Background: In recent years, healthcare organizations worldwide have shifted away from clinic- and medical professional-centered service delivery models toward more patient-centered approaches. These approaches emphasize personalized care, active patient engagement in medical decision-making, and support for patients in managing their chronic conditions. Aim: To study patient-centered care in outpatient services of public and private hospitals. Materials and Methods: A hospital-based analytical cross-sectional study design was employed using a quantitative survey method. A total of 575 patients who received outpatient care in public and private hospitals were included in the study. The Patient–Professional Interaction Questionnaire (PPIQ) was used to evaluate patient-centered outpatient care. The questionnaire consisted of 16 items grouped into four domains. The internal consistency of the instrument was high, with a Cronbach’s α=0.929. Data were analyzed using SPSS version 25.0. Statistical significance was set at p< 0.05. Result: The mean score for effective communication was higher in private hospitals 4.36 (SD=0.61) compared with public hospitals 3.90 (SD=0.66) with a mean difference of 0.46 points (p<0.001). The mean score for attention to the patient’s agenda was higher in private hospitals 3.93 (SD=0.80) than in public hospitals 3.36 (SD=0.88), showing a statistically significant difference of 0.57 points (p<0.001). Similarly, empathy scores were higher in private hospitals 3.94 (SD=0.76) than in public hospitals 3.51(SD=0.79), with a mean difference of 0.43 points (p<0.001). Patient involvement scores were also higher in private hospitals 4.11(SD=0.80) compared with public hospitals 3.56 (SD=0.87), indicating a statistically significant difference of 0.55 points (p<0.001). Conclusion This study compared patient-centered outpatient care between public and private hospitals and found that all indicators-including effective communication, interest patient’s agenda, empathy, and patient involvement in care -were statistically significantly higher in private hospitals (p<0.001).

Background: Patient-centred care is one of the six dimensions of healthcare quality, alongside safety, timeliness, effectiveness, efficiency, and equity. Among these dimensions, patient centredness encompasses many of the characteristics of high-quality care and has been rapidly integrated into clinical practice worldwide. This growing emphasis on patient-centred care provides the rationale for the present study. Aim: To assess the attitudes of physicians and healthcare professionals in public and private hospitals toward patient-centered care and to investigate the factors influencing its implementation. Materials and Methods: A hospital-based analytical cross-sectional study was conducted using a quantitative research approach. A total of 218 physicians and healthcare professionals from public and private hospitals participated in the study. Patient-centred care was assessed using the Provider–Patient Relationship Questionnaire (PPRQ-16) developed by Gremigni et al. The questionnaire consists of 16 items grouped into four domains. The overall reliability of the instrument was excellent (Cronbach’s α = 0.944). Data were analyzed using SPSS version 25.0. A p-value of less than 0.05 was considered statistically significant. Results: Among the participants, 43.1% (n = 94) demonstrated a moderate level of knowledge regarding patient-centred care. The overall mean score for patient-centred care was 3.79 (SD = 0.64). Among the four domains, information exchange had the highest mean score (4.09 ± 0.70), while empathy had the lowest mean score (3.59 ± 0.71). No statistically significant differences were observed between public and private hospitals across any patient-centred care domains (p>0.05).
Pearson correlation analysis revealed significant positive correlations between patient centred care dimensions and several factors, including knowledge of patient-centred care (r = 0.184–0.233, p < 0.001), time available for patients (r = 0.142–0.243, p < 0.001), nurses’ cooperation (r = 0.249–0.323, p < 0.001), low patient health literacy (r = 0.137–0.253, p < 0.001), and job satisfaction (r = 0.176–0.249, p<0.01). Conclusion Healthcare professionals’ patient-centred care practices did not differ by hospital ownership (public versus private). These findings indicate that the implementation of patient-centred care is influenced not only by healthcare professionals’ knowledge and attitudes, but also by organizational and work-related factors, including organizational culture, workload, time allocated to patients, and effective collaboration among healthcare team members.

Background: The career and work of medical workers are considered to be the occupation of the highly responsible job of the worldwide. Goal: To identify the percentage of the work-related stress, the burnout, and the symptoms of work-related stress of the physicians and nurses who is working at the critical and intensive care units of UB hospitals. Materials and methodology: The survey was done by quantitative methods and cross sectional design. The study data was collected using the validated questionnaire for the work related stress. The results of the study were analyzed by the Microsoft Excel and SPSS 20 program. Results The response rate was 97.3% The study found that 78.7% of respondents reported having regular stress; and 89.4% of all participants in the survey had a personal burnout, 90.4% had work-related burnout and 94.5% had a high level of client-related burnout.
Physical symptoms include the insomnia 76.7%; psychological symptoms - the headaches 65%; behavioral symptoms as like forgetfulness and annoyance 53.3%; cognitive symptoms as like an increase in sick days or absenteeism by 40% for all physicians and nurses.

Background: Several researchers had been previously done the health professional workload study,however, because of the lack of studies of the relationship between physicians’ volume and outcome, wedid not have enough evidence of the resource allocation, the surgery outcome and quality improvementin our country.Goal: The study was aimed to study general surgeon volume and surgery outcome.Materials and Methods: We randomly selected 1147 patients diagnosed with gallbladder disease whounderwent laparoscopic cholecystectomy (LC) and acute appendicitis from 2012-2013 at the First andThird Clinical hospital and Khovd province Regional Diagnostic and Treatment Center were included.Patient demographics and clinical information, such as drug cost, duration of surgery, and name ofsurgeons were derived from patient medical records. Surgeons’ information, such as age, gender,professional and academic degree, and work experience were derived from hospital human resourcedepartment and correlation analysis was performed to examine the association between surgeryduration, surgeon experience and drug cost.Results: Hospitals LC was done 51,3±32,8 minutes with 24900,70 tugriks, appendectomy was done52,7±31,4 minutes with 18361,00 tugriks of drug cost. The Third Clinical hospital surgeons operatedhigher costs (28631,34±16985,86tugriks) and shorter time (39,86±39,54 ìèí) of an appendectomy. Butthe First Clinical hospital surgeons incurred lower cost (8460,82±13231,40 tugriks) of appendectomy.However, there were no significant differences in operation time and drug average cost in appendectomyin terms of positive and weak correlation(r<0.5, p>0.05). Conclusion: General surgeon volume was notassociated with surgery outcome.

Background: World health organization had recommended to certify the effect of herbs and procedures that used in traditional medicine. It indicates the necessity to perform pharmacological study on herbs and standardize their dosage and ingredients. In recent years Mongolian traditional medicine has began to develop and its consumption rates are increased. Concomitantly, traditional herb manufactories are raised. In Mongolia traditional herbs each ingredients nature and potency has been studied well and their usage was relied on their potency. Compare with Chinese medicine their ingredient dosage were not well established. In our study we had used Mongolian academician B.Tserendavga’s calculation method andInner Mongolian approximate measurement method to clarify the Yunva 4’s ingredients dosage. Objective of the study: 1. To determine approximate amount of ingredients contained in Yunva 4. 2. To determine Yunva 4’s approximate taste, color and potency. 3. To provide comparative information on Yunva 4 4. To provide treatment and control group information on Yunva 4. Materials and method: 1. Unva 4 calculation points Taste: bitter-1, salty sour- 0.5, stinky sour -0.5, sweetish -1 Quality: hot 1, lukewarm 0.5, cold -0.5, chilly -1 Wisdom: firy-1, greasy and watery-0.5, light chilly -0.5, harsh chilly -1 Color: Yellow-1, red, green, pink, blue-0.5, brown, pale-0.5, white -1 2. To study Unva4’s ingredients according to 5 elements. Approximate percentage : each elements accounts 1 percent. Results - Wind and water combined together produces better taste and accounts 9 point. Wind and earth combined together produces stinky taste and accounts 8 point. Earth and water combined together produces watery and sweetish taste and accounts 7.5 points.Other elements could be combined together but it can be suppressed by these three elements and cannot be tasted by human taste sensing organ. Therefore Yunva 4 tastes bitter, stinky and sweetish. Discussion - Results from Mongolian and Inner Mongolian drug measurement methods were not differed. It tastes bitter and strong sweetish. But human sense organ does not sense its sweetish taste. We found that Yunva 4 herb’s quality is chilly,its wisdom is cold. Therefore, it is able to cure hot disease. Conclusion - Yunva 4 tastes bitter, stinky and sweetish. Its color is sharp yellow able to cure yellow and has little effect on badgana.

Introduction Managers in the service sector are under increasing pressure to demonstrate that their services are customerfocused and that continuous performance improvement is being delivered. Given the financial and resource constraints under which service organizations must manage it is essential that customer expectations are properly understood and measured and that, from the customers ’perspective, any gaps in service quality are identified. Goal • SERVQUAL instrument in order to ascertain any actual or perceived gaps between customer expectations and perceptions of the service offered. • To point out how management of service improvement can become more logical and integrated with respect to the prioritized service quality dimensions and their affections on increasing/decreasing service quality gaps. Model of Service Quality Gaps There are seven major gaps in the service quality concept and three of them important gaps, which are more associated with the external customers are Gap1, Gap5 and Gap6. Gap1: Customers’ expectations versus management perceptions Gap2: Management perceptions versus service specifications Gap3: Service specifications versus service delivery Gap4: Service delivery versus external communication Gap5: The discrepancy between customer expectations and their perceptions of the service delivered Gap6: The discrepancy between customer expectations and employees’ perceptions Gap7: The discrepancy between employee’s perceptions and management perceptions According to this model, five dimensions are stated as follows 1) Tangibles. Physical facilities, equipments and appearance of personnel. 2) Reliability. Ability to perform the promised service dependably and accurately. 3) Responsiveness. Willingness to help customers and provide prompt service. 4) Assurance (including competence, courtesy, credibility and security). Knowledge and courtesy of employees and their ability to inspire trust and confidence. 5) Empathy (including access, communication, understanding the customer). Caring and individualized attention that the firm provides to its customers. The SERVQUAL approach contains a questionnaire that evaluates five generic service dimensions or factors through 27 questions, evaluating both expectation and performance using a seven point Likert scale. This approach evaluates service quality by calculating difference (gap) between customer expectations and perceptions (service quality= P – E). ‘P’ denotes customer perception of service or performance and ‘E’ denotes expectations before a service encounter deliver the actual. If the answer is negative, then dissatisfaction occurs. This equation is usually called gap analysis, but as it was emphasized, this approach only measures gap 5.

Goal: The aim of the study was to identify economic burden from hypertention in Ulaanbaatar and develop some recommenadations. Material and Method: The top down approach was used to calculate direct costs of hypertension in five hospitals of the secondary and tertiary levels. To calculate cost of hypertension financial reports and cost centres data were used. A self-administered questionnaire was used to calculate indirect costs from the disease. Patients, admitted to six UB district and three tertiary level hospitals due to hypertension filled in the questionnaire. Data was analysed using SPSS 15 programme.Results: Some 114 patients were surveyed. The average cost of hypertension was 143914 ± 38189.5 (average bed days 8.7) and 264756 ± 40760.4¥ (average bed days 9.5) in the selected district and tertiary level hospitals respectively. The average cost for per out-patient visit was 4237 ± 2123.5¥ in the selected district hospitals and 3,162 ± 308.3¥ in the selected tertiary level hospitals. The indirect costs included transport cost to and from hospital, food, transport cost of relatives to visit them, cost of medications, and some other expenses related to their admission. Average indirect cost of an admission of patients with the hypertension was 253,395 and 212,717.44¥ in district and tertiary level hospitals respectively. Economic burden from temporary loss of working ablility due to hypertension was 177.1 millions tugrigs. National average wage was 300500¥ in 2009. Some 65.8% of respondents used antihypertension drugs at least once a day and average cost was 653.4¥ per patient per day. Annual and 10 years drug use estimates were 238491 and 2.3 million tugrigs per patient respectively (Inflation and price changes were not counted).Conclusion: Indirect and direct costs for admission were 1.1 billion (49.6%) and 939 million (42.5%) tugrigs respectively. Cost of hypertension in Ulaanbaatar was 2.2 billion tugrigs in 2009 and it is 1.1% of total health sector financing.