Primary health care remains at the top of the government’s agenda. To address the issues of inequity, the Department of Health adopted mobile health clinics to ensure that the places that are hard to reach have access to primary health care. Without good health people do not have means to enjoy other aspect such as education and employment. Apartheid policies implemented by the old regime resulted in many rural areas in South Africa remaining underdeveloped and underserviced. Hence, the introduction of mobile health clinic ensured that the population in rural areas have access to health care. Unlike fixed clinics, there are no specific sets of guidelines set up for the operations of mobile health clinic. This include, displaying health posters at mobile health clinics, providing patients with safe drinking water at the mobile site. With more and more mobile health clinics being added to the rural population there should be established scope of services to for rural population. This will ensure equality of service delivery between the mobile health clinics and fixed clinics. Thus, guaranteeing its acceptability to the users. Using qualitative methods the study explored the experiences of patients at the mobile health clinic. Following the health equity model the study explored what the community of KwaMachi use the mobile health clinic for and the experiences of individual when accessing health care at the mobile health clinic. The findings suggest that patients have both positive and negative experiences at the mobile health clinic. The majority of respondents commented that mobile health clinic offered them an entry point to the South African national health system. They also pointed out the services offered are limited. Hence, providing a range of primary health care services will ensure the maximisation of positive experiences at the mobile health clinic and this is likely to contribute positively to the morbidity and mortality rates in rural areas in South Africa. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2013.

In 1997 and 2002 the Østfold Hospital Trust conducted patient satisfaction surveys. This study presented the results of the 2002 survey and compares them with the 1997 results. This is done to ascertain if there are any changes with regards to the dimensions the hospital scored poorly on in 1997. The purpose of this study is to find out if the patient satisfaction survey conducted at the Østfold Hospital Trust in 1997 was a serious attempt to improve the quality of the health care provided or only a symbolic act. The concepts of innovation, rational choice and institutional theory were used as spectacles to analyse how the Østfold Hospital Trust acted on the results of the 1997 patient satisfaction survey. The choice of study design is not an "either / or" situation between the quantitative and qualitative approach, since both methods can strengthen each other. This study has therefore employed a form of methodological triangulation. The finding of the study showed that the Østfold Hospital Trust can be termed as innovative, when they implemented the patient satisfaction survey in 1997. This because there was no coercive forces from the hospital owners to implement such surveys. There were only signals in the form of strategy documents. In spite of the hospitals innovative action in implementing the non-mandatory survey in 1997, the hospital leadership did not use the results to improve quality. Based on the findings, the study can conclude that the implementation of the patient satisfaction survey in 1997 was more symbolic, rather than a quality improvement act. Looking further than 1997, it’s important to remark that the hospital leadership resolved a number measures to improve quality, based on the 2002 patient survey. At the time of writing the issue of patient feedback as a quality improvement tool is high on the agenda at the Østfold Hospital Trust. The development point in the direction of a paradigm shift / I 1997 og 2002 gjennomførte Sykehuset Østfold to pasienttilfredshetsundersøkelser. Dette studiet har presentert resultatet av undersøkelsen fra 2002 og sammenlignet det med resultatet fra 1997. Dette for å se om det er forskjell på dimensjonene sykehuset har scoret dårlig på i de to forskjellige undersøkelsene. Hensikten med studiet er å undersøke om pasienttilfredshetsundersøkelsen gjennomført ved Sykehuset Østfold i 1997 var et kvalitetsforbedringstiltak eller en symbolskhandling. Fra organisasjonsteori ble begreper som innovasjon, ”Rational Choice” og institusjonsteori brukt som briller for å analysere det som har skjedd. Valg av metode var ikke en enten eller situasjon i forhold til kvantitativ eller kvalitativ metode, siden metodene kan styrke hverandre. Studiet legger vekt på metodetriangulering Funnene fra studiet har vist at Sykehuset Østfold kan betegnes som en innovativ organisasjon da organisasjonen gjennomførte undersøkelsen i 1997. Dette fordi det ikke var krav fra omgivelsene for å gjennomføre undersøkelsen, kun signaler i form av strategidokumenter fra sentrale myndigheter. Selv om organisasjonen er innovativ hva gjelder initiering og implementering av pasienttilfredshetsundersøkelsen, har sykehusledelsen ikke brukt resultatet til kvalitetsforbedringstiltak. Ut fra funnene kan studiet konkludere med at gjennomføringen av pasienttilfredsundersøkelsen i 1997 var mer preget av en symbolskhandling enn et kvalitetsforbedringstiltak.Ser en utover 1997 er det viktig å nevne at sykehusledelsen har vedtatt flere kvalitetsforbedringstiltak basert på undersøkelsen fra 2002. Akkurat nå er pasienttilfredshetsundersøkelser som kvalitetsforbedringstiltak satt høyt på dagsorden av sykehusledelsen. Utviklingen kan betegnes som et paradigmeskifte / <p>ISBN 91-7997-135-0</p>

The purpose of the research – to evaluate satisfaction of patients expectations in Vilnius emergency university hospital. The object of the research. In-patient expectations in Vilnius emergency university hospital. The hypothesis of the research- patient’s expectations are not successfully satisfied because of the organizational problems, their analysis is useful in order to make better organizational work. Conclusions. Patient's expectayions satisfaction is influenced by the structure of resources in healthcare organization and person's (patient's) individual characteristics.

This thesis consists of an overview and five essays. The purpose of the thesis is to show how economics can contribute to a better understanding of medical practice variations – why they exist, their consequences, and the extent to which they can – and should – be influenced. The first essay, Econometric analysis of variation in cesarean section rates – a cross-sectional study of 59 obstetrical departments in Sweden, is an attempt to identify the causes of variation in cesarean section rates, and to discuss their economic consequences. The econometric model applied explains 27 percent of the variation. We conclude that the unexplained variation in cesarean section rates indicates inefficiency, mainly due to over-utilisation. Estimates of the economic consequences indicate an additional cost for "unnecessary" cesarean sections of 13-16 million SEK per year. The welfare loss to society due to undesired variation is tentatively estimated to be about twice as high. In the second essay, Estimating the effect of cesarean section rate on health outcome – evidence from Swedish hospital data, we test the null hypothesis of a zero effect of cesarean section rate on health outcome, against the alternative of a positive effect. We could not reject the null hypothesis of a zero effect, i.e., we did not find any significant positive relationship between cesarean section rate and health outcome, in terms of perinatal mortality or rate of asphyxia. In the third essay, Benchmarking in obstetric care – a comparative study based on data envelopment analysis (DEA), we apply the DEA method to compare technical efficiency (productivity) of inpatient obstetric care in Swedish hospitals in 1994 and 1995. The results indicate an average potential for enhanced productivity of at least 6-7 percent each year. Most hospitals show decreasing productivity 1994-1995, partly due to inability to adjust production capacity and costs to a decreasing demand. The last two essays apply a new method – Quality Satisfaction Performance (QSP) – for incorporating patient perspectives into the management of health care, i.e., as a basis for quality improvement. Change-oriented patient questionnaires – testing a new method at three departments of ophthalmology, is a pilot study. The results show consistently high patient satisfaction indices. Satisfaction varies somewhat among the different patient segments and departments. We conclude that decisions on improvements must be preceded by thorough assessment of costs as well as effects associated with the various changes. The last essay, Patient satisfaction and priority setting – an economic approach, aims at analysing if and how priorities according to the QSP approach are influenced when an economic perspective is explicitly included. This is accomplished by a cost-effectiveness analysis of certain proposed changes/improvements, and a cost-benefit analysis based upon the patients` willingness-to-pay for these changes. Our results show that the ranking between various improvements is strongly influenced when an economic dimension is included. We conclude that even a methodologically appropriate measurement of patient satisfaction may lead to cost-ineffective priority setting, unless economic consequences are explicitly considered. / Diss. (sammanfattning) Stockholm : Handelshögsk., 2001

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 4 uppsatser.

Diss. (sammanfattning) Linköping : Univ., 2003. / Härtill 4 uppsatser.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2004. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 5 uppsatser.

Disputats, Linköping, 2006. / Med litteraturhenvisninger.