing introductions and information about available facilities (P < 0.001) and conducting case conferences (P < 0.002). This was significantly different than prefectural health centers that did not provide consultation services (n = 198). At the prefectural health centers that “follow up on” the results of the mental health screening, psychiatry consultations were reported twice as often as the prefectural health centers that did “not follow up on” the results of mental health screening. These findings indicate that childcare support systems for postpartum mental health and the prevention of child abuse were established. However, the lack of prenatal health and support systems for the prenatal period remains an issue.

Evaluating the Efficiency and Determinants of Efficiency of Rural Health Centers Situated in Punjab, Pakistan

This study calculates the efficiency of Rural Health Centers (RHCs) and investigates the impact of other variables affecting the efficiency of RHCs. The study considers 29 RHCs, 13 of District Faisalabad, 9 of Toba and 7 of Jhang;a survey was conducted to collect data from each RHC for the year 2016. Data Envelopment Analysis (DEA) model was utilized to get the scores for efficiency. Thereafter, after getting the results from DEA Tobit regression was used in the second stage. Out of the 29 Rural Health Centers, only 11 (38%) are working efficiently as compare to others. Distance from the tehsil headquarter, Distance from the road with “0” probability, Distance from private hospital with “0” probability, Behavior of the staff with “0.0064” probability and laboratory equipment’s with “0” probability, have an impact on the efficiency scores. Distance from other health facilitators, Staff’s behavior, list of medicine and equipment’s used at RHCs should be improved to increase the efficiency of RHC’s.

Job Satisfaction and Mental Health among Physicians in Primary Health Care Centers in Kuwait

Objectives: To measure the level of job satisfaction among primary health care physicians Ministry of Health (MOH) Primary Healthcare Center (PHC) physicians, to evaluate the physicians’ mental health, and to assess their associated factors. Study Setting: Kuwait Ministry of Health, Primary Care Centers. Study Design: Cross-sectional study. Data Collection: The study was conducted from July to September, 2017. Of 746 questionnaires distributed to all PHC physicians in the MOH, 417 questionnaires were completed. Information was collected on socio-demographic characteristics, work and health-related factors, job satisfaction (using the Warr-Cook-Wall job satisfaction scale), and mental health (using General Health Questionnaire). Principal Findings: Of participants, 40.8% were male, and 24.9% were Kuwaitis. Median overall job satisfaction was 71.4%. There were significant differences in overall job satisfaction with the physician rank (p = 0.008) and governorate (p = 0.05). The GPs were moderately satisfied with work surroundings;work freedom;recognition;degree of responsibility;salary;opportunity to use abilities;attention given to suggestions;relationship with hospital physicians, colleagues, and fellow workers;relations between management and workers;working hours;and the amount of variety in their job, but more satisfied with their immediate supervisors. Conclusions: Job satisfaction of PHC physicians is critical for the improvement of health systems. This study showed that GPs (General Practitioners) were more satisfied overall than previously reported studies done in Kuwait. They were moderately satisfied with their salary and the amount of variety in work.

Analysis on influencing factors of patients experience in community health centers of Shenzhen,China

Objective To investigate the patients experience in community health centers( CHCs) and explore its associated factors. Methods A cross-sectional study was conducted among 330 patients who visited CHCs in Shenzhen,China from January to March 2018. Dependent variable was patient experience. Key descriptive variables were age,gender,marital status,working status groups,visits frequency for the past 6 months,whether patients had signed a family doctor,whether trusted in family doctor,whether had chronic diseases. Results Questionnaires for 300 patients were assessed. In the univariate analysis,patients experience total score was significantly associated with marital status( P < 0. 1),working status groups( P < 0. 1),frequency of visit for the past 6 months( P < 0. 05),whether had signed a family doctor( P < 0. 05),whether trusted in family doctor( P < 0. 05),whether had chronic diseases( P < 0. 05). The multivariate analysis showed that unmarried patients( P = 0. 011,OR = 2. 96,95% CI: 1. 24-5. 43) and had signed a family doctor( P = 0. 023,OR = 0. 44,95% CI: 0. 22-0. 85) were more likely to get a higher score. Conclusions Findings of this study showed a medium-level score of patients experience in the community. Patients had a quite good experience and more interventions should be focused upon the influence factors to improve patients experience.

Earthquake planning and crisis management with an emphasis on the facilities, utilities, and services of the health care centers of Tiran and Karvan County, Isfahan Province, Iran: A case study

Objective: To study earthquake planning and crisis management with an emphasis on the facilities, utilities, and services of the health care centers of Tiran and Karvan County, Isfahan Province. Methods: This is a descriptive-analytical survey based on the quantitative and qualitative characteristics of Tiran and Karvan County Health Care Centers(HCCs). Twenty quantitative and qualitative indicators were derived from the studied HCCs and analyzed using the strengths, weaknesses, opportunities and threats analysis technique. The top crisis management strategies were identified and a number of strategies and solutions were proposed. Results: The HCC utilities such as water, electricity, gas, and heating and cooling systems were in average condition, whereas the facilities of the majority of HCCs were in vulnerable-to-average condition. In addition, they sustained relatively high degree of instability which calls for reassessment and effective policies to minimize weaknesses and eliminate threats using strengths and opportunities. Conclusions: It is recommended that the condition of Tiran and Karvan County HCCs be enhanced by distributing new HCCs based on the population density, expanding the road network and creating vast, wide-open spaces to enable field hospital construction in times of crisis.

Effects of Community Mental Health Centers on Oxidative Stress in Patients with Schizophrenia

Objective: The aim of our study was to evaluate of oxidative stress between the schizophrenic patients who regularly continued to Community Mental Health Centers (CMHC) and the patients who did not continue to CMHC. By this study, the effects of CMHC on oxidative stress between these two group of patients were assessed. Methods: Total number of 86 volunteers were enrolled in this study;43 (27 males, 16 females) patients who regularly continued (average 2 years, at least 3 days a week) to CMHC and 43 (25 males, 18 females) patients who regularly did not continue to CMHC. Total antioxidative stress (TAS), total oxidative stress (TOS), oxidative stress index (OSI), paraoxanase (PON1), arylesterase (ARE) and total thiol (T.Thl) levels were measured with a novel automated method. Positive and Negative Syndrome Scale (PANSS) was used to assess the patients. Results: TOS, PANSS-Negative subscale and PANSS-Total subscale were found to be significantly higher in the group of patients who were not continuing to CMHC, than the group of patients who were continuing to CMHC. ARE and T.thl were found significantly lower in the group of patients who were not continuing to CMHC. There was a significant positive correlation between PANSS-Negative Subscale and TOS, OSI in the group of patients who were not continuing to CMHC. There was a positive correlation between PANSS-Negative Subscale and TOS in the group of patients who were continuing to CMHC. Conclusions: Oxidative stress and negative symptoms of schizophrenia in the group of patients who were continuing to CMHC were less than in the group of patients who were not continuing to CMHC. Thus, regular follow up at CMHC is very important in the treatment of schizophrenia patients.

Intention to Leave and Associated Factors among Health Professionals in Jimma Zone Public Health Centers, Southwest Ethiopia

Background: Inadequate human resources are a major constraint to improving global health. The health sector is characterized by a high turnover coupled with internal as well as external brain drain but there is little information on intention to leave among health professionals in public health centers of Jimma Zone, Oromia Regional State. The aim of this study is to assess intention to leave and associated factors among health professionals in public health centers of Jimma Zone, southwest Ethiopia. Methods: A cross-sectional quantitative and qualitative study was conducted on seven randomly selected woredas (districts) which have 53 public health centers. All health professionals in sampled district public health centers were included (n = 505). Factor analysis was employed for all Likert scale instruments to extract factor(s) representing each of the scales using SPSS version 16.0. The qualitative data was analyzed by thematic analysis methods. Ethical approval was obtained from Jimma University. Results: Four hundred fifty five (90.1%) health professionals participated in the study;out of this, 290 (63.7%) had intention to leave. Among variables, job satisfaction (Beta = -0.298, (95% CI, -0.568 to -0.029), working environment (Beta = -0.612, (95% CI, -0.955 to -0.270), and organizational management (Beta = -0.552, (95% CI, 0.289 to 0.815) had statistically significant association with intention to leave among health professionals in public health centers of Jimma Zone. Conclusions: The overall intention to leave among health professionals was high. Level of job satisfaction, working environment, work pressure, and organizational management had statistically significant association with intention to leave. Thus, responsible bodies should aggressively work on the concerns identified, like, improvements in salary, promotion in terms of training/educational opportunity, improving working environment, and transfer of health professionals, and improvement of the leadership skills of managers.