seconds ; Skeletal bone ; therapeutic aspects ; Malignant Neoplasms

Frozen shoulder ; Shoulder ; Joints

Upper case tea ; incidence of cases ; United States ; Hospitals ; Malignant Neoplasms

Objective: This study determined the association between work engagement among hospital nurses and their work outcomes (i.e., job satisfaction, stress, burnout, and turnover intention) and patient outcomes (i.e., missed nursing care, adverse events, and quality of care). Methods: A cross-sectional study was employed using secondary data derived from 549 registered nurses working in different hospitals in Central Philippines. Eight self-report questionnaires were adopted to gather data in this study. Multiple linear and logistic regression analyses were used to test the hypotheses. Results: Nurses with lower levels of work engagement reported increased levels of job burnout and turnover intention. Those nurses with higher scores on the dedication subscale reported increased job satisfaction and perceived quality of patient care. Conclusion Work engagement influences nurse work and patient outcomes in the Philippines. Higher levels of work engagement prevent nursing staff from leaving their workplaces and may help them find their work fulfilling personally and professionally. Nursing management should highly consider promoting work engagement through enhancing job resources to meet the needs of nurses and, eventually, improve professional work outcomes and quality patient care.
burnout ; job satisfaction ; nurses ; patient care ; Philippines ; work engagement

BACKGROUND

Coronary artery disease is the leading cause of death in the Philippines and can present as acute coronary syndrome. Hospitalization for ACS has epidemiologic and economic burden. In fact, last 2017, there were 1.52% or 152 admissions for every 10,000 hospitalized patients for medical conditions in PhilHealth-accredited hospitals locally. However, coronary angioplasty was performed in only less than 1% of these cases mainly because of its cost and the out-of-pocket expense that the treatment entail, when primary percutaneous intervention has been proven to be effective in reducing mortality in STEMI and early invasive intervention performed during index hospitalization for NSTEMI is likewise recommended. Moreover, there is a big disparity between the current case rates for ACS for medical therapy alone and for invasive intervention compared to the actual ACS hospitalization cost.

1) To propose revisions to the current PhilHealth case rates for acute coronary syndrome (ACS); and 2) To determine the budget impact of the proposed ACS case rates.

The Philippine Heart Association with the assistance of a technical working group undertook the study. A panel of experts composed of general and invasive cardiologists from Luzon, Visayas, and Mindanao was formed. The ACS hospitalization costs based on the recent study by Mendoza were presented and discussed during the focus group discussions with the panelists. Issues pertinent to their localities that may affect the costs were discussed. The proposed revised costs on the particular ACS conditions and therapeutic regimens were then voted and agreed upon. A budget impact analysis of the proposed case rates was then performed.

The proposed case rates for ACS ranged from Php 80,000 (for low risk unstable angina given medical treatment) to Php 530,000 (for ST-elevation myocardial infarction initially given a thrombolytic agent then underwent PCI which necessitated the use of three stents). The budget impact analysis showed that the proposed ACS rates would require an additional PHP 1.5 billion to 2.3 billion during the first year of a 3- versus 5-year implementation period, respectively. The period of implementation will be affected by budgetary constraints as well as the availability of cardiac catheterization facilities in the country.

The proposed revised PhilHealth hospitalization coverage for ACS is more reflective or realistic of the ACS hospitalization costs in contrast with the current PhilHealth case rates. The corresponding budget impact analysis of these proposed case rates showed that PHP 7.6 billion is needed for full implementation. However, given the budget constraints, the percentage of the total costs for the first and subsequent years of implementation may be modified.