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

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

No abstract available.
Humans ; Quality of Life* ; Self 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

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

This article expounds the quality assurance for the radiotherapy simulator. Emphasis is given to its necessities and the methods, and standards of regular examinations are illustrated for the aim of meeting the requirements of the quality assurance in radiotherapy by the WHO.
Quality Assurance, Health Care ; Quality Control ; Radiotherapy ; instrumentation

BACKGROUND: To prevent medically significant errors, hospital laboratories must perform thorough statistical quality control (QC) procedures. We surveyed the QC status of small laboratories and created new statistical QC software that they can easily use for improving QC. METHODS: A questionnaire on the status of external and internal QC was created and sent to clinics and hospitals with small-scale laboratories. We then created QC software that can be downloaded and installed for free. RESULTS: External quality assessments were performed in 32% of the clinics (22 of 66) and 52% of the hospitals (12 of 23). Seventy-three percent of all institutions (66 of 90) carried out an internal quality assessment based on their own guidelines, mostly using commercialized QC materials. However, only 52% of clinics and 23% of hospitals used their own acceptable range instead of the manufacturer's expected range. In addition, the proportion of manual QC management reached 52% in clinics and 82% in hospitals. The QC software we designed covers all the basic functions of statistical QC and aims to improve the quality of laboratories. CONCLUSIONS: We obtained basic data on the current status of external and internal QC in small-scale laboratories using this survey. Furthermore, we suggested that new QC software may actually help to improve QC of small laboratories.
Laboratories, Hospital* ; Quality Assurance, Health Care ; Quality Control*

The quality management processes used by industrial companies have become commonplace in the healthcare system and are proving successful in improving quality and controlling costs. The total quality management system is important for safe and efficiently run medical imaging. Quality management includes quality control, quality assurance, and continuous quality improvement in all aspects of medical imaging to improve the quality of healthcare. For quality improvement of medical imaging, medical imaging accreditation programs are being systematically implemented in many countries including Korea. Quality management in the medical imaging process will be effective within a system of cooperation among stakeholders and professionals. In this review, I describe the concept and basic definition of quality management in medical imaging and introduce quality management programs from countries outside Korea.
Accreditation ; Delivery of Health Care ; Diagnostic Imaging* ; Korea ; Quality Assurance, Health Care ; Quality Control ; Quality Improvement ; Quality of Health Care ; Total Quality Management