Management of Public Health The assessment of patients right to choose primary health care institution in the context of competition Simona Stulpinaitytė Supervisor Prof., dr. Irayda Jakušovaitė Department of Social Medicine, Faculty of Public Health, Kaunas University of Medicine. Kaunas; 2005. 65 p. Aim of the study. To assess and compare patients possibility to use their right to choose primary health care institutions in the context of competition. Objectives. 1) To assess factors who determine the choice of private or public primary health care institution; 2) To compare patients opinion about services that are provided in public and private health care institutions; 3) To compare ethical problems in healh care in micro (doctor – pacient) level in public and private health care institutions. Methods. During the survey there were questioned 380 patients at the public and private health care institutions in Garliava. Response rate in public health care institutions was 81% and in private health care institution it was 84%. Statistical analysis was carried out using statistical package for social sciences - SPSS 11.5 for Windows. Associations between the variables were tested by Chi squared. Patients answers under provided services in public and private health care institutions were analyzed by measuring means that were compared using the Stujdent test (t). Significance level (p) less than 0,05 was considered as statistically significant (p<0,05). Results. The most... [to full text]

Aim of the study: to evaluate competence of school health care specialists in Kaunas. Objectives: 1. to evaluate professional competence; 2. to evaluate personal and social competence; 3. to determine the factors related to competence evaluation. Methods: The object of the research – competence of school health care specialists. Three levels of competence – professional, personal and social – are evaluated. Methods – 1. review of scientific literature; 2. juridical paper analysis; 3. questionnaire survey; 4. statistical data analysis (Spearman correlation coefficient, t – test, descriptive statistics. Results: The analysis of professional knowledge self-assessment of separate functions showed that 10 functions out of 17 were evaluated by 4 points and over. Total evaluation of knowledge of all 17 functions was 67,9±8,8 points out of 85 points possible. The analysis of professional skills self-assessment showed that skills of 9 functions out of 17 were evaluated by 4 points and over. Total evaluation of professional skills was 64,6±10,2 points out of 85 points possible. The evaluation of personal competence showed that respondents gave 4 points and over to 3 personal features out of 8 features possible. Total evaluation of personal competence was 31,7±4,3 points out of 40 points possible. The analysis of social competence evaluation showed that 2 out of 5 social features were evaluated by 4 points and over. Total evaluation of social competence reached 19,5±2,7... [to full text]

SUMMARY Assessment of health care services quality and accessibility for tick-borne encephalitis patients in Kaunas region Liucijus Ambraška Supervisor Janina Petkevičienė, Dr.Sc.Assoc. Prof., Department of Social Medicine. Faculty of Public Health, Kaunas University of Medicine.- Kaunas, 2005.-P.68 Key words: tick-borne encephalitis, quality and accessibility of health care services Incidence of tick-borne encephalitis (TBE) is increasing by data of Lithuanian health information center. Aim of the study – to assess accessibility and quality of health care services for TBE patients in Kaunas region. Objectives: to establish peculiarities of transmission TBE infection and opinion about TBE prophylaxis of reconvalescents; to evaluate duration of admission period of TBE patients to specialized hospital and peculiarities of monitoring after discharging and satisfaction with health care services; to determine standpoint of general practitioners (GP) on TBE prophylaxis and reconvalescents monitoring problems. Methods. Case histories of TBE patients treated in Kaunas Clinical Hospital of Infectious Diseases in years 2001-2002 (n=187) analyzed. Questionnaires about state of health and assessment of quality of health care services during period of illness and reconvalescence were posted. 104 answers received. Questionnaires about standpoint on TBE control problems handed to 150 GP and returned by 101. Original questionnaires used. Differences between groups assessed using Mann-Whitney... [to full text]

Uždaviniai : 1. įvertinti mokinių sveikatą ir jų naudojimąsi sveikatinimo paslaugomis; 2. nustatyti mokinių žinias apie sveikatą, gyvenseną ir žalingus įpročius; 3. nustatyti veiksnius, įtakojančius mokyklos sveikatos specialisto veiklos vertinimą; 4. palyginti nuomones apie VSS veiklą tarp mieste ir rajone gyvenančių mokinių bei tarp mokinių, lankančių vidurines mokyklas ir gimnazijas. Metodika. Tyrimo objektas – mokyklos sveikatos specialisto veiklos vertinimas. Tiriamos VSS veiklos sąsajos su mokinių sveikatos vertinimu ir sveikatos raštingumu. Atlikta anoniminė anketinė apklausa ir lyginamoji statistinė analizė naudojant SPSS programą (12.0 versiją). Apklausoje dalyvavo 406 8-tų ir 11-tų klasių mokiniai iš Kauno miesto ir rajono gimnazijų bei bendrojo lavinimo mokyklų. Atsako dažnis – 95,7 proc. Rezultatai. Mokiniai mokyklos VSS veiklą vertino patenkinamai. Paaugliai nurodė, jog pagrindinis, gautos sveikatinimo informacijos šaltinis yra gydytojas, antrasis – artimieji, tik 4 proc. nurodė VSS. Trečdalis paauglių sveikatos žinių negauna per jokias pamokas. 42,6 proc. dėl traumos apsilankiusiųjų specialisto darbą vertino gerai. Dauguma apsilankiusių iš jo negavo pakankamai informacijos. 59,9 proc. nurodė, jog VSS veikla nepakito. Blogiausiai įvertintos dvi VSS veiklos sritys – medicininės pagalbos, patarimų sveikatos klausimais teikimas bei jų suprantamumas, geriausiai – prevencinių priemonių įgyvendinimas. Dauguma buvo nepatenkinti VSS darbo laiku. Svarbiausia veikla... [toliau žr. visą tekstą] / Goals: 1. to evaluate schoolchildren’ health status and ability to seek for medical help. 2. to evaluate schoolchildren’ knowledge of health, lifestyle and bad habits. 3. to evaluate assessment of school health care specialists influencing factors. 4. to compare students opinion about SHCS activity between urban and rural, comprehensive school and gymnasium. Methodology. The object of research – activities of school health care specialists (SHCS) from schoolchildren’ point of view. Researching SHCS activities coherence with schoolchildren knowledge of health and own health status. Methods – questionnaire survey and statistical data analysis using statistical package SPSS 12.0. 406 students studying in 8th and 11th grades from various gymnasiums and schools of Kaunas (urban and rural areas) were questioned. The feedback – 95.7%. Results. The schoolchildren evaluated the activities of a SHCS as satisfactory. A half of teenagers the main source of health information noted doctor and family members. Only 4 % marked SHCS. The third children don’t get any health information during their lessons. 42.6 % children, visited SHCS with trauma, described his work as fine. The majority of visitors had insufficiency in health information from SHCS. 59.9 % noted that SHCS work hasn’t changed. The worst evaluations have medical help, advices rendering and its transparency, the best – promoting preventive implements. Respondents wished SHCS to be on full time. As the main SHCS activity... [to full text]

Aim of the study – to assess the implementation of the right to health information of pregnant women and to analyze the differences of its practice between services of general practitioners and obstetricians - gynecologists. Methods. The anonymous survey of women within the third trimester of pregnancy performed since August to December 2004. A sample included 120 pregnant women who were consulted by the general practitioners in the Family Clinics of Kaunas University of Medicine and 124 pregnant women within the consultations with obstetricians - gynecologists in maternity clinic of Dainava health center. Respectively, the response rate was 80% (N=96) in Family Clinics and 82.3% (N=102) in Dainava health center. The right to health information of the pregnant women was evaluated accordingly to actual Lithuanian laws. Results. Less than half of respondents (48.5%) acknowledged the Law on Patients’ Rights and the Reimbursement of Harm. The half of respondents were familiar with ability to copy their medical documents, nearly half of respondents were in part familiar about available services and opportunities to use it. One of four respondents indicated as unsatisfied with medical information during the consultations, while feeling the lack of proper information provided by physicians and rare negotiations about health examination and procedures. One of three respondents stated that physician presented them only the most important aspects of their pregnancy and health status... [to full text]

Aim of the Master thesis is: To evaluate the education demand of the health literacy program in the Kaunas University Hospital. Goals of the paper are: 1. To reveal the interface between the knowledge and behavior of the patients treated in the Kaunas University Hospital. 2. To motivate the education demand of the patients’ health literacy. Research methodology: From December of 2005 to January of 2006 the autonomous survey of the Kaunas University Hospital respondents, using the standardized questionnaire, designed for the patients, was accomplished. 183 patients participated (96.3 % response rate) in the survey. The research material was processed using the SPSS statistical package of data analysis. Research results: The patients who had enough knowledge on the health maintenance (52,2 %) more valuated their health (76,1 %) (χ² = 18; LLS = 4; p = 0,001) as well as were careful about their health while were healthy (67 %) (χ² = 26,3; LLS = 4; p = 0,000), and when got sick have changed their lifestyle and behavior: have changed their nutrition habits (45,8%), have reduced their weight (44 %), tried to leave off smoking (32 %), tried to drink less alcohol (90 %). Because of an unsuitable communication of health specialists, using many complicated medical concepts the patents are not able to understand the provided health information (69,7 %) (χ² = 46; LLS = 4; p = 0,000), and therefore perform worse the medical prescription (16,2 %) (χ² = 19,2; LLS = 4; p = 0,001)... [to full text]

The aim of the study: To evaluate accessibility and quality of health care services in urban and countryside areas. Objectives of the study: · Review of juridical acts that determine services of primary health care and their quality; · Analysis of health care sector of Marijampolė Municipality; · Comparison of accessibility and quality of health care services provided by health care institutions in urban and countryside areas from patients point of view. Investigation methods: Systemic analysis of scientific literature and periodical editions; review of juridical acts and juridical documents; analysis of a sociological survey – anonymous inquiry by a questionnaire. The patients were questionared by Marijampolė Municipality PHC institutions in urban and countryside areas. 300 questionnaires were delivered, 300 respondents answered the questions (response rate 100%). Statistical data analysis was carried out on the basis of program package SPSS 10. Correlation between peculiarities was estimated according to the Chi square criterion test (χ2). As the basis for hypotheses checking was chosen significance level equal to 0,05 or less. Results. The majority of respondents evaluated primary health care from the communication point of view and organization as satisfactory. The bigger part of respondents did not face any problems in: arrival to PHC institution (76,9%), 74,4% of the respondents had to spend not long at the receptionists, spent less time in the waiting hall (57,9%). 8... [to full text]

Darbo tikslas: Įvertinti sveikatos priežiūros paslaugas Jurbarko rajono mokyklose mokytojų ir visuomenės sveikatos specialistų požiūriu. Uždaviniai.1.Įvertinti mokytojų požiūrį į moksleivių sveikatą ir teikiamas sveikatos priežiūros paslaugas mokykloje. 2. Įvertinti mokyklų visuomenės sveikatos specialistų nuomonę apie sveikatos priežiūros paslaugų organizavimo problemas. 3. Palyginti sveikatos priežiūros paslaugų organizavimą Jurbarko rajono miesto ir kaimo vietovių bendrojo lavinimo mokyklose. Metodika. Jurbarko rajono bendrojo lavinimo mokyklose atlikta anketinė mokytojų apklausa. Išdalinta 600 anketų. Anketas grąžino 360 respondentų (60,0 proc.). Buvo vertinamas mokytojų požiūris į sveikatos priežiūros paslaugų poreikį mokykloje ir visuomenės sveikatos priežiūros specialisto veiklą. Visuomenės sveikatos priežiūros specialistų nuomonės tyrimui panaudotas kokybinis tikslinių grupių apklausos metodas. Kiekybinio tyrimo duomenys apdoroti panaudojant specializuotą duomenų tvarkymo ir statistinės analizės paketą SPSS 16.0. Rezultatai. 70,2 proc. miesto ir 47,0 proc. kaimo mokytojų mokinių sveikatą vertino patenkinamai. Atitinkamai 78,1 ir 56,9 proc. mokytojų mano, kad mokinių sveikata blogėja. Tik šiek tiek visuomenės sveikatos specialisto funkcijas žino 55,3 proc. miesto ir 65,3 proc. kaimo mokytojų. 9,0 proc. mokytojų nežino specialisto funkcijų. 42,6 proc. kaimo mokytojų vertina sveikatos priežiūros paslaugų prieinamumą mokykloje kaip nepakankamą. 89,0 proc.mokytojų visas... [toliau žr. visą tekstą] / Aim of the study: to conduct survey among teachers and medical staff of school health services and to evaluate provision of health care services in public schools of Jurbarkas district. Objectives: 1. To evaluate the attitudes of teachers on provision of health care services in schools. 2. To evaluate the opinion of schools’ public health specialists about the problems of provision of health care services at schools. 3. To compare the health care services organization between the general education schools in urban and rural areas in the Jurbarkas district. Methods. Questionnaire survey of teachers was conducted in the general schools of Jurbarkas district. 600 questionnaires were distributed. 360 respondents filled in and returned questionnaires (response rate - 60.0%). Teachers’ opinions on health care needs in school and public functions of health care specialist of school was evaluated by conducting questionnaire survey. Also qualitative research method – focus group discussion - was applied in order to get deeper insight into the issues of provision of health cares services at school. The quantitative survey data was processed through a specialized data management and statistical analysis package SPSS-16.0. Results. 70.2% urban and 47.0% rural teachers assessed the students' health satisfactory. Respectively, 78.1% and 56.9% teachers believe that students' health is deteriorating. 60.0% of teachers indicated pupils’ health care as an important problem. Only some... [to full text]

Magistro darbe nagrinėjama pirminės sveikatos priežiūros kokybė pacientų ir gydytojų požiūriu. Pirmoje darbo dalyje nagrinėjama kokybės samprata sveikatos priežiūroje, sveikatos priežiūros kokybės valdymas, sveikatos priežiūros veiklos tobulinimas ir kokybės reglamentavimas, kokybės vadybos sistemų taikymas sveikatos priežiūros įstaigose, Lietuvos sveikatos sistemos valdymo reformos žingsniai, sveikatos priežiūros paslaugų kokybės problemos Lietuvoje, paciento saugumo revoliucija. Antroje darbo dalyje aptariama darbe naudota tyrimo metodologija. Analitinėje baigiamojo darbo dalyje, taikant atvejo tyrimą, anketinę apklausą, dokumentų analizę, lyginamąją analizę bei statistinės analizės metodus, pateikiami ir nagrinėjami pacientų ir gydytojų požiūriu pirminės sveikatos priežiūros kokybės tyrimo rezultatai. Darbo pabaigoje pateikiamos išvados ir rekomendacijos tirtos organizacijos vadovams. / Master's thesis examines the quality of primary care patients and physicians perspective. The first part deals with the concept of quality in health care, quality of health care management, health care and quality improvement activities regulation quality management systems for health care facilities, Lithuanian health management reform steps, health care quality problems in Lithuania, the patient safety revolution. The second part discusses the research methodology used in the work. The analytical part of the thesis, through case study, a questionnaire survey, document analysis, comparative analysis, and statistical analysis methods are presented and analyzed in terms of patients and physicians in primary care quality results. At the end of the conclusions and recommendations of the studied organization.

Kurpė V. Korupcijos kontrolė Lietuvos sveikatos apsaugos sistemoje / magistro baigiamasis darbas. Vadovė Dr. N. Černiauskienė – Vilnius: Mykolo Romerio universitetas, politikos ir vadybos fakultetas, 2014. – 76 p. Magistro baigiamajame darbe išanalizuota ir įvertinta korupcijos kontrolė Lietuvos sveikatos apsaugos sistemoje, iškeltos korupcijos sveikatos apsaugos sistemoje problemos. Pirmoje dalyje remiantis mokslinės bei teisinės literatūros šaltiniais nagrinėjama teorinė dalis: korupcijos sąvoka, formos, korupciją įtakojantys veiksniai. Antroje dalyje analizuojamas korupcijos lygis bei korupcijos kontrolė sveikatos apsaugos sistemoje. Trečioje dalyje pagrindžiama tyrimo problema, pateikiamas instrumentarijus, aptariama atliekamo tyrimo eiga. Ketvirtoje dalyje analizuojamas visuomenės bei gydytojų požiūris į korupciją sveikatos apsaugos sistemoje. Pagrindiniai žodžiai: korupcija, korupcijos kontrolė, sveikatos apsauga, sveikatos apsaugos sistema. / Kurpe V.. Corruption control in Lithuania health care system / Master’s Work in. Supervisor assoc. N. Cerniauskiene – Vilnius: Fakulcity of Fakulcity Policy and Management, Mykolas Romeris University, 2014. – 76 p. Master's thesis analyzed and evaluated corruption control Lithuanian health system, bringing health care system corruption problems. In the first part of the scientific and legal literature examines the theoretical part: Corruption concept, shape, corruption influencing factors. The second part analyzes the level of corruption and corruption control health care system. The third section justifies the problem, the instrumentation, discusses the progress of the investigation. The fourth part analyzes public perceptionsand doctors position of corruption in the health care system.