My thesis aims several objectives. The first goal is to search the theoretical basis of management simulators and health management in order to create an overview of these two topics. Healthcare is an exceptional field, so as I set out to find specifics in health service management. Another aim of my thesis is to create a management simulator using Powersim software. Created management simulator is used as a modeling tool for simulation of processes and behavior of the upper or ward nurse on each shift the focus on utilization of subordinate nurses and supervisors themselves. The simulator is designed as a decision support system. The simulator has been tested and consulted on gastroenterology department of Nemocnice Milosrdných sester sv. Karla Boromejského in Prague. One of the goals is to make accessible the system thinking and its application to management. Using system dynamics approaches to case study to find appropriate recommendations for lower-level management in health care facilities in general. The last objective is the creation of test scenarios to verify the functionality of the simulator and testing hypotheses from which emerges a recommendation for hospital departments.

The purpose of this study was to investigate the health service delivery by private health sector and develop guidelines to enhance provision of health service so as to increase their contribution in the country’s health system. Interviews with 1112 participants were conducted in phase I. Descriptive statistics, chi square tests and logistic regression analysis were used for analysis. Private health facilities (30.5%) were providing healthcare services in their own buildings that were constructed for that purpose while others work in a rented houses built for residence or others. Some facilities (11.7%) received loan services from financial institutions in the region. A significant association was found between obtaining loan and owning building for healthcare services delivery (x2=13.99, p<0.001). Private health facilities were mainly engaged in profit driven and curative services while their participation in the promotive and preventive services like FP, ANC HIV test, TB and malaria prevention and control was not minimal. Majority, 247 (96.5%) provide services for extended hours out of normal working time such as evening, weekends and holidays. Physicians, more than other professionals were found practicing part time work (dual practice). Service consumers of the private health sector were urban dwellers 417 (71.6%) and 165 (28.4%) rural residents. Nearly three-fourth (73.0%) of study participants had a history of multiple visits to both public and private health facilities for current medical condition. Median payment of patients in a single visit including diagnosis and medicine was 860 birr ($30.85) (IQR = 993 ($35.62). Only 2.1% have paid through insurance services while others through out of pocket payments. Price of services delivered in private health facilities were set mainly by owners’ will (91.4%) while others with established team. Satisfaction on the fairness of prices to services obtained from each facility were reported by 63.1% service consumers. Those patients without any companion (AOR=1.83, 95% CI=1.16-2.91) and no history of visit to other facilities (AOR=1.97, 95% CI=1.24-3.12) were more likely to be satisfied than those coming with companions and those with history of visit. In addition, as age of consumers increase, satisfaction to services prices tend to decline (AOR=0.97, 95% CI=0.96-0.99). Uncomplimentary regulatory system to private health facilities, lack of training and continuing education for health professionals, unavailability of enough health workforce in the market and shortage of supplies to private facilities were among main gaps disclosed. Based on findings, five guidelines were developed to enhance health services delivery in the private health sector, namely, increase facilitation for financial access to actors in the sector, increase facilitation to access regular updating trainings and continuing education for healthcare workers, enhance and scale up the capability of existing association in the private health sector, strengthen and support working for extended hours to promote user friendly services and accessibility of healthcare services for the poor through community based health insurance and exemption. Therefore, these recommendations to help enhance the private health sector for better performance and contribution. / Health Studies / D.Lit.Phil (Health Studies

This thesis handles about informative technologiesthat the find exercise in health sector. Below conception electronic health service we can introduce systemsthat the expressive in a way castigate and largely oversimplify work doctors with reference to legislature in Czech republic. On this account are pick out only such sizes compatibility use it electronic health documentation (so - called datal standards), which guarantee the quality technical protection and safeguard personal data before pertinent misuse. Part those diploma work work handles about proposal Internet health system realized by the help of web interface, making use programmatic languages HTML, CSS, PHP and database system MySQL. Information system makes it possible to distant repair and administration patients' data. For example browsing anamneses, diagnosis, medicines, survey doctors, medical arrangement and laboratory values. Next his feature is compatibility with informative system IZIPthat the will prove send round news in language XML.

The subject of the work is marketing planning in service business. The aim of the work is creating of marketing plan for the company which is going to enter in market of nonstate health service device in colonhydroteraphy concretely. The aim of the work is creating long term strategic marketing plan and annual marketing plan. Theoretic part of the work is created by theoretic premises of marketing planning in service business. Next there is an explained notion from sector of companny business, for which the plan was created. Practical part of the work is occupied by marketing planning and creating of strategic and annual marketing plan for company called XY.

This thesis engage in design of outdoor multifunctional madical box for vaccination. It´s a mobile rear specified firstly for humanitarian missions and for resolution of current inconvenient conditions. Its multifunctionality consist in a transport of necessary supply, in a possibility of siting of medics and pacients, in satisfactory stacking area and in possibility of networking. Many things are compact in this project. mobility with sufficiency of space, simplicity with variability, weight with stability as well as shaping with acceptable financial expenses.

Orientador: Antonio de Padua Pithon Cyrino / Resumo: Introdução: o diabetes mellitus tipo 2 (DM 2) é caracterizado como um problema de saúde pública que exige políticas públicas que facilitem o acesso aos serviços de saúde e que estes atuem de forma efetiva na atenção a estas condições. Neste sentido, a Atenção Primária à Saúde (APS) apresenta-se como estratégia fundamental. É nesse contexto, que o “Questionário de Avaliação e Monitoramento de Serviços de Atenção Básica” - QualiAB coloca-se como ferramenta avaliativa dos serviços de APS e pode ser instrumento de direcionamento tanto para equipes das unidades de saúde quanto para as gestões municipais. Objetivo: avaliar a organização da atenção à saúde de pessoas com DM 2 em serviços de APS de uma Região de Saúde do interior do estado de São Paulo. Materiais e Métodos: estudo avaliativo, quantitativo, transversal e descritivo. Os indicadores que foram analisados são provenientes do banco de respostas do questionário QualiAB aplicado em serviços de APS, em 2017, dos municípios da região de saúde de Araras que aderiram a pesquisa (Santa Cruz da Conceição, Leme, Conchal e Araras). Resultados: a organização da atenção à saúde de pessoas com DM 2 prestada pelos serviços de APS da região de saúde de Araras, está ainda distante do que é considerado desejável. Identificou-se pouco desenvolvimento de ações de educação e de promoção à saúde, recomendando-se que tais práticas sejam ampliadas baseado em conhecimento já disponível em políticas públicas e recomendações vigentes no país / Abstract: Introduction: Type 2 diabetes mellitus (DM 2) is characterized as a public health problem that requires public policies that facilitate access to health services and that they act effectively in the care of type 2 diabetes mellitus. Primary Health Care (PHC) is presented as a fundamental strategy. It is in this context that the “Questionnaire for Evaluation and Monitoring of Primary Care Services” - QualiAB stands as an evaluation tool for PHC services and can be a guiding instrument for both health unit teams and municipal administrations. Objective: To evaluate the organization of health care for people with type 2 diabetes mellitus in PHC services in a health region in the interior of the state of São Paulo. Materials and Methods: evaluative, quantitative, crosssectional and descriptive study. The indicators that were analyzed come from the QualiAB questionnaire answers database applied in Primary Health Care services in 2017, from the municipalities of the Araras health region that joined the survey (Santa Cruz da Conceição, Leme, Conchal and Araras). Results: the organization of health care for people with DM 2 provided by PHC services in the Araras health region are still far from those considered desirable. Little development of education and health promotion actions was identified, recommending that such practices be expanded based on knowledge already available in public policies and recommendations in force in the country. / Mestre

This thesis examines the law relating health care in South Africa rather than medical law which is a subset of this field. It attempts to synthesise five major traditional areas of law, namely international, constitutional, and administrative law, the law of contract and the law of delict, into a legal conceptual framework relating specifically to health care in South Africa. Systemic inconsistencies with regard to the central issue of health care across these five traditional fields are highlighted. The alignment of the various pre-existing areas of statutory and common law with the Constitution is an ongoing preoccupation of the executive, the judiciary, the legislature and academia. In the health care context, the thesis critically examines the extent to which such alignment has taken place and identifies areas in which further development is still necessary. It concludes that the correct approach to the constitutional right of access to health care services is to regard it as a unitary concept supported by each of the five traditional areas of law. The traditional division of law into categories of public and private and their further subdivision into, for instance, the law of delict and the law of contract is criticized. It promotes a fragmented approach to a central constitutional construct resulting in legal incongruencies. This is anathema to a constitutionally based legal system. There is no golden thread of commonality discernible within the various public international law instruments that contain references to rights relating to health and it is of limited practical use in South African health law. The rights in the Bill of Rights are interdependent and interconnected. The approach of the courts to the right of access to health care needs to be considerably broader than it is at present in order to fully embrace the idea of rights as a composite concept. Administrative law, especially in the public health sector, offers an alternative basis to pure contract for the provider-patient relationship. It is preferable to a contractual relationship because of the many inbuilt protections and legal requirements for administrative action. Contracts can be unfair but courts refuse to strike them down purely on this basis. Administrative action is much more likely to be struck down on grounds of unfairness: The law of contract as a legal vehicle for health service delivery is not ideal. This is due to the antiquated approach of South African courts to this area of law. There is still an almost complete failure to incorporate constitutional principles and values into the law of contract. The law of delict in relation to health care services has its blind spots. Although it seeks to place the claimant in the position in which he or she found himself prior to the unlawful act whereas the law of contract seeks to place him in the position he would have occupied had the contract been fulfilled, in the context of health care this is a notional distinction since contracts for health services seldom guarantee a specific outcome. / Thesis (LLD)--University of Pretoria, 2004. / Public Law / unrestricted

Measles immunization coverage in Namibia has not yet reached the WHO target of 90% in all provinces and districts, particularly in Luderitz district. The study aimed to determine the factors associated with the uptake of measles immunization among children in Luderitz district. A quantitative cross-sectional study was conducted among 150 parents/caregivers and their children who visited Luderitz clinic during July 2019 to August 2019. A developed questionnaire collected data on the several factors including child-related ,health service related and the perception of parents/caregivers. Data was analysed using STATA 14. Measles immunization uptake was 61% and significantly associated with child’s age (p=0.001) and gender (p=0.003), parents/caregivers age (p≤0.0001), gender (p=0.021), marital status (p≤0.0001) and employment status (p=0.009). Barriers to measles immunization were mainly inconvenient vaccination time (44%) and forgetfulness (25%) while suggested cues to action, were sending the reminders (30%), providing immunization the whole day (40%) and health education and promotion. / Health Studies / M.A. (Nursing Science)

Philosophiae Doctor - PhD / In order to manage public dental services, information is required about what work is being performed by the staff at the various clinics. Tally sheets have been used in the past to record treatment procedures but this is not an effective method of recording the amount of work done by staff at public dental clinics. But tally sheets are inaccurate, open to abuse, and fail to provide the necessary information for managers. Nor is it of any real value for providing feedback to staff on their performance. This inhibits a core aspect of job satisfaction for the staff, which is feedback. The staff just persevere, continue doing the same thing and feel frustrated. This contributes to poor work performance. Instead of using a tally sheet, 4 digit treatment codes are used for all treatment procedures (as used in the private sector for billing purposes) and additional codes were developed for services such as brushing programmes for which billing codes do not exist. These are recorded for each patient, together with a code for the patient category. A relative value unit (RVU) has been developed for each treatment code that has been weighted according to policy guidelines and the amount of time and effort required to provide the service. This was done for clinical treatment procedures as well as for community-based preventive activities . A computer program has been developed that captures the treatment codes which are saved in a number of databases that are linked to Excel pivot tables. The data can therefore be easily manipulated by the user to obtain the required information in the form of counts of procedures, monetary cost of the same clinical services in the private sector (useful with the proposed advent of National Health Insurance) and also in the form of relative value units. This is available for the current reporting period as well as for previous periods, allowing a detailed analysis of services rendered and staff performance over a period of time to show trends. Use is also made of an Objectives Matrix where the performance of each staff member can be measured according to seven objectives (Key Performance Areas) (five in the case of oral hygienists) to produce an overall Performance Index - which is a score out of ten. This enables performance appraisal to be carried out much easier than by comparing performance based on a number of diverse treatments provided. The data for all the public dental clinics in the Western Cape Province has been analysed for the period 1994 to 2012 using this system, and it has been shown that the system is sensitive enough to highlight problem areas as well as provide a balanced overall view of the service, as measured by a number of variables. The system is "low tech" in that it runs on a "stand alone" personal computer, but it could easily be applied to an integrated, networked information system provided the latter contained the treatment codes, and certain other patient, staff and clinic identifiers. It is therefore suitable for developing countries, such as South Africa, that may later develop a comprehensive Health Information System based on an electronic medical record. The emphasis is not on the information technology, it is focussed on the concepts behind the processing of the data into meaningful information for managing public dental services.

African American women tend to experience higher health disparities in cancer-related illness than any other female population in the United States. The purpose of this qualitative case study was to identify and examine access-related barriers that play a significant role in the decision-making process of this population when seeking breast cancer health services. The central research question explored the effect that barriers to health care have on African American women in the Southeastern region of the United States. Secondary research questions explored the role the Patient Protection and Affordable Care Act of 2010 has on improving access to affordable, quality breast cancer screening services for the sample population. A critical theory lens of racism and ethnicity provided conceptual framework for this case study. Significant findings identified barriers to accessing breast cancer related health services as personal, community, social, systemic, and institutional. Personal barriers identified were related to access, autonomy, and benefits of the Affordable Care Act. Social barriers corresponded to cultural, financial burden, funding, health conditions, insurance, role within the family self-discovery, and spirituality. Community barriers included access, advocacy, and autonomy. Systemic and institutional barriers consisted of doctor listening, doctor's rapport, doctor treatment, lack of trust, and benefits of the Affordable Care Act. Implications for social change included bringing awareness of the need to establish a Breast Cancer Resource Center in the region to engage this population in preventive measures, improve health outcome and reduce health disparities.