Comparing the Quality of Three Models of Postabortion Care in Public Hospitals in Mexico City

2003 ◽  
Vol 29 (3) ◽  
pp. 112 ◽  
Author(s):  
Deborah L. Billings ◽  
Jaime Fuentes Velasquez ◽  
Ricardo Perez-Cuevas
2021 ◽  
Vol 9 ◽  
Author(s):  
Horacio Márquez-González ◽  
Edith Valdez-Martínez ◽  
Miguel Bedolla

Background: Non-therapeutic hysterectomy has been performed to this day in Mexican women with intellectual disabilities (IDs), but the rationale for performing the procedure has been rarely submitted to clinical ethics committees. The objectives of the present research were to determine the frequency of hysterectomy and the clinical and epidemiologic characteristics that associated to the indication of hysterectomy in girls and young females with IDs and to analyse the emerging ethical issues related to the procedure.Materials and Methods: A medical chart review was conducted to identify female patients aged ≤ 25 years who had IDs based on anatomical pathologies and hospital records and underwent hysterectomy between January 2014 and December 2019 in nine high-concentration hospitals in Mexico City. Data were collected using a questionnaire developed ex professo and validated through a pilot study and analysed using the Statistical Package for the Social Sciences (SPSS) 21.0 software.Results: Information of 234 female patients with or without ID who were ≤ 25 years of age was reported by the departments of anatomical pathology and paediatrics. Of the patients, 184 (79%) were excluded because the information reported was found to be erroneous or incomplete during the medical records review. Most of the 50 emales included in the study had moderate ID (n = 23, 46%) followed by those with severe ID (n = 17, 34%). The mean age at hysterectomy was 15 ± 2.9 years. Prophylactic-total abdominal hysterectomy was the most frequently performed (n = 42, 84%). A concurrence was observed between the parental and medical reasons justifying hysterectomy. The most frequent reasons were fertility control (parents vs. physicians: 46 vs. 42%), management of menstrual hygiene (28 vs. 30%) and risk of sexual abuse (6 vs. 6%).Conclusion: This study showed that performing non-therapeutic hysterectomy is subject to the clinical judgement of physicians according to their perception of the patient's quality of life. Therefore, the ethical quality of the decision to perform the procedure in girls and young females resides in the ethical value of its consequences.


2018 ◽  
Vol 8 (6) ◽  
pp. 76-81
Author(s):  
Chu Cao Minh ◽  
Thang Vo Van ◽  
Dat Nguyen Tan ◽  
Hung Vo Thanh

Background: The criteria set of assessing hospital quality in Vietnam in 2016 was revied from the criteria set in 2013 by the Ministry of Health in order to help hospitals to self-assess towards improvinge quality of hospitals in the international integration context. The study aimed to assess the quality of public hospitals in Can Tho City according to the revised criteria set of the Ministry of Health in 2016 and compare the quality among three hospital ranks (including grade I, grade II, and grade III) via to 5 groups of quality criteria. Methods: A cross-sectional study, using secondary data analysis was applied to assess the service quality of 7 general public hospitals in Can Tho City. Results: The average total score of 7 hospitals is 245 and the average for the criteria of 7 hospitals is 2.99, which is just satisfactory. In the criterion of quality, criterion D and E had the lowest scores compared to the other three groups. There was no statistically significant difference (p = 0.076) among the mean scores for the three hospital categories. Conclusion: The quality of public hospitals in Can Tho city in 2016 only reached moderately good level (2.99). Interventions should be developed to improve the quality of hospitals, with particular emphasis on improving the quality of criteria groups D and E. Key words: Quality, hospital, medicine, health, public, Can Tho


2019 ◽  
Vol 4 (6) ◽  
pp. e001817 ◽  
Author(s):  
Apostolos Tsiachristas ◽  
David Gathara ◽  
Jalemba Aluvaala ◽  
Timothy Chege ◽  
Edwine Barasa ◽  
...  

IntroductionNeonatal mortality is an urgent policy priority to improve global population health and reduce health inequality. As health systems in Kenya and elsewhere seek to tackle increased neonatal mortality by improving the quality of care, one option is to train and employ neonatal healthcare assistants (NHCAs) to support professional nurses by taking up low-skill tasks.MethodsMonte-Carlo simulation was performed to estimate the potential impact of introducing NHCAs in neonatal nursing care in four public hospitals in Nairobi on effectively treated newborns and staff costs over a period of 10 years. The simulation was informed by data from 3 workshops with >10 stakeholders each, hospital records and scientific literature. Two univariate sensitivity analyses were performed to further address uncertainty.ResultsStakeholders perceived that 49% of a nurse full-time equivalent could be safely delegated to NHCAs in standard care, 31% in intermediate care and 20% in intensive care. A skill-mix with nurses and NHCAs would require ~2.6 billionKenyan Shillings (KES) (US$26 million) to provide quality care to 58% of all newborns in need (ie, current level of coverage in Nairobi) over a period of 10 years. This skill-mix configuration would require ~6 billion KES (US$61 million) to provide quality of care to almost all newborns in need over 10 years.ConclusionChanging skill-mix in hospital care by introducing NHCAs may be an affordable way to reduce neonatal mortality in low/middle-income countries. This option should be considered in ongoing policy discussions and supported by further evidence.


2010 ◽  
Vol 16 (8) ◽  
pp. S6
Author(s):  
Aurelia O'Connell ◽  
Tracy Finegan ◽  
Jennifer Galindo ◽  
Gisele Munoz ◽  
Andrene Schonberg ◽  
...  

2021 ◽  
Vol 3 (2) ◽  
pp. 444-453
Author(s):  
Arturo Cervantes Trejo ◽  
Sophie Domenge Treuille ◽  
Isaac Castañeda Alcántara

AbstractThe Institute for Security and Social Services for State Workers (ISSSTE) is a large public provider of health care services that serve around 13.2 million Mexican government workers and their families. To attain process efficiencies, cost reductions, and improvement of the quality of diagnostic and imaging services, ISSSTE was set out in 2019 to create a digital filmless medical image and report management system. A large-scale clinical information system (CIS), including radiology information system (RIS), picture archiving and communication system (PACS), and clinical data warehouse (CDW) components, was implemented at ISSSTE’s network of forty secondary- and tertiary-level public hospitals, applying global HL-7 and Digital Imaging and Communications in Medicine (DICOM) standards. In just 5 months, 40 hospitals had their endoscopy, radiology, and pathology services functionally interconnected within a national CIS and RIS/PACS on secure private local area networks (LANs) and a secure national wide area network (WAN). More than 2 million yearly studies and reports are now in digital form in a CDW, securely stored and always available. Benefits include increased productivity, reduced turnaround times, reduced need for duplicate exams, and reduced costs. Functional IT solutions allow ISSSTE hospitals to leave behind the use of radiographic film and printed medical reports with important cost reductions, as well as social and environmental impacts, leading to direct improvement in the quality of health care services rendered.


Author(s):  
Beniamino Schiavone ◽  
Andrea Vitale ◽  
Mena Gallo ◽  
Gianlucasalvatore Russo ◽  
Domenico Ponticelli ◽  
...  

Background: Facebook is the most popular social network across the world and also allows users access to health information. Our study presents an overview of the official Facebook profiles of hospitals in Italy (n = 1351) and how much they are used. Methods: All hospitals were surveyed on the number of Facebook posts in May (post-lockdown) and October (second pandemic wave) 2020. The number of followers, the creation date of the official page, and the frequency of publication—that is, the average number of days between two subsequent posts—were determined. Results: In Italy, only 28% (n = 379) of the hospitals had official Facebook pages, of which 20.6% (n = 78) were public hospitals, and 79.4% (n = 301) were private hospitals. Of the hospitals with Facebook pages, 49.1% used them every week, and public hospitals published more often. Conclusions: Despite the differences between regions and types of management, the number of hospitals in Italy that use Facebook as a tool for the public dissemination of health information is still low. Hospitals should adopt an effective communication strategy using social networks to improve the quality of health care.


2021 ◽  
Vol 33 (2) ◽  
Author(s):  
Yubraj Acharya ◽  
Nigel James ◽  
Rita Thapa ◽  
Saman Naz ◽  
Rishav Shrestha ◽  
...  

Abstract Background Nepal has made significant strides in maternal and neonatal mortality over the last three decades. However, poor quality of care can threaten the gains, as maternal and newborn services are particularly sensitive to quality of care. Our study aimed to understand current gaps in the process and the outcome dimensions of the quality of antenatal care (ANC), particularly at the sub-national level. We assessed these dimensions of the quality of ANC in 17 primary, public hospitals across Nepal. We also assessed the variation in the ANC process across the patients’ socio-economic gradient. Methods We used a convergent mixed methods approach, whereby we triangulated qualitative and quantitative data. In the quantitative component, we observed interactions between providers (17 hospitals from all 7 provinces) and 198 women seeking ANC and recorded the tasks the providers performed, using the Service Provision Assessments protocol available from the Demographic and Health Survey program. The main outcome variable was the number of tasks performed by the provider during an ANC consultation. The tasks ranged from identifying potential signs of danger to providing counseling. We analyzed the resulting data descriptively and assessed the relationship between the number of tasks performed and users’ characteristics. In the qualitative component, we synthesized users’ and providers’ narratives on perceptions of the overall quality of care obtained through focus group discussions and in-depth interviews. Results Out of the 59 tasks recommended by the World Health Organization, providers performed only 22 tasks (37.3%) on average. The number of tasks performed varied significantly across provinces, with users in province 3 receiving significantly higher quality care than those in other provinces. Educated women were treated better than those with no education. Users and providers agreed that the overall quality of care was inadequate, although providers mentioned that the current quality was the best they could provide given the constraints they faced. Conclusion The quality of ANC in Nepal’s primary hospitals is poor and inequitable across education and geographic gradients. While current efforts, such as the provision of 24/7 birthing centers, can mitigate gaps in service availability, additional equipment, infrastructure and human resources will be needed to improve quality. Providers also need additional training focused on treating patients from different backgrounds equally. Our study also points to the need for additional research, both to document the quality of care more objectively and to establish key determinants of quality to inform policy.


Author(s):  
Amira Omrane ◽  
Asma Khedher ◽  
Chayma Harrathi ◽  
Maher Maoua ◽  
Taoufik Khalfallah ◽  
...  

Background: Healthcare workers are at a high risk of developing Occupational Dermatitis (OD). Affected workers often experience severe impairment of their Quality of Life (QoL). This study aimed to assess the skin-related QoL of healthcare workers with OD and to explore its related factors. Methods: A cross-sectional and exhaustive study was conducted among healthcare personnel of four public hospitals in the central region of Tunisia. All the cases of OD declared were included. Skin-related QoL was assessed using the validated Tunisian version of the “Dermatology Life Quality Index” (DLQI). Some related patents were discussed. Results: A total of 37 cases of OD were collected with an annual incidence of 4.2 cases per 10000 workers. The population was predominantly female (73%) and mean aged 44.7±9.4 years. Nurses were the most represented occupational category (38%). Allergic contact dermatitis was the most frequent diagnosis (96%). Use of gloves was the most frequently reported occupational hazard (86%). The most frequently affected sites were hands (97%). The median score of DLQI was five. Multivariate analysis showed an association between the impairment of skin-related QoL and female gender (p = 0.04; OR = 19.3,84), exposure to disinfecting chemicals in the workplace (p = 0.01; OR = 17,306) and the absence of occupational reclassification (p = 0.01; OR = 21,567). Conclusion: About one third of the population had an impaired quality of life. The score impairment was significantly related to female gender, exposure to disinfecting chemicals and the absence of occupational reclassification.


2013 ◽  
Vol 03 (12) ◽  
pp. 01-14
Author(s):  
Keelson, Solomon A. ◽  
Ann Dodor

The study was purposed to consider how encouraging use of locum nursing could aid in managing nurse shortage in the country and consequently improve the service quality of healthcare in Ghana. To be able to address the research problem and achieve the objectives, thirty public hospitals and thirty private hospitals were selected from the three major cities in Ghana to provide data for the study. Also, 250 locum nurses were sampled for information. Nursing Supervisors or Hospital Administrators from the selected hospitals were use as informant for the study. The paper adopted a survey approach, where incidental sampling technique was used to select the hospitals, and the snowball together with incidental sampling methods were used for selecting locum nurses for the study. Mean and standard deviation were the data analysis method used. The findings confirmed that locum practice in Ghana is relatively low. Similarly, the paper also suggested that locum contribute to addressing the issue of nurse shortage in Ghana. At the same time locum nursing was found to contribute to quality healthcare delivery in the country. Appropriate policy directions were recommended.


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