Among the 61 surveyed commune health stations (CHS) are staffed with medical doctors. Most of these physicians do not have enough knowledge on primary health care. Low salary and poor equipment are real constraints, thus it is difficult to encourage them to accept long-term working at CHS. The surveyors estimate that the performance quality of CHS staffed with medical doctors is about 20% higher than that of CHS without doctor.
Health ; Quality of Health Care

With quality ; Health Care

Health Personnel ; Quality of Health Care

The health inspection should continuous renew and strengthen its quality and efficacy to contribute to implement successfully the strategy of people health protection and care in the period of 2001-2010, including content and subjects, method of inspection and discipline.
Delivery of Health Care ; Quality Assurance, Health Care

Quality health care is one of the central themes in the reform areas of the Universal Health Care (UHC). But in low- and middleincome countries like the Philippines, quality of health care is suboptimal. There are several challenges in implementing quality improvement in family and community practice. These include a weak health system arising from inadequate human resource and capacity, low utilization of data for health care improvement, and minimal involvement of patients to demand better quality and safety. There are also barriers, such as lack of access to evidence-based medicine resources, poor insurance systems compound the complexity of addressing health care quality. While the PAFP has already done these trainings in the past and available experiences on primary care CQI initiatives published in the local literature, in this article, we propose simple steps in line with what may be the requirement of the UHC reform.
Quality of Health Care ; Delivery of Health Care

Introduction: The 12- item General Health Questionnaire (GHQ-12) has been translated into many languages and widely used in different settings and countries. Its reliability and psychometric properties were extensively studied in many population groups which suggested that it measures psychological distress in multidimensional construct. Objective: The objective of this study was to assess the reliability and factor structure of the Bahasa Malaysia version of the GHQ-12 among university students attending a health program at a Malaysian public university. Method: The cross sectional survey was conducted on 306 undergraduate students aged between 18 to 27 years old who visited the booth set up for mental health screening at a health program. The screening was conducted using a self-administered, validated Bahasa Malaysia version of GHQ-12 questionnaire. Results: Using exploratory factor analysis, the Bahasa Malaysia version of GHQ-12 was found to have a three factor structures namely depressive symptoms, self-esteem and perceived abilities which accounted for 58% of the item variance. The overall Cronbach’s alpha coefficient of the scale was found to be high (0.84) with each factor having acceptable inter-item consistency ranging from 0.61 to 0.82. Conclusion: The findings of the study show that the Bahasa Malaysia version GHQ-12 is reliable and has good structural characteristics. It can assess a few domains of the psychological status of university students. It also helps in providing more information on the domain which may become a focus target of intervention in the prevention of mental illness.
Quality of Life ; Delivery of Health Care

Quality of Health Care ; Critical Pathways

Objective: This is a health systems research conducted with the goal of evaluating the quality of care (QoC) in diabetic emergencies, specifically Diabetic Ketoacidosis (DKA) and Hyperglycemic hyperosmolar state (HHS), at the Philippine General Hospital (PGH) in terms of structures, processes and outcomes, and determining facilitators and barriers to effective delivery of care from the healthcare providers’ point of view. Methods: The first phase of this study is a retrospective chart review involving an audit of the quality of services rendered to patients diagnosed to have DKA/HHS at the PGH. The second phase is a series of focus group discussions (FGDs) among physicians and nurses involved in the care of DKA/HHS patients. Facilitators and barriers to delivery of care were identified in these FGDs, as well as recommendations on how to improve delivery of care. Results: The recognition of DKA/HHS as a possible diagnosis at first encounter was observed in only 67% of cases. Timely initiation of hydration was met in 40% of cases and only 10% of the patients underwent adequate laboratory monitoring. Correction of at least half of the estimated water deficit in the first 24 hours of admission was achieved in 84% of the cases. Despite this, mortality rate was still high at 23%. Among those who died, thirty-seven percent (37%), seventy-five percent (75%) and over thirty percent (31%) had delayed initiation of hydration, at least one episode of hypokalemia or hypoglycemia, respectively. Barriers to good quality of care for DKA/HHS were mostly attributed to delays. These delays were due to lack of resources, limited bed-capacity and challenges experienced in the handling of specimen from the ER clerk to the laboratory and release of results. Conclusion Failure to follow guidelines and delays in the delivery of care are possible reasons for the high mortality rates noted and could be a reflection of poor quality of care among DM emergency patients in PGH. Proper documentation in the medical charts is also important. Clinical pathways and DM emergency kits are a few of the suggested approach to address the barriers to good quality care.
Diabetic Ketoacidosis ; Quality of Health Care

PURPOSE: The purpose of this study was to identify the differences and relationships among knowledge, attitudes, skill, self-efficacy (SE), and Job satisfaction (JS) of healthcare managers (HMs) participated in the 4 kinds of continuing education. METHODS: The subjects were 152 HMs. Data were analyzed by Mann-Whitney U test, Kruskal-Wallis H test, and partial correlation. RESULTS: There were significant differences in knowledge according to the amount of healthcare management experience (HME) and the training program level (TPL); in the attitudes according to gender, age, and the TPL; in the skill according to the amount of HME and the TPL; and in SE according to gender and the TPL. There was no significant difference in JS according to general characteristics. There were significant positive correlations among knowledge, attitudes, skill, SE, and JS. CONCLUSION: The TPL was identified as a significant common variable that affects all variables apart from JS. According to these results, knowledge, attitudes, skill, and SE are considered as intrapersonal constructs, whereas JS is considered as an organizational construct. Therefore, in order to improve the quality of healthcare management, organizational strategy to enhance job satisfaction of HMs are recommended.
Delivery of Health Care ; Job Satisfaction ; Quality of Health Care

The investigation was conducted at 30 communes health stations of zones II, III in 3 districts – Huu Lung, Cao Loc, Van Lang – Lang Son province. There were many shortenings in essential care and were not at a same level in various communes even in a same district. For a same commune, there were large gaps between various communes. The main causes of shortening were not the lack of resources, in term of quantity, but of management capacity. Among them, the non homogenous management not basing on the concrete condition of each commune, the negligence of quality standard are the most important
Delivery, Obstetric ; Delivery of Health Care ; Quality of Health Care ; epidemiology