Thesis (Ph. D.)--Virginia Commonwealth University, 2005. / Prepared for: Dept. of Health Administration. Bibliography: leaves 202-251. Also available online.

Recently, the health care services in Taiwan have rocket booming both in scale and in quantity. The competition among these health care service organizations are forging these facilities into cost effective systems through, promoting various quality control programs, elevating clinic & treatment capabilities, and improving quality of health care services. This study is to investigate how the medical staffs¡¦ recognitions are, and at what priority to initiate proper actions, while promoting Taiwan Quality Indicator Project in a medical center in southern Taiwan and its relative influences in clinic quality. The method is to conduct a survey of four hundred and twenty eight (428) clinic personnel from six (6) departments ¡V Emergency Dept., Surgery Dept., Intensive Care Unit, Obstetric & Gynecology Dept., Nursing Dept. and, Psychlogical Dept. - of the sampled medical center. A total of 428 copies of inquires were released to the sampled clinic personnel on April 1st, 2007; and those were collected back with a returning rate of 86.9%, on April 30th, 2007. Software package SPSS is applied to analyze the distribution of this survey. And methods of chi-square test, ANOVA are used to investigate the influence to health care quality caused by various different personnel characteristics. Conclusions are as follows: 1.The results demonstrate that 52.4% clinic personnel do not fully understand about TQIP. And among them, Nurses, Resident Doctors and, Chief Doctors are the most. While the clinic personnel completely understand TQIP are mostly Registered Nurses and, Attending Physicians. Obvious differences of understanding about TQIP exist, apparently, per different job titles. 2.The importance of TQIP given by the sampled persons is 4.08, categorized as ¡¥important¡¦. Without discrimination, same importance is indicated by all clinic personnel of different job titles. 3.The index/indicators of TQIP are accepted as capable to evaluate health care quality of their unit/department by 64.1% of the sampled personnel. Thus, the index/indicator chosen are adequate and proper. 4.69.4% of sampled clinic personnel agree that quality improvement policies are prepared and are realized in their unit/department. The results of TQIP in those units/departments illustrate positive quality improvements of health care service. 5.On the whole, after participating TQIP, the sampled hospital finds quality improvement in health care. The positive influences in health care are, sequentially from more to less, elevating concept of quality control, understanding quality status of the hospital, assessing quality problem of clinic service unit/department, improving health care service quality, improving capabilities in problem solving, improving operation processes & procedures, improving in methods of data collection, better team work, accelerating information computerization in the hospital, better communication and coordination among unit/department. 6.The sampled hospital standardized the ¡§Monitoring & Testing Procedures of Health Care Quality Index/Indicators¡¨. The details of operation procedures are posted on the intra-net for unit/department¡¦s inquiring and following. Annual data of index/indicators collected are to be introduced in the hopistal¡¦s MIS System for top managements¡¦ inquiry and references. Five (5) recommendations after analyses: 1.The sampled hospital is graded as medical center hospital holding the responsibilities in education. The education in quality control shall be promoted and continuously initiate improving programs in health care quality, due to in depth knowledge affects the attitude and behavior in health care quality performed. 2.Clinic personnel have heavy work loads. Computerized Index/Indicator related information should be easy to access on the information system. Thus, the programmer/engineer of the information center shall simplify the procedures/ processes as year planning even the resources are limited. 3.Unit/department requires specific person to handling index /indicator. Thus, the department management can lead daily jobs down to the ground, actively involving in quality improvement programs within the unit/department. 4.One of the opinions of ¡¥not important¡¦ category is that ¡¥no solid benefit for doctors following up index/indicators. The suggestion to top management is to elevate the morale by rewarding the participants with monetary efficiency bonus instead of just merits. 5.It is very complicated about how to increase knowledge and consensus in health care quality. Besides sufficient communication with clinic personnel, man-power integration, and continuous education and on job training, problem solving and quality improvement programs are necessary. Learning from the successful experience of other health care facilities, within the country or from foreign countries, is also an efficient method.

Thesis (Ph. D.)--University of Hong Kong, 2009. / Includes bibliographical references (leaves 242-260). Also available in print.

Thesis (Ph.D.)--Virginia Commonwealth University, 2010. / Prepared for: Dept. of Health Administration. Title from title-page of electronic thesis. Bibliography: leaves 158-177.

Thesis (Ph. D.)--Case Western Reserve University, 2006. / [School of Medicine] Department of Epidemiology and Biostatistics. Includes bibliographical references. Available online via OhioLINK's ETD Center.

No description available.

ABSTRACT Aim: To assess the overall quality of child health services provided at primary health care facilities in the Johannesburg metropolitan area. Objectives: Primary Objective To evaluate the quality of clinical care provided by health care workers caring for children; including an assessment of the treatment of common childhood illnesses, counselling and health promotion. Secondary Objectives 1. To assess the quality of well baby services such as immunisation, growth promotion and developmental monitoring. 2. To assess the availability of drug supplies and equipment. 3. To assess the quality of record keeping. 4. To describe the infrastructure available at health facilities and the availability of services provided to children, including appropriate referral services. Design: This was a cross-sectional, observational study over a two-month period conducted at 16 primary health care facilities in the Johannesburg Metropolitan area; four community health centres (CHC) and 12 primary health care (PHC) clinics. A researcher-developed structured checklist, based on national guidelines and protocols was utilised. Results: A total of 141 sick child and 149 well child visits were observed. Caregivers experienced long waiting hours (mean [SD] of 135±72 minutes). Many routine examination procedures were poorly performed, with an appropriate diagnosis established in only 77% of consultations. Almost half of the children (46%) received antibiotics; their use was unwarranted in one-third of instances. Health promotion activities (such as growth monitoring) were consistently ignored during sick child visits. The mother or sick child’s HIV status was seldom considered or investigated. At least a third of children requiring cotrimoxazole prophylaxis were not prescribed the antibiotic. Growth promotion and nutritional counselling at well child visits was generally inadequate with not one of 11 children requiring food supplementation receiving it. The majority of facilities were adequately equipped and well-stocked with drugs. A lack of capacity to manage children with chronic conditions (such as asthma), mental health problems and disabilities exists. Conclusion: The poor quality of care offered to children in the richest city in Africa is a sad indictment of the inability of health service providers in the city to meaningfully address children’s health needs. Nothing short of a deliberate and radical overhaul in the way that health care is organised for children, with clearly defined and monitored standard clinical practice routines, is likely to significantly change the status quo.

The final thesis follows up the quality of health care. This topic has been nowadays much discussed and is very current. The aim of this work was to bring the issue of health care quality and analyze the quality of health care in the facility Dr. Pírko Clinic by using a questionnaire to research the satisfaction of it's patients.

Aim of the study. To evaluate possibilities to implement the program of health care quality assurance in health care institutions from the physicians’ point of view. 58.4 percent of respondents are aware with the program of health care quality assurance. 71.2 percent of those who are aware with the program believe in health care quality improvement when the program will be implemented. 41.5 percent of respondents maintain that program will be implemented under condition of proper financing while 20.8 percent assert that program will not be implemented. 65.4 percent of physicians evaluate quality of care in their institution as good and 33.7 percent as satisfactory. According the opinion of the respondents’ quality of care could be improved with teamwork and good qualification of the physicians, a half of respondents maintain that the main obstacle for better examination of the patients is insufficient financing. Almost one third of physicians state that information about safety of health care is insufficient. 44.6 percent of respondents are not satisfied with their work, and 85.1 percent affirm that quality of care is influenced with satisfaction with work, 93.1 percent maintain that quality of care is influenced with workload, 43.6 percent relate their quality of work with payment. The major part of physicians assesses their knowledge about quality management as satisfactory and would like to improve in that area. 83.6 percent of physicians state that proper financing is... [to full text]

Quality-based payment in healthcare—also known as pay-for-performance—is a popular policy intervention aimed at improving healthcare quality. However, there has been little theoretical work characterizing the underlying quality problem or the interaction between pay-for-performance and existing payment mechanisms. Furthermore, there is little empirical evidence that pay-for-performance has a substantial effect on healthcare quality.