Prevalence of Cesarean Section at Georgetown Public Hospital Corporation, Guyana: An Institution-Based Cross-Sectional Study

The International Healthcare Community recommends that countries do not exceed a 15% rate for cesarean section (CS). Our objective was to determine the prevalence and factors associated with CS at GPHC from July to September 2022. Methods: A cross-sectional study was carried out and data were collected from 1296 mothers, who met the inclusion criteria, through face-to-face interviews after obtaining prior informed consent. We performed descriptive analyses both for the outcome and independent variables. Bivariate and multiple logistic regression were used to identify factors associated with CS with a p-value Results: The prevalence of CS at GPHC was 28.9% (95%CI: 26.5-31.5). Factors associated factors with CS were mothers aged 20 to 34 years (AOR: 1.56, 95%CI: 1.02 - 2.39, P = 0.039);mothers who received more than three minimum wages (AOR: 1.95, 95%CI: 1.29 - 2.97, P = 0.002) and who attended prenatal care at both public and private health facilities (AOR: 2.49, 95% CI: 1.19 - 5.22, P = 0.022). Likewise, the highest Odds of CS were observed in mothers with gestational hypertension (AOR: 2.00, 95%CI: 1.35 - 2.96, P Conclusion: The prevalence of CS is higher than the ideal rate recommended by the International Healthcare Community. More studies are needed to understand the reasons for such high prevalence at GPHC.

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.

Efficiency and Productivity of County-level Public Hospitals Based on the Data Envelopment Analysis Model and Malmquist Index in Anhui, China

Background： China began to implement the national medical and health system and public hospital reforms in 2009 and 2012, respectively. Anhui Province is one of the four pilot provinces, and the medical reform measures received wide attention nationwide. The effectiveness of the above reform needs to get attention. This study aimed to master the efficiency and productivity of county-level public hospitals based on the data envelopment analysis （DEA） model and Malmquist index in Anhui, China, and then provide improvement measures for the future hospital development. Methods： We chose 12 country-level hospitals based on geographical distribution and the economic development level inAnhui Province. Relevant data that were collected in the field and then sorted were provided by the administrative departments of the hospitals. DEA models were used to calculate the dynamic efficiency and Malmquist index factors for the 12 institutions. Results： During 2010-2015, the overall average relative service efficiency of 12 county-level public hospitals was 0.926, and the number of hospitals achieved an effective DEA for each year from 2010 to 2015 was 4, 6, 7, 7, 6, and 8, respectively, as measured using DEA. During this same period, the average overall production efficiency was 0.983, and the total productivity factor had declined. The overall production efficiency of five hospitals was 〉1, and the rest are 〈1 between 2010 and 2015. Conclusions： In 2010-2015, the relative service efficiency of 12 county-level public hospitals in Anhui Province showed a decreasing trend, and the service efficiency of each hospital changed. In the past 6 years, although some hospitals have been effective, the efficiency of the county-level public hospitals in Anhui Province has not improved significantly, and the total factor productivity has not been effectively improved. County-level public hospitals need to combine their own reality to find their own deficiencies.

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.

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.

Day of Surgery Cancellation in Urology at a Public Tertiary Hospital and a Private Specialist Hospital

Background: There is a high variability in the reasons for cancellation of elective urological surgery cases. Case cancellation rate is expected to be high in the Public Health System with perceived inefficiencies compared to private facilities in the same developing economy. Aims and Objectives: This comparative analysis was to determine the case cancellation rate and the reasons for cancellation of elective urological surgeries in a public tertiary hospital and a private specialist hospital in Accra. This is intended to form a basis for interventions aimed at reducing the case cancellation rate. Methods: This was a retrospective analysis of prospectively collected data on Day of Surgery cancelled elective urological cases from September 2014 to October 2015 at the urology unit of the Korle-Bu Teaching Hospital (KBTH), a public Tertiary Hospital and the Trust Specialist Hospital (TSH), a privately managed hospital in Accra. The reasons for case cancellation were categorized into structural factors, patient factors and process factors. Results: There was no significant difference between the case cancellation rate for elective urological cases at KBTH and the TSH which were 20.8% and 17.1% respectively (p = 0.317). For KBTH, the reasons for cancellation of elective urological cases were due to structural factors in 11/117 (9.4%), patient factors in 15/117 (12.8%) and process factors in 91/117 (77.8%) which was due mainly to surgery running late. At the TSH, the reasons were due to structural factors in 1/29 (3.4%), patient factors in 27/29 (93.1%) mainly due to patient not turning up and process factors in 1/29 (3.4%). Conclusion: The case cancellation rate of elective urological surgeries in both the Public Tertiary Hospital and the Private Specialist Hospital were high with no significant difference between the two. However, in the Public Tertiary Hospital, process factors predominated as the cause of these cancellations while patient factors were the predominant cause in the privately managed facility. Exposure of theater managers in public facilities to management practices in privately run facilities should be encouraged to help improve the efficiency of the public facilities.

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.

Nurses: Workers Particularly Concerned by Contact Dermatitis in Public Hospital

Background: Contact dermatitis is common disease and represents a significant problem in healthcare sector, mainly among nurses. Many studies reported the prevalence of contact dermatitis from different parts of the world. Nevertheless, data about its frequency in Tunisia especially in public hospital seems to be insufficient. This study aims to assess the prevalence of contact dermatitis among nurses working in public hospital and identify risk factors. Patient and Methods: A cross sectional study was conducted among a representative sample of 1278 health professionals working in a public hospital matched by professional status and department. The survey was based on a questionnaire, a specialized examination and patch tests. Results: The prevalence of occupational contact dermatitis was 22% (17.5 - 27.2). The worker profile at risk of contact dermatitis was a female nurse aged 37 years working in a surgical department during 12.7 ± 9.36 years. Hands were damaged in 92.4% of cases and rhythmicity with occupational exposure was reported by 86% of affected individuals. Patch tests using European Standard Battery were performed among 33 workers and revealed a sensitization to an allergen among 26 workers. Patch test using rubber battery (if suspicion of allergic contact dermatitis to gloves) was performed among 29 agents and positive among 12. The analytical study revealed that history of atopy, job tenure, the mean daily number of hand washing, the mean daily number of worn gloves and mean duration of glove wearing were significantly higher in the affected population. Conclusion: Contact dermatitis affects particularly nurses in public hospitals. Its prevention requires a diagnostic approach based on a detailed professional investigation and patch tests.

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.

The discussion on the impact of medical service charge standard adjustment on public hospital’s income

[目的] 探讨天津市公立医院综合改革实施意见的颁布及实施后对医院医疗总收入情况的影响. [方法]对天津市7 8家医院2015年相关数据进行调价改革测算和对比分析.[结果]医疗总收入总量得到了控 制,收入结构进行了调整,药品收入占总收入比例由48. 97 %下降到43.45%.[结论]改革的实施,提高了医 疗服务价格的含金量,有助于促进医疗技术水平的提升.但还存在着价格调整不均X 、患者费用增长不平衡、 病源流动性等问题.

Nurses’ Experiences in Service Provision a COVID-19 Dedicated Tertiary Public Hospital

Objectives: To assess the nurses’ experiences in service provision a COVID-19 dedicated tertiary public hospital. Materials and Methods: This descriptive cross-sectional study was conducted in one tertiary level public hospital namely Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh from January to December 2021. Data were collected through face-to-face interview using a structured questionnaire containing demographic details and experiences faced by the nurses in service provision during COVID-19. Data was analysed by using SPSS (Statistical Package for Social Science) software version 23. Results: The findings revealed that the mean age of the respondents was 32.35 ± 7.248 years, the minimum age was 23 years and maximum age was 58 years. About half of the respondents 52.1% were in 21 - 30 years. The majorities 89% were female. More than half of the respondents 72.6% were Muslim and 63.83% of respondents have completed Diploma in nursing. About 32.2% respondents were living with senior citizen, 33% respondents were infected by COVID-19, 24.23% respondent mentioned nurse-Patient ratio in general ward was 1:7 and 71.08% mentioned nurse-patient ratio in I.C.U/C.C.U. was 1:3 (December 2021). PPE were available among 88.0% respondents and N95 mask were available among 84.0% respondent. About 34.8% respondents got COVID-19 guideline training and 32.4% got donning and doffing training. More than half of the respondents 76% stated that equipment is adequate, 56.38% respondents mention that insufficient of nurses and 53.7% were mentioned insufficient of subordinate staff. About 22.6% respondents faced social stigma and majorities 96.5% respondents mentioned they got proper family support. There was a significant association found between Professional educational qualification and satisfaction of current designation (p value = 0.001 Conclusion: The most important findings of this study was lack of training, insufficient of manpower especially nurses and subordinate staff, high nurse-patient ratio and fear about personal and family safety. The findings of the study will be helpful for the authority in planning for future course of action.

How to Promote Financial Management Level of Public Hospital under the New Medical Reform

Following the continuous development of our country's economy,the new medical reform of our country is also gradually speeding up.And potential problems existing in public hospital's financial department are being gradually magnified that has brought new challenge to financial management.The financial staff are studying the problems and trying to solve the problems through their working experiences from long-term practices and on a certain basis.Therefore,in this article,we try to find out the existing problems and to explore efficient solutions to the problems under the background of new medical reform and in the light of the importance of financial management to public hospital's development.The main purpose of this study is to try to solve the existing problems in financial management of public hospital so as to promote perfecting the systems of public medical institutions to get a better development.

Practice and Exploration of Interview in Hospital Public Recruitment

Afterentering the era of economic knowledge,for the development of enterprises,the role of human resources in enterprise development is more important than material resources,for which,hospitals have no exception.With the continuous development of the society and the continuous progress of the medical industry,in order to meet the medical service needs of the general public,hospitals must expand their scale,which requires seeking more human resources.The interview is a very important link in the hospital’s public recruitment.The author explores and analyzes the current situation of the practice and application of interview,and puts forward the practical application and exploration strategy of the interview in hospital public recruitment,hoping to help improve the hospital’s human resources.

Private hospital expansion in China:a global perspective

Objective:To assess the private hospital development in China during 2005-2016 from a global perspective.Methods:We searched the English and Chinese literature in PubMed,CNKI and Google Scholar databases with the keywords including“private hospitals in China”,“hospital ownership”,“public and private hospital”,“private hospital development”.Descriptive statistical analysis was used to assess the trend of the private hospital development in China and worldwide.Both the change of private hospitals in supply capacity and health care delivery were studied in this paper.The number of hospitals,number of hospital beds and the average number of hospital beds per hospital were employed to measure the supply capacity.The visit number,inpatients number,and bed occupancy rate(BOR)were used to measure the healthcare delivery.The data was collected from the China Health Statistical Yearbook and the“Organisation for Economic and Co-operation and Development(OECD)Statistics”website.Results:The private sector rapidly expanded in China’s hospital market in recent years.The number of private hospitals exceeded the public in 2015.There has also been a signi cant rise for the indicators of both the supply capacity(including number of hospitals,number of hospital beds and the average number of hospital beds per hospital)and the health care delivery(inpatients number and BOR)of the private hospitals.However,the growth rates of them were relatively lower than the public.The expansion trend of China’s private sector in the hospital market accorded with most the OECD countries around the world.In 2016,China was above the medium level of the share of the private hospitals’number with the OECD countries,but below the medium for the supply capacity,in terms of the hospital beds.Conclusion:As a result of the economic growth and supporting policy,the private sector has experienced a vast expansion in China’s hospital market in the past decade.The rising gap in average size between private and publicly owned hospitals,and the inconsistent development between the private hospitals’supply capacity and their market share,have become the two main challenges.Meanwhile,the future policy in supporting the private sector should be carefully introduced to advance the whole healthcare delivery system development in China.

Relationship between the Current Account Balance Ratio and Salary Ratio in Japanese Municipal Hospitals

Background: While public municipal hospitals in Japan are supported by public financing and are less likely to fail than private hospitals, more than half are in financial deficit. Hospitals running at a deficit may have poorer outcomes and less investment in maintenance of human or physical capital, as well as increased rates of patient adverse events. We sought to clarify the relationship between municipal hospital surpluses or deficits and salary expenditures. Methods: We extracted financial data for 253 general hospitals of 300 beds or more from financial statements for the 2013 fiscal year available in the Yearbook of Public Firms, Edition for Hospital. From these data, we calculated account balance ratios and compared the average value of the ratio of labor to the output (salary ratio) for each group using analysis of variance (ANOVA). Results: The salary ratios of hospitals in the surplus group were significantly lower than the salary ratios of hospitals in the deficit group (55.5% vs. 49.4%;p p = 0.342). In the surplus group, the average value of salary ratios was different among the three-bed count groups (mean salary ratio: 53.0% vs. 48.5% vs. 47.4%;ANOVA p = 0.012). In addition, there was a significant difference in mean value between the 300-bed group and ≥500 beds group (mean salary ratio: 53.0% vs. 47.4%;p = 0.002). Conclusion: This study suggests that maintaining a favorable salary ratio to the current account balance is a useful proxy of fiscal health, and interventions to improve the salary ratio may be effective in improving municipal hospital management. Furthermore, among well-managed municipal hospitals, larger hospital size may confer some advantage in purchasing power.