BACKGROUND

Waiting time of patients from a consult with a primary care physician to a specialist is poorly understood. It is one indicator of health service delivery and patient satisfaction. Patients consider waiting for a specialist consult for more than three months too long and unacceptable.

To describe the sociodemographic and clinical factors associated with length of referral waiting time.

Cross-sectional retrospective chart review of patient records in a tertiary government hospital from 2015 to 2019.

A total of 366 charts were reviewed. Many of the patients referred to other specialty clinics were middle-aged adults and females. Median wait times for medical and surgical specialties were 11 (IQR: 0-29) and 18 (IQR: 6-35) days, respectively (p=0.003). Nutrition, rehabilitative medicine, and family health unit received the most number of referrals among non-surgical fields. Ophthalmology, otorhinolaryngology, and general surgery received the highest number of referrals among the surgical fields. Referral waiting times were longest for cardiology (median: 125, IQR: 91-275 days) and shortest for nutrition (median: 0, IQR: 0-6 days).

Waiting times from a primary care clinic to a specialty clinic at a tertiary government hospital vary based on urgency, specialty clinic, purpose of referral, presence of comorbidities, and chronicity of condition. Clinical factors found to be significantly associated with referral waiting time include urgency, type of clinic, and purpose of referral.

The condition of work environment (patient room) is often out of concern to the management so that they do not meet the requirements of Regulation of Minister of Health of the Republic of Indonesia (Permenkes) No. 1204 of 2004 concerning Hospital Environmental Health Requirements. It will have implications for the performance of the doctor (specialist). This study aimed to describe the conditions of the work environment (temperature, lighting, and dust) and the doctor's performance and the relationship between the work environment and the doctor's performance. This research was a quantitative study with a cross sectional design. The research was conducted in 3 teaching hospitals in Medan, namely H. Adam Malik Hospital, dr. Pirngadi and RSU USU during April - November 2018. The study population was 236 people with a sample of 22 people taken using incidental sampling technique. The data obtained by measuring the conditions of the work environment (temperature, lighting, and dust) and interviews using a questionnaire to measure the performance of doctors. Data analysis used Fisher's Exact Test. The results showed that there was no influence of work environment conditions on the doctor's performance, however the temperature and lighting conditions did not meet the requirements. Meanwhile, the temperature of the work room affected the behavior of doctors. Thus, the hospital management needs to take corrective action on working environment conditions by replacing old air conditioners or regularly maintaining air conditioners, setting up a barrier against noise sources, and replacing the bulb with a lighter intensity. The medical committee needs to regularly supervise the work of doctors so that their performance is achieved according to the target.
effect of working environment, specialist physicians&rsquo ; , performance

No abstract available.
Specialization*

The Korean Urological Association analysed the difficulty index, discriminating index and response distribution for the test items of the selection type of Korean Urological Board Examination which we re undergone during last 3 years and considered the countermeasures. All test items were consisted only with the One Best Response type and Multiple True False type. So two types of test items were compared with the above mentioned methods. The results were as follows : 1. The difficulty index and the response distribution were improved more and more every years. 2. The discriminating index were become worse and worse every years. 3. The question of Multiple True False type were more good in all 3-test items analysis methods compared One Best Response Type. 4. Every year the best question in the desirable range of all 3-test items analysis methods were only 5 items and about 15 test items were located in the acceptable range. The Korean Urological Association considered the counterplans which were the necessity of test item analysis for each category of specification table, recording of response distribution on the banking cards and growing of specialist for the board examination.
Specialization ; Urology*

No abstract available.
Humans ; Specialization*

Medicine ; Specialization

Introduction: Specialists constitute a major ‘driving force’ and catalyst for growth of research in their speciality. A clearer understanding is required as to what motivates their participation in research as well as the barriers they faced. This research aims to study the attitudes, barriers and facilitators faced by specialists and to identify strategies to promote and sustain research activities in their hospitals. Methodology: A cross-sectional survey using selfadministered questionnaires was conducted among all specialists working in government specialist hospitals in the northern states of Malaysia. Results: Out of 733 questionnaires distributed, 467 were returned giving a response rate of 63.7%. Ninety-nine percent of the respondents believed that research benefits patients while 93.3% think research helps in their professional development. However, 34.8% think that under their present working conditions, it is unlikely they will participate in research. The major barriers identified were lack of funds for research (81%); lack access to expertise, software or statistical analysis (78.4%); interference with daily work schedule (75.1%) and inconsistent manpower in their department (74.2%). There are three barriers with statistically significant difference between hospitals with CRC compared to hospitals without CRC; lack of funds, mentors and access to expertise, software or statistical analysis. The demographic factors, attitudes and barriers contributing to involvement in research also investigated. The main facilitators for the conduct of research are potential to benefit patients and potential for professional development. Conclusion: Taking note of the findings, the Ministry of Health can implement appropriate strategies to improve specialist participation in research.
Specialization ; Attitude

No abstract available.
Education, Medical* ; Specialization

No abstract available.
Education, Professional* ; Specialization*

The purpose of this study was to analyze information about food and nutrition topics presented throughout the television broadcast media, thereby suggest the optimal communication method to give right information to the general public. To perform this study, total sixteen monitoring people were recruited and trained through monitoring practice before and during the study. Five domestic TV channels were selected to be monitored, for six months. For the best efficiency, all the monitoring people were divided into 8 teams based on the regional consideration. The statistical analysis of data was completed using SAS program. The main results of this study are as follows. First, the total reporting cases of information about foods and nutrition were 237 , among which about 30% was classified as appropriate and 70% as inappropriate based on the trained monitors' evaluation. Second, the analysis of contents about incorrect informations showed that the insufficient descriptions of terminology and contents were the highest. And insufficient scientific evidences, incorrect contents excessively entertainment-oriented, no provision of alternatives , improper selection of expert advisors were followed. These results suggest that systematical monitoring should be continued to reduce the frequency of incorrect communication thereby give the right information in food and nutrition area to the general public. And there should be a closely cooperated system to provide the professional information to broadcasting production team by establishing the strategic program. In order to do that, most importantly the advisory team should be organized to professionally connect mass media to corresponding specialists. In addition, more educational programs about food and nutrition should be developed to provide right information to the general public.
Mass Media* ; Specialization ; Television*