Evaluation of Pictorial Dietary Assessment Tool for Hospitalized Patients with Diabetes: Cost, Accuracy, and User Satisfaction Analysis

PubMed Central

Shahar, Suzana; Abdul Manaf, Zahara; Mohd Nordin, Nor Azlin; Susetyowati, Susetyowati

2017-01-01

Although nutritional screening and dietary monitoring in clinical settings are important, studies on related user satisfaction and cost benefit are still lacking. This study aimed to: (1) elucidate the cost of implementing a newly developed dietary monitoring tool, the Pictorial Dietary Assessment Tool (PDAT); and (2) investigate the accuracy of estimation and satisfaction of healthcare staff after the use of the PDAT. A cross-over intervention study was conducted among 132 hospitalized patients with diabetes. Cost and time for the implementation of PDAT in comparison to modified Comstock was estimated using the activity-based costing approach. Accuracy was expressed as the percentages of energy and protein obtained by both methods, which were within 15% and 30%, respectively, of those obtained by the food weighing. Satisfaction of healthcare staff was measured using a standardized questionnaire. Time to complete the food intake recording of patients using PDAT (2.31 ± 0.70 min) was shorter than when modified Comstock (3.53 ± 1.27 min) was used (p < 0.001). Overall cost per patient was slightly higher for PDAT (United States Dollar 0.27 ± 0.02) than for modified Comstock (USD 0.26 ± 0.04 (p < 0.05)). The accuracy of energy intake estimated by modified Comstock was 10% lower than that of PDAT. There was poorer accuracy of protein intake estimated by modified Comstock (<40%) compared to that estimated by the PDAT (>71%) (p < 0.05). Mean user satisfaction of healthcare staff was significantly higher for PDAT than that for modified Comstock (p < 0.05). PDAT requires a shorter time to be completed and was rated better than modified Comstock. PMID:29283401

An Analysis of the Field Service Function of Selected Electronics Firms

DTIC Science & Technology

1992-01-01

Customer Engineer Evaluation ............... 175 Customer Satisfaction ...................... 176 Customer Complaints ......................... 176...system to assure satisfaction of requirements for operation, maintenance, and repair of products; -- the establishment of a responsive, efficient, and cost...research. This dissertation addresses some of the identified research needs and provides a contribution to the field service body of knowledge. By analyzing

Frontline registered nurse job satisfaction and predictors over three decades: a meta-analysis from 1980 to 2009.

PubMed

Saber, Deborah A

2014-01-01

Frontline registered nurses' job satisfaction is important because it is tied to retention, organizational commitment, workforce safety, patient safety, and cost savings. The purpose of this study was to comprehensively, quantitatively examine the largest, moderate, and smallest predictors of frontline registered nurse job satisfaction from 1980 to 2009. A non-a priori meta-analysis was used to analyze studies that met inclusion. Sixty-two studies and 27 job satisfaction predictors met inclusion for analysis. The largest effect sizes were found for task requirements (r = .61), empowerment (r = .55), and control (r = .52), and moderate effect sizes were found for 10 predictors. Fail-safe N indicates high reliability. Heterogeneity between studies was present in all of the 27 predictor analyses. The largest predictors of job satisfaction for the frontline registered nurse may be different than previously thought. Supporting past research, autonomy and stress were found to be moderate predictors of satisfaction. Heterogeneity indicates study differences or moderator influence in studies. Copyright © 2014 Elsevier Inc. All rights reserved.

Satisfaction and responsiveness with health-care services in Qatar--evidence from a survey.

PubMed

Ali, Faleh Mohamed Hussain; Nikoloski, Zlatko; Reka, Husein

2015-11-01

Satisfaction and responsiveness with health care are some of the main outcome variables of a health system. Although health outcomes have been studied in countries with different levels of economic development, there is limited information on the health provision/satisfaction/responsiveness nexus in countries where rapid transitions from middle to high-income status have occurred. Using a 2012 survey conducted in Qatar (amongst both Qatari and non-Qatari respondents), we analysed satisfaction and responsiveness of health care. The sample consisted of 4083 respondents. We use logit analysis [as well as robustness checks involving ordered logit, ordered probit, ordinary least squares (OLS) and probit analysis] in order to estimate the determinants of satisfaction and responsiveness. Both, satisfaction and responsiveness rates were high. Gender, nationality and, to some extent, income and age were significant sociodemographic determinants of satisfaction, with non-Qataris and females, having higher levels of satisfaction. Cost, previous experience with the same health provider and provision of medical insurance for a particular health provider were the attributes significantly correlated with general satisfaction. The results are consistent when the analysis is applied to the correlates of responsiveness. Sociodemographic factors explain the satisfaction with quality of health care in the state of Qatar (both from the general population point of view and from the patient point of view). Copyright © 2015. Published by Elsevier Ireland Ltd.

Measuring the operational efficiency of individual theme park attractions.

PubMed

Kim, Changhee; Kim, Soowook

2016-01-01

This study assesses the operation efficiency of theme park attractions using the data envelopment analysis, utilizing actual data on 15 attractions at Samsung Everland located in Yongin-si, Republic of Korea. In particular, this study identifies crowding and waiting time as one of the main causes of visitor's satisfaction, and analyzes the efficiency of individual attractions in terms of waiting time. The installation area, installation cost, and annual repair cost are set as input factors and the number of annual users and customer satisfaction as output factors. The results show that the roller coaster-type attractions were less efficient than other types of attractions while rotating-type attractions were relatively more efficient. However, an importance performance analysis on individual attraction's efficiency and satisfaction showed that operational efficiency should not be the sole consideration in attraction installation. In addition, the projection points for input factors for efficient use of attractions and the appropriate reference set for benchmarking are provided as guideline for attraction efficiency management.

"I got it on Ebay!": cost-effective approach to surgical skills laboratories.

PubMed

Schneider, Ethan; Schenarts, Paul J; Shostrom, Valerie; Schenarts, Kimberly D; Evans, Charity H

2017-01-01

Surgical education is witnessing a surge in the use of simulation. However, implementation of simulation is often cost-prohibitive. Online shopping offers a low budget alternative. The aim of this study was to implement cost-effective skills laboratories and analyze online versus manufacturers' prices to evaluate for savings. Four skills laboratories were designed for the surgery clerkship from July 2014 to June 2015. Skills laboratories were implemented using hand-built simulation and instruments purchased online. Trademarked simulation was priced online and instruments priced from a manufacturer. Costs were compiled, and a descriptive cost analysis of online and manufacturers' prices was performed. Learners rated their level of satisfaction for all educational activities, and levels of satisfaction were compared. A total of 119 third-year medical students participated. Supply lists and costs were compiled for each laboratory. A descriptive cost analysis of online and manufacturers' prices showed online prices were substantially lower than manufacturers, with a per laboratory savings of: $1779.26 (suturing), $1752.52 (chest tube), $2448.52 (anastomosis), and $1891.64 (laparoscopic), resulting in a year 1 savings of $47,285. Mean student satisfaction scores for the skills laboratories were 4.32, with statistical significance compared to live lectures at 2.96 (P < 0.05) and small group activities at 3.67 (P < 0.05). A cost-effective approach for implementation of skills laboratories showed substantial savings. By using hand-built simulation boxes and online resources to purchase surgical equipment, surgical educators overcome financial obstacles limiting the use of simulation and provide learning opportunities that medical students perceive as beneficial. Copyright © 2016 Elsevier Inc. All rights reserved.

Public satisfaction with the healthcare system performance in South Korea: Universal healthcare system.

PubMed

Park, Kisoo; Park, Jumin; Kwon, Young Dae; Kang, Yoonjeong; Noh, Jin-Won

2016-06-01

An awareness of the public's level of satisfaction with health professionals is becoming more important as steps are being taken to improve quality, reduce costs, and implement reform. The purpose of this study is to assess public satisfaction with the healthcare system and to examine the relationship between satisfaction and socio-demographic factors in the context of the health care environment in the Republic of Korea. The data were obtained from 1573 adults aged 20-69 in three major areas - Seoul, Gyeonggi, and Busan - by the Ministry of Health and Welfare during June and July 2011 in South Korea. Satisfaction with the healthcare system was evaluated by using 13 items in three sections: access to care, cost of care, and quality of care. A confirmatory factor analysis (CFA) was conducted to examine the validity of satisfaction with a healthcare system performance questionnaire. A structural equation model (SEM) was estimated to assess the relative impact of demographic and socio-economic variables on satisfaction. The study proposed a comprehensive three-factor model of healthcare system performance satisfaction. Among the three factors, the quality of care had the largest impact on satisfaction with the healthcare system, suggesting that is the most important determinant of consumers' satisfaction with their healthcare system. Regarding the relationships between public satisfaction and demographic and socio-economic variables, residence and marital status were significant predictors of the satisfaction level. It is important to be aware of the potential significance of background variables in determining satisfaction with the healthcare system. An understanding of the characteristics of the sample enables healthcare managers and/or policymakers to inform targeted follow-up actions. Copyright © 2016. Published by Elsevier Ireland Ltd.

Cost Effectiveness of a Novel Attempt to Reduce Readmission after Ileostomy Creation.

PubMed

Iqbal, Atif; Raza, Ahsan; Huang, Emina; Goldstein, Lindsey; Hughes, Steven J; Tan, Sanda A

2017-01-01

Dehydration is a common complication after ileostomy creation and is the most frequent reason for postoperative readmission to the hospital. We sought to determine the clinical and economic impact of an outpatient intervention to decrease readmissions for dehydration after ileostomy creation. All new ileostomates from 09/2011 through 10/2012 at the University of Florida were enrolled to receive an ileostomy education and management protocol and a daily telephone call for 3 weeks after discharge. Counseling and medication adjustments were provided, with a satisfaction survey at the end. Outcomes of these patients were compared to those in a historical control cohort. A cost analysis was conducted to calculate the savings to the hospital. Thirty-eight patients were enrolled. All patients required telephone counseling, and the mean satisfaction score rating was 4.69, on a scale of 1 to 5. The readmission rate for dehydration within 30 days of discharge decreased significantly from 65% before intervention to 16% (5/32 patients) after intervention ( P = .002). The length of readmission hospital stay decreased from a mean of 4.2 days before the introduction of the intervention to 3 days after. Cost analysis revealed that the actual total hospital cost of dehydration-specific readmission decreased from $88,858 to $25,037, a saving of $63,821. A standardized ileostomy pathway with comprehensive patient education and outpatient telephone follow-up is cost effective, has a positive influence on patient satisfaction, and reduces dehydration-related readmission rates.

Healthcare expenditures and patient satisfaction: cost and quality from the consumer's perspective in the US.

PubMed

Fu, Alex Z; Wang, Nan

2008-05-01

Both cost and quality of healthcare are major concerns in the United States. Using patient satisfaction as a quality indicator, we seek to identify the relationship between healthcare cost and quality from the perspective of the community-dwelling population in the United States. We examined a nationally representative sample of 13,980 adults (age >or= 18 years) in the 2003 Medical Expenditure Panel Survey (MEPS). Given the idiosyncrasies of the cost data distribution, a recently developed extended estimating equation (EEE) model was employed to identify the relationship between patient satisfaction and healthcare expenditure, after controlling for individual demographic covariates, co-morbidity profile, and functional and activity limitations. A series of sensitivity analyses were conducted, in addition, to verify the identified relationship. All statistics were adjusted using the proper sampling weight from the MEPS data. Average annual healthcare expenditures for 2003 ranged between $3923 and $6073 when grouped by patient satisfaction ratings with a mean value $4779 for all individuals who rated perceived satisfaction of their healthcare. We found that there is no statistically significant relationship between patient satisfaction and total healthcare expenditure (p = 0.60) and a non-monotonic relationship is not identified either. All sensitivity analyses results revealed a lack of relationship between patient satisfaction and healthcare expenditures. Patient satisfaction might not reflect the quality of healthcare from an objective clinical standpoint. The identified cost-satisfaction relationship may not be extrapolated to other quality indicators. Due to the cross-sectional study design, no causal relationship could be inferred between patient satisfaction and healthcare expenditure. Our study adds to the literature on health care cost and quality by suggesting that the improvement of patient satisfaction may not require additional health care spending.

Benefit Coverage and Employee Cost: Critical Factors in Explaining Compensation Satisfaction.

ERIC Educational Resources Information Center

Dreher, George F.; And Others

1988-01-01

Examined joint effects of benefit coverage and costs borne by employees on multiple dimensions of compensation satisfaction among 2,925 highway patrol, state police, and department of public safety employees in eight states. Found that satisfaction with benefits increased with improved coverage and decreased with higher employee costs. Employees…

The role of job satisfaction, work engagement, self-efficacy and agentic capacities on nurses' turnover intention and patient satisfaction.

PubMed

De Simone, Silvia; Planta, Anna; Cicotto, Gianfranco

2018-02-01

Nurses' voluntary turnover is a worrying global phenomenon which affects service quality. Retaining nursing staff within a hospital is important to eliminate the negative influence of voluntary turnover on the quality of care and organisation costs. This research helps explain nurses' voluntary turnover by analysing the role of self-efficacy, agentic capacities, job satisfaction, and work engagement on hospital turnover intention, and to study the relationships between these variables and patient satisfaction. This study gathered data from 194 nurses and 181 patients from 22 inpatient wards at two hospitals in southern Italy. Correlation analysis revealed that job satisfaction, work engagement, self-efficacy and agentic capacities were positively interrelated and negatively correlated with turnover intention. Path analysis showed that self-efficacy, some agentic capacities (anticipation and self-regulation), job satisfaction, and work engagement had direct or indirect effects on nurses' turnover intention, and that job satisfaction exerted a stronger effect on turnover intention. Also, patient satisfaction was positively correlated with nurses' job satisfaction, work engagement, self-efficacy, self-regulation and anticipation and negatively correlated with nurses' turnover intention. Results highlighted the importance of implementing actions (for example through feedforward methodology and the goal setting technique) to improve self-efficacy, self-regulation skill, work engagement and job satisfaction in order to reduce nurses' turnover intention and increase patient satisfaction with nursing care. Copyright © 2017 Elsevier Inc. All rights reserved.

Economic Analysis of Waterfront Area Services at Naval Station, Long Beach

DTIC Science & Technology

1991-06-01

the Gradall for waterfront area services, would result in improved responsiveness and timely service. Customer satisfaction and overall customer ...overall cost. Hence, both quality and efficiency will improve leading to greater customer satisfaction . 58 VII. RECOMMENDATIONS FOR ACTION RECOMMENDATION 1...prompting the need for improved efficiency. To ensure adequate future support can be provided to its customers , Naval Station Long Beach (Navsta) is

Cross-cultural adaptation and validation of the Physical Therapy Outpatient Satisfaction Survey in an Italian musculoskeletal population

PubMed Central

2013-01-01

Background Although patient satisfaction is a relevant outcome measure for health care providers, few satisfaction questionnaires have been generally available to physical therapists or have been validated in an Italian population for use in the outpatient setting. The aim of this study was to translate, culturally adapt, and validate the Italian version of the Physical Therapy Outpatient Satisfaction Survey (PTOPS). Methods The Italian version of the PTOPS (PTOPS-I) was developed through forward-backward translation, review, and field-testing a pre-final version. The reliability of the final questionnaire was measured by internal consistency and test-retest stability at 7 days. Factor analysis was also used to explore construct validity. Concurrent validity was measured by comparing PTOPS-I with a 5-point Likert-type scale measure assessing the Global Perceived Effect (GPE) of the treatment and with a Visual Analogue Scale (VAS). Results 354 outpatients completed the PTOPS-I, and 56 took the re-test. The internal consistency (Cronbach’s alpha) of the original domains (Enhancers, Detractors, Location, and Cost) was 0.758 for Enhancers, 0.847 for Detractors, 0.885 for Location, and 0.706 for Cost. The test-retest stability (Intra-class Correlation Coefficients) was 0.769 for Enhancers, 0.893 for Detractors, 0.862 for Location, and 0.862 for Cost. The factor analysis of the Italian version revealed a structure into four domains, named Depersonalization, Inaccessibility, Ambience, and Cost. Concurrent validity with GPE was significantly demonstrated for all domains except Inaccessibility. Irrelevant or non-significant correlations were observed with VAS. Conclusion The PTOPS-I showed good psychometric properties. Its use can be suggested for Italian-speaking outpatients who receive physical therapy. PMID:23560848

The relationships between organisational citizenship behaviour, job satisfaction and turnover intention.

PubMed

Tsai, Yafang; Wu, Shih-Wang

2010-12-01

This study aims to explore the relationships between organisational citizenship behaviour, job satisfaction and turnover intention. Because of the changing health policies landscape, Taiwan's hospital administrators are facing major cost reduction challenges. Specifically, the high turnover rate of nurses represents a hindrance and a human resource cost. This study focuses on ways of reducing the employee turnover rate through enhanced organisational citizenship behaviour and job satisfaction. A cross-sectional study. This study focuses on hospital nurses in Taiwan. Our research samples were obtained from one medical centre, three regional hospitals and seven district hospitals. Out of 300 questionnaires distributed among samples, 237 were completed and returned. Pearson's correlation was used to test for relationships among the main variables. One-way analysis of variance and Scheffé's post hoc analysis were employed to test the influence of demographic data on the main variables. The results reveal that the nurses' job satisfaction has a significantly positive correlation with organisational citizenship behaviour and a negative correlation with turnover intention. This study has proven that the turnover intention of clinical nurses is related to their organisational citizenship behaviour and job satisfaction. Hospital administrators can reduce the turnover intention by meeting nurses' needs and by promoting their organisational citizenship behaviour. Organisational citizenship behaviour involves behaviour that encourages staff to endeavour to voluntarily improve organisational performance without lobbying for compensation. Employees' job satisfaction includes satisfaction with the working environment or welfare programme in the context of human resource initiatives. Similarly, human resource protocols may serve as the starting point for promoting staff organisational citizenship behaviour. Administrators in clinical healthcare are encouraged to meet their employees' working needs through human resource practices. © 2010 Blackwell Publishing Ltd.

Are Facebook user ratings associated with hospital cost, quality and patient satisfaction? A cross-sectional analysis of hospitals in New York State.

PubMed

Campbell, Lauren; Li, Yue

2018-02-01

Hospital care costs are high while quality varies across hospitals. Patient satisfaction may be associated with better clinical quality, and social media ratings may offer another opportunity to measure patient satisfaction with care. To test if Facebook user ratings of hospitals are associated with existing measures of patient satisfaction, cost and quality. Data were obtained from Centers for Medicare and Medicaid Services Hospital Compare, the Hospital Inpatient Prospective Payment System impact files and the Area Health Resource File for 2015. Information from hospitals' Facebook pages was collected in July 2016. Multivariate linear regression was used to test if there is an association between Facebook user ratings (star rating and adjusted number of 'likes') and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction measures, the 30-day all-cause readmission rate, and the Medicare spending per beneficiary (MSPB) ratio. One hundred and thirty-six acute care hospitals in New York State in 2015. An increase in the Facebook star rating is associated with significant increases in 21/23 HCAHPS measures (p≤0.003). An increase in the adjusted number of 'likes' is associated with very small increases in 3/23 HCAHPS measures (p<0.05). Facebook user ratings are not associated with the 30-day all-cause readmission rate or the Medicare spending per beneficiary ratio. Results demonstrate an association between HCAHPS patient satisfaction measures and Facebook star ratings. Adjusted number of 'likes' may not be a useful measure of patient satisfaction. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Performance-based contracting in home-care work in The Netherlands: professionalism under pressure?

PubMed

Oomkens, Rosanne; Hoogenboom, Marcel; Knijn, Trudie

2016-07-01

Our aim was to improve the understanding of the relationships between performance-based contracting, management supportiveness and professionalism in home care. Using path analysis, this article explores the relationships between home-care workers' perceptions of management support, implementation of performance-based contracting (i.e. use of strict time registration rules and cost-efficiency measures) and autonomy and intrinsic job satisfaction. We hypothesised that: use of strict time registration rules and cost-efficiency measures relates to lower levels of autonomy and intrinsic job satisfaction (H1); there is an indirect relationship between use of strict time registration rules and use of cost-efficiency measures and intrinsic job satisfaction via autonomy (H2); higher levels of management support relate to the use of looser time registration rules and less use of cost-efficiency measures (H3); and higher levels of management support relate to higher levels of autonomy and intrinsic job satisfaction (H4). We used data from a cross-sectional survey conducted in 2010 of a sample of Dutch home-care workers (N = 156, response rate = 34%). Overall, our study suggests that the consequences of performance-based contracting for professionalism are ambiguous. More specifically, using strict time registration rules is related to lower levels of autonomy, whereas using cost-efficiency measures does not seem to affect autonomy (H1). Performance-based contracting has no consequences for the level of fulfilment home-care workers find in their job, as neither of the two contracting dimensions measured was directly or indirectly related to intrinsic job satisfaction (H1, H2). The role of managers must be taken into account when studying performance-based contracting, because perceived higher management support is related to managers' less frequent use of both strict time registration rules and of cost-efficiency measures (H3). The insight we gained into the importance of supportive managers for both autonomy and job satisfaction (H4) can help home-care organisations improve the attractiveness of home-care work. © 2015 John Wiley & Sons Ltd.

Customer satisfaction planning and industrial engineering move hospital towards in-house stockless program.

PubMed

Burton, R; Mauk, D

1993-03-01

By integrating customer satisfaction planning and industrial engineering techniques when examining internal costs and efficiencies, materiel managers are able to better realize what concepts will best meet their customers' needs. Defining your customer(s), applying industrial engineering techniques, completing work sampling studies, itemizing recommendations and benefits to each alternative, performing feasibility and cost-analysis matrixes and utilizing resources through productivity monitoring will get you on the right path toward selecting concepts to use. This article reviews the above procedures as they applied to one hospital's decision-making process to determine whether to incorporate a stockless inventory program. Through an analysis of customer demand, the hospital realized that stockless was the way to go, but not by outsourcing the function--the hospital incorporated an in-house stockless inventory program.

Career satisfaction and retention risk among Wisconsin internists.

PubMed

Giriyappa, Pradeep; Sullivan, Kandis K

2009-09-01

Physician career satisfaction has been studied extensively, but career satisfaction as it relates to retention is less well studied. The objective was to assess the relationship between career satisfaction and retention in primary care internal medicine physicians in Wisconsin. In this descriptive quantitative study, survey data was assessed for correlations between career satisfaction, risk to retention, and demographics. The survey included 1231 primary care internal medicine physicians in the Wisconsin Medical Directory (2007). Responses were measured by career satisfaction variables, and demographics and retention variables for the purpose of correlations and regression analysis. Survey responses included 573 physicians. An additional 85 physicians were disqualified. The final survey group included 1146 physicians for a response rate of 50%. A total of 116 physicians (20.2%) reported anticipating leaving their current position, 84 (14.7%) physicians reported anticipating leaving the career of medicine. Identified at risk for retention were 144 (25.1%) physicians. The lowest career satisfaction scores were reported in the areas of compensation (3.19) and practice (3.42) on a scale of 1 (very dissatisfied) to 5 (very satisfied). The highest correlations to retention were associated with practice, followed by compensation satisfaction. The level of significance for this study was identified as 0.05, and the P-value was 0.000. The study findings reveal a significant risk to the stability of continuity of care for patients, and may cost Wisconsin health care organizations more than $35 million in recruitment costs to replace departing physicians.

An Empirical Study of the Impact of Service Quality on Patient Satisfaction in Private Hospitals, Iran

PubMed Central

Zarei, Ehsan; Daneshkohan, Abbas; Pouragha, Behrouz; Marzban, Sima; Arab, Mohammad

2015-01-01

Objective: Perceived service quality is the most important predictor of patient satisfaction. The purpose of this study was to investigate the impact of the service quality on the overall satisfaction of patients in private hospitals of Tehran, Iran. Method: This cross-sectional study was conducted in the year 2010. The study’s sample consisted of 969 patients who were recruited from eight private general hospitals in Tehran, Iran using consecutive sampling. A questionnaire was used for data collection; contacting 21 items (17 items about service quality and 4 items about overall satisfaction) and its validity and reliability were confirmed. Data analysis was performed using t-test, ANOVA and multivariate regression. Result: this study found a strong relationship between service quality and patient satisfaction. About 45% of the variance in overall satisfaction was explained by four dimensions of perceived service quality. The cost of services, the quality of the process and the quality of interaction had the greatest effects on the overall satisfaction of patients, but not found a significant effect on the quality of the physical environment on patient satisfaction. Conclusions: Constructs related to costs, delivery of service and interpersonal aspect of care had the most positive impact on overall satisfaction of patients. Managers and owners of private hospitals should set reasonable prices compared to the quality of service. In terms of process quality, waiting time for visits, admissions, and surgeries must be declined and services provided at the fastest possible time. It should be emphasized to strengthen of interpersonal aspects of care and communication skills of care providers. PMID:25560338

An empirical study of the impact of service quality on patient satisfaction in private hospitals, Iran.

PubMed

Zarei, Ehsan; Daneshkohan, Abbas; Pouragha, Behrouz; Marzban, Sima; Arab, Mohammad

2014-07-29

Perceived service quality is the most important predictor of patient satisfaction. The purpose of this study was to investigate the impact of the service quality on the overall satisfaction of patients in private hospitals of Tehran, Iran. This cross-sectional study was conducted in the year 2010. The study's sample consisted of 969 patients who were recruited from eight private general hospitals in Tehran, Iran using consecutive sampling. A questionnaire was used for data collection; contacting 21 items (17 items about service quality and 4 items about overall satisfaction) and its validity and reliability were confirmed. Data analysis was performed using t-test, ANOVA and multivariate regression. this study found a strong relationship between service quality and patient satisfaction. About 45% of the variance in overall satisfaction was explained by four dimensions of perceived service quality. The cost of services, the quality of the process and the quality of interaction had the greatest effects on the overall satisfaction of patients, but not found a significant effect on the quality of the physical environment on patient satisfaction. Constructs related to costs, delivery of service and interpersonal aspect of care had the most positive impact on overall satisfaction of patients. Managers and owners of private hospitals should set reasonable prices compared to the quality of service. In terms of process quality, waiting time for visits, admissions, and surgeries must be declined and services provided at the fastest possible time. It should be emphasized to strengthen of interpersonal aspects of care and communication skills of care providers.

An economic evaluation of maxillary implant overdentures based on six vs. four implants.

PubMed

Listl, Stefan; Fischer, Leonhard; Giannakopoulos, Nikolaos Nikitas

2014-08-18

The purpose of the present study was to assess the value for money achieved by bar-retained implant overdentures based on six implants compared with four implants as treatment alternatives for the edentulous maxilla. A Markov decision tree model was constructed and populated with parameter estimates for implant and denture failure as well as patient-centred health outcomes as available from recent literature. The decision scenario was modelled within a ten year time horizon and relied on cost reimbursement regulations of the German health care system. The cost-effectiveness threshold was identified above which the six-implant solution is preferable over the four-implant solution. Uncertainties regarding input parameters were incorporated via one-way and probabilistic sensitivity analysis based on Monte-Carlo simulation. Within a base case scenario of average treatment complexity, the cost-effectiveness threshold was identified to be 17,564 € per year of denture satisfaction gained above of which the alternative with six implants is preferable over treatment including four implants. Sensitivity analysis yielded that, depending on the specification of model input parameters such as patients' denture satisfaction, the respective cost-effectiveness threshold varies substantially. The results of the present study suggest that bar-retained maxillary overdentures based on six implants provide better patient satisfaction than bar-retained overdentures based on four implants but are considerably more expensive. Final judgements about value for money require more comprehensive clinical evidence including patient-centred health outcomes.

An economic evaluation of maxillary implant overdentures based on six vs. four implants

PubMed Central

2014-01-01

Background The purpose of the present study was to assess the value for money achieved by bar-retained implant overdentures based on six implants compared with four implants as treatment alternatives for the edentulous maxilla. Methods A Markov decision tree model was constructed and populated with parameter estimates for implant and denture failure as well as patient-centred health outcomes as available from recent literature. The decision scenario was modelled within a ten year time horizon and relied on cost reimbursement regulations of the German health care system. The cost-effectiveness threshold was identified above which the six-implant solution is preferable over the four-implant solution. Uncertainties regarding input parameters were incorporated via one-way and probabilistic sensitivity analysis based on Monte-Carlo simulation. Results Within a base case scenario of average treatment complexity, the cost-effectiveness threshold was identified to be 17,564 € per year of denture satisfaction gained above of which the alternative with six implants is preferable over treatment including four implants. Sensitivity analysis yielded that, depending on the specification of model input parameters such as patients’ denture satisfaction, the respective cost-effectiveness threshold varies substantially. Conclusions The results of the present study suggest that bar-retained maxillary overdentures based on six implants provide better patient satisfaction than bar-retained overdentures based on four implants but are considerably more expensive. Final judgements about value for money require more comprehensive clinical evidence including patient-centred health outcomes. PMID:25135370

Integrated system links cost data, patient satisfaction scores for the first time.

PubMed

1999-10-01

Linking cost data, patient satisfaction scores. HBS International and The Picker Institute have joined forces to make integrated data available that directly links operational efficiency and patient satisfaction. Find out how the systems lets providers know when reducing expenses compromises care.

The problem of bias when nursing facility staff administer customer satisfaction surveys.

PubMed

Hodlewsky, R Tamara; Decker, Frederic H

2002-10-01

Customer satisfaction instruments are being used with increasing frequency to assess and monitor residents' assessments of quality of care in nursing facilities. There is no standard protocol, however, for how or by whom the instruments should be administered when anonymous, written responses are not feasible. Researchers often use outside interviewers to assess satisfaction, but cost considerations may limit the extent to which facilities are able to hire outside interviewers on a regular basis. This study was designed to investigate the existence and extent of any bias caused by staff administering customer satisfaction surveys. Customer satisfaction data were collected in 1998 from 265 residents in 21 nursing facilities in North Dakota. Half the residents in each facility were interviewed by staff members and the other half by outside consultants; scores were compared by interviewer type. In addition to a tabulation of raw scores, ordinary least-squares analysis with facility fixed effects was used to control for resident characteristics and unmeasured facility-level factors that could influence scores. Significant positive bias was found when staff members interviewed residents. The bias was not limited to questions directly affecting staff responsibilities but applied across all types of issues. The bias was robust under varying constructions of satisfaction and dissatisfaction. A uniform method of survey administration appears to be important if satisfaction data are to be used to compare facilities. Bias is an important factor that should be considered and weighed against the costs of obtaining outside interviewers when assessing customer satisfaction among long term care residents.

Cost analysis of single-use (Ambu® aScope™) and reusable bronchoscopes in the ICU.

PubMed

Perbet, S; Blanquet, M; Mourgues, C; Delmas, J; Bertran, S; Longère, B; Boïko-Alaux, V; Chennell, P; Bazin, J-E; Constantin, J-M

2017-12-01

Flexible optical bronchoscopes are essential for management of airways in ICU, but the conventional reusable flexible scopes have three major drawbacks: high cost of repairs, need for decontamination, and possible transmission of infectious agents. The main objective of this study was to measure the cost of bronchoalveolar lavage (BAL) and percutaneous tracheostomy (PT) using reusable bronchoscopes and single-use bronchoscopes in an ICU of an university hospital. The secondary objective was to compare the satisfaction of healthcare professionals with reusable and single-use bronchoscopes. The study was performed between August 2009 and July 2014 in a 16-bed ICU. All BAL and PT procedures were performed by experienced healthcare professionals. Cost analysis was performed considering ICU and hospital organization. Healthcare professional satisfaction with single-use and reusable scopes was determined based on eight factors. Sensitivity analysis was performed by applying discount rates (0, 3, and 5%) and by simulation of six situations based on different assumptions. At a discount rate of 3%, the costs per BAL for the two reusable scopes were 188.86€ (scope 1) and 185.94€ (scope 2), and the costs per PT for the reusable scope 1 and scope 2 and single-use scopes were 1613.84€, 410.24€, and 204.49€, respectively. The cost per procedure for the reusable scopes depended on the number of procedures performed, maintenance costs, and decontamination costs. Healthcare professionals were more satisfied with the third-generation single-use Ambu ® aScope™. The cost per procedure for the single-use scope was not superior to that for reusable scopes. The choice of single-use or reusable bronchoscopes in an ICU should consider the frequency of procedures and the number of bronchoscopes needed.

Simultaneous bilateral cataract surgery: economic analysis; Helsinki Simultaneous Bilateral Cataract Surgery Study Report 2.

PubMed

Leivo, Tiina; Sarikkola, Anna-Ulrika; Uusitalo, Risto J; Hellstedt, Timo; Ess, Sirje-Linda; Kivelä, Tero

2011-06-01

To present an economic-analysis comparison of simultaneous and sequential bilateral cataract surgery. Helsinki University Eye Hospital, Helsinki, Finland. Economic analysis. Effects were estimated from data in a study in which patients were randomized to have bilateral cataract surgery on the same day (study group) or sequentially (control group). The main clinical outcomes were corrected distance visual acuity, refraction, complications, Visual Function Index-7 (VF-7) scores, and patient-rated satisfaction with vision. Health-care costs of surgeries and preoperative and postoperative visits were estimated, including the cost of staff, equipment, material, floor space, overhead, and complications. The data were obtained from staff measurements, questionnaires, internal hospital records, and accountancy. Non-health-care costs of travel, home care, and time were estimated based on questionnaires from a random subset of patients. The main economic outcome measures were cost per VF-7 score unit change and cost per patient in simultaneous versus sequential surgery. The study comprised 520 patients (241 patients included non-health-care and time cost analyses). Surgical outcomes and patient satisfaction were similar in both groups. Simultaneous cataract surgery saved 449 Euros (€) per patient in health-care costs and €739 when travel and paid home-care costs were included. The savings added up to €849 per patient when the cost of lost working time was included. Compared with sequential bilateral cataract surgery, simultaneous bilateral cataract surgery provided comparable clinical outcomes with substantial savings in health-care and non-health-care-related costs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Implementing Group Medical Visits for Older Adults at Group Health Cooperative

PubMed Central

Levine, Martin D.; Ross, Tyler R.; Balderson, Benjamin H.K.; Phelan, Elizabeth A.

2010-01-01

In a pair of randomized controlled trials in Kaiser Colorado in the 1990s, Group Visits for older adults (monthly non disease-specific group medical appointments for a cohort of patients led by primary care teams) were proven to reduce costs, decrease hospitalizations, and improve patient and provider satisfaction. As part of a translational effort, this Group Visit intervention was replicated in a delivery system in Seattle, WA, and the log of total health care costs measured in the first year of the intervention. Utilization and patient and physician satisfaction were secondary outcomes. For the cost and utilization analysis, a retrospective case-control design compared 221 case patients 65 years of age and older with high outpatient utilization in the previous 18 months with 1,015 control patient selected randomly from clinics not participating in the intervention. Controls were matched to cases on the number of primary care visits in the prior 18 months. Total costs were not statistically different for intervention patients compared to controls ($8,845 vs. $10,288, p=0.11), nor were there statistically significant differences in utilization, including hospital admissions and outpatient visits. However, patient and provider satisfaction was high. This translational effort did not demonstrate the cost savings of the original efficacy trials. Possible explanations for these divergent results may have to do with differences in those who participated and differences between the two delivery systems. PMID:20002506

Are the Affordable Care Act Restrictions Warranted? A Contemporary Statewide Analysis of Physician-Owned Hospitals.

PubMed

Lundgren, Daniel K; Courtney, Paul M; Lopez, Joshua A; Kamath, Atul F

2016-09-01

The Affordable Care Act placed a moratorium on physician-owned hospital (POH) expansion. Concern exists that POHs increase costs and target healthier patients. However, limited historical data support these claims and are not weighed against contemporary measures of quality and patient satisfaction. The purpose of this study was to investigate the quality, costs, and efficiency across hospital types. One hundred forty-five hospitals in a single state were analyzed: 8 POHs; 16 proprietary hospitals (PHs); and 121 general, full-service acute care hospitals (ACHs). Multiyear data from the Centers for Medicare and Medicaid Services Medicare Cost Report and the statewide Health Care Cost Containment Council were analyzed. ACHs had a higher percentage of Medicare patients as a share of net patient revenue, with similar Medicare volume. POHs garnered significantly higher patient satisfaction: mean Hospital Consumer Assessment of Healthcare Providers and Systems summary rating was 4.86 (vs PHs: 2.88, ACHs: 3.10; P = .002). POHs had higher average total episode spending ($22,799 vs PHs: $18,284, ACHs: $18,856), with only $1435 of total spending on post-acute care (vs PHs: $3867, ACHs: $3378). Medicare spending per beneficiary and Medicare spending per beneficiary performance rates were similar across all hospital types, as were complication and readmission rates related to hip or knee surgery. POHs had better patient satisfaction, with higher total costs compared to PHs and ACHs. A focus on efficiency, patient satisfaction, and ratio of inpatient-to-post-acute care spending should be weighted carefully in policy decisions that might impact access to quality health care. Copyright © 2016 Elsevier Inc. All rights reserved.

Costs and effects of new professional roles: Evidence from a literature review.

PubMed

Tsiachristas, A; Wallenburg, I; Bond, C M; Elliot, R F; Busse, R; van Exel, J; Rutten-van Mölken, M P; de Bont, A

2015-09-01

One way in which governments are seeking to improve the efficiency of the health care sector is by redesigning health services to contain labour costs. The aim of this study was to investigate the impact of new professional roles on a wide range of health service outcomes and costs. A systematic literature review was performed by searching in different databases for evaluation papers of new professional roles (published 1985-2013). The PRISMA checklist was used to conduct and report the systematic literature review and the EPHPP-Quality Assessment Tool to assess the quality of the studies. Forty-one studies of specialist nurses (SNs) and advanced nurse practitioners (ANPs) were selected for data extraction and analysis. The 25 SN studies evaluated most often quality of life (10 studies), clinical outcomes (8), and costs (8). Significant advantages were seen most frequently regarding health care utilization (in 3 of 3 studies), patient information (5 of 6), and patient satisfaction (4 of 6). The 16 ANP studies evaluated most often patient satisfaction (8), clinical outcomes (5), and costs (5). Significant advantages were seen most frequently regarding clinical outcomes (5 of 5), patient information (3 of 4), and patient satisfaction (5 of 8). Promoting new professional roles may help improve health care delivery and possibly contain costs. Exploring the optimal skill-mix deserves further attention from health care professionals, researchers and policy makers. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Comparison of minimally invasive parathyroidectomy under local anaesthesia and minimally invasive video-assisted parathyroidectomy for primary hyperparathyroidism: a cost analysis.

PubMed

Melfa, G I; Raspanti, C; Attard, M; Cocorullo, G; Attard, A; Mazzola, S; Salamone, G; Gulotta, G; Scerrino, G

2016-01-01

Primary hyperparathyroidism (PHPT) origins from a solitary adenoma in 70- 95% of cases. Moreover, the advances in methods for localizing an abnormal parathyroid gland made minimally invasive techniques more prominent. This study presents a micro-cost analysis of two parathyroidectomy techniques. 72 consecutive patients who underwent minimally invasive parathyroidectomy, video-assisted (MIVAP, group A, 52 patients) or "open" under local anaesthesia (OMIP, group B, 20 patients) for PHPT were reviewed. Operating room, consumable, anaesthesia, maintenance costs, equipment depreciation and surgeons/anaesthesiologists fees were evaluated. The patient's satisfaction and the rate of conversion to conventional parathyroidectomy were investigated. T-Student's, Kolmogorov-Smirnov tests and Odds Ratio were used for statistical analysis. 1 patient of the group A and 2 of the group B were excluded from the cost analysis because of the conversion to the conventional technique. Concerning the remnant patients, the overall average costs were: for Operative Room, 1186,69 € for the MIVAP group (51 patients) and 836,11 € for the OMIP group (p<0,001); for the Team, 122,93 € (group A) and 90,02 € (group B) (p<0,001); the other operative costs were 1388,32 € (group A) and 928,23 € (group B) (p<0,001). The patient's satisfaction was very strongly in favour of the group B (Odds Ratio 20,5 with a 95% confidence interval). MIVAP is more expensive compared to the "open" parathyroidectomy under local anaesthesia due to the costs of general anaesthesia and the longer operative time. Moreover, the patients generally prefer the local anaesthesia. Nevertheless, the rate of conversion to the conventional parathyroidectomy was relevant in the group of the local anaesthesia compared to the MIVAP, since the latter allows a four-gland exploration.

Job Satisfaction of Nurses in a Regional Hospital in Oman: A Cross-Sectional Survey.

PubMed

Al Maqbali, Mohammed Abdullah

2015-09-01

Job satisfaction has become a critical issue for healthcare organizations, particularly in nursing, because of the shortage of nursing labor, the effect on patient care, and the associated costs. This study explores the factors that influence the level of job satisfaction of nurses working in one regional hospital in Oman. This study aims to measure the job satisfaction of nurses working at a regional hospital in Oman and to determine the factors that most significantly influence this satisfaction. Job satisfaction is measured using the McCloskey/Mueller Satisfaction Scale. In addition, the demographic characteristics of participants (age, gender, level of education, years of experience, marital status, work shift, work unit, and nationality) are obtained to assess potential correlations. A questionnaire survey was used to collect the data, and stratified random sampling was used to recruit potential participants. A cross-sectional survey was used to collect data from 155 participants who worked at one regional hospital in Oman, with survey data analyzed using SPSS version 19. One hundred forty-three valid responses were received (response rate: 92%). The study used descriptive data analysis to address the first research question and used analysis methods such as multiregression analyses, and one-way analysis of variance to identify the relationships between the other variables. The overall mean score for satisfaction was 3.49, indicating that participants had a moderate level of job satisfaction. "Interaction with coworkers" and "extrinsic reward" earned, respectively, the highest and lowest job satisfaction ratings on the subscale of McCloskey/Mueller Satisfaction Scale. The results showed that age, work shift, and nationality each had a statistically significant effect on overall job satisfaction. A multiple regression analysis indicated that 21.8% of the total variance in the dependent variables was explained by being non-Omani in nationality, indicating that that overall job satisfaction was higher in non-Omani nurses than in Omani nurses. The result suggests that professional opportunity and extrinsic reward are two important factors that affect the job satisfaction of nurses in Oman. Addressing these two factors effectively may help improve the quality of nursing care in Oman. Furthermore, this study may be conducted more widely in government hospitals in Oman to validate the identified factors and to identify additional factors that may affect job satisfaction.

Self-reported financial burden and satisfaction with care among patients with cancer.

PubMed

Chino, Fumiko; Peppercorn, Jeffrey; Taylor, Donald H; Lu, Ying; Samsa, Gregory; Abernethy, Amy P; Zafar, S Yousuf

2014-04-01

Health care-related costs and satisfaction are compelling targets for quality improvement in cancer care delivery; however, little is known about how financial burden affects patient satisfaction. This was an observational, cross-sectional, survey-based study assessing patient-reported financial burden (FB). Eligible patients were ≥ 21 years with solid tumor malignancy and were receiving chemotherapy or hormonal therapy for ≥ 1 month. The Patient Satisfaction Questionnaire Short-Form assessed patient satisfaction with health care. Subjective FB related to cancer treatment was measured on a 5-point Likert scale. Of 174 participants (32% response rate), 47% reported significant/catastrophic FB. Participants reported highest satisfaction with interpersonal manner and lowest satisfaction with financial aspects of care. In adjusted analysis, high FB was negatively associated with general satisfaction (coefficient: -.29), satisfaction with technical quality (coefficient: -.26), and satisfaction with financial aspects of care (coefficient: -.62). Older age was associated with higher scores in all satisfaction subscales except patient-physician communication and financial aspects. Annual household income of <$20,000 was associated with lower satisfaction scores in all subscales except time spent with doctor. High FB was not associated with patient satisfaction scores for accessibility and convenience, communication, interpersonal manner, or time spent with doctor. FB is a potentially modifiable correlate of poor satisfaction with cancer care including general satisfaction and satisfaction with the technical quality of care. Addressing cancer-associated FB may lead to improved satisfaction, which in turn can influence adherence, outcomes, and quality of life.

Understanding the link between leadership style, employee satisfaction, and absenteeism: a mixed methods design study in a mental health care institution.

PubMed

Elshout, Rachelle; Scherp, Evelien; van der Feltz-Cornelis, Christina M

2013-01-01

In service oriented industries, such as the health care sector, leadership styles have been suggested to influence employee satisfaction as well as outcomes in terms of service delivery. However, how this influence comes into effect has not been widely explored. Absenteeism may be a factor in this association; however, no studies are available on this subject in the mental health care setting, although this setting has been under a lot of strain lately to provide their services at lower costs. This may have an impact on employers, employees, and the delivery of services, and absenteeism due to illness of employees tends to already be rather high in this particular industry. This study explores the association between leadership style, absenteeism, and employee satisfaction in a stressful work environment, namely a post-merger specialty mental health care institution (MHCI) in a country where MHCIs are under governmental pressure to lower their costs (The Netherlands). We used a mixed methods design with quantitative as well as qualitative research to explore the association between leadership style, sickness absence rates, and employee satisfaction levels in a specialty MHCI. In depth, semi-structured interviews were conducted with ten key informants and triangulated with documented research and a contrast between four departments provided by a factor analysis of the data from the employee satisfaction surveys and sickness rates. Data was analyzed thematically by means of coding and subsequent exploration of patterns. Data analysis was facilitated by qualitative analysis software. Quantitative analysis revealed sickness rates of 5.7% in 2010, which is slightly higher than the 5.2% average national sickness rate in The Netherlands in 2010. A general pattern of association between low employee satisfaction, high sickness rates, and transactional leadership style in contrast to transformational leadership style was established. The association could be described best by: (1) communication between the manager and employees; (2) the application of sickness protocols by the managers; and (3) leadership style of the manager. We conclude that the transformational leadership style is best suited for attaining employee satisfaction, for adequate handling of sickness protocols, and for lower absenteeism, in a post-merger specialty mental health setting.

Understanding the link between leadership style, employee satisfaction, and absenteeism: a mixed methods design study in a mental health care institution

PubMed Central

Elshout, Rachelle; Scherp, Evelien; van der Feltz-Cornelis, Christina M

2013-01-01

Background In service oriented industries, such as the health care sector, leadership styles have been suggested to influence employee satisfaction as well as outcomes in terms of service delivery. However, how this influence comes into effect has not been widely explored. Absenteeism may be a factor in this association; however, no studies are available on this subject in the mental health care setting, although this setting has been under a lot of strain lately to provide their services at lower costs. This may have an impact on employers, employees, and the delivery of services, and absenteeism due to illness of employees tends to already be rather high in this particular industry. This study explores the association between leadership style, absenteeism, and employee satisfaction in a stressful work environment, namely a post-merger specialty mental health care institution (MHCI) in a country where MHCIs are under governmental pressure to lower their costs (The Netherlands). Methods We used a mixed methods design with quantitative as well as qualitative research to explore the association between leadership style, sickness absence rates, and employee satisfaction levels in a specialty MHCI. In depth, semi-structured interviews were conducted with ten key informants and triangulated with documented research and a contrast between four departments provided by a factor analysis of the data from the employee satisfaction surveys and sickness rates. Data was analyzed thematically by means of coding and subsequent exploration of patterns. Data analysis was facilitated by qualitative analysis software. Results Quantitative analysis revealed sickness rates of 5.7% in 2010, which is slightly higher than the 5.2% average national sickness rate in The Netherlands in 2010. A general pattern of association between low employee satisfaction, high sickness rates, and transactional leadership style in contrast to transformational leadership style was established. The association could be described best by: (1) communication between the manager and employees; (2) the application of sickness protocols by the managers; and (3) leadership style of the manager. Conclusion We conclude that the transformational leadership style is best suited for attaining employee satisfaction, for adequate handling of sickness protocols, and for lower absenteeism, in a post-merger specialty mental health setting. PMID:23818784

The effect of telehealth systems and satisfaction with health expenditure among patients with metabolic syndrome.

PubMed

Uei, Shu-Lin; Tsai, Chung-Hung; Kuo, Yu-Ming

2016-04-29

Telehealth cost analysis has become a crucial issue for governments in recent years. In this study, we examined cases of metabolic syndrome in Hualien County, Taiwan. This research adopted the framework proposed by Marchand to establish a study process. In addition, descriptive statistics, a t test, analysis of variance, and regression analysis were employed to analyze 100 questionnaires. The results of the t$ test revealed significant differences in medical health expenditure, number of clinical visits for medical treatment, average amount of time spent commuting to clinics, amount of time spent undergoing medical treatment, and average number of people accompanying patients to medical care facilities or assisting with other tasks in the past one month, indicating that offering telehealth care services can reduce health expenditure. The statistical analysis results revealed that customer satisfaction has a positive effect on reducing health expenditure. Therefore, this study proves that telehealth care systems can effectively reduce health expenditure and directly improve customer satisfaction with medical treatment.

Taking the pulse of Internet pharmacies.

PubMed

Yang, Z; Peterson, R T; Huang, L

2001-01-01

Like most businesses, online pharmacy companies will only be successful if they make sure customers are satisfied with the service they receive. But what attributes of service quality lead to satisfaction and dissatisfaction? This study identified 19 Internet pharmacy service quality dimensions in three categories: (1) product cost and availability, (2) customer service, and (3) the online information system. Our analysis uncovered attributes that tend to determine consumer satisfaction and points out ways to improve overall service quality in the Internet pharmacy arena.

Cost-Consequence Analysis Alongside a Randomised Controlled Trial of Hospital Versus Telephone Follow-Up after Treatment for Endometrial Cancer.

PubMed

Dixon, Padraig; Beaver, Kinta; Williamson, Susan; Sutton, Chris; Martin-Hirsch, Pierre; Hollingworth, William

2018-06-01

Regular outpatient follow-up programmes are usually offered to patients following treatment for gynaecological and other cancers. Despite the substantial resources involved in providing these programmes, there is evidence that routine follow-up programmes do not affect survival or the likelihood of detecting recurrence and may not meet patient needs. Alternative follow-up modalities may offer the same outcomes at lower cost. We examined the costs of using telephone-based routine follow-up of women treated for endometrial cancer undertaken by specialist gynaecology oncology nurses in comparison to routine hospital-based follow-up. The ENDCAT trial randomised 259 women at five centres in the north west of England with a known diagnosis of Stage I endometrial cancer who had completed primary treatment on a 1:1 basis to receive either standard hospital outpatient follow-up or a telephone follow-up intervention administered by specialist nurses. A cost-consequence analysis was undertaken in which we compared costs to the health system and to individuals with the trial's co-primary outcomes of psychological morbidity and participant satisfaction with information received. Psychological morbidity, psychosocial needs, patient satisfaction and quality of life did not differ between arms. Patients randomised to telephone follow-up underwent more and longer consultations. There was no difference in total health service mean per patient costs at 6 months (mean difference £8, 95% percentile confidence interval: - £147 to £141) or 12 months (mean difference: - £77, 95% percentile confidence interval: - £334 to £154). Estimated return journey costs per patient for hospital consultations were £11.47. Productivity costs were approximately twice as high under hospital follow-up. Telephone follow-up was estimated to be cost-neutral for the NHS and may free up clinic time for other patients. There was some evidence that telephone follow-up may be more efficient for patients and wider society, and is not associated with additional psychological morbidity, lower patient satisfaction or reduced quality of life. ISRCTN: 75220876, prospectively registered 28 October 2011.

Self efficacy, perceptions of social context, job satisfaction and their relationship with absence from work. An integrated model founded on social cognitive theory.

PubMed

Di Tecco, Cristina; Borgogni, Laura

2014-05-28

Absenteeism is a major concern for organizations and companies since it has negative repercussions on productivity and represents a huge cost due to sick pay and expensive temporary replacement of employees who are obliged to take long-term absences. The current study aimed at focussing on absenteeism and its causes through the investigation of a conceptual model founded on social cognitive theory where self-efficacy and Perceptions of Social Context (PoSC, i.e., perceptions of immediate supervisor, colleagues and top management) concur to predict absence from work through the mediating role of job satisfaction. A group of 361 sales assistants and administrative staff employed by the Italian branch of a retail clothing multinational were administered a self-report questionnaire for measuring self-efficacy, PoSC and job satisfaction. We then matched the self-report answers with objective absence measures. Structural equation modelling lent support to the presumed relationships between variables. We found that: 1) self-efficacy was positively related to the three PoSC; 2) PoSC had a positive relationship with job satisfaction; 3) job satisfaction was negatively related to absence from work; 4) job satisfaction mediated the relationship between PoSC and absence from work. Overall, our contribution offers a theoretical basis for further investigations on the role of individual characteristics and perceptions of social context in absenteeism studies via both observational and intervention studies and cost-effectiveness analysis.

Satisfaction of Nigerian stroke survivors with outpatient physiotherapy care.

PubMed

Olaleye, Olubukola A; Hamzat, Talhatu K; Akinrinsade, Marvellous A

2017-01-01

To investigate the satisfaction of stroke survivors with outpatient physiotherapy care. Sixty stroke survivors were surveyed using the European Physiotherapy Treatment Outpatient Satisfaction Survey (EPTOPS). Focus group discussion (FGD) was also conducted with four stroke survivors from the same sample. Data were analyzed using the Kruskal Wallis test and Spearman's correlation coefficients at p = 0.05. FGD was transcribed and thematically analyzed. Nearly all the participants (98.3%) indicated one of good, very good, and excellent improvement in their clinical conditions with physiotherapy. Majority expressed satisfaction with their physiotherapy care, the modal response being very good (59.3%). Patients' satisfaction and socio-demographics were not significantly correlated (p > 0.05). Overarching themes from FGD were physiotherapy in stroke rehabilitation, satisfaction with physiotherapy care, cost, and lack of continuity of care as sources of dissatisfaction. Physiotherapists' demeanor was a facilitator of satisfaction. The stroke survivors were generally satisfied with outpatient physiotherapy care. However, lack of continuity and cost of care were sources of dissatisfaction among patients. Delivery of physiotherapy to stroke survivors in Nigeria should be structured to allow for continuity of care as this may enhance satisfaction. Implementation of inexpensive rehabilitation strategies may help reduce cost of physiotherapy.

Cost and quality trends in direct contracting arrangements.

PubMed

Lyles, Alan; Weiner, Jonathan P; Shore, Andrew D; Christianson, Jon; Solberg, Leif I; Drury, Patricia

2002-01-01

This paper presents the first empirical analysis of a 1997 initiative of the Buyers Health Care Action Group (BHCAG) known as Choice Plus. This initiative entailed direct contracts with provider-controlled delivery systems; annual care system bidding; public reports of consumer satisfaction and quality; uniform benefits; and risk-adjusted payment. After case-mix adjustment, hospital costs decreased, ambulatory care costs rose modestly, and pharmacy costs increased substantially. Process-oriented quality indicators were stable or improved. The BHCAG employer-to-provider direct contracting and consumer choice model appeared to perform reasonably well in containing costs, without measurable adverse effects on quality.

Comprehensive survivorship care with cost and revenue analysis.

PubMed

Rosales, Alicia R; Byrne, Dia; Burnham, Christa; Watts, Lori; Clifford, Kathleen; Zuckerman, Dan S; Beck, Thomas

2014-03-01

The 2015 Commission on Cancer standards require that cancer survivors receive an individualized survivorship care plan (SCP). To meet this new standard, St Luke's Mountain States Tumor Institute (MSTI), with support from the National Community Cancer Centers Program, implemented a successful survivorship model. At MSTI, the patient's SCP is prepared in the electronic health record by a registered health information technician. This document is reviewed during an appointment with a nurse practitioner and social worker. The provider's dictation is mailed to the primary care physician with the SCP. From August 2011 to Oct 2012, 118 patients with breast cancer were seen for survivorship appointments. Medical record audit and follow-up telephone call were completed to evaluate patient survivorship needs and satisfaction with the appointment. Patient accounts were reviewed for reimbursement. From medical record review, the most common patient concerns were weight management (35%), fatigue (30%), sexuality (27%), anxiety (23%), caregiver stress (17%), and depression (16%). Telephone calls showed high patient satisfaction and understanding. Patients rated the following statements on a Likert scale from 1 (strongly disagree) to 5 (strongly agree): I understand my treatment summary and care plan (88% strongly agree or agree), and I feel the survivorship visit met my survivorship needs (86% strongly agree or agree). At 1 month, 80% of participants were still working on wellness goals. Patient accounts analysis showed revenue covered costs. Survivorship care at MSTI meets new standards, allows for patient engagement and satisfaction, and improves care coordination. Costs are covered by reimbursement.

The use of remote presence for health care delivery in a northern Inuit community: a feasibility study

PubMed Central

Mendez, Ivar; Jong, Michael; Keays-White, Debra; Turner, Gail

2013-01-01

Objective To evaluate the feasibility of remote presence for improving the health of residents in a remote northern Inuit community. Study design A pilot study assessed patient's, nurse's and physician's satisfaction with and the use of the remote presence technology aiding delivery of health care to a remote community. A preliminary cost analysis of this technology was also performed. Methods This study deployed a remote presence RP-7 robot to the isolated Inuit community of Nain, Newfoundland and Labrador for 15 months. The RP-7 is wirelessly controlled by a laptop computer equipped with audiovisual capability and a joystick to maneuver the robot in real time to aid in the assessing and care of patients from a distant location. Qualitative data on physician's, patient's, caregiver's and staff's satisfaction were collected as well as information on its use and characteristics and the number of air transports required to the referral center and associated costs. Results A total of 252 remote presence sessions occurred during the study period, with 89% of the sessions involving direct patient assessment or monitoring. Air transport was required in only 40% of the cases that would have been otherwise transported normally. Patients and their caregivers, nurses and physicians all expressed a high level of satisfaction with the remote presence technology and deemed it beneficial for improved patient care, workloads and job satisfaction. Conclusions These results show the feasibility of deploying a remote presence robot in a distant northern community and a high degree of satisfaction with the technology. Remote presence in the Canadian North has potential for delivering a cost-effective health care solution to underserviced communities reducing the need for the transport of patients and caregivers to distant referral centers. PMID:23984292

The use of remote presence for health care delivery in a northern Inuit community: a feasibility study.

PubMed

Mendez, Ivar; Jong, Michael; Keays-White, Debra; Turner, Gail

2013-01-01

To evaluate the feasibility of remote presence for improving the health of residents in a remote northern Inuit community. A pilot study assessed patient's, nurse's and physician's satisfaction with and the use of the remote presence technology aiding delivery of health care to a remote community. A preliminary cost analysis of this technology was also performed. This study deployed a remote presence RP-7 robot to the isolated Inuit community of Nain, Newfoundland and Labrador for 15 months. The RP-7 is wirelessly controlled by a laptop computer equipped with audiovisual capability and a joystick to maneuver the robot in real time to aid in the assessing and care of patients from a distant location. Qualitative data on physician's, patient's, caregiver's and staff's satisfaction were collected as well as information on its use and characteristics and the number of air transports required to the referral center and associated costs. A total of 252 remote presence sessions occurred during the study period, with 89% of the sessions involving direct patient assessment or monitoring. Air transport was required in only 40% of the cases that would have been otherwise transported normally. Patients and their caregivers, nurses and physicians all expressed a high level of satisfaction with the remote presence technology and deemed it beneficial for improved patient care, workloads and job satisfaction. These results show the feasibility of deploying a remote presence robot in a distant northern community and a high degree of satisfaction with the technology. Remote presence in the Canadian North has potential for delivering a cost-effective health care solution to underserviced communities reducing the need for the transport of patients and caregivers to distant referral centers.

The Psychiatric Patient as a Health Resource Consumer: Costs Associated with Electroconvulsive Therapy

PubMed Central

Selva-Sevilla, Carmen; Gonzalez-Moral, Maria Luisa; Tolosa-Perez, Maria Teresa

2016-01-01

Background: Clinical practice protocols should consider both the psychological criteria related to a patient’s satisfaction as a consumer of health services and the economic criteria to allocate resources efficiently. An electroconvulsive therapy (ECT) program was implemented in our hospital to treat psychiatric patients. The main objective of this study was to determine the cost associated with the ECT sessions implemented in our hospital between 2008 and 2014. A secondary objective was to calculate the cost of sessions that were considered ineffective, defined as those sessions in which electrical convulsion did not reach the preset threshold duration, in order to identify possible ways of saving money and improving satisfaction among psychiatric patients receiving ECT. Methods: A descriptive analysis of the direct health costs related to ECT from the perspective of the public health system between 2008 and 2014 was performed using a retrospective chart review. All of the costs are in euros (2011) and were discounted at a rate of 3%. Based on the base case, a sensitivity analysis of the changes of those variables showing the greatest uncertainty was performed. Results: Seventy-six patients received 853 sessions of ECT. The cumulative cost of these sessions was €1409528.63, and 92.9% of this cost corresponded to the hospital stay. A total of €420732.57 (29.8%) was inefficiently spent on 269 ineffective sessions. A sensitivity analysis of the economic data showed stable results to changes in the variables of uncertainty. Conclusion: The efficiency of ECT in the context outlined here could be increased by discerning a way to shorten the associated hospital stay and by reducing the number of ineffective sessions performed. PMID:27303347

The Psychiatric Patient as a Health Resource Consumer: Costs Associated with Electroconvulsive Therapy.

PubMed

Selva-Sevilla, Carmen; Gonzalez-Moral, Maria Luisa; Tolosa-Perez, Maria Teresa

2016-01-01

Clinical practice protocols should consider both the psychological criteria related to a patient's satisfaction as a consumer of health services and the economic criteria to allocate resources efficiently. An electroconvulsive therapy (ECT) program was implemented in our hospital to treat psychiatric patients. The main objective of this study was to determine the cost associated with the ECT sessions implemented in our hospital between 2008 and 2014. A secondary objective was to calculate the cost of sessions that were considered ineffective, defined as those sessions in which electrical convulsion did not reach the preset threshold duration, in order to identify possible ways of saving money and improving satisfaction among psychiatric patients receiving ECT. A descriptive analysis of the direct health costs related to ECT from the perspective of the public health system between 2008 and 2014 was performed using a retrospective chart review. All of the costs are in euros (2011) and were discounted at a rate of 3%. Based on the base case, a sensitivity analysis of the changes of those variables showing the greatest uncertainty was performed. Seventy-six patients received 853 sessions of ECT. The cumulative cost of these sessions was €1409528.63, and 92.9% of this cost corresponded to the hospital stay. A total of €420732.57 (29.8%) was inefficiently spent on 269 ineffective sessions. A sensitivity analysis of the economic data showed stable results to changes in the variables of uncertainty. The efficiency of ECT in the context outlined here could be increased by discerning a way to shorten the associated hospital stay and by reducing the number of ineffective sessions performed.

Job Satisfaction of Certified Nurse Midwives: An Examination

ERIC Educational Resources Information Center

Hampton, Gerald M.; Peterson, Robin T.

2012-01-01

Health care providers face pressure to reduce costs and enhance patient satisfaction. One approach is to employ primary care providers such as nurse practitioners, physician assistants, and certified nurse midwives. Since there is a positive relationship between job satisfaction and patient satisfaction, positive job satisfaction on the part of…

Implementation of medical scribes in an academic urology practice: an analysis of productivity, revenue, and satisfaction.

PubMed

McCormick, Benjamin J; Deal, Allison; Borawski, Kristy M; Raynor, Mathew C; Viprakasit, Davis; Wallen, Eric M; Woods, Michael E; Pruthi, Raj S

2018-04-10

Pressure on physicians to increase productivity is rising in parallel with administrative tasks, regulations, and the use of electronic health records (EHRs). Physician extenders and clinical pathways are already in use to increase productivity and reduce costs and burnout, but other strategies are required. We evaluated whether implementation of medical scribes in an academic urology clinic would affect productivity, revenue, and patient/provider satisfaction. Six academic urologists were assigned scribes for 1 clinic day per week for 3 months. Likert-type patient and provider surveys were developed to evaluate satisfaction with and without scribes. Matched clinic days in the year prior were used to evaluate changes in productivity and physician/hospital charges and revenue. After using scribes for 3 months, providers reported increased efficiency (p value = 0.03) and work satisfaction (p value = 0.03), while seeing a mean 2.15 more patients per session (+ 0.96 return visits, + 0.99 new patients, and + 0.22 procedures), contributing to an additional 2.6 wRVUs, $542 in physician charges, and $861 in hospital charges per clinic session. At a gross collection rate of 36%, actual combined revenue was + $506/session, representing a 26% increase in overall revenue. At a cost of $77/session, the net financial impact was + $429 per clinic session, resulting in a return-to-investment ratio greater than 6:1, while having no effect on patient satisfaction scores. Additionally, with scribes, clinic encounters were closed a mean 8.9 days earlier. Implementing medical scribes in academic urology practices may be useful in increasing productivity, revenue, and provider satisfaction, while maintaining high patient satisfaction.

Health impact and economic analysis of NGO-supported neurosurgery in Bolivia.

PubMed

Ament, Jared D; Greene, Kevin R; Flores, Ivan; Capobianco, Fernando; Salas, Gueider; Uriona, Maria Ines; Weaver, John P; Moser, Richard

2014-04-01

Bolivia, one of the poorest countries in the world, ranks 108th on the 2013 Human Development Index. With approximately 1 neurosurgeon per 200,000 people, access to neurosurgery in Bolivia is a growing health concern. Furthermore, neurosurgery in nonindustrialized countries has been considered both cost-prohibitive and lacking in outcomes evaluation. A non-governmental organization (NGO) supports spinal procedures in Bolivia (Solidarity Bridge), and the authors sought to determine its impact and cost-effectiveness. In a retrospective review of prospectively collected data, 19 patients were identified prior to spinal instrumentation and followed over 12 months. For inclusion, patients required interviewing prior to surgery and during at least 2 follow-up visits. All causes of spinal pathology were included. Sixteen patients met inclusion criteria and were therefore part of the analysis. Outcomes measured included assessment of activities of daily living, pain, ambulation, return to work/school, and satisfaction. Cost-effectiveness was determined by cost-utility analysis. Utilities were derived using the Health Utilities Index. Complications were incorporated into an expected value decision tree. Median (± SD) preoperative satisfaction was 2.0 ± 0.3 (on a scale of 0-10), while 6-month postoperative satisfaction was 7 ± 1.4 (p < 0.0001). Ambulation, pain, and emotional disability data suggested marked improvement (56%, 69%, and 63%, respectively; p = 0.035, 0.003, and 0.006). Total discounted incremental quality-adjusted life year (QALY) gain was 0.771. The total discounted cost equaled $9036 (95% CI $8561-$10,740) at 2 years. Computing the incremental cost-effectiveness ratio resulted in a value of $11,720/QALY, ranging from $9220 to $15,473/QALY in a univariate sensitivity analysis. This NGO-supported spinal instrumentation program in Bolivia appears to be cost-effective, especially when compared with the conventional $50,000/QALY benchmark and the WHO endorsed country-specific threshold of $16,026/QALY. However, with a gross domestic product per capita in Bolivia equaling $4800 per year and 30.3% of the population living on less than $2 per day, this cost continues to appear unrealistic. Additionally, the study has several significant limitations, namely its limited sample size, follow-up period, the assumption that patients not receiving surgical intervention would not make any clinical improvement, the reliance on the NGO for patient selection and sustainable practices such as follow-up care and ancillary services, and the lack of a randomized prospective design. These limitations, as well as an unclear understanding of Bolivian willingness-to-pay data, affect the generalizability of the study findings and impede widespread economic policy reform. Because cost-effectiveness research may inevitably direct care decisions and prove that an effort such as this can be cost saving, a prospective, properly controlled investigation is now warranted.

Prospective study of cost of care at multidisciplinary ALS centers adhering to American Academy of Neurology (AAN) ALS practice parameters.

PubMed

Boylan, Kevin; Levine, Todd; Lomen-Hoerth, Catherine; Lyon, Mary; Maginnis, Kimberly; Callas, Peter; Gaspari, Celeste; Tandan, Rup

2015-01-01

Multidisciplinary care in ALS is associated with longer survival, improved quality of life, and reduced hospital admissions, but there are no published data on institutional costs associated with multidisciplinary ALS care at U.S. centers. We prospectively examined institutional costs, adherence to AAN Practice Parameters and patient satisfaction in multidisciplinary ALS clinics at 18 U.S. ALS centers. Centers reported patient volumes; direct costs for staff salary/benefits, supplies and equipment; and institutional non-salary and overhead costs over a three-month period. In 1117 patients seen during this period, mean age was 61.5 years (range 25-91 years), 56% were male, and mean ALSFRS-R score was 29. Mean total salary/benefit cost per clinic day for all providers was $2964 (range $1692-$5236 across centers). Mean salary/benefit cost per patient per clinic was $507 (range $258-$806 across centers). Differences among centers in reporting non-salary costs prevented meaningful analysis. Practice parameter adherence and patient satisfaction were high. This prospective collaborative study demonstrates the direct financial burden of evidence-based multidisciplinary ALS care in the U.S.; more refined non-salary and overhead cost data are needed to evaluate the full cost impact of care. These data may be useful in supporting evidence-based models of patient centered care for ALS.

Breakeven, cost benefit, cost effectiveness, and willingness to pay for web-based versus face-to-face education delivery for health professionals.

PubMed

Maloney, Stephen; Haas, Romi; Keating, Jenny L; Molloy, Elizabeth; Jolly, Brian; Sims, Jane; Morgan, Prue; Haines, Terry

2012-04-02

The introduction of Web-based education and open universities has seen an increase in access to professional development within the health professional education marketplace. Economic efficiencies of Web-based education and traditional face-to-face educational approaches have not been compared under randomized controlled trial conditions. To compare costs and effects of Web-based and face-to-face short courses in falls prevention education for health professionals. We designed two short courses to improve the clinical performance of health professionals in exercise prescription for falls prevention. One was developed for delivery in face-to-face mode and the other for online learning. Data were collected on learning outcomes including participation, satisfaction, knowledge acquisition, and change in practice, and combined with costs, savings, and benefits, to enable a break-even analysis from the perspective of the provider, cost-effectiveness analysis from the perspective of the health service, and cost-benefit analysis from the perspective of the participant. Face-to-face and Web-based delivery modalities produced comparable outcomes for participation, satisfaction, knowledge acquisition, and change in practice. Break-even analysis identified the Web-based educational approach to be robustly superior to face-to-face education, requiring a lower number of enrollments for the program to reach its break-even point. Cost-effectiveness analyses from the perspective of the health service and cost-benefit analysis from the perspective of the participant favored face-to-face education, although the outcomes were contingent on the sensitivity analysis applied (eg, the fee structure used). The Web-based educational approach was clearly more efficient from the perspective of the education provider. In the presence of relatively equivocal results for comparisons from other stakeholder perspectives, it is likely that providers would prefer to deliver education via a Web-based medium. Australian New Zealand Clinical Trials Registry (ACTRN): 12610000135011; http://www.anzctr.org.au/trial_view.aspx?id=335135 (Archived by WebCite at http://www.webcitation.org/668POww4L).

Breakeven, Cost Benefit, Cost Effectiveness, and Willingness to Pay for Web-Based Versus Face-to-Face Education Delivery for Health Professionals

PubMed Central

Haas, Romi; Keating, Jenny L; Molloy, Elizabeth; Jolly, Brian; Sims, Jane; Morgan, Prue; Haines, Terry

2012-01-01

Background The introduction of Web-based education and open universities has seen an increase in access to professional development within the health professional education marketplace. Economic efficiencies of Web-based education and traditional face-to-face educational approaches have not been compared under randomized controlled trial conditions. Objective To compare costs and effects of Web-based and face-to-face short courses in falls prevention education for health professionals. Methods We designed two short courses to improve the clinical performance of health professionals in exercise prescription for falls prevention. One was developed for delivery in face-to-face mode and the other for online learning. Data were collected on learning outcomes including participation, satisfaction, knowledge acquisition, and change in practice, and combined with costs, savings, and benefits, to enable a break-even analysis from the perspective of the provider, cost-effectiveness analysis from the perspective of the health service, and cost-benefit analysis from the perspective of the participant. Results Face-to-face and Web-based delivery modalities produced comparable outcomes for participation, satisfaction, knowledge acquisition, and change in practice. Break-even analysis identified the Web-based educational approach to be robustly superior to face-to-face education, requiring a lower number of enrollments for the program to reach its break-even point. Cost-effectiveness analyses from the perspective of the health service and cost-benefit analysis from the perspective of the participant favored face-to-face education, although the outcomes were contingent on the sensitivity analysis applied (eg, the fee structure used). Conclusions The Web-based educational approach was clearly more efficient from the perspective of the education provider. In the presence of relatively equivocal results for comparisons from other stakeholder perspectives, it is likely that providers would prefer to deliver education via a Web-based medium. Trial Registration Australian New Zealand Clinical Trials Registry (ACTRN): 12610000135011; http://www.anzctr.org.au/trial_view.aspx?id=335135 (Archived by WebCite at http://www.webcitation.org/668POww4L) PMID:22469659

Improving Consumer Satisfaction with Addiction Treatment: An Analysis of Alumni Preferences.

PubMed

Sanghani, Ruchi M; Moler, Alexander K

2015-01-01

Objective. The primary objective of this investigation is to determine which individual and aggregate factors of residential addiction treatment centers are most significant influencers of alumni satisfaction. Design. Survey targeted alumni of residential addiction treatment facilities. Alumni were queried through a survey, which utilized Likert-scale matrices and binary response options: 379 respondents met the completion threshold. Alumni rated amenities and individual and group counseling factors; additionally, respondents provided feedback on two satisfaction proxies: cost worthiness and future recommendations. Descriptive and relational analyses were conducted, with the latter utilizing logistic regression models. Results. Individual factors' scores of group counseling, and overall aggregate group counseling score, are most enthusiastically positive. Group counseling is also the most significant influencer of satisfaction. Other significant influencers of satisfaction are met expectations for individual counseling and psychiatric care offerings. Conclusions. While individual counseling and facility amenities should not be ignored, group counseling may be the most significant influencer of alumni satisfaction. Long-term outcomes are not single-faceted; however, treatment providers should be encouraged to invest in high-quality group counseling offerings in order to best satisfy, and thereby empower, clients.

Improving Consumer Satisfaction with Addiction Treatment: An Analysis of Alumni Preferences

PubMed Central

Sanghani, Ruchi M.; Moler, Alexander K.

2015-01-01

Objective. The primary objective of this investigation is to determine which individual and aggregate factors of residential addiction treatment centers are most significant influencers of alumni satisfaction. Design. Survey targeted alumni of residential addiction treatment facilities. Alumni were queried through a survey, which utilized Likert-scale matrices and binary response options: 379 respondents met the completion threshold. Alumni rated amenities and individual and group counseling factors; additionally, respondents provided feedback on two satisfaction proxies: cost worthiness and future recommendations. Descriptive and relational analyses were conducted, with the latter utilizing logistic regression models. Results. Individual factors' scores of group counseling, and overall aggregate group counseling score, are most enthusiastically positive. Group counseling is also the most significant influencer of satisfaction. Other significant influencers of satisfaction are met expectations for individual counseling and psychiatric care offerings. Conclusions. While individual counseling and facility amenities should not be ignored, group counseling may be the most significant influencer of alumni satisfaction. Long-term outcomes are not single-faceted; however, treatment providers should be encouraged to invest in high-quality group counseling offerings in order to best satisfy, and thereby empower, clients. PMID:26483986

A Generalizable Methodology for Quantifying User Satisfaction

NASA Astrophysics Data System (ADS)

Huang, Te-Yuan; Chen, Kuan-Ta; Huang, Polly; Lei, Chin-Laung

Quantifying user satisfaction is essential, because the results can help service providers deliver better services. In this work, we propose a generalizable methodology, based on survival analysis, to quantify user satisfaction in terms of session times, i. e., the length of time users stay with an application. Unlike subjective human surveys, our methodology is based solely on passive measurement, which is more cost-efficient and better able to capture subconscious reactions. Furthermore, by using session times, rather than a specific performance indicator, such as the level of distortion of voice signals, the effects of other factors like loudness and sidetone, can also be captured by the developed models. Like survival analysis, our methodology is characterized by low complexity and a simple model-developing process. The feasibility of our methodology is demonstrated through case studies of ShenZhou Online, a commercial MMORPG in Taiwan, and the most prevalent VoIP application in the world, namely Skype. Through the model development process, we can also identify the most significant performance factors and their impacts on user satisfaction and discuss how they can be exploited to improve user experience and optimize resource allocation.

Financial analysis for the infusion alliance.

PubMed

Perucca, Roxanne

2010-01-01

Providing high-quality, cost-efficient care is a major strategic initiative of every health care organization. Today's health care environment is transparent; very competitive; and focused upon providing exceptional service, safety, and quality. Establishing an infusion alliance facilitates the achievement of organizational strategic initiatives, that is, increases patient throughput, decreases length of stay, prevents the occurrence of infusion-related complications, enhances customer satisfaction, and provides greater cost-efficiency. This article will discuss how to develop a financial analysis that promotes value and enhances the financial outcomes of an infusion alliance.

Pavement Smoothness and Fuel Efficiency: An Analysis of the Economic Dimensions of the Missouri Smooth Roads Initiative.

DOT National Transportation Integrated Search

2006-11-01

Its widely accepted that smooth roads provide greater driver comfort and satisfaction, decreased vehicle maintenance costs, and better fuel economy. Now thanks to a recently completed study, the affect of pavement smoothness on fuel efficiency has...

Comparison of minimally invasive parathyroidectomy under local anaesthesia and minimally invasive video-assisted parathyroidectomy for primary hyperparathyroidism: a cost analysis

PubMed Central

MELFA, G.I.; RASPANTI, C.; ATTARD, M.; COCORULLO, G.; ATTARD, A.; MAZZOLA, S.; SALAMONE, G.; GULOTTA, G.; SCERRINO, G.

2016-01-01

Background Primary hyperparathyroidism (PHPT) origins from a solitary adenoma in 70–95% of cases. Moreover, the advances in methods for localizing an abnormal parathyroid gland made minimally invasive techniques more prominent. This study presents a micro-cost analysis of two parathyroidectomy techniques. Patients and methods 72 consecutive patients who underwent minimally invasive parathyroidectomy, video-assisted (MIVAP, group A, 52 patients) or “open” under local anaesthesia (OMIP, group B, 20 patients) for PHPT were reviewed. Operating room, consumable, anaesthesia, maintenance costs, equipment depreciation and surgeons/anaesthesiologists fees were evaluated. The patient’s satisfaction and the rate of conversion to conventional parathyroidectomy were investigated. T-Student’s, Kolmogorov-Smirnov tests and Odds Ratio were used for statistical analysis. Results 1 patient of the group A and 2 of the group B were excluded from the cost analysis because of the conversion to the conventional technique. Concerning the remnant patients, the overall average costs were: for Operative Room, 1186,69 € for the MIVAP group (51 patients) and 836,11 € for the OMIP group (p<0,001); for the Team, 122,93 € (group A) and 90,02 € (group B) (p<0,001); the other operative costs were 1388,32 € (group A) and 928,23 € (group B) (p<0,001). The patient’s satisfaction was very strongly in favour of the group B (Odds Ratio 20,5 with a 95% confidence interval). Conclusions MIVAP is more expensive compared to the “open” parathyroidectomy under local anaesthesia due to the costs of general anaesthesia and the longer operative time. Moreover, the patients generally prefer the local anaesthesia. Nevertheless, the rate of conversion to the conventional parathyroidectomy was relevant in the group of the local anaesthesia compared to the MIVAP, since the latter allows a four-gland exploration. PMID:27381690

Role of sexual self-disclosure in the sexual satisfaction of long-term heterosexual couples.

PubMed

MacNeil, Sheila; Byers, E Sandra

2009-01-01

This study examined two proposed pathways between sexual self-disclosure (SSD) and sexual satisfaction in a sample of 104 heterosexual couples in long-term relationships. According to the proposed instrumental pathway, disclosure of sexual preferences increases a partner's understanding of those preferences resulting in a sexual script that is more rewarding and less costly. A more favorable balance of sexual rewards to sexual costs, in turn, results in greater sexual satisfaction for the disclosing individual. According to the proposed expressive pathway, mutual self-disclosure contributes to relationship satisfaction, which in turn leads to greater sexual satisfaction. Support was found for the instrumental pathway for both men and women. Support also was found for an expressive pathway between own SSD and partner nonsexual self-disclosure (NSD) and men's sexual satisfaction, and between own NSD and women's sexual satisfaction. These results are interpreted in terms of mechanisms for establishing and maintaining sexual satisfaction in long-term relationships in men and women.

[Cost-consequence analysis of respiratory preventive intervention among institutionalized older people: randomized controlled trial].

PubMed

Cebrià I Iranzo, Maria Dels Àngels; Tortosa-Chuliá, M Ángeles; Igual-Camacho, Celedonia; Sancho, Patricia; Galiana, Laura; Tomás, José Manuel

2014-01-01

The institutionalized elderly with functional impairment show a greater decline in respiratory muscle (RM) function. The aims of the study are to evaluate outcomes and costs of RM training using Pranayama in institutionalized elderly people with functional impairment. A randomized controlled trial was conducted on institutionalized elderly people with walking limitation (n=54). The intervention consisted of 6 weeks of Pranayama RM training (5 times/week). The outcomes were measured at 4 time points, and were related to RM function: the maximum respiratory pressures and the maximum voluntary ventilation. Perceived satisfaction in the experimental group (EG) was assessed by means of an ad hoc questionnaire. Direct and indirect costs were estimated from the social perspective. The GE showed a significant improvement related with strength (maximum respiratory pressures) and endurance (maximum voluntary ventilation) of RM. Moreover, 92% of the EG reported a high satisfaction. The total social costs, direct and indirect, amounted to Euro 21,678. This evaluation reveals that RM function improvement is significant, that intervention is well tolerated and appreciated by patients, and the intervention costs are moderate. Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.

Health economic studies: an introduction to cost-benefit, cost-effectiveness, and cost-utility analyses.

PubMed

Angevine, Peter D; Berven, Sigurd

2014-10-15

Narrative overview. To provide clinicians with a basic understanding of economic studies, including cost-benefit, cost-effectiveness, and cost-utility analyses. As decisions regarding public health policy, insurance reimbursement, and patient care incorporate factors other than traditional outcomes such as satisfaction or symptom resolution, health economic studies are increasingly prominent in the literature. This trend will likely continue, and it is therefore important for clinicians to have a fundamental understanding of the common types of economic studies and be able to read them critically. In this brief article, the basic concepts of economic studies and the differences between cost-benefit, cost-effectiveness, and cost-utility studies are discussed. An overview of the field of health economic analysis is presented. Cost-benefit, cost-effectiveness, and cost-utility studies all integrate cost and outcome data into a decision analysis model. These different types of studies are distinguished mainly by the way in which outcomes are valued. Obtaining accurate cost data is often difficult and can limit the generalizability of a study. With a basic understanding of health economic analysis, clinicians can be informed consumers of these important studies.

Computerized test versus personal interview as admission methods for graduate nursing studies: A retrospective cohort study.

PubMed

Hazut, Koren; Romem, Pnina; Malkin, Smadar; Livshiz-Riven, Ilana

2016-12-01

The purpose of this study was to compare the predictive validity, economic efficiency, and faculty staff satisfaction of a computerized test versus a personal interview as admission methods for graduate nursing studies. A mixed method study was designed, including cross-sectional and retrospective cohorts, interviews, and cost analysis. One hundred and thirty-four students in the Master of Nursing program participated. The success of students in required core courses was similar in both admission method groups. The personal interview method was found to be a significant predictor of success, with cognitive variables the only significant contributors to the model. Higher satisfaction levels were reported with the computerized test compared with the personal interview method. The cost of the personal interview method, in annual hourly work, was 2.28 times higher than the computerized test. These findings may promote discussion regarding the cost benefit of the personal interview as an admission method for advanced academic studies in healthcare professions. © 2016 John Wiley & Sons Australia, Ltd.

Comprehensive Survivorship Care With Cost and Revenue Analysis

PubMed Central

Rosales, Alicia R.; Byrne, Dia; Burnham, Christa; Watts, Lori; Clifford, Kathleen; Zuckerman, Dan S.; Beck, Thomas

2014-01-01

Purpose: The 2015 Commission on Cancer standards require that cancer survivors receive an individualized survivorship care plan (SCP). To meet this new standard, St Luke's Mountain States Tumor Institute (MSTI), with support from the National Community Cancer Centers Program, implemented a successful survivorship model. Patients and Methods: At MSTI, the patient's SCP is prepared in the electronic health record by a registered health information technician. This document is reviewed during an appointment with a nurse practitioner and social worker. The provider's dictation is mailed to the primary care physician with the SCP. From August 2011 to Oct 2012, 118 patients with breast cancer were seen for survivorship appointments. Medical record audit and follow-up telephone call were completed to evaluate patient survivorship needs and satisfaction with the appointment. Patient accounts were reviewed for reimbursement. Results: From medical record review, the most common patient concerns were weight management (35%), fatigue (30%), sexuality (27%), anxiety (23%), caregiver stress (17%), and depression (16%). Telephone calls showed high patient satisfaction and understanding. Patients rated the following statements on a Likert scale from 1 (strongly disagree) to 5 (strongly agree): I understand my treatment summary and care plan (88% strongly agree or agree), and I feel the survivorship visit met my survivorship needs (86% strongly agree or agree). At 1 month, 80% of participants were still working on wellness goals. Patient accounts analysis showed revenue covered costs. Conclusion: Survivorship care at MSTI meets new standards, allows for patient engagement and satisfaction, and improves care coordination. Costs are covered by reimbursement. PMID:24065401

Sauti Za Wananchi "voice of the people": patient satisfaction on the medical wards at a Kenyan Referral Hospital.

PubMed

Stone, Geren Starr; Jerotich, Tecla Sum; Cheriro, Betsy Rono; Kiptoo, Robert Sitienei; Crowe, Susie Joanne; Koros, Elijah Kipkorir; Muthoni, Doreen Mutegi; Onalo, Paul Theodore

2014-01-01

Patient satisfaction is one indicator of healthcare quality. Few studies have examined the inpatient experiences in resource-scarce environments in sub-Saharan Africa. To examine patient satisfaction on the public medical wards at a Kenyan referral hospital, we performed a cross-sectional survey focused on patients' satisfaction with medical information and their relationship with staffing and hospital routine. Ratings of communication with providers, efforts to protect privacy, information about costs, food, and hospital environment were also elicited. Overall, the average patient satisfaction rating was 64.7, nearly midway between "average" and "good" Higher rated satisfaction was associated with higher self-rated general health scores and self-rated health gains during the hospitalization (p=0.023 and p=0.001). Women who shared a hospital bed found privacy to be "below average" to "poor" Most men (72.7%) felt information about costs was insufficient. Patients rated food and environmental quality favorably while also frequently suggesting these areas could be improved. Overall, patients expressed satisfaction with the care provided. These ratings may reflect modest patients' expectations as well as acceptable circumstances and performance. Women expressed concern about privacy while men expressed a desire for more information on costs. Inconsistencies were noted between patient ratings and free response answers.

Job Satisfaction of Home Health Satisfaction Workers in the Environment of Cost Containment

ERIC Educational Resources Information Center

Egan, Marcia; Kadushin, Goldie

2004-01-01

This national survey examined the job satisfaction of 228 home health social workers in the restrictive reimbursement environment of the Medicare interim payment system. Administrators' helpfulness in resolving ethical conflicts between patient access to services and agency financial priorities contributed significantly to greater satisfaction in…

Strategic Analysis Overview

NASA Technical Reports Server (NTRS)

Cirillo, William M.; Earle, Kevin D.; Goodliff, Kandyce E.; Reeves, J. D.; Stromgren, Chel; Andraschko, Mark R.; Merrill, R. Gabe

2008-01-01

NASA s Constellation Program employs a strategic analysis methodology in providing an integrated analysis capability of Lunar exploration scenarios and to support strategic decision-making regarding those scenarios. The strategic analysis methodology integrates the assessment of the major contributors to strategic objective satisfaction performance, affordability, and risk and captures the linkages and feedbacks between all three components. Strategic analysis supports strategic decision making by senior management through comparable analysis of alternative strategies, provision of a consistent set of high level value metrics, and the enabling of cost-benefit analysis. The tools developed to implement the strategic analysis methodology are not element design and sizing tools. Rather, these models evaluate strategic performance using predefined elements, imported into a library from expert-driven design/sizing tools or expert analysis. Specific components of the strategic analysis tool set include scenario definition, requirements generation, mission manifesting, scenario lifecycle costing, crew time analysis, objective satisfaction benefit, risk analysis, and probabilistic evaluation. Results from all components of strategic analysis are evaluated a set of pre-defined figures of merit (FOMs). These FOMs capture the high-level strategic characteristics of all scenarios and facilitate direct comparison of options. The strategic analysis methodology that is described in this paper has previously been applied to the Space Shuttle and International Space Station Programs and is now being used to support the development of the baseline Constellation Program lunar architecture. This paper will present an overview of the strategic analysis methodology and will present sample results from the application of the strategic analysis methodology to the Constellation Program lunar architecture.

Cross-sectional-derived determinants of satisfaction with physician-scientist training among Canadian MD/PhD graduates.

PubMed

Twa, David D W; Skinnider, Michael A; Squair, Jordan W; Lukac, Christine D

2017-01-01

Although MD/PhD programs require considerable commitment on behalf of students and learning institutions, they serve as an integral means of training future physician-scientists; individuals who engage in translational medicine. As attrition from these programs has longstanding effects on the community of translational medicine and comes at substantial cost to MD/PhD programs, we aimed to identify determinants that were associated with satisfaction among MD/PhD graduates, a feature that might inform on limiting program attrition. Anonymized data from a national survey of 139 Canadian MD/PhD alumni was analyzed. Factor analysis was conducted to evaluate the reliability of three questions that measured satisfaction and logistic regression was used to assess the association of outcomes with 17 independent determinants. Eighty-one percent of graduates were satisfied with MD/PhD training. Factor analysis confirmed the reliability of the questions measuring satisfaction. Determinants of self-reported satisfaction with physician-scientist training included co-authorship of more than six manuscripts during MD/PhD training. Additionally, protected research time at the place of current appointment was strongly associated with agreement that MD/PhD training had helped career progression. Demographic variables were not associated with any satisfaction indicator. Taken together, the majority of Canadian MD/PhD graduates are satisfied with their physician-scientist training. Project collaboration leading to co-authorships and protected research time were strongly associated with training satisfaction among graduates. If the value of collaboration can be realized among current and future physician-scientist trainees who are dissatisfied with their training, this might ultimately reduce program attrition.

77 FR 66182 - TRICARE Over-the-Counter Drug Demonstration Project

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-02

... costs/benefits and beneficiary satisfaction of providing OTC drugs under the pharmacy benefits program... (TPharm) which was on November 4, 2009. In order to more thoroughly evaluate the clinical and cost effectiveness of OTC drugs as well as beneficiary satisfaction with the project, the Department published a...

[Profitability of a day hospital: analysis of activity, cost and effectiveness].

PubMed

Hernando Ortiz, Lili; Hinojosa Mena-Bernal, Carmen; González Sarmiento, Enrique; González Guilabert, Isabel; Arana Ruiz, Jorge; Muñoz Moreno, M Fe

2012-01-01

Day hospitals are an alternative to conventional hospital care. We analyzed the functioning and profitability of the day hospital of Hospital Clínico de Valladolid, Spain, in 2009. Profitability is expressed as the provision of identical health coverage at a lower cost than that generated by conventional hospital care and with adequate quality indicators. We performed a retrospective, observational and descriptive study of the information obtained on each patient attended in the day hospital from January 1 to December 31, 2009. We studied four quality indicators: cancellation of meetings, the rate of transfusion reactions, the out-patient rate and the satisfaction index. The estimated savings for each process was calculated as the difference in the average cost of hospitalization minus the average cost of the process in the day hospital. The most frequent diseases were systemic and connective tissue diseases, accounting for 25.4% of the processes treated; of these, 17.1% corresponded to rheumatoid arthritis. Patient satisfaction was 93%. Meetings cancellations and the rate of transfusion reactions were 0%. The out-patient rate was 26%. Day hospital costs were 8.6% of conventional hospital costs, with savings of 78,390.69 euros. The day hospital is cost effective due to savings compared with conventional hospitalization and has a satisfactory quality index. Copyright © 2011 SESPAS. Published by Elsevier España, S.L. All rights reserved.

Arthroscopy for mechanical symptoms in osteoarthritis: a cost-effective procedure.

PubMed

Hutt, Jonathan R B; Craik, Johnathan; Phadnis, Joideep; Cobb, Andrew G

2015-12-01

The place of knee arthroscopy as a therapeutic option for osteoarthritis (OA) has been the subject of some debate. The hypothesis for this study was that arthroscopic debridement is beneficial in patients with OA who have significant mechanical symptoms. Forty-three patients with radiological OA on plain radiographs and mechanical symptoms were prospectively followed. No further imaging was obtained. They were assessed pre- and postoperatively with an Oxford Knee Score (OKS) and pain visual analogue score (VAS). Postoperative patient satisfaction was measured with a VAS. A cost-benefit analysis was performed using a transformed OKS to generate a quality-adjusted life year (QALY) measurement. At a mean of 1.5 years, seven patients (16 %) had undergone total knee arthroplasty at a mean of 8.2 months postarthroscopy. For the remaining 35 patients, there were significant improvements in pain (median 7-5, p < 0.05) and OKS (median 24-36.5, p < 0.05). Satisfaction was a median 6.2 for all patients. The mean calculated EQ-5D improved from 0.43 (SD 0.16) to 0.79 (SD 0.23), which gave a gain of 0.52 QALYs in the study period. This generated a cost per QALY of £2,088, well below the threshold of £30,000 quoted by the UK National Institute for Health and Care Excellence as demonstration of cost-effective treatment. This prospective study demonstrates that although not universally effective, arthroscopic debridement for patients with knee OA and mechanical symptoms can result in significant improvements in pain and function. The procedure gave good patient satisfaction, and even at an early follow-up period proves to be cost-effective. IV.

Perceived value in food selection when dining out: comparison of African Americans and Euro-Americans.

PubMed

Vinci, Debra M; Philipp, Steven F

2007-06-01

This descriptive study compares African Americans' and Euro-Americans' perceived value of food selection pertaining to cost, portion size, and meal satisfaction when eating away from home. A stratified sample was drawn from a southern U.S. metropolitan area (N= 1,011; 486 African American, 525 Euro-American). Analysis showed no difference between African-American and Euro-American adults by sex or how often they dined out. These two groups significantly differed across years of education, age, and answering 14 of 18 rated statements on value perceptions. African-Americans' value perceptions were influenced more by lower cost foods and larger portion sizes than those of Euro-Americans. For meal satisfaction, African Americans were more likely to agree with statements that indicate preferring foods high in energy and low in essential micronutrient density. This study supports the need for more investigation.

Cost-effectiveness of linaclotide compared to antidepressants in the treatment of irritable bowel syndrome with constipation in Scotland.

PubMed

Fisher, Mark; Walker, Andrew; Falqués, Meritxell; Moya, Miguel; Rance, Mark; Taylor, Douglas; Lindner, Leandro

2016-12-01

Presently, linaclotide is the only EMA-approved therapy indicated for the treatment of irritable bowel syndrome with constipation (IBS-C). This study sought to determine the cost-effectiveness of linaclotide compared to antidepressants for the treatment of adults with moderate to severe IBS-C who have previously received antispasmodics and/or laxatives. A Markov model was created to estimate costs and QALYs over a 5-year time horizon from the perspective of NHS Scotland. Health states were based on treatment satisfaction (satisfied, moderately satisfied, not satisfied) and mortality. Transition probabilities were based on satisfaction data from the linaclotide pivotal studies and Scottish general all-cause mortality statistics. Treatment costs were calculated from the British National Formulary. NHS resource use and disease-related costs for each health state were estimated from Scottish clinician interviews in combination with NHS Reference costs. Quality of life was based on EQ-5D data collected from the pivotal studies. Costs and QALYs were discounted at 3.5 % per annum. Uncertainty was explored through extensive deterministic and probabilistic sensitivity analyses. Over a 5-year time horizon, the additional costs and QALYs generated with linaclotide were £659 and 0.089, resulting in an incremental cost-effectiveness ratio of £7370 per QALY versus antidepressants. Based on the probabilistic sensitivity analysis, the likelihood that linaclotide was cost-effective at a willingness to pay of £20,000 per QALY was 73 %. Linaclotide can be a cost-effective treatment for adults with moderate-to-severe IBS-C who have previously received antispasmodics and/or laxatives in Scotland.

A research model of health-care competition and customer satisfaction.

PubMed

Asoh, Derek A; Rivers, Patrick A

2007-11-01

In all industries, competition among businesses has long been encouraged as a mechanism to increase value for customers. In other words, competition ensures the provision of better products and services to satisfy the needs of customers. Various perspectives of competition, the nature of service quality, health-care system costs and customer satisfaction in health care are examined. A model of the relationship among these variables is developed. The model depicts customer satisfaction as an outcome measure directly dependent on competition. Quality of care and health-care system costs, while also directly dependent on competition, are considered as determinants of customer satisfaction as well. The model is discussed in the light of propositions for empirical research.

2001 contract management survey.

PubMed

2001-10-01

For the second year running, hospitals are spending more on clinical outsourcing than on business services. The Eleventh Annual Contract Services Survey shows that, in clinical areas, executives use outsourcing to acquire specialized expertise with cost savings secondary. Reducing costs and FTEs are the primary reasons for outsourcing business operations. Business service contracts are more likely to meet expectations for cost savings. Overall, satisfaction levels are up, but in some areas there's still a lot of room for improvement. This report examines current trends in outsourcing, strategies for the future, satisfaction levels, the decisionmaking process, contract features, and costs.

Cost-effectiveness of a physician-nurse supplementary triage assessment team at an academic tertiary care emergency department.

PubMed

Cheng, Ivy; Castren, Maaret; Kiss, Alex; Zwarenstein, Merrick; Brommels, Mats; Mittmann, Nicole

2016-05-01

The purpose of this study was to evaluate the cost-effectiveness of physician-nurse supplementary triage assistance team (MDRNSTAT) from a hospital and patient perspective. This was a cost-effectiveness evaluation of a cluster randomized control trial comparing the MDRNSTAT with nurse-only triage in the emergency department (ED) between the hours of 0800 and 1500. Cost was MDRNSTAT salary. Revenue was from Ontario's Pay-for-Results and patient volume-case mix payment programs. The incremental cost-effectiveness ratio was based on MDRNSTAT cost and three consequence assessments: 1) per additional patient-seen; 2) per physician initial assessment (PIA) hour saved; and 3) per ED length of stay (EDLOS) hour saved. Patient opportunity cost was determined. Patient satisfaction was quantified by a cost-benefit ratio. A sensitivity analysis extrapolating MDRNSTAT to different working hours, salary, and willingness-to-pay data was performed. The added cost of the MDRNSTAT was $3,597.27 [$1,729.47 to ∞] per additional patient-seen, $75.37 [$67.99 to $105.30] per PIA hour saved, and $112.99 [$74.68 to $251.43] per EDLOS hour saved. From the hospital perspective, the cost-benefit ratio was 38.6 [19.0 to ∞] and net present value of -$447,996 [-$435,646 to -$459,900]. For patients, the cost-benefit ratio for satisfaction was 2.8 [2.3 to 4.6]. If MDRNSTAT performance were consistently implemented from noon to midnight, it would be more cost-effective. The MDRNSTAT is not a cost-effective daytime strategy but appears to be more feasible during time periods with higher patient volume, such as late morning to evening.

The Effect of Entrepreneurial Orientation on Teacher Satisfaction and Retention

ERIC Educational Resources Information Center

Thibault, Melissa Rihm

2016-01-01

Teacher turnover is a costly problem. Since teacher working conditions influence teacher's satisfaction and career intentions, managers may theoretically increase teacher satisfaction and retention by fostering a school environment supportive of the highly-trained professional. Entrepreneurial Orientation is an organizational construct correlated…

Preliminary development of an advanced modular pressure relief cushion: Testing and user evaluation.

PubMed

Freeto, Tyler; Mitchell, Steven J; Bogie, Kath M

2018-02-01

Effective pressure relief cushions are identified as a core assistive technology need by the World Health Organization Global Cooperation on Assistive Technology. High quality affordable wheelchair cushions could provide effective pressure relief for many individuals with limited access to advanced assistive technology. Value driven engineering (VdE) principles were employed to develop a prototype modular cushion. Low cost dynamically responsive gel balls were arranged in a close packed array and seated in bilayer foam for containment and support. Two modular cushions, one with high compliance balls and one with moderate compliance balls were compared with High Profile and Low Profile Roho ® and Jay ® Medical 2 cushions. ISO 16480-2 biomechanical standardized tests were applied to assess cushion performance. A preliminary materials cost analysis was carried out. A prototype modular cushion was evaluated by 12 participants who reported satisfaction using a questionnaire based on the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0) instrument. Overall the modular cushions performed better than, or on par with, the most widely prescribed commercially available cushions under ISO 16480-2 testing. Users rated the modular cushion highly for overall appearance, size and dimensions, comfort, safety, stability, ease of adjustment and general ease of use. Cost-analysis indicated that every modular cushion component a could be replaced several times and still maintain cost-efficacy over the complete cushion lifecycle. A VdE modular cushion has the potential provide effective pressure relief for many users at a low lifetime cost. Copyright © 2017. Published by Elsevier Ltd.

A Bayesian cost-effectiveness analysis of a telemedicine-based strategy for the management of sleep apnoea: a multicentre randomised controlled trial.

PubMed

Isetta, Valentina; Negrín, Miguel A; Monasterio, Carmen; Masa, Juan F; Feu, Nuria; Álvarez, Ainhoa; Campos-Rodriguez, Francisco; Ruiz, Concepción; Abad, Jorge; Vázquez-Polo, Francisco J; Farré, Ramon; Galdeano, Marina; Lloberes, Patricia; Embid, Cristina; de la Peña, Mónica; Puertas, Javier; Dalmases, Mireia; Salord, Neus; Corral, Jaime; Jurado, Bernabé; León, Carmen; Egea, Carlos; Muñoz, Aida; Parra, Olga; Cambrodi, Roser; Martel-Escobar, María; Arqué, Meritxell; Montserrat, Josep M

2015-11-01

Compliance with continuous positive airway pressure (CPAP) therapy is essential in patients with obstructive sleep apnoea (OSA), but adequate control is not always possible. This is clinically important because CPAP can reverse the morbidity and mortality associated with OSA. Telemedicine, with support provided via a web platform and video conferences, could represent a cost-effective alternative to standard care management. To assess the telemedicine impact on treatment compliance, cost-effectiveness and improvement in quality of life (QoL) when compared with traditional face-to-face follow-up. A randomised controlled trial was performed to compare a telemedicine-based CPAP follow-up strategy with standard face-to-face management. Consecutive OSA patients requiring CPAP treatment, with sufficient internet skills and who agreed to participate, were enrolled. They were followed-up at 1, 3 and 6 months and answered surveys about sleep, CPAP side effects and lifestyle. We compared CPAP compliance, cost-effectiveness and QoL between the beginning and the end of the study. A Bayesian cost-effectiveness analysis with non-informative priors was performed. We randomised 139 patients. At 6 months, we found similar levels of CPAP compliance, and improved daytime sleepiness, QoL, side effects and degree of satisfaction in both groups. Despite requiring more visits, the telemedicine group was more cost-effective: costs were lower and differences in effectiveness were not relevant. A telemedicine-based strategy for the follow-up of CPAP treatment in patients with OSA was as effective as standard hospital-based care in terms of CPAP compliance and symptom improvement, with comparable side effects and satisfaction rates. The telemedicine-based strategy had lower total costs due to savings on transport and less lost productivity (indirect costs). NCT01716676. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Health care cost implications of sildenafil citrate.

PubMed

Miner, Martin

2004-09-01

As prescription drug expenditures increase, third-party payors are increasingly scrutinizing costs and reimbursement guidelines, such as for medications that treat chronic conditions that are not necessarily directly life threatening (i.e., obesity, nicotine addiction, and erectile dysfunction). To review the costs and consequences of pharmacy benefit reimbursement policies related to erectile dysfunction therapies, using sildenafil citrate as the case study. Data and references were found through searches of PubMed and Google. To meet the varied health needs of a defined population under reasonable resource constraints requires analysis of cost and of the economic and non-economic consequences of a treatment. Based on analysis of sildenafil data, oral therapy of erectile dysfunction provides substantial cost savings when compared with other treatment options and contributes insignificant overall costs to health plans. Regardless, health plans impose controls to limit reimbursement. Because erectile dysfunction is often a precursor to other conditions, such limitations could compromise detection and management of underlying disease (e.g., depressive, cardiovascular, and urogenital). Reimbursement restrictions may also decrease membership satisfaction and re-enrollment rates.

Cost effectiveness analysis of intravenous ketorolac and morphine for treating pain after limb injury: double blind randomised controlled trial

PubMed Central

Rainer, Timothy H; Jacobs, Philip; Ng, Y C; Cheung, N K; Tam, Michael; Lam, Peggo K W; Wong, Robert; Cocks, Robert A

2000-01-01

Objectives To investigate the cost effectiveness of intravenous ketorolac compared with intravenous morphine in relieving pain after blunt limb injury in an accident and emergency department. Design Double blind, randomised, controlled study and cost consequences analysis. Setting Emergency department of a university hospital in the New Territories of Hong Kong. Participants 148 adult patients with painful isolated limb injuries (limb injuries without other injuries). Main outcome measures Primary outcome measure was a cost consequences analysis comparing the use of ketorolac with morphine; secondary outcome measures were pain relief at rest and with limb movement, adverse events, patients' satisfaction, and time spent in the emergency department. Results No difference was found in the median time taken to achieve pain relief at rest between the group receiving ketorolac and the group receiving morphine, but with movement the median reduction in pain score in the ketorolac group was 1.09 per hour (95% confidence interval 1.05 to 2.02) compared with 0.87 (0.84 to 1.06) in the morphine group (P=0.003). The odds of experiencing adverse events was 144.2 (41.5 to 501.6) times more likely with morphine than with ketorolac. The median time from the initial delivery of analgesia to the participant leaving the department was 20 (4.0 to 39.0) minutes shorter in the ketorolac group than in the morphine group (P=0.02). The mean cost per person was $HK44 (£4; $5.6) in the ketorolac group and $HK229 in the morphine group (P<0.0001). The median score for patients' satisfaction was 6.0 for ketorolac and 5.0 for morphine (P<0.0001). Conclusion Intravenous ketorolac is a more cost effective analgesic than intravenous morphine in the management of isolated limb injury in an emergency department in Hong Kong, and its use may be considered as the dominant strategy. PMID:11082083

Changing community health service delivery in economically less-developed rural areas in China: impact on service use and satisfaction

PubMed Central

Liu, Yong; Yuan, Zhaokang; Liu, Yuxi; Jayasinghe, Upali W; Harris, Mark F

2014-01-01

Objective To evaluate the impact of a model of rural community health service (CHS) on the use and acceptability of primary healthcare services. Design Quasi-experimental. Setting Two adjacent rural counties in China. Participants 5842 residents in 2009 and 3807 in 2010 from 980 households in 7 intervention townships and 49 villages; 2232 residents in 2009 and 2315 in 2010 from 628 households in 3 comparison townships and 9 villages. All residents were approached to participate, with no significant differences in age or sex between groups. Intervention Multilevel intervention in 2009 including training rural practitioners, encouraging clinic improvements, providing clinical guidelines, standards and subsidies. Data collection Surveys of community members from randomly sampled households in 2009 and 2010. Primary outcome measures Satisfaction with and utilisation of outpatient and public health services. Analysis Factor analysis confirmed two components of satisfaction. Univariate and multilevel analysis was used. Results Satisfaction scores for intervention county respondents increased from 21.4 (95% CI 21.1 to 21.7) to 22.1 (95% CI 21.7 to 22.4) with no change in comparison area. In multilevel analysis, satisfaction with patient-centred care was associated with chronic disease, shorter waiting times and county. Satisfaction with clinic environment and cost was associated with female gender, shorter waiting times but not county. The proportion of children receiving immunisation in intervention village clinics increased from 42.5% (95% CI 27.9% to 47.1%) to 59.2% (95% CI 53.8% to 64.6%) whereas this decreased in comparison villages (16.5%; 95% CI 10.3% to 22.7% to 6.0%; 95% CI 1.3% to 10.7%). Antenatal visits increased in intervention villages (from 69.0%, 95% CI 65.8% to 73.1% to 75.8%, 95% CI 72.2% to 79.4%) with no change in comparison villages. Conclusions Introduction of a CHS model adapted to economically less-developed rural areas was associated with some improvements in satisfaction with care and use of some village-based public health services. Further research is needed to determine its public health impact and application to other areas. PMID:24583760

Economic Model Cost-Satisfaction in Inclusive Education. Based on Research Made in Georgia

ERIC Educational Resources Information Center

Mantaluta, Ovidiu; Rukhadze, Nino

2008-01-01

This research comprises a brief analysis of the economic model design, projected for poor countries, where complex assessments of the health status, education outcomes and motivation for children with disabilities are impossible to be done; is possible to be applied on a national scale in Georgia, if the actual government has the necessary…

3 CFR 13522 - Executive Order 13522 of December 9, 2009. Creating Labor-Management Forums To Improve Delivery...

Code of Federal Regulations, 2010 CFR

2010-01-01

..., nonprofit organizations, State and local governments, Federal employees, and customers of Federal services... satisfaction, manager satisfaction, and organizational performance resulting from the labor-management forums... labor-management satisfaction, productivity gains, cost savings, and other areas as identified by the...

42 CFR 423.156 - Consumer satisfaction surveys.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and... Healthcare Providers and Systems (CAHPS) survey vendors to conduct the Medicare CAHPS satisfaction survey of...

Explaining turnover intention in Korean public community hospitals: occupational differences.

PubMed

Hwang, Jee-In; Chang, Hyejung

2008-01-01

Personnel in public hospitals had relatively low job satisfaction despite of tenure employment. High turnover rates degrade hospital image and incur additional costs related to recruitment and training. The purposes of this study were to describe the occupational differences and to identify factors affecting turnover intention among public hospital personnel. A questionnaire survey was conducted as part of Administrative Services Quality Evaluation Program by Seoul metropolitan municipality from 1 November to 1 December in 2003. The subjects were 1251 entire hospital personnel in four hospitals. The questionnaire was designed to measure job satisfaction, organizational commitment, turnover intention, and demographic characteristics. Logistic regression analysis was performed to determine factors influencing turnover intention. There were significant differences in job satisfaction, organizational commitment, and turnover intention according to the occupations. The turnover intention rates were highest among physicians, followed by paramedicals and nursing staffs and then administrators. The significant factors affecting turnover intention were involvement and loyalty among physicians, hospital type, satisfaction with systems and loyalty among nursing staffs, satisfaction with relationship and loyalty among administrators, and loyalty among paramedicals. There were different moderators that influence turnover intentions of hospital personnel. Loyalty had the most important effect upon turnover intention in all occupations. 2007 John Wiley & Sons, Ltd

Predictors of nursing faculty members' organizational commitment in governmental universities.

PubMed

Al-Hussami, Mahmoud; Saleh, Mohammad Y N; Abdalkader, Raghed Hussein; Mahadeen, Alia I

2011-05-01

It is essential for all university leaders to develop and maintain an effective programme of total quality management in a climate that promotes work satisfaction and employee support. The purpose of the study was to investigate the relationship of faculty members' organizational commitment to their job satisfaction, perceived organizational support, job autonomy, workload, and pay. A quantitative study, implementing a correlational research design to determine whether relationships existed between organizational commitment and job satisfaction, perceived organizational support, job autonomy, workload and pay. Stepwise linear regression analysis was used to estimate the probability of recorded variables included significant sample characteristics namely, age, experience and other work related attributes. The outcome showed a predictive model of three predictors which were significantly related to faculty members' commitment: job satisfaction, perceived support and age.   Although the findings were positive toward organizational commitment, continued consideration should be given to the fact that faculty members remain committed as the cost associated with leaving is high. A study of this nature increases the compartment in which faculty administrators monitor the work climate, observe and identify factors that may increase or decrease job satisfaction and the work commitment. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

Patient Satisfaction with private Physiotherapy for musculoskeletal Pain

PubMed Central

Casserley-Feeney, Sarah N; Phelan, Martin; Duffy, Fionnuala; Roush, Susan; Cairns, Melinda C; Hurley, Deirdre A

2008-01-01

Background Despite emphasis on patient centred healthcare, healthcare professionals have been slow to use validated measurements of patient satisfaction in physiotherapy practice. The aim of this cross sectional survey was to measure patient satisfaction with private physiotherapy in Ireland, for patients with musculoskeletal pain, using a previously validated survey instrument. Methods A multidimensional patient satisfaction questionnaire 'PTOPS', which assesses patient satisfaction with outpatient physiotherapy treatment, was translated from American English to European English, and relevant demographic and global satisfaction items were included. This was then circulated to patients with musculoskeletal pain (n = 240) for anonymous completion and return to the research team. Data were analysed using the Statistical Package for the Social Sciences (SPSS, v.12). Results In total 55% (n = 131/240) of questionnaires were returned. Just over half of the respondents were male (53.4%, n = 70), with a mean age (SD) of 37.7 years (12.4), and had previous experience of physiotherapy (65.6%, n = 86). The most common site of musculoskeletal pain was spinal (51.5% n = 66). The mean (SD) number of treatments was 8.3 (8.3), at a mean total cost (SD) of €350.2 (€322.8). The 'PTOPS' questionnaire categorised and scored satisfaction items under four domains, Enhancer, Detractor, Location and Cost. The mean score (SD), optimum score, and scoring range for each domain were: 'Enhancer' 41.2 (3.8), 50, 10–50; 'Detractor' 19.4 (4.4), 10, 10–50; 'Location' 28.0 (4.1), 35, 7–35; 'Cost' 18.9 (2.8), 7, 7–35. "Overall satisfaction with physiotherapy experience" was scored on a five-point scale "excellent to poor", with a modal response of "Very Good" (42%; n = 55). Conclusion This study measured patient satisfaction with private physiotherapy treatment for musculoskeletal pain in Ireland using a previously validated outcome measure and provides a template for future studies of this increasingly important topic. Results demonstrated high levels of satisfaction with all components of physiotherapy treatment, except cost, and provided valuable patient feedback regarding their physiotherapy treatment for musculoskeletal pain. Results can be used by physiotherapists to improve future patient experiences with a view to improving patient attendance and compliance with physiotherapy treatment protocols for patients with musculoskeletal pain. PMID:18412974

Is family-friendly policy (FFP) working in the private sector of South Korea?

PubMed

Kang, Young-Hee

2013-01-01

Using the Korean Labor and Income Panel Study (KLIPS), I investigated the impact of family-friendly policies (FFPs) on job satisfaction and organizational commitment in the private sector of South Korea. Paid leave, childcare leave, and support for housing are positively related to both job satisfaction and organizational commitment. Sick leave is positively related to organizational commitment. However, subsidized family event cost is a marginally significant predictor of job satisfaction and organizational commitment. In addition, the relationships between subsidized childcare cost and employee attitudes were not supported. Implications and suggestions for future research are discussed.

Implementing a routine outcome assessment procedure to evaluate the quality of assistive technology service delivery for children with physical or multiple disabilities: Perceived effectiveness, social cost, and user satisfaction.

PubMed

Desideri, Lorenzo; Bizzarri, Martina; Bitelli, Claudio; Roentgen, Uta; Gelderblom, Gert-Jan; de Witte, Luc

2016-01-01

There is a lack of evidence on the effects and quality of assistive technology service delivery (ATSD). This study presents a quasi-experimental 3-months follow-up using a pre-test/post-test design aimed at evaluating outcomes of assistive technology (AT) interventions targeting children with physical and multiple disabilities. A secondary aim was to evaluate the feasibility of the follow-up assessment adopted in this study with a view to implement the procedure in routine clinical practice. Forty-five children aged 3-17 years were included. Parents were asked to complete the Individual Prioritised Problem Assessment (IPPA) for AT effectiveness; KWAZO (Kwaliteit van Zorg [Quality of Care]) and Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) 2.0 for satisfaction with ATSD; Siva Cost Analysis Instrument (SCAI) for estimating the social cost of AT interventions. At follow-up, 25 children used the AT recommended. IPPA effect sizes ranged from 1.4 to 0.7, showing a large effect of AT interventions. Overall, parents were satisfied with ATSD, but Maintenance, Professional Services, and AT Delivery were rated not satisfactory. SCAI showed more resources spent for AT intervention compared to human assistance without technological supports. AT may be an effective intervention for children with disabilities. Issues concerning responsiveness and feasibility of the IPPA and the SCAI instruments are discussed with a view to inform routine clinical practice.

Health versus money. Value judgments in the perspective of decision analysis.

PubMed

Thompson, M S

1983-01-01

An important, but largely uninvestigated, value trade-off balances marginal nonhealth consumption against marginal medical care. Benefit-cost analysts have traditionally, if not fully satisfactorily, dealt with this issue by valuing health gains by their effects on productivity. Cost-effectiveness analysts compare monetary and health effects and leave their relative valuations to decision makers. A decision-analytic model using the satisfaction or utility gained from nonhealth consumption and the level of health enables one to calculate willingness to pay--a theoretically superior way of assigning monetary values to effects for benefit-cost analysis-and to determine minimally acceptable cost-effectiveness ratios. Examples show how a decision-analytic model of utility can differentiate medical actions so essential that failure to take them would be considered negligent from actions so expensive as to be unjustifiable, and can help to determine optimal legal arrangements for compensation for medical malpractice.

Analysis of a managed psychiatric disability program.

PubMed

McCulloch, J; Ozminkowski, R J; Cuffel, B; Dunn, R L; Goldman, W; Kelleher, D; Comporato, A

2001-02-01

The cost of mental illness to employers has been well documented; however, efforts to effectively reduce the costs of psychiatric disability are adversely affected by the fragmentation of health care services. This report is a case study of a program in which a managed behavioral health care organization managed the psychiatric disability of a telecommunications company. Compared with a non-random cohort of claimants not managed under the pilot, the duration of disability was reduced by 23% (17.1 days). Patient and provider satisfaction with the program was high. This study illustrates the potential for effectively reducing the cost of psychiatric disability and the challenges in coordinating health care.

[Application of clinical nursing path in standard management of advanced schistosomiasis patients with splenomegaly].

PubMed

Yang, Liu; Liu, Juan-Juan

2013-04-01

To study the feasibility and effect of clinical nursing path in the standard management of advanced schistosomiasis patients with splenomegaly. A total of 64 advanced schistosomiasis patients with splenomegaly were randomly divided into a routine nursing group (control group) and a clinical nursing pathway group (CNP group), and the postoperative situation, average hospitalization days, cost of hospitalization and the satisfaction of the patients of the 2 groups were compared. The complications, average hospitalization days, costs of hospitalization in the CNP group were significantly decreased compared with those in the control group, and satisfaction rate of the patients in the CNP group increased from 81.25% to 100%. The implementation of CNP effectively reduces the length of hospitalization, costs and complications, and improves the satisfaction of the patients.

A randomized controlled study comparing community based with health facility based direct observation of treatment models on patients' satisfaction and TB treatment outcome in Nigeria.

PubMed

Adewole, Olanisun O; Oladele, T; Osunkoya, Arinola H; Erhabor, Greg E; Adewole, Temitayo O; Adeola, Oluwaseun; Obembe, Olufemi; Ota, Martin O C

2015-12-01

Directly observed treatment short-course (DOTS) strategy is an effective mode of treating TB. We aimed to study the cost effectiveness and patients' satisfaction with home based direct observation of treatment (DOT), an innovative approach to community-based DOT (CBDOT) and hospital based DOT (HBDOT). A randomized controlled trial involving 150 newly diagnosed pulmonary TB patients in four TB clinics in Ile Ife , Nigeria, was done. They were randomly assigned to receive treatment with anti TB drugs for the intensive phase administered at home by a TB worker (CBDOT) or at the hospital (HBDOT). Outcome measures were treatment completion/default rates, cost effectiveness and patients' satisfaction with care using a 13 item patients satisfaction questionnaire (PS-13) at 2 months. This trial was registered with pactr.org: number PACTR 201503001058381. At the end of intensive phase, 15/75 (20%) and 2/75 (3%) of patients in the HBDOT and CBDOT, respectively had defaulted from treatment, p= 0.01. Of those with pretreatment positive sputum smear, 97% (68/70) on CBDOT and 54/67 (81%) on HBDOT were sputum negative for AFB at the end of 2 months of treatment, p=0.01. The CBDOT method was associated with a higher patient satisfaction score compared with HBDOT (OR 3.1; 95% CI 1.25-7.70), p=0.001.The total cost for patients was higher in HBDOT (US$159.38) compared with the CBDOT (US$89.52). The incremental cost effectiveness ratio was US$410 per patient who completed the intensive phase treatment with CBDOT. CBDOT is a cost effective approach associated with better compliance to treatment and better patient satisfaction compared to HBDOT. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

An Industrial Engineering Approach to Cost Containment of Pharmacy Education.

PubMed

Duncan, Wendy; Bottenberg, Michelle; Chase, Marilea; Chesnut, Renae; Clarke, Cheryl; Schott, Kathryn; Torry, Ronald; Welty, Tim

2015-11-25

A 2-semester project explored employing teams of fourth-year industrial engineering students to optimize some of our academic management processes. Results included significant cost savings and increases in efficiency, effectiveness, and student and faculty satisfaction. While we did not adopt all of the students' recommendations, we did learn some important lessons. For example, an initial investment of time in developing a mutually clear understanding of the problems, constraints, and goals maximizes the value of industrial engineering analysis and recommendations. Overall, industrial engineering was a valuable tool for optimizing certain academic management processes.

The analysis of cost-effectiveness of implant and conventional fixed dental prosthesis.

PubMed

Chun, June Sang; Har, Alix; Lim, Hyun-Pil; Lim, Hoi-Jeong

2016-02-01

This study conducted an analysis of cost-effectiveness of the implant and conventional fixed dental prosthesis (CFDP) from a single treatment perspective. The Markov model for cost-effectiveness analysis of the implant and CFDP was carried out over maximum 50 years. The probabilistic sensitivity analysis was performed by the 10,000 Monte-Carlo simulations, and cost-effectiveness acceptability curves (CEAC) were also presented. The results from meta-analysis studies were used to determine the survival rates and complication rates of the implant and CFDP. Data regarding the cost of each treatment method were collected from University Dental Hospital and Statistics Korea for 2013. Using the results of the patient satisfaction survey study, quality-adjusted prosthesis year (QAPY) of the implant and CFDP strategy was evaluated with annual discount rate. When only the direct cost was considered, implants were more cost-effective when the willingness to pay (WTP) was more than 10,000 won at 10(th) year after the treatment, and more cost-effective regardless of the WTP from 20(th) year after the prosthodontic treatment. When the indirect cost was added to the direct cost, implants were more cost-effective only when the WTP was more than 75,000 won at the 10(th) year after the prosthodontic treatment, more than 35,000 won at the 20(th) year after prosthodontic treatment. The CFDP was more cost-effective unless the WTP was more than 75,000 won at the 10(th) year after prosthodontic treatment. But the cost-effectivenss tendency changed from CFDP to implant as time passed.

Life satisfaction, general well-being and costs of treatment for severe fear of childbirth in nulliparous women by psychoeducative group or conventional care attendance.

PubMed

Rouhe, Hanna; Salmela-Aro, Katariina; Toivanen, Riikka; Tokola, Maiju; Halmesmäki, Erja; Saisto, Terhi

2015-05-01

Fear of childbirth is a common reason for seeking cesarean section. It is important to consider outcomes and costs associated with alternative treatment and delivery mode. We compared well-being and costs of group psychoeducation and conventional care for fear of childbirth. Randomized controlled trial. A total of 371 nulliparous women scoring over the 95th centile in the Wijma Delivery Expectancy Questionnaire (W-DEQ) during the first trimester. Finland, data from obstetrical patient records and questionnaires. Randomization to group psychoeducation with relaxation (six sessions during pregnancy, one after childbirth, n = 131), or surveillance and referral on demand (n = 240). All costs in maternity care during pregnancy, delivery and postnatally according to Diagnoses Related Groups. Life satisfaction and general well-being 3 months after childbirth (by a Satisfaction with Life Scale and Well-being Visual Analogue Scale). The groups did not differ in total direct costs (€3786/woman in psychoeducative group and €3830/woman in control group), nor in life satisfaction or general well-being. Although only 76 (30%) of the women assigned to the surveillance were referred to special maternity care and 36 (15%) attended advanced prenatal classes, costs in the psychoeducation group did not exceed the costs of the controls, mostly because of the greater number of uncomplicated vaginal deliveries (63% vs. 47%, p = 0.005). Through an association with safer childbirth and equal well-being after delivery, psychoeducative group treatment for nulliparous women with fear of childbirth can be a recommended choice for the same overall costs as conventional treatment. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

The Cost of Caring: An Exploration of Compassion Fatigue, Compassion Satisfaction, and Job Satisfaction in Pediatric Nurses.

PubMed

Roney, Linda Nancy; Acri, Mary C

The purpose of this study was to describe levels of compassion satisfaction, compassion fatigue, and job satisfaction among pediatric nurses in the United States and determine if there was a relationship among these constructs. All members Society of Pediatric Nurses were sent an electronic invitation to participate, and those who consented received three measures; a demographic questionnaire, the Job Satisfaction Survey (JSS) and the Professional Quality of Life (ProQOL) measure. Three hundred eighteen (10.6%) of members of the Society of Pediatric Nurses participated in the study: Over three quarters (245, 76%) of the sample had another career before nursing. The sample's mean job satisfaction level was 149.8 (SD=29.74), which was significantly higher than published reported means for nurses. Bivariate analyses revealed a significant relationship between gender and the compassion satisfaction, in that women were more likely to evidence compassion satisfaction than men (t=1.967, p=.05, df=298). No other significant relationships were found. The majority of nurses had high levels of compassion satisfaction and job satisfaction; further, female gender was associated with higher levels of compassion satisfaction. This current study had a very high response from second-career nurses (n=245, 76.8%) and overall, the sample had higher levels of compassion satisfaction. It is possible that second career nurses are better equipped in some way that helps them mediate negative responses of caring as a pediatric nurse and future research should explore this. Due to the significant financial costs to institutions of having nurses who have low levels of job satisfaction and high levels on compassion fatigue, it is imperative for hospital administrators to develop infrastructures to support employees. Copyright © 2018 Elsevier Inc. All rights reserved.

A retrospective review comparing two-year patient-reported outcomes, costs, and healthcare resource utilization for TLIF vs. PLF for single-level degenerative spondylolisthesis.

PubMed

Kim, Elliott; Chotai, Silky; Stonko, David; Wick, Joseph; Sielatycki, Alex; Devin, Clinton J

2018-03-01

The purpose of this study was to compare patient-reported outcomes (PROs), morbidity, and costs of TLIF vs PLF to determine whether one treatment was superior in the setting of single-level degenerative spondylolisthesis. Patients undergoing TLIF or PLF for single-level spondylolisthesis were included for retrospective analysis. EQ-5D, ODI, SF-12 MCS/PCS, NRS-BP/LP scores were collected at baseline and 24 months after surgery. 90-day post-operative complications, revision surgery rates, and satisfaction scores were also collected. Two-year resource use was multiplied by unit costs based on Medicare payment amounts (direct cost). Patient and caregiver workday losses were multiplied by the self-reported gross-of-tax wage rate (indirect cost). Total cost was used to assess mean total 2-year cost per QALYs gained after surgery. 62 and 37 patients underwent TLIF and PLF, respectively. Patients in the PLF group were older (p < 0.01). No significant differences were seen in baseline or 24-month PROs between the two groups. There was a significant improvement in all PROs from baseline to 24 months after surgery (p < 0.001). Both groups had similar rates of 90-day complications, revision surgery, satisfaction, and similar gain in QALYs and cost per QALYs gained. There was no significant difference in 24-month direct, indirect, and total cost. Overall costs and health care utilization were similar in both the groups. Both TLIF and PLF for single-level degenerative spondylolisthesis provide improvement in disability, pain, quality of life, and general health.

Evaluation of a hydrogen peroxide-based system for high-level disinfection of vaginal ultrasound probes.

PubMed

Johnson, Stephen; Proctor, Matthew; Bluth, Edward; Smetherman, Dana; Baumgarten, Katherine; Troxclair, Laurie; Bienvenu, Michele

2013-10-01

Because of the complex process and the risk of errors associated with the glutaraldehyde-based solutions previously used at our institution for disinfection, our department has implemented a new method for high-level disinfection of vaginal ultrasound probes: the hydrogen peroxide-based Trophon system (Nanosonics, Alexandria, New South Wales, Australia). The aim of this study was to compare the time difference, safety, and sonographers' satisfaction between the glutaraldehyde-based Cidex (CIVCO Medical Solutions, Kalona, IA) and the hydrogen peroxide-based Trophon disinfection systems. The Institutional Review Board approved a 14-question survey administered to the 13 sonographers in our department. Survey questions addressed a variety of aspects of the disinfection processes with graded responses over a standardized 5-point scale. A process diagram was developed for each disinfection method with segmental timing analysis, and a cost analysis was performed. Nonvariegated analysis of the survey data with the Wilcoxon signed rank test showed a statistical difference in survey responses in favor of the hydrogen peroxide-based system over the glutaraldehyde-based system regarding efficiency (P = .0013), ease of use (P = .0013), ability to maintain work flow (P = .026), safety (P = .0026), fixing problems (P = .0158), time (P = .0011), and overall satisfaction (P = .0018). The glutaraldehyde-based system took 32 minutes versus 14 minutes for the hydrogen peroxide-based system; the hydrogen peroxide-based system saved on average 7.5 hours per week. The cost of the hydrogen peroxide-based system and weekly maintenance pays for itself if 1.5 more ultrasound examinations are performed each week. The hydrogen peroxide-based disinfection system was proven to be more efficient and viewed to be easier and safer to use than the glutaraldehyde-based system. The adoption of the hydrogen peroxide-based system led to higher satisfaction among sonographers.

An examination of blood center structure and hospital customer satisfaction: what can centralized and decentralized blood centers learn from each other?

PubMed

Carden, Robert; DelliFraine, Jami L

2005-01-01

The cost of blood and blood products has increased rapidly over the last several years while the supply of available blood donors has simultaneously decreased. Higher blood costs and donor shortages have put a strain on the relationship between blood suppliers and their hospital customers. This study examines the association between blood center centralization or decentralization and several aspects of hospital satisfaction. Centralized and decentralized blood centers have significant differences in various aspects of hospital customer satisfaction. Advantages and disadvantages of the two structures are discussed, as well as areas for future research.

Health care competition, strategic mission, and patient satisfaction: research model and propositions.

PubMed

Rivers, Patrick A; Glover, Saundra H

2008-01-01

In all industries, competition among businesses has long been encouraged as a mechanism to increase value for patients. In other words, competition ensures the provision of better products and services to satisfy the needs of customers This paper aims to develop a model that can be used to empirically investigate a number of complex issues and relationships associated with competition in the health care industry. A literature review was conducted. A total of 50 items of literature related to the subject were reviewed. Various perspectives of competition, the nature of service quality, health system costs, and patient satisfaction in health care are examined. A model of the relationship among these variables is developed. The model depicts patient satisfaction as an outcome measure directly dependent on competition. Quality of care and health care systems costs, while also directly dependent on the strategic mission and goals, are considered as determinants of customer satisfaction as well. The model is discussed in the light of propositions for empirical research. Empirical studies based on the model proposed in this paper should help identify areas with significant impact on patient satisfaction while maintaining high quality of service at lower costs in a competitive environment. The authors develop a research model which included propositions to examine the complex issues of competition in the health care industry.

Clinical Decision Making and Mental Health Service Use Among Persons With Severe Mental Illness Across Europe.

PubMed

Cosh, Suzanne; Zenter, Nadja; Ay, Esra-Sultan; Loos, Sabine; Slade, Mike; De Rosa, Corrado; Luciano, Mario; Berecz, Roland; Glaub, Theodora; Munk-Jørgensen, Povl; Krogsgaard Bording, Malene; Rössler, Wulf; Kawohl, Wolfram; Puschner, Bernd

2017-09-01

The study explored relationships between preferences for and experiences of clinical decision making (CDM) with service use among persons with severe mental illness. Data from a prospective observational study in six European countries were examined. Associations of baseline staff-rated (N=213) and patient-rated (N=588) preferred and experienced decision making with service use were examined at baseline by using binomial regressions and at 12-month follow-up by using multilevel models. A preference by patients and staff for active patient involvement in decision making, rather than shared or passive decision making, was associated with longer hospital admissions and higher costs at baseline and with increases in admissions over 12 months (p=.043). Low patient-rated satisfaction with an experienced clinical decision was also related to increased costs over the study period (p=.005). A preference for shared decision making may reduce health care costs by reducing inpatient admissions. Patient satisfaction with decisions was a predictor of costs, and clinicians should maximize patient satisfaction with CDM.

Self-Efficacy, Satisfaction, and Academic Achievement: The Mediator Role of Students' Expectancy-Value Beliefs

PubMed Central

Doménech-Betoret, Fernando; Abellán-Roselló, Laura; Gómez-Artiga, Amparo

2017-01-01

Although there is considerable evidence to support the direct effects of self-efficacy beliefs on academic achievement, very few studies have explored the motivational mechanism that mediates the self-efficacy–achievement relationship, and they are necessary to understand how and why self-efficacy affects students' academic achievement. Based on a socio-cognitive perspective of motivation, this study examines the relationships among academic self-efficacy, students' expectancy-value beliefs, teaching process satisfaction, and academic achievement. Its main aim is to identify some motivational-underlying processes through which students' academic self-efficacy affects student achievement and satisfaction. Student achievement and satisfaction are two of the most important learning outcomes, and are considered key indicators of education quality. The sample comprises 797 Spanish secondary education students from 36 educational settings and three schools. The scales that referred to self-efficacy and expectancy-value beliefs were administered at the beginning of the course, while student satisfaction and achievement were measured at the end of the course. The data analysis was conducted by structural equation modeling (SEM). The results revealed that students' expectancy-value beliefs (Subject value, Process expectancy, Achievement expectancy, Cost expectancy) played a mediator role between academic self-efficacy and the achievement/satisfaction relationship. These results provided empirical evidence to better understand the mechanism that mediates self-efficacy–achievement and efficacy–course satisfaction relationships. The implications of these findings for teaching and learning in secondary education are discussed. PMID:28769839

Self-Efficacy, Satisfaction, and Academic Achievement: The Mediator Role of Students' Expectancy-Value Beliefs.

PubMed

Doménech-Betoret, Fernando; Abellán-Roselló, Laura; Gómez-Artiga, Amparo

2017-01-01

Although there is considerable evidence to support the direct effects of self-efficacy beliefs on academic achievement, very few studies have explored the motivational mechanism that mediates the self-efficacy-achievement relationship, and they are necessary to understand how and why self-efficacy affects students' academic achievement. Based on a socio-cognitive perspective of motivation, this study examines the relationships among academic self-efficacy, students' expectancy-value beliefs, teaching process satisfaction, and academic achievement. Its main aim is to identify some motivational-underlying processes through which students' academic self-efficacy affects student achievement and satisfaction. Student achievement and satisfaction are two of the most important learning outcomes, and are considered key indicators of education quality. The sample comprises 797 Spanish secondary education students from 36 educational settings and three schools. The scales that referred to self-efficacy and expectancy-value beliefs were administered at the beginning of the course, while student satisfaction and achievement were measured at the end of the course. The data analysis was conducted by structural equation modeling (SEM). The results revealed that students' expectancy-value beliefs (Subject value, Process expectancy, Achievement expectancy, Cost expectancy) played a mediator role between academic self-efficacy and the achievement/satisfaction relationship. These results provided empirical evidence to better understand the mechanism that mediates self-efficacy-achievement and efficacy-course satisfaction relationships. The implications of these findings for teaching and learning in secondary education are discussed.

Satisfaction with Hearing Aids Based on Technology and Style among Hearing Impaired Persons

PubMed Central

Faraji- Khiavi, Farzad; Dashti, Rezvan; Sameni, Seyyed-Jalal; Bayat, Arash

2016-01-01

Introduction: Hearing loss is one of the most disabling impairments. Using a hearing aid as an attempt to improve the hearing problem can positively affect the quality of life for these people. This research was aimed to assess satisfaction of hearing impaired patients with their hearing aids regarding the employed technology and style. Materials and Methods: This descriptive-analytic cross-sectional research was conducted on 187 subjects with hearing loss who were using a hearing aid. The subjects were over 18 years of age and were using a hearing aid for at least 6 months. The Persian version of Satisfaction with Amplification in Daily Life (SADL) questionnaire was the instrument which was used for assessing satisfaction with the hearing aid. Cronbach’s alpha was calculated to be 0.80 for instrument reliability. Results: A significant difference was observed among satisfaction subscales’ mean scores with hearing aid technology. Also a significant difference was observed between the total satisfaction score and the hearing aid model. With respect to the analysis of satisfaction with the hearing aid and its style, cost and services was the only subscale which showed a significant difference (P=0.005). Conclusion: Respondents using hearing aids with different technology and style were estimated to be quite satisfied. Training audiologists in using more appropriate and fitting hearing aids in addition to using self-reporting questionnaires like SADL for estimating patients’ social condition and participation in their life can essentially change their disability condition and countervail their hearing loss. PMID:27738608

Career Commitment of Nurse Faculty.

PubMed

Jones, Malena

2017-11-01

A nurse faculty shortage exists, and it is predicted to continue in the United States (American Association of Colleges of Nursing [AACN], 2016). Several factors that have been identified as contributing to this shortage include aging faculty, lack of doctoral-prepared faculty, and the economic cost of pursuing an academic career (AACN, 2016). However, there is a need to explore subtle factors. This study was conducted to examine the interaction of career commitment to education, faculty satisfaction, and teacher efficacy on developing qualified and retaining committed faculty. The purpose of this study was to investigate relationships among education, teacher self-efficacy, and career satisfaction of nurse faculty to career commitment. A cross-sectional design was used to survey a convenience sample of nurse faculty (N = 470). An online survey contained three scales (Career Satisfaction, Teacher Self-Efficacy Beliefs, and Career Commitment) to obtain data. Descriptive data, Pearson's correlations, and path analysis were used to analyze data. Teacher self-efficacy and career satisfaction predicted career commitment. Education measured by credit hours significantly predicted teacher self-efficacy. The relationship between career satisfaction and career commitment was significant and statistically positive. Model fit indices confirm the career commitment for nurse faculty model fits the data. The study highlights the importance of teacher self-efficacy, career satisfaction, and career commitment among nurse faculty. The results provide valuable insight to the factors that may influence attraction or retention of nurse faculty.

Patient and referring health care provider satisfaction with a physiotherapy spinal triage assessment service

PubMed Central

Bath, Brenna; Janzen, Bonnie

2012-01-01

Purpose To evaluate participant and referring care provider satisfaction associated with a spinal triage assessment service delivered by physiotherapists in collaboration with orthopedic surgeons. Methods People with low back-related complaints were recruited from those referred to a spinal triage assessment program delivered by physiotherapists. Measures of patient and provider satisfaction were completed at approximately 4 weeks after the assessment. The satisfaction surveys were analyzed quantitatively with descriptive statistics and qualitatively with an inductive thematic approach of open and axial coding. Results A total of 108/115 participants completed the posttest satisfaction survey. Sixty-six percent of participants were “very satisfied” with the service and 55% were “very satisfied” with the recommendations that were made. Only 18% of referring care providers completed the satisfaction survey and 90.5% of those were “very satisfied” with the recommendations. Sixty-one participants and 14 care providers provided comments which revealed a diverse range of themes which were coded into positive (ie, understanding the problem, communication, customer service, efficiency, and management direction), negative (ie, lack of detail, time to follow-up, cost) and neutral related to the triage service, and an “other” category unrelated to the service (ie, chronic symptoms, comorbidities, and limited access to health care.) Conclusion The quantitative results of the participant survey demonstrated very high levels of satisfaction with the service and slightly less satisfaction with the recommendations that were made. Satisfaction of referring care providers with the recommendations and report was also high, but given the low response rate, these results should be interpreted with caution. Qualitative analysis of participant and provider comments revealed a diverse range of themes. These other issues may be important contextual factors that have the potential to impact patient relevant outcomes. PMID:22328826

Patient and referring health care provider satisfaction with a physiotherapy spinal triage assessment service.

PubMed

Bath, Brenna; Janzen, Bonnie

2012-01-01

To evaluate participant and referring care provider satisfaction associated with a spinal triage assessment service delivered by physiotherapists in collaboration with orthopedic surgeons. People with low back-related complaints were recruited from those referred to a spinal triage assessment program delivered by physiotherapists. Measures of patient and provider satisfaction were completed at approximately 4 weeks after the assessment. The satisfaction surveys were analyzed quantitatively with descriptive statistics and qualitatively with an inductive thematic approach of open and axial coding. A total of 108/115 participants completed the posttest satisfaction survey. Sixty-six percent of participants were "very satisfied" with the service and 55% were "very satisfied" with the recommendations that were made. Only 18% of referring care providers completed the satisfaction survey and 90.5% of those were "very satisfied" with the recommendations. Sixty-one participants and 14 care providers provided comments which revealed a diverse range of themes which were coded into positive (ie, understanding the problem, communication, customer service, efficiency, and management direction), negative (ie, lack of detail, time to follow-up, cost) and neutral related to the triage service, and an "other" category unrelated to the service (ie, chronic symptoms, comorbidities, and limited access to health care.) The quantitative results of the participant survey demonstrated very high levels of satisfaction with the service and slightly less satisfaction with the recommendations that were made. Satisfaction of referring care providers with the recommendations and report was also high, but given the low response rate, these results should be interpreted with caution. Qualitative analysis of participant and provider comments revealed a diverse range of themes. These other issues may be important contextual factors that have the potential to impact patient relevant outcomes.

An observational study of powered wheelchair provision in Italy.

PubMed

Salatino, Claudia; Andrich, Renzo; Converti, R M; Saruggia, M

2016-01-01

Powered wheelchairs are complex and expensive assistive devices that must be selected and configured on the basis of individual user needs, lifestyle, motivation, driving ability, and environment. Providing agencies often require evidence that their financial investment will lead to a successful outcome. The authors surveyed a sample of 79 users who had obtained powered wheelchairs from a Regional Health Service in Italy in the period 2008-2013. Follow-up interviews were conducted at the users' homes in order to collect information about wheelchair use, and its effectiveness, usefulness, and economic impact. The instruments used in the interviews included an introductory questionnaire, QUEST (Quebec User Evaluation of Satisfaction with Assistive Technology), PIADS (Psychosocial Impact of Assistive Devices Scale), FABS/M (Facilitators and Barriers Survey/Mobility), and SCAI (Siva Cost Analysis Instrument). The results indicated positive outcomes, especially in relation to user satisfaction and psychosocial impact. A number of barriers were identified in various settings that sometimes restrict user mobility, and suggest corrective actions. The provision of a powered wheelchair generated considerable savings in social costs for most users: an average of about $38,000 per person over a projected 5-year period was estimated by comparing the cost of the intervention with that of non-intervention.

Management of continuous positive airway pressure treatment compliance using telemonitoring in obstructive sleep apnoea.

PubMed

Turino, Cecilia; de Batlle, Jordi; Woehrle, Holger; Mayoral, Ana; Castro-Grattoni, Anabel Lourdes; Gómez, Sílvia; Dalmases, Mireia; Sánchez-de-la-Torre, Manuel; Barbé, Ferran

2017-02-01

Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnoea (OSA), but treatment compliance is often unsatisfactory. This study investigated the efficacy and cost-effectiveness of telemonitoring for improving CPAP compliance.100 newly diagnosed OSA patients requiring CPAP (apnoea-hypopnoea index >15 events·h -1 ) were randomised to standard management or a telemonitoring programme that collected daily information about compliance, air leaks and residual respiratory events, and initiated patient contact to resolve issues. Clinical/anthropometric variables, daytime sleepiness and quality of life were recorded at baseline and after 3 months. Patient satisfaction, additional visits/calls, side-effects and total costs were assessed.There were no significant differences between the standard and telemedicine groups in terms of CPAP compliance (4.9±2.2 versus 5.1±2.1 h·night -1 ), symptoms, clinical variables, quality of life and unwanted effects. Telemedicine was less expensive than standard management (EUR123.65 versus EUR170.97; p=0.022) and was cost-effective (incremental cost-effectiveness ratio EUR17 358.65 per quality-adjusted life-year gained). Overall patient satisfaction was high, but significantly more patients rated satisfaction as high/very high in the standard management versus telemedicine group (96% versus 74%; p=0.034).Telemonitoring did not improve CPAP treatment compliance and was associated with lower patient satisfaction. However, it was more cost-effective than traditional follow-up. Copyright ©ERS 2017.

Relationship of work-family conflict, self-reported social support and job satisfaction to burnout syndrome among medical workers in southwest China: A cross-sectional study.

PubMed

Yang, Shujuan; Liu, Danping; Liu, Hongbo; Zhang, Juying; Duan, Zhanqi

2017-01-01

Burnout is a psychosomatic syndrome widely observed in Chinese medical workers due to the increasing cost of medical treatment, excessive workload, and excessive prescribing behavior. No studies have evaluated the interrelationship among occupational burnout, work-family conflict, social support, and job satisfaction in medical workers. The aim of this study was to evaluate these relationships among medical workers in southwest China. This cross-sectional study was conducted between March 2013 and December 2013, and was based on the fifth National Health Service Survey (NHSS). A total of 1382 medical workers were enrolled in the study. Pearson correlation analysis and general linear model univariate analysis were used to evaluate the relationship of work-family conflict, self-reported social support, and job satisfaction with burnout syndrome in medical workers. We observed that five dimensions of job satisfaction and self-reported social support were negatively associated with burnout syndrome, whereas three dimensions of work-family conflict showed a positive correlation. In a four-stage general linear model analysis, we found that demographic factors accounted for 5.4% of individual variance in burnout syndrome (F = 4.720, P<0.001, R2 = 0.054), and that work-family conflict, self-reported social support, and job satisfaction accounted for 2.6% (F = 5.93, P<0.001, R2 = 0.080), 5.7% (F = 9.532, P<0.001, R2 = 0.137) and 17.8% (F = 21.608, P<0.001, R2 = 0.315) of the variance, respectively. In the fourth stage of analysis, female gender and a lower technical title correlated to a higher level of burnout syndrome, and medical workers without administrative duties had more serious burnout syndrome than those with administrative duties. In conclusion, the present study suggests that work-family conflict and self-reported social support slightly affect the level of burnout syndrome, and that job satisfaction is a much stronger influence on burnout syndrome in medical workers of southwest China.

Relationship of work-family conflict, self-reported social support and job satisfaction to burnout syndrome among medical workers in southwest China: A cross-sectional study

PubMed Central

Yang, Shujuan; Liu, Danping; Liu, Hongbo; Zhang, Juying; Duan, Zhanqi

2017-01-01

Background Burnout is a psychosomatic syndrome widely observed in Chinese medical workers due to the increasing cost of medical treatment, excessive workload, and excessive prescribing behavior. No studies have evaluated the interrelationship among occupational burnout, work-family conflict, social support, and job satisfaction in medical workers. The aim of this study was to evaluate these relationships among medical workers in southwest China. Methods This cross-sectional study was conducted between March 2013 and December 2013, and was based on the fifth National Health Service Survey (NHSS). A total of 1382 medical workers were enrolled in the study. Pearson correlation analysis and general linear model univariate analysis were used to evaluate the relationship of work-family conflict, self-reported social support, and job satisfaction with burnout syndrome in medical workers. Results We observed that five dimensions of job satisfaction and self-reported social support were negatively associated with burnout syndrome, whereas three dimensions of work-family conflict showed a positive correlation. In a four-stage general linear model analysis, we found that demographic factors accounted for 5.4% of individual variance in burnout syndrome (F = 4.720, P<0.001, R2 = 0.054), and that work-family conflict, self-reported social support, and job satisfaction accounted for 2.6% (F = 5.93, P<0.001, R2 = 0.080), 5.7% (F = 9.532, P<0.001, R2 = 0.137) and 17.8% (F = 21.608, P<0.001, R2 = 0.315) of the variance, respectively. In the fourth stage of analysis, female gender and a lower technical title correlated to a higher level of burnout syndrome, and medical workers without administrative duties had more serious burnout syndrome than those with administrative duties. Conclusions In conclusion, the present study suggests that work-family conflict and self-reported social support slightly affect the level of burnout syndrome, and that job satisfaction is a much stronger influence on burnout syndrome in medical workers of southwest China. PMID:28207821

Transforming Patient Value: Comparison of Hospital, Surgical, and General Surgery Patients.

PubMed

Pitt, Henry A; Tsypenyuk, Ella; Freeman, Susan L; Carson, Steven R; Shinefeld, Jonathan A; Hinkle, Sally M; Powers, Benjamin D; Goldberg, Amy J; DiSesa, Verdi J; Kaiser, Larry R

2016-04-01

Patient value (V) is enhanced when quality (Q) is increased and cost (C) is diminished (V = Q/C). However, calculating value has been inhibited by a lack of risk-adjusted cost data. The aim of this analysis was to measure patient value before and after implementation of quality improvement and cost reduction programs. Multidisciplinary efforts to improve patient value were initiated at a safety-net hospital in 2012. Quality improvement focused on adoption of multiple best practices, and minimizing practice variation was the strategy to control cost. University HealthSystem Consortium (UHC) risk-adjusted quality (patient mortality + safety + satisfaction + effectiveness) and cost (length of stay + direct cost) data were used to calculate patient value over 3 fiscal years. Normalized ranks in the UHC Quality and Accountability Scorecard were used in the value equation. For all hospital patients, quality scores improved from 50.3 to 66.5, with most of the change occurring in decreased mortality. Similar trends were observed for all surgery patients (42.6 to 48.4) and for general surgery patients (30.9 to 64.6). For all hospital patients, cost scores improved from 71.0 to 2.9. Similar changes were noted for all surgical (71.6 to 27.1) and general surgery (85.7 to 23.0) patients. Therefore, value increased more than 30-fold for all patients, 3-fold for all surgical patients, and almost 8-fold for general surgery patients. Multidisciplinary quality and cost efforts resulted in significant improvements in value for all hospitalized patients as well as general surgery patients. Mortality improved the most in general surgery patients, and satisfaction was highest among surgical patients. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Quality of Life Measurement and Analysis (QUAILMAN).

DTIC Science & Technology

1996-03-01

quality of life programs. Quality ...respondents who were satisfied with the issue. Generally the SSMP data suggest that the overall quality of life in the Army may have declined recently...while the quality of life cost per soldier has increased. Specifically there was a 10 percent drop in the percent satisfaction for the total Army population in the area of government housing quality over 2-1/2

[Hospital at home: assessment of early discharge in terms of patients mortality and satisfaction].

PubMed

Damiani, G; Pinnarelli, L; Ricciardi, G

2006-01-01

New organizational models are essentials for European Hospitals because of restraining budget and ageing of population. Hospital at home is an alternative to inpatient care, effective both in clinical and economic ground. The aim of our study was to evaluate the impact of Hospital at Home in terms of decreased mortality and patient satisfaction. We carried out a meta-analysis of the literature about hospital at home interventions. We searched Medline (to December 2002), the Cochrane Controlled Trials Register (to October 2002) and other bibliographical databases, with a supplementary handsearching of literature. We used the following keywords: hospital at home, home hospitalization, mortality, patient satisfaction, cost, acute hospital care, conventional hospitalization. We included studies respecting the following criteria: analytical or experimental studies aimed at compare early discharge to hospital at home and continued care in an acute hospital. Review Manager 4.2 software was used to collect data and perform statistical analysis. We found 2420 articles searching for the chosen keywords. Twelve studies (2048 patients) were included for death outcome and six studies (1382 patients) were included for satisfaction outcome. The selected studies indicated a greater effect size of patient satisfaction in home patients than hospitalized ones (Odds Ratio: 1.58 95% CI: 1.25, 2.00) and showed no difference in terms of mortality (Risk Difference: -0.01 95% CI: -0.03, 0.02). Our results underline the effectiveness of this organizational model, as an alternative to continued care in an acute hospital. Further useful considerations could be drawn by economic evaluation studies carried out on field.

Specialist home-based nursing services for children with acute and chronic illnesses.

PubMed

Parab, Chitra S; Cooper, Carolyn; Woolfenden, Susan; Piper, Susan M

2013-06-15

Specialist paediatric home-based nursing services have been proposed as a cost-effective means of reducing distress resulting from hospital admissions, while enhancing primary care and reducing length of hospital stay. This review is an update of our original review, which was published in 2006. To evaluate specialist home-based nursing services for children with acute and chronic illnesses. We searched the following databases in February 2012: the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library 2012 Issue 2, Ovid MEDLINE, EMBASE, PsycINFO, CINAHL and Sociological Abstracts. We also searched ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. No language restrictions were applied. Randomised controlled trials (RCTs) of children from birth to age 18 years with acute or chronic illnesses allocated to specialist home-based nursing services compared with conventional health care. Outcomes included utilisation of health care, physical and mental health, satisfaction, adverse health outcomes and costs. Two review authors extracted data from the studies independently and resolved any discrepancies by recourse to a third author. Meta-analysis was not appropriate because of the clinical diversity of the studies and the lack of common outcome measures. We screened 4226 titles to yield seven RCTs with a total of 840 participants. Participants, interventions and outcomes were diverse. No significant differences were reported in health outcomes; two studies reported a reduction in the hospital stay with no difference in the hospital readmission rates. Three studies reported a reduction in parental anxiety and improvement in child behaviours was reported in three studies. Overall increased parental satisfaction was reported in three studies. Also, better parental coping and family functioning was reported in one study. By contrast, one study each reported no impact on parental burden of care or on functional status of children. Home care was reported as more costly for service providers with substantial cost savings for the family in two studies, while one study revealed no significant cost benefits for the family. Current research does not provide supporting evidence for a reduction in access to hospital services or a reduction in hospital readmission rate for children with acute and chronic illnesses using specialist home-based nursing services; however, the only summary finding across a few studies was that there is a significant decrease in length of hospitalisation. The preliminary results show no adverse impact on physical health outcomes and a number of papers reported improved satisfaction with home-based care. Further trials are required, measuring health, satisfaction, service utilisation and long-term costs.

An Industrial Engineering Approach to Cost Containment of Pharmacy Education

PubMed Central

Bottenberg, Michelle; Chase, Marilea; Chesnut, Renae; Clarke, Cheryl; Schott, Kathryn; Torry, Ronald; Welty, Tim

2015-01-01

A 2-semester project explored employing teams of fourth-year industrial engineering students to optimize some of our academic management processes. Results included significant cost savings and increases in efficiency, effectiveness, and student and faculty satisfaction. While we did not adopt all of the students’ recommendations, we did learn some important lessons. For example, an initial investment of time in developing a mutually clear understanding of the problems, constraints, and goals maximizes the value of industrial engineering analysis and recommendations. Overall, industrial engineering was a valuable tool for optimizing certain academic management processes. PMID:26839421

Case-based reimbursement for psychiatric hospital care.

PubMed

Sederer, L I; Eisen, S V; Dill, D; Grob, M C; Gougeon, M L; Mirin, S M

1992-11-01

A fixed-prepayment system (case-based reimbursement) for patients initially requiring hospital-level care was evaluated for one year through an arrangement between a private nonprofit psychiatric hospital and a self-insured company desiring to provide psychiatric services to its employees. This clinical and financial experiment offered a means of containing costs while monitoring quality of care. A two-group, case-control study was undertaken of treatment outcomes at discharge, patient satisfaction with hospital care, and service use and costs during the program's first year. Compared with costs for patients in the control group, costs for those in the program were lower per patient and per admission; cumulative costs for patients requiring rehospitalization were also lower. However, costs for outpatient services for patients in the program were not calculated. Treatment outcomes and patients' satisfaction with hospital care were comparable for the two groups.

Health care competition, strategic mission, and patient satisfaction: research model and propositions

PubMed Central

Rivers, Patrick A.; Glover, Saundra H.

2010-01-01

Purpose In all industries, competition among businesses has long been encouraged as a mechanism to increase value for patients. In other words, competition ensures the provision of better products and services to satisfy the needs of customers This paper aims to develop a model that can be used to empirically investigate a number of complex issues and relationships associated with competition in the health care industry. Design/methodology/approach A literature review was conducted. A total of 50 items of literature related to the subject were reviewed.. Various perspectives of competition, the nature of service quality, health system costs, and patient satisfaction in health care are examined Findings A model of the relationship among these variables is developed. The model depicts patient satisfaction as an outcome measure directly dependent on competition. Quality of care and health care systems costs, while also directly dependent on the strategic mission and goals, are considered as determinants of customer satisfaction as well. The model is discussed in the light of propositions for empirical research. Practical implications Empirical studies based on the model proposed in this paper should help identify areas with significant impact on patient satisfaction while maintaining high quality of service at lower costs in a competitive environment. Originality/value The authors develop a research model which included propositions to examine the complex issues of competition in the health care industry. PMID:19579575

Cost and logistics of implementing a tissue-based American College of Surgeons/Association of Program Directors in Surgery surgical skills curriculum for general surgery residents of all clinical years.

PubMed

Henry, Brandon; Clark, Philip; Sudan, Ranjan

2014-02-01

The cost and logistics of deploying the American College of Surgeons (ACS)/Association of Program Directors in Surgery (APDS) National Technical Skills Curriculum across all training years are not known. This information is essential for residency programs choosing to adopt similar curricula. A task force evaluated the authors' institution's existing simulation curriculum and enhanced it by implementing the ACS/APDS modules. A 35-module curriculum was administered to 35 general surgery residents across all 5 clinical years. The costs and logistics were noted, and resident satisfaction was assessed. The annual operational cost was $110,300 ($3,150 per resident). Cost per module, per resident was $940 for the cadaveric module compared with $220 and $240 for dry simulation and animal tissue-based modules, respectively. Resident satisfaction improved from 2.45 to 4.78 on a 5-point, Likert-type scale after implementing the ACS/APDS modules. The ACS/APDS skills curriculum was implemented successfully across all clinical years. Cadaveric modules were the most expensive. Animal and dry simulation modules were equivalent in cost. The addition of tissue-based modules was associated with high satisfaction. Copyright © 2014 Elsevier Inc. All rights reserved.

Accreditation in a public hospital: perceptions of a multidisciplinary team.

PubMed

Camillo, Nadia Raquel Suzini; Oliveira, João Lucas Campos de; Bellucci Junior, José Aparecido; Cervilheri, Andressa Hirata; Haddad, Maria do Carmo Fernandez Lourenço; Matsuda, Laura Misue

2016-06-01

to analyze the perceptions of the multidisciplinary team on Accreditation in a public hospital. descriptive, exploratory, qualitative research, performed in May 2014, using recorded individual interviews. In total, 28 employees of a public hospital, Accredited with Excellence, answered the guiding question: "Tell me about the Accreditation system used in this hospital". The interviews were transcribed and subjected to content analysis. of the speeches, three categories emerged: Advantages offered by the Accreditation; Accredited public hospital resembling a private hospital; Pride/satisfaction for acting in an accredited public hospital. participants perceived Accreditation as a favorable system for a quality management in the public service because it promotes the development of professional skills and improves cost management, organizational structure, management of assistance and perception of job pride/satisfaction.

Self-reported "worth it" rating of aesthetic surgery in social media.

PubMed

Domanski, Mark C; Cavale, Naveen

2012-12-01

A wide variety of surveys have been used to validate the satisfaction of patients who underwent aesthetic surgery. However, such studies are often limited by patient number and number of surgeons. Social media now allows patients, on a large scale, to discuss and rate their satisfaction with procedures. The views of aesthetic procedures patients expressed in social media provide unique insight into patient satisfaction. The "worth it" percentage, average cost, and number of respondents were recorded on October 16, 2011, for all topics evaluated on the aesthetic procedure social media site www.realself.com . Procedures were divided into categories: surgical, liposuction, nonsurgical, and dental. For each group, procedures with the most respondents were chosen and ordered by "worth it" score. A literature search was performed for the most commonly rated surgical procedures and the satisfaction rates were compared. A total of 16,949 evaluations of 159 aesthetic surgery topics were recorded. A correlation between cost of the procedure and percentage of respondents indicating that the procedure was "worth it" was not found. The highest-rated surgical procedure was abdominoplasty, with 93 % of the 1,589 self-selected respondents expressing that abdominoplasty was "worth it." The average self-reported cost was $8,400. The highest-rated nonsurgical product was Latisse, with 85 % of 231 respondents reporting it was "worth it" for an average cost of $200. The satisfaction scores in the literature for commonly rated surgical procedures ranged from 62 to 97.6 %. No statistically significant correlations between literature satisfaction scores and realself.com "worth it" scores were found. Abdominoplasty had the highest "worth it" rating among aesthetic surgical procedures. Aesthetic surgeons should be wary that satisfaction scores reported in the literature might not correlate with commonly achieved results. Social media has opened a new door into how procedures are evaluated and perceived. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the table of contents or the online instructions to authors www.springer.com/00266 .

Early magnetic resonance imaging in acute knee injury: a cost analysis.

PubMed

Patel, Nirav K; Bucknill, Andrew; Ahearne, David; Denning, Janet; Desai, Kailash; Watson, Martin

2012-06-01

Acute knee injury is common, and MRI is often only used when non-operative management fails because of limited availability. We investigated whether early MRI in acute knee injury is more clinically and cost-effective compared to conventional physiotherapy and reassessment. All patients with acute indirect soft tissue knee injury referred to fracture clinic were approached. Recruited patients were randomised to either the MRI group: early MRI within 2 weeks or the control group: conventional management with physiotherapy. Patients were assessed in clinic initially, at 2 weeks and 3 months post-injury. Management costs were calculated for all patients until surgical treatment or discharge. Forty-six patients were recruited: 23 in the MRI and 23 in the control group. Male sex and mean age were similar in the two groups. The total management cost of the MRI group was £16,127 and control group was £16,170, with a similar mean cost per patient (NS). The MRI group had less mean physiotherapy (2.5 ± 1.9 vs. 5.1 ± 3.5, p < 0.01) and outpatient appointments (NS). Median time to surgery and time off work was less in the MRI group (NS). The MRI group had less pain (p < 0.05), less activity limitation (p = 0.04) and better satisfaction (p = 0.04). Early MRI in acute knee injury facilitates faster diagnosis and management of internal derangement at a cost comparable to conventional treatment. Moreover, patients had significantly less time off work with improved pain, activity limitation and satisfaction scores. II.

Perceived service quality, perceived value, overall satisfaction and happiness of outlook for long-term care institution residents.

PubMed

Lin, Jesun; Hsiao, Chih-Tung; Glen, Robert; Pai, Jar-Yuan; Zeng, Sin-Huei

2014-06-01

To investigate the psychometric properties and relationships of perceived service quality, perceived value and overall satisfaction for residents with respect to their long-term care institutions. The five-point Likert scale questionnaire administered through facetoface interviews. Fourteen long-term care institutions located in central and southern Taiwan stratified according to services and accommodation population. One hundred and eighty long-term institutional care residents. Perceived service quality (the SERVPERF model), perceived value and overall satisfaction (models based on the literature on perceived value and satisfaction). Student's t-test on institutional location shows a significant difference between overall satisfaction for central and southern institution long-term care recipients. The correlation test revealed that the higher a resident's level of education, the higher the scores for perceived value. The factor loading results of confirmation factor analysis show acceptable levels of reliability and index-of-model fits for perceived service, perceived value and overall satisfaction. In addition, the results suggest that an additional construct, a positive attitude (happiness of outlook) towards long-term care institutions, is also an important factor in residents' overall satisfaction. The primary goal of long-term institutional care policy in Taiwan, as in other countries, is to provide residents with practical, cost-effective but high-quality care. On the basis of the results of in-depth interviews with long-term institutional care residents, this study suggests long-term care institutions arrange more family visit days to increase the accessibility and interaction of family and residents and thereby increase the happiness of outlook of the residents. © 2012 John Wiley & Sons Ltd.

Improving quality and patient satisfaction in a pediatric resident continuity clinic through advanced access scheduling.

PubMed

Tuli, Sanjeev Y; Thompson, Lindsay A; Ryan, Kathleen A; Srinivas, Ganga L; Fillipps, Donald J; Young, Christopher M; Tuli, Sonal S

2010-06-01

To evaluate the impact of advanced access scheduling in a pediatric residency clinic on resident and patient satisfaction, medical education, practice quality, and efficiency. Residents were assigned to either the advanced access template (10 appointments available to patients and 2 physician overbooks) or the prior template (5 available and 8 overbooks). Outcomes included resident and patient satisfaction, appointment availability, and continuity of care and clinic costs. Patient satisfaction improved in 7 areas (P < .001). Residents in either template did not report an impact on medical education experiences. Significant increases were realized with appointment availability and the number of patients seen. Continuity also increased as the overflow/acute visits decreased (P < .001). Overall costs per visit decreased 22%. Because of the significant improvements in access, continuity, and efficiency, all residents were switched to the advanced access template after completion of the study. Improvement in access to the primary physician has a significant impact on patient satisfaction with health care delivery. This model optimizes the limited time that residents have in continuity clinic, and it has implications for health care delivery quality improvement.

Exploring the Impact of Early Decisions in Variable Ordering for Constraint Satisfaction Problems.

PubMed

Ortiz-Bayliss, José Carlos; Amaya, Ivan; Conant-Pablos, Santiago Enrique; Terashima-Marín, Hugo

2018-01-01

When solving constraint satisfaction problems (CSPs), it is a common practice to rely on heuristics to decide which variable should be instantiated at each stage of the search. But, this ordering influences the search cost. Even so, and to the best of our knowledge, no earlier work has dealt with how first variable orderings affect the overall cost. In this paper, we explore the cost of finding high-quality orderings of variables within constraint satisfaction problems. We also study differences among the orderings produced by some commonly used heuristics and the way bad first decisions affect the search cost. One of the most important findings of this work confirms the paramount importance of first decisions. Another one is the evidence that many of the existing variable ordering heuristics fail to appropriately select the first variable to instantiate. Another one is the evidence that many of the existing variable ordering heuristics fail to appropriately select the first variable to instantiate. We propose a simple method to improve early decisions of heuristics. By using it, performance of heuristics increases.

Exploring the Impact of Early Decisions in Variable Ordering for Constraint Satisfaction Problems

PubMed Central

Amaya, Ivan

2018-01-01

When solving constraint satisfaction problems (CSPs), it is a common practice to rely on heuristics to decide which variable should be instantiated at each stage of the search. But, this ordering influences the search cost. Even so, and to the best of our knowledge, no earlier work has dealt with how first variable orderings affect the overall cost. In this paper, we explore the cost of finding high-quality orderings of variables within constraint satisfaction problems. We also study differences among the orderings produced by some commonly used heuristics and the way bad first decisions affect the search cost. One of the most important findings of this work confirms the paramount importance of first decisions. Another one is the evidence that many of the existing variable ordering heuristics fail to appropriately select the first variable to instantiate. Another one is the evidence that many of the existing variable ordering heuristics fail to appropriately select the first variable to instantiate. We propose a simple method to improve early decisions of heuristics. By using it, performance of heuristics increases. PMID:29681923

Satisfaction with Quality of Care Received by Patients without National Health Insurance Attending a Primary Care Clinic in a Resource-Poor Environment of a Tertiary Hospital in Eastern Nigeria in the Era of Scaling up the Nigerian Formal Sector Health Insurance Scheme

PubMed Central

Iloh, GUP; Ofoedu, JN; Njoku, PU; Okafor, GOC; Amadi, AN; Godswill-Uko, EU

2013-01-01

Background: The increasing importance of the concept of patients’ satisfaction as a valuable tool for assessing quality of care is a current global healthcare concerns as regards consumer-oriented health services. Aim: This study assessed satisfaction with quality of care received by patients without national health insurance (NHI) attending a primary care clinic in a resource-poor environment of a tertiary hospital in South-Eastern Nigeria. Subject and Methods: This was a cross-sectional study carried out on 400 non-NHI patients from April 2011 to October 2011 at the primary care clinic of Federal Medical Centre, Umuahia, Nigeria. Adult patients seen within the study period were selected by systematic sampling using every second non-NHI patient that registered to see the physicians and who met the selection criteria. Data were collected using pretested, structured interviewer administered questionnaire designed on a five points Likert scale items with 1 and 5 indicating the lowest and highest levels of satisfaction respectively. Satisfaction was measured from the following domains: patient waiting time, patient–staff communication, patient-staff relationship, and cost of care, hospital bureaucracy and hospital environment. Operationally, patients who scored 3 points and above in the assessed domain were considered satisfied while those who scored less than 3 points were dissatisfied. Results: The overall satisfaction score of the respondents was 3.1. Specifically, the respondents expressed satisfaction with patient–staff relationship (3.9), patient–staff communication (3.8), and hospital environment (3.6) and dissatisfaction with patient waiting time (2.4), hospital bureaucracy (2.5), and cost of care (2.6). Conclusion: The overall non-NHI patient's satisfaction with the services provided was good. The hospital should set targets for quality improvement in the current domains of satisfaction while the cost of care has implications for government intervention as it mirrors the need to make NHI universal for all Nigerians irrespective of the employment status. PMID:23634326

Satisfaction with Quality of Care Received by Patients without National Health Insurance Attending a Primary Care Clinic in a Resource-Poor Environment of a Tertiary Hospital in Eastern Nigeria in the Era of Scaling up the Nigerian Formal Sector Health Insurance Scheme.

PubMed

Iloh, Gup; Ofoedu, Jn; Njoku, Pu; Okafor, Goc; Amadi, An; Godswill-Uko, Eu

2013-01-01

The increasing importance of the concept of patients' satisfaction as a valuable tool for assessing quality of care is a current global healthcare concerns as regards consumer-oriented health services. This study assessed satisfaction with quality of care received by patients without national health insurance (NHI) attending a primary care clinic in a resource-poor environment of a tertiary hospital in South-Eastern Nigeria. This was a cross-sectional study carried out on 400 non-NHI patients from April 2011 to October 2011 at the primary care clinic of Federal Medical Centre, Umuahia, Nigeria. Adult patients seen within the study period were selected by systematic sampling using every second non-NHI patient that registered to see the physicians and who met the selection criteria. Data were collected using pretested, structured interviewer administered questionnaire designed on a five points Likert scale items with 1 and 5 indicating the lowest and highest levels of satisfaction respectively. Satisfaction was measured from the following domains: patient waiting time, patient-staff communication, patient-staff relationship, and cost of care, hospital bureaucracy and hospital environment. Operationally, patients who scored 3 points and above in the assessed domain were considered satisfied while those who scored less than 3 points were dissatisfied. The overall satisfaction score of the respondents was 3.1. Specifically, the respondents expressed satisfaction with patient-staff relationship (3.9), patient-staff communication (3.8), and hospital environment (3.6) and dissatisfaction with patient waiting time (2.4), hospital bureaucracy (2.5), and cost of care (2.6). The overall non-NHI patient's satisfaction with the services provided was good. The hospital should set targets for quality improvement in the current domains of satisfaction while the cost of care has implications for government intervention as it mirrors the need to make NHI universal for all Nigerians irrespective of the employment status.

The development of an integrated Indonesian health care model using Kano's model, quality function deployment and balanced scorecard

NASA Astrophysics Data System (ADS)

Jonny, Zagloed, Teuku Yuri M.

2017-11-01

This paper aims to present an integrated health care model for Indonesian health care industry. Based on previous researches, there are two health care models in the industry such as decease- and patient-centered care models. In their developments, the patient-centered care model is widely applied due to its capability in reducing cost and improving quality simultaneously. However, there is still no comprehensive model resulting in cost reduction, quality improvement, patient satisfaction and hospital profitability simultaneously. Therefore, this research is intended to develop that model. In doing so, first, a conceptual model using Kano's Model, Quality Function Deployment (QFD) and Balanced Scorecard (BSC) is developed to generate several important elements of the model as required by stakeholders. Then, a case study of an Indonesian hospital is presented to evaluate the validity of the model using correlation analysis. As a result, it can be concluded that the model is validated implying several managerial insights among its elements such as l) leadership (r=0.85) and context of the organization (r=0.77) improve operations; 2) planning (r=0.96), support process (r=0.87) and continual improvement (r=0.95) also improve operations; 3) operations improve customer satisfaction (r=0.89) and financial performance (r=0.93) and 4) customer satisfaction improves the financial performance (0.98).

Relationship between health promotion volunteer experience and medical costs: Hoken-hodouin activities in Suzaka, Nagano.

PubMed

Imamura, Haruhiko; Murakami, Yoshitaka; Okamura, Tomonori; Nishiwaki, Yuji

2017-01-01

Objectives This study demonstrated the relationship between experience as a health promotion volunteer (Hoken-hodouin) and medical costs in Japan. The study area was Suzaka City (March 2016 population: 51,637) in Nagano Prefecture, Japan, where a total of about 300 women have been engaged and trained as health promotion volunteers since 1958.Methods A cross-sectional survey was conducted in 2014 using a self-administered questionnaire, which included items on experiences as a health promotion volunteer, age at engagement, leadership status, and satisfaction with the experience. Eligible study participants were all residents of Suzaka aged 65 years or over. Medical cost data from April 2013 to March 2014 were collected for women aged 65-74 years who were beneficiaries of the Japanese National Health Insurance (n=2,304). Medical consultation rates and costs for treatment at outpatient and inpatient clinics were analyzed as outcomes. Adjustments were made for age, marital status, educational level, cohabitation status, equivalent income, alcohol use, smoking status, awareness about a healthy diet, and walking time per day.Results Of the 2,304 study participants, 1,274 (55.3%) had experience as health promotion volunteers. Poisson regression analysis revealed that volunteers' experience was positively associated with outpatient care rates (adjusted relative risk [RR]=1.04; 95% confidence interval [CI]=1.02-1.07), and negatively associated with inpatient care rates (RR=0.74; 95% CI=0.56-0.98). Multivariate regression analysis revealed that the adjusted geometric means of outpatient and inpatient care costs were 7% and 23% lower, respectively, among participants with volunteer experience than that among those with no volunteer experience (140,588-151,465 JPY for outpatient costs; 418,457-539,971 JPY for inpatient costs). These associations were stronger among participants who began health promotion volunteer at age 60 years or more, those who had leadership roles, and participants who had high levels of satisfaction regarding their volunteer experience.Conclusion These results suggest that experience as a health promotion volunteer is associated with lower medical costs, particularly for inpatient care.

Protocol for a randomised crossover trial to evaluate patient and nurse satisfaction with electronic and elastomeric portable infusion pumps for the continuous administration of antibiotic therapy in the home: the Comparing Home Infusion Devices (CHID) study

PubMed Central

Ryan, Melissa K; Ritchie, Brett; Sluggett, Janet K; Sluggett, Andrew J; Ralton, Lucy; Reynolds, Karen J

2017-01-01

Introduction Previous studies comparing satisfaction with electronic and elastomeric infusion pumps are limited, and improvements in size and usability of electronic pumps have since occurred. The Comparing Home Infusion Devices (CHID) study plans to assess patient and nurse satisfaction with an elastomeric and electronic pump for delivering intravenous antibiotic treatment in the home. Secondary objectives are to determine pump-related complications and actual antibiotic dose administered, evaluate temperature variation and compare pump operating costs. Methods and analysis The CHID study will be a randomised, crossover trial. A trained research nurse will recruit patients with infectious disease aged ≥18 years and prescribed ≥8 days of continuous intravenous antibiotic therapy from the Royal Adelaide Hospital (RAH) (Adelaide, Australia). Patients will be randomised to receive treatment at home via an elastomeric (Baxter Infusor) or an electronic (ambIT Continuous) infusion pump for 4–7 days, followed by the other for a further 4–7 days. Patient satisfaction will be assessed by a 10-item survey to be completed at the end of each arm. Nurse satisfaction will be assessed by a single 24-item survey. Patient logbooks and case notes from clinic visits will be screened to identify complications. Pumps/infusion bags will be weighed to estimate the volume of solution delivered. Temperature sensors will record skin and ambient temperatures during storage and use of the pumps throughout the infusion period. Costs relating to pumps, consumables, antibiotics and servicing will be determined. Descriptive statistics will summarise study data. Ethics and dissemination This study has been approved by the RAH Human Research Ethics Committee (HREC/16/RAH/133 R20160420, version 6.0, 5 September 2016). Study results will be disseminated through peer-reviewed publications and conference presentations. The CHID study will provide key insights into patient and provider satisfaction with elastomeric and electronic infusion pumps and inform future device selection. Trial registration number ACTRN12617000251325; Pre-results. PMID:28760798

Improving Intercontinental Ballistic Missile Maintenance Scheduling Through the Use of Location Analysis Methodologies

DTIC Science & Technology

2006-03-01

Requirements for the Degree of Master of Science in Logistics Management Dale L. Overholts II, BS Capt, USAF March 2006 APPROVED...distance (e. g . , travel time or cost, demand satisfaction) is fundamental to such problems” (Current et al, 2002:86). The set covering location... the total number of scheduled launch facilities, can be found in Appendix F. Appendix G provides detailed information regarding the impacts of

Quality and price--impact on patient satisfaction.

PubMed

Pantouvakis, Angelos; Bouranta, Nancy

2014-01-01

The purpose of this paper is to synthesize existing quality-measurement models and applies them to healthcare by combining a Nordic service-quality with an American service performance model. Results are based on a questionnaire survey of 1,298 respondents. Service quality dimensions were derived and related to satisfaction by employing a multinomial logistic model, which allows prediction and service improvement. Qualitative and empirical evidence indicates that customer satisfaction and service quality are multi-dimensional constructs, whose quality components, together with convenience and cost, influence the customer's overall satisfaction. The proposed model identifies important quality and satisfaction issues. It also enables transitions between different responses in different studies to be compared.

Associations between degrees of task delegation and job satisfaction of general practitioners and their staff: a cross-sectional study.

PubMed

Riisgaard, Helle; Søndergaard, Jens; Munch, Maria; Le, Jette V; Ledderer, Loni; Pedersen, Line B; Nexøe, Jørgen

2017-01-17

In recent years, the healthcare system in the western world has undergone a structural development caused by changes in demography and pattern of disease. In order to maintain the healthcare system cost-effective, new tasks are placed in general practice urging the general practitioners to rethink the working structure without compromising the quality of care. However, there is a substantial variation in the degree to which general practitioners delegate tasks to their staff, and it is not known how these various degrees of task delegation influence the job satisfaction of general practitioners and their staff. We performed a cross-sectional study based on two electronic questionnaires, one for general practitioners and one for their staff. Both questionnaires were divided into two parts, a part exploring the degree of task delegation regarding management of patients with chronic obstructive pulmonary disease in general practice and a part concerning the general job satisfaction and motivation to work. We found a significant association between perceived "maximal degree" of task delegation in management of patients with chronic obstructive pulmonary disease and the staff's overall job satisfaction. The odds ratio of the staff's satisfaction with the working environment displayed a tendency that there is also an association with "maximal degree" of task delegation. In the analysis of the general practitioners, the odds ratios of the results indicate that there is a tendency that "maximal degree" of task delegation is associated with overall job satisfaction, satisfaction with the challenges in work, and satisfaction with the working environment. We conclude that a high degree of task delegation is significantly associated with overall job satisfaction of the staff, and that there is a tendency that a high degree of task delegation is associated with the general practitioners' and the staff's satisfaction with the working environment as well as with general practitioners' overall job satisfaction and satisfaction with challenges in work. To qualify future delegation processes within general practice, further research could explore the reasons for our findings.

Adverse Impacts of Furlough Programs on Employee Work Rate and Organizational Productivity

DTIC Science & Technology

2014-04-01

interval (0, 1) os = level of satisfaction of the objective (rated on a scale of 0 to 1) oc = cost of achieving the objective (expressed in pertinent cost...basis: money, time, measurable resource, etc.) If an objective is fully achieved, its satisfaction rating will be 1. If not achieved at all, it will...1990). The effects of the compressed workweek: A review of the evidence. Australian Bulletin of Labour , 16(2), 104–127. Giachetti, R. E. (2010

Cost-effectiveness analysis of implants versus autologous perforator flaps using the BREAST-Q.

PubMed

Matros, Evan; Albornoz, Claudia R; Razdan, Shantanu N; Mehrara, Babak J; Macadam, Sheina A; Ro, Teresa; McCarthy, Colleen M; Disa, Joseph J; Cordeiro, Peter G; Pusic, Andrea L

2015-04-01

Reimbursement has been recognized as a physician barrier to autologous reconstruction. Autologous reconstructions are more expensive than prosthetic reconstructions, but provide greater health-related quality of life. The authors' hypothesis is that autologous tissue reconstructions are cost-effective compared with prosthetic techniques when considering health-related quality of life and patient satisfaction. A cost-effectiveness analysis from the payer perspective, including patient input, was performed for unilateral and bilateral reconstructions with deep inferior epigastric perforator (DIEP) flaps and implants. The effectiveness measure was derived using the BREAST-Q and interpreted as the cost for obtaining 1 year of perfect breast health-related quality-adjusted life-year. Costs were obtained from the 2010 Nationwide Inpatient Sample. The incremental cost-effectiveness ratio was generated. A sensitivity analysis for age and stage at diagnosis was performed. BREAST-Q scores from 309 patients with implants and 217 DIEP flap reconstructions were included. The additional cost for obtaining 1 year of perfect breast-related health for a unilateral DIEP flap compared with implant reconstruction was $11,941. For bilateral DIEP flaps compared with implant reconstructions, the cost for an additional breast health-related quality-adjusted life-year was $28,017. The sensitivity analysis demonstrated that the cost for an additional breast health-related quality-adjusted life-year for DIEP flaps compared with implants was less for younger patients and earlier stage breast cancer. DIEP flaps are cost-effective compared with implants, especially for unilateral reconstructions. Cost-effectiveness of autologous techniques is maximized in women with longer life expectancy. Patient-reported outcomes findings can be incorporated into cost-effectiveness analyses to demonstrate the relative value of reconstructive procedures.

42 CFR 423.156 - Consumer satisfaction surveys.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Consumer satisfaction surveys. 423.156 Section 423.156 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality...

Family Medicine Panel Size with Care Teams: Impact on Quality.

PubMed

Angstman, Kurt B; Horn, Jennifer L; Bernard, Matthew E; Kresin, Molly M; Klavetter, Eric W; Maxson, Julie; Willis, Floyd B; Grover, Michael L; Bryan, Michael J; Thacher, Tom D

2016-01-01

The demand for comprehensive primary health care continues to expand. The development of team-based practice allows for improved capacity within a collective, collaborative environment. Our hypothesis was to determine the relationship between panel size and access, quality, patient satisfaction, and cost in a large family medicine group practice using a team-based care model. Data were retrospectively collected from 36 family physicians and included total panel size of patients, percentage of time spent on patient care, cost of care, access metrics, diabetic quality metrics, patient satisfaction surveys, and patient care complexity scores. We used linear regression analysis to assess the relationship between adjusted physician panel size, panel complexity, and outcomes. The third available appointments (P < .01) and diabetic quality (P = .03) were negatively affected by increased panel size. Patient satisfaction, cost, and percentage fill rate were not affected by panel size. A physician-adjusted panel size larger than the current mean (2959 patients) was associated with a greater likelihood of poor-quality rankings (≤25th percentile) compared with those with a less than average panel size (odds ratio [OR], 7.61; 95% confidence interval [CI], 1.13-51.46). Increased panel size was associated with a longer time to the third available appointment (OR, 10.9; 95% CI, 1.36-87.26) compared with physicians with panel sizes smaller than the mean. We demonstrated a negative impact of larger panel size on diabetic quality results and available appointment access. Evaluation of a family medicine practice parameters while controlling for panel size and patient complexity may help determine the optimal panel size for a practice. © Copyright 2016 by the American Board of Family Medicine.

Retrospective analysis of the financial break-even point for intrathecal morphine pump use in Korea.

PubMed

Kim, Eun Kyoung; Shin, Ji Yeon; Castañeda, Anyela Marcela; Lee, Seung Jae; Yoon, Hyun Kyu; Kim, Yong Chul; Moon, Jee Youn

2017-10-01

The high cost of intrathecal morphine pump (ITMP) implantation may be the main obstacle to its use. Since July 2014, the Korean national health insurance (NHI) program began paying 50% of the ITMP implantation cost in select refractory chronic pain patients. The aims of this study were to investigate the financial break-even point and patients' satisfaction in patients with ITMP treatment after the initiation of the NHI reimbursement. We collected data retrospectively or via direct phone calls to patients who underwent ITMP implantation at a single university-based tertiary hospital between July 2014 and May 2016. Pain severity, changes in the morphine equivalent daily dosage (MEDD), any adverse events, and patients' satisfaction were determined. We calculated the financial break-even point of ITMP implantation via investigating the patient's actual medical costs and insurance information. During the studied period, 23 patients received ITMP implantation, and 20 patients were included in our study. Scores on an 11-point numeric rating scale (NRS) for pain were significantly reduced compared to the baseline value ( P < 0.001). The MEDD before ITMP implantation was 0.59 [IQR: 0.55-0.82]. The total MEDD increased steadily to 0.77 [IQR: 0.53-1.08] at 1 year, which was 126% of the baseline ( P < 0.001). More than a half (60%) responded that the ITMP therapy was somewhat satisfying. The financial break-even point was 28 months for ITMP treatment after the NHI reimbursement policy. ITMP provided effective chronic pain management with improved satisfaction and reasonable financial break-even point of 28 months with 50% financial coverage by NHI program.

New proposal of silver diamine fluoride use in arresting approximal caries: study protocol for a randomized controlled trial.

PubMed

Mattos-Silveira, Juliana; Floriano, Isabela; Ferreira, Fernanda R; Viganó, Maria E F; Frizzo, M A; Reyes, Alessandra; Novaes, Tatiane F; Moriyama, Caroline M; Raggio, Daniela P; Imparato, José C P; Mendes, Fausto M; Braga, Mariana M

2014-11-19

Approximal surfaces are a challenge to caries lesions control. Silver diamine fluoride (SDF) is a simple,low-cost and promisor intervention for arresting caries lesions, but it has never been tested on approximal surfaces. Our aim is to evaluate the efficacy and cost-efficacy of SDF in arresting initial lesions compared to resin infiltration and exclusively flossing (control group). Our second aim is to assess discomfort and satisfaction regarding interventions. This is a randomized clinical trial, double-blinded, placebo-controlled study. Children/adolescents presenting at least one approximal initial caries lesion in primary molars/permanent premolars and molars will be included. Surfaces with advanced dentine lesions identified by radiography and participants who refuse to participate or present negative behaviors will be excluded. A minimum sample size of 504 surfaces will be required for each subgroup. Individuals will be randomly allocated in three groups of interventions: SDF, resin infiltration, and control group. Depending on the allocation, the patients will receive the active treatment and respective placebo therapies. All patients will be oriented to daily flossing the included surfaces. Our primary outcome will be caries progression by clinical and radiographic examinations. Appointments will be timed and costs of materials will be considered to calculate cost-efficacy. Patient discomfort will be assessed after interventions. Parent and patient satisfaction with the treatment will be collected after treatment and in the last follow-up visit. Individuals will be assessed at 1 and 3 months after treatment to evaluate dental biofilm and at 6, 12, and 24 months to assess caries progression by visual examination and/or radiography. Multilevel analyses will be used to verify if the type of treatment influenced on the tested outcomes. Costs will be compared and analyses of cost-efficacy will be performed. Poisson analysis will test the association between intervention and reported discomfort and satisfaction. Our hypothesis is that SDF is the most cost-efficacious option from all tested interventions. If our hypothesis is confirmed, the use of SDF in private and public contexts could represent an easier and effective option in the treatment of enamel approximal caries in children/adolescents. ClinicalTrials.gov (NCT01477385), Initial release: 11/16/2011: last update: 06/02/2014.

Disease management improves ESRD outcomes.

PubMed

Sands, J J

2006-02-01

Renal disease management organizations have reported achieving significant decreases in mortality and hospitalization in conjunction with cost savings, improved patient satisfaction and quality of life. Disease management organizations strive to fill existing gaps in care delivery through the standardized use of risk assessment, predictive modeling, evidence based guidelines and process and outcomes measurement. Patient self-management education and the provision of individual nurse care managers are also key program components. As we more fully measure clinical outcomes and total health-care costs including payments from all insurance and government entities, pharmacy costs and out-of-pocket expenditures, the full implications of disease management can be better defined. The results of this analysis will have a profound influence on United States healthcare policy. At present, current data suggests that the promise of disease management, improved care at reduced cost, can and is being realized in ESRD.

Comparison of three types of central venous catheters in patients with malignant tumor receiving chemotherapy

PubMed Central

Fang, Shirong; Yang, Jinhong; Song, Lei; Jiang, Yan; Liu, Yuxiu

2017-01-01

Background Central venous catheters (CVCs) have been an effective access for chemotherapy instead of peripherally intravenous catheters. There were limited studies on the choices and effects of different types of CVCs for chemotherapy. The aim of this study was to compare the complications, cost, and patients’ quality of life and satisfaction of three commonly used CVCs for chemotherapy, such as implanted venous port, peripherally inserted central catheters (PICCs), and external non-tunneled central venous catheters (NTCs). Methods A double-center prospective cohort study was carried out from March 2014 to December 2016. Catheterization situation, complications, catheter maintenance, cost, and patients’ quality of life and satisfaction were recorded, investigated, and analyzed. Forty-five ports, 60 PICCs and 40 NTCs were included. All the CVCs were followed up to catheter removal. Results There was no statistical difference in catheterization success rates between port and PICC. NTC had less success rate by one puncture compared with port. Ports had fewer complications compared with PICCs and NTCs. The complication rates of ports, PICCs and NTCs were 2.2%, 40%, and 27.5%, respectively. If the chemotherapy process was <12 months, NTCs cost least, and the cost of port was much higher than PICC and NTC. When the duration time was longer than 12 months, the cost of port had no difference with the cost of PICC. Quality of life and patients’ satisfaction of port group were significantly higher than the other two groups. Conclusion Although port catheterization costs more and needs professional medical staff and strict operational conditions, ports have fewer complications and higher quality of life and patients’ satisfaction than PICCs and NTCs. Therefore, not following consideration of the economic factor, we recommend port as a safe and an effective chemotherapy access for cancer patients, especially for whom needing long chemotherapy process. PMID:28744109

Improving the economic and humanistic outcomes for diabetic patients: making a case for employer-sponsored medication therapy management

PubMed Central

Pinto, Sharrel L; Kumar, Jinender; Partha, Gautam; Bechtol, Robert A

2013-01-01

Background The purpose of this study was to determine the cost savings of a pharmacist-led, employer-sponsored medication therapy management (MTM) program for diabetic patients and to assess for any changes in patient satisfaction and self-reported medication adherence for enrollees. Methods Participants in this study were enrollees of an employer-sponsored MTM program. They were included if their primary medical insurance and prescription coverage was from the City of Toledo, they had a diagnosis of type 2 diabetes, and whether or not they had been on medication or had been given a new prescription for diabetes treatment. The data were analyzed on a prospective, pre-post longitudinal basis, and tracked for one year following enrollment. Outcomes included economic costs, patient satisfaction, and self-reported patient adherence. Descriptive statistics were used to characterize the population, calculate the number of visits, and determine the mean costs for each visit. Friedman’s test was used to determine changes in outcomes due to the nonparametric nature of the data. Results The mean number of visits to a physician’s office decreased from 10.22 to 7.07. The mean cost of these visits for patients increased from $47.70 to $66.41, but use of the emergency room and inpatient visits decreased by at least 50%. Employer spending on emergency room visits decreased by $24,214.17 and inpatient visit costs decreased by $166,610.84. Office visit spending increased by $11,776.41. A total cost savings of $179,047.80 was realized by the employer at the end of the program. Significant improvements in patient satisfaction and adherence were observed. Conclusion Pharmacist interventions provided through the employer-sponsored MTM program led to substantial cost savings to the employer with improved patient satisfaction and adherence on the part of employees at the conclusion of the program. PMID:23610526

Treatment adherence and other patient-reported outcomes as cost determinants in multiple sclerosis: a review of the literature.

PubMed

Lizán, Luis; Comellas, Marta; Paz, Silvia; Poveda, José Luis; Meletiche, Dennis M; Polanco, Carlos

2014-01-01

Treatment adherence is one of the key factors for achieving optimal clinical outcomes. In order to assess costs related to adherence to, and persistence and compliance with, disease-modifying therapies (DMTs) in patients with multiple sclerosis (MS), a narrative review of the literature was performed. Satisfaction with and preference for DMTs and their delivery devices were also assessed, as both can have an influence on patients' adherence and persistence. Electronic databases (MEDLINE, PubMed, Google Scholar, congress proceedings) were searched to identify publications analyzing MS costs related to adherence, persistence, satisfaction, and preferences for MS treatments. Bibliographic references were hand searched. English or Spanish studies published between January 2007 and January 2013 were selected. A total of 398 titles were identified, of which 12 met the inclusion criteria. Six studies evaluated the impact of adherence, persistence, and compliance on treatment costs; four publications analyzed satisfaction with DMTs; and two assessed treatment preferences based on attributes of the delivery device. Increased adherence and persistence were associated with better clinical outcomes, leading to lower relapse risk (odds ratio [OR]: 0.71; 95% confidence interval [CI]: 0.59-0.85) and a decrease in health care resource use, such as MS-related hospitalizations (OR: 0.63; 95% CI: 0.47-0.83) and emergency department visits (OR: 0.80; 95% CI: 0.60-1.07). This reduction in resource use led to a patient/year total cost reduction (excluding DMT costs) of up to 22%. This review highlights the importance of ensuring adequate adherence in MS patients through treatments and devices better tailored to patients' needs that could enhance clinical outcomes and reduce MS costs. Understanding the factors underlying satisfaction and compliance with treatment and patients' preference for certain therapies could help in the development of strategies that can improve adherence.

An evaluation of a nurse-led ear care service in primary care: benefits and costs.

PubMed Central

Fall, M; Walters, S; Read, S; Deverill, M; Lutman, M; Milner, P; Rodgers, R

1997-01-01

BACKGROUND: Nurses trained in ear care provide a new model for the provision of services in general practice, with the aim of cost-effective treatment of minor ear and hearing problems that affect well-being and quality of life. AIM: To compare a prospective observational cohort study measuring health outcomes and resource use for patients with ear or hearing problems treated by nurses trained in ear care with similar patients treated by standard practice. METHOD: A total of 438 Rotherham and 196 Barnsley patients aged 16 years or over received two self-completion questionnaires: questionnaire 1 (Q1) on the day of consultation and questionnaire 2 (Q2) after three weeks. Primary measured outcomes were changes in discomfort and pain; secondary outcomes included the effect on normal life, health status, patient satisfaction, and resources used. RESULTS: After adjusting for differences at Q1, by Q2 there was no statistical evidence of a difference in discomfort and pain reduction, or differential change in health status between areas. Satisfaction with treatment was significantly higher (P = 0.0001) in Rotherham (91%) than in Barnsley (82%). Average total general practitioner (GP) consultations were lower in Rotherham at 0.4 per patient with an average cost of 6.28 Pounds compared with Barnsley at 1.4 per patient and an average cost of 22.53 Pounds (P = 0.04). Barnsley GPs prescribed more drugs per case (6% of total costs compared with 1.5%) and used more systemic antibiotics (P = 0.001). CONCLUSIONS: Nurses trained in ear care reduce costs, GP workload, and the use of systemic antibiotics, while increasing patient satisfaction with care. With understanding and support from GPs, such nurses are an example of how expanded nursing roles bring benefits to general practice. Nurses trained in ear care reduce treatment costs, reduce the use of antibiotics, educate patients in ear care, increase patient satisfaction, and raise ear awareness. PMID:9519514

Evaluation and comparison of safety, convenience and cost of administering intravenous pamidronate infusions to children in the home and ambulatory care settings.

PubMed

Rush, Eric T; DeHaai, Kristi; Kreikemeier, Rose M; Lutz, Richard E

2012-01-01

The use of bisphosphonates in children to treat low bone mineral density has increased. Safety and efficacy of pamidronate has been previously demonstrated. However, little research has been done on pamidronate infusion in the home health setting for patients with metabolic bone disease. Data were collected via a survey to assess satisfaction and convenience of infusions. Adverse events were measured by collecting calcium levels before and after infusions. Infusion costs were estimated from the standard orders from one home health agency and our infusion center. We found no difference in the rates of hypocalcemia between the two groups. The survey results showed high satisfaction for both groups, with higher scores in the home health group for convenience and stress. Home health infusions showed lower cost and less absenteeism from school and work. Home health-based pamidronate infusion appears to be safe, less expensive, and is associated with high patient satisfaction.

The influences of patient's satisfaction with medical service delivery, assessment of medical service, and trust in health delivery system on patient's life satisfaction in China.

PubMed

Tang, Liyang

2012-09-14

Patient's satisfaction with medical service delivery/assessment of medical service/trust in health delivery system may have significant influence on patient's life satisfaction in China's health delivery system/in various kinds of hospitals.The aim of this study was to test whether and to what extent patient's satisfaction with medical service delivery/patient's assessments of various major aspects of medical service/various major aspects of patient's trust in health delivery system influenced patient's life satisfaction in China's health delivery system/in various kinds of hospitals. This study collaborated with National Bureau of Statistics of China to carry out a 2008 national urban resident household survey in 17 provinces, autonomous regions, and municipalities directly under the central government (N = 3,386), and specified ordered probit models were established to analyze dataset from this household survey. The key considerations in generating patient's life satisfaction involved patient's overall satisfaction with medical service delivery, assessment of doctor-patient communication, assessment of medical cost, assessment of medical treatment process, assessment of medical facility and hospital environment, assessment of waiting time for medical service, trust in prescription, trust in doctor, and trust in recommended medical examination. But the major considerations in generating patient's life satisfaction were different among low level public hospital, high level public hospital, and private hospital. The promotion of patient's overall satisfaction with medical service delivery, the improvement of doctor-patient communication, the reduction of medical cost, the improvement of medical treatment process, the promotion of medical facility and hospital environment, the reduction of waiting time for medical service, the promotion of patient's trust in prescription, the promotion of patient's trust in doctor, and the promotion of patient's trust in recommended medical examination could all help promote patient's life satisfaction. But their promotion effects were different among low level public hospital, high level public hospital, and private hospital.

20 CFR 631.62 - Cost limitations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... THE JOB TRAINING PARTNERSHIP ACT Federal Delivery of Dislocated Worker Services Through National... not adequately justify to the Grant Officer's satisfaction the costs to be incorporated into the grant...

20 CFR 631.62 - Cost limitations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... THE JOB TRAINING PARTNERSHIP ACT Federal Delivery of Dislocated Worker Services Through National... not adequately justify to the Grant Officer's satisfaction the costs to be incorporated into the grant...

Hearing Aid Satisfaction: What Does Research from the Past 20 Years Say?

PubMed Central

Wong, Lena L. N.; Hickson, Louise; McPherson, Bradley

2003-01-01

Hearing aid satisfaction is a pleasurable emotional experience as an outcome of an evaluation of performance. Many tools have been designed to measure the degree of satisfaction overall, or along the dimensions of cost, appearance, acoustic benefit, comfort, and service. Various studies have used these tools to examine the relationships between satisfaction and other factors. Findings are not always consistent across studies, but in general, hearing aid satisfaction has been found to be related to experience, expectation, personality and attitude, usage, type of hearing aids, sound quality, listening situations, and problems in hearing aid use. Inconsistent findings across studies and difficulties in evaluating the underlying relationships are probably caused by problems with the tools (eg, lack of validity) and the methods used to evaluate relationships (eg, correlation analyses evaluate association and not causal effect). Whether satisfaction changes over time and how service satisfaction contributes to device satisfaction are unclear. It is hoped that this review will help readers understand current satisfaction measures, how various factors affect satisfaction, and how the way satisfaction is measured may be improved to yield more reliable and valid data. PMID:15004650

Reconsidering the Affordable Care Act's Restrictions on Physician-Owned Hospitals: Analysis of CMS Data on Total Hip and Knee Arthroplasty.

PubMed

Courtney, P Maxwell; Darrith, Brian; Bohl, Daniel D; Frisch, Nicholas B; Della Valle, Craig J

2017-11-15

Concerns about financial incentives and increased costs prompted legislation limiting the expansion of physician-owned hospitals in 2010. Supporters of physician-owned hospitals argue that they improve the value of care by improving quality and reducing costs. The purpose of the present study was to determine whether physician-owned and non-physician-owned hospitals differ in terms of costs, outcomes, and patient satisfaction in the setting of total hip arthroplasty (THA) and total knee arthroplasty (TKA). With use of the U.S. Centers for Medicare & Medicaid Services (CMS) Inpatient Charge Data, we identified 45 physician-owned and 2,657 non-physician-owned hospitals that performed ≥11 primary TKA and THA procedures in 2014. Cost data, patient-satisfaction scores, and risk-adjusted complication and 30-day readmission scores for knee and hip arthroplasty patients were obtained from the multiyear CMS Hospital Compare database. Physician-owned hospitals received lower mean Medicare payments than did non-physician-owned hospitals for THA and TKA procedures ($11,106 compared with $12,699; p = 0.002). While the 30-day readmission score did not differ significantly between the 2 types of hospitals (4.48 compared with 4.62 for physician-owned and non-physician-owned, respectively; p = 0.104), physician-owned hospitals had a lower risk-adjusted complication score (2.83 compared with 3.04; p = 0.015). Physician-owned hospitals outperformed non-physician-owned hospitals in all patient-satisfaction categories, including mean linear scores for recommending the hospital (93.9 compared with 87.9; p < 0.001) and overall hospital rating (93.4 compared with 88.4; p < 0.001). When controlling for hospital demographic variables, status as a non-physician-owned hospital was an independent risk factor for being in the upper quartile of all inpatient payments for Medicare Severity-Diagnosis Related Group (MS-DRG) 470 (odds ratio, 3.317; 95% confidence interval, 1.174 to 9.371; p = 0.024), which may be because of a difference in CMS payment methodology. Our findings suggest that physician-owned hospitals are associated with lower mean Medicare costs, fewer complications, and higher patient satisfaction following THA and TKA than non-physician-owned hospitals. Policymakers should consider these data when debating the current moratorium on physician-owned hospital expansion. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Developing a tool to measure pharmacoeconomic outcomes of post-surgical pain management interventions.

PubMed

Keller, Deborah S; Smalarz, Amy; Haas, Eric M

2016-01-01

Financial pressures have limited the ability of providers to use medication that may improve clinical outcomes and patient satisfaction. New interventions are often fraught with resistance from individual cost centers. A value realization tool (VRT) is essential for separate cost centers to communicate and comprehend the overall financial and clinical implications of post-surgical pain management medication interventions (PSMI). The goal was to describe development of a VRT. An evaluation of common in-patient PSMI approaches, impacts, and costs was performed. A multidisciplinary task force guided development of the VRT to ensure appropriate representation and relevance to clinical practice. The main outcome was an Excel-based tool that communicates the overall cost/benefit of PSMI for the post-operative patient encounter. The VRT aggregated input data on costs, clinical impact, and nursing burden of PSMI assessment and monitoring into two high-level outcome reports: Overall Cost Impact and Nurse & Patient Impact. Costs included PSMI specific medication, equipment, professional placement, labor, overall/opioid-related adverse events, re-admissions, and length of stay. Nursing impact included level of practice interference, job satisfaction, and patient care metrics. Patient impact included pain scores, opioid use, PACU time, and satisfaction. Reference data was provided for individual institutions that may not collect all variables included in the VRT. The VRT is a valuable way for administrators to assess PSMI cost/benefits and for individual cost centers to see the overall value of individual interventions. The user-friendly, decision-support tool allows the end-user to use built-in referenced or personalized outcome data, increasing relevance to their institutions. This broad picture could facilitate communication across cost centers and evidence-based decisions for appropriate use and impacts of PSMI.

[How significant are customer surveys in the rehabilitation of patients with mental illness?].

PubMed

Queri, S; Spörrle, M

2008-12-01

In Germany, customer surveys in the field of rehabilitation meanwhile are of high political relevance - particularly since the Deutsche Rentenversicherung (German Pension Insurance) has defined customer judgements as a significant outcome parameter. Both the theoretical conceptualization and the empirical data available suggest that customer satisfaction is a construct widely dependent on subjective factors, which has only little reference to the reality of treatment. In the Herzogsägmühle Rehabilitation Centre a detailed customer survey (rehabilitants with mental illness) was carried out for the first time in 2007 in the framework of internal quality management. Data analysis was to yield new knowledge concerning the validity of subjective patient-related outcome parameters as well as relative to the content dimensioning regarding satisfaction and quality judgments in this specific sample. A Centre-specific questionnaire was constructed taking into account existing empirical data and theoretical considerations concerning the relevant content dimensions of customer satisfaction. Forty-six mostly male rehabilitants with an average age of 25 were interviewed. The majority of the interviewees had been diagnosed as having a schizophrenic or an affective disorder. The data obtained was submitted to a predominantly explorative data analysis, also testing various hypotheses. The results show that the rehabilitants' judgements are differentiated and that the expected positive bias was restricted to a few areas. Also it could be shown that treatment satisfaction and quality evaluations present different content dimensions. While satisfaction depends on the evaluation of treatment efficacy, the quality judgement is dependent on evaluation of the professional skills of the staff involved. CONCLUSION/CONSEQUENCES: In particular the quality judgments of the rehabilitants are important in both internal and external (by the cost carriers) quality management assurance. Both theoretical considerations and empirical findings on the subject of patient satisfaction suggest that surveys should be embedded in a comprehensive evaluation concept in the framework of effectiveness research. It is therefore projected to validate the patient judgements given at the Rehabilitation Centre on objective, treatment-related outcome parameters.

Bringing Cost-Wise Readiness to the Deckplates of a Strike Fighter Squadron Using the Balanced Scorecard

DTIC Science & Technology

2013-12-01

equity employed). Customer measures, such as customer satisfaction , are intended to measure the company’s performance from the customer’s perspective...link between a non-financial measure and a firm’s financial performance. For example, one could meet objectives relating to customer satisfaction ... customer satisfaction . Who then is the customer of a strike fighter squadron? Kaplan and Norton (2004) write extensively about 61 the value

A System Dynamics Model for Assessing the Cost-Effectiveness of USAF Engineering Officer Compensation Policies.

DTIC Science & Technology

1980-12-01

VI and jA-VI] [p. 46]. This article also gives a pertinent quote attributed to Vroom . job satisfaction is closely affected by the amounts of rewards...Presentation of Typical QOAFL Question . . . . 40 6. Comparison of Mean Quality of Air Force Life Factor Satisfaction Levels . ....... . 41 7...Scientific Officers (AFSCs 2XXX) ...... ................ . 150 A-II. Mean Values of Satisfaction and Importance Ratings of Job Characteristics, and Their

The comfort and satisfaction of air travelers - Basis for a descriptive model

NASA Technical Reports Server (NTRS)

Jacobson, I. D.; Martinez, J.

1974-01-01

The results of a questionnaire and interview survey are used as a basis for proposing a descriptive model of the comfort and satisfaction of the commercial air traveler. Passenger attitudes toward the present commercial air travel system are examined. Comfort is interpreted as being represented by a four-dimensional composite of commonly encountered environmental variables. Satisfaction is represented as a composite of safety, cost-benefit, luxury, and in-flight activity dimensions.

Representative marketing-oriented study on implants in the Austrian population. II. Implant acceptance, patient-perceived cost and patient satisfaction.

PubMed

Tepper, Gabor; Haas, Robert; Mailath, Georg; Teller, Christoph; Bernhart, Thomas; Monov, Gabriel; Watzek, Georg

2003-10-01

Oral implantology is an established subspecialty of restorative dental and oral surgery. While an extensive body of evidence on the fundamentals of osseointegration and associated factors has been published, marketing-oriented analyses based on representative public opinion polls of implant acceptance, patient-perceived cost and patient satisfaction are scarce. In this study, an attempt was made to address these points by questioning a representative sample of 1000 adults in the household setting. The interviewees were presented with 14 questions. Of those familiar with implants as one of the treatment alternatives, 61% reported they would accept implants if the need arose. Implant acceptance was highest among males and interviewees below the age of 30 years. The interest in implants increased with increasing family incomes. Four percent of those questioned already had implants. Twenty-five percent knew someone who had undergone implant treatment. All those questioned found implant-supported rehabilitation to be very expensive. Many of them blamed the dentists for the high cost. One detail was particularly evident: satisfaction among implanted patients was clearly higher than satisfaction rates perceived by them from what they were told about implants by others. First-hand experiences with implants proved to be less biased than reported second-hand information.

The effects of differentiation of self, adult attachment, and sexual communication on sexual and marital satisfaction: a path analysis.

PubMed

Timm, Tina M; Keiley, Margaret K

2011-01-01

This article explores the relations among differentiation of self, adult attachment, sexual communication, sexual satisfaction, and marital satisfaction, in a path analysis model. In a sample of 205 married adults, the path analysis results indicated that (a) differentiation of self had no direct effect on marital or sexual satisfaction, although it was significantly related to sexual communication; (b) adult attachment had a direct effect on marital satisfaction, but not on sexual satisfaction; (c) sexual communication is a mediating variable; (d) sexual communication was positively related to sexual satisfaction and marital satisfaction; and (e) no gender differences existed in the model.

Effects of high-involvement work systems on employee satisfaction and service costs in veterans healthcare.

PubMed

Harmon, Joel; Scotti, Dennis J; Behson, Scott; Farias, Gerard; Petzel, Robert; Neuman, Joel H; Keashly, Loraleigh

2003-01-01

Two strong imperatives for healthcare managers are reducing costs of service and attracting and retaining highly dedicated and competent patient care and support employees. Is there a trade-off or are there organizational practices that can further both objectives at the same time? High-involvement work systems (HIWS) represent a holistic work design that includes interrelated core features such as involvement, empowerment, development, trust, openness, teamwork, and performance-based rewards. HIWS have been linked to higher productivity, quality, employee and customer satisfaction, and market and financial performance in Fortune 1000 firms. Apparently, few prior studies have looked at the impacts of this holistic design within the healthcare sector. This research found that HIWS were associated with both greater employee satisfaction and lower patient service costs in 146 Veterans Health Administration centers, indicating that such practices pay off in both humanistic and financial terms. This suggests that managers implementing HIWS will incur real expenses that are likely to be more than offset by more satisfied employees, less organizational turmoil, and lower service delivery costs, which, in this study, amounted to over $1.2 million in savings for an average VHA facility.

Impact of a new method of warfarin management on patient satisfaction, time, and cost.

PubMed

Meyer, Sarah; Frei, Christopher R; Daniels, Kelly R; Forcade, Nicolas A; Bussey, Marie; Bussey-Smith, Kristin L; Bussey, Henry I

2013-11-01

International normalized ratio self-testing with online remote monitoring and management (STORM₂) is an alternative to anticoagulation clinic management, but the patient's perspective of this method has not been evaluated in the United States; thus we sought to evaluate the impact of STORM₂ on patient satisfaction, time, and cost. Prospective pre- and postintervention study. Freestanding clinical research center. Forty-three patients treated with long-term warfarin therapy and monitored initially in the anticoagulation clinic setting and then with STORM₂, referred from 11 medical practices. Patients were asked to complete a survey and the Duke Anticoagulation Satisfaction Scale (DASS) before (at baseline) and after at least 3 months of STORM₂ (at follow-up). Patient satisfaction and time were assessed by survey and the DASS. Costs were measured from the patient's perspective. Overall 90% of responders preferred STORM₂ to traditional clinic management. The DASS questions indicated that patients were more satisfied with their anticoagulation treatment and more likely to recommend oral anticoagulation to a friend after experiencing STORM₂. In addition, patients found STORM₂ to be less complicated and more convenient than traditional clinic management. For each traditional monthly visit, patients drove 20 miles and expended a total of 1.8 hours; using 55¢/mile for mileage reimbursement and $15/hour for lost wages, the cost for each visit was $38. The total cost for four STORM₂ visits per month was $10, for a net savings of $28 per patient per month. A total of 76% of patients were willing to pay additional money to eliminate a monthly clinic visit. STORM₂ is more convenient, less complicated, preferred by patients, and saves patients time and money compared with clinic management. © 2013 Pharmacotherapy Publications, Inc.

A multimedia campaign to improve back beliefs in patients with non-specific low back pain: a process evaluation.

PubMed

Suman, Arnela; Schaafsma, Frederieke G; Bamarni, Jiman; van Tulder, Maurits W; Anema, Johannes R

2017-05-18

Low back pain (LBP) is one of the most prevalent and costly disorders worldwide. To reduce its burden in the Netherlands, implementation of a multidisciplinary guideline for LBP was supported by a multifaceted eHealth campaign for patients with LBP. The current study aims 1) to evaluate whether the implementation strategy was performed as planned; 2) to assess the feasibility, barriers and facilitators of the patient based eHealth campaign; 3) to gain insight into the satisfaction and experiences of patients with various ethnic backgrounds with the implementation strategy and to make a comparison between them; and 4) to explore the association between exposure to and satisfaction with the implementation strategy. This process evaluation was performed using the Linnan and Steckler framework, and used a mixed methods approach for data collection and analysis. The relationship between satisfaction of patients and exposure to the strategy was statistically examined. Semi-structured interviews were analysed using qualitative data analysis methods. Two hundred and fourteen patients participated in the quantitative, and 44 in the qualitative analysis. Most were female and had a high level of education. Many patients did not use the campaign at all or only once, and those that did rated it as reasonable. Patient satisfaction with the campaign increased significantly with an increase in its use. Qualitative analysis showed that four main themes played a role in campaign rating and use: satisfaction with intervention components, perceived benefits of the intervention, usage of the intervention, and satisfaction with the medium used. This process evaluation showed that the eHealth campaign was used only by a small proportion of patients with non-specific LBP. It seemed that the campaign was offered to the patients too late, that the lay-out of the campaign did not meet patient needs, and that healthcare providers rarely discussed the campaign with their patients, while involvement of those providers seemed to improve trustworthiness of the campaign and increase its usage. It is important to invest effort into healthcare providers to motivate patients to use eHealth intervention and to tailor strategies better to the needs of users. Netherlands Trial Register (NTR): NTR4329 . Registered December 20th, 2013.

Do You Automate? Saving Time and Dollars

ERIC Educational Resources Information Center

Carmichael, Christine H.

2010-01-01

An automated workforce management strategy can help schools save jobs, improve the job satisfaction of teachers and staff, and free up precious budget dollars for investments in critical learning resources. Automated workforce management systems can help schools control labor costs, minimize compliance risk, and improve employee satisfaction.…

The Role of Pay Satisfaction in Instructor Satisfaction

ERIC Educational Resources Information Center

Wilson, Jackson

2009-01-01

Voluntary employee turnover is a major factor affecting adventure education (AE) organizations (Garret, 2003). Voluntary turnover often is dysfunctional for both employees and organizations (Birmingham, 1989; Podsakoff, LePine, & LePine, 2007). Turnover can result in increased employee and organizational costs (e.g., McKinney, Bartlett, &…

Effectiveness of Case Management for 'At Risk' Patients in Primary Care: A Systematic Review and Meta-Analysis.

PubMed

Stokes, Jonathan; Panagioti, Maria; Alam, Rahul; Checkland, Kath; Cheraghi-Sohi, Sudeh; Bower, Peter

2015-01-01

An ageing population with multimorbidity is putting pressure on health systems. A popular method of managing this pressure is identification of patients in primary care 'at-risk' of hospitalisation, and delivering case management to improve outcomes and avoid admissions. However, the effectiveness of this model has not been subjected to rigorous quantitative synthesis. We carried out a systematic review and meta-analysis of the effectiveness of case management for 'at-risk' patients in primary care. Six bibliographic databases were searched using terms for 'case management', 'primary care', and a methodology filter (Cochrane EPOC group). Effectiveness compared to usual care was measured across a number of relevant outcomes: Health--self-assessed health status, mortality; Cost--total cost of care, healthcare utilisation (primary and non-specialist care and secondary care separately), and; Satisfaction--patient satisfaction. We conducted secondary subgroup analyses to assess whether effectiveness was moderated by the particular model of case management, context, and study design. A total of 15,327 titles and abstracts were screened, 36 unique studies were included. Meta-analyses showed no significant differences in total cost, mortality, utilisation of primary or secondary care. A very small significant effect favouring case management was found for self-reported health status in the short-term (0.07, 95% CI 0.00 to 0.14). A small significant effect favouring case management was found for patient satisfaction in the short- (0.26, 0.16 to 0.36) and long-term (0.35, 0.04 to 0.66). Secondary subgroup analyses suggested the effectiveness of case management may be increased when delivered by a multidisciplinary team, when a social worker was involved, and when delivered in a setting rated as low in initial 'strength' of primary care. This was the first meta-analytic review which examined the effects of case management on a wide range of outcomes and considered also the effects of key moderators. Current results do not support case management as an effective model, especially concerning reduction of secondary care use or total costs. We consider reasons for lack of effect and highlight key research questions for the future. The review protocol is available as part of the PROSPERO database (registration number: CRD42014010824).

Effectiveness of Case Management for 'At Risk' Patients in Primary Care: A Systematic Review and Meta-Analysis

PubMed Central

Stokes, Jonathan; Panagioti, Maria; Alam, Rahul; Checkland, Kath; Cheraghi-Sohi, Sudeh; Bower, Peter

2015-01-01

Background An ageing population with multimorbidity is putting pressure on health systems. A popular method of managing this pressure is identification of patients in primary care ‘at-risk’ of hospitalisation, and delivering case management to improve outcomes and avoid admissions. However, the effectiveness of this model has not been subjected to rigorous quantitative synthesis. Methods and Findings We carried out a systematic review and meta-analysis of the effectiveness of case management for ‘at-risk’ patients in primary care. Six bibliographic databases were searched using terms for ‘case management’, ‘primary care’, and a methodology filter (Cochrane EPOC group). Effectiveness compared to usual care was measured across a number of relevant outcomes: Health – self-assessed health status, mortality; Cost – total cost of care, healthcare utilisation (primary and non-specialist care and secondary care separately), and; Satisfaction – patient satisfaction. We conducted secondary subgroup analyses to assess whether effectiveness was moderated by the particular model of case management, context, and study design. A total of 15,327 titles and abstracts were screened, 36 unique studies were included. Meta-analyses showed no significant differences in total cost, mortality, utilisation of primary or secondary care. A very small significant effect favouring case management was found for self-reported health status in the short-term (0.07, 95% CI 0.00 to 0.14). A small significant effect favouring case management was found for patient satisfaction in the short- (0.26, 0.16 to 0.36) and long-term (0.35, 0.04 to 0.66). Secondary subgroup analyses suggested the effectiveness of case management may be increased when delivered by a multidisciplinary team, when a social worker was involved, and when delivered in a setting rated as low in initial ‘strength’ of primary care. Conclusions This was the first meta-analytic review which examined the effects of case management on a wide range of outcomes and considered also the effects of key moderators. Current results do not support case management as an effective model, especially concerning reduction of secondary care use or total costs. We consider reasons for lack of effect and highlight key research questions for the future. Review Protocol The review protocol is available as part of the PROSPERO database (registration number: CRD42014010824). PMID:26186598

Satisfaction with hearing aids: a consumer research perspective.

PubMed

Wong, Lena L N; Hickson, Louise; McPherson, Bradley

2009-01-01

This research aimed at describing satisfaction with hearing aids from the perspective of the client as a consumer. A disconfirmation-expectancy model, derived from consumer research, was evaluated. This model posits that pre-fitting expectations, post-fitting performance, and the experience of how performance compares to expectations (disconfirmation), contribute to satisfaction. Positive disconfirmation occurs when performance is better than original expectations and is associated with higher satisfaction. Negative disconfirmation is when performance is poorer than expectations and is associated with dissatisfaction. New hearing aid users in Hong Kong (N=42) were tested with a newly developed self-report measure (PHACS: profile of hearing aid consumer satisfaction) that included items focused on hearing ability, problems, cost, and service. Pre-fitting expectations and post-fitting performance, disconfirmation, and satisfaction were measured. Results showed that expectations were generally not related to satisfaction, that disconfirmation was correlated with many aspects of satisfaction, and that performance was most strongly related to satisfaction. The implications of the findings are that hearing aid performance is the most important element for determining satisfaction; however disconfirmation should not be overlooked.

Implementation and Evaluation of Self-Scheduling in a Hospital System.

PubMed

Wright, Christina; McCartt, Peggy; Raines, Diane; Oermann, Marilyn H

Inflexible work schedules affect job satisfaction and influence nurse turnover. Job satisfaction is a significant predictor of nurse retention. Acute care hospitals report that job satisfaction is influenced by autonomy and educational opportunity. This project discusses implementation of computer-based self-scheduling in a hospital system and its impact. It is important for staff development educators to be aware that self-scheduling may play a key role in autonomy, professional development, turnover, and hospital costs.

Compensation, Culture and Contracts: The Realities of the DoD’s Blended Workforce

DTIC Science & Technology

2010-05-01

structure, based on customer satisfaction , business development, collateral duties, and participation in morale- building activities. On the government...and customer satisfaction . “One time, an employee bargained for a 30% pay increase. He was working on a cost-plus contract. There’s no way I...and manageable workloads.” Certainly, job satisfaction can be found outside of the DoD as well. One industry manager reminisced, “I’ve held jobs

Clinical Use of the Marital Satisfaction Inventory: Two Case Studies.

ERIC Educational Resources Information Center

Wills, Robert M.; Snyder, Douglas K.

1982-01-01

Describes the clinical use of the Marital Satisfaction Inventory (MSI), a multidimensional self-report measure of marital interaction. Two case studies of couples in marital therapy are presented. The MSI is presented as a cost-efficient procedure, permitting objective assessment across multiple areas of a couple's relationship. (Author/JAC)

A Model for Employee Motivation and Satisfaction.

ERIC Educational Resources Information Center

Grant, Philip C.

1979-01-01

To increase an employee's motivation, an employee must perceive that s/he will achieve higher satisfaction for greater effort. To generate such perception, rewards must clearly be contingent on effort and the cost of increased effort must grow at a slower rate than the increase in reward. (Author/IRT)

The relationship between office type and job satisfaction: Testing a multiple mediation model through ease of interaction and well-being.

PubMed

Otterbring, Tobias; Pareigis, Jörg; Wästlund, Erik; Makrygiannis, Alexander; Lindström, Anton

2018-05-01

Objectives This cross-sectional study investigated the associations between office type (cellular, shared-room, small open-plan, and medium-sized open-plan) and employees' ease of interaction with coworkers, subjective well-being, and job satisfaction. Methods A brief survey including measures of office type, ease of interaction with coworkers, subjective well-being, and job satisfaction was sent electronically to 1500 Swedish real-estate agents, 271 of whom returned usable surveys. The data were analyzed using a regression-based serial multiple mediation model (PROCESS Model 6), which tested whether the relationship between office type and job satisfaction would be mediated by ease of interaction and, in turn, subjective well-being. Results A negative relationship was found between the number of coworkers sharing an office and employees' job satisfaction. This association was serially mediated by ease of interaction with coworkers and subjective well-being, with employees working in small and medium-sized open-plan offices reporting lower levels of both these aspects than employees who work in either cellular or shared-room offices. Conclusions Open-plan offices may have short-term financial benefits, but these benefits may be lower than the costs associated with decreased job satisfaction and well-being. Therefore, decision-makers should consider the impact of office type on employees rather than focusing solely on cost-effective office layout, flexibility, and productivity.

Telemedicine in the management of chronic pain: a cost analysis study.

PubMed

Pronovost, Antoine; Peng, Philip; Kern, Ralph

2009-08-01

Telemedicine provides patients with easy and remote access to consultant expertise irrespective of geographic location. In a randomized controlled trial, this study has applied a rigorous costing methodology to the use of telemedicine in chronic pain management. We performed a randomized two-period crossover trial comparing in-person (IP) consultation with telemedicine (TM) consultation in the management of chronic pain. Over an 18-month period, 26 patients each completed two diaries capturing their direct and indirect travel costs, daily pain scores, and satisfaction with physician consultation. Costing models were developed to account for direct, indirect, fixed, and variable costs in order to perform break-even analyses. Sensitivity analysis was performed over a broad range of assumptions. Direct patient costs were significantly lower in the TM group than in the IP group, with median cost and interquartile range 133 dollars (28-377) vs 443 dollars (292-1075), respectively (P = 0.001). More patients were highly satisfied with the TM consultation than with the IP consultation (56 and 24%, respectively; P < 0.05). Break-even annual patient volume was estimated at 57 patients. A two-way sensitivity analysis controlling for annual patient volume and round-trip distance indicated that TM remains cost-effective at volumes >50 patients/year or at round-trip distances >200 km. Telemedicine is cost-effective over a broad range of assumptions, including annual patient volumes, travel distance, fuel costs, amortization, and discount rates. This study provides data from a real-world setting to determine relevant thresholds and targets for establishing a TM program for patients who are undergoing chronic pain therapy.

Evaluation of customer satisfaction at the Department of Paediatric Dentistry of "Sapienza" University of Rome.

PubMed

Ierardo, G; Luzzi, V; Vestri, A; Sfasciotti, G L; Polimeni, A

2008-03-01

Healthcare facility management requires the optimisation of the quality of services offered. The Authors adopted a questionnaire as a means to assess customer satisfaction and needs. The Questionnaire has been designed to address adults, i.e., parents or guardians of children attending the Paediatric unit as patients. To estimate their degree of satisfaction, either regarding the environment where children are treated or about the direct interactions between the parents and the structure (waiting room, waiting time, treatment time and time needed to make the payments, costs, etc.), the questionnaire was submitted to a sample of approximately 600 customers, between March and June of 2005. On one hand results provide a pleasant confirmation on customers' perception of the service, especially regarding the direct relationship between the parties; on the other, they highlight aspects that could be improved (waiting room, optimisation of waiting time), distinguishing between factors that need extra funding to be implemented, and those that, instead, could be simply improved through a better and more efficient organisation of labour and time. The present analysis and previous experiences confirm that appraisal of the degree of customers' satisfaction by means of questionnaires is a valid and necessary instrument for the quality improvement of a healthcare service. Doing so, economic and human resources can be more efficiently allocated.

The paradox of compassionate work: a mixed-methods study of satisfying and fatiguing experiences of animal health care providers.

PubMed

Polachek, Alicia J; Wallace, Jean E

2018-03-01

Compassionate work appears paradoxical as it may provide great rewards, but may also come at great costs to care providers. This paper explores the paradox of compassionate work by examining what interactions contribute to compassion satisfaction and what interactions contribute to compassion fatigue. This mixed-methods, cross-sectional study uses qualitative interview data from animal health care providers (N = 20) to identify work interactions that they find satisfying or stressful. Quantitative survey data (N = 572) are used to test hypotheses generated from the interviews regarding predictors of compassion satisfaction and compassion fatigue. Interview transcripts were analyzed using a directed content analysis approach. Survey data were analyzed using ordinary least squares regression. The results highlight the complex nature of compassionate work. As hypothesized, making a difference to animals and building relationships with animal patients and human clients relate to greater compassion satisfaction. Human client barriers to animal care and witnessing client grief relate to greater compassion fatigue, as predicted. None of the predictors relate to less compassion fatigue, but forming relationships with animal patients relates to both greater compassion satisfaction and compassion fatigue. This paper enhances our understanding of provider-client-patient interactions and highlights the paradox of compassionate work.

Disease management improves end-stage renal disease outcomes.

PubMed

Sands, Jeffrey J

2006-01-01

Renal disease management organizations have reported achieving significant decreases in mortality and hospitalization in conjunction with cost savings, improved patient satisfaction and quality of life. Disease management organizations strive to fill existing gaps in care delivery through the standardized use of risk assessment, predictive modeling, evidence-based guidelines, and process and outcomes measurement. Patient self-management education and the provision of individual nurse care managers are also key program components. As we more fully measure clinical outcomes and total healthcare costs, including payments from all insurance and government entities, pharmacy costs and out of pocket expenditures, the full implications of disease management can be better defined. The results of this analysis will have a profound influence on United States healthcare policy. At present current data suggest that the promise of disease management, improved care at reduced cost, can and is being realized in end-stage renal disease. Copyright 2006 S. Karger AG, Basel.

The Role of Preceptorship and Group Cohesion on Newly Licensed Registered Nurses' Satisfaction and Intent to Stay.

PubMed

Bontrager, Sarah; Hart, Patricia L; Mareno, Nicole

2016-03-01

Thirteen percent of newly licensed registered nurses (NLRNs) vacate their first job after 1 year, and 37% report that they feel ready to change jobs. Turnover can lead to consistent and detrimental nursing shortages in nursing units, as well as increased costs for health care systems. A descriptive, prospective, cross-sectional design was used to understand how preceptor role effectiveness and group cohesion affect NLRNs' satisfaction and intent to stay. NLRNs reported high levels of perceived preceptor role effectiveness, group cohesion, and job satisfaction, with only moderate levels of intent to stay. Statistically significant relationships were found among preceptor role effectiveness, job satisfaction, and intent to stay, as well as among group cohesion, job satisfaction, and intent to stay. Preceptor role effectiveness and group cohesion are predictors of NLRNs' level of job satisfaction. Job satisfaction is a predictor of NLRNs' intent to stay. Effective preceptors and positive group cohesion are factors that are important to NLRNs' job satisfaction and intent to stay. Copyright 2016, SLACK Incorporated.

Understanding the low uptake of bone-anchored hearing aids: a review.

PubMed

Powell, R; Wearden, A; Pardesi, S M; Green, K

2017-03-01

Bone-anchored hearing aids improve hearing for patients for whom conventional behind-the-ear aids are problematic. However, uptake of bone-anchored hearing aids is low and it is important to understand why this is the case. A narrative review was conducted. Studies examining why people accept or decline bone-anchored hearing aids and satisfaction levels of people with bone-anchored hearing aids were reviewed. Reasons for declining bone-anchored hearing aids included limited perceived benefits, concerns about surgery, aesthetic concerns and treatment cost. No studies providing in-depth analysis of the reasons for declining or accepting bone-anchored hearing aids were identified. Studies of patient satisfaction showed that most participants reported benefits with bone-anchored hearing aids. However, most studies used cross-sectional and/or retrospective designs and only included people with bone-anchored hearing aids. Important avenues for further research are in-depth qualitative research designed to fully understand the decision-making process for bone-anchored hearing aids and rigorous quantitative research comparing satisfaction of people who receive bone-anchored hearing aids with those who receive alternative (or no) treatments.

The economic impact of work and family issues: child care satisfaction and financial considerations of employed mothers.

PubMed

Poms, Laura Wheeler; Botsford, Whitney E; Kaplan, Seth A; Buffardi, Louis C; O'Brien, Alison S

2009-10-01

This article introduces the role of financial considerations into work-family research by considering the costs and benefits of employed mothers' child care satisfaction. Data from 2 samples offer empirical support for the addition of a fourth factor to a current measure of child care satisfaction so that the measure reflects mothers' satisfaction not only with caregiver attentiveness, communication, and dependability but also with child care-related financial considerations. This article also discusses relationships between child care satisfaction and work-family conflict and job satisfaction for this population. The results of this study provide both organizations and child care providers with a broader picture of the concerns that employed mothers face as they search for reliable, affordable child care. PsycINFO Database Record (c) 2009 APA, all rights reserved.

The ethical leadership challenge for effective resolution of patient and family complaints and grievances: proven methods and models.

PubMed

Piper, Llewellyn E; Tallman, Erin

2015-01-01

Health care leaders and managers face the ethical leadership challenge in ensuring effective resolution of patient and family complaints and grievances. In today's society of increasing discontent about safety, quality, cost, and satisfaction, patient complaints and grievances are becoming more prevalent. Under the mandates of the Patient Protection and Affordable Care Act for transparency of quality and patient satisfaction scores and to be compliant with the standards from the Centers for Medicare & Medicaid Services and The Joint Commission, it is imperative that leadership ensure an ethical culture for effective resolution of patient and family complaints and grievances. This article addresses this ethical leadership challenge by providing a systematic approach with proven methods and models for effective resolution of complaints and grievances and thereby improving satisfaction, quality, safety, and cost.

Feasibility and acceptability of alternate methods of postnatal data collection.

PubMed

McCormack, Lacey A; Friedrich, Christa; Fahrenwald, Nancy; Specker, Bonny

2014-05-01

This study was done in preparation for the launch of the National Children's Study (NCS) main study. The goal of this study was to examine the feasibility (completion rates and completeness of data), acceptability, staff time and cost-effectiveness of three methods of data collection for the postnatal 3- and 9-month questionnaires completed as part of NCS protocol. Eligible NCS participants who were scheduled to complete a postnatal questionnaire at three and nine months were randomly assigned to receive either: (a) telephone data collection (b) web-based data collection, or (c) self-administered (mailed) questionnaires. Event completion rates and satisfaction across the three data collection methods were compared and the influence of socio-demographic factors on completion rates and satisfaction rates was examined. Cost data were compared to data for completion and satisfaction for each of the delivery methods. Completion rates and satisfaction did not differ significantly by method, but completeness of data did, with odds of data completeness higher among web than phone (p < 0.001) or mail (p < 0.001). Costs were highest for the phone, followed by mail and web methods (p < 0.001). No significant differences in participant time (i.e. burden) across the three data collection methods were seen. Mail and phone data collection were the least complete of the three methods and were the most expensive. Mailed data collection was neither complete nor exceptionally economical. Web-based data collection was the least costly and provided the most complete data. Participants without web access could complete the questionnaire over the phone.

Development and enrolee satisfaction with basic medical insurance in China: A systematic review and stratified cluster sampling survey.

PubMed

Jing, Limei; Chen, Ru; Jing, Lisa; Qiao, Yun; Lou, Jiquan; Xu, Jing; Wang, Junwei; Chen, Wen; Sun, Xiaoming

2017-07-01

Basic Medical Insurance (BMI) has changed remarkably over time in China because of health reforms that aim to achieve universal coverage and better health care with adequate efforts by increasing subsidies, reimbursement, and benefits. In this paper, we present the development of BMI, including financing and operation, with a systematic review. Meanwhile, Pudong New Area in Shanghai was chosen as a typical BMI sample for its coverage and management; a stratified cluster sampling survey together with an ordinary logistic regression model was used for the analysis. Enrolee satisfaction and the factors associated with enrolee satisfaction with BMI were analysed. We found that the reenrolling rate superficially improved the BMI coverage and nearly achieved universal coverage. However, BMI funds still faced dual contradictions of fund deficit and insured under compensation, and a long-term strategy is needed to realize the integration of BMI schemes with more homogeneous coverage and benefits. Moreover, Urban Resident Basic Medical Insurance participants reported a higher rate of dissatisfaction than other participants. The key predictors of the enrolees' satisfaction were awareness of the premium and compensation, affordability of out-of-pocket costs, and the proportion of reimbursement. These results highlight the importance that the Chinese government takes measures, such as strengthening BMI fund management, exploring mixed payment methods, and regulating sequential medical orders, to develop an integrated medical insurance system of universal coverage and vertical equity while simultaneously improving enrolee satisfaction. Copyright © 2017 John Wiley & Sons, Ltd.

Comparison of student's satisfaction on school food service environment by the eating place and gender

PubMed Central

Jung, Jisook; Oh, Yu-jin

2009-01-01

The purpose of this study was to compare student's satisfaction with school food service environment to improve the quality of middle school meal service. A survey was conducted of 680 students (boys 246, girls 433) from 6 middle schools providing school meals from October to November 2007. The questionnaires were directly distributed to the subjects for comparison of satisfaction of school meals depending on the eating place. As for the quantity of food, classroom group (3.40) expressed significantly higher satisfaction than cafeteria group (3.16, P < 0.01), but as for the satisfaction on hygiene, classroom group (2.76) showed significantly lower satisfaction than cafeteria group (3.03, P < 0.01). About the satisfaction of school meal environment, classroom group showed more satisfaction on distribution time, eating place, eating atmosphere (P < 0.001). The classroom group showed higher satisfaction than cafeteria group in cases of quantity, diversity of types of soup, dessert, and the cost of school meal. To improve eating place and hygiene of school meal, sufficient cafeteria space and pleasant environment is needed to be established. PMID:20098582

[Quality concept in health care. Methodology for its measurement].

PubMed

Morera Guitart, J

2003-12-01

It is increasingly necessary that the neurologists achieve basic knowledgement in clinical management and medical care quality. We will review the concepts of medical care quality (MCQ). Of the definitions checked, we want to emphasize the following aspects. a) application of current scientific knowledge; b) interpersonal relationship; c) environment where the assistance is dispensed; d) results in health; e) cost of assistance; f) risks for the patient and g) patient satisfaction. For the analysis of the MCQ we could distinguish several components: scientific-technical component, efficacy, effectiveness, efficiency, accessibility, continuity, equity, appropriateness, and satisfaction of the patient and of the professional. One of the main objectives to measure the MCQ is to improve the assistance itself. For its measurement we can employ diverse methods depending on our objective: to improve the process, to do Benchmarking, to know the satisfaction of the patients or to guarantee the quality of the medical attention. The most used tools for this measurement are: establishment of criteria-indicator-standard for quality, elaboration of satisfaction questionnaires, interviews to key informant, analysis of complaints and claims of patients and professionals, and clinical audits. The role of the neurologist in the achievement of a high quality neurological attention if fundamental. Therefore, it is necessary some specific formation on: scientific and technical matter, communicative abilities, teamworking, management and organisation of tasks and pharmaco-economic evaluation, and a cultural change that involves every professional on the co-responsibility of the continuous improvement of the processes and of the results of his work, advancing gradually towards the excellence of medical assistance.

Turnover among healthcare professionals.

PubMed

Wood, Ben D

2009-01-01

Turnover among healthcare professionals is a costly consequence. The existing body of knowledge on healthcare professional turnover is correlated with job satisfaction levels. A landmark study differentiated 2 areas of job satisfaction categories: satisfiers and dissatisfiers (intrinsic and extrinsic motivators). The aim of this article is to examine existing research on precursors of turnover, such as burnout behaviors experienced by healthcare professionals, job satisfaction levels, employee organizational commitment, health complications which precede turnover, some current strategies to reduce turnover, and some effects CEO turnover has on employee turnover intentions.

Outcome analysis in lumbar spine: instabilities/degenerative disease.

PubMed

Fessler, R G

1997-01-01

In summary, expectations for outcome analysis have changed over the last several years. It is no longer the case that outcome analysis is expected to be done by academic institutions alone. Surgeons in private practice are rapidly approaching the time when outcome analysis of personal results will be necessary for competitive marketing purposes. In addition, the definition of outcome analysis has been considerably expanded from medical outcome to include functional outcome, return to work, quality of life, patient satisfaction, and cost-effectiveness. The above discussion has considered several aspects of data outcome analysis for degenerative disease of the lumbar spine. It is the intent of this review to help surgeons prepare themselves for changing expectations in their new medical environment.

Expanding Access: An Evaluation of ReadCube Access as an ILL Alternative.

PubMed

Grabowsky, Adelia

2016-01-01

ReadCube Access is a patron-driven, document delivery system that provides immediate access to articles from journals owned by Nature Publishing Group. The purpose of this study was to evaluate the use of ReadCube Access as an interlibrary loan (ILL) alternative for nonsubscribed Nature journals at Auburn University, a research university with a School of Pharmacy and a School of Veterinary Medicine. An analysis of ten months' usage and costs are presented along with the results of a user satisfaction survey. Auburn University Libraries found ReadCube to be an acceptable alternative to ILL for unsubscribed Nature journals and at current levels of use and cost, consider ReadCube to be financially sustainable.

Pulsed CO2 Laser Ablation of Superficial Basal Cell of Limbs and Trunk: A Comparative Randomized Clinical Trial With Cryotherapy and Surgical Ablation.

PubMed

Zane, Cristina; Facchinetti, Elena; Arisi, Mariachiara; Ortel, Bernhard; Calzavara-Pinton, Piergiacomo

2017-07-01

Pulsed CO2 laser is a treatment of superficial basal cell carcinoma (sBCC) although robust clinical evidence has not been reported so far. The authors investigated efficacy, safety, time to wound healing, cosmetic outcome, patient satisfaction, and cost-effectiveness ratio of pulsed CO2 laser in comparison to cryotherapy and surgery. BCCs of the trunk and extremities were randomized to one of the treatments. After 90 days, efficacy and cosmetic outcome were assessed. Patients recorded the time to complete healing of the wound and scored their overall satisfaction. Two hundred forty patients were randomized. After 3 months, complete remission (CR) rate with pulsed CO2 laser was 78.8%. This was significantly lower than surgery, whereas the CR rate with cryotherapy was not significantly different. Cosmetic result was better with surgery. High satisfaction was reported by 65.0% of patients treated with CO2 ablation. Time of wound healing was significantly shorter with CO2 laser. In comparison to cryotherapy, pulsed CO2 laser showed no statistically significant difference in efficacy, cosmetic outcome, and patient satisfaction. Time to healing was shorter; the cost and cost-effectiveness ratio were similar. Surgery had the greatest efficacy rate. The main limitation of this study was the short duration of follow-up (3 months).

The Influence of Changing Nurse Documentation Practices Have on Patient Satisfaction

ERIC Educational Resources Information Center

Blaney, Charon D.

2012-01-01

Health care leaders in the 21st century face challenges that stem from issues concerning quality care in a cost efficient environment while maintaining customer satisfaction. Technology has played a vital part in offering more advanced diagnostic and surgical equipment. The proliferation of technology has resulted in documentation at the…

Conflict Management Styles and Job Satisfaction by Organizational Level and Status in a Private University

ERIC Educational Resources Information Center

Williams, Irene Ana

2011-01-01

Effective handling of conflict can result in effective teamwork and leadership, higher morale, increased productivity, satisfied customers, and satisfied employees. Ineffective conflict management styles in the workplace can lead to low levels of job satisfaction, resulting in high levels of turnover. Research indicates that the economic cost to…

Performance Plan: Progress Report, 3rd Quarter Fiscal Year 2000.

ERIC Educational Resources Information Center

Department of Education, Washington, DC. Student Financial Assistance.

The U.S. Department of Education Student Financial Assistance (SFA) outlines its three major objectives for fiscal year 2000 in its progress report. The objectives are: 1)customer satisfaction; 2) reduction in the overall cost of delivering student aid; and 3) employee satisfaction. Several new capabilities were added to the Direct Loan servicing…

The Sloan-C Pillars and Boundary Objects As a Framework for Evaluating Blended Learning

ERIC Educational Resources Information Center

Laumakis, Mark; Graham, Charles; Dziuban, Chuck

2009-01-01

The authors contend that blended learning represents a boundary object; a construct that brings together constituencies from a variety of backgrounds with each of these cohorts defining the object somewhat differently. The Sloan-C Pillars (learning effectiveness, access, cost effectiveness, student satisfaction, and faculty satisfaction) provide…

A hybrid genetic algorithm for solving bi-objective traveling salesman problems

NASA Astrophysics Data System (ADS)

Ma, Mei; Li, Hecheng

2017-08-01

The traveling salesman problem (TSP) is a typical combinatorial optimization problem, in a traditional TSP only tour distance is taken as a unique objective to be minimized. When more than one optimization objective arises, the problem is known as a multi-objective TSP. In the present paper, a bi-objective traveling salesman problem (BOTSP) is taken into account, where both the distance and the cost are taken as optimization objectives. In order to efficiently solve the problem, a hybrid genetic algorithm is proposed. Firstly, two satisfaction degree indices are provided for each edge by considering the influences of the distance and the cost weight. The first satisfaction degree is used to select edges in a “rough” way, while the second satisfaction degree is executed for a more “refined” choice. Secondly, two satisfaction degrees are also applied to generate new individuals in the iteration process. Finally, based on genetic algorithm framework as well as 2-opt selection strategy, a hybrid genetic algorithm is proposed. The simulation illustrates the efficiency of the proposed algorithm.

The influences of patient's satisfaction with medical service delivery, assessment of medical service, and trust in health delivery system on patient's life satisfaction in China

PubMed Central

2012-01-01

Background Patient’s satisfaction with medical service delivery/assessment of medical service/trust in health delivery system may have significant influence on patient’s life satisfaction in China’s health delivery system/in various kinds of hospitals. The aim of this study was to test whether and to what extent patient’s satisfaction with medical service delivery/patient’s assessments of various major aspects of medical service/various major aspects of patient’s trust in health delivery system influenced patient’s life satisfaction in China’s health delivery system/in various kinds of hospitals. Methods This study collaborated with National Bureau of Statistics of China to carry out a 2008 national urban resident household survey in 17 provinces, autonomous regions, and municipalities directly under the central government (N = 3,386), and specified ordered probit models were established to analyze dataset from this household survey. Results The key considerations in generating patient’s life satisfaction involved patient’s overall satisfaction with medical service delivery, assessment of doctor-patient communication, assessment of medical cost, assessment of medical treatment process, assessment of medical facility and hospital environment, assessment of waiting time for medical service, trust in prescription, trust in doctor, and trust in recommended medical examination. But the major considerations in generating patient’s life satisfaction were different among low level public hospital, high level public hospital, and private hospital. Conclusion The promotion of patient’s overall satisfaction with medical service delivery, the improvement of doctor-patient communication, the reduction of medical cost, the improvement of medical treatment process, the promotion of medical facility and hospital environment, the reduction of waiting time for medical service, the promotion of patient’s trust in prescription, the promotion of patient’s trust in doctor, and the promotion of patient’s trust in recommended medical examination could all help promote patient’s life satisfaction. But their promotion effects were different among low level public hospital, high level public hospital, and private hospital. PMID:22978432

THE EFFECT OF OUTPATIENT SERVICE QUALITY ON PATIENT SATISFACTION IN TEACHING HOSPITALS IN IRAN

PubMed Central

Pouragha, Behrouz; Zarei, Ehsan

2016-01-01

Aim: The quality of services plays a primary role in achieving patient satisfaction. The main purpose of this study was to explore the effect of outpatient service quality on patient satisfaction in teaching hospitals in Iran. Methods: this cross-sectional study was conducted in 2014. The study sample included 500 patients were selected with systematic random method from the outpatient departments (clinics) of four teaching hospitals in Tehran. The survey instrument was a questionnaire consisted of 44 items, which were confirmed its reliability and validity. The data were analyzed by using descriptive statistics, Pearson’s correlation, and multivariate regression methods with the SPSS.18 software. Results: According to the findings of this study, the majority of patients had a positive experience in the outpatient departments of the teaching hospitals and thus evaluated the services as good. Perceived service costs, physician consultation, physical environment, and information to patient were found to be the most important determinants of outpatient satisfaction. Conclusion: The results suggest that improving the quality of consultation, providing information to the patients during examination and consultation, creating value for patients by reducing costs or improving service quality, and enhancing the physical environment quality of the clinic can be regarded as effective strategies for the management of teaching hospitals toward increasing outpatient satisfaction. PMID:27047262

THE EFFECT OF OUTPATIENT SERVICE QUALITY ON PATIENT SATISFACTION IN TEACHING HOSPITALS IN IRAN.

PubMed

Pouragha, Behrouz; Zarei, Ehsan

2016-02-01

The quality of services plays a primary role in achieving patient satisfaction. The main purpose of this study was to explore the effect of outpatient service quality on patient satisfaction in teaching hospitals in Iran. this cross-sectional study was conducted in 2014. The study sample included 500 patients were selected with systematic random method from the outpatient departments (clinics) of four teaching hospitals in Tehran. The survey instrument was a questionnaire consisted of 44 items, which were confirmed its reliability and validity. The data were analyzed by using descriptive statistics, Pearson's correlation, and multivariate regression methods with the SPSS.18 software. According to the findings of this study, the majority of patients had a positive experience in the outpatient departments of the teaching hospitals and thus evaluated the services as good. Perceived service costs, physician consultation, physical environment, and information to patient were found to be the most important determinants of outpatient satisfaction. The results suggest that improving the quality of consultation, providing information to the patients during examination and consultation, creating value for patients by reducing costs or improving service quality, and enhancing the physical environment quality of the clinic can be regarded as effective strategies for the management of teaching hospitals toward increasing outpatient satisfaction.

Multifaceted Comparison of Two Cryotherapy Devices Used After Total Knee Arthroplasty: Cryotherapy Device Comparison.

PubMed

Schinsky, Mark F; McCune, Christine; Bonomi, Judith

2016-01-01

Some form of cryotherapy used after total knee arthroplasty is commonplace. However, various factors determine the specific device deployed. This study aimed to answer the following questions: : A group of 100 patients undergoing primary total knee arthroplasty by a single surgeon were enrolled in an institutional review board-approved, prospective study and randomized to receive either a circulating cold water or ice/gel pack cryotherapy device postoperatively. Demographic, pain, swelling, blood loss, range of motion, compliance, satisfaction, and adverse event outcomes were recorded until 6 weeks after surgery. Hospital staff satisfaction and economic variables were examined. The ice/gel pack cryotherapy wrap was noninferior to the cold water cryotherapy device for any patient outcome measured. Average pain level at 6 weeks postoperative was significantly less in the ice/gel pack cryotherapy wrap group. Hospital staff satisfaction was higher with the ice/gel pack cryotherapy wrap.Substantial economic savings can be realized at our institution by switching to the lower cost cryotherapy device. In this study, the lower cost ice/gel pack cryotherapy wrap was noninferior to the circulating ice water cryotherapy device with respect to objective patient outcomes and subjective patient satisfaction after total knee arthroplasty. Hospital staff satisfaction and economic considerations also favor the ice/gel pack compression cryotherapy wraps.

Effect of an imaging-based streamlined electronic healthcare process on quality and costs.

PubMed

Bui, Alex A T; Taira, Ricky K; Goldman, Dana; Dionisio, John David N; Aberle, Denise R; El-Saden, Suzie; Sayre, James; Rice, Thomas; Kangarloo, Hooshang

2004-01-01

A streamlined process of care supported by technology and imaging may be effective in managing the overall healthcare process and costs. This study examined the effect of an imaging-based electronic process of care on costs and rates of hospitalization, emergency room (ER) visits, specialist diagnostic referrals, and patient satisfaction. A healthcare process was implemented for an employer group, highlighting improved patient access to primary care plus routine use of imaging and teleconsultation with diagnostic specialists. An electronic infrastructure supported patient access to physicians and communication among healthcare providers. The employer group, a self-insured company, manages a healthcare plan for its employees and their dependents: 4,072 employees were enrolled in the test group, and 7,639 in the control group. Outcome measures for expenses and frequency of hospitalizations, ER visits, traditional specialist referrals, primary care visits, and imaging utilization rates were measured using claims data over 1 year. Homogeneity tests of proportions were performed with a chi-square statistic, mean differences were tested by two-sample t-tests. Patient satisfaction with access to healthcare was gauged using results from an independent firm. Overall per member/per month costs post-implementation were lower in the enrolled population (126 dollars vs 160 dollars), even though occurrence of chronic/expensive diseases was higher in the enrolled group (18.8% vs 12.2%). Lower per member/per month costs were seen for inpatient (33.29 dollars vs 35.59 dollars); specialist referrals (21.36 dollars vs 26.84 dollars); and ER visits (3.68 dollars vs 5.22 dollars). Moreover, the utilization rate for hospital admissions, ER visits, and traditional specialist referrals were significantly lower in the enrolled group, although primary care and imaging utilization were higher. Comparison to similar employer groups showed that the company's costs were lower than national averages (119.24 dollars vs 146.32 dollars), indicating that the observed result was not attributable to normalization effects. Patient satisfaction with access to healthcare ranked in the top 21st percentile. A streamlined healthcare process supported by technology resulted in higher patient satisfaction and cost savings despite improved access to primary care and higher utilization of imaging.

Improving Access to Eye Care among Persons at High-Risk of Glaucoma in Philadelphia — Design and Methodology: The Philadelphia Glaucoma Detection and Treatment Project

PubMed Central

Myers, Jonathan S.; Henderer, Jeffrey; Crews, John E.; Saaddine, Jinan B.; Molineaux, Jeanne; Johnson, Deiana; Sembhi, Harjeet; Stratford, Shayla; Suleiman, Ayman; Pizzi, Laura; Spaeth, George L.; Katz, L. Jay

2016-01-01

Purpose The Wills Eye Glaucoma Research Center initiated a 2-year demonstration project to develop and implement a community-based intervention to improve detection and management of glaucoma in Philadelphia. Methods The glaucoma detection examination consisted of: ocular, medical, and family history; visual acuity testing; corneal pachymetry; biomicroscopy of the anterior segment; intraocular pressure (IOP) measurement; gonioscopy; funduscopy; automated visual field testing; and fundus-color photography. Treatment included laser surgery and/or IOP-lowering medication. A cost analysis was conducted to understand resource requirements. Outcome measures included; prevalence of glaucoma-related pathology and other eye diseases among high-risk populations; the impact of educational workshops on level of knowledge about glaucoma (assessed by pre- and post-test evaluation); and patient satisfaction of the glaucoma detection examinations in the community (assessed by satisfaction survey). Treatment outcome measures were change in IOP at 4–6 weeks and 4–6 months following selective laser trabeculoplasty treatment, deepening of the anterior chamber angle following laser-peripheral iridotomy treatment, and rate of adherence to recommended follow-up examinations. Cost outcomes included total program costs, cost per case of glaucoma detected, and cost per case of ocular disease detected. Results This project enrolled 1649 participants (African Americans aged 50+ years, adults 60+ years and individuals with a family history of glaucoma). A total of 1074 individuals attended a glaucoma educational workshop and 1508 scheduled glaucoma detection examination appointments in the community setting. Conclusions The Philadelphia Glaucoma Detection and Treatment Project aimed to improve access and use of eye care and to provide a model for a targeted community-based glaucoma program. PMID:26950056

Improving Access to Eye Care among Persons at High-Risk of Glaucoma in Philadelphia--Design and Methodology: The Philadelphia Glaucoma Detection and Treatment Project.

PubMed

Hark, Lisa; Waisbourd, Michael; Myers, Jonathan S; Henderer, Jeffrey; Crews, John E; Saaddine, Jinan B; Molineaux, Jeanne; Johnson, Deiana; Sembhi, Harjeet; Stratford, Shayla; Suleiman, Ayman; Pizzi, Laura; Spaeth, George L; Katz, L Jay

2016-01-01

The Wills Eye Glaucoma Research Center initiated a 2-year demonstration project to develop and implement a community-based intervention to improve detection and management of glaucoma in Philadelphia. The glaucoma detection examination consisted of: ocular, medical, and family history; visual acuity testing; corneal pachymetry; biomicroscopy of the anterior segment; intraocular pressure (IOP) measurement; gonioscopy; funduscopy; automated visual field testing; and fundus-color photography. Treatment included laser surgery and/or IOP-lowering medication. A cost analysis was conducted to understand resource requirements. Outcome measures included; prevalence of glaucoma-related pathology and other eye diseases among high-risk populations; the impact of educational workshops on level of knowledge about glaucoma (assessed by pre- and post-test evaluation); and patient satisfaction of the glaucoma detection examinations in the community (assessed by satisfaction survey). Treatment outcome measures were change in IOP at 4-6 weeks and 4-6 months following selective laser trabeculoplasty treatment, deepening of the anterior chamber angle following laser-peripheral iridotomy treatment, and rate of adherence to recommended follow-up examinations. Cost outcomes included total program costs, cost per case of glaucoma detected, and cost per case of ocular disease detected. This project enrolled 1649 participants (African Americans aged 50+ years, adults 60+ years and individuals with a family history of glaucoma). A total of 1074 individuals attended a glaucoma educational workshop and 1508 scheduled glaucoma detection examination appointments in the community setting. The Philadelphia Glaucoma Detection and Treatment Project aimed to improve access and use of eye care and to provide a model for a targeted community-based glaucoma program.

Utilising three-dimensional printing techniques when providing unique assistive devices: A case report.

PubMed

Day, Sarah Jane; Riley, Shaun Patrick

2018-02-01

The evolution of three-dimensional printing into prosthetics has opened conversations about the availability and cost of prostheses. This report will discuss how a prosthetic team incorporated additive manufacture techniques into the treatment of a patient with a partial hand amputation to create and test a unique assistive device which he could use to hold his French horn. Case description and methods: Using a process of shape capture, photogrammetry, computer-aided design and finite element analysis, a suitable assistive device was designed and tested. The design was fabricated using three-dimensional printing. Patient satisfaction was measured using a Pugh's Matrix™, and a cost comparison was made between the process used and traditional manufacturing. Findings and outcomes: Patient satisfaction was high. The three-dimensional printed devices were 56% cheaper to fabricate than a similar laminated device. Computer-aided design and three-dimensional printing proved to be an effective method for designing, testing and fabricating a unique assistive device. Clinical relevance CAD and 3D printing techniques can enable devices to be designed, tested and fabricated cheaper than when using traditional techniques. This may lead to improvements in quality and accessibility.

Hospital quality: a product of good management as much as good treatment.

PubMed

Hyde, Andy; Frafjord, Anders

2013-01-01

In Norway, as in most countries, the demands placed on hospitals to reduce costs and improve the quality of services are intense. Although many say that improving quality reduces costs, few can prove it. Futhermore, how many people can show that improving quality improves patient satisfaction. Diakonhjemmet hospital in Norway has designed and implemented a hospital management system based on lean principles and the PDCA (Plan-Do-Check-Act) quality circle introduced by WE Deming (Deming 2000). The results are quite impressive with improvements in quality and patient satisfaction. The hospital also runs at a profit.

Generational differences of the frontline nursing workforce in relation to job satisfaction: what does the literature reveal?

PubMed

Saber, Deborah A

2013-01-01

The job satisfaction of registered nurses has been found to be associated with retention, organizational commitment, workforce safety, and cost savings to health care organizations. Satisfaction of the workforce is vital because nursing turnover can be detrimental for a labor force that is growing older. However, the summation of the most important variables that are linked to job satisfaction has been difficult to discern in part because the workforce includes 3 main generations (ie, Baby Boomers, Gen Xers, and Millennials) with unique work values that drive their job satisfiers. This article provides a review of existing literature to examine the differences in variables that are linked to job satisfaction that exist between the generational cohorts. Differences in stress sources, need for work-life balance, and compensation are discussed. The knowledge about generationally driven variables that influence job satisfaction can help managers develop strategies to maintain a diverse nursing workforce.

Heating and Cooling from the Ground Up.

ERIC Educational Resources Information Center

Jackson, Lisa M.

1998-01-01

Explains why converting to geothermal heating and cooling is a good option when constructing or retrofitting schools. Reasons discussed include competitive installation costs, lower operating and maintenance costs, greater building-design flexibility, and greater user satisfaction. (GR)

SERVQUAL: a tool for evaluating patient satisfaction with nursing care.

PubMed

Scardina, S A

1994-01-01

Rising health care costs and competition among hospital facilities have resulted in the need to recognize patient satisfaction as an important indicator of quality care. Nurses provide the primary service to patients; therefore, their role is influential in overall satisfaction. Several instruments have been developed to measure patient satisfaction with nursing care; however, most of them focus only on patient perceptions. One such approach to evaluating patient satisfaction with nursing care involves an instrument, SERVQUAL, derived from a marketing service perspective. Adapting SERVQUAL for use in evaluating nursing care is the focus of this article. SERVQUAL assesses both patient perceptions and expectations of quality service and permits managers and clinicians to view the gaps between the two; thus, the overall areas of improvement in nursing services can be determined.

Understanding patient satisfaction ratings for radiology services.

PubMed

Lang, Elvira V; Yuh, William T C; Ajam, Amna; Kelly, Ronda; Macadam, Luke; Potts, Richard; Mayr, Nina A

2013-12-01

Under the Hospital Value-Based Purchasing Program of the Centers for Medicare & Medicaid Services, patient satisfaction accounts for 30% of the measures of and payments for quality of care. Understanding what drives patient satisfaction data and how the data are obtained, converted into scores, and formulated into rankings is increasingly critical for imaging departments. The objectives of this article are to describe the potential impact of patient satisfaction ratings on institutions and individuals, explain how patient satisfaction is rated and ranked, identify drivers that affect the ratings and rankings, and probe the resulting challenges unique to radiology departments. Research results indicate that training providers to make simple modifications in their language and behavior during patient care can significantly impact patient satisfaction, which, in turn, can impact both quality-of-care ratings and the bottom line of hospitals. Training providers is a simple and cost-effective way to potentiate the clinical expression of compassion into improvement of patient satisfaction and financial reward, a national trend that no one in the game can afford to ignore.

Practice-driven evaluation of a multi-layered psychosocial care package for children in areas of armed conflict.

PubMed

Jordans, M J D; Komproe, I H; Tol, W A; Susanty, D; Vallipuram, A; Ntamatumba, P; Lasuba, A C; De Jong, J T V M

2011-06-01

Psychosocial and mental health service delivery frameworks for children in low-income countries are scarce. This paper presents a practice-driven evaluation of a multi-layered community-based care package in Burundi, Indonesia, Sri Lanka and Sudan, through a set of indicators; (a) perceived treatment gains; (b) treatment satisfaction; (c) therapist burden; (d) access to care; (e) care package costs. Across four settings (n = 29,292 children), beneficiaries reported high levels of client satisfaction and moderate post-treatment problem reductions. Service providers reported significant levels of distress related to service delivery. Cost analyses demonstrated mean cost per service user to vary from 3.46 to 17.32 depending on country and specification of costs. The results suggest a multi-layered psychosocial care package appears feasible and satisfactory in reaching out to substantial populations of distressed children through different levels of care. Future replication should address therapist burden, cost reductions to increase sustainability and increase evidence for treatment efficacy.

Outcome evaluation of a new model of critical care orientation.

PubMed

Morris, Linda L; Pfeifer, Pamela; Catalano, Rene; Fortney, Robert; Nelson, Greta; Rabito, Robb; Harap, Rebecca

2009-05-01

The shortage of critical care nurses and the service expansion of 2 intensive care units provided a unique opportunity to create a new model of critical care orientation. The goal was to design a program that assessed critical thinking, validated competence, and provided learning pathways that accommodated diverse experience. To determine the effect of a new model of critical care orientation on satisfaction, retention, turnover, vacancy, preparedness to manage patient care assignment, length of orientation, and cost of orientation. A prospective, quasi-experimental design with both quantitative and qualitative methods. The new model improved satisfaction scores, retention rates, and recruitment of critical care nurses. Length of orientation was unchanged. Cost was increased, primarily because a full-time education consultant was added. A new model for nurse orientation that was focused on critical thinking and competence validation improved retention and satisfaction and serves as a template for orientation of nurses throughout the medical center.

The influence of facility design and human resource management on health care professionals.

PubMed

Sadatsafavi, Hessam; Walewski, John; Shepley, Mardelle M

2015-01-01

Cost control of health care services is a strategic concern for organizations. To lower costs, some organizations reduce staffing levels. However, this may not be worth the trade-off, as the quality of services will likely be reduced, morale among health care providers tends to suffer, and patient satisfaction is likely to decline. The potential synergy between human resource management and facility design and operation was investigated to achieve the goal of providing cost containment strategies without sacrificing the quality of services and the commitment of employees. About 700 health care professionals from 10 acute-care hospitals participated in this cross-sectional study. The authors used structural equation modeling to test whether employees' evaluations of their physical work environment and human resource practices were significantly associated with lower job-related anxiety, higher job satisfaction, and higher organizational commitment. The analysis found that employees' evaluations of their physical work environment and human resource practices influenced their job-related feelings and attitudes. Perceived organizational support mediated this relationship. The study also found a small but positive interaction effect between the physical work environment and human resource practices. The influence of physical work environment was small, mainly because of the high predictive value of human resource practices and strong confounding variables included in the analysis. This study specifically showed the role of facility design in reducing job-related anxiety among caregivers. Preliminary evidence is provided that facility design can be used as a managerial tool for improving job-related attitudes and feelings of employees and earning their commitment. Providing a healthy and safe work environment can be perceived by employees as an indication that the organization respects them and cares about their well-being, which might be reciprocated with higher levels of motivation and commitment toward the organization.

Development and validation of an instrument to assess job satisfaction in eye-care personnel.

PubMed

Paudel, Prakash; Cronjé, Sonja; O'Connor, Patricia M; Khadka, Jyoti; Rao, Gullapalli N; Holden, Brien A

2017-11-01

The aim was to develop and validate an instrument to measure job satisfaction in eye-care personnel and assess the job satisfaction of one-year trained vision technicians in India. A pilot instrument for assessing job satisfaction was developed, based on a literature review and input from a public health expert panel. Rasch analysis was used to assess psychometric properties and to undertake an iterative item reduction. The instrument was then administered to vision technicians in vision centres of Andhra Pradesh in India. Associations between vision technicians' job satisfaction and factors such as age, gender and experience were analysed using t-test and one-way analysis of variance. Rasch analysis confirmed that the 15-item job satisfaction in eye-care personnel (JSEP) was a unidimensional instrument with good fit statistics, measurement precisions and absence of differential item functioning. Overall, vision technicians reported high rates of job satisfaction (0.46 logits). Age, gender and experience were not associated with high job satisfaction score. Item score analysis showed non-financial incentives, salary and workload were the most important determinants of job satisfaction. The 15-item JSEP instrument is a valid instrument for assessing job satisfaction among eye-care personnel. Overall, vision technicians in India demonstrated high rates of job satisfaction. © 2016 Optometry Australia.

Patient satisfaction and perceived quality of care: evidence from a cross-sectional national exit survey of HIV and non-HIV service users in Zambia.

PubMed

Dansereau, Emily; Masiye, Felix; Gakidou, Emmanuela; Masters, Samuel H; Burstein, Roy; Kumar, Santosh

2015-12-30

To examine the associations between perceived quality of care and patient satisfaction among HIV and non-HIV patients in Zambia. Patient exit survey conducted at 104 primary, secondary and tertiary health clinics across 16 Zambian districts. 2789 exiting patients. Five dimensions of perceived quality of care (health personnel practice and conduct, adequacy of resources and services, healthcare delivery, accessibility of care, and cost of care). Respondent, visit-related, and facility characteristics. Patient satisfaction measured on a 1-10 scale. Indices of perceived quality of care were modelled using principal component analysis. Statistical associations between perceived quality of care and patient satisfaction were examined using random-effect ordered logistic regression models, adjusting for demographic, socioeconomic, visit and facility characteristics. Average satisfaction was 6.9 on a 10-point scale for non-HIV services and 7.3 for HIV services. Favourable perceptions of health personnel conduct were associated with higher odds of overall satisfaction for non-HIV (OR=3.53, 95% CI 2.34 to 5.33) and HIV (OR=11.00, 95% CI 3.97 to 30.51) visits. Better perceptions of resources and services were also associated with higher odds of satisfaction for both non-HIV (OR=1.66, 95% CI 1.08 to 2.55) and HIV (OR=4.68, 95% CI 1.81 to 12.10) visits. Two additional dimensions of perceived quality of care--healthcare delivery and accessibility of care--were positively associated with higher satisfaction for non-HIV patients. The odds of overall satisfaction were lower in rural facilities for non-HIV patients (OR 0.69; 95% CI 0.48 to 0.99) and HIV patients (OR=0.26, 95% CI 0.16 to 0.41). For non-HIV patients, the odds of satisfaction were greater in hospitals compared with health centres/posts (OR 1.78; 95% CI 1.27 to 2.48) and lower at publicly-managed facilities (OR=0.41, 95% CI=0.27 to 0.64). Perceived quality of care is an important driver of patient satisfaction with health service delivery in Zambia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Child Care Arrangements: Results from the 1992 DoD Surveys of Officers and Enlisted Personnel and Military Spouses.

DTIC Science & Technology

1997-04-01

child care. The focus of the analysis included: (a) factors that related to the cost of child care; (b) demographics and characteristics of military...life that are associated with use and satisfaction with DoD-provided child care services; (c) characteristics of Service members who experience...difficulties in responding quickly to recalls or alerts because of child care problems; and (d) factors that are related to the decision to select on- or off

Optimizing claims payment for successful risk management.

PubMed

Frates, Janice; Ginty, Mary Jo; Baker, Linda

2002-05-01

Disputed claims and delayed payments are among the principal sources of provider and vendor dissatisfaction with managed care payment systems. Timely and accurate claims-payment systems are essential to ensure provider and vendor satisfaction, fiscal stability, and regulatory compliance. A focused analysis of conditions contributing to late payment of claims can disclose problems in provider, vendor, or payer operational and billing procedures, contracting processes, information systems, or human resources management. Resolution of these conditions equips claims-processing staff with tools to resolve problem claims promptly, thereby lowering costs.

Historical Analysis of Costs, Risks, and Uncertainties: Moving From a Proprietary to an Open Architected Systems, Open Business Acquisitions Management Approach

DTIC Science & Technology

2012-04-30

businesses look for tangible ROI when evaluating or approving new or continuing investments. One British study found that 89% of companies use...Only by understanding the full range of SOA value propositions can companies begin to get a handle on calculating the ROI of SOA” (para. 2...by nonmonetary valuations , such as customer satisfaction and avoidance of loss of life (Buck, Das, & Hanf, 2008). Figure 1 displays some nonmonetary

Anticipated Effects of Restructuring on Army Career Decisions: An Analysis of Comments from the 1990 Army Career Satisfaction Survey

DTIC Science & Technology

1992-03-01

outcome of the future of the military then will our military leaders. Cost cutting can be accomplished by means other than force reduction. (i.e...In August 1990, after this survey was complete, Iraq invaded Kuwait and President Bush ordered American military personnel into Saudi Arabia. It may...topics raised by all soldiers. An example of the comments expressing impatience within the officer corps about involuntary separation is this comment

Economic evaluation of single-tooth replacement: dental implant versus fixed partial denture.

PubMed

Kim, Younhee; Park, Joo-Yeon; Park, Sun-Young; Oh, Sung-Hee; Jung, YeaJi; Kim, Ji-Min; Yoo, Soo-Yeon; Kim, Seong-Kyun

2014-01-01

This study assessed the cost-effectiveness from a societal perspective of a dental implant compared with a three-unit tooth-supported fixed partial denture (FPD) for the replacement of a single tooth in 2010. A decision tree was developed to estimate cost-effectiveness over a 10-year period. The survival rates of single-tooth implants and FPDs were extracted from a meta-analysis of single-arm studies. Medical costs included initial treatment costs, maintenance costs, and costs to treat complications. Patient surveys were used to obtain the costs of the initial single-tooth implant or FPD. Maintenance costs and costs to treat complications were based on surveys of seven clinical experts at dental clinics or hospitals. Transportation costs were calculated based on the number of visits for implant or FPD treatment. Patient time costs were estimated using the number of visits and time required, hourly wage, and employment rate. Future costs were discounted by 5% to convert to present values. The results of a 10-year period model showed that a single dental implant cost US $261 (clinic) to $342 (hospital) more than an FPD and had an average survival rate that was 10.4% higher. The incremental cost-effectiveness ratio was $2,514 in a clinic and $3,290 in a hospital for a prosthesis in situ for 10 years. The sensitivity analysis showed that initial treatment costs and survival rate influenced the cost-effectiveness. If the cost of an implant were reduced to 80% of the current cost, the implant would become the dominant intervention. Although the level of evidence for effectiveness is low, and some aspects of single-tooth implants or FPDs, such as satisfaction, were not considered, this study will help patients requiring single-tooth replacement to choose the best treatment option.

An investigation into the effects of quality improvement method on patients' satisfaction: a semi experimental research in Iran.

PubMed

Navipour, Hasan; Nayeri, Nahid Dehghan; Hooshmand, Abbas; Zargar, Marjaneh Taghavi

2011-01-01

Today, to increase effectiveness is a Strategy for success of organizations and their viability. In health care organization not only service cost- effectiveness is a major problem for productivity and organizational management but also customer-centred is in first priority. Because of these reasons, most of health organization trend to patient satisfaction for their viability. If complex process implemented for viability without attention to patient satisfaction, this is no success result. The FOCUS PDCA process is a new strategy for effectiveness of service quality. To this reason, the recent research done and its objective is to assess effect of FOCUS PDCA process strategy on patient satisfaction in surgery units of hospitals affiliated to Tehran Medical University. This research is a semi experimental with non- equivalent design. The sample was all of patients who hospitalized in two selected surgery units. Self-report was method of data gathering. Patient satisfaction assessed with questionnaire in pre and posttest. Then manipulation implemented as post-operation care process selected. Modelling and opportunity statement Diagrams prepared and improvement team organized. Flow process, convergences and cause- effect charts used to prepare list of items to be improved. Executive program was written. This include personnel training, standard implementation, election and training of quality control nurses (Q.C Ns), daily QC of caring and providing appropriate feed back to personnel, forming group session for determining corrective actions. Then after 1 month patient satisfaction was assessed. Statistical analysis shows this process increase patient satisfaction and it leads to care effectiveness. The findings of the pre-intervention phase indicated that the satisfaction level had been low in both groups and it is not significantly different in the two groups (P> 0.05). There was a significant difference before and after following intervention in the case study group (P>0.0001). FOCUS PDCA is effective method for access to various objectives especially patient satisfaction. it is suggested other researcher assess effects of this strategy for other indexes and total care process effectiveness.

Service quality, trust, and patient satisfaction in interpersonal-based medical service encounters.

PubMed

Chang, Ching-Sheng; Chen, Su-Yueh; Lan, Yi-Ting

2013-01-16

Interaction between service provider and customer is the primary core of service businesses of different natures, and the influence of trust on service quality and customer satisfaction could not be ignored in interpersonal-based service encounters. However, lack of existing literature on the correlation between service quality, patient trust, and satisfaction from the prospect of interpersonal-based medical service encounters has created a research gap in previous studies. Therefore, this study attempts to bridge such a gap with an evidence-based practice study. We adopted a cross-sectional design using a questionnaire survey of outpatients in seven medical centers of Taiwan. Three hundred and fifty copies of questionnaire were distributed, and 285 valid copies were retrieved, with a valid response rate of 81.43%. The SPSS 14.0 and AMOS 14.0 (structural equation modeling) statistical software packages were used for analysis. Structural equation modeling clarifies the extent of relationships between variables as well as the chain of cause and effect. Restated, SEM results do not merely show empirical relationships between variables when defining the practical situation. For this reason, SEM was used to test the hypotheses. Perception of interpersonal-based medical service encounters positively influences service quality and patient satisfaction. Perception of service quality among patients positively influences their trust. Perception of trust among patients positively influences their satisfaction. According to the findings, as interpersonal-based medical service encounters will positively influence service quality and patient satisfaction, and the differences for patients' perceptions of the professional skill and communication attitude of personnel in interpersonal-based medical service encounters will influence patients' overall satisfaction in two ways: (A) interpersonal-based medical service encounter directly affects patient satisfaction, which represents a direct effect; and (B) service quality and patient trust are used as intervening variables to affect patient satisfaction, which represents an indirect effect. Due to differences in the scale, resources and costs among medical institutions of different levels, it is a most urgent and concerning issue of how to control customers' demands and preferences and adopt correct marketing concepts under the circumstances of intense competition in order to satisfy the public and build up a competitive edge for medical institutions.

[Job satisfaction of sales people: a covariance structure analysis of the motivational process].

PubMed

Adachi, T

1998-08-01

The purpose of this study was to investigate the relationship among job satisfaction, job involvement, and work motivation. Two hundred thirty-nine sales people completed a questionnaire of job satisfaction (pay, interpersonal relationship, work environment, and job content), job involvement, and work motivation. The data were analyzed with covariance structure analysis, and the model, which was constructed beforehand, fitted well with relatively high GFI and AGFI. Results of the analysis showed that job satisfaction, in terms of pay and interpersonal relationship, influenced job content satisfaction, which in turn indirectly influenced work motivation, mediated through job involvement. In addition, the data indicated that satisfaction with customer relationship was strongly related to job content satisfaction in the sample of sales people.

Health-related quality of life, satisfaction, and economic outcome measures in studies of prostate cancer screening and treatment, 1990-2000.

PubMed

McNaughton-Collins, Mary; Walker-Corkery, Elizabeth; Barry, Michael J

2004-01-01

Prostate cancer outcomes research incorporates a broad spectrum of endpoints, from clinical or intermediate endpoints, such as tumor shrinkage or patient compliance, to final endpoints, such as survival or disease-free survival. Three types of nontraditional endpoints that are of growing interest-health-related quality of life (QOL), satisfaction with care, and economic cost impact-hold the promise of improving our ability to understand the full burden of prostate cancer screening and treatment. In this article we review the last decade's published literature regarding the health-related QOL, satisfaction, and economic outcomes of prostate cancer screening and treatment to determine the "state of the science" of outcomes measurement. The focus is the enumeration of the types of outcome measurement used in the studies not the determination of the results of the studies. Studies were identified by searching Medline (1990-2000). Articles were included if they presented original data on any patient-centered outcome (including costs or survival alone) for men screened and treated for prostate cancer. Review papers were excluded unless they were quantitative syntheses of the results of other primary studies. Economic and decision analytic papers were included if they presented information on outcomes of real or hypothetical patient cohorts. Each retrieved article was reviewed by one of the authors. Included papers were assigned one primary, mutually exclusive study design. For the "primary data" studies, information was abstracted on care setting, dates of the study, sample size, racial distribution, age, tumor differentiation, tumor stage, survival, statistical power, and types of outcomes measures (QOL-generic, QOL-cancer specific, QOL-prostate cancer specific, satisfaction, costs, utilities, and other). For the "economic and decision analytic" papers, information was abstracted on stage of disease, age range, outcomes, costs, and whether utilities were measured. Of the 198 included papers, there were 161 primary data papers categorized as follows: randomized trial (n = 28), nonrandomized trial (n = 13), prospective or retrospective cohort study (n = 55), case-control study (n = 0), cross-sectional study (n = 63), and meta-analysis (n = 2). The remaining 37 papers were economic and decision analytic papers. Among the 149 primary data papers that contained patient outcome data, there were 42 standard instruments used, accounting for 44% (179 of 410) of the measures overall. Almost three-quarters (71%) of papers included one, two, or three outcomes measures of all types (standard and nonstandard); three papers included seven outcomes measures, and one paper included nine. Over the 11-year time period, there was a nonstatistically significant trend toward more frequent use of standardized QOL instruments and a statistically significant trend toward increased reporting of race (P = .003). Standardization of measurement of health-related QOL, satisfaction with care, and economic cost effect among men screened and treated for prostate cancer is needed. A core set of similar questions, both generic and disease-specific, should ideally be asked in every study, although investigators should be encouraged to include additional question sets as appropriate to individual studies to get a more complete picture of how patients screened and treated for this condition are doing over time.

Evaluation of a Dining Facility Intervention on U.S. Army Special Operations Soldiers’ Meal Quality, Dining Satisfaction, and Cost Effectiveness

DTIC Science & Technology

2016-11-18

Eating Index (HEI) scores were computed. Descriptive and independent t-test analyses were performed pre to post HPP implementation ( =0.05; 80% power...Appendix B: HPP THOR3 Point-of-Service Label Examples ....................................... 77 Appendix C: Demographic & Lifestyle Survey ...78 Appendix D: Dining Facility Satisfaction Survey

The Effect of Prior Knowledge and Feedback Type Design on Student Achievement and Satisfaction in Introductory Accounting

ERIC Educational Resources Information Center

Campbell, Donald P.

2013-01-01

This study investigated the effect of student prior knowledge and feedback type on student achievement and satisfaction in an introductory managerial accounting course using computer-based formative assessment tools. The study involved a redesign of the existing Job Order Costing unit using the ADDIE model of instructional design. The…

Job satisfaction of village doctors during the new healthcare reforms in China.

PubMed

Zhang, Xiaoyan; Fang, Pengqian

2016-04-01

Objective China launched new healthcare reforms in 2009 and several policies targeted village clinics, which affected village doctors' income, training and duties. The aim of the present study was to assess village doctors' job satisfaction during the reforms and to explore factors affecting job satisfaction. Methods Using a stratified multistage cluster sampling process, 935 village doctors in Jiangxi Province were surveyed with a self-administered questionnaire that collected demographic information and contained a job satisfaction scale and questions regarding their work situation and individual perceptions of the new healthcare reforms. Descriptive analysis, Pearson's Chi-squared test and binary logistic regression were used to identify village doctors' job satisfaction and the factors associated with their job satisfaction. Results Only 12.72% of village doctors were either satisfied or very satisfied with their jobs and the top three items leading to dissatisfaction were pay and the amount of work that had to be done, opportunities for job promotion and work conditions. Marriage, income, intention to leave, satisfaction with learning and training, social status, relationship with patients and satisfaction with the new healthcare reforms were significantly associated with job satisfaction (P<0.05). Conclusions China is facing critical challenges with regard to village doctors because of their low job satisfaction. For future healthcare reforms, policy makers should pay more attention to appropriate remuneration and approaches that incentivise village doctors to achieve the goals of the health reforms. What is known about the topic? Village doctors act as gatekeepers at the bottom tier of the rural health system. However, the policies of the new healthcare reform initiatives in China were centred on improving the quality of care delivered to the rural population and reducing fast-growing medical costs. There have been limited studies on village doctors' reactions to these reforms. What does this paper add? The findings of the present study indicate that in the process of implementing the new healthcare reforms, village doctors' overall job satisfaction is low and most respondents are dissatisfied with the reforms. The factors affecting job satisfaction include income, training, social status, relationship with patients and satisfaction with the reforms. What are the implications for practitioners? Health reform policy makers should ensure village doctors feel appropriately remunerated and are motivated while aiming to reduce the financial burden on patients. The views of stakeholders (i.e. patients and village doctors) should be considered when designing future health reforms.

Satisfaction Rate Regarding Health-care Services and Its Determinant Factors in South-West of Iran: A Population-based Study.

PubMed

Lankarani, Kamran B; Maharlouei, Najmeh; Akbari, Mojtaba; Yazdanpanah, Dorna; Akbari, Maryam; Moghadami, Mohsen; Joulaei, Hassan

2016-01-01

The aim of this study was to evaluate clients' satisfaction regarding health-care services and its determinant factors in South-West of Iran. Totally, 3400 households were randomly selected for this cross-sectional study, carried out in Shiraz, Iran, from December 2013 to March 2014. Data were collected using a checklist that includes insurance status of the household, enrollment in family physician program, and client's satisfaction level with received health services. The level of statistical significance was set at P < 0.05. The mean age of the interviewees was 51.71 (±14.01) years, including 2427 (71.4%) females. 9.4% were insured while 72.3% had registered in family physician program. With respect to the family physician and governmental clinics, most subjects were "satisfied" or "very satisfied" with distance, time for admission, time spent at the clinic, privacy, and cost. As for private clinics, specialist clinics, and private hospitals, the studied subjects were more "dissatisfied" with cost but were more satisfied with other items. Living in higher socioeconomic regions ( P = 0.001), dissatisfaction with family physician ( P < 0.001, odds ratio [OR] = 2.3), scarcity of prescribed medication ( P = 0.02, OR = 1.6), medication cost ( P < 0.001, OR = 1.9), and existing chronic diseases in the household ( P = 0.03, OR = 1.4) had determinant role in dissatisfaction with health system. Results of the present study demonstrated a high level of satisfaction with the health-care system and family physician in Shiraz, Iran. Moreover, dissatisfaction with family physicians, socioeconomic status, scarcity and cost of drugs, and existing chronic disease(s) were important predictors for dissatisfaction with the health-care system.

Duplicate laboratory test reduction using a clinical decision support tool.

PubMed

Procop, Gary W; Yerian, Lisa M; Wyllie, Robert; Harrison, A Marc; Kottke-Marchant, Kandice

2014-05-01

Duplicate laboratory tests that are unwarranted increase unnecessary phlebotomy, which contributes to iatrogenic anemia, decreased patient satisfaction, and increased health care costs. We employed a clinical decision support tool (CDST) to block unnecessary duplicate test orders during the computerized physician order entry (CPOE) process. We assessed laboratory cost savings after 2 years and searched for untoward patient events associated with this intervention. This CDST blocked 11,790 unnecessary duplicate test orders in these 2 years, which resulted in a cost savings of $183,586. There were no untoward effects reported associated with this intervention. The movement to CPOE affords real-time interaction between the laboratory and the physician through CDSTs that signal duplicate orders. These interactions save health care dollars and should also increase patient satisfaction and well-being.

The Milieu Manager: A Nursing Staffing Strategy to Reduce Observer Use in the Acute Psychiatric Inpatient Setting.

PubMed

Triplett, Patrick; Dearholt, Sandra; Cooper, Mary; Herzke, John; Johnson, Erin; Parks, Joyce; Sullivan, Patricia; Taylor, Karin F; Rohde, Judith

Rising acuity levels in inpatient settings have led to growing reliance on observers and increased the cost of care. Minimizing use of observers, maintaining quality and safety of care, and improving bed access, without increasing cost. Nursing staff on two inpatient psychiatric units at an academic medical center pilot-tested the use of a "milieu manager" to address rising patient acuity and growing reliance on observers. Nursing cost, occupancy, discharge volume, unit closures, observer expense, and incremental nursing costs were tracked. Staff satisfaction and reported patient behavioral/safety events were assessed. The pilot initiatives ran for 8 months. Unit/bed closures fell to zero on both units. Occupancy, patient days, and discharges increased. Incremental nursing cost was offset by reduction in observer expense and by revenue from increases in occupancy and patient days. Staff work satisfaction improved and measures of patient safety were unchanged. The intervention was effective in reducing observation expense and improved occupancy and patient days while maintaining patient safety, representing a cost-effective and safe approach for management of acuity on inpatient psychiatric units.

Accelerated Recovery Within Standardized Recovery Pathways After Esophagectomy: A Prospective Cohort Study Assessing the Effects of Early Discharge on Outcomes, Readmissions, Patient Satisfaction, and Costs.

PubMed

Schmidt, Henner M; El Lakis, Mustapha A; Markar, Sheraz R; Hubka, Michal; Low, Donald E

2016-09-01

After esophagectomy, some patients exceed targeted discharge goal within enhanced recovery after surgery programs. This study reviews the demographics, outcomes, cost, readmission rates, and patient satisfaction for the accelerated recovery (AR) group. Between 2010 and 2013, 137 consecutive esophagectomy patients were compared according to the length of hospital stay: AR 5 to 6 days, targeted recovery (TR) 7 to 8 days, and delayed recovery (DR) 9 days or more. The AR patients increased from 3% to 46% during the study period. The AR patients were younger, but all groups were comparable regarding comorbidities (Charlson, American Society of Anesthesiologists, and Eastern Cooperative Oncology Group score), cancer stage, and treatment approach. The AR patients were more likely to have neoadjuvant therapy, shorter operations, and less blood loss. The DR patients were more likely to have complications (40% AR versus 45% TR versus 90% DR, p < 0.001). Inhospital and 90-day mortality was 1.5%. All AR patients were discharged home (100% AR versus 87% TR versus 63% DR, p < 0.001), and 30-day readmission rates were comparable between groups (14% AR versus 19% TR versus 5% DR, p = 0.122). Overall mean costs ($38,385 AR versus $41,607 TR versus $61,199 DR, p < 0.001) as well as readmission costs ($7,470 AR versus $27,695 TR versus $33,398 DR, p = 0.202) were lower in the AR group. Patient satisfaction scores were comparable between groups. Accelerated recovery is achievable in a significant proportion of patients undergoing esophagectomy. Accelerated recovery is associated with decreased treatment costs but does not lead to increased readmissions or decreased patient satisfaction. Enhanced recovery after surgery programs should be designed to accommodate patients appropriate for AR. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

The impact of job satisfaction on the risk of disability pension. A 15-year prospective study.

PubMed

Labriola, Merete; Feveile, Helene; Christensen, Karl Bang; Bültmann, Ute; Lund, Thomas

2009-09-01

To identify the impact of job satisfaction on the risk of disability pension. A total of 8,338 employees were sampled from the total working population in Denmark. They were interviewed regarding age, gender, job satisfaction and health behaviour. Interview data were merged with national register data on granted disability pension for up to 15 years after baseline data collection. The study found a statistically significant association between low job satisfaction and disability pension for women when adjusted for age, smoking status and BMI. Based on the results, investing in giving workers a satisfying work environment could be a low-cost way of improving employee health and prolonging labour market participation.

Agentic and communal narcissism and satisfaction with life: The mediating role of psychological entitlement and self-esteem.

PubMed

Żemojtel-Piotrowska, Magdalena A; Piotrowski, Jarosław P; Maltby, John

2017-10-01

This study examined the mediational role of self-esteem (as an enhancement) and psychological entitlement (as a cost) in the relationship between an agentic-communal model of grandiose narcissism and satisfaction with life. Two hundred and forty-eight university undergraduate students completed measures of agentic and communal narcissism, self-esteem, psychological entitlement and satisfaction with life. The findings suggest that there is support for the usefulness of the agentic-communal model of narcissism, and, consistent with predictions in the wider literature, self-esteem and psychological entitlement mediated the relationship between agentic-communal narcissism and life satisfaction. © 2015 International Union of Psychological Science.

The overall impact of emotional intelligence on nursing students and nursing

PubMed Central

Michelangelo, Lori

2015-01-01

Healthcare employers often criticize the lack of emotional competency and critical thinking skills demonstrated by newly licensed nurses. The purpose of this study was to evaluate whether emotional intelligence (EI) training for nurses improves critical thinking and emotional competence enough to justify including EI in nursing curricula. A meta-analysis was conducted inclusive of EI related nursing abilities and traits such as leadership, health, reflection, ethical behavior, nursing student performance, and job retention/satisfaction. Studies of EI constructs, test instruments, and contrary viewpoints were also examined. The analysis included 395 EI studies of approximately 65,300 participants. All the studies reported a positive correlation with EI ranging from weak to strong with a moderate cumulative effect size of r = 0.3022 across all studies. This study may contribute to positive social change by reducing employers time and cost for training newly licensed nurses, thereby decreasing the overall cost of health care to the public. PMID:27981103

The overall impact of emotional intelligence on nursing students and nursing.

PubMed

Michelangelo, Lori

2015-01-01

Healthcare employers often criticize the lack of emotional competency and critical thinking skills demonstrated by newly licensed nurses. The purpose of this study was to evaluate whether emotional intelligence (EI) training for nurses improves critical thinking and emotional competence enough to justify including EI in nursing curricula. A meta-analysis was conducted inclusive of EI related nursing abilities and traits such as leadership, health, reflection, ethical behavior, nursing student performance, and job retention/satisfaction. Studies of EI constructs, test instruments, and contrary viewpoints were also examined. The analysis included 395 EI studies of approximately 65,300 participants. All the studies reported a positive correlation with EI ranging from weak to strong with a moderate cumulative effect size of r = 0.3022 across all studies. This study may contribute to positive social change by reducing employers time and cost for training newly licensed nurses, thereby decreasing the overall cost of health care to the public.

Factors affecting job satisfaction in nurse faculty: a meta-analysis.

PubMed

Gormley, Denise K

2003-04-01

Evidence in the literature suggests job satisfaction can make a difference in keeping qualified workers on the job, but little research has been conducted focusing specifically on nursing faculty. Several studies have examined nurse faculty satisfaction in relationship to one or two influencing factors. These factors include professional autonomy, leader role expectations, organizational climate, perceived role conflict and role ambiguity, leadership behaviors, and organizational characteristics. This meta-analysis attempts to synthesize the various studies conducted on job satisfaction in nursing faculty and analyze which influencing factors have the greatest effect. The procedure used for this meta-analysis consisted of reviewing studies to identify factors influencing job satisfaction, research questions, sample size reported, instruments used for measurement of job satisfaction and influencing factors, and results of statistical analysis.

7 CFR 2201.11 - Application requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... of such conditions in the future, including: (i) The adequacy and stability of the business' customer... acquisition cost or cost per gross added, subscriber penetration, geographic concentration of customers, nature of the terms of customer contracts, customer technical support, customer satisfaction and...

7 CFR 2201.11 - Application requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... of such conditions in the future, including: (i) The adequacy and stability of the business' customer... acquisition cost or cost per gross added, subscriber penetration, geographic concentration of customers, nature of the terms of customer contracts, customer technical support, customer satisfaction and...

7 CFR 2201.11 - Application requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... of such conditions in the future, including: (i) The adequacy and stability of the business' customer... acquisition cost or cost per gross added, subscriber penetration, geographic concentration of customers, nature of the terms of customer contracts, customer technical support, customer satisfaction and...

7 CFR 2201.11 - Application requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... of such conditions in the future, including: (i) The adequacy and stability of the business' customer... acquisition cost or cost per gross added, subscriber penetration, geographic concentration of customers, nature of the terms of customer contracts, customer technical support, customer satisfaction and...

Seeking and using intention of health information from doctors in social media: The effect of doctor-consumer interaction.

PubMed

Wu, Tailai; Deng, Zhaohua; Zhang, Donglan; Buchanan, Paula R; Zha, Dongqing; Wang, Ruoxi

2018-07-01

The aim of this study is to investigate how doctor-consumer interaction in social media influences consumers' health information seeking and usage intention. Based on professional-client interaction theory and expectation confirmation theory, we propose that doctor-consumer interaction can be divided into instrumental interaction and affective interaction. These two types of interaction influence consumers' health information seeking and usage intention through consumer satisfaction and trust towards doctors. To validate our proposed research model, we employed the survey method. The measurement instruments for all constructs were developed based on previous literatures, and 352 valid answers were collected by using these instruments. Our results reveal that consumers' intention to seek health information significantly predicts their intention to use health information from social media. Meanwhile, both consumer satisfaction and trust towards doctors influences consumers' health information seeking and usage intention significantly. With regards to the impact of the interaction between doctors and consumers, the results show that both types of doctor-consumer interaction significantly affect consumer satisfaction and trust towards doctors. The mediation analysis confirms the mediation role of consumer satisfaction and trust towards doctors. Compared with many intentional intervention programs, doctor-consumer interaction can be treated as an effective intervention with low cost to promote consumers' health information seeking and usage. Meanwhile, both instrumental and affective interaction should be highlighted for the best interaction results. At last, consumer satisfaction and trust towards doctors could be considered as the important working mechanisms for the effect of doctor-consumer interaction. Copyright © 2018 Elsevier B.V. All rights reserved.

Immediate effect of couple relationship education on low-satisfaction couples: a randomized clinical trial plus an uncontrolled trial replication.

PubMed

Kim Halford, W; Pepping, Christopher A; Hilpert, Peter; Bodenmann, Guy; Wilson, Keithia L; Busby, Dean; Larson, Jeffry; Holman, Thomas

2015-05-01

Couple relationship education (RE) usually is conceived of as relationship enhancement for currently satisfied couples, with a goal of helping couples sustain satisfaction. However, RE also might be useful as a brief, accessible intervention for couples with low satisfaction. Two studies were conducted that tested whether couples with low relationship satisfaction show meaningful gains after RE. Study 1 was a three-condition randomized controlled trial in which 182 couples were randomly assigned to RELATE with Couple CARE (RCC), a flexible delivery education program for couples, or one of two control conditions. Couples with initially low satisfaction receiving RCC showed a moderate increase in relationship satisfaction (d=0.50) relative to the control. In contrast, couples initially high in satisfaction showed little change and there was no difference between RCC and the control conditions. Study 2 was an uncontrolled trial of the Couple Coping Enhancement Training (CCET) administered to 119 couples. Couples receiving CCET that had initially low satisfaction showed a moderate increase in satisfaction (g=.44), whereas initially highly satisfied couples showed no change. Brief relationship education can assist somewhat distressed couples to enhance satisfaction, and has potential as a cost-effective way of enhancing the reach of couple interventions. Copyright © 2015. Published by Elsevier Ltd.

Patient satisfaction with nursing care: a concept analysis within a nursing framework.

PubMed

Wagner, Debra; Bear, Mary

2009-03-01

This paper is a report of a concept analysis of patient satisfaction with nursing care. Patient satisfaction is an important indicator of quality of care, and healthcare facilities are interested in maintaining high levels of satisfaction in order to stay competitive in the healthcare market. Nursing care has a prominent role in patient satisfaction. Using a nursing model to measure patient satisfaction with nursing care helps define and clarify this concept. Rodgers' evolutionary method of concept analysis provided the framework for this analysis. Data were retrieved from the Cumulative Index of Nursing and Allied Health Literature and MEDLINE databases and the ABI/INFORM global business database. The literature search used the keywords patient satisfaction, nursing care and hospital. The sample included 44 papers published in English, between 1998 and 2007. Cox's Interaction Model of Client Health Behavior was used to analyse the concept of patient satisfaction with nursing care. The attributes leading to the health outcome of patient satisfaction with nursing care were categorized as affective support, health information, decisional control and professional/technical competencies. Antecedents embodied the uniqueness of the patient in terms of demographic data, social influence, previous healthcare experiences, environmental resources, intrinsic motivation, cognitive appraisal and affective response. Consequences of achieving patient satisfaction with nursing care included greater market share of healthcare finances, compliance with healthcare regimens and better health outcomes. The meaning of patient satisfaction continues to evolve. Using a nursing model to measure patient satisfaction with nursing care delineates the concept from other measures of patient satisfaction.

A novel trauma leadership model reflective of changing times.

PubMed

DʼHuyvetter, Cecile; Cogbill, Thomas H

2014-01-01

As a result of generational changes in the health care workforce, we sought to evaluate our current Trauma Medical Director Leadership model. We assessed the responsibilities, accountability, time requirements, cost, and provider satisfaction with the current leadership model. Three new providers who had recently completed fellowship training were hired, each with unique professional desires, skill sets, and experience. Our goal was to establish a comprehensive, cost-effective, accountable leadership model that enabled provider satisfaction and equalized leadership responsibilities. A 3-pronged team model was established with a Medical Director title and responsibilities rotating per the American College of Surgeons verification cycle to develop leadership skills and lessen hierarchical differences.

[Job Satisfaction of Young Professionals in Health Care].

PubMed

Ulrich, Gert; Homberg, Angelika; Karstens, Sven; Goetz, Katja; Mahler, Cornelia

2017-05-29

Background Job satisfaction in health care is currently important in view of workforce shortage in the health care area. The purpose of this study was to evaluate job satisfaction in young health professionals and to identify factors possibly influencing overall job satisfaction. Methods About one year after graduating from vocational training, a total of 579 graduates from various health care professions [Nursing (N), Nursing and Geriatric Nursing; Therapy (TP), Physical therapy and Logopaedics; Diagnostics (D), Diagnostic Radiography and Biomedical Science], were invited to participate in an online-survey. Job satisfaction was assessed with the 10-item Warr-Cook-Wall (WCW) job satisfaction questionnaire. Descriptive analysis of the WCW was performed, and the impact of various factors on job satisfaction was determined by stepwise linear regression analysis. Results In total, 189 graduates (N, n=121; TP, n=32; D, n=36) were included in data analysis (32.6% response rate). Overall job satisfaction in all young professionals was 4.9±1.6 (mean±SD) and was slightly higher in TP (5.4±1.4) compared with N (4.7±1.6) and D (5.0±1.5), respectively. Highest satisfaction was identified with "colleagues" and lowest satisfaction with "income" was identified in all professional groups. Colleagues and fellow workers showed the highest score of association regarding overall job satisfaction in regression analysis. Conclusions As a whole, our data suggest good to very good satisfaction in various WCW items of job satisfaction. "Colleagues" were shown to have a high impact on job satisfaction. To improve the attractiveness of job profiles in health care, the presented results may provide a valuable input regarding workforce shortage. © Georg Thieme Verlag KG Stuttgart · New York.

Performance Analysis of Hospital Information System of the National Health Insurance Corporation Ilsan Hospital

PubMed Central

Han, Jung Mi; Boo, Eun Hee; Kim, Jung A; Yoon, Soo Jin; Kim, Seong Woo

2012-01-01

Objectives This study evaluated the qualitative and quantitative performances of the newly developed information system which was implemented on November 4, 2011 at the National Health Insurance Corporation Ilsan Hospital. Methods Registration waiting time and changes in the satisfaction scores for the key performance indicators (KPI) before and after the introduction of the system were compared; and the economic effects of the system were analyzed by using the information economics approach. Results After the introduction of the system, the waiting time for registration was reduced by 20%, and the waiting time at the internal medicine department was reduced by 15%. The benefit-to-cost ratio was increased to 1.34 when all intangible benefits were included in the economic analysis. Conclusions The economic impact and target satisfaction rates increased due to the introduction of the new system. The results were proven by the quantitative and qualitative analyses carried out in this study. This study was conducted only seven months after the introduction of the system. As such, a follow-up study should be carried out in the future when the system stabilizes. PMID:23115744

Affects of Provider Type on Patient Satisfaction, Productivity and Cost Efficiency

DTIC Science & Technology

2006-04-25

plus inflation. With the implementation of the prospective payment system, the MTF Commanders will need to examine ways to demonstrate effectiveness ...practitioner’s performed well when compared to physicians, the longer time spent with patients can reduce productivity and thereby reduce cost effectiveness ...are most cost effective in use of resources (Vincent, 2002). Cost per visit ratio is derived by dividing the variable cost of Provider Type 22

Does the Planetree patient-centered approach to care pay off?: a cost-benefit analysis.

PubMed

Coulmont, Michel; Roy, Chantale; Dumas, Lucie

2013-01-01

Although the Planetree patient-centered approach to care is being implemented in many institutions around the world, its impact is still the subject of some debate. On the one hand, it is viewed as the most cost-effective way to provide care and create a positive work environment that reduces staff burnout. On the other hand, it is argued that it requires higher staffing ratios and a substantial infusion of financial resources and is time consuming, which in turn results in more work. The present study addresses the economic agenda of the Planetree patient-centered approach to care and has been designed to answer the following question: do the advantages of the Planetree patient-centered approach outweigh its costs? This question is of considerable interest for health care administrators and managers because the relevant authorities the world over have limited resources to allocate to health care organizations. Using a trend analysis approach to cost-benefit in a rehabilitation center, this study shows that the revenues the model generates are greater than the costs of implementing it. Fewer grievances and vacant positions, an improved employee retention rate, a better working atmosphere, and a high level of employee satisfaction (higher than in similar establishments) were also noted.

How Does Sensitivity Training of Health Care Workers Impact Patient Satisfaction?

ERIC Educational Resources Information Center

De Vinci, Katrina Marie

2010-01-01

Health care of the 21st century is undergoing major changes due to a myriad of social factors affecting every level of society. From financial desperation due to the high cost of health care to the increased awareness of a generation asking for better services, the importance of patient satisfaction is paramount. The Centers for Medicare and…

Effect of Job Satisfaction and Motivation towards Employee's Performance in XYZ Shipping Company

ERIC Educational Resources Information Center

Octaviannand, Ramona; Pandjaitan, Nurmala K.; Kuswanto, Sadikin

2017-01-01

In the digital and globalization era which are demanding for tech progress. Human resources need to work more closely and concentration. Small errors can lead to fatal errors that result in high costs for the company. The loss of motivation at work influences employee satisfaction and have a negative impact on employee performance. Research was…

Skype clinics after intestinal transplantation - follow-up beyond post codes.

PubMed

Gerlach, Undine A; Vrakas, Georgios; Holdaway, Lydia; O'Connor, Marion; Macedo, Rubens; Reddy, Srikanth; Friend, Peter J; Giele, Henk; Vaidya, Anil

2016-07-01

The follow-up after intestinal transplantation (ITX) is complex and limited to specialized centers. ITX recipients often travel all over the country to be seen in the outpatient clinic of specialized centers which is costly and time-consuming. Videoconferences through Skype have been implemented to eliminate travel time, costs, and to improve patient compliance without jeopardizing safety. Eighteen of 19 patients followed up after ITX or modified multivisceral transplantation (MMVTX) in conventional outpatient clinics in Oxford agreed to attend additional Skype clinics. All patients who were followed up through Skype clinics after ITX/MMVTX received a questionnaire to measure their satisfaction with methods and technical aspects of videoconferencing as well as time/mode of traveling, travel expenses/costs, waiting time in outpatient clinic and patients' satisfaction. Mean travel distance to Oxford was 236 ± 168 miles, mean travel time was 277 ± 175 min, and mean travel cost was 200 ± 56 Great Britain Pounds. A total of 56% had to take time off work and/or find child/family care for the time spent in travel. These patients reported a satisfaction score of 4.38 ± 0.77 of 5 points as opposed to 2.88 ± 0.90 for attending the conventional outpatient clinic. Skype clinics have been proven successful and feasible in highly specialized fields like ITX in eligible patients. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Barriers to discharge from inpatient rehabilitation: a teamwork approach.

PubMed

Cruz, Lisanne Catherine; Fine, Jeffrey S; Nori, Subhadra

2017-03-13

Purpose In order to prevent adverse events during the discharge process, coordinating appropriate community resources, medication reconciliation, and patient education needs to be implemented before the patient leaves the hospital. This coordination requires communication and effective teamwork amongst staff members. In order to address these concerns, the purpose of this paper is to incorporate the TeamSTEPPS principles to develop a discharge plan that would best meet the needs of the patients as they return to the community. Design/methodology/approach Through a gap analysis, barriers to discharge were identified from the following disciplines: nursing, social work, physical and occupational therapy, psychology, and rehabilitation physician. To improve communication, weekly meetings and twice-weekly huddles were implemented so that concerns regarding discharge obstacles could be identified and resolved. Visibility of discharge dates were improved by use of graduation certificates in patient rooms and green ribbons on patient wheelchairs. Findings After implementation of this discharge intervention, length of stay was reduced providing cost savings to the hospital, patient satisfaction on HCAHP surveys improved and demonstrated patient satisfaction with the discharge process, and readmission rates improved. Originality/value This study demonstrated that effective teamwork and communication can improve patient safety and satisfaction during the discharge period.

Career Involvement and Job Satisfaction as Related to Job Strain and Marital Satisfaction of Teachers and Their Spouses.

ERIC Educational Resources Information Center

Zimmerman, Karen W.; And Others

1980-01-01

A study of dual-employed couples examined the relationship between the variables of job status, job satisfaction, and marital satisfaction. Analysis revealed a significant positive relationship between job satisfaction and marital satisfaction and a significant negative relationship between job strain and marital satisfaction. (JOW)

Cost-effective hydrocele ablation.

PubMed

Fracchia, J A; Armenakas, N A; Kohan, A D

1998-03-01

The surgical repair of hydroceles can be relatively expensive in some cases in terms of costs and initial limitation of activity. We ascertain whether aspiration and sclerotherapy of hydroceles is a safe, efficient, cost-effective treatment modality in select patients. In 47 patients 51 hydroceles were treated in the office with aspiration and instillation of a sclerosing solution based on a sodium tetradecyl sulfate preparation. One treatment was done in 14 cases and 2 in the remainder. Medicare data for 1995 were used for charge analysis. The overall success rate was 61% (34 of 51 cases) with success defined as no perceptible ipsilateral scrotal fluid reaccumulation on palpation by a physician and complete patient satisfaction. The failure rate was 39% (17 cases) with failure defined as perceptible ipsilateral scrotal fluid reaccumulation on palpation by a physician and/or patient dissatisfaction. The charge differential of surgery versus aspiration and sclerotherapy was greater than 9:1. The aspiration and sclerotherapy technique that we used appears to be an efficacious, safe, cost-effective treatment modality in select patients with idiopathic hydroceles.

Cautious to a Fault: Self-Protection and the Trajectory of Marital Satisfaction

PubMed Central

Murray, Sandra L.; Holmes, John G.; Derrick, Jaye L.; Harris, Brianna; Griffin, Dale W.; Pinkus, Rebecca T.

2012-01-01

A contextual model of self-protection is proposed to explain when adhering to cautious “if-then” rules in daily interaction erodes marital satisfaction. People can self-protect against partner non-responsiveness by distancing when a partner seems rejecting, promoting a partner’s dependence when feeling unworthy, or by devaluing a partner in the face of costs. The model implies that being less trusting elicits self-protection, and that mismatches between self-protective practices and encountered risk accelerate declines in satisfaction. A longitudinal study of newlyweds revealed that the fit between self-protection practices and risk predicted declines in satisfaction over three years. When people self-protected more initially, satisfaction declined more in low-risk (i.e., low conflict, resilient partner) than high-risk relationships (i.e., high conflict, vulnerable partner). However, when people self-protected less initially, satisfaction declined more in high-risk than low-risk relationships. Process evidence was consistent with moderated mediation: In low-risk relationships only, being less trusting predicted higher levels of self-protective caution that forecast later declines in satisfaction. PMID:25013236

A Comparative Study of Male and Female Early Childhood Teachers' Job Satisfaction in Turkey

ERIC Educational Resources Information Center

Sahin, Fatma Tezel; Sak, Ramazan

2016-01-01

The aim of the present study is to provide a comparative analysis of job satisfaction among male and female teachers in early childhood education. A total of 163 teachers participated in the study, which utilized Tahta's (An analysis of job satisfaction of preschool teachers, Hacettepe University, Ankara, 1995) Job Satisfaction Survey and a…

Psychometric testing of the clinical nurse leader staff satisfaction instrument.

PubMed

Spiva, LeeAnna; Hart, Patricia L; Wesley, Mary Lou; Gallagher, Erin; McVay, Frank; Waggoner, Jessica; Jarrell, Nicole; Threatt, Jamie L

2014-01-01

Patient care is changing rapidly with increased complexity of care, patient volumes, and financial constraints with rising health care costs and limited reimbursements. In response, the clinical nurse leader (CNL) role was developed. No appropriate instrument exists to measure staff satisfaction with the CNL role. This study describes the development and testing of an instrument designed to measure staff satisfaction with implementation of the CNL role. The psychometric properties and factor structure of the Clinical Nurse Leader Staff Satisfaction (CNLSS) instrument was examined. A 2-factor solution was discovered for the CNLSS. Cronbach's alpha coefficients were acceptable for the subscales and instrument. The CNLSS is a valid and reliable instrument. Future research should focus on establishing test-retest reliability and construct validity.

The influence of nurses' working motivation and job satisfaction on intention to quit: an empirical investigation in Taiwan.

PubMed

Tzeng, Huey-Ming

2002-11-01

The present era of cost-containment pressures indicates that nursing executives have to ensure that, their nurses have a work environment with the work characteristics known to be linked to job satisfaction and good outcomes. The research hypothesis investigated here was: the higher nurses' levels on general job satisfaction, overall satisfaction with their professional role, and general job happiness, the lower their intention to quit would be. The controlling variables included demographic characteristics, working motivation, and nine job satisfaction subscales. This study was conducted in 3 hospitals located in southern Taiwan. All nurses working for these 3 hospitals were the target subjects. The overall response rate (648 completed questionnaires) was 82%. The nurses' Job Satisfaction and the perceptual degree of its importance questionnaire was used. Ordinal logistics regression analyses were utilized. General job satisfaction, general job happiness, satisfaction with salary and promotion, institution, educational background, and age of nurses' youngest child were proved to be significant predictors of nurses' intention to quit. Suggestions for future studies and administrative strategies in decreasing nurses' intention to quit were discussed. Copyright 2002 Elsevier Science Ltd.

Relationships among factors affecting advanced practice registered nurses' job satisfaction and intent to leave: A systematic review.

PubMed

Han, Robin M; Carter, Patricia; Champion, Jane Dimmitt

2018-02-01

This systematic review explores relationships between advanced practice registered nurses' (APRN) job satisfaction and intent to leave. There exists a dearth of APRN providers compared with the ever-growing need for their services. Furthermore, the organizational costs associated with the APRN turnover are extremely high. It, therefore, behooves practice administrators to understand what factors most contribute to APRN job satisfaction and retention. A search of research databases CINAHL, PubMed, and PsycINFO, using keywords "Advanced Practice Registered Nurse," "job satisfaction," "intent to leave," "anticipated turnover," and "Nurse Practitioner" to yield articles included in this review. The strength of existing evidence for this topic is weak. Studies have found that extrinsic factors, such as administrative support and salary, significantly contribute to job dissatisfaction, whereas intrinsic factors, such as autonomy and finding work meaningful, most significantly contribute to job satisfaction. Additional research is needed to better understand the factors relating to APRN job satisfaction and dissatisfaction, and how those factors influence practitioners' intent to leave. Efforts to improve APRN job satisfaction will have positive implications for provider retention, practices, and patients. Administrators should consider the job satisfaction factors identified herein when implementing practice improvement and retention efforts.

Patient satisfaction with intravenous acetaminophen: a pooled analysis of five randomized, placebo-controlled studies in the acute postoperative setting.

PubMed

Apfel, Christian C; Souza, Kimberly; Portillo, Juan; Dalal, Poorvi; Bergese, Sergio D

2015-01-01

Intravenous (IV) acetaminophen has been shown to reduce postoperative pain and opioid consumption, which may lead to increased patient satisfaction. To determine the effect IV acetaminophen has on patient satisfaction, a pooled analysis from methodologically homogenous studies was conducted. We obtained patient-level data from five randomized, placebo-controlled studies in adults undergoing elective surgery in which patient satisfaction was measured using a 4-point categorical rating scale. The primary endpoint was "excellent" satisfaction and the secondary endpoint was "good" or "excellent" satisfaction at 24 hr after first study drug administration. Bivariate analyses were conducted using the chi-square test and Student's t-test and multivariable analyses were conducted using logistic regression analysis. Patients receiving IV acetaminophen were more than twice as likely as those who received placebo to report "excellent" patient satisfaction ratings (32.3% vs. 15.9%, respectively). Of all variables that remained statistically significant in the multivariable analysis (i.e., type of surgery, duration of anesthesia, last pain rating, and opioid consumption), IV acetaminophen had the strongest positive effect on "excellent" patient satisfaction with an odds ratio of 2.76 (95% CI 1.81-4.23). Results for "excellent" or "good" satisfaction were similar. When given as part of a perioperative analgesic regimen, IV acetaminophen was associated with significantly improved patient satisfaction.

A 10-year case study on the changing determinants of university student satisfaction in the UK.

PubMed

Burgess, Adrian; Senior, Carl; Moores, Elisabeth

2018-01-01

Higher Education (HE), once the prerogative of a tiny elite, is now accessible to larger numbers of people around the world than ever before yet despite the fact that an understanding of student satisfaction has never been more important for today's universities, the concept remains poorly understood. Here we use published data from the UK's National Student Survey (NSS), representing data from 2.3 million full-time students collected from 2007 to 2016, as a case study of the benefits and limitations of measuring student satisfaction that might have applicability for other countries, particularly those that, like the UK, have experienced significant growth in student numbers. The analyses showed that the factor structure of the NSS remained generally stable and that the ability of the NSS to discriminate between different subjects at different universities actually improved over the ten-year sample period. The best predictors of overall satisfaction were 'Teaching Quality' and 'Organisation & Management', with 'Assessment & Feedback' having relatively weak predictive ability, despite the sector's tangible efforts to improve on this metric. The tripling of student fees in 2012 for English students (but not the rest of the UK) was used as a 'natural experiment' to investigate the sensitivity of student satisfaction ratings to the real economic costs of HE. The tuition fee increase had no identifiable negative effect, with student satisfaction steadily improving throughout the decade. Although the NSS was never designed to measure perceived value-for-money, its insensitivity to major changes in the economic costs of HE to the individual suggest that the conventional concept of student satisfaction is incomplete. As such we propose that the concept of student satisfaction: (i) needs to be widened to take into account the broader economic benefits to the individual student by including measures of perceived value-for-money and (ii) should measure students' level of satisfaction in the years post-graduation, by which time they may have a greater appreciation of the value of their degree in the workplace.

A 10-year case study on the changing determinants of university student satisfaction in the UK

PubMed Central

Burgess, Adrian; Senior, Carl; Moores, Elisabeth

2018-01-01

Higher Education (HE), once the prerogative of a tiny elite, is now accessible to larger numbers of people around the world than ever before yet despite the fact that an understanding of student satisfaction has never been more important for today’s universities, the concept remains poorly understood. Here we use published data from the UK’s National Student Survey (NSS), representing data from 2.3 million full-time students collected from 2007 to 2016, as a case study of the benefits and limitations of measuring student satisfaction that might have applicability for other countries, particularly those that, like the UK, have experienced significant growth in student numbers. The analyses showed that the factor structure of the NSS remained generally stable and that the ability of the NSS to discriminate between different subjects at different universities actually improved over the ten-year sample period. The best predictors of overall satisfaction were ‘Teaching Quality’ and ‘Organisation & Management’, with ‘Assessment & Feedback’ having relatively weak predictive ability, despite the sector’s tangible efforts to improve on this metric. The tripling of student fees in 2012 for English students (but not the rest of the UK) was used as a ‘natural experiment’ to investigate the sensitivity of student satisfaction ratings to the real economic costs of HE. The tuition fee increase had no identifiable negative effect, with student satisfaction steadily improving throughout the decade. Although the NSS was never designed to measure perceived value-for-money, its insensitivity to major changes in the economic costs of HE to the individual suggest that the conventional concept of student satisfaction is incomplete. As such we propose that the concept of student satisfaction: (i) needs to be widened to take into account the broader economic benefits to the individual student by including measures of perceived value-for-money and (ii) should measure students’ level of satisfaction in the years post-graduation, by which time they may have a greater appreciation of the value of their degree in the workplace. PMID:29474452

The patient-breast cancer care pathway: how could it be optimized?

PubMed

Baffert, Sandrine; Hoang, Huong Ly; Brédart, Anne; Asselain, Bernard; Alran, Séverine; Berseneff, Hélène; Huchon, Cyrille; Trichot, Caroline; Combes, Aline; Alves, Karine; Koskas, Martin; Nguyen, Thuy; Roulot, Aurélie; Rouzier, Roman; Héquet, Delphine

2015-05-12

A care pathway is defined as patient-focused global care that addresses temporal (effective and coordinated management throughout the illness) and spatial issues (treatment is provided near the health territory in or around the patient's home). Heterogeneity of the care pathways in breast cancer (BC) is presumed but not well evaluated. The OPTISOINS01 study aims to assess every aspect of the care pathway for early BC patients using a temporal and spatial scope. An observational, prospective, multicenter study in a regional health territory (Ile-de-France, France) in different types of structures: university or local hospitals and comprehensive cancer centers. We will include and follow during 1 year 1,000 patients. The study consists of 3 work-packages: - Cost of pathway The aim of this WP is to calculate the overall costs of the early BC pathway at 1 year from different perspectives (society, health insurance and patient) using a cost-of-illness analysis. Using a bottom-up method, we will assess direct costs, including medical direct costs and nonmedical direct costs (transportation, home modifications, home care services, and social services), and indirect costs (loss of production). - Patient satisfaction and work reintegration Three questionnaires will assess the patients' satisfaction and possible return to work: the occupational questionnaire for employed women; the questionnaire on the need for supportive care, SCNS-SF34 ('breast cancer' module, SCNS-BR8); and the OUTPASSAT-35 questionnaire. - Quality, coordination and access to innovation Quality will be evaluated based on visits and treatment within a set period, whether the setting offers a multidisciplinary consultative framework, the management by nurse coordinators, the use of a personalized care plan, the provision of information via documents about treatments and the provision of supportive care. The coordination between structures and caregivers will be evaluated at several levels. Day surgery, home hospitalization and one-stop breast clinic visits will be recorded to assess the patient's access to innovation. The assessment of care pathways encourages the implementation of new payment models. Our approach could help health care professionals and policymakers to establish other cost-of-illness studies and plan the allocation of resources on a patient basis rather than a visit basis.

The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: a systematic review.

PubMed

Jennings, Natasha; Clifford, Stuart; Fox, Amanda R; O'Connell, Jane; Gardner, Glenn

2015-01-01

To provide the best available evidence to determine the impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department for adult patients. The delivery of quality care in the emergency department is emerging as one of the most important service indicators in health delivery. Increasing service pressures in the emergency department have resulted in the adoption of service innovation models: the most common and rapidly expanding of these is emergency nurse practitioner services. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this service model in terms of outcomes related to safety and quality of patient care. Previous research is now outdated and not commensurate with the changing domain of delivering emergency care with nurse practitioner services. A comprehensive search of four electronic databases from 2006 to 2013 was conducted to identify research evaluating nurse practitioner service impact in the emergency department. English language articles were sought using MEDLINE, CINAHL, Embase and Cochrane and included two previous systematic reviews completed five and seven years ago. A three step approach was used. Following a comprehensive search, two reviewers assessed all identified studies against the inclusion criteria. From the original 1013 studies, 14 papers were retained for critical appraisal on methodological quality by two independent reviewers and data were extracted using standardised tools. Narrative synthesis was conducted to summarise and report the findings as insufficient data was available for meta-analysis of results. This systematic review has shown that emergency nurse practitioner service has a positive impact on quality of care, patient satisfaction and waiting times. There was insufficient evidence to draw conclusions regarding outcomes of a cost benefit analysis. Synthesis of the available research attempts to provide an evidence base for emergency nurse practitioner service to guide healthcare leaders, policy makers and clinicians in reform of emergency service provision. The findings suggest that further high quality research is required for comparative measures of clinical and service effectiveness of emergency nurse practitioner service. In the context of increased health service demand and the need to provide timely and effective care to patients, such measures will assist in evidence based health service planning. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Influence of the difference in the pollen count on medical costs in an allergen-specific immunotherapy for Japanese cedar pollinosis].

PubMed

Yuta, Atsushi; Miyamoto, Yukiko; Hattori, Reiko; Ogihara, Hitomi; Takeuchi, Kazuhiko; Majima, Yuichi

2007-11-01

We studied medical economic efficacy and influence by the different number of pollen scattering in patients treated with allergen-specific immunotherapy for Japanese cedar pollinosis. We calculated medical treatment costs and the medicine expense from medical records in eighteen cedar pollinosis patients treated with allergen-specific immunotherapy (IT-G) and with medications (M-G). We examined with the same patients for three years of different pollen scattering, mass scattering year (2005), moderate scattering year (2003), a few scattering year (2004). Furthermore, satisfaction of treatment and symptom score measured by visual analog scale in both subjects was studied in a mass scattering year. Total medical costs at hospital was cheaper in IT-G than in M-G. The result was depended on prescribed medical costs. In addition, prescribed medicine agents and total medical costs did not increase by the mass scattering year of pollen. Satisfaction of treatment and symptom score in IT-G was better than that in M-G. Immunotherapy had a benefit on a medical economy.

[Satisfaction and perceived quality of people insured by the Social Health Protection in Mexico. Methodological foundations].

PubMed

Saturno-Hernández, Pedro J; Gutiérrez-Reyes, Juan Pablo; Vieyra-Romero, Waldo Ivan; Romero-Martínez, Martín; O'Shea-Cuevas, Gabriel Jaime; Lozano-Herrera, Javier; Tavera-Martínez, Sonia; Hernández-Ávila, Mauricio

2016-01-01

To describe the conceptual framework and methods for implementation and analysis of the satisfaction survey of the Mexican System for Social Protection in Health. We analyze the methodological elements of the 2013, 2014 and 2015 surveys, including the instrument, sampling method and study design, conceptual framework, and characteristics and indicators of the analysis. The survey captures information on perceived quality and satisfaction. Sampling has national and State representation. Simple and composite indicators (index of satisfaction and rate of reported quality problems) are built and described. The analysis is completed using Pareto diagrams, correlation between indicators and association with satisfaction by means of multivariate models. The measurement of satisfaction and perceived quality is a complex but necessary process to comply with regulations and to identify strategies for improvement. The described survey presents a design and rigorous analysis focused on its utility for improving.

Generating Gratitude in the Workplace to Improve Faculty Job Satisfaction.

PubMed

Stegen, Amy; Wankier, Jamie

2018-06-01

The current nursing shortage affects all settings. In an effort to promote retention of nursing faculty, an "attitude of gratitude" was cultivated to improve job satisfaction and increase collaboration in one school of nursing. This was a quantitative study using a convenience sample of faculty at one school of nursing. A presurvey of faculty on perceived gratitude levels and job satisfaction was administered prior to the start of the school year. Multiple gratitude interventions were implemented throughout the year and a postsurvey was administered to measure the effectiveness of interventions. The findings of this study show an improvement of 17.9% in overall job satisfaction, which is consistent with other studies on the topic. Collaboration was not affected by gratitude interventions. Implementing gratitude is a cost-effective and easy way to improve job satisfaction to increase faculty retention rates. [J Nurs Educ. 2018;57(6):375-378.]. Copyright 2018, SLACK Incorporated.

Electronic health records: postadoption physician satisfaction and continued use.

PubMed

Wright, Edward; Marvel, Jon

2012-01-01

One goal of public-policy makers in general and health care managers in particular is the adoption and efficient utilization of electronic health record (EHR) systems throughout the health care industry. Consequently, this investigation focused on the effects of known antecedents of technology adoption on physician satisfaction with EHR technology and the continued use of such systems. The American Academy of Family Physicians provided support in the survey of 453 physicians regarding their satisfaction with their EHR use experience. A conceptual model merging technology adoption and computer user satisfaction models was tested using structural equation modeling. Results indicate that effort expectancy (ease of use) has the most substantive effect on physician satisfaction and the continued use of EHR systems. As such, health care managers should be especially sensitive to the user and computer interface of prospective EHR systems to avoid costly and disruptive system selection mistakes.

Results of the Software Process Improvement Efforts of the Early Adopters in NAVAIR 4.0

DTIC Science & Technology

2007-12-01

and customer satisfaction. AIRSpeed utilizes a structured, problem solving methodology called DMAIC (Define, Measure, Analyze, Improve, Control...widely used in business. DMAIC leads project teams through the logical steps from problem definition to problem resolution. Each phase has a specific set...costs and improving productivity and customer satisfaction. AIRSpeed utilizes the DMAIC (Define, Measure, Analyze, Improve, Control) structured problem

Squaring the Project Management Circle: Updating the Cost, Schedule, and Performance Methodology

DTIC Science & Technology

2016-04-30

success is measured as achieving technical performance and/or mission performance goals, coupled with customer (warfighter) satisfaction (De Wit, 1988...studies added criteria such as customer satisfaction , efficiency of execution, and effectiveness of the project organization (Pinto & Slevin, 1998...team and the user customer organization, management policy and project control. This clustering of success factors represents the amalgamation of the

Effectiveness of implementing a dyadic psychoeducational intervention for cancer patients and family caregivers.

PubMed

Titler, Marita G; Visovatti, Moira A; Shuman, Clayton; Ellis, Katrina R; Banerjee, Tanima; Dockham, Bonnie; Yakusheva, Olga; Northouse, Laurel

2017-11-01

This study examined the effectiveness, feasibility, and satisfaction with implementation of the FOCUS program in two US Cancer Support Community affiliates in Ohio and California as well as the cost to deliver the program. FOCUS is an evidence-based psychoeducational intervention for dyads (cancer patients and caregivers). A pre-post-intervention design was employed. Eleven, five-session Focus programs were delivered by licensed professionals in a small group format (three-four dyads/group) to 36 patient-caregiver dyads. An Implementation Training Manual, a FOCUS Intervention Protocol Manual, and weekly conference calls were used to foster implementation. Participants completed questionnaires prior to and following completion of each five-session FOCUS program to measure primary (emotional distress, quality of life) and secondary outcomes (benefits of illness, self-efficacy, and dyadic communication). Enrollment and retention rates and fidelity to FOCUS were used to measure feasibility. Cost estimates were based on time and median hourly wages. Repeated analysis of variance was used to analyze the effect of FOCUS on outcomes for dyads. Descriptive statistics were used to examine feasibility, satisfaction, and cost estimates. FOCUS had positive effects on QOL (p = .014), emotional (p = .012), and functional (p = .049) well-being, emotional distress (p = .002), benefits of illness (p = .013), and self-efficacy (p = .001). Intervention fidelity was 85% with enrollment and retention rates of 71.4 and 90%, respectively. Participants were highly satisfied. Cost for oversight and delivery of the five-session FOCUS program was $168.00 per dyad. FOCUS is an economic and effective intervention to decrease distress and improve the quality of life for dyads.

Effect of musculoskeletal pain of care workers on job satisfaction.

PubMed

Kim, DeokJu

2018-01-01

[Purpose] The purpose of this study was to examine the musculoskeletal pain of care workers and investigate its effect on their job satisfaction. [Subjects and Methods] Subjects were 87 care workers working at C elderly care service center in P region. The average age of men was 62.5 ± 3.4 years and that of women was 57.3 ± 2.7 years. The 'Guidelines for Risk Factor Survey on Tasks with Musculoskeletal Burden' of the KOSHA CODE (H-30-2003) of the Korea Occupational Safety and Health Agency (KOSHA) was used for measurement of musculoskeletal pain. This survey tool for job satisfaction consisted of 12 questions including the areas of wage satisfaction, professional satisfaction, job performance satisfaction, and relationship satisfaction. [Results] Study results showed that musculoskeletal pain varied depending on professional satisfaction, job performance satisfaction, and relationship satisfaction. The correlation between the areas of musculoskeletal pain and job satisfaction was examined and the following was revealed. Professional satisfaction was correlated with arm/elbow pain and lower back pain, job performance satisfaction with lower back pain, and relationship satisfaction with shoulder pain and lower back pain. [Conclusion] In this study, subjects were older and could have been easily exposed to diseases because of their age. To improve job efficiency among care workers, continuing education related to the job should take precedence. In addition, social support is required that can alleviate the heavy workload related to physical activity support, which is among the responsibilities of care workers. Moreover, application standards and coverage of industrial insurance for the treatment of musculoskeletal disorders of care workers should be extended further to relieve the burden of medical costs. A series of such measures will have a positive effect on improving the job satisfaction of care workers.

[Peripherally inserted central catheter antibiotic therapy for cystic fibrosis patients].

PubMed

Betegnie, A-L; Cracowski, C; Bedouch, P; Segond, C; Robein-Dobremez, M-J; Pin, I; Allenet, B

2014-11-01

Peripherally inserted central catheters (PICC) are more and more used for intravenous antibiotic infusions in cystic fibrosis (CF) patients in the Grenoble area (France). The aim of this study was to assess the use of this technique in this indication. 1. Retrospective evaluation of 102 consecutive PICC insertions over 3years and the incidence of adverse events during the therapy. 2. Prospective evaluation of 12 patient's satisfaction and their nurses over a 3-month period. 3. Comparative analysis of single domiciliary treatment costs using PICC versus peripheral catheter (PC). 102 PICC insertions were attempted in 31 patients. Seven failures and 7 complications occurred during the treatment requiring removal of the PICC, i.e. an overall success rate of 86.2% (88/102). Pain during PICC introduction was 4.2/10 (visual analogical scale). Mean satisfaction levels during therapy were 9.3/10 for patients and 8.7/10 for nurses. Compared with PC, all the patients said that PICC was "more comfortable". Differential costs of treatment with PC and with PICC at home were estimated at 57.15€ and 590.16€ respectively. PICC is an alternative to CP for intravenous antibiotherapy in CF patients, providing better safety and comfort. PICC use should be promoted in this indication. Copyright © 2013 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Application of Gray Relational Analysis Method in Comprehensive Evaluation on the Customer Satisfaction of Automobile 4S Enterprises

NASA Astrophysics Data System (ADS)

Cenglin, Yao

The car sales enterprises could continuously boost sales and expand customer groups, an important method is to enhance the customer satisfaction. The customer satisfaction of car sales enterprises (4S enterprises) depends on many factors. By using the grey relational analysis method, we could perfectly combine various factors in terms of customer satisfaction. And through the vertical contrast, car sales enterprises could find specific factors which will improve customer satisfaction, thereby increase sales volume and benefits. Gray relational analysis method has become a kind of good method and means to analyze and evaluate the enterprises.

Descriptive analysis of staff satisfaction and turnover intention in a Malaysian University

NASA Astrophysics Data System (ADS)

Sidik, Mohamad Hazeem; Hamid, Mohd Rashid Ab; Ibrahim, Abdullah

2017-05-01

This paper discussed the descriptive analysis of staff satisfaction in education organisation. This study employed a cross-sectional study involving a total of 1042 of respondents from a university in east coast of Malaysia. The survey covers six dimensions of staff satisfaction which are leadership, staff involvement, workload, self-development, working environment and communication. From the analysis of the mean score, it reveals that the staff enjoyed moderate level of satisfaction and the findings of the study generally support the past findings in the literature. This study paved the way for in-depth investigation towards staff satisfaction at the university under study.

Survival analysis for customer satisfaction: A case study

NASA Astrophysics Data System (ADS)

Hadiyat, M. A.; Wahyudi, R. D.; Sari, Y.

2017-11-01

Most customer satisfaction surveys are conducted periodically to track their dynamics. One of the goals of this survey was to evaluate the service design by recognizing the trend of satisfaction score. Many researchers recommended in redesigning the service when the satisfaction scores were decreasing, so that the service life cycle could be predicted qualitatively. However, these scores were usually set in Likert scale and had quantitative properties. Thus, they should also be analyzed in quantitative model so that the predicted service life cycle would be done by applying the survival analysis. This paper discussed a starting point for customer satisfaction survival analysis with a case study in healthcare service.

AB064. Estimation of direct and indirect costs and quality of life of patients with chronic obstructive pulmonary disease and their burden on Greek Health System

PubMed Central

Zarogoulidou, Vasiliki; Arbanitidou-Bagiona, Maria; Papakosta, Despoina; Zarogoulidis, Paul; Porpodis, Konstantinos; Panagopoulou, Evaggelia; Chaidits, Athanasios Basileio; Kontakiotis, Theodore; Zarogoulidis, Konstantinos

2016-01-01

Background The aim of this study was to make an attempt to estimate the direct and indirect costs of chronic obstructive pulmonary disease since in Greece very few attempts have been done to measure these costs and data available are insufficient. Our research focused on evaluating these direct and indirect costs according to demographic factors, response to treatment, patient survival, quality of life and patient satisfaction from the health care services provided. Methods This study was performed in Pulmonary Department of Aristotle University of Thessaloniki, General Hospital “G. Papanikolaou” and 110 patients with chronic obstructive pulmonary disease were enrolled. The follow-up duration of the patients was two years from the time of diagnosis. First, for study purposes the calculation of direct and indirect costs were performed and their correlations with patients’ demographics (gender, age, profession, place of residence), number of exacerbations, response to treatment and survival. In parallel, every three months from the time of diagnosis patients’ quality of life was recorded, using questionnaires, which was also correlated with the direct and indirect costs of each disease under investigation. The exploration of patient satisfaction from the health services provided was performed once for each patient during the first hospital stay in the Pulmonary Department of Aristotle University of Thessaloniki, General Hospital “G. Papanikolaou”. Results The total mean costs per patient in a one year follow-up was: total mean direct cost: 3.889,08€, total mean indirect cost: 18.01€. In chronic obstructive pulmonary disease (COPD) higher costs were observed in patients over 70 years old, of secondary education and pensioners, while for bronchial asthma higher costs were observed mainly in women. The disease severity, the frequency of exacerbations and the need for hospitalization significantly increased the economic burden of Greek health care system. The increase of the medication and patients’ monitoring cost resulted in improved control of the disease. Patients with COPD showed stable or deteriorating quality of life during the 12 month period of time. At 24 months of follow-up, patients with COPD reported improved quality of life compared to diagnosis. Improved the quality of life was associated with increased direct and indirect costs. The increased costs that were partly the result of frequent examinations, treatments and visits to the doctor, seemed to have negatively affected the emotional state of patients. Improved quality of life in COPD patients was related with reduced direct and indirect costs. Patient satisfaction from the provided health services could not be assessed as there was no homogeneity among the questions of the questionnaire used for the study. Future research should be made for the development of a reliable tool for recording patient satisfaction from the provided health services in hospitals of our country. Conclusions The higher annual burden of COPD patients is probably due to the infectious exacerbations COPD patients experience, which usually leads them to hospitalization. Patients quality of life is influenced from a variety of factors and was correlated with direct or/and indirect hospitalisation and/or monitoring cost.

Social Workers' Perceptions of Job Satisfaction, Interdisciplinary Collaboration, and Organizational Leadership.

PubMed

Marmo, Suzanne; Berkman, Cathy

2018-01-01

To address job satisfaction, and therefore employment retention, of hospice social workers, this study examined how relationships with other members of the interdisciplinary hospice team and perceptions of hospice leadership may be associated with job satisfaction of hospice social workers. The sample of 203 hospice social workers was recruited by e-mailing invitations to hospice social workers identified by hospice directors in three states, use of online social media sites accessed by hospice social workers, and snowball sampling. Study measures included professional experience, hospice characteristics, interdisciplinary collaboration, perception of servant leadership, and intrinsic and extrinsic job satisfaction. Variables significant in the model for intrinsic satisfaction were perception of servant leadership, interdisciplinary collaboration, and feeling valued by the hospice physician. Variables significant in the model for extrinsic satisfaction were perception of servant leadership, interdisciplinary collaboration, feeling valued by the hospice physician, and number of social workers at the hospice. Interdisciplinary collaboration was more important for intrinsic job satisfaction and leadership style was more important for extrinsic job satisfaction. Profit status of the hospice, experience of the social worker, caseload size, and other variables were not significant in either model. These results support previous findings that leadership style of the hospice director and relationships with hospice colleagues are important for hospice social workers' job satisfaction. Such low-cost modifications to the hospice work environment, albeit not simple, may improve job satisfaction of hospice social workers.

The roles of vibration analysis and infrared thermography in monitoring air-handling equipment

NASA Astrophysics Data System (ADS)

Wurzbach, Richard N.

2003-04-01

Industrial and commercial building equipment maintenance has not historically been targeted for implementation of PdM programs. The focus instead has been on manufacturing, aerospace and energy industries where production interruption has significant cost implications. As cost-effectiveness becomes more pervasive in corporate culture, even office space and labor activities housed in large facilities are being scrutinized for cost-cutting measures. When the maintenance costs for these facilities are reviewed, PdM can be considered for improving the reliability of the building temperature regulation, and reduction of maintenance repair costs. An optimized program to direct maintenance resources toward a cost effective and pro-active management of the facility can result in reduced operating budgets, and greater occupant satisfaction. A large majority of the significant rotating machinery in a large building environment are belt-driven air handling units. These machines are often poorly designed or utilized within the facility. As a result, the maintenance staff typically find themselves scrambling to replace belts and bearings, going from one failure to another. Instead of the reactive-mode maintenance, some progressive and critical institutions are adopting predictive and proactive technologies of infrared thermography and vibration analysis. Together, these technologies can be used to identify design and installation problems, that when corrected, significantly reduce maintenance and increase reliability. For critical building use, such as laboratories, research facilities, and other high value non-industrial settings, the cost-benefits of more reliable machinery can contribute significantly to the operational success.

Analysis of cost and assessment of computerized patient record systems in Japan based on questionnaire survey.

PubMed

Zhang, W P; Yamauchi, K; Mizuno, S; Zhang, R; Huang, D M

2004-01-01

The purpose of this study was to clarify the implementation and maintenance costs of a computerized patient record (CPR) system by means of a questionnaire survey. Moreover, the benefits of CPR systems were evaluated to determine their contribution to enhancing the quality of medical care and hospital management. Data were collected by a questionnaire survey mailed out to participants. The per-bed mean cost for implementation was 14,308 dollars (range: 3538-38,077 dollars). The mean annual maintenance cost for the CPR system was 457,615 dollars (range: 39,769-2,307,692 dollars). The multivariate analysis (Hayashi's Quantification Type I) revealed high partial correlation coefficients between implementation cost and the CPR system maker. In addition, the multiple correlation coefficient for four factors (CPR system maker, number of servers, institution type and implementation date) in predicting implementation cost was 0.798. Over 60% of respondents replied that their satisfaction with the CPR system was 'very high' or 'high.' Eighty-two percent of the hospitals responded positively that CPR systems improve the quality of medical care, and 70% felt that the systems help prevent medical errors. Our findings indicate that the maker of CPR system, number of servers, institution type and implementation date had a strong influence on per-bed implementation costs in that order. Finally, it was found that CPR systems were considered effective for hospital administration and medical examinations, based on the high assessments of the results of installing a CPR system.

Effect of part-time practice on patient outcomes.

PubMed

Parkerton, Patricia H; Wagner, Edward H; Smith, Dean G; Straley, Hugh L

2003-09-01

Primary care physicians are spending fewer hours in direct patient care, yet it is not known whether reduced hours are associated with differences in patient outcomes. To determine whether patient outcomes vary with physicians' clinic hours. Cross-sectional retrospective design assessing primary care practices in 1998. All 25 outpatient-clinics of a single medical group in western Washington. One hundred ninety-four family practitioners and general internists, 80% of whom were part-time, who provided ambulatory primary care services to specified HMO patient panels. Physician appointment hours ranged from 10 to 35 per week (30% to 100% of full time). Twenty-three measures of individual primary care physician performance collected in an administrative database were aggregated into 4 outcome measures: cancer screening, diabetic management, patient satisfaction, and ambulatory costs. Multivariate regression on each of the 4 outcomes controlled for characteristics of physicians (administrative role, gender, seniority) and patient panels (size, case mix, age, gender). While the effects were small, part-time physicians had significantly higher rates for cancer screening (4% higher, P =.001), diabetic management (3% higher, P =.033), and for patient satisfaction (3% higher, P =.035). After controlling for potential confounders, there was no significant association with patient satisfaction (P =.212) or ambulatory costs (P =.323). Primary care physicians working fewer clinical hours were associated with higher quality performance than were physicians working longer hours, but with patient satisfaction and ambulatory costs similar to those of physicians working longer hours. The trend toward part-time clinical practice by primary care physicians may occur without harm to patient outcomes.

Assessing the Relationship between Airlines' Maintenance Outsourcing and Aviation Professionals' Job Satisfaction

NASA Astrophysics Data System (ADS)

McCamey, Rotorua

The current economic and security challenges placed an additional burden on U.S. airlines to provide optimum service at reasonable costs to the flying public. In efforts to stay competitive, U.S. airlines increased foreign-based outsourcing of aircraft major repair and overhaul (MRO) mainly to reduce labor costs and conserve capital. This concentrated focus on outsourcing and restructuring, ignored job dissatisfaction among remaining employees which could reduce and or eliminate an airline's competitiveness. The purpose of this quantitative study was (a) to assess the relationship between increased levels of foreign-based MRO outsourcing and aviation professionals' job satisfaction (Y1); (b) to assess the influence of increased levels of foreign-based outsourcing on MRO control (Y2), MRO error rate (Y3), and MRO technical punctuality (Y4) as perceived by aviation professionals; and (c) to assess the influence of increased levels of foreign-based MRO outsourcing on technical skills (Y5) and morale ( Y6) as perceived by aviation professionals. The survey instrument was utilized based on Paul Spector's Job Satisfaction Questionnaire and MRO specific questions. A random sample of 300 U.S. airline participants was requested via MarketTools to meet required sample size of 110 as determined through a priori power analysis. Study data rendered 198 useable surveys of 213 total responses, and correlation, multiple regression, and ANOVA methods were used to test study hypotheses. The Spearman's rho for (Y 1) was statistically significant, p = .010 and multiple regression was statistically significant, p < .001. A one-way ANOVA indicated participants differed in their opinions of (Y2) through (Y6), Recommendations for future research include contrasting domestic and global MRO providers, and examining global aircraft parts suppliers and aviation technical training.

Vocal local versus pharmacological treatments for pain management in tubal ligation procedures in rural Kenya: a non-inferiority trial.

PubMed

Keogh, Sarah C; Fry, Kenzo; Mbugua, Edwin; Ayallo, Mark; Quinn, Heidi; Otieno, George; Ngo, Thoai D

2014-02-04

Vocal local (VL) is a non-pharmacological pain management technique for gynecological procedures. In Africa, it is usually used in combination with pharmacological analgesics. However, analgesics are associated with side-effects, and can be costly and subject to frequent stock-outs, particularly in remote rural settings. We compared the effectiveness of VL + local anesthesia + analgesics (the standard approach), versus VL + local anesthesia without analgesics, on pain and satisfaction levels for women undergoing tubal ligations in rural Kenya. We conducted a site-randomised non-inferiority trial of 884 women receiving TLs from 40 Marie Stopes mobile outreach sites in Kisii and Machakos Districts. Twenty sites provided VL + local anesthesia + analgesics (control), while 20 offered VL + local anesthesia without additional analgesics (intervention). Pain was measured using a validated 11-point Numeric Rating Scale; satisfaction was measured using 11-point scales. A total of 461 women underwent tubal ligations with VL + local anesthesia, while 423 received tubal ligations with VL + local anesthesia + analgesics. The majority were aged ≥30 years (78%), and had >3 children (99%). In a multivariate analysis, pain during the procedure was not significantly different between the two groups. The pain score after the procedure was significantly lower in the intervention group versus the control group (by 0.40 points; p = 0.041). Satisfaction scores were equally high in both groups; 96% would recommend the procedure to a friend. VL + local anesthesia is as effective as VL + local anesthesia + analgesics for pain management during tubal ligation in rural Kenya. Avoiding analgesics is associated with numerous benefits including cost savings and fewer issues related to the maintenance, procurement and monitoring of restricted opioid drugs, particularly in remote low-resource settings where these systems are weak. Pan-African Clinical Trials Registry PACTR201304000495942.

Minimal Custom Pack Design and Wide-Awake Hand Surgery: Reducing Waste and Spending in the Orthopedic Operating Room.

PubMed

Thiel, Cassandra L; Fiorin Carvalho, Rafaela; Hess, Lindsay; Tighe, Joelle; Laurence, Vincent; Bilec, Melissa M; Baratz, Mark

2017-11-01

The US health care sector has substantial financial and environmental footprints. As literature continues to study the differences between wide-awake hand surgery (WAHS) and the more traditional hand surgery with sedation & local anesthesia, we sought to explore the opportunities to enhance the sustainability of WAHS through analysis of the respective costs and waste generation of the 2 techniques. We created a "minimal" custom pack of disposable surgical supplies expressly for small hand surgery procedures and then measured the waste from 178 small hand surgeries performed using either the "minimal pack" or the "standard pack," depending on physician pack choice. Patients were also asked to complete a postoperative survey on their experience. Data were analyzed using 1- and 2-way ANOVAs, 2-sample t tests, and Fisher exact tests. As expected, WAHS with the minimal pack produced 0.3 kg (13%) less waste and cost $125 (55%) less in supplies per case than sedation & local with the standard pack. Pack size was found to be the driving factor in waste generation. Patients who underwent WAHS reported slightly greater pain and anxiety levels during their surgery, but also reported greater satisfaction with their anesthetic choice, which could be tied to the enthusiasm of the physician performing WAHS. Surgical waste and spending can be reduced by minimizing the materials brought into the operating room in disposable packs. WAHS, as a nascent technique, may provide an opportunity to drive sustainability by paring back what is considered necessary in these packs. Moreover, despite some initial anxiety, many patients report greater satisfaction with WAHS. All told, our study suggests a potentially broader role for WAHS, with its concomitant emphases on patient satisfaction and the efficient use of time and resources.

36 CFR 228.110 - Indemnification.

Code of Federal Regulations, 2010 CFR

2010-07-01

... United States for: (a) Injury, loss or damage, including fire suppression costs, which the United States incurs as a result of the operations; and (b) Payments made by the United States in satisfaction of claims, demands or judgments for an injury, loss or damage, including fire suppression costs, which...

Client satisfaction of maternity care in Lorestan province Iran

PubMed Central

Changee, Farahnaz; Irajpour, Alireza; Simbar, Masoumeh; Akbari, Soheila

2015-01-01

Background: Client satisfaction is an important indicator for assessment of the quality of care provided. Detecting patients dissatisfaction and trying to find the most effective and costly services is the basic way for improvement of service quality. The purpose of this study was to determine the satisfaction level of women in the maternity care centers (hospitals) of Lorestan University of Medical Sciences, Iran. Materials and Methods: In this descriptive cross-sectional study, the satisfaction level of 200 patients who received care during childbirth in province hospitals was assessed using a researcher-made questionnaire. Women in maternity care units completed the questionnaires. Results: The mean maternity care satisfaction score was 66.6 ± 3.5. The lowest satisfaction level was related to getting to know the delivery room (64%) and vaginal examination (66%). The highest satisfaction score was related to confidentiality of the information (86%) and trusting the midwife (84%). Regarding the environmental factors, the lowest satisfaction was related to respecting silence in the pain room (69.5%) and the highest was related to cleanliness and hygiene of the delivery room (84%). Conclusions: Our results suggest the relative satisfaction of women receiving care in the health centers of Lorestan province; but this level of satisfaction does not mean that the delivery of care in this province is perfect. By reviewing the policies and the existing care programs regarding promoting the quality of services, managers can increase clients’ satisfaction. PMID:26120342

Impact of a value-based insurance design for back pain on health plan member satisfaction and its implications for patient outcomes.

PubMed

Maeng, Daniel D; Fisher, Dorothy Y; Graboski, Anthony; Allison, Peiling L; Rodriguez, Jennifer M; Starr, Alison E; Tomcavage, Janet F; Davis, Duane E

2015-06-01

Back pain is one of the most common reasons for seeking care, and physical therapy (PT) can be an effective treatment option. However, PT coverage for back pain varies widely among private health plans, usually requiring high cost sharing, thereby potentially leading to member dissatisfaction and worse outcomes. In this study, a quasi-experimental design was used to estimate the impact of a new value-based insurance design for back pain-related PT on selected Consumer Assessment of Healthcare Providers and Systems survey items. Under this design, eligible members receive a bundle of 5 PT sessions for a 1-time co-payment; if deemed necessary, the bundle is renewable for 1 additional co-payment. The results indicate that the proportion of members reporting the highest satisfaction rating was higher by about 6 to 10 percentage points among those who received the PT bundle. The data also indicate that those PT bundle members who reported the highest satisfaction rating had improvements in their functional status scores that were roughly 3 to 4 times higher than those who reported a lower satisfaction rating. These findings suggest that providing a value-based insurance design for back pain-related PT can potentially improve health plan members' care experiences and their overall satisfaction. Further study is needed to determine its impact on back pain-related medical care utilization and cost of care.

Increasing Resident Wellness Through a Novel Retreat Curriculum

PubMed Central

Cornelius, Brian G; Edens, Mary Ann

2017-01-01

Background Because of their arduous schedules, residents are susceptible to burnout, fatigue, and depression. In 2015, the Accreditation Council for Graduate Medical Education (ACGME) launched a campaign to foster physician wellness, in response to the suicides of three residents during the previous year. The campaign calls for strategies to developing resiliency, identify problems, and promote well-being. One of the suggested methods to promote well-being was a residency retreat. Objective To implement a novel retreat curriculum that emphasizes team building between residents and faculty, with which residents expressed high satisfaction. Methods We created an "Amazing Race" style retreat involving five activity stations set up in a neighborhood park in which 25 of our 34 residents participated. These stations implemented team building, faculty-resident bonding and resident-resident bonding. An anonymous survey was administered to the 25 participating emergency medicine (EM) residents after the retreat, of whom 21 returned the survey. The survey consisted of questions to assess the resident’s perception of the team building activities, their satisfaction with each of the five activity stations and overall retreat satisfaction. Results Of the 25 residents who participated in the retreat, 21 (84%) returned the post-retreat survey (one participant returned a survey leaving the ranking questions incomplete). This low-cost event received high satisfaction ratings in regard to team-building, resident bonding, and faculty-resident bonding. Conclusions This novel retreat proved to be a low-cost and easily implemented activity with which the residents expressed high levels of satisfaction. PMID:28966896

Service quality, trust, and patient satisfaction in interpersonal-based medical service encounters

PubMed Central

2013-01-01

Background Interaction between service provider and customer is the primary core of service businesses of different natures, and the influence of trust on service quality and customer satisfaction could not be ignored in interpersonal-based service encounters. However, lack of existing literature on the correlation between service quality, patient trust, and satisfaction from the prospect of interpersonal-based medical service encounters has created a research gap in previous studies. Therefore, this study attempts to bridge such a gap with an evidence-based practice study. Methods We adopted a cross-sectional design using a questionnaire survey of outpatients in seven medical centers of Taiwan. Three hundred and fifty copies of questionnaire were distributed, and 285 valid copies were retrieved, with a valid response rate of 81.43%. The SPSS 14.0 and AMOS 14.0 (structural equation modeling) statistical software packages were used for analysis. Structural equation modeling clarifies the extent of relationships between variables as well as the chain of cause and effect. Restated, SEM results do not merely show empirical relationships between variables when defining the practical situation. For this reason, SEM was used to test the hypotheses. Results Perception of interpersonal-based medical service encounters positively influences service quality and patient satisfaction. Perception of service quality among patients positively influences their trust. Perception of trust among patients positively influences their satisfaction. Conclusions According to the findings, as interpersonal-based medical service encounters will positively influence service quality and patient satisfaction, and the differences for patients’ perceptions of the professional skill and communication attitude of personnel in interpersonal-based medical service encounters will influence patients’ overall satisfaction in two ways: (A) interpersonal-based medical service encounter directly affects patient satisfaction, which represents a direct effect; and (B) service quality and patient trust are used as intervening variables to affect patient satisfaction, which represents an indirect effect. Due to differences in the scale, resources and costs among medical institutions of different levels, it is a most urgent and concerning issue of how to control customers’ demands and preferences and adopt correct marketing concepts under the circumstances of intense competition in order to satisfy the public and build up a competitive edge for medical institutions. PMID:23320786

Relationship between nurse psychological empowerment and job satisfaction: A systematic review and meta-analysis.

PubMed

Li, Huanhuan; Shi, Ying; Li, Yuan; Xing, Zhuangjie; Wang, Shouqi; Ying, Jie; Zhang, Meiling; Sun, Jiao

2018-06-01

This systematic review and meta-analysis aimed to synthesize and analyse studies that explored the relationship between the psychological empowerment and job satisfaction of nurses. Nurse turnover is an important cause of staff shortage. Job satisfaction is a major predictor of nurse turnover and is connected to the psychological empowerment of nurses. This systematic review and meta-analysis is based on the Joanna Briggs Institute guidelines. A total of 1,572 articles on psychological empowerment and job satisfaction were retrieved from PubMed, PsycINFO, EMBASE and Web of Science. The articles were written in English and published before or by April 2017. Studies on the relationship between psychological empowerment and job satisfaction were summarized. The majority of the included studies revealed that psychological empowerment and job satisfaction are significantly correlated. Only two studies showed that the two factors are not significantly correlated. The result of this meta-analysis is consistent with the results of most studies. One study reported that psychological empowerment partially mediates the structural empowerment and job satisfaction of school health nurses. Two studies, however, did not find that the mediating role of psychological empowerment between structural empowerment and job satisfaction. The results of this review provided evidence for the importance of psychological empowerment for the job satisfaction of among nurses. Exploring the correlation between psychological empowerment and job satisfaction can provide guidelines and recommendation for the development of strategies to promote nurse retention and alleviate nursing shortage. © 2018 John Wiley & Sons Ltd.

Cross-cultural adaptation and validation of the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0): the development of the Taiwanese version.

PubMed

Mao, Hui-Fen; Chen, Wan-Yin; Yao, Grace; Huang, Sheau-Ling; Lin, Chia-Chi; Huang, Wen-Ni Wennie

2010-05-01

To develop and validate a cross-cultural version of the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0) for users of assistive technology devices in Taiwan. A cross-sectional survey. The standard cultural adaptation procedure was used for questionnaire translation and cultural item design. A field test was then conducted for item selection and psychometric properties testing. One hundred and five volunteer assistive device users in community. A questionnaire comprising 12 items of the QUEST 2.0 and 16 culture-specific items. One culture-specific item, 'Cost', was selected based on eight criteria and added to the QUEST 2.0 (12 items) to formulate the Taiwanese version of QUEST 2.0 (T-QUEST). The T-QUEST consisted of 13 items which were classified into two domains: device (8 items) and service (5 items). The internal consistencies of the device, service and total T-QUEST scores were 0.87, 0.84 and 0.90, respectively. The device, services and total T-QUEST scores achieved good test-retest stability (intraclass correlation coefficient (ICC) 0.90, 0.97, 0.95). Exploratory factor analysis revealed that T-QUEST had a two-factor structure for device and service in the construct of user satisfaction (53.42% of the variance explained). Users of assistive device in different culture may have different concerns regarding satisfaction. T-QUEST is the first published version of QUEST with culture-specific items added to the original translated items of QUEST 2.0. T-QUEST was a valid and reliable tool for measuring user satisfaction among Mandarin-speaking individuals using various kinds of assistive devices.

Patient satisfaction in Dental Healthcare Centers.

PubMed

Ali, Dena A

2016-01-01

This study aimed to (1) measure the degree of patient satisfaction among the clinical and nonclinical dental services offered at specialty dental centers and (2) investigate the factors associated with the degree of overall satisfaction. Four hundred and ninety-seven participants from five dental centers were recruited for this study. Each participant completed a self-administered questionnaire to measure patient satisfaction with clinical and nonclinical dental services. Analysis of variance, t-tests, a general linear model, and stepwise regression analysis was applied. The respondents were generally satisfied, but internal differences were observed. The exhibited highest satisfaction with the dentists' performance, followed by the dental assistants' services, and the lowest satisfaction with the center's physical appearance and accessibility. Females, participants with less than a bachelor's degree, and younger individuals were more satisfied with the clinical and nonclinical dental services. The stepwise regression analysis revealed that the coefficient of determination (R (2)) was 40.4%. The patient satisfaction with the performance of the dentists explained 42.6% of the overall satisfaction, whereas their satisfaction with the clinical setting explained 31.5% of the overall satisfaction. Additional improvements with regard to the accessibility and physical appearance of the dental centers are needed. In addition, interventions regarding accessibility, particularly when booking an appointment, are required.

Patient satisfaction in Dental Healthcare Centers

PubMed Central

Ali, Dena A.

2016-01-01

Objectives: This study aimed to (1) measure the degree of patient satisfaction among the clinical and nonclinical dental services offered at specialty dental centers and (2) investigate the factors associated with the degree of overall satisfaction. Materials and Methods: Four hundred and ninety-seven participants from five dental centers were recruited for this study. Each participant completed a self-administered questionnaire to measure patient satisfaction with clinical and nonclinical dental services. Analysis of variance, t-tests, a general linear model, and stepwise regression analysis was applied. Results: The respondents were generally satisfied, but internal differences were observed. The exhibited highest satisfaction with the dentists’ performance, followed by the dental assistants’ services, and the lowest satisfaction with the center's physical appearance and accessibility. Females, participants with less than a bachelor's degree, and younger individuals were more satisfied with the clinical and nonclinical dental services. The stepwise regression analysis revealed that the coefficient of determination (R2) was 40.4%. The patient satisfaction with the performance of the dentists explained 42.6% of the overall satisfaction, whereas their satisfaction with the clinical setting explained 31.5% of the overall satisfaction. Conclusion: Additional improvements with regard to the accessibility and physical appearance of the dental centers are needed. In addition, interventions regarding accessibility, particularly when booking an appointment, are required. PMID:27403045

An intelligent algorithm for optimizing emergency department job and patient satisfaction.

PubMed

Azadeh, Ali; Yazdanparast, Reza; Abdolhossein Zadeh, Saeed; Keramati, Abbas

2018-06-11

Purpose Resilience engineering, job satisfaction and patient satisfaction were evaluated and analyzed in one Tehran emergency department (ED) to determine ED strengths, weaknesses and opportunities to improve safety, performance, staff and patient satisfaction. The paper aims to discuss these issues. Design/methodology/approach The algorithm included data envelopment analysis (DEA), two artificial neural networks: multilayer perceptron and radial basis function. Data were based on integrated resilience engineering (IRE) and satisfaction indicators. IRE indicators are considered inputs and job and patient satisfaction indicators are considered output variables. Methods were based on mean absolute percentage error analysis. Subsequently, the algorithm was employed for measuring staff and patient satisfaction separately. Each indicator is also identified through sensitivity analysis. Findings The results showed that salary, wage, patient admission and discharge are the crucial factors influencing job and patient satisfaction. The results obtained by the algorithm were validated by comparing them with DEA. Practical implications The approach is a decision-making tool that helps health managers to assess and improve performance and take corrective action. Originality/value This study presents an IRE and intelligent algorithm for analyzing ED job and patient satisfaction - the first study to present an integrated IRE, neural network and mathematical programming approach for optimizing job and patient satisfaction, which simultaneously optimizes job and patient satisfaction, and IRE. The results are validated by DEA through statistical methods.

Compassion satisfaction: A concept analysis in nursing.

PubMed

Sacco, Tara L; Copel, Linda Carman

2018-01-01

Nurses experience an intrinsic sense of fulfillment derived from their work in caring for other people. There is a need to further investigate the concept of compassion satisfaction as it is experienced in the profession of nursing. The aim of this analysis is to provide clarity to the concept of compassion satisfaction in nursing. A search of social work and nursing literature was completed. The search terms "compassion satisfaction," "nursing," "social workers," "teachers," and "educators" were entered in various combinations to the CINAHL, Journals@Ovid, ProQuest Nursing & Allied Health Source, ProQuest Psychology Journals, PsychINFO, ERIC, and Education Full Text databases. A comprehensive review of the literature was completed to identify features of compassion satisfaction. Utilizing the Walker and Avant method, assumptions, antecedents, characteristics, and consequences of compassion satisfaction were identified. A conceptual model of compassion satisfaction was developed encompassing 7 antecedents, 11 characteristics, and 8 consequences. Further, a theoretical definition of compassion satisfaction in nursing was derived. There is a need to focus on the positive effects of caring. This concept analysis provides the initial step to strengthening the science related to compassion satisfaction in nursing and other helping professions. © 2017 Wiley Periodicals, Inc.

Job satisfaction in nursing: a concept analysis study.

PubMed

Liu, Y; Aungsuroch, Y; Yunibhand, J

2016-03-01

This study aims to undertake a concept analysis of job satisfaction in the nursing profession. Around current global shortage of nurses, it is important to stabilize the nursing workforce. Nurses' job satisfaction has been found to be related to intention to leave. In the nursing profession, there is a lack of evidence to support the attributes of nurses' job satisfaction. Walker and Avant's approach of concept analysis was used. The main attributes of job satisfaction from this study are (1) fulfillment of desired needs within the work settings, (2) happiness or gratifying emotional responses towards working conditions, and (3) job value or equity. These attributes are influenced by antecedent conditions like demographic, emotional, work characteristics and environmental variables. Additionally, the consequences of nurses' job satisfaction have a significant impact on both nurses and patients. This study integrated both the content and process of motivational theories to generate the attributes of job satisfaction in nursing that overcome the limitation of the previous studies, which looked only at the definitions of nurses' job satisfaction based on content motivational theories. The findings of this study can facilitate both nursing researchers to develop a cultural adaption instrument and policy makers to improve clinical nursing practice. This analysis provides nurse managers with a new perspective to deal with nurses' job satisfaction by taking into account all the attributes that influence it in the nursing field. © 2015 International Council of Nurses.

Emergency wounds treated with cyanoacrylate and long-term results in pediatrics: a series of cases; what are the advantages and boards?

PubMed Central

Gulalp, Betul; Seyhan, Tamer; Gursoy, Sonnur; Altinors, M Nur

2009-01-01

Background Ethyl-2-cyanoacrylate (ECA) is a tissue adhesive material applied to close superficial wounds. The aim of this study was to explore the benefits of cyanoacrylates in the emergency department in children with current application with regard to cost-effectiveness, satisfaction and long follow up. Findings Patients were treated after assignment of the consent with an explanation by the relatives in a tertiary emergency department (ED), 2007. The evaluation was based on different superficial wound repairs due to blunt trauma within a 2-hour time period (<6 hours), and small wounds (≤3 cm). These wounds were cleansed with serum sale and then dried with gauze. Wound repairs were observed for six months in order to observe the tissue changes. The patient's age, sex, indication, application time, pain score, cost, additional tending (if needed), complications, and cosmetic satisfaction were recorded. A total of 9 patients were evaluated and followed for 6 months. Except for one, all children were treated without any serious complications. ECA was cost-effective, time-saving, and provided successful repair satisfaction by a blinded plastic surgeon and patient/parents. Conclusion This report displayed the pediatric effective use of cyanoacrylates, even in non- traditional repairs in the emergency departments. PMID:19594954

Cluster-randomised non-inferiority trial comparing DVD-assisted and traditional genetic counselling in systematic population testing for BRCA1/2 mutations.

PubMed

Manchanda, Ranjit; Burnell, Matthew; Loggenberg, Kelly; Desai, Rakshit; Wardle, Jane; Sanderson, Saskia C; Gessler, Sue; Side, Lucy; Balogun, Nyala; Kumar, Ajith; Dorkins, Huw; Wallis, Yvonne; Chapman, Cyril; Tomlinson, Ian; Taylor, Rohan; Jacobs, Chris; Legood, Rosa; Raikou, Maria; McGuire, Alistair; Beller, Uziel; Menon, Usha; Jacobs, Ian

2016-07-01

Newer approaches to genetic counselling are required for population-based testing. We compare traditional face-to-face genetic counselling with a DVD-assisted approach for population-based BRCA1/2 testing. A cluster-randomised non-inferiority trial in the London Ashkenazi Jewish population. Ashkenazi Jewish men/women >18 years; exclusion criteria: (a) known BRCA1/2 mutation, (b) previous BRCA1/2 testing and (c) first-degree relative of BRCA1/2 carrier. Ashkenazi Jewish men/women underwent pre-test genetic counselling prior to BRCA1/2 testing in the Genetic Cancer Prediction through Population Screening trial (ISRCTN73338115). Genetic counselling clinics (clusters) were randomised to traditional counselling (TC) and DVD-based counselling (DVD-C) approaches. DVD-C involved a DVD presentation followed by shorter face-to-face genetic counselling. Outcome measures included genetic testing uptake, cancer risk perception, increase in knowledge, counselling time and satisfaction (Genetic Counselling Satisfaction Scale). Random-effects models adjusted for covariates compared outcomes between TC and DVD-C groups. One-sided 97.5% CI was used to determine non-inferiority. relevance, satisfaction, adequacy, emotional impact and improved understanding with the DVD; cost-minimisation analysis for TC and DVD-C approaches. 936 individuals (clusters=256, mean-size=3.6) were randomised to TC (n=527, clusters=134) and DVD-C (n=409, clusters=122) approaches. Groups were similar at baseline, mean age=53.9 (SD=15) years, women=66.8%, men=33.2%. DVD-C was non-inferior to TC for increase in knowledge (d=-0.07; lower 97.5% CI=-0.41), counselling satisfaction (d=-0.38, 97.5% CI=1.2) and risk perception (d=0.08; upper 97.5% CI=3.1). Group differences and CIs did not cross non-inferiority margins. DVD-C was equivalent to TC for uptake of genetic testing (d=-3%; lower/upper 97.5% CI -7.9%/1.7%) and superior for counselling time (20.4 (CI 18.7 to 22.2) min reduction (p<0.005)). 98% people found the DVD length and information satisfactory. 85-89% felt it improved their understanding of risks/benefits/implications/purpose of genetic testing. 95% would recommend it to others. The cost of genetic counselling for DVD-C=£7787 and TC=£17 307. DVD-C resulted in cost savings=£9520 (£14/volunteer). DVD-C is an effective, acceptable, non-inferior, time-saving and cost-efficient alternative to TC. ISRCTN 73338115. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Developing an online certification program for nutrition education assistants.

PubMed

Christofferson, Debra; Christensen, Nedra; LeBlanc, Heidi; Bunch, Megan

2012-01-01

To develop an online certification program for nutrition education paraprofessionals to increase knowledge and confidence and to overcome training barriers of programming time and travel expenses. An online interactive certification course based on Supplemental Nutrition Assistance Program-Education and Expanded Food and Nutrition Education Program core competencies was delivered to employees of both programs. Traditional vs online training was compared. Course content validity was determined through expert review by registered dietitians. Parameters studied included increase of nutrition knowledge and teaching technique/ability, educator satisfaction, and programming costs related to training. Utah State University Extension. Twenty-two Supplemental Nutrition Assistance Program-Education and Expanded Food and Nutrition Education Program educators in Utah. Knowledge and skills were measured using pre/posttest statistics. Participant satisfaction was measured with a survey. Paired t test; satisfaction survey. The change in paraprofessional knowledge score was statistically significant (P < .001). Forty percent of paraprofessionals strongly agreed and 60% agreed they were better prepared as nutrition educators because of the training. An estimated $16,000 was saved by providing the training online as compared to a face-to-face training. This interactive online program is a cost-effective way to increase paraprofessional knowledge and job satisfaction. Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

What Is Your Budget Saying about Your Library?

ERIC Educational Resources Information Center

Jacobs, Leslie; Strouse, Roger

2002-01-01

Discusses budgeting for corporate libraries and how to keep budgets from getting cut. Topics include whether the budget is considered corporate overhead; recovering costs; models for content cost recovery; showing return on library investment; marketing library value to senior management; user needs and satisfaction; and comparing budgets to other…

Managing Food Service Costs and Satisfying Customers.

ERIC Educational Resources Information Center

Reuther, Anne; Otto, Ione

1987-01-01

Milwaukee Area Technical College, Wisconsin, has four campuses, each with its own food service operation that, combined, serve nearly 3,000 people daily. Several food service-related programs are part of the curriculum. Cost containment and customer satisfaction are the two overriding goals of the food service programs. (MLF)

Shared decision-making for biologic treatment of autoimmune disease: influence on adherence, persistence, satisfaction, and health care costs.

PubMed

Lofland, Jennifer H; Johnson, Phaedra T; Ingham, Mike P; Rosemas, Sarah C; White, John C; Ellis, Lorie

2017-01-01

Shared decision-making (SDM), a process whereby physicians and patients collaborate to select interventions, is not well understood for biologic treatment of autoimmune conditions. This was a cross-sectional survey of adults initiating treatment for Crohn's disease or ulcerative colitis (inflammatory bowel disease, IBD) or psoriatic arthritis or rheumatoid arthritis (RA/PA). Survey data were linked to administrative claims for 6 months before (baseline) and after (follow-up) therapy initiation. Measures included the Shared Decision Making Questionnaire, Patient Activation Measure (PAM), Morisky Medication Adherence Scale (MMAS), general health, and treatment satisfaction. Claims-based Quan-Charlson comorbidity scores, persistence, medication possession ratio (MPR), and health care costs were examined. Patients were compared by participation (SDM) and nonparticipation (non-SDM) in SDM. Among 453 respondents, 357 were eligible, and 306 patients (204 RA/PA and 102 IBD) were included in all analyses. Overall (n=357), SDM participants (n=120) were more often females (75.0% vs 62.5%, P =0.018), had lower health status (48.0 vs 55.4, P =0.005), and higher Quan-Charlson scores (1.0 vs 0.7, P =0.035) than non-SDM (n=237) participants. Lower MMAS scores (SDM 0.17 vs non-SDM 0.41; P <0.05) indicated greater likelihood of adherence; SDM participants also reported higher satisfaction with medication and had greater activation (PAM: SDM vs non-SDM: 66.9 vs 61.6; P <0.001). Mean MPR did not differ, but persistence was longer among SDM participants (111.2 days vs 102.2 days for non-SDM; P =0.029). Costs did not differ by SDM status overall, or among patients with RA/PA. The patients with IBD, however, experienced lower ( P =0.003) total costs ($9,404 for SDM vs $25,071 for non-SDM) during follow-up. This study showed greater likelihood of adherence and satisfaction for patients who engaged in SDM and reduced health care costs among patients with IBD who engaged in SDM. This study provides a basis for defining SDM participation and detecting differences by SDM participation for biologic treatment selection for autoimmune conditions.

The Separate Constructs of Communication Satisfaction and Job Satisfaction.

ERIC Educational Resources Information Center

Gregson, Terry

1991-01-01

A random sample of 889 certified public accountants was administered modified versions of the Job Descriptive Index and the Downs and Hazen Communication Satisfaction Questionnaire. There were 310 (35 percent) usable questionnaires returned. Factor analysis indicated that the accountants viewed job satisfaction and communication satisfaction as…

Business-unit-level relationship between employee satisfaction, employee engagement, and business outcomes: a meta-analysis.

PubMed

Harter, James K; Schmidt, Frank L; Hayes, Theodore L

2002-04-01

Based on 7,939 business units in 36 companies, this study used meta-analysis to examine the relationship at the business-unit level between employee satisfaction-engagement and the business-unit outcomes of customer satisfaction, productivity, profit, employee turnover, and accidents. Generalizable relationships large enough to have substantial practical value were found between unit-level employee satisfaction-engagement and these business-unit outcomes. One implication is that changes in management practices that increase employee satisfaction may increase business-unit outcomes, including profit.

A World Wide Web-based antimicrobial stewardship program improves efficiency, communication, and user satisfaction and reduces cost in a tertiary care pediatric medical center.

PubMed

Agwu, Allison L; Lee, Carlton K K; Jain, Sanjay K; Murray, Kara L; Topolski, Jason; Miller, Robert E; Townsend, Timothy; Lehmann, Christoph U

2008-09-15

Antimicrobial stewardship programs aim to reduce inappropriate hospital antimicrobial use. At the Johns Hopkins Children's Medical and Surgical Center (Baltimore, MD), we implemented a World Wide Web-based antimicrobial restriction program to address problems with the existing restriction program. A user survey identified opportunities for improvement of an existing antimicrobial restriction program and resulted in subsequent design, implementation, and evaluation of a World Wide Web-based antimicrobial restriction program at a 175-bed, tertiary care pediatric teaching hospital. The program provided automated clinical decision support, facilitated approval, and enhanced real-time communication among prescribers, pharmacists, and pediatric infectious diseases fellows. Approval status, duration, and rationale; missing request notifications; and expiring approvals were stored in a database that is accessible via a secure Intranet site. Before and after implementation of the program, user satisfaction, reports of missed and/or delayed doses, antimicrobial dispensing times, and cost were evaluated. After implementation of the program, there was a $370,069 reduction in projected annual cost associated with restricted antimicrobial use and an 11.6% reduction in the number of dispensed doses. User satisfaction increased from 22% to 68% and from 13% to 69% among prescribers and pharmacists, respectively. There were 21% and 32% reductions in the number of prescriber reports of missed and delayed doses, respectively, and there was a 37% reduction in the number of pharmacist reports of delayed approvals; measured dispensing times were unchanged (P = .24). In addition, 40% fewer restricted antimicrobial-related phone calls were noted by the pharmacy. The World Wide Web-based antimicrobial approval program led to improved communication, more-efficient antimicrobial administration, increased user satisfaction, and significant cost savings. Integrated tools, such as this World Wide Web-based antimicrobial approval program, will effectively enhance antimicrobial stewardship programs.

Patient satisfaction with the perioperative surgical services and associated factors at a University Referral and Teaching Hospital, 2014: a cross-sectional study.

PubMed

Gebremedhn, Endale Gebreegziabher; Lemma, Girmay Fitiwi

2017-01-01

Globally, increasing consideration has been given to the assessment of patient satisfaction as a method of monitor of the quality of health care provision in the health institutions. Perioperative patient satisfaction has been contemplated to be related with the level of postoperative pain intensity, patients' expectation of the outcome, patient health provider relationship, inpatient services, hospital facilities, access to care, waiting time, cost and helpfulness of treatments received. The study aimed to assess the level of patient satisfaction with perioperative surgical services and associated factors. Hospital based quantitative cross-sectional study was conducted in University of Gondar teaching hospital from April1-30, 2014. Structured Amharic version questionnaire and checklist used for data collection. All patients who operated upon during the study period were included. Both bivariate and multivariate logistic regression model used to identify the variables which had association with the dependent variable. P-values < 0.05 were considered statistically significant. Two hundred and seventy eight patients underwent surgery during the study period. Nine patients were excluded due to refusal to participate in the study. A total of 269 out of 278 patients were included in the study with a response rate of 96.8%. The overall level of patient satisfaction with perioperative surgical services was 98.1%. The variables that had association with the outcome variable from the multivariate analysis were patient admission status (AOR=0.073, CI=0.007-0.765, P=0.029), information about the disease and operation (AOR=0.010, CI=0.001-0.140, P=0.001) and operation theatre staff attention to the patients complains (AOR=0.028, CI=0.002-0.390, P=0.008) respectively. The level of patient satisfaction with perioperative surgical services was high compared with previous studies conducted in the country and other countries in the world. Health professionals need to give emphasis for information on care provision processes, patients' health progress and patients' complaints.

Building and Sustaining Strong Public Health Agencies: Determinants of Workforce Turnover.

PubMed

Pourshaban, Deena; Basurto-Dávila, Ricardo; Shih, Margaret

2015-01-01

Workforce shortages have been identified as a priority for US public health agencies. Voluntary turnover results in loss of expertise and institutional knowledge as well as high costs to recruit and train replacement workers. To analyze patterns and predictors of voluntary turnover among public health workers. Descriptive analysis and linear probability regression models. Employees of state health agencies in the United States who participated in the Public Health Workforce Interests and Needs Survey (PH WINS). Intended retirement and voluntary departure; pay satisfaction; job satisfaction. Nearly 25% of workers reported plans to retire before 2020, and an additional 18% reported the intention to leave their current organization within 1 year. Four percent of staff are considering leaving their organization in the next year for a job at a different health department. There was significant heterogeneity by demographic, socioeconomic, and job characteristics. Areas such as administration/management, health education, health services, social services, and epidemiology may be particularly vulnerable to turnover. The strongest predictors of voluntary departure were pay and job satisfaction, which were associated with 9 (P < .001) and 24 (P < .001) percentage-point decreases, respectively, in the probability to report the intention to leave. Our findings suggest that if all workers were satisfied with their job and pay, intended departure would be 7.4%, or less than half the current 18% rate. Controlling for salary levels, higher levels of education and longer work experience were associated with lower pay satisfaction, except for physicians, who were 11 percentage points (P = .02) more likely to be satisfied with their pay than employees with doctoral degrees. Several workplace characteristics related to relationships with supervisors, workplace environment, and employee motivation/morale were significantly associated with job satisfaction. Our findings suggest that public health agencies may face significant pressure from worker retirement and voluntary departures in coming years. Although retirement can be addressed through recruitment efforts, addressing other voluntary departures will require focusing on improving pay and job satisfaction.

Sexual Satisfaction Concept Analysis in Iranian Married Women: A Hybrid Model Study

PubMed Central

Yekta, Zohre Parsa; Raisi, Firoozeh; Ebadi, Abbas; Shahvari, Zahra

2015-01-01

Background: Sexual satisfaction is considered to be a sexual right and an important component of sexual health. The purpose of this qualitative study was to clarify the meaning and the nature of sexual satisfaction in Iranian married women, and to provide a cultural-based definition of it. Method: Sexual satisfaction was examined in three phases by the Hybrid Model of concept analysis: (1) the theoretical phase; (2) the fieldwork phase and (3) the analytical phase. Hybrid concept analysis method was chosen because its inclusion of married women’s perspectives enriches the limits of sexual health search literature. Result: The critical attributes of sexual satisfaction were investigated. They included ‘two-dimensional structure’, ‘an affective response’, ‘a means to achieve marital satisfaction’, ‘unique’, ‘a concept based on expectations’ and ‘a concept on shadow of values’. Conclusion: The concept analysis of sexual satisfaction showed some of the attributes and antecedents for this concept that, have not been mentioned in the literature. PMID:26153166

Explaining public satisfaction with health-care systems: findings from a nationwide survey in China.

PubMed

Munro, Neil; Duckett, Jane

2016-06-01

To identify factors associated with health-care system satisfaction in China. Recent research suggests that socio-demographic characteristics, self-reported health, income and insurance, ideological beliefs, health-care utilization, media use and perceptions of services may affect health-care system satisfaction, but the relative importance of these factors is poorly understood. New data from China offer the opportunity to test theories about the sources of health-care system satisfaction. Stratified nationwide survey sample analysed using multilevel logistic regression. 3680 Chinese adults residing in family dwellings between 1 November 2012 and 17 January 2013. Satisfaction with the way the health-care system in China is run. We find only weak associations between satisfaction and socio-demographic characteristics, self-reported health and income. We do, however, find that satisfaction is strongly associated with having insurance and belief in personal responsibility for meeting health-care costs. We also find it is negatively associated with utilization, social media use, perceptions of access as unequal and perceptions of service providers as unethical. To improve satisfaction, Chinese policymakers - and their counterparts in countries with similar health-care system characteristics - should improve insurance coverage and the quality of health services, and tackle unethical medical practices. © 2015 The Authors. Health Expectations published by John Wiley & Sons Ltd.

Medication therapy management and condition care services in a community-based employer setting.

PubMed

Johannigman, Mark J; Leifheit, Michael; Bellman, Nick; Pierce, Tracey; Marriott, Angela; Bishop, Cheryl

2010-08-15

A program in which health-system pharmacists and pharmacy technicians provide medication therapy management (MTM), wellness, and condition care (disease management) services under contract with local businesses is described. The health-system pharmacy department's Center for Medication Management contracts directly with company benefits departments for defined services to participating employees. The services include an initial wellness and MTM session and, for certain patients identified during the initial session, ongoing condition care. The initial appointment includes a medication history, point-of-care testing for serum lipids and glucose, body composition analysis, and completion of a health risk assessment. The pharmacist conducts a structured MTM session, reviews the patient's test results and risk factors, provides health education, discusses opportunities for cost savings, and documents all activities on the patient's medication action plan. Eligibility for the condition care program is based on a diagnosis of diabetes, hypertension, asthma, heart failure, or hyperlipidemia or elevation of lipid or glucose levels. Findings are summarized for employers after the initial wellness screening and at six-month intervals. Patients receiving condition care sign a customized contract, establish goals, attend up to four MTM sessions per year, and track their information on a website; employers may offer incentives for participation. When pharmacists recommend adjustments to therapy or cost-saving changes, it is up to patients to discuss these with their physician. A survey completed by each patient after the initial wellness session has indicated high satisfaction. Direct cost savings related to medication changes have averaged $253 per patient per year. Total cost savings to companies in the first year of the program averaged $1011 per patient. For the health system, the program has been financially sustainable. Key laboratory values indicate positive clinical outcomes. A business model in which health-system pharmacists provide MTM and condition care services for company employees has demonstrated successful outcomes in terms of patient satisfaction, cost savings, and clinical benefits.

Intelligence, Education, and Facets of Job Satisfaction.

ERIC Educational Resources Information Center

Ganzach, Yoav

2003-01-01

Analysis of two sets of National Longitudinal Survey data found that intelligence had a strong negative effect on intrinsic satisfaction, little effect on pay satisfaction, and positive association with desired job complexity, not expected pay. Education had a strong negative effect on pay satisfaction, little effect on intrinsic satisfaction, and…

Job satisfaction of nurses and identifying factors of job satisfaction in Slovenian Hospitals.

PubMed

Lorber, Mateja; Skela Savič, Brigita

2012-06-01

To determine the level of job satisfaction of nursing professionals in Slovenian hospitals and factors influencing job satisfaction in nursing. The study included 4 hospitals selected from the hospital list comprising 26 hospitals in Slovenia. The employees of these hospitals represent 29.8% and 509 employees included in the study represent 6% of all employees in nursing in Slovenian hospitals. One structured survey questionnaire was administered to the leaders and the other to employees, both consisting 154 items evaluated on a 5 point Likert-type scale. We examined the correlation between independent variables (age, number of years of employment, behavior of leaders, personal characteristics of leaders, and managerial competencies of leaders) and the dependent variable (job satisfaction - satisfaction with the work, coworkers, management, pay, etc) by applying correlation analysis and multivariate regression analysis. In addition, factor analysis was used to establish characteristic components of the variables measured. We found a medium level of job satisfaction in both leaders (3.49±0.5) and employees (3.19±0.6), however, there was a significant difference between their estimates (t=3.237; P=lt;0.001). Job satisfaction was explained by age (Plt;0.05; β=0.091), years of employment (Plt;0.05; β=0.193), personal characteristics of leaders (Plt;0.001; β=0.158), and managerial competencies of leaders (Plt;0.000; β=0.634) in 46% of cases. The factor analysis yielded four factors explaining 64% of the total job satisfaction variance. Satisfied employees play a crucial role in an organization's success, so health care organizations must be aware of the importance of employees' job satisfaction. It is recommended to monitor employees' job satisfaction levels on an annual basis.

Couple communication, emotional and sexual intimacy, and relationship satisfaction.

PubMed

Yoo, Hana; Bartle-Haring, Suzanne; Day, Randal D; Gangamma, Rashmi

2014-01-01

Emotional and sexual aspects of intimacy in romantic relationships are important correlates of couples' relationship satisfaction. However, few studies have examined the effect of emotional and sexual aspects of intimacy on relationship satisfaction within the context of the interpersonal relationship processes. In addition, the association between emotional and sexual aspects of intimacy remains unclear. With a sample of 335 married couples from the Flourishing Families Project, the authors examined the associations between couple communication, emotional intimacy, sexual satisfaction, and relationship satisfaction, using the couple as the unit of analysis. The results of path analysis suggested that sexual satisfaction significantly predicted emotional intimacy for husbands and wives, while emotional intimacy did not appear to have a significant influence on sexual satisfaction. Further, mediation associations were suggested within as well as between spouses. Within spouses (for each spouse), emotional intimacy and sexual satisfaction mediated the association between spouses' appraisal of their partners' communication and their own relationship satisfaction. Gender differences were revealed in terms of how a spouse's perception of sexual satisfaction is associated with his or her partner's relationship satisfaction. In this study, although wives' relationship satisfaction was not associated with their husbands' sexual satisfaction, husbands tended to report high levels of relationship satisfaction when their wives reported greater sexual satisfaction. Findings suggest that both components of intimacy--emotional and sexual--should be comprehensively addressed in research and clinical work with couples.

The influences of patient's trust in medical service and attitude towards health policy on patient's overall satisfaction with medical service and sub satisfaction in China

PubMed Central

2011-01-01

Background It is widely accepted that patient generates overall satisfaction with medical service and sub satisfaction on the basis of response to patient's trust in medical service and response to patient's attitude towards health policy in China. This study aimed to investigate the correlations between patient's trust in medical service/patient's attitude towards health policy and patient's overall satisfaction with medical service/sub satisfaction in current medical experience and find inspiration for future reform of China's health delivery system on improving patient's overall satisfaction with medical service and sub satisfaction in considering patient's trust in medical service and patient's attitude towards health policy. Methods This study collaborated with the National Bureau of Statistics to collect a sample of 3,424 residents from 17 provinces and municipalities in a 2008 China household survey on patient's trust in medical service, patient's attitude towards health policy, patient's overall satisfaction and sub satisfaction in current medical experience. Results Patient's overall satisfaction with medical service and most kinds of sub satisfaction in current medical experience were significantly influenced by both patient's trust in medical service and patient's attitude towards health policy; among all kinds of sub satisfaction in current medical experience, patient's trust in medical service/patient's attitude towards health policy had the largest influence on patient's satisfaction with medical costs, the influences of patient's trust in medical service/patient's attitude towards health policy on patient's satisfaction with doctor-patient interaction and satisfaction with treatment process were at medium-level, patient's trust in medical service/patient's attitude towards health policy had the smallest influence on patient's satisfaction with medical facilities and hospital environment, while patient's satisfaction with waiting time in hospital was not influenced by patient's trust in medical service/patient's attitude towards health policy. Conclusion In order to improve patient's overall satisfaction with medical service and sub satisfaction in considering patient's trust in medical service and patient's attitude towards health policy, both improving patient's interpersonal trust in medical service from individual's own medical experience/public trust in medical service and improving patient's attitude towards health policy were indirect but effective ways. PMID:21676228

The influences of patient's trust in medical service and attitude towards health policy on patient's overall satisfaction with medical service and sub satisfaction in China.

PubMed

Tang, Liyang

2011-06-15

It is widely accepted that patient generates overall satisfaction with medical service and sub satisfaction on the basis of response to patient's trust in medical service and response to patient's attitude towards health policy in China. This study aimed to investigate the correlations between patient's trust in medical service/patient's attitude towards health policy and patient's overall satisfaction with medical service/sub satisfaction in current medical experience and find inspiration for future reform of China's health delivery system on improving patient's overall satisfaction with medical service and sub satisfaction in considering patient's trust in medical service and patient's attitude towards health policy. This study collaborated with the National Bureau of Statistics to collect a sample of 3,424 residents from 17 provinces and municipalities in a 2008 China household survey on patient's trust in medical service, patient's attitude towards health policy, patient's overall satisfaction and sub satisfaction in current medical experience. Patient's overall satisfaction with medical service and most kinds of sub satisfaction in current medical experience were significantly influenced by both patient's trust in medical service and patient's attitude towards health policy; among all kinds of sub satisfaction in current medical experience, patient's trust in medical service/patient's attitude towards health policy had the largest influence on patient's satisfaction with medical costs, the influences of patient's trust in medical service/patient's attitude towards health policy on patient's satisfaction with doctor-patient interaction and satisfaction with treatment process were at medium-level, patient's trust in medical service/patient's attitude towards health policy had the smallest influence on patient's satisfaction with medical facilities and hospital environment, while patient's satisfaction with waiting time in hospital was not influenced by patient's trust in medical service/patient's attitude towards health policy. In order to improve patient's overall satisfaction with medical service and sub satisfaction in considering patient's trust in medical service and patient's attitude towards health policy, both improving patient's interpersonal trust in medical service from individual's own medical experience/public trust in medical service and improving patient's attitude towards health policy were indirect but effective ways.

Follow-up care by a genetic counsellor for relatives at risk for cardiomyopathies is cost-saving and well-appreciated: a randomised comparison.

PubMed

Nieuwhof, Karin; Birnie, Erwin; van den Berg, Maarten P; de Boer, Rudolf A; van Haelst, Paul L; van Tintelen, J Peter; van Langen, Irene M

2017-02-01

Increasing numbers of patient relatives at risk of developing dilated or hypertrophic cardiomyopathy (DCM/HCM) are being identified and followed up by cardiologists according to the ACC/ESC guidelines. However, given limited healthcare resources, good-quality low-cost alternative approaches are needed. Therefore, we have compared conventional follow-up by a cardiologist with that provided at a cardiogenetic clinic (CGC) led by a genetic counsellor. Phenotype-negative first-degree relatives at risk for DCM/HCM were randomly assigned to see either a cardiologist or to attend a CGC. Uptake and resource use were recorded. For 189 participants, we evaluated quality of care experienced, patient satisfaction and perceived personal control (PPC) using validated questionnaires and estimated the average cost difference of these two modes of care. Maximum patient satisfaction scores were achieved more frequently at the CGC (86% vs 45%, P<0.01). In terms of follow-up care provided, the genetic counsellor did not perform worse than the cardiologist (95% vs 59%, P<0.01). The genetic counsellor more often enquired about the relative-at risk's health (100% vs 65%, P<0.01) and family health (97% vs 33%, P<0.01), measured blood pressure (98% vs 29%, P<0.01) and gave disease-specific information (77% vs 52%, P<0.01). Although PPC scores were equal in both groups, the average cost per patient of CGC follow-up was 25% lower. Follow-up of phenotype-negative relatives at risk for DCM/HCM at a CGC led to greater patient satisfaction and is well-appreciated at lower cost. CGC care is a good alternative to conventional cardiological follow-up for this growing group of patients.

First-contact care with a medical vs chiropractic provider after consultation with a swiss telemedicine provider: comparison of outcomes, patient satisfaction, and health care costs in spinal, hip, and shoulder pain patients.

PubMed

Houweling, Taco A W; Braga, Andrea V; Hausheer, Thomas; Vogelsang, Marco; Peterson, Cynthia; Humphreys, B Kim

2015-09-01

The purpose of this study was to identify differences in outcomes, patient satisfaction, and related health care costs in spinal, hip, and shoulder pain patients who initiated care with medical doctors (MDs) vs those who initiated care with doctors of chiropractic (DCs) in Switzerland. A retrospective double cohort design was used. A self-administered questionnaire was completed by first-contact care spinal, hip, and shoulder pain patients who, 4 months previously, contacted a Swiss telemedicine provider regarding advice about their complaint. Related health care costs were determined in a subsample of patients by reviewing the claims database of a Swiss insurance provider. The study sample included 403 patients who had seen MDs and 316 patients who had seen DCs as initial health care providers for their complaint. Differences in patient sociodemographic characteristics were found in terms of age, pain location, and mode of onset. Patients initially consulting MDs had significantly less reduction in their numerical pain rating score (difference of 0.32) and were significantly less likely to be satisfied with the care received (odds ratio = 1.79) and the outcome of care (odds ratio = 1.52). No significant differences were found for Patient's Global Impression of Change ratings. Mean costs per patient over 4 months were significantly lower in patients initially consulting DCs (difference of CHF 368; US $368). Spinal, hip, and shoulder pain patients had clinically similar pain relief, greater satisfaction levels, and lower overall cost if they initiated care with DCs, when compared with those who initiated care with MDs. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

[Satisfaction with work in the home care sector].

PubMed

Haumann, Anja; Bellin, Judith; Gräske, Johannes

2013-01-01

Due to the demographic change and the growing number of care-dependent people, the number of professional caregivers is increasing. To slow down the cost explosion in the health care sector, the German government brings forward the home care principle. However, the recruitment of new nursing staff is challenging already, and will become harder in the future. A higher satisfaction with work indicates staying in the job and in the nursing sector. Valid data, concerning the satisfaction of work of nursing staff in the home care sector is lacking, yet. The present study aims to reduce this research gap. A written, standardized cross-sectional study was conducted in 2011. In this study socio-demographic characteristics as well as characteristics of the working circumstances were collected. In addition, the satisfaction with work (SAZ) and the satisfaction with life (SWLS) were evaluated. In total, 102 staff members of community health care providers were included in the study (37.5 years; 85 percent female). Registered nurses (n = 62) are significant older than nursing assistants (n = 40). No differences between satisfaction with work and satisfaction with life, professions, gender, marital status, and working condition could be found. Satisfaction with work interacts not significantly with age. However, it depends significantly on working in three shifts (morning, afternoon, night). Staff members working in all three shifts show a significant higher satisfaction with work. The present study adds knowledge in terms of satisfaction with work in the German home care sector.

Listening to the customer: implementing a patient satisfaction measurement system.

PubMed

Cohen, L; Delaney, P; Boston, P

1994-01-01

Patient satisfaction is an important issue in positioning ambulatory medical services. An effective patient satisfaction measurement program not only helps hospital managers improve the quality of clinical and administrative activities, but also helps the hospital remain viable in increasingly competitive markets. A method for the design and measurement of patient satisfaction with outpatient Endoscopy Lab services is described in this article. The survey focuses on the sequence of events experienced by the patient. Outcome measures of primary interest include global patient satisfaction and the likelihood of using the service again if given a choice. Analysis of patient responses shows that global satisfaction with the outpatient experience is positively associated with service return intention. Additional analysis shows that facility cleanliness, privacy and nurse attention are most strongly associated with global patient satisfaction. Results underscore the importance of various service attributes on patient satisfaction and return intention and of the need to further expand the uses of patient satisfaction measurement in the outpatient Endoscopy Lab.

Analysis of the relationships among perceived service encounter quality, service value, satisfaction and behavioral intention for physical therapy patients

PubMed Central

Ko, Min-Seok; Lee, Won-Hwee

2017-01-01

[Purpose] The purpose of this study was to investigate the relationships among perceived service encounter quality, service value, patient satisfaction, and behavioral intention in physical therapy patients. [Subjects and Methods] This study surveyed 335 patients who received physical therapy treatment at five medical institutions in Jeonju-si, Republic of Korea. This study conducted path analysis on the collected data using Smart PLS 2.0 M3. [Results] The analysis of this study showed that service encounter quality had significantly positive relationship with service value, patient satisfaction, and behavioral intention. Service value had significantly positive relationship with patient satisfaction and behavioral intention. Patient satisfaction had significantly positive relationship with behavioral intention. [Conclusion] Improving the perceived quality of service encounters for physical therapy patients increases service value and patient satisfaction, and positively influences behavioral intention. PMID:29200644

Analysis of the relationships among perceived service encounter quality, service value, satisfaction and behavioral intention for physical therapy patients.

PubMed

Ko, Min-Seok; Lee, Won-Hwee

2017-11-01

[Purpose] The purpose of this study was to investigate the relationships among perceived service encounter quality, service value, patient satisfaction, and behavioral intention in physical therapy patients. [Subjects and Methods] This study surveyed 335 patients who received physical therapy treatment at five medical institutions in Jeonju-si, Republic of Korea. This study conducted path analysis on the collected data using Smart PLS 2.0 M3. [Results] The analysis of this study showed that service encounter quality had significantly positive relationship with service value, patient satisfaction, and behavioral intention. Service value had significantly positive relationship with patient satisfaction and behavioral intention. Patient satisfaction had significantly positive relationship with behavioral intention. [Conclusion] Improving the perceived quality of service encounters for physical therapy patients increases service value and patient satisfaction, and positively influences behavioral intention.

Consumer satisfaction with telehealth advice-nursing.

PubMed

Chang, B L; Mayo, A; Omery, A

2001-01-01

An increase in interest in the establishment of telephone advice services has resulted in the proliferation of call centers. Despite their wide usage, research for the most part has not addressed the quality of care in relation to consumer satisfaction. This paper examines consumer outcomes of satisfaction, and follow-up with recommendations, within a framework of the nursing process and its associated components of assessment (including problem identification), care planning, intervention, and evaluation. The data for the study were obtained from seven after-hours call centers operating under the auspices of health maintenance organizations, preferred provider organizations, and private insurance companies. A sample of 157 non-redundant telephone calls from adults with medical-surgical problems were audiotaped with providers' and callers' consent. Sociodemographic information of the advice nurses, and chief complaints of the callers were obtained. The quality of nursing of the audiotaped calls was rated through an implicit review method by registered nurse raters using an advice nurse structured implicit review (AN-SIR) form developed for the study. Follow-up information was obtained through telephone calls to ascertain the consumers' perceptions of satisfaction, helpfulness, and follow-through with recommendations. Results indicated that consumers calling with a variety of general complaints contacted 32 nurses in advice nurse call centers. The quality of nursing process was found to be the best in the area of intervention. Evaluation was also well above the midpoint on a transformed scale of zero to 100. Assessment, although slightly above midpoint, was the lowest of the three components of the nursing process examined. Consumer satisfaction was high with 95.4 percent of the consumers rating the calls as completely or at least somewhat satisfied, and 93.2 percent, stating the advice was very or somewhat helpful. Exploratory regression analysis showed that the component of intervention was significantly related to consumer satisfaction. The present study pioneers the way to rate the quality of the advice nurses' interactions with consumers, and lays the groundwork for further investigations of health care provider behavior and consumer outcomes. Further studies are recommended to investigate predictors of consumer satisfaction, and cost-benefit in terms of consumer expenditures of time, funds, and energy.

Quality of life among residents in a sub-urban area. Case study: Puncak Alam, Selangor, Malaysia.

NASA Astrophysics Data System (ADS)

Leh, Oliver Ling Hoon; Mahbot, Norseha Mohd; Asma Aqmalina Hadzaman, Nur; Azyyati Marzukhi, Marlyana; Abdullah, Jamalunlaili

2018-02-01

Along with the sub-urbanisation, people working in urban can stay in the sub-urban areas. Sub-urban housing areas provide cheaper and larger houses and more greenery environment. However, the residents are required to travel in longer distance. The effect on Quality of Life (QOL) due to the migration to sub-urban areas may not be positive even with the better environmental quality and lower direct housing cost. Puncak Alam, a new sub-urban area in Selangor, Malaysia had been chosen as the study area to examine the change of QOL among the residents after they moved into the study area. Through a questionnaire survey, the satisfaction of residents on the various aspects/indicators of QOL were examined. Through the statistical analysis, it is found that slightly more than half of the respondents felt that the QOL was dropped after they were moved to the study area. The sub-urban area did provide better quality for their residents. It had increased respondents’ satisfaction on most of the indicators in the aspects of economic, social and physical. However, due to the decreasing of satisfaction in job opportunities, family life, social activities, safety, and transportation system, most of the respondents were felt that their QOL were dropped.

Relationships between Parental Attachment, Work and Family Roles, and Life Satisfaction

ERIC Educational Resources Information Center

Perrone, Kristin M.; Webb, L. Kay; Jackson, Z. Vance

2007-01-01

The purpose of this study was to examine the relationship between parental attachment and satisfaction with work and family roles, as well as the relationship of these variables to life satisfaction. Results from a multiple regression analysis indicated that satisfaction with work and marriage, but not parenting satisfaction or parental…

The impact of software quality characteristics on healthcare outcome: a literature review.

PubMed

Aghazadeh, Sakineh; Pirnejad, Habibollah; Moradkhani, Alireza; Aliev, Alvosat

2014-01-01

The aim of this study was to discover the effect of software quality characteristics on healthcare quality and efficiency indicators. Through a systematic literature review, we selected and analyzed 37 original research papers to investigate the impact of the software indicators (coming from the standard ISO 9126 quality characteristics and sub-characteristics) on some of healthcare important outcome indicators and finally ranked these software indicators. The results showed that the software characteristics usability, reliability and efficiency were mostly favored in the studies, indicating their importance. On the other hand, user satisfaction, quality of patient care, clinical workflow efficiency, providers' communication and information exchange, patient satisfaction and care costs were among the healthcare outcome indicators frequently evaluated in relation to the mentioned software characteristics. Regression Logistic Method was the most common assessment methodology, and Confirmatory Factor Analysis and Structural Equation Modeling were performed to test the structural model's fit. The software characteristics were considered to impact the healthcare outcome indicators through other intermediate factors (variables).

The effectiveness of 2-implant overdentures - a pragmatic international multicentre study.

PubMed

Rashid, F; Awad, M A; Thomason, J M; Piovano, A; Spielberg, G P; Scilingo, E; Mojon, P; Müller, F; Spielberg, M; Heydecke, G; Stoker, G; Wismeijer, D; Allen, F; Feine, J S

2011-03-01

The purpose of this multicentre observational study was to determine patient satisfaction with either conventional dentures or mandibular 2-implant overdentures in a 'real world' setting. Two hundred and three edentulous patients (mean age 68·8 ± 10·4 years) were recruited at eight centres located in North America, South America and Europe. The patients were provided with new mandibular conventional dentures or implant overdentures supported by two implants and ball attachments. At baseline and at 6 months post-treatment, they rated their satisfaction with their mandibular prostheses on 100-mm visual analogue scale questionnaires. One hundred and two (50·2%) participants had valid baseline and 6-month satisfaction data. Although both groups reported improvements, the implant overdenture group reported significantly higher ratings of overall satisfaction, comfort, stability, ability to speak and ability to chew. These results suggest that edentulous patients who choose mandibular implant overdentures have significantly greater improvements in satisfaction, despite their relatively higher cost, than those who choose new conventional dentures. © 2010 Blackwell Publishing Ltd.

Determining job satisfaction of nurses working in hospitals of Iran: A systematic review and meta-analysis.

PubMed

Amiresmaili, Mohammadreza; Moosazadeh, Mahmood

2013-09-01

Employees feeling and attitude to their job has a significant role on their performance. Present study sought to investigate documents related to nurses job satisfaction, using systematic review and meta-analysis to estimate nurses job satisfaction in Iran. Papers on nurses job satisfaction were identified by searching different data bases using appropriate key words. Seventeen studies were extracted using inclusuion criteria. Data were analyzed using Meta-analysis command in STATA 11. Considerable hetrogenecity is apparent in results of nurses job satisfaction studies. Although, according to random effect model, nurses total job satisfaction was estimated at 46.3 (CI: 32.1-60.4), this was estimated at 51.9 (CI = 51.1-52.8) using fixed effect model. Additionally, a reverse relationship was observed between nurses overall job satisfaction and their age. Nurses' job satisfaction in Iran is at a good level compared with other countries. The more satisfied the nurses are with their working conditions, the less is their intention to leave their job. Dissatisfaction is associated with higher resignment and turnover, paying deep attention to efficient factors on nurses dissatisfaction and trying to overcome them is important to improve nurses' working conditions.

Evaluation of Patient Satisfaction with Tuberculosis Services in Southern Nigeria

PubMed Central

Onyeonoro, Ugochukwu U; Chukwu, Joseph N; Nwafor, Charles C; Meka, Anthony O; Omotowo, Babatunde I; Madichie, Nelson O; Ogbudebe, Chidubem; Ikebudu, Joy N; Oshi, Daniel C; Ekeke, Ngozi; Paul, Nsirimobu I; Duru, Chukwuma B

2015-01-01

OBJECTIVE Knowing tuberculosis (TB) patients’ satisfaction enables TB program managers to identify gaps in service delivery and institute measures to address them. This study is aimed at evaluating patients’ satisfaction with TB services in southern Nigeria. MATERIALS AND METHODS A total of 378 patients accessing TB care were studied using a validated Patient Satisfaction (PS-38) questionnaire on various aspects of TB services. Factor analysis was used to identify eight factors related to TB patient satisfaction. Test of association was used to study the relation between patient satisfaction scores and patient and health facility characteristics, while multilinear regression analysis was used to identify predictors of patient satisfaction. RESULTS Highest satisfaction was reported for adherence counseling and access to care. Patient characteristics were associated with overall satisfaction, registration, adherence counseling, access to care, amenities, and staff attitude, while health system factors were associated with staff attitude, amenities, and health education. Predictors of satisfaction with TB services included gender, educational status, if tested for HIV, distance, payment for TB services, and level and type of health-care facility. CONCLUSION Patient- and health system–related factors were found to influence patient satisfaction and, hence, should be taken into consideration in TB service programing. PMID:26508872

The evaluation of the National Long Term Care Demonstration. 10. Overview of the findings.

PubMed Central

Kemper, P

1988-01-01

The channeling demonstration sought to substitute community care for nursing home care through comprehensive case management and expanded community services. The channeling intervention was implemented largely according to design. Although the population served was, as intended, extremely frail, it turned out not to be at high risk of nursing home placement. The costs of the additional case management and community services--provided in most cases to clients who would not have entered nursing homes even without channeling--were not offset by reductions in the cost of nursing home use. Hence, total costs increased. The expanded formal community care did not, however, result in a substantial reduction in informal caregiving. Moreover, channeling benefited clients, and the family and friends who cared for them, in several ways: increased services, reduced unmet needs, increased confidence in receipt of care and satisfaction with arrangements for it, and increased satisfaction with life. Expansion of case management and community services beyond what already exists, then, must be justified on the basis not of cost savings but of benefits to clients and their caregivers. PMID:3130326

A chiropractic service arrangement for musculoskeletal complaints in industry: a pilot study.

PubMed

Jay, T C; Jones, S L; Coe, N; Breen, A C

1998-09-01

Chiropractic services are commonly used by workers with musculoskeletal problems, especially low back and neck complaints. Research into the effectiveness and cost-effectiveness of this approach is, however, difficult to design without prior pilot studies. This study followed 32 workers with these complaints attending one such service and used five measures of outcome over a 6-month period. These measured pain (VAS), disability (FLP), quality of life (SF-36), perceived benefit and satisfaction with care. Additionally, sickness costs to the companies were recorded over two years encompassing the study period. Treatment utilization was also monitored. Over half the population were chronic sufferers. The effect sizes were large for pain and for seven out of eight dimensions of the SF-36 questionnaire at 6-month follow-up, although not for disability (FLP). High levels of satisfaction and perceived improvement were reported and sickness costs to the companies fell. However, the sample size in this pilot study was small and did not include controls. We would, therefore, recommend a full cost-effectiveness study incorporating a randomized trial in this area.

Which kind of psychometrics is adequate for patient satisfaction questionnaires?

PubMed

Konerding, Uwe

2016-01-01

The construction and psychometric analysis of patient satisfaction questionnaires are discussed. The discussion is based upon the classification of multi-item questionnaires into scales or indices. Scales consist of items that describe the effects of the latent psychological variable to be measured, and indices consist of items that describe the causes of this variable. Whether patient satisfaction questionnaires should be constructed and analyzed as scales or as indices depends upon the purpose for which these questionnaires are required. If the final aim is improving care with regard to patients' preferences, then these questionnaires should be constructed and analyzed as indices. This implies two requirements: 1) items for patient satisfaction questionnaires should be selected in such a way that the universe of possible causes of patient satisfaction is covered optimally and 2) Cronbach's alpha, principal component analysis, exploratory factor analysis, confirmatory factor analysis, and analyses with models from item response theory, such as the Rasch Model, should not be applied for psychometric analyses. Instead, multivariate regression analyses with a direct rating of patient satisfaction as the dependent variable and the individual questionnaire items as independent variables should be performed. The coefficients produced by such an analysis can be applied for selecting the best items and for weighting the selected items when a sum score is determined. The lower boundaries of the validity of the unweighted and the weighted sum scores can be estimated by their correlations with the direct satisfaction rating. While the first requirement is fulfilled in the majority of the previous patient satisfaction questionnaires, the second one deviates from previous practice. Hence, if patient satisfaction is actually measured with the final aim of improving care with regard to patients' preferences, then future practice should be changed so that the second requirement is also fulfilled.

[European standardization and German language adaptation of scales for collection of outcomes and costs of treatment for patients with severe mental disorders].

PubMed

Kilian, R; Roick, C; Bernert, S; Mory, C; Matschinger, H; Becker, T; Angermeyer, M C

2001-03-01

For the evaluation of the effectiveness of psychiatric service systems internationally standardised instruments for the assessment of the outcome and the costs of psychiatric and psychosocial treatment and care are increasingly needed. Beside the measurement of objective facts there is a growing importance of the consideration of the subjective perspective of patients and relatives. In the research project "Cost-effectiveness analysis of psychiatric service systems in the European comparison" of the Research association for Public Health in Saxony, developments were worked out, in close cooperation with the BIOMED-2 project "European Psychiatric Services: Inputs Linked to Outcome Domains and Needs", German versions of five European standardized instruments for the assessment of needs for care, treatment satisfaction, burden of care on relatives, quality of life and service costs. The psychometric properties of the instruments were tested within the framework of a longitudinal study with 307 patients with the diagnosis of schizophrenia. As a result of this study, German versions of all relevant European instruments for psychiatric service evaluation are now available.

Circuit class or seven-day therapy for increasing intensity of rehabilitation after stroke: protocol of the CIRCIT trial.

PubMed

Hillier, Susan; English, Coralie; Crotty, Maria; Segal, Leonie; Bernhardt, Julie; Esterman, Adrian

2011-12-01

There is strong evidence for a dose-response relationship between physical therapy early after stroke and recovery of function. The optimal method of maximizing physical therapy within finite health care resources is unknown. To determine the effectiveness and cost-effectiveness of two alternative models of physical therapy service delivery (seven-days per week therapy services or group circuit class therapy over five-days a week) to usual care for people receiving inpatient rehabilitation after stroke. Multicenter, three-armed randomized controlled trial with blinded assessment of outcomes. A total of 282 people admitted to inpatient rehabilitation facilities after stroke with an admission functional independence measure (FIM) score within the moderate range (total 40-80 points or motor 38-62 points) will be randomized to receive one of three interventions: • usual care therapy over five-days a week • standard care therapy over seven-days a week, or • group circuit class therapy over five-days a week. Participants will receive the allocated intervention for the length of their hospital stay. Analysis will be by intention-to-treat. The primary outcome measure is walking ability (six-minute walk test) at four-week postintervention with three- and six-month follow-up. Economic analysis will include a costing analysis based on length of hospital stay and staffing/resource costs and a cost-utility analysis (incremental quality of life per incremental cost, relative to usual care). Secondary outcomes include walking speed and independence, ability to perform activities of daily living, arm function, quality of life and participant satisfaction. © 2011 The Authors. International Journal of Stroke © 2011 World Stroke Organization.

Perceived affordability of health insurance and medical financial burdens five years in to Massachusetts health reform.

PubMed

Zallman, Leah; Nardin, Rachel; Sayah, Assaad; McCormick, Danny

2015-10-29

Under the Massachusetts health reform, low income residents (those with incomes below 150 % of the Federal Poverty Level [FPL]) were eligible for Medicaid and health insurance exchange-based plans with minimal cost-sharing and no premiums. Those with slightly higher incomes (150 %-300 % FPL) were eligible for exchange-based plans that required cost-sharing and premium payments. We conducted face to face surveys in four languages with a convenience sample of 976 patients seeking care at three hospital emergency departments five years after Massachusetts reform. We compared perceived affordability of insurance, financial burden, and satisfaction among low cost sharing plan recipients (recipients of Medicaid and insurance exchange-based plans with minimal cost-sharing and no premiums), high cost sharing plan recipients (recipients of exchange-based plans that required cost-sharing and premium payments) and the commercially insured. We found that despite having higher incomes, higher cost-sharing plan recipients were less satisfied with their insurance plans and perceived more difficulty affording their insurance than those with low cost-sharing plans. Higher cost-sharing plan recipients also reported more difficulty affording medical and non-medical health care as well as insurance premiums than those with commercial insurance. In contrast, patients with low cost-sharing public plans reported higher plan satisfaction and less financial concern than the commercially insured. Policy makers with responsibility for the benefit design of public insurance available under health care reforms in the U.S. should calibrate cost-sharing to income level so as to minimize difficulty affording care and financial burdens.

Satisfaction with and Benefits of a Psych-social Club: Development of a Mixed Method Evaluation Instrument

PubMed Central

Labun, Evelyn; Yurkovich, Eleanor; Ide, Bette A.

2015-01-01

Deinstitutionalization of psychiatric mental health hospitals began in the 1960’s; thus, the delivery of mental health services became dependent on regional centers and community based, contracted services. One such service model is the psych-social club. Such clubs provide mental health services on the lower end of the cost continuum and reduce the utilization of higher cost services (Yurkovich, Labun, Cook & Lattergrass, 2005). This paper fills a gap by reporting on the development of a mixed method instrument entitled Benefits & Satisfaction Tool for Members of a Psych-social Club (B&ST-MPC). It also reports on the psychometric properties of the instrument, and measures members’ perception of satisfaction with and benefits of their psych-social club utilization, thus providing evaluative information for developing client centered continuums of care (Yurkovich et al., 2005). The paper includes a brief overview of the first mixed method study, background information on the rationale for instrument development, including methods used, and a discussion of the instrument’s psychometric properties. PMID:23164402

Job satisfaction among Australian doctors: the use of latent class analysis.

PubMed

Joyce, Catherine; Wang, Wei Chun

2015-10-01

To identify patterns of job satisfaction among Australian doctors using latent class analysis, and to determine the relationships of these patterns to personal and professional characteristics so as to improve satisfaction and minimize medical wastage. MABEL (Medicine in Australia: Balancing Employment and Life) data in 2011 were used. The study collected information on 5764 doctors about their job satisfaction, demographic characteristics, their health, country of medical training, opportunities for professional development and social interaction, taking time off work, views of patients' expectations, unpredictable working hours, hours worked per week, preference to reduce hours and intention to leave the medical workforce. Four latent classes of job satisfaction were identified: 5.8% had high job satisfaction; 19.4% had low satisfaction with working hours; 16.1% had high satisfaction with working hours but felt undervalued; and 6.5% had low job satisfaction. Low job satisfaction was associated with reporting poor health, having trained outside Australia, having poor opportunities for professional development and working longer hours. Low satisfaction was associated with a preference to reduce work hours and an intention to leave the medical workforce. To improve job satisfaction and minimize medical wastage, policies need to address needs of overseas trained doctors, provide continuing professional development and provide good health care for doctors. © The Author(s) 2015.

The impact of psychological empowerment and organisational commitment on Chinese nurses' job satisfaction.

PubMed

Ouyang, Yan-Qiong; Zhou, Wen-Bin; Qu, Hui

2015-01-01

Research findings have shown that job satisfaction of Chinese nurses is at a low level. Limited studies have focused on the impact of psychological empowerment and organisational commitment on job satisfaction of Chinese nurses. The aim of this study is to describe job satisfaction, psychological empowerment and organisational commitment of Chinese nurses and to explore the impact of psychological empowerment and organisational commitment on the nurses' job satisfaction. A total of 726 nurses were recruited in a convenience sample from 10 tertiary hospitals. Data were collected using four questionnaires including Job Satisfaction Survey, Psychological Empowerment Scale, Organisational Commitment Scale and Demographic Questionnaire. Descriptive analysis, correlation and stepwise multiple regression were used for data analysis. Nurses' job satisfaction, psychological empowerment and organisational commitment were identified at moderate levels. Nurses' job satisfaction and psychological empowerment were significantly different in terms of age and length of service; nurse job satisfaction varied with respect to marital status. Findings further indicated that nurse job satisfaction was positively correlated with psychological empowerment and organisational commitment. Psychological empowerment, organisational commitment and marital status were significant predicting factors of nurse job satisfaction. This study provides evidence to help nursing managers and health policy-makers to develop intervention programs aimed at enhancing nurse job satisfaction and retaining nurses.

The impact of psychological empowerment and organizational commitment on Chines nurses' job satisfaction.

PubMed

Zhou, Wen-Bin; Ouyang, Yan-Qiong; Qu, Hui

2014-11-10

Abstract Background: Research findings have shown that job satisfaction of Chinese nurses is at a low level. Limited studies have focused on the impact of psychological empowerment and organizational commitment on job satisfaction of Chinese nurses. Aims: The aim of this study is to describe job satisfaction, psychological empowerment and organizational commitment of Chinese nurses and to explore the impact of psychological empowerment and organizational commitment on the nurses' job satisfaction. Methods: A total of 726 nurses were recruited in a convenience sample from 10 tertiary hospitals. Data were collected using four questionnaires including Job Satisfaction Survey, Psychological Empowerment Scale, Organizational Commitment Scale and Demographic Questionnaire. Descriptive analysis, correlation and stepwise multiple regression were used for data analysis. Results: Nurses' job satisfaction, psychological empowerment, and organizational commitment were identified at moderate levels. Nurses' job satisfaction and psychological empowerment were significantly different in terms of age and length of service; nurse job satisfaction varied with respect to marital status. Findings further indicated that nurse job satisfaction was positively correlated with psychological empowerment and organizational commitment. Psychological empowerment, organizational commitment, and marital status were significant predicting factors of nurse job satisfaction. Conclusions: This study provides evidence to help nursing managers and health policy-makers to develop intervention programs aimed at enhancing nurse job satisfaction and retaining nurses.

An Investigation of One Aspect of College Unrest: College Student Satisfaction. The Measurement and Analysis of College Student Satisfaction.

ERIC Educational Resources Information Center

Betz, Ellen L.; And Others

Although infrequently investigated, college student satisfaction and dissatisfaction are viewed as a clear indicator of student unrest. Results of a series of studies aimed at a systematic investigation of college student satisfaction are described. A measure was designed and used to investigate the relationships between student satisfaction and…

The Impact of Organizational Commitment and Nursing Organizational Culture on Job Satisfaction in Korean American Registered Nurses.

PubMed

Kim, Young Im; Geun, Hyo Geun; Choi, SookJa; Lee, Young Sil

2016-09-01

This study aimed to describe the perceived level of organizational commitment and organizational culture of Korean American Registered Nurses (KARNs) and to investigate predictors of job satisfaction. A total of 163 KARNs working in U.S. hospitals responded to a Web survey. Descriptive analysis, t test, analysis of variance, and stepwise regressions were used for data analysis. KARNs reported moderate levels of job satisfaction (3.5 ± 0.58). Job satisfaction was positively correlated with both organizational commitment (r = .85, p < .001) and culture (r = .66, p < .001). KARNs who were aged ≥50, married, hospital-employed, had longer nursing experience, and experienced turnover at least once were more likely to report higher job satisfaction compared with other nurses. Organizational commitment, culture, marital status, and workplace were significant predictors of and explained 76.8% of the variance in job satisfaction. This study provides evidence to help nursing managers and health policy makers develop educational programs aimed at enhancing job satisfaction and retention of KARNs. © The Author(s) 2016.

Evaluating foodservice software: a suggested approach.

PubMed

Fowler, K D

1986-09-01

In an era of cost containment, the computer has become a viable management tool. Its use in health care has demonstrated accelerated growth in recent years, and a literature review supports an increased trend in this direction. Foodservice, which is a major cost center, is no exception to this predicted trend. Because software has proliferated, foodservice managers and dietitians are experiencing growing concern about how to evaluate the numerous software packages from which to choose. A suggested approach to evaluating software is offered to dietitians and managers alike to lessen the confusion in software selection and to improve the system satisfaction level post-purchase. Steps of the software evaluatory approach include: delineation of goals, assessment of needs, assignment of value weight factors, development of a vendor checklist, survey of vendors by means of the vendor checklist and elimination of inappropriate systems, thorough development of the request for proposal (RFP) for submission to the selected vendors, an analysis of the returned RFPs in terms of system features and cost factors, and selection of the system(s) for implementation.

Preclinic group education sessions reduce waiting times and costs at public pain medicine units.

PubMed

Davies, Stephanie; Quintner, John; Parsons, Richard; Parkitny, Luke; Knight, Paul; Forrester, Elizabeth; Roberts, Mary; Graham, Carl; Visser, Eric; Antill, Tracy; Packer, Tanya; Schug, Stephan A

2011-01-01

To assess the effects of preclinic group education sessions and system redesign on tertiary pain medicine units and patient outcomes. Prospective cohort study. Two public hospital multidisciplinary pain medicine units. People with persistent pain. A system redesign from a "traditional" model (initial individual medical appointments) to a model that delivers group education sessions prior to individual appointments. Based on Patient Triage Questionnaires patients were scheduled to attend Self-Training Educative Pain Sessions (STEPS), a two day eight hour group education program, followed by optional patient-initiated clinic appointments. Number of patients completing STEPS who subsequently requested individual outpatient clinic appointment(s); wait-times; unit cost per new patient referred; recurrent health care utilization; patient satisfaction; Global Perceived Impression of Change (GPIC); and utilized pain management strategies. Following STEPS 48% of attendees requested individual outpatient appointments. Wait times reduced from 105.6 to 16.1 weeks at one pain unit and 37.3 to 15.2 weeks at the second. Unit cost per new patient appointed reduced from $1,805 Australian Dollars (AUD) to AUD$541 (for STEPS). At 3 months, patients scored their satisfaction with "the treatment received for their pain" more positively than at baseline (change score=0.88; P=0.0003), GPIC improved (change score=0.46; P<0.0001) and mean number of active strategies utilized increased by 4.12 per patient (P=0.0004). The introduction of STEPS was associated with reduced wait-times and costs at public pain medicine units and increased both the use of active pain management strategies and patient satisfaction. Wiley Periodicals, Inc.

Cost and Time Effectiveness Analysis of a Telemedicine Service in Bangladesh.

PubMed

Sorwar, Golam; Rahamn, Md Mustafizur; Uddin, Ramiz; Hoque, Md Rakibul

2016-01-01

Telemedicine has great potential to overcome geographical barriers to providing access to equal health care services, particularly for people living in remote and rural areas in developing countries like Bangladesh. A number of telemedicine systems have been implemented in Bangladesh. However, no significant studies have been conducted to determine either their cost effectiveness or efficiency in reducing travel time required by patients. In addition, very few studies have analyzed the attitude and level of satisfaction of telemedicine service recipients in Bangladesh. The aim of this study was to analyze the cost and time effectiveness of a telemedicine service, implemented through locally developed PC based diagnostic equipment and software in Bangladesh, compared to conventional means of providing those services. The study revealed that the introduced telemedicine service reduced cost and travel time on average by 56% and 94% respectively compared to its counterpart conventional approach. The study also revealed that majority of users were highly satisfied with the newly introduced telemedicine service. Therefore, the introduced telemedicine service can be considered as a low cost and time efficient health service solution to improve health care facilities in the remote rural areas in Bangladesh.

Addressing the business of discharge: building a case for an electronic discharge summary.

PubMed

Mourad, Michelle; Cucina, Russell; Ramanathan, Rajiv; Vidyarthi, Arpana R

2011-01-01

Hospitalists are increasingly involved in implementing quality improvement initiatives around patient safety, clinical informatics, and transitions of care, but may lack expertise in promoting these important interventions. Developing a sound business case is essential to garnering support and resources for any quality improvement initiative. We present a framework for developing a business case using a structured approach to exploring qualitative and quantitative costs and benefits and describe its application in the experience of developing an electronic discharge summary at the University of California San Francisco (UCSF). At our institution, we found that the primary financial benefits are the cost reductions in eliminating transcription needs and decreasing billing delays, as well as reducing the cost of tracking completion of and dissemination of discharge summaries. Costs incurred from a new information technology (IT) infrastructure, programmer time, maintenance and training must also be accounted for. While benefits may be apparent to front line providers (improved communication, efficiency of data transfer, and increased referring physician satisfaction), implementing and sustaining such an innovation depends on articulating a sound business case with a detailed cost-benefit analysis to institutional decision making. Copyright © 2010 Society of Hospital Medicine.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pickerell, D.H.; Abkowitz, M.; Tozzi, J.

The 9 papers in the report deal with the following areas: Federal operating assistance for urban mass transit; a decade of experience; transit route characteristics and headway-based reliability control; day-of-week and part-of-month variation in bus ridership; job satisfaction and transit operator recognition programs; results of a survey of muni operators; bus marketing costs: the experience of 18 section 15 reporters from 1981 to 1983; prospects for differential transit pricing in the United States; an initial analysis of total factor productivity for public-transit coordination of transportation resources: the Georgia experience; absenteeism, accidents, and attrition: part-time versus full-time bus drivers.

The effectiveness of workplace dietary modification interventions: a systematic review.

PubMed

Geaney, F; Kelly, C; Greiner, B A; Harrington, J M; Perry, I J; Beirne, P

2013-11-01

To evaluate the effectiveness of workplace dietary modification interventions alone or in combination with nutrition education on employees' dietary behaviour, health status, self-efficacy, perceived health, determinants of food choice, nutrition knowledge, co-worker support, job satisfaction, economic cost and food-purchasing patterns. Data sources included PubMed, Medline, Embase, Psych Info., Web of Knowledge and Cochrane Library (November 2011). This review was guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Studies were randomised controlled trials and controlled studies. Interventions were implemented for at least three months. Cochrane Collaboration's risk of bias tool measured potential biases. Heterogeneity precluded meta-analysis. Results were presented in a narrative summary. Six studies conducted in Brazil, the USA, Netherlands and Belgium met the inclusion criteria. Four studies reported small increases in fruit and vegetable consumption (≤half serving/day). These studies involved workplace dietary modifications and three incorporated nutrition education. Other outcomes reported included health status, co-worker support, job satisfaction, perceived health, self-efficacy and food-purchasing patterns. All studies had methodological limitations that weakened confidence in the results. Limited evidence suggests that workplace dietary modification interventions alone and in combination with nutrition education increase fruit and vegetable intakes. These interventions should be developed with recommended guidelines, workplace characteristics, long-term follow-up and objective outcomes for diet, health and cost. © 2013.

Factors affecting patient satisfaction at the Lagos State University Teaching Hospital Dental Clinic.

PubMed

Adeniyi, A A; Adegbite, K O; Braimoh, M O; Ogunbanjo, B O

2013-03-01

Satisfaction is important in dental care because satisfaction with care alleviates dental anxiety, influences patients' compliance and is an important indicator of quality of care. This study was designed to determine the factors that contribute to satisfaction with dental care among patients attending the Lagos State University (LASUTH) Dental Clinic. Across-sectional, descriptive questionnaire-based survey was conducted among adult patients attending the LASUTH Dental Clinic. The questionnaire, a modification of the Dental Satisfaction Questionnaire (DSQ), contained 19 items on a Likert-pattern scale with scores ranging from 0 to 4. The scores obtained for satisfaction with the dental services ranged from 19 to 75 with a mean of 55.30 +/- 11.55. The majority of respondents (305 or 87.4%) were satisfied with the services received. The items generating the highest and lowest mean satisfaction score were cleanliness/comfort of the facility and cost of services respectively. Long waiting time was the item respondents liked least about the services. There was a statistically significant relationship between the items assessing communication and respondent's gender (p = 0.001). The relationship between the overall satisfaction score and gender (p = 0.233), age category (p = 0.842) and educational status (p = 0.565) were not statistically significant. The results indicate a high level of satisfaction with services provided at the LASUTH Dental Clinic. However, there is need for improvement in communication with patients and reduction in waiting time.

Effects of acuity-adaptable rooms on flow of patients and delivery of care.

PubMed

Hendrich, Ann L; Fay, Joy; Sorrells, Amy K

2004-01-01

Delayed transfers of patients between nursing units and lack of available beds are significant problems that increase costs and decrease quality of care and satisfaction among patients and staff. To test whether use of acuity-adaptable rooms helps solve problems with transfers of patients, satisfaction levels, and medical errors. A pre-post method was used to compare the effects of environmental design on various clinical and financial measures. Twelve outcome-based questions were formulated as the basis for inquiry. Two years of baseline data were collected before the unit moved and were compared with 3 years of data collected after the move. Significant improvements in quality and operational cost occurred after the move, including a large reduction in clinician handoffs and transfers; reductions in medication error and patient fall indexes; improvements in predictive indicators of patients' satisfaction; decrease in budgeted nursing hours per patient day and increased available nursing time for direct care without added cost; increase in patient days per bed, with a smaller bed base (number of beds per patient days). Some staff turnover occurred during the first year; turnover stabilized thereafter. Data in 5 key areas (flow of patients and hospital capacity, patients' dissatisfaction, sentinel events, mean length of stay, and allocation of nursing productivity) appear to be sufficient to test the business case for future investment in partial or complete replication of this model with appropriate populations of patients.

A hybrid meta-heuristic algorithm for the vehicle routing problem with stochastic travel times considering the driver's satisfaction

NASA Astrophysics Data System (ADS)

Tavakkoli-Moghaddam, Reza; Alinaghian, Mehdi; Salamat-Bakhsh, Alireza; Norouzi, Narges

2012-05-01

A vehicle routing problem is a significant problem that has attracted great attention from researchers in recent years. The main objectives of the vehicle routing problem are to minimize the traveled distance, total traveling time, number of vehicles and cost function of transportation. Reducing these variables leads to decreasing the total cost and increasing the driver's satisfaction level. On the other hand, this satisfaction, which will decrease by increasing the service time, is considered as an important logistic problem for a company. The stochastic time dominated by a probability variable leads to variation of the service time, while it is ignored in classical routing problems. This paper investigates the problem of the increasing service time by using the stochastic time for each tour such that the total traveling time of the vehicles is limited to a specific limit based on a defined probability. Since exact solutions of the vehicle routing problem that belong to the category of NP-hard problems are not practical in a large scale, a hybrid algorithm based on simulated annealing with genetic operators was proposed to obtain an efficient solution with reasonable computational cost and time. Finally, for some small cases, the related results of the proposed algorithm were compared with results obtained by the Lingo 8 software. The obtained results indicate the efficiency of the proposed hybrid simulated annealing algorithm.

Happy and Unhappy Patients: A Quantitative Analysis of Online Plastic Surgeon Reviews for Breast Augmentation.

PubMed

Dorfman, Robert G; Purnell, Chad; Qiu, Cecil; Ellis, Marco F; Basu, C Bob; Kim, John Y S

2018-05-01

Online reviews have become modern versions of the word-of-mouth recommendation, and prospective patients are increasingly consulting them before making decisions about their surgical care. The authors' objectives were to (1) identify trends in the use of online reviews, and (2) important reasons for patient satisfaction and dissatisfaction with aesthetic surgery. The authors selected breast augmentation as the primary procedure of interest. Reviews of the top 10 to 20 most reviewed plastic surgeons in each of six large metropolitan areas were obtained from Google, Yelp, and RealSelf. Reviews were assessed for predefined dimensions of satisfaction and dissatisfaction. A total of 1077 breast augmentation reviews were obtained. Ratings were distributed bimodally, with peaks at five stars and one star. The majority of reviews were positive (87.5 percent). Relative popularity of Google versus Yelp varied across geographic regions, and average rating varied by platform. Between 2011 and 2016, the number of online reviews for breast augmentation grew at an average rate of 42.6 percent per year. Aesthetic outcome was the most commonly cited dimension (69.8 percent of reviews), whereas cost was mentioned in only 7.8 percent of reviews. A substantial minority of negative Yelp (37 percent) and Google (9.4 percent) reviews were written by patients who did not actually undergo surgery. Free-text analysis of heterogeneous reviews (containing positive and negative attributes) classified dimensions as critical, redeemable, or protective. As the influence of online review platforms continues to grow, understanding drivers of positive and negative reviews may help surgeons improve patient satisfaction.

Understanding the motivations of the multigenerational physician assistant workforce.

PubMed

Lopes, John E; Delellis, Nailya O

2013-10-01

Physician assistants (PAs) are more frequently finding themselves in positions where they are responsible for staff recruitment and retention. Staff turnover is associated with significant financial costs for organizations. Motivational theories focusing on job design indicate that paying attention to a combination of factors related to the work itself, in addition to the environment where the work is performed, increases satisfaction. This study asked a convenience sample of practicing PAs to rate the importance of a number of work-related factors known to influence job satisfaction. The results may be used as a basis for designing an environment to increase job satisfaction and improve recruitment and retention of highly qualified staff.

42 CFR 423.156 - Consumer satisfaction surveys.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality... as of July of the prior year must contract with approved Medicare Consumer Assessment of Healthcare...

[Volunteer satisfaction: Internal structure and relationship with permanence in organizations].

PubMed

Vecina Jiménez, M L; Chacón Fuertes, Fernando; Sueiro Abad, Manuel J

2009-02-01

Volunteer satisfaction: Internal structure and relationship with permanence in organizations. The concept of satisfaction is considered theoretically relevant in practically all the studies that have investigated the factors that influence the permanence of volunteer participation in organizations. However, the practical results are not conclusive, perhaps due to the wide range of ways in which the concept is understood and measured. The object of this study is: to analyse the internal structure of satisfaction and to verify its relationship with volunteer duration in organizations. The results of the factor analysis yield a three-factor structure: Satisfaction with the management of the organization, Satisfaction with the tasks, Satisfaction of motivations. The three factors allow us to differentiate between individuals who remain in the organization for a period of 12 consecutive months, and those who leave earlier. The results of structural equation model analysis show that the relationship between satisfaction and the length of time that volunteers stay with the organization is affected by the intention to remain.

Life Satisfaction and Frequency of Doctor Visits

PubMed Central

Kim, Eric S.; Park, Nansook; Sun, Jennifer K.; Smith, Jacqui; Peterson, Christopher

2015-01-01

Objective Identifying positive psychological factors that reduce health care use may lead to innovative efforts that help build a more sustainable and high quality health care system. Prospective studies indicate that life satisfaction is associated with good health behaviors, enhanced health, and longer life, but little information is available about the association between life satisfaction and health care use. We tested whether higher life satisfaction was prospectively associated with fewer doctor visits. We also examined potential interactions between life satisfaction and health behaviors. Methods Participants were 6,379 adults from the Health and Retirement Study, a prospective and nationally representative panel study of American adults over the age of 50. Participants were tracked for four years. We analyzed the data using a generalized linear model with a gamma distribution and log link. Results Higher life satisfaction was associated with fewer doctor visits. On a six-point life satisfaction scale, each unit increase in life satisfaction was associated with an 11% decrease in doctor visits—after adjusting for sociodemographic factors (RR = 0.89, 95% CI = 0.86 to 0.93). The most satisfied respondents (N=1,121; 17.58%) made 44% fewer doctor visits than the least satisfied (N=182; 2.85%). The association between higher life satisfaction and reduced doctor visits remained even after adjusting for baseline health and a wide range of sociodemographic, psychosocial, and health-related covariates (RR = 0.96, 95% CI = 0.93 to 0.99). Conclusions Higher life satisfaction is associated with fewer doctor visits, which may have important implications for reducing health care costs. PMID:24336427

Patient, staff and physician satisfaction: a new model, instrument and their implications.

PubMed

York, Anne S; McCarthy, Kim A

2011-01-01

Customer satisfaction's importance is well-documented in the marketing literature and is rapidly gaining wide acceptance in the healthcare industry. The purpose of this paper is to introduce a new customer-satisfaction measuring method - Reichheld's ultimate question - and compare it with traditional techniques using data gathered from four healthcare clinics. A new survey method, called the ultimate question, was used to collect patient satisfaction data. It was subsequently compared with the data collected via an existing method. Findings suggest that the ultimate question provides similar ratings to existing models at lower costs. A relatively small sample size may affect the generalizability of the results; it is also possible that potential spill-over effects exist owing to two patient satisfaction surveys administered at the same time. This new ultimate question method greatly improves the process and ease with which hospital or clinic administrators are able to collect patient (as well as staff and physician) satisfaction data in healthcare settings. Also, the feedback gained from this method is actionable and can be used to make strategic improvements that will impact business and ultimately increase profitability. The paper's real value is pinpointing specific quality improvement areas based not just on patient ratings but also physician and staff satisfaction, which often underlie patients' clinical experiences.

Home Healthcare Nurses' Job Satisfaction Scale: refinement and psychometric testing.

PubMed

Ellenbecker, Carol H; Byleckie, James J

2005-10-01

This paper describes a study to further develop and test the psychometric properties of the Home Healthcare Nurses' Job Satisfaction Scale, including reliability and construct and criterion validity. Numerous scales have been developed to measure nurses' job satisfaction. Only one, the Home Healthcare Nurses' Job Satisfaction Scale, has been designed specifically to measure job satisfaction of home healthcare nurses. The Home Healthcare Nurses' Job Satisfaction Scale is based on a theoretical model that integrates the findings of empirical research related to job satisfaction. A convenience sample of 340 home healthcare nurses completed the Home Healthcare Nurses' Job Satisfaction Scale and the Mueller and McCloskey Satisfaction Scale, which was used to test criterion validity. Factor analysis was used for testing and refinement of the theory-based assignment of items to constructs. Reliability was assessed by Cronbach's alpha internal consistency reliability coefficients. The data were collected in 2003. Nine factors contributing to home healthcare nurses' job satisfaction emerged from the factor analysis and were strongly supported by the underlying theory. Factor loadings were all above 0.4. Cronbach's alpha coefficients for each of the nine subscales ranged from 0.64 to 0.83; the alpha for the global scale was 0.89. The correlations between the Home Healthcare Nurses' Job Satisfaction Scale and Mueller and McCloskey Satisfaction Scale was 0.79, indicating good criterion-related validity. The Home Healthcare Nurses' Job Satisfaction Scale has potential as a reliable and valid scale for measurement of job satisfaction of home healthcare nurses.

Determinants of job satisfaction of healthcare professionals in public hospitals in Belgrade, Serbia--Cross-sectional analysis.

PubMed

Kuburović, Nina B; Dedić, Velimir; Djuricić, Slavisa; Kuburović, Vladimir

2016-01-01

The quality of health care significantly depends on the satisfaction of the employees. The objective of this study was to establish the level of professional satisfaction of healthcare professionals in state hospitals in Belgrade, Serbia, and to determine and to rank the factors which impact on their satisfaction or dissatisfaction. Professional satisfaction survey was designed and conducted as a cross-sectional study in 2008. Completed questionnaires were returned by 6,595 healthcare professionals from Belgrade's hospitals. Statistical analysis was performed using the Student's t-test, χ² test and ANOVA. Factor analysis was applied in order to define determinants of professional satisfaction, i.e. dissatisfaction. This study showed that the degree of professional satisfaction of Serbian healthcare professionals was low. The main causes of professionals'dissatisfaction were wages, equipment, the possibility of continuous medical education/training and the opportunities for professional development. Healthcare professionals with university education were more satisfied with all the individual aspects of job satisfaction than those with secondary school and college education. There were significantly more healthcare professionals satisfied with their job among males, older than 60 years, in the age group 50-59 years, with managerial function, and with 30 or more years of service. Development strategy of human resources in the Serbian health care system would significantly improve the professional satisfaction and quality of the provided health care.

A break-even analysis for dementia care collaboration: Partners in Dementia Care.

PubMed

Morgan, Robert O; Bass, David M; Judge, Katherine S; Liu, C F; Wilson, Nancy; Snow, A Lynn; Pirraglia, Paul; Garcia-Maldonado, Maurilio; Raia, Paul; Fouladi, N N; Kunik, Mark E

2015-06-01

Dementia is a costly disease. People with dementia, their families, and their friends are affected on personal, emotional, and financial levels. Prior work has shown that the "Partners in Dementia Care" (PDC) intervention addresses unmet needs and improves psychosocial outcomes and satisfaction with care. We examined whether PDC reduced direct Veterans Health Administration (VHA) health care costs compared with usual care. This study was a cost analysis of the PDC intervention in a 30-month trial involving five VHA medical centers. Study subjects were veterans (N = 434) 50 years of age and older with dementia and their caregivers at two intervention (N = 269) and three comparison sites (N = 165). PDC is a telephone-based care coordination and support service for veterans with dementia and their caregivers, delivered through partnerships between VHA medical centers and local Alzheimer's Association chapters. We tested for differences in total VHA health care costs, including hospital, emergency department, nursing home, outpatient, and pharmacy costs, as well as program costs for intervention participants. Covariates included caregiver reports of veterans' cognitive impairment, behavior problems, and personal care dependencies. We used linear mixed model regression to model change in log total cost post-baseline over a 1-year follow-up period. Intervention participants showed higher VHA costs than usual-care participants both before and after the intervention but did not differ significantly regarding change in log costs from pre- to post-baseline periods. Pre-baseline log cost (p ≤ 0.001), baseline cognitive impairment (p ≤ 0.05), number of personal care dependencies (p ≤ 0.01), and VA service priority (p ≤ 0.01) all predicted change in log total cost. These analyses show that PDC meets veterans' needs without significantly increasing VHA health care costs. PDC addresses the priority area of care coordination in the National Plan to Address Alzheimer's Disease, offering a low-cost, structured, protocol-driven, evidence-based method for effectively delivering care coordination.

Structural and reliability analysis of a patient satisfaction with cancer-related care measure: a multisite patient navigation research program study.

PubMed

Jean-Pierre, Pascal; Fiscella, Kevin; Freund, Karen M; Clark, Jack; Darnell, Julie; Holden, Alan; Post, Douglas; Patierno, Steven R; Winters, Paul C

2011-02-15

Patient satisfaction is an important outcome measure of quality of cancer care and 1 of the 4 core study outcomes of the National Cancer Institute (NCI)-sponsored Patient Navigation Research Program to reduce race/ethnicity-based disparities in cancer care. There is no existing patient satisfaction measure that spans the spectrum of cancer-related care. The objective of this study was to develop a Patient Satisfaction With Cancer Care measure that is relevant to patients receiving diagnostic/therapeutic cancer-related care. The authors developed a conceptual framework, an operational definition of Patient Satisfaction With Cancer Care, and an item pool based on literature review, expert feedback, group discussion, and consensus. The 35-item Patient Satisfaction With Cancer Care measure was administered to 891 participants from the multisite NCI-sponsored Patient Navigation Research Program. Principal components analysis (PCA) was conducted for latent structure analysis. Internal consistency was assessed using Cronbach coefficient alpha (α). Divergent analysis was performed using correlation analyses between the Patient Satisfaction With Cancer Care, the Communication and Attitudinal Self-Efficacy-Cancer, and demographic variables. The PCA revealed a 1-dimensional measure with items forming a coherent set explaining 62% of the variance in patient satisfaction. Reliability assessment revealed high internal consistency (α ranging from 0.95 to 0.96). The Patient Satisfaction With Cancer Care demonstrated good face validity, convergent validity, and divergent validity, as indicated by moderate correlations with subscales of the Communication and Attitudinal Self-Efficacy-Cancer (all P < .01) and nonsignificant correlations with age, primary language, marital status, and scores on the Rapid Estimate of Adult Literacy in Medicine Long Form (all P > .05). The Patient Satisfaction With Cancer Care is a valid tool for assessing satisfaction with cancer-related care for this sample. Copyright © 2010 American Cancer Society.

Job satisfaction of nurses and identifying factors of job satisfaction in Slovenian Hospitals

PubMed Central

Lorber, Mateja; Skela Savič, Brigita

2012-01-01

Aim To determine the level of job satisfaction of nursing professionals in Slovenian hospitals and factors influencing job satisfaction in nursing. Methods The study included 4 hospitals selected from the hospital list comprising 26 hospitals in Slovenia. The employees of these hospitals represent 29.8% and 509 employees included in the study represent 6% of all employees in nursing in Slovenian hospitals. One structured survey questionnaire was administered to the leaders and the other to employees, both consisting 154 items evaluated on a 5 point Likert-type scale. We examined the correlation between independent variables (age, number of years of employment, behavior of leaders, personal characteristics of leaders, and managerial competencies of leaders) and the dependent variable (job satisfaction – satisfaction with the work, coworkers, management, pay, etc) by applying correlation analysis and multivariate regression analysis. In addition, factor analysis was used to establish characteristic components of the variables measured. Results We found a medium level of job satisfaction in both leaders (3.49 ± 0.5) and employees (3.19 ± 0.6), however, there was a significant difference between their estimates (t = 3.237; P = <0.001). Job satisfaction was explained by age (P < 0.05; β = 0.091), years of employment (P < 0.05; β = 0.193), personal characteristics of leaders (P < 0.001; β = 0.158), and managerial competencies of leaders (P < 0.000; β = 0.634) in 46% of cases. The factor analysis yielded four factors explaining 64% of the total job satisfaction variance. Conclusion Satisfied employees play a crucial role in an organization’s success, so health care organizations must be aware of the importance of employees’ job satisfaction. It is recommended to monitor employees’ job satisfaction levels on an annual basis. PMID:22661140

Predictors of job satisfaction and absenteeism in two samples of Hong Kong nurses.

PubMed

Siu, Oi-Ling

2002-10-01

Stress-related outcomes of job satisfaction and absenteeism among nurses should receive more attention in Hong Kong because absenteeism is costly. Many nurses' complaints are due to organizational change in privatization since the establishment of the Hong Kong Hospital Authority in 1991. Organizational climate is found to be an antecedent of job dissatisfaction and absenteeism in many studies in western societies. To investigate the role of organizational climate and psychological distress on job satisfaction; and the role of climate, distress and job satisfaction on absenteeism in Hong Kong nurses, while controlling for demographic variables. A self-administered questionnaire survey method was used to collect data from two samples of nurses within a 8-month period. They are, respectively, 144 (74 general nurses, 70 psychiatric nurses; 47 males, 97 females) and 114 (85 general nurses, 29 psychiatric nurses; 17 males, 97 females) nurses. Multiple regression analyses revealed that occupational type (psychiatric/general), environment (the physical conditions in the work area) and psychological distress were significant predictors of job satisfaction for sample 1; and well-being (social relations, welfare and health issues) was the only significant predictor of job satisfaction for sample 2. However, age, involvement (the degree of commitment displayed towards employees by the organization), psychological distress and job satisfaction were significant predictors of absenteeism for sample 1; and occupational type, organization (the interaction between the worker and the organization), and involvement were significant predictors of absenteeism for sample 2. The empirical findings provide support for the climate-job satisfaction and climate-absenteeism relationships. Psychological distress could be an antecedent of job satisfaction; and job satisfaction could be an antecedent of absenteeism. Certain climate dimensions should be improved to enhance job satisfaction and reduce distress, which in turn will reduce absenteeism.

Patients' satisfaction with inpatient services provided in hospitals affiliated to Tehran University of Medical Sciences, Iran, during 2011-2013

PubMed Central

Makarem, Jalil; Larijani, Bagher; Joodaki, Kobra; Ghaderi, Sahar; Nayeri, Fatemeh; Mohammadpoor, Masoud

2016-01-01

Implementation of patient feedback is considered as a critical part of effective and efficient management in developed countries. The main objectives of this study were to assess patient satisfaction with the services provided in hospitals affiliated to Tehran University of Medical Sciences, Iran, identify areas of patient dissatisfaction, and find ways to improve patient satisfaction with hospital services. This cross-sectional study was conducted in 3 phases. After 2 initial preparation phases, the valid instrument was applied through telephone interviews with 21476 participants from 26 hospitals during August, 2011 to February, 2013.Using the Satisfaction Survey tool, information of patient's demographic characteristics were collected and patient satisfaction with 15 areas of hospital services and the intent to return the same hospitals were assessed. The mean score of overall satisfaction with hospital services was 16.86 ± 2.72 out of 20. It was found that 58% of participants were highly satisfied with the services provided. Comparison of mean scores showed physician and medical services (17.75 ± 4.02), laboratory and radiology services (17.67 ± 3.66), and privacy and religious issues (17.55 ± 4.32) had the highest satisfaction. The patients were the most dissatisfied with the food services (15.50 ± 5.54). It was also found that 83.7% of the participants intended to return to the same hospital in case of need, which supported the measured satisfaction level. Patient satisfaction in hospitals affiliated to Tehran University of Medical Sciences was high. It seems that the present study, with its large sample size, has sufficient reliability to express the patient satisfaction status. Moreover, appropriate measures should be taken in some areas (food, cost, and etc.) to increase patient satisfaction. PMID:27471589

[Path analysis on workplace violence affecting work ability, job satisfaction and turnover intent in health professionals in Shangqiu City].

PubMed

Wang, Pei-xi; Wang, Mian-zhen; Bai, Qin; Jia, Cai-feng; Lan, Ya-jia; Wang, Zhi-ming; Luan, Rong-sheng

2006-11-01

To explore the effects of workplace violence on work ability, work satisfaction and turnover intent based on the theory of occupational stress in health professionals and to provide evidence for evaluating the process and consequence of workplace violence. Subjects of 483 health professionals from 5 hospitals in Shangqiu city of Hennan Province were selected with stratified cluster random sampling method. Workplace violence, violent fear at work, coping resources, work ability, job satisfaction and turnover intent were measured with questionnaires. Ordinal regression analysis and path analysis were applied to analyze the data. Workplace violence had direct or indirect effects on the work ability and job satisfaction through the fear of future violence at work. Workplace violence only had indirect effects on turnover intent through the fear and job satisfaction in health professionals. Workplace violence had direct and indirect effects on the work ability, job satisfaction and turnover intent. Measures should be taken to reduce workplace violence and it' s effects in health professionals.

The Relationship between Pay and Job Satisfaction: A Meta-Analysis of the Literature

ERIC Educational Resources Information Center

Judge, Timothy A.; Piccolo, Ronald F.; Podsakoff, Nathan P.; Shaw, John C.; Rich, Bruce L.

2010-01-01

Whereas the motivational aspects of pay are well-documented, the notion that high pay leads to high levels of satisfaction is not without debate. The current study used meta-analysis to estimate the population correlation between pay level and measures of pay and job satisfaction. Cumulating across 115 correlations from 92 independent samples,…

The health law partnership: adding a lawyer to the health care team reduces system costs and improves provider satisfaction.

PubMed

Pettignano, Robert; Caley, Sylvia B; McLaren, Susan

2012-01-01

Addressing the legal issues of patients of low socioeconomic status can be useful in increasing organizational reimbursements, reducing costs and improving access to care. Medical-legal partnership is an addition to the health care armamentarium that directly addresses this goal. A medical-legal partnership is an interdisciplinary collaboration between a medical entity such as a hospital or clinic and a legal entity such as a law school or legal aid society that addresses barriers to access to care and limitations to well-being experienced by patients of low socioeconomic status. The Health Law Partnership is one such medical legal partnership that provides a holistic, interdisciplinary approach to health care. An evaluation of the legal and educational services provided by Health Law Partnership showed that Health Law Partnership secured otherwise unreimbursed Medicaid payments for services over a 4-year period from 2006 to 2010, increased physician satisfaction, and saved hospital employers approximately $10 000 in continuing education costs annually.

Preceptorship planning is essential to perioperative nursing retention: matching teaching and learning styles.

PubMed

Willemsen-McBride, Tara

2010-03-01

Current nursing shortages along with unsuccessful nursing orientation programs have been a major concern for the past decade because they result in poor retention, reduced quality of patient care, decreased job satisfaction and high financial costs to the organization. Specialty areas, such as the Operating Room (OR), are even more vulnerable due to the stressful working environment and critical care skill set. It has been estimated that approximately 35-65% of new graduates will leave their work place within the first year of employment, lending to the 55% nursing turnover rate. The cost of orientating a new nurse to the perioperative role is estimated to cost between $50,000 and $59,000 U.S. Thus, it is imperative to improve the orientation experience for both new and senior perioperative nurses. Matching preceptor/preceptee learning styles is one way to enhance job satisfaction levels. This paper revisits the literature on preceptorship and provides suggestions on how to enhance existing orientation programs.

Examining the Factors Contributing to Students' Life Satisfaction

ERIC Educational Resources Information Center

Dogan, Ugur; Celik, Eyup

2014-01-01

In this study, the authors examined the relationship between students' life satisfaction, school engagement, and confidence in the classroom. An analysis was performed of how students' life satisfaction differs according to their housing, school type, and classroom level. The multidimensional student satisfaction scale, confidence scale in the…

The Multivariate Nature of Professional Job Satisfaction.

ERIC Educational Resources Information Center

Wood, Donald A.; LeBold, William K.

Discussed are two theories of professional job satisfaction--(1) unidimensional and (2) multidimensional with special reference to Herzberg's two factor theory. A national sample of over 3,000 engineering graduates responded to a questionnaire and satisfaction index. Analysis of results revealed that job satisfaction is multidimensional. Job…

Are There Geographical Variations in the Psychological Cost of Unemployment in South Africa?

ERIC Educational Resources Information Center

Powdthavee, Nattavudh

2007-01-01

Are certain groups of unemployed individuals hurt less by unemployment than others? This paper is an attempt to test the hypothesis that non-pecuniary costs of unemployment may vary between societies with different unemployment rates. Using cross-sectional data from the SALDRU93 survey, I show that households' perceptions of life satisfaction are…

Organizational performance impacting patient satisfaction in Ontario hospitals: a multilevel analysis.

PubMed

Koné Péfoyo, Anna J; Wodchis, Walter P

2013-12-05

Patient satisfaction in health care constitutes an important component of organizational performance in the hospital setting. Satisfaction measures have been developed and used to evaluate and improve hospital performance, quality of care and physician practice. In order to direct improvement strategies, it is necessary to evaluate both individual and organizational factors that can impact patients' perception of care. The study aims were to determine the dimensions of patient satisfaction, and to analyze the individual and organizational determinants of satisfaction dimensions in hospitals. We used patient and hospital survey data as well as administrative data collected for a 2008 public hospital report in Ontario, Canada. We evaluated the clustering of patient survey items with exploratory factor analysis and derived plausible dimensions of satisfaction. A two-level multivariate model was fitted to analyze the determinants of satisfaction. We found eight satisfaction factors, with acceptable to good level of loadings and good reliability. More than 95% of variation in patient satisfaction scores was attributable to patient-level variation, with less than 5% attributable to hospital-level variation. The hierarchical models explain 5 to 17% of variation at the patient level and up to 52% of variation between hospitals. Individual patient characteristics had the strongest association with all dimensions of satisfaction. Few organizational performance indicators are associated with patient satisfaction and significant determinants differ according to the satisfaction dimension. The research findings highlight the importance of adjusting for both patient-level and organization-level characteristics when evaluating patient satisfaction. Better understanding and measurement of organization-level activities and processes associated with patient satisfaction could contribute to improved satisfaction ratings and care quality.

49 CFR 262.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... financing instruments and costs incurred by the Grantee in performing project related audits, and includes.... Quality of life means the level of social, environmental and economic satisfaction and well being a...

Investigation of marital satisfaction and its relationship with job stress and general health of nurses in Qazvin, Iran.

PubMed

Azimian, Jalil; Piran, Pegah; Jahanihashemi, Hassan; Dehghankar, Leila

2017-04-01

Pressures in nursing can affect family life and marital problems, disrupt common social problems, increase work-family conflicts and endanger people's general health. To determine marital satisfaction and its relationship with job stress and general health of nurses. This descriptive and cross-sectional study was done in 2015 in medical educational centers of Qazvin by using an ENRICH marital satisfaction scale and General Health and Job Stress questionnaires completed by 123 nurses. Analysis was done by SPSS version 19 using descriptive and analytical statistics (Pearson correlation, t-test, ANOVA, Chi-square, regression line, multiple regression analysis). The findings showed that 64.4% of nurses had marital satisfaction. There was significant relationship between age (p=0.03), job experience (p=0.01), age of spouse (p=0.01) and marital satisfaction. The results showed that there was a significant relationship between marital satisfaction and general health (p<0.0001). Multiple regression analysis showed that there was a significant relationship between depression (p=0.012) and anxiety (p=0.001) with marital satisfaction. Due to high levels of job stress and disorder in general health of nurses and low marital satisfaction by running health promotion programs and paying attention to its dimensions can help work and family health of nurses.

The balanced scorecard framework-a case study of patient and employee satisfaction: what happens when it does not work as planned?

PubMed

Lorden, Andrea; Coustasse, Alberto; Singh, Karan P

2008-01-01

The successful utilization of the balanced scorecard (BSC) framework in health care has been demonstrated in the literature. Given these successes, a financially struggling hospital implemented a BSC framework intervention which attempted a culture change centered upon patient satisfaction which it hoped would translate to improved financial stability. Despite the evidence of BSC successes, the intervention, entitled Route 99, did not succeed in this hospital. This case study was conducted to identify learnable lessons and confounding factors associated with the successes and failures of Route 99. Metrics for patient satisfaction and employee satisfaction were examined as reflections of the intervention, the BSC framework, and the confounding financial condition of the hospital. Through case study methodology, mean quarterly patient satisfaction scores tabulated by an outside vendor for inpatient and outpatient services were divided into four time intervals and compared through analysis of variance. Employee satisfaction was measured through a hospital-provided 12-question employee survey, administered through convenience sampling at the beginning and 7 months into Route 99. Each question utilized a 5-point Likert scale and generated two samples which were verified for sample independence through chi-square analysis. Mann-Whitney U test was used for comparison. Inpatient patient satisfaction scores exhibited a nonsignificant upward trend. However, the analysis of variance demonstrated a significant rise in outpatient patient satisfaction (p < .05). An interesting finding was that employee satisfaction declined (p < .05) significantly for supervisors and directors in three areas. The inverse relationship between patient satisfaction and employee satisfaction is in contrast to that found in the literature by the authors. Examination of the BSC framework, the hospital's financial standing, and the metrics for patient satisfaction and employee satisfaction illuminated the importance of management transparency, leadership support, appropriate metric selection, and the strength of the BSC under turbulent circumstances.

The Effect of Race on Determinants of Job Satisfaction.

DTIC Science & Technology

1985-12-01

satisfaction was disputed by Konar. Konar claimed that Moch’s inability to demonstrate that cultural, organizational, social and social psychological factors...effect of race * as a determinant of an individual’s job satisfaction. Analysis of the effect of gender on the determinantion of job satisfaction may

Instructional Coach Job Satisfaction: An Exploration of Role Stressors

ERIC Educational Resources Information Center

Debacker, Jeffrey Paul

2013-01-01

This mixed methods dissertation examines the relationships between role conflict and job satisfaction, role ambiguity and job satisfaction, and role conflict and job satisfaction within a convenience sample of American instructional coaches (n = 46). Theoretically, this analysis is formed by Merton's idea of role-sets and how instructional…

Ethical concerns and career satisfaction in obstetrics and gynecology: a review of recent findings from the Collaborative Ambulatory Research Network.

PubMed

Farrow, Victoria A; Leddy, Meaghan A; Lawrence, Hal; Schulkin, Jay

2011-09-01

Obstetricians-gynecologists (ob-gyns) are frequently confronted with situations that have ethical implications (e.g., whether to accept gifts or samples from drug companies or disclosing medical errors to patients). Additionally, various factors, including specific job-related tasks, costs, and benefits, may impact ob-gyns' career satisfaction. Ethical concerns and career satisfaction can play a role in the quality of women's health care. This article summarizes the studies published between 2005 and 2009 by the Research Department of the American College of Obstetricians and Gynecologists, which encompass ethical concerns regarding interactions with pharmaceutical representatives and patient safety/medical error reporting, as well as ob-gyn career satisfaction. Additionally, a brief discussion regarding ethical concerns in the ob-gyn field, in general, highlights key topics for the last 30 years. Ethical dilemmas continue to be of concern for ob-gyns. Familiarity with guidelines on appropriate interactions with industry is associated with lower percentages of potentially problematic relationships with pharmaceutical industries. Physicians report that the expense of patient safety initiatives is one of the top barriers for improving patient safety, followed by fear of liability. Overall, respondents reported being satisfied with their careers. However, half of the respondents reported that they were extremely concerned about the impact of professional liability costs on the duration of their careers. Increased familiarity with guidelines may lead to a decreased ob-gyn reliance on pharmaceutical representatives and free samples, whereas specific and practical tools may help them implement patient safety techniques. The easing of malpractice insurance and threat of litigation may enhance career satisfaction among ob-gyns. This article will discuss related findings in recent years. Obstetricians & Gynecologists and Family Physicians. After the completing the CME activity, physicians should be better able to analyze how interactions with pharmaceutical industry may pose ethical dilemmas, examine current barriers to implementing patient safety initiatives, and evaluate the factors that influence career satisfaction among obstetrician-gynecologists.

Retrospective Cohort Study to Assess Outcomes, Cost-Effectiveness, and Patient Satisfaction in Primary Vaginal Ovarian Cystectomy versus the Laparoscopic Approach.

PubMed

Yoong, Wai; Fadel, Michael G; Walker, Sophie; Williams, Sophie; Subba, Beena

2016-02-01

To compare surgical outcomes, cost-effectiveness, and patient satisfaction in women undergoing primary vaginal or laparoscopic ovarian cystectomy for benign ovarian cysts. Retrospective cohort control study (Canadian Task Force classification II-3). Gynecologic unit at a university-affiliated hospital. Fifty patients who underwent primary ovarian cystectomy either through the vaginal route via posterior colpotomy (n = 29) or laparoscopic route (n = 21). Nonmalignant ovarian cysts were initially determined by transvaginal ultrasonography and serum tumor markers. The index group of women (n = 29) underwent vaginal ovarian cystectomy via a posterior colpotomy incision, whereas the control group (n = 21) comprised women who had laparoscopic ovarian cystectomy using the traditional "grasp and peel" technique. The following outcomes were evaluated: duration of surgery, intraoperative complications, estimated blood loss, length of inpatient stay, and postoperative pain (visual analogue scale). The average cost of both surgical methods was calculated by factoring in theater time, equipment required, and the length of hospital stay. Patients were then surveyed to compare postoperative pain and satisfaction scores as well as the time taken to return to work (in days). The 2 groups had similar mean ages (35.79 vs 36.72 years) and cyst diameter (6.8 vs 6.6 cm) (p > .05 in both cases). Vaginal ovarian cystectomy took a mean of 13.7 minutes longer (91.7 vs 78.0 minutes, p < .001) to perform and resulted in a greater mean estimated blood loss (116.1 vs 95 mL, p < .001). The spillage rate in the index group was 6-fold less compared with control cases (6% ± 2.4% vs 35% ± 4.6, p < .01). Although patients from the index group spent a mean of 2 hours longer as inpatients (10.9 vs 8.9 hours, p < .001), they reported a lower mean visual analogue pain score (2.01/10 vs 3.95/10, p < .05) and higher patient satisfaction scores (8.2/10 vs 6.5/10, p < .001). Mean perioperative cost of women who underwent vaginal ovarian cystectomy was lower (£1690.13 vs 1761.67) and they returned to work quicker compared with the laparoscopic group (13.6 vs 39.2 days, p < .001). Vaginal ovarian cystectomies took longer to perform and led to longer inpatient stay. However, these women had less postoperative pain and reported higher satisfaction scores compared with laparoscopic ovarian cystectomy, with a quicker return to work. The vaginal approach is a viable and cost-effective alternative to the laparoscopic approach in carefully selected patients. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

Determinants of the Job Satisfaction of PhD Holders: An Analysis by Gender, Employment Sector, and Type of Satisfaction in Spain

ERIC Educational Resources Information Center

Escardíbul, Josep-Oriol; Afcha, Sergio

2017-01-01

We analyze the determinants of job satisfaction of PhD holders in Spain. Specifically, we consider overall job satisfaction as well as basic and motivational satisfaction, following Herzberg's typology (based on Maslow's hierarchy of needs). Using representative data for Spain's PhD population--collected from the Spanish Survey on Human Resources…

Measuring the Financial Impact of Employee Attitudes

ERIC Educational Resources Information Center

Mirvis, Philip H.; Lawler, Edward E., III

1977-01-01

Results show expected direct-cost savings in absenteeism, turnover, and performance from an increase in job satisfaction. Saving associated with enhanced job involvement and motivation are also reported. (Author/IRT)

The prospective relationship between satisfaction with information and symptoms of depression and anxiety in breast cancer: A structural equation modeling analysis.

PubMed

Faller, Hermann; Strahl, André; Richard, Matthias; Niehues, Christiane; Meng, Karin

2017-11-01

Previous research has demonstrated associations between satisfaction with information and reduced emotional distress in cancer patients. However, as most studies were cross-sectional, the direction of this relationship remained unclear. We therefore aimed to test whether information satisfaction predicted subsequent depression and anxiety levels, and, reciprocally, depression and anxiety levels predicted subsequent information satisfaction, thus clarifying the direction of impact. We performed a secondary analysis of a prospective cohort study with 436 female breast cancer patients (mean age 51 years). We measured information satisfaction with 2 self-developed items, symptoms of depression with the 2-item Patient Heath Questionnaire and symptoms of anxiety with the 2-item Generalized Anxiety Disorder Scale. We created 2 structural equation models, 1 for depression and 1 for anxiety, that examined the prediction of 1-year depression (or anxiety) levels by baseline information satisfaction and, in the same model, 1-year information satisfaction by baseline depression (or anxiety) levels (cross-lagged panel analysis). Baseline information satisfaction predicted 1-year levels of both depression (beta = -0.17, P < .01) and anxiety (beta = -0.13, P < .01), adjusting for the baseline scores of the outcome variables. Conversely, baseline levels of depression (beta = -0.12, P < .05) and anxiety (beta = -0.16, P < .01) predicted 1-year information satisfaction, adjusting for its baseline score. Our results suggest a bidirectional relationship between information satisfaction and symptoms of depression and anxiety. Thus, provision of information may reduce subsequent depression and anxiety, while reducing depression and anxiety levels may increase satisfaction with received information. Combining the provision of information with emotional support may be particularly beneficial. Copyright © 2016 John Wiley & Sons, Ltd.

Patient evaluation of the hotel function of hospitals.

PubMed

Oz, M C; Zikria, J; Mutrie, C; Slater, J P; Scott, C; Lehman, S; Connolly, M W; Asher, D T; Ting, W; Namerow, P B

2001-01-01

A means of measuring patient satisfaction is essential in the effort to improve the quality of health care delivered in our nation's hospitals. Accurate feedback allows employers to better meet patients' needs and allows hospital administrators to improve service delivery. Patients are empowered by having a voice in the manner in which their health care is delivered. Moreover, improving the efficiency of the health care delivery system decreases health care costs. Hospital comparisons can be made readily available to a large audience through the Internet, resulting in empowerment of the patient and a universal improvement in hospital care. This is the first multi-institutional analysis of patient satisfaction among New York City and northern New Jersey area tertiary care hospitals. In this study, we evaluated the patient-assessed hotel function of hospitals in a single geographic region to determine whether clinically and statistically significant differences would be revealed that could provide beneficial information to stakeholders in the healthcare system. Patients (n = 261) who had spent a night during the past year in one of eleven hospitals within 60 miles of New York City were chosen at random from doctors' waiting rooms. On average, 24 patients from each hospital were surveyed. They were asked to complete a questionnaire that rated the various departments in the hospital on qualities such as courtesy, promptness, and cleanliness. The questionnaire also rated important characteristics of the patient experience, such as the ease of parking and the taste of the food. Each item on the survey was coded on a scale of 1 to 10 with 10 being the most positive response. The 26 specific questions were divided into 14 domains. Averages in each domain were compared by gender, age, and hospital identity, attractiveness, and setting. All statistical calculations were performed using SPSS/PC, and means were compared using t-tests. Analysis designed to evaluate outcomes between each of the possible 54 pairs of hospitals comparisons revealed statistically significant differences as often as 44% of the time in some outcomes measures (logistics), but as rarely as 7% of the time in others (billing function). Clinically significant differences (>2 units per scale) were frequently evident, although the ranges differed dramatically depending on the domains surveyed. Although age, gender, and race/ethnicity were generally not predictive of satisfaction, non-urban setting was correlated with greater patient satisfaction. By having access to patient satisfaction comparisons among hospitals, patients are empowered to make better choices, employers can identify and adapt to patient preferences, and administrators can improve the services delivered and decrease health care costs by improving efficiency. Although our study was somewhat limited by patient selection biases, the study's results suggest that Internet-based tools of comparison will enable patients to make free and informed decisions about their health care by comparing local hospitals and voting on their impressions of the facilities from which they receive care.

Dimensions of patient satisfaction with comprehensive abortion care in Addis Ababa, Ethiopia.

PubMed

Mossie Chekol, Bekalu; Abera Abdi, Dame; Andualem Adal, Tamirie

2016-12-07

Patient satisfaction is a measure of the extent to which a patient is content with the health care received from health care providers. It has been recognized as one of the most vital indicators of quality. Hence, it has been studied and measured extensively as part of service quality and as a standalone construct. In spite of this, there has been limited or no studies in Ethiopia that describe factors of abortion care contributed to women's satisfaction. This study aimed to identifying the underlying factors that contribute to patient satisfaction with comprehensive abortion care and at exploring relationships between total satisfaction scores and socio-demographic and care-related variables in Addis Ababa, Ethiopia. At the beginning of the study in-depth interviews with 16 participants and a focus group discussion of 8 participants were conducted consecutively at the time of discharge to generate questions used to evaluate women's satisfaction with abortion care. Following generation of the perceived indicators, expert review, pilot study, and item analysis were performed in order to produce the reduced and better 26 items used to measure abortion care satisfaction. A total sample size of 450 participants from eight health facilities completed the survey. Principal component exploratory factor analysis and confirmatory factor analysis were conducted respectively to identify and confirm the factors of abortion care contributing to women's satisfaction. Mean satisfaction scores were compared across socio demographic and care-related variables such as age, educational level, gestational age (first trimester and second trimester), and facility type using analysis of variance. Exploratory factor analysis of the 26 items indicated that satisfaction with abortion care consisted of five main components accounting for 60.48% of the variance in total satisfaction scores. Factor loadings of all items were found to be greater than 0.4. These factors are named as follows: "art of care" which means interpersonal relationships with the care-provider, "physical environment" which means the perceived quality of physical surroundings in which care is delivered, including cleanliness of facilities and equipment, "information" which means the information received related to abortion procedures, "privacy and confidentiality", "quality of care" which refers to technical quality of the care provider. Furthermore, analysis of variance showed that overall satisfaction is found to be related to facility type, relationship status, gestational age, and procedural type. The findings provided support that women's satisfaction with comprehensive abortion care has five major factors. Therefore, to improve the overall quality of comprehensive abortion care, attention should be given to the advancement of these components namely, positive interpersonal communication with care-receiver, pleasantness of physical environment, offering enough information related to the procedure, securing clients' privacy during counseling and treatment, and technical quality of the providers.

Predictors of patients' satisfaction with health care services in three balkan countries (macedonia, bulgaria and serbia): a cross country survey.

PubMed

Lazarevik, Vladimir; Kasapinov, Blasko

2015-02-01

Patients' satisfaction with provided healthcare services is one of the factors to measure the overall quality of the delivered health care. Main objective of our study was to determine the common predictors associated with patients 'satisfaction in three Balkan countries. We conducted web based survey among population in Macedonia, Serbia and Bulgaria using paid campaign over the social network Facebook. A questionnaire consisted of 31 questions was developed following studies on patients' satisfaction conducted elsewhere. Descriptive analysis was performed to assess the predictors associated with patients' satisfaction. In addition we performed content analysis to all open-ended responses. In total 4118 respondents participated in the survey. Main predictors associated with low users satisfaction with the health care services in three surveyed countries are waiting time to appointments, huge administrative procedures, and attitudes of the medical personnel towards the patients. The analysis showed that there are many similarities in user experiences in three countries, but also there are some differences. The health care systems in these three counties are organized around centralized and monopolistic position of one health insurance fund that serves as main purchaser of health care services. Top three indicators of patients' satisfaction across three countries are trust and overall satisfaction with the attention of the doctors, as well as satisfaction with the outcome of the treatment. Long waiting time and huge administrative procedures are determined as common predictor for lower patients' satisfaction across these Balkan countries. Patients' privacy protection is issue for concern in all three countries.

Voluntary Associations, Life Satisfaction, and Other Correlates of Participation in Programs for the Elderly. A Preliminary Analysis.

ERIC Educational Resources Information Center

Grote, N. P.; Baumhover, L. A.

The relationship between life satisfaction and voluntary association membership is passing through its descriptive phases and is now being examined in depth. As part of a three-year longitudinal study to evaluate a Title VII program, this data reports on an analysis of life satisfaction, voluntary association membership, health status, and SES…

Analysis of the Influence of Quantile Regression Model on Mainland Tourists' Service Satisfaction Performance

PubMed Central

Wang, Wen-Cheng; Cho, Wen-Chien; Chen, Yin-Jen

2014-01-01

It is estimated that mainland Chinese tourists travelling to Taiwan can bring annual revenues of 400 billion NTD to the Taiwan economy. Thus, how the Taiwanese Government formulates relevant measures to satisfy both sides is the focus of most concern. Taiwan must improve the facilities and service quality of its tourism industry so as to attract more mainland tourists. This paper conducted a questionnaire survey of mainland tourists and used grey relational analysis in grey mathematics to analyze the satisfaction performance of all satisfaction question items. The first eight satisfaction items were used as independent variables, and the overall satisfaction performance was used as a dependent variable for quantile regression model analysis to discuss the relationship between the dependent variable under different quantiles and independent variables. Finally, this study further discussed the predictive accuracy of the least mean regression model and each quantile regression model, as a reference for research personnel. The analysis results showed that other variables could also affect the overall satisfaction performance of mainland tourists, in addition to occupation and age. The overall predictive accuracy of quantile regression model Q0.25 was higher than that of the other three models. PMID:24574916

Analysis of the influence of quantile regression model on mainland tourists' service satisfaction performance.

PubMed

Wang, Wen-Cheng; Cho, Wen-Chien; Chen, Yin-Jen

2014-01-01

It is estimated that mainland Chinese tourists travelling to Taiwan can bring annual revenues of 400 billion NTD to the Taiwan economy. Thus, how the Taiwanese Government formulates relevant measures to satisfy both sides is the focus of most concern. Taiwan must improve the facilities and service quality of its tourism industry so as to attract more mainland tourists. This paper conducted a questionnaire survey of mainland tourists and used grey relational analysis in grey mathematics to analyze the satisfaction performance of all satisfaction question items. The first eight satisfaction items were used as independent variables, and the overall satisfaction performance was used as a dependent variable for quantile regression model analysis to discuss the relationship between the dependent variable under different quantiles and independent variables. Finally, this study further discussed the predictive accuracy of the least mean regression model and each quantile regression model, as a reference for research personnel. The analysis results showed that other variables could also affect the overall satisfaction performance of mainland tourists, in addition to occupation and age. The overall predictive accuracy of quantile regression model Q0.25 was higher than that of the other three models.

Professional values, job satisfaction, career development, and intent to stay.

PubMed

Yarbrough, Susan; Martin, Pam; Alfred, Danita; McNeill, Charleen

2017-09-01

Hospitals are experiencing an estimated 16.5% turnover rate of registered nurses costing from $44,380 - $63,400 per nurse-an estimated $4.21 to $6.02 million financial loss annually for hospitals in the United States of America. Attrition of all nurses is costly. Most past research has focused on the new graduate nurse with little focus on the mid-career nurse. Attrition of mid-career nurses is a loss for the profession now and into the future. The purpose of the study was to explore relationships of professional values orientation, career development, job satisfaction, and intent to stay in recently hired mid-career and early-career nurses in a large hospital system. A descriptive correlational study of personal and professional factors on job satisfaction and retention was conducted. Participants and research context: A convenience sample of nurses from a mid-sized hospital in a metropolitan area in the Southwestern United States was recruited via in-house email. Sixty-seven nurses met the eligibility criteria and completed survey documents. Ethical considerations: Institutional Review Board approval was obtained from both the university and hospital system. Findings indicated a strong correlation between professional values and career development and that both job satisfaction and career development correlated positively with retention. Newly hired mid-career nurses scored higher on job satisfaction and planned to remain in their jobs. This is important because their expertise and leadership are necessary to sustain the profession into the future. Nurse managers should be aware that when nurses perceive value conflicts, retention might be adversely affected. The practice environment stimulates nurses to consider whether to remain on the job or look for other opportunities.

The effects of fatigue and dissatisfaction on how physicians perceive their social responsibilities.

PubMed

O'Donnell, Erin P; Humeniuk, Katherine M; West, Colin P; Tilburt, Jon C

2015-02-01

To examine how fatigue and dissatisfaction with practicing medicine relate to US physicians' perceptions of their professional responsibilities in a time of upheaval in health care. From May 30, 2012, through September 1, 2012, we mailed an 8-page paper survey, including measures of perceived social responsibility, fatigue, and satisfaction, to a random sample of 3897 physicians selected from the American Medical Association Physician Masterfile. We performed bivariate tests and multivariable logistic regression to examine associations between key predictors (fatigue and satisfaction) and 3 dependent variables: obligations to care for the uninsured and underinsured, obligations to address policy issues, and agreement with cost-containment. A total of 2556 physicians (65.6%) responded to the survey. Nearly half of physicians (1160 [45.4%]) reported high levels of fatigue, whereas most (1810 [70.8%]) expressed satisfaction with practicing medicine. Dissatisfaction in practicing medicine proved to be a significant predictor in how physicians perceive their professional responsibilities and in medical decision-making. Overall, physicians who rated themselves as very dissatisfied had a significantly reduced likelihood of favoring limiting reimbursement to expand basic coverage (odds ratio, 0.5; 95% CI, 0.3-0.7), recognizing an obligation to care for the uninsured (odds ratio, 0.5; 95% CI, 0.3-0.7), and addressing societal health policy issues (OR, 0.7; 95% CI, 0.5-0.9). Although fatigue and satisfaction are strongly associated, only satisfaction appears to correlate with physicians' perceived social responsibilities. Physicians who are dissatisfied with their profession may be less inclined to address health policy issues, embrace charity care, or practice cost containment. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Job satisfaction of primary care physicians in Switzerland: an observational study.

PubMed

Goetz, Katja; Jossen, Marianne; Szecsenyi, Joachim; Rosemann, Thomas; Hahn, Karolin; Hess, Sigrid

2016-10-01

Job satisfaction of physicians is an important issue for performance of a health care system. The aim of the study was to evaluate the job satisfaction of primary care physicians in Switzerland and to explore associations between overall job satisfaction, individual characteristics and satisfaction with aspects of work within the practice separated by gender. This cross-sectional study was based on a job satisfaction survey. Data were collected from 176 primary care physicians working in 91 primary care practices. Job satisfaction was measured with the 10-item Warr-Cook-Wall job satisfaction scale. Stepwise linear regression analysis was performed for physicians separated by gender. The response rate was 92.6%. Primary care physicians reported the highest level of satisfaction with 'freedom of working method' (mean = 6.45) and the lowest satisfaction for 'hours of work' (mean = 5.38) and 'income' (mean = 5.49). Moreover, some aspects of job satisfaction were rated higher by female physicians than male physicians. Within the stepwise regression analysis, the aspect 'opportunity to use abilities' (β = 0.644) showed the highest association to overall job satisfaction for male physicians while for female physicians it was income (β = 0.733). The presented results contribute to an understanding of factors that influence levels of satisfaction of female and male physicians. Therefore, research and intervention about job satisfaction should consider gender as well as the stereotypes that come along with these social roles. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Student peer teaching in paediatric simulation training is a feasible low-cost alternative for education.

PubMed

Wagner, Michael; Mileder, Lukas P; Goeral, Katharina; Klebermass-Schrehof, Katrin; Cardona, Francesco S; Berger, Angelika; Schmölzer, Georg M; Olischar, Monika

2017-06-01

The World Health Organization recommends regular simulation training to prevent adverse healthcare events. We used specially trained medical students to provide paediatric simulation training to their peers and assessed feasibility, cost and confidence of students who attended the courses. Students at the Medical University of Vienna, Austria were eligible to participate. Students attended two high-fidelity simulation training sessions, delivered by peers, which were videorecorded for evaluation. The attendees then completed questionnaires before and after the training. Associated costs and potential benefits were analysed. From May 2013 to June 2015, 152 students attended the sessions and 57 (37.5%) completed both questionnaires. Satisfaction was high, with 95% stating their peer tutor was competent and 90% saying that peer tutors were well prepared. The attendees' confidence in treating critically ill children significantly improved after training (p < 0.001). The average costs for a peer tutor were six Euros per working hour, compared to 35 Euros for a physician. Using peer tutors for paediatric simulation training was a feasible and low-cost option that increased the number of medical students who could be trained and increased the self-confidence of the attendees. Satisfaction with the peer tutors was high. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Degree of patient satisfaction with health care performance assesed by marketing surveys.

PubMed

Druguş, Daniela; Azoicăi, Doina

2015-01-01

Marketing surveys of the health system collect useful information to develop effective management strategies. The research aim consisted in measuring patient satisfaction with health care quality. The qualitative research was based on an online SurveyMonkey open-ended questionnaire. The analysis of patient satisfaction/dissatisfaction with healthcare professionals was performed in 1838 patients. Correlation analysis allowed the identification of some determinants associated with patient satisfaction. The variable most commonly associated with satisfaction was "I got adequate information about procedures/treatment" according to 32.2% of respondents. The patients who were dissatisfied most commonly complained that they were "Not adequately informed about maneuvers and treatment", reported by 40.0% of respondents. This study provides a basis for building an original model for determining the variables of an efficient healthcare system which to ensure a high degree of patient satisfaction.

Associations Among Health Care Workplace Safety, Resident Satisfaction, and Quality of Care in Long-Term Care Facilities.

PubMed

Boakye-Dankwa, Ernest; Teeple, Erin; Gore, Rebecca; Punnett, Laura

2017-11-01

We performed an integrated cross-sectional analysis of relationships between long-term care work environments, employee and resident satisfaction, and quality of patient care. Facility-level data came from a network of 203 skilled nursing facilities in 13 states in the eastern United States owned or managed by one company. K-means cluster analysis was applied to investigate clustered associations between safe resident handling program (SRHP) performance, resident care outcomes, employee satisfaction, rates of workers' compensation claims, and resident satisfaction. Facilities in the better-performing cluster were found to have better patient care outcomes and resident satisfaction; lower rates of workers compensation claims; better SRHP performance; higher employee retention; and greater worker job satisfaction and engagement. The observed clustered relationships support the utility of integrated performance assessment in long-term care facilities.

Organizational performance impacting patient satisfaction in Ontario hospitals: a multilevel analysis

PubMed Central

2013-01-01

Background Patient satisfaction in health care constitutes an important component of organizational performance in the hospital setting. Satisfaction measures have been developed and used to evaluate and improve hospital performance, quality of care and physician practice. In order to direct improvement strategies, it is necessary to evaluate both individual and organizational factors that can impact patients’ perception of care. The study aims were to determine the dimensions of patient satisfaction, and to analyze the individual and organizational determinants of satisfaction dimensions in hospitals. Methods We used patient and hospital survey data as well as administrative data collected for a 2008 public hospital report in Ontario, Canada. We evaluated the clustering of patient survey items with exploratory factor analysis and derived plausible dimensions of satisfaction. A two-level multivariate model was fitted to analyze the determinants of satisfaction. Results We found eight satisfaction factors, with acceptable to good level of loadings and good reliability. More than 95% of variation in patient satisfaction scores was attributable to patient-level variation, with less than 5% attributable to hospital-level variation. The hierarchical models explain 5 to 17% of variation at the patient level and up to 52% of variation between hospitals. Individual patient characteristics had the strongest association with all dimensions of satisfaction. Few organizational performance indicators are associated with patient satisfaction and significant determinants differ according to the satisfaction dimension. Conclusions The research findings highlight the importance of adjusting for both patient-level and organization-level characteristics when evaluating patient satisfaction. Better understanding and measurement of organization-level activities and processes associated with patient satisfaction could contribute to improved satisfaction ratings and care quality. PMID:24304888

Overload, and Cutbacks, and Freezes, Oh My! The Relative Effects of the Recession-Related Stressors on Employee Strain and Job Satisfaction.

PubMed

Jones, Morgan D; Sliter, Michael; Sinclair, Robert R

2016-12-01

Across the globe, economic fluctuations have taken their toll on both organizations and employees, particularly during sustained recessions. Surprisingly, little research, however, has directly investigated the effects of recessions on employees. As such, the goal of the current study was to investigate the effects of specific recession-related stressors on employee outcomes (strain and satisfaction). We investigated an archival data set of 7666 individuals collected as part of the Workplace Employment Relations Study for relations among recession-related stressors with strain and job satisfaction variables. We found that recession-related stressors were significantly related to both strain and satisfaction. More specifically, certain recession-related stressors (e.g. increased workload and reorganization of work) were more strongly related to strain and satisfaction than others. These results imply the need for greater attention to stress management strategies aimed at helping both employees and their organizations cope with the human costs of economic recessions. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Job satisfaction among recent graduates of schools of nursing.

PubMed

Munro, B H

1983-01-01

Using a randomly selected national sample and multiple regression analysis, the correlates of job satisfaction among recent graduates of nursing programs were investigated. Factor analysis was used to test the validity of Herzberg's theory of job satisfaction/dissatisfaction. For these 329 employed RNs, responsibility (the importance and challenge of the work) was the most important determinant of job satisfaction, and working conditions was the second strongest predictor. Graduates from diploma, associate degree, and baccalaureate programs did not differ in terms of job satisfaction. Support was given for the validity of Herzberg's dual-factor theory in relation to all five motivators included in the analysis (achievement, work itself, responsibility, advancement, and growth) and for the hygiene salary. The validity of four other hygienes (supervision, working conditions, status, and security) was not established. The results imply that administrators need to appeal to nurses' needs for important challenging jobs and opportunities to grow and develop professionally.

Job Satisfaction among Health-Care Staff in Township Health Centers in Rural China: Results from a Latent Class Analysis.

PubMed

Wang, Haipeng; Tang, Chengxiang; Zhao, Shichao; Meng, Qingyue; Liu, Xiaoyun

2017-09-22

Background : The lower job satisfaction of health-care staff will lead to more brain drain, worse work performance, and poorer health-care outcomes. The aim of this study was to identify patterns of job satisfaction among health-care staff in rural China, and to investigate the association between the latent clusters and health-care staff's personal and professional features; Methods : We selected 12 items of five-point Likert scale questions to measure job satisfaction. A latent-class analysis was performed to identify subgroups based on the items of job satisfaction; Results : Four latent classes of job satisfaction were identified: 8.9% had high job satisfaction, belonging to "satisfied class"; 38.2% had low job satisfaction, named as "unsatisfied class"; 30.5% were categorized into "unsatisfied class with the exception of interpersonal relationships"; 22.4% were identified as "pseudo-satisfied class", only satisfied with management-oriented items. Low job satisfaction was associated with specialty, training opportunity, and income inequality. Conclusions : The minority of health-care staff belong to the "satisfied class". Three among four subgroups are not satisfied with income, benefit, training, and career development. Targeting policy interventions should be implemented to improve the items of job satisfaction based on the patterns and health-care staff's features.

FLOW (finding lasting options for women)

PubMed Central

Howard, Courtney; Rose, Caren Lee; Trouton, Konia; Stamm, Holly; Marentette, Danielle; Kirkpatrick, Nicole; Karalic, Sanja; Fernandez, Renee; Paget, Julie

2011-01-01

Abstract Objective To determine whether menstrual cups are a viable alternative to tampons. Design Randomized controlled trial. Setting Prince George, Victoria, and Vancouver, BC. Participants A total of 110 women aged 19 to 40 years who had previously used tampons as their main method of menstrual management. Intervention Participants were randomized into 2 groups, a tampon group and a menstrual cup group. Using online diaries, participants tracked 1 menstrual cycle using their regular method and 3 menstrual cycles using the method of their allocated group. Main outcome measures Overall satisfaction; secondary outcomes included discomfort, urovaginal infection, cost, and waste. Results Forty-seven women in each group completed the final survey, 5 of whom were subsequently excluded from analysis (3 from the tampon group and 2 from the menstrual cup group). Overall satisfaction on a 7-point Likert scale was higher for the menstrual cup group than for the tampon group (mean [standard deviation] score 5.4 [1.5] vs 5.0 [1.0], respectively; P = .04). Approximately 91% of women in the menstrual cup group said they would continue to use the cup and recommend it to others. Women used a median of 13 menstrual products per cycle, or 169 products per year, which corresponds to approximately 771 248 400 products used annually in Canada. Estimated cost for tampon use was $37.44 a year (similar to the retail cost of 1 menstrual cup). Subjective vaginal discomfort was initially higher in the menstrual cup group, but the discomfort decreased with continued use. There was no significant difference in physician-diagnosed urovaginal symptoms between the 2 groups. Conclusion Both of the menstrual management methods evaluated were well tolerated by subjects. Menstrual cups are a satisfactory alternative to tampons and have the potential to be a sustainable solution to menstrual management, with moderate cost savings and much-reduced environmental effects compared with tampons. Trial registration number C06-0478 (ClinicalTrials.gov). PMID:21673197

FLOW (finding lasting options for women): multicentre randomized controlled trial comparing tampons with menstrual cups.

PubMed

Howard, Courtney; Rose, Caren Lee; Trouton, Konia; Stamm, Holly; Marentette, Danielle; Kirkpatrick, Nicole; Karalic, Sanja; Fernandez, Renee; Paget, Julie

2011-06-01

To determine whether menstrual cups are a viable alternative to tampons. Randomized controlled trial. Prince George, Victoria, and Vancouver, BC. A total of 110 women aged 19 to 40 years who had previously used tampons as their main method of menstrual management. Participants were randomized into 2 groups, a tampon group and a menstrual cup group. Using online diaries, participants tracked 1 menstrual cycle using their regular method and 3 menstrual cycles using the method of their allocated group. Overall satisfaction; secondary outcomes included discomfort, urovaginal infection, cost, and waste. Forty-seven women in each group completed the final survey, 5 of whom were subsequently excluded from analysis (3 from the tampon group and 2 from the menstrual cup group). Overall satisfaction on a 7-point Likert scale was higher for the menstrual cup group than for the tampon group (mean [standard deviation] score 5.4 [1.5] vs 5.0 [1.0], respectively; P=.04). Approximately 91% of women in the menstrual cup group said they would continue to use the cup and recommend it to others. Women used a median of 13 menstrual products per cycle, or 169 products per year, which corresponds to approximately 771,248,400 products used annually in Canada. Estimated cost for tampon use was $37.44 a year (similar to the retail cost of 1 menstrual cup). Subjective vaginal discomfort was initially higher in the menstrual cup group, but the discomfort decreased with continued use. There was no significant difference in physician-diagnosed urovaginal symptoms between the 2 groups. Both of the menstrual management methods evaluated were well tolerated by subjects. Menstrual cups are a satisfactory alternative to tampons and have the potential to be a sustainable solution to menstrual management, with moderate cost savings and much-reduced environmental effects compared with tampons. Trial registration number C06-0478 (ClinicalTrials.gov).

Evaluation of a low-cost, 3D-printed model for bronchoscopy training.

PubMed

Parotto, Matteo; Jiansen, Joshua Qua; AboTaiban, Ahmed; Ioukhova, Svetlana; Agzamov, Alisher; Cooper, Richard; O'Leary, Gerald; Meineri, Massimiliano

2017-01-01

Flexible bronchoscopy is a fundamental procedure in anaesthesia and critical care medicine. Although learning this procedure is a complex task, the use of simulation-based training provides significant advantages, such as enhanced patient safety. Access to bronchoscopy simulators may be limited in low-resource settings. We have developed a low-cost 3D-printed bronchoscopy training model. A parametric airway model was obtained from an online medical model repository and fabricated using a low-cost 3D printer. The participating physicians had no prior bronchoscopy experience. Participants received a 30-minute lecture on flexible bronchoscopy and were administered a 15-item pre-test questionnaire on bronchoscopy. Afterwards, participants were instructed to perform a series of predetermined bronchoscopy tasks on the 3D printed simulator on 4 consecutive occasions. The time needed to perform the tasks and the quality of task performance (identification of bronchial anatomy, technique, dexterity, lack of trauma) were recorded. Upon completion of the simulator tests, participants were administered the 15-item questionnaire (post-test) once again. Participant satisfaction data on the perceived usefulness and accuracy of the 3D model were collected. A statistical analysis was performed using the t-test. Data are reported as mean values (± standard deviation). The time needed to complete all tasks was 152.9 ± 71.5 sec on the 1st attempt vs. 98.7 ± 40.3 sec on the 4th attempt (P = 0.03). Likewise, the quality of performance score improved from 8.3 ± 6.7 to 18.2 ± 2.5 (P < 0.0001). The average number of correct answers in the questionnaire was 6.8 ± 1.9 pre-test and 13.3 ± 3.1 post-test (P < 0.0001). Participants reported a high level of satisfaction with the perceived usefulness and accuracy of the model. We developed a 3D-printed model for bronchoscopy training. This model improved trainee performance and may represent a valid, low-cost bronchoscopy training tool.

Evaluating the Effect of Margin Consensus Guideline Publication on Operative Patterns and Financial Impact of Breast Cancer Operation.

PubMed

Bhutiani, Neal; Mercer, Megan K; Bachman, Katelynn C; Heidrich, Samantha R; Martin, Robert C G; Scoggins, Charles R; McMasters, Kelly M; Ajkay, Nicolás

2018-02-09

This study sought to evaluate re-excision rates, patient satisfaction with their breasts, and healthcare costs before and after publication of 2014 Society of Surgical Oncology/American Society of Radiation Oncology consensus guideline on margins for breast conserving operation with whole-breast irradiation for stage I and II breast cancer at an academic institution. Patients with stage I and II invasive carcinomas who underwent partial mastectomy were divided into 2 groups based on whether they were treated before (PRE) or after (POST) guideline publication in March 2014. Groups were compared with respect to re-excision rates, conversion to mastectomy, specimen volumes, mean cost per patient of surgical care, and prospectively collected patient post-procedure quality of life. A total of 237 patients who underwent partial mastectomy were examined (n = 126 in the PRE group and n = 111 in the POST group). Patients in the POST group were less likely to require re-excision (9% POST vs 37% PRE; p < 0.001) and were less likely to undergo conversion to mastectomy (5% POST vs 14% PRE; p = 0.02). After consensus guideline publication, mean operative cost per patient decreased ($4,874 POST vs $5,772 PRE; p < 0.001), and patients had improved breast quality of life scores (77 out of 100 POST vs 61 out of 100 PRE; p = 0.03). On multivariable analysis, publication of the consensus statement was an independent predictor of decreased re-excision rates (odds ratio 0.17; 95% CI 0.08 to 0.38; p < 0.001) and operative cost per patient (odds ratio 0.14; 95% CI 0.78 to 0.30; p < 0.001). Widespread implementation of the consensus guideline on margins for breast conserving operation will likely lead to the intended improvements in operative and financial outcomes, as well as patient satisfaction with breast conserving operation. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Intrinsic Satisfactions from Academic Versus Other Professional Work: A Comparative Analysis. ASHE Annual Meeting 1981 Paper.

ERIC Educational Resources Information Center

Bess, James L.

Recent theories of professional work satisfaction are reviewed and applied to the college or university professor. Additionally, the professional satisfactions available to the academic person are compared with those of professionals in other occupations. The following theories of job satisfaction are examined: job facets theory, expectancy…

Understanding and Promoting Birth Satisfaction in New Mothers.

PubMed

Hinic, Katherine

The purpose of this study was to examine the impact of select maternal psychosocial and experiential factors on birth satisfaction of new mothers during early postpartum. This is a descriptive correlational study exploring the relationships among birth satisfaction, breastfeeding self-efficacy, and perceived stress in 107 new mothers in the first 4 days postpartum. Instruments used included the Birth Satisfaction Scale-Revised, the Perceived Stress Scale, the Breastfeeding Self-Efficacy Scale-Short Form, and a researcher-generated demographic form. Quantitative analysis included descriptive statistics, correlation, one-way Analysis of Variance, and multiple linear regression. Birth satisfaction was negatively correlated with perceived stress (r = -.299, p < .05) and positively correlated with feeling prepared for birth (rho = .243, p < .05) and breastfeeding self-efficacy (r = .226, p < .05). The predictive model for birth satisfaction was significant (R = .204, F [6, 99] = 4.225, p = .001), explaining approximately 20.4% of variance in birth satisfaction in the sample. Stress reduction and management, establishment of realistic expectations for labor and birth, and promotion of togetherness with newborn immediately after birth are nursing priorities to promote birth satisfaction.

Job satisfaction and intention to quit: an empirical analysis of nurses in Turkey

PubMed Central

Azad, Md. Abul Kalam; Hoque, Kazi Enamul; Beh, Loo-See; Wanke, Peter; Arslan, Özgün

2016-01-01

The aim of this study was to identify the facets influencing job satisfaction and intention to quit of nurses employed in Turkey. Using a non-probability sampling technique, 417 nurses from six large private hospitals were surveyed from March 2014 to June 2014. The nurses’ demographic data, their job-related satisfaction and turnover intentions were recorded through a self-administered questionnaire. In this study, descriptive and bivariate analyses were used to explore data, and multivariate analysis was performed using logistic regression. Nurses’ job satisfaction was found at a moderate level with 61% of the nurses intended to quit. Nevertheless, nurses reported a high satisfaction level with work environment, supervisor support, and co-workers among the selected nine facets of job satisfaction. They also reported a low satisfaction level with contingent reward, fringe benefits, and pay. The impact of demographic characteristics on job satisfaction and intention to quit was also examined. The study revealed a negative relationship between job satisfaction and intention to quit the existing employment. Moreover, satisfaction with supervisor support was the only facet that significantly explained turnover intent when controlling for gender, age, marital status, education, and experience. The implications for nurse management were also described for increasing nurses’ job satisfaction and retention. This study is beneficial for hospital management to ensure proper nursing care that would lead to a better quality healthcare service. PMID:27168960

Job satisfaction and intention to quit: an empirical analysis of nurses in Turkey.

PubMed

Masum, Abdul Kadar Muhammad; Azad, Md Abul Kalam; Hoque, Kazi Enamul; Beh, Loo-See; Wanke, Peter; Arslan, Özgün

2016-01-01

The aim of this study was to identify the facets influencing job satisfaction and intention to quit of nurses employed in Turkey. Using a non-probability sampling technique, 417 nurses from six large private hospitals were surveyed from March 2014 to June 2014. The nurses' demographic data, their job-related satisfaction and turnover intentions were recorded through a self-administered questionnaire. In this study, descriptive and bivariate analyses were used to explore data, and multivariate analysis was performed using logistic regression. Nurses' job satisfaction was found at a moderate level with 61% of the nurses intended to quit. Nevertheless, nurses reported a high satisfaction level with work environment, supervisor support, and co-workers among the selected nine facets of job satisfaction. They also reported a low satisfaction level with contingent reward, fringe benefits, and pay. The impact of demographic characteristics on job satisfaction and intention to quit was also examined. The study revealed a negative relationship between job satisfaction and intention to quit the existing employment. Moreover, satisfaction with supervisor support was the only facet that significantly explained turnover intent when controlling for gender, age, marital status, education, and experience. The implications for nurse management were also described for increasing nurses' job satisfaction and retention. This study is beneficial for hospital management to ensure proper nursing care that would lead to a better quality healthcare service.

Reduce costs and improve patient satisfaction with home pre-operative bowel preparations.

PubMed

Hearn, K; Dailey, M; Harris, M T; Bodian, C

2000-01-01

The results of a home-based preoperative bowel preparation, with and without the support of home care services, are compared with hospital-based preoperative bowel preparation. Length of stay, morbidity, and mortality rates; issues of patient satisfaction; and demographics are reported. The method and tools used in planning, implementing, and evaluating the home preoperative bowel preparation program are also shared. Other issues discussed are the healthcare market forces that promote an increased value of care. Economic and patient satisfaction considerations by employers, payers, and patients; the increasing influence of patient choice on healthcare provider selection and care setting preferences; the nursing workforce issues related to the impending shortage; and issues of regulatory and accrediting agencies are also discussed.

Easing the Policy Environments of Small Schools and Schools-within-Schools: Lessons from Six Cities. Policy Brief.

ERIC Educational Resources Information Center

AEL, Inc., Charleston, WV.

Research shows that small schools and schools within schools can yield positive outcomes for students and improved satisfaction and effectiveness among school staff. Small schools can be less costly than larger ones if judged by expenditure per graduate instead of cost per pupil enrolled. Examination of the policy environments of urban schools in…

Making Politics "Click": The Costs and Benefits of Using Clickers in an Introductory Political Science Course

ERIC Educational Resources Information Center

Evans, Heather K.

2012-01-01

In this article, the author addresses both the costs and benefits of implementing clickers into an introductory political science course. Comparing student responses to a mid-semester survey in both a clicker and non-clicker course, the results show that students have higher satisfaction of the course and instructor, higher exam scores, and feel…

48 CFR 1352.213-70 - Evaluation utilizing simplified acquisition procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... services, cost management, communications between contracting parties, proactive management and customer satisfaction. (4) Price. (End of clause) [75 FR 10570, Mar. 8, 2010; 75 FR 14496, Mar. 26, 2010] ...

Optimizing Skin and Skin Structure Infection Outcomes: Considerations of Cost of Care.

PubMed

Almarzoky Abuhussain, S S; Goodlet, K J; Nailor, M D; Nicolau, D P

2018-03-09

Skin and skin structure infections (SSSIs) refer to a collection of clinical infectious syndromes involving layers of skin and associated soft tissues. Although associated with less morbidity and mortality than other common skin infections, SSSIs represent a significant increasing source of healthcare expense, with a prevalence of 500 episodes per 10,000 patient-years in the United States resulting in burdening health care systems, of approximately $6 billion annually. Areas covered: Opportunities to reduce costs of care associated with SSSI are highlighted, including transitions of care and avoiding unnecessary hospital admissions. Moreover, we reviewed new antibiotics (e.g. single dose glycopeptides), and the impact of consulting specialists in the emergency department on SSSI treatment outcomes. Expert commentary: New healthcare models and payment strategies combined with new therapeutics are challenging norms of care. Newer drugs to treat skin infections can move a substantive percent of patients previously admitted to hospital care to the outpatient setting. Additionally, patients can be managed with oral or one time intravenous regimens, improving the likelihood of patient adherence and satisfaction. These variables need to be weighed against added acquisition costs and the development of thoughtful algorithms is needed to direct care and optimize treatment, cost, and patient satisfaction.

The impact of a nursing transitions programme on retention and cost savings.

PubMed

Hillman, Lynne; Foster, Rhonda R

2011-01-01

To identify the benefits and essential elements of a new graduate residency programme. Retention of nurses is a global nursing concern. New graduate nurses have the lowest retention rates and, therefore, the present study focused on the unique needs of this group. Valid and reliable tools were utilized to evaluate work satisfaction, clinical decision making, organizational commitment and skill development during and after each residency. We also compared resident retention and associated cost savings. The adoption and implementation of the residency programme represented a change in culture. Hiring and education practices for new nurses changed dramatically. Before the development of a new graduate transition programme, our 1-year retention rate was as low as 50%. Five years after programme adoption, retention increased to 72.5%, resulting in major cost savings to the organization.   Nursing Management must be creative and transformational in their thinking in order to address nursing retention. Implications for nurse managers who are considering residency programmes include the potential for significant cost savings for the hospital, increased resident, nursing and unit satisfaction and a demand for nurses who desire to work at their hospitals. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

Evaluation of medical staff and patient satisfaction of Chinese hospitals and measures for improvement.

PubMed

Li, Min; Huang, Chengyu; Lu, Xiangchan; Chen, Siyuan; Zhao, Pan; Lu, Hongzhou

2015-06-01

Our goal is to establish criteria for evaluating satisfaction of medical staff and patients of Chinese hospitals and propose measures for improvement. A survey was conducted among medical staff and patients of infectious disease hospitals in three locations, i.e., Shanghai, Chongqing, and Nanning. The analyses included item analysis, factor analysis, reliability analysis, Pearson correlation and one-way analysis of variance. For the patient group, Kaiser-Meyer-Olkin (KMO) = 0.973, Cronbach's α = 0.962 and the Pearson correlation coefficients among the five dimensions of satisfaction ranged from 0.583 to 0.795. For the medical staff group, KMO = 0.972, Cronbach's α = 0.970, and the Pearson correlation coefficients among the five dimensions of satisfaction ranged from 0.603 to 0.854. The means on the five dimensions of satisfaction for the patient group were 0.74 to 1.34, 0.81 to 1.17, 0.78 to 1.07, 0.89 to 1.34, and 0.71 to 1.10. The means on the five dimensions of satisfaction for the medical staff group were 0.17 to 1.03, ‒ 0.16 to 0.60, ‒ 0.18 to 0.74, 0.23 to 0.72, and ‒ 0.39 to 0.37. The clinicians were less satisfied with the hospitals than the patients. Medical staff and patients in Shanghai were relatively more satisfied. Improving the evaluation criteria and survey methods with respect to medical staff and patient satisfaction with Chinese hospitals may increase clinician and patient satisfaction and improve the health care environment in China.

Personal Factors that Affect the Satisfaction of Female Patients Undergoing Esthetic Suture after Typical Thyroidectomy.

PubMed

Kim, Hyo Young; Kim, Jung Won; Park, Jin Hyung; Kim, Jung Hun; Han, Yea Sik

2013-07-01

In esthetic surgery, understanding the factors that influence patient satisfaction is important for successful practice. We hypothesize that the factors that influence patient satisfaction include not only aesthetic and functional outcomes, but also personal factors such as the level of familiarity with factors affecting wound healing and expectations regarding aesthetic outcome. One hundred patients who underwent esthetic closure after thyroidectomy were included in this study. In order to evaluate the individual characteristics of the patients, a preoperative survey was administered to the patients. We estimated the patient satisfaction six months postoperatively and assessed the aesthetic and functional outcomes using the Patient and Observer Scar Assessment Scale. According to the results of correlation analysis, level of familiarity with wound healing factors had a positive correlation with satisfaction. High expectations, pain, itching, and high observer scale score had negative correlations with satisfaction. The factors that were correlated with satisfaction were included in the multiple regression analysis. Level of familiarity with wound healing factors was found to have a positive relationship with satisfaction, while itching and observer scale were found to have a negative relationship with satisfaction. After excluding 10 patients who had hypertrophic scars, only level of familiarity with wound healing factors and expectations affected satisfaction. The level of familiarity with factors affecting wound healing and expectations were found to independently affect satisfaction. Improving patients' level of familiarity with wound healing factors and reducing their expectations by providing suitable preoperative education has the potential to improve patient satisfaction.

The Job Satisfaction of Finnish Nursing Staff: The Development of a Job Satisfaction Scale and Survey Results

PubMed Central

Kvist, Tarja; Mäntynen, Raija; Partanen, Pirjo; Turunen, Hannele; Miettinen, Merja; Vehviläinen-Julkunen, Katri

2012-01-01

This paper describes the development of the Kuopio University Hospital Job Satisfaction Scale (KUHJSS) and the results of the survey. The scale was developed through a systematic literature review, and its validity and reliability were assessed using several psychometric properties including expert evaluation (n = 5), a pilot survey (n = 172), and exploratory factor analysis. The final version of KUHJSS included 37 items. A large sample psychometric evaluation was made by nursing staff (n = 2708). The exploratory factor analysis revealed seven factors with modest internal consistency (0.64–0.92). The staff reported relatively high job satisfaction. The greatest satisfaction was derived from motivating factors associated with the work; the least, from the job's demands. Respondents who considered their working units to provide an excellent quality of care reported the highest job satisfaction in every subarea (P < .0001). The KUHJSS proved to be a reliable and valid tool for measuring job satisfaction in hospital care. PMID:23133750

Cost-effectiveness v patient preference in the choice of treatment for distal ureteral calculi: a literature-based decision analysis.

PubMed

Wolf, J S; Carroll, P R; Stoller, M L

1995-06-01

Ureteroscopy (URS) and extracorporeal shockwave lithotripsy (SWL) battle for supremacy in the management distal ureteral calculi. In order to clarify issues surrounding this controversy, we created a decision tree modeling URS or SWL with literature-based probabilities and used as endpoints both cost and patient preferences. Ureteroscopy was more successful than single-session or multiple-session SWL, 92.1% v 74.3% or 84.5%, and had a lower retreatment/complication rate. Although initial SWL was only slightly more expensive than URS, $4,420 v $4,337, the difference increased when the additional costs of complications and retreatment were calculated, $6,745 v $5,555. Using values for an "average" patient, SWL was preferred to URS in terms of patient satisfaction. The most important factors distinguishing between URS and SWL were the success of treatment, the cost of initial therapy, and patient attitudes toward unplanned ancillary procedures and retreatment. Although no alteration of success rates and cost figures within reasonable ranges made URS less cost-effective than SWL, individual differences in patients' aversion for complications allowed URS to be preferred to SWL in some situations. Therefore, SWL is less cost-effective than URS and is not necessarily preferred by patients. The physician should be aware of the principal determinants of the choice between URS and SWL treatment of distal ureteral calculi.

Investigation of marital satisfaction and its relationship with job stress and general health of nurses in Qazvin, Iran

PubMed Central

Azimian, Jalil; Piran, Pegah; Jahanihashemi, Hassan; Dehghankar, Leila

2017-01-01

Background Pressures in nursing can affect family life and marital problems, disrupt common social problems, increase work-family conflicts and endanger people’s general health. Aim To determine marital satisfaction and its relationship with job stress and general health of nurses. Methods This descriptive and cross-sectional study was done in 2015 in medical educational centers of Qazvin by using an ENRICH marital satisfaction scale and General Health and Job Stress questionnaires completed by 123 nurses. Analysis was done by SPSS version 19 using descriptive and analytical statistics (Pearson correlation, t-test, ANOVA, Chi-square, regression line, multiple regression analysis). Results The findings showed that 64.4% of nurses had marital satisfaction. There was significant relationship between age (p=0.03), job experience (p=0.01), age of spouse (p=0.01) and marital satisfaction. The results showed that there was a significant relationship between marital satisfaction and general health (p<0.0001). Multiple regression analysis showed that there was a significant relationship between depression (p=0.012) and anxiety (p=0.001) with marital satisfaction. Conclusions Due to high levels of job stress and disorder in general health of nurses and low marital satisfaction by running health promotion programs and paying attention to its dimensions can help work and family health of nurses. PMID:28607660

Ageing, Health and Life Satisfaction of the Oldest Old: An Analysis for Germany

ERIC Educational Resources Information Center

Gwozdz, Wencke; Sousa-Poza, Alfonso

2010-01-01

This analysis uses data from the German Socio-Economic Panel and the Survey on Health, Ageing and Retirement in Europe to assess the effect of ageing and health on the life satisfaction of the oldest old (defined as 75 and older). We observe a U-shaped relationship between age and levels of life satisfaction for individuals aged between 16 and 65.…

The role of home-based information and communications technology interventions in chronic disease management: a systematic literature review.

PubMed

Gaikwad, Rekha; Warren, Jim

2009-06-01

This article presents a systematic literature review done to evaluate the feasibility and benefits of home-based information and communications technology enabled interventions for chronic disease management, with emphasis on their impact on health outcomes and costs. Relevant articles were retrieved from PubMed and evaluated using quality worksheets with pre-identified inclusion and exclusion criteria. Of the 256 articles retrieved, 27 were found to concord with the study criteria. Evaluation of the identified articles was conducted irrespective of study design, type of home-based intervention or chronic disease involved. The review demonstrates that HBIs applied to chronic disease management improve functional and cognitive patient outcomes and reduce healthcare spending. However, further research is needed to assess benefit in terms of evidence-based outcome indicators (that can provide a basis for meta-analysis), to confirm sustainable cost benefits, and to systematically collect data on physician satisfaction with patient management.

How critical cost analysis can save money in today’s NHS: a review of carpal tunnel surgery in a district general hospital

PubMed Central

Williamson, Mark; Sehjal, Ranjit; Jones, Mark; James, Chris; Smith, Andrew

2018-01-01

With today’s National Health Service (NHS) facing huge financial pressures the healthcare profession cannot afford to carry on spending at the current rate. Individual clinicians should be encouraged to critically appraise their own practices to bring about a more efficient and cost-effective service. The purpose of this project was to analyse the way that carpal tunnel surgery was being performed within our institution and bring about safe changes to practice that reduce expenditure. By critiquing our practices and applying simple changes based around sound evidence an annual saving of over £15 500 to the department was made. The changes instigated are simple, sustainable and safe to implement while providing improved patient satisfaction. They are also easily transferrable across institutions and to other minor hand surgical procedures to afford even greater ongoing savings to the NHS. PMID:29946571

Making the Right Treatment Decision Requires Consideration of Utility and Reconsideration of Value.

PubMed

Rossi, Michael J; Lubowitz, James H; Brand, Jefferson C; Provencher, Matthew T

2017-02-01

To achieve a good clinical outcome, arthroscopic and related surgeons must choose the proper treatment, and the basis of this choice is accurate diagnosis. Generally, our clinical focus is on outcome, but outcome is achieved after the fact. While this seems obvious, arthroscopic and related surgeons-and our patients who participate in shared decision making-evaluate the utility, or usefulness, of potential treatments based on desired and expected benefits versus potential risks. Today, cost is frequently considered as a determinant of value in medicine and may be applied to the decision analysis, but if an individual patient perceives health to be priceless, cost becomes irrelevant. In the end, an individual patient's satisfaction is determined on a case-by-case basis. Proper choice of treatment cannot be formulaic. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

How critical cost analysis can save money in today's NHS: a review of carpal tunnel surgery in a district general hospital.

PubMed

Williamson, Mark; Sehjal, Ranjit; Jones, Mark; James, Chris; Smith, Andrew

2018-01-01

With today's National Health Service (NHS) facing huge financial pressures the healthcare profession cannot afford to carry on spending at the current rate. Individual clinicians should be encouraged to critically appraise their own practices to bring about a more efficient and cost-effective service. The purpose of this project was to analyse the way that carpal tunnel surgery was being performed within our institution and bring about safe changes to practice that reduce expenditure. By critiquing our practices and applying simple changes based around sound evidence an annual saving of over £15 500 to the department was made. The changes instigated are simple, sustainable and safe to implement while providing improved patient satisfaction. They are also easily transferrable across institutions and to other minor hand surgical procedures to afford even greater ongoing savings to the NHS.

Achilles tenotomy as an office procedure and current practising trends among New Zealand orthopaedic surgeons.

PubMed

Agius, Lewis; Wickham, Angus; Walker, Cameron; Knudsen, Joshua

2018-05-18

Percutaneous Achilles tenotomy (PAT) is performed during the final phase of casting with Ponseti method. Several settings have been proposed as venues for this procedure, however it is increasingly being performed in theatre under a general anaesthetic (GA). General anaesthesia, however, is expensive and not without risks. The purpose of the present study was to compare results of outpatient releases to theatre releases, and assess current practising trends among orthopaedic surgeons. Retrospective comparison of patients with idiopathic clubfoot managed by Ponseti method who had Achilles tenotomy performed in outpatient clinic and in theatre. Surveys were sent to all POSNZ members to determine current practising trends in New Zealand. Parental satisfaction surveys were performed. Comparative cost analysis was performed using hospital billing information. The current study includes 64 idiopathic congenital clubfeet (19 bilateral cases). PAT was performed on 26 clubfeet under local anaesthetic in an outpatient setting, and 33 clubfeet under GA in a theatre setting. There was no significant difference for post-operative complications, or recurrence (p=0.67). Those in theatre group were exposed to a greater number of general anaesthetics before the age of four. Among practising New Zealand paediatric orthopaedic surgeons, 77.78% perform this in theatre under general anaesthesia, while only 22.22% perform PAT in outpatient clinic. The main barriers included concerns regarding pain control, concerns regarding incomplete release, concerns regarding distress to family and concerns regarding sterility. Parental satisfaction surveys found pain management to be excellent. Financial data was analysed and indicative costs were $6,061 NZD per procedure in theatre, compared to $378 NZD per procedure in clinic. PAT performed in a clinic setting is both safe and efficacious with results comparative to that performed in theatre. There was no difference in post-operative complications or recurrence. Parental satisfaction to this procedure is excellent. There are significant financial advantages. Based on this data, our institution now performs all releases in an outpatient setting.

The Asheville Project: short-term outcomes of a community pharmacy diabetes care program.

PubMed

Cranor, Carole W; Christensen, Dale B

2003-01-01

To assess short-term clinical, economic, and humanistic outcomes of pharmaceutical care services (PCS) for patients with diabetes in community pharmacies. Intention-to-treat, pre-post cohort-with-comparison group study. Twelve community pharmacies in Asheville, N.C. Eighty-five patients with diabetes who were employees, dependents, or retirees from two self-insured employers; community pharmacists who completed a diabetes certificate program and received reimbursement for PCS. Patients scheduled consultations with pharmacists over 7 to 9 months. Pharmacists provided education, self-monitored blood glucose (SMBG) meter training, clinical assessment, patient monitoring, follow-up, and referral. Group 1 patients began receiving PCS in March 1997, and group 2 patients began in March 1999. Change from baseline in the two employer groups in glycosylated hemoglobin (A1c) values, serum lipid concentrations, health-related quality of life (HRQOL), satisfaction with pharmacy services, and health care utilization and costs. Patients used SMBG meters at home, stored all readings, and brought their meters with them to 87% of the 317 PCS visits (3.7 visits per patient). Patients' A1c concentrations were significantly reduced, and their satisfaction with pharmacy services improved significantly. Patients experienced no change in HRQOL. From the payers' perspective, there was a significant dollars 52 per patient per month increase in diabetes costs for both groups, with PCS fees and diabetes prescriptions accounting for most of the increase. In contrast, both groups experienced a nonsignificant but economically important 29% decrease in nondiabetes costs and a 16% decrease in all-diagnosis costs. A clear temporal relationship was found between PCS and improved A1c, improved patient satisfaction with pharmacy services, and decreased all-diagnosis costs. Findings from this study demonstrate that pharmacists provided effective cognitive services and refute the idea that pharmacists must be certified diabetes educators to help patients with diabetes improve clinical outcomes.

Impact of a colorectal enhanced recovery program implementation on clinical outcomes and institutional costs: A prospective cohort study with retrospective control.

PubMed

Portinari, Mattia; Ascanelli, Simona; Targa, Simone; Dos Santos Valgode, Elisabete Maria; Bonvento, Barbara; Vagnoni, Emidia; Camerani, Stefano; Verri, Marco; Volta, Carlo Alberto; Feo, Carlo V

2018-05-01

The enhanced recovery program for perioperative care of the surgical patient reduces postoperative metabolic response and organ dysfunction, accelerating functional recovery. The aim of this study was to determine the impact on postoperative recovery and cost-effectiveness of implementing a colorectal enhanced recovery program in an Italian academic centre. A prospective series of consecutive patients (N = 100) undergoing elective colorectal resection completing a standardized enhanced recovery program in 2013-2015 (ERP group) was compared to patients (N = 100) operated at the same institution in 2010-2011 (Pre-ERP group) before introducing the program. The exclusion criteria were: >80 years old, ASA score of IV, a stage IV TNM, and diagnosis of inflammatory bowel disease. The primary outcome was hospital length of stay which was used as a proxy of functional recovery. Secondary outcomes included: postoperative complications, 30-day readmission and mortality, protocol adherence, nursing workload, cost-effectiveness, and factors predicting prolonged hospital stay. The ERP group patient satisfaction was also evaluated. Hospital stay was significantly reduced in the ERP versus the Pre-ERP group (4 versus 8 days) as well as nursing workload, with no increase in postoperative complications, 30-day readmission or mortality. ERP group protocol adherence (81%) and patient satisfaction were high. Conventional perioperative protocol was the only independent predictor of prolonged hospital stay. Total mean direct costs per patient were significantly higher in the Pre-ERP versus the ERP group (6796.76 versus 5339.05 euros). Implementing a colorectal enhanced recovery program is feasible, efficient for functional recovery and hospital stay reduction, safe, and cost-effective. High patient satisfaction and nursing workload reduction may also be expected, but high protocol adherence is necessary. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Mini-intervention for subacute low back pain: a randomized controlled trial.

PubMed

Karjalainen, Kaija; Malmivaara, Antti; Pohjolainen, Timo; Hurri, Heikki; Mutanen, Pertti; Rissanen, Pekka; Pahkajärvi, Helena; Levon, Heikki; Karpoff, Hanna; Roine, Risto

2003-03-15

Randomized controlled trial. To investigate the effectiveness and costs of a mini-intervention, provided in addition to the usual care, and the incremental effect of a work site visit for patients with subacute disabling low back pain. There is lack of data on cost-effectiveness of brief interventions for patients with prolonged low back pain. A total of 164 patients with subacute low back pain were randomized to a mini-intervention group (A), a work site visit group (B), or a usual care group (C). Groups A (n = 56) and B (n = 51) underwent one assessment by a physician plus a physiotherapist. Group B received a work site visit in addition. Group C served as controls (n = 57) and was treated in municipal primary health care. All patients received a leaflet on back pain. Pain, disability, specific and generic health-related quality of life, satisfaction with care, days on sick leave, and use and costs of health care consumption were measured at 3-, 6-, and 12-month follow-ups. During follow-up, fewer subjects had daily pain in Groups A and B than in Group C (Group A Group C, = 0.002; Group B Group C, = 0.030). In Group A, pain was less bothersome (Group A Group C, = 0.032) and interfered less with daily life (Group A Group C, = 0.040) than among controls. Average days on sick leave were 19 in Group A, 28 in Group B, and 41 in Group C (Group A Group C, = 0.019). Treatment satisfaction was better in the intervention groups than among the controls, and costs were lowest in the mini-intervention group. Mini-intervention reduced daily back pain symptoms and sickness absence, improved adaptation to pain and patient satisfaction among patients with subacute low back pain, without increasing health care costs. A work site visit did not increase effectiveness.

Evaluation of job satisfaction and working atmosphere of dental nurses in Germany.

PubMed

Goetz, Katja; Hasse, Philipp; Campbell, Stephen M; Berger, Sarah; Dörfer, Christof E; Hahn, Karolin; Szecsenyi, Joachim

2016-02-01

The purpose of the study was to assess the level of job satisfaction of dental nurses in ambulatory care and to explore the impact of aspects of working atmosphere on and their association with job satisfaction. This cross-sectional study was based on a job satisfaction survey. Data were collected from 612 dental nurses working in 106 dental care practices. Job satisfaction was measured with the 10-item Warr-Cook-Wall job satisfaction scale. Working atmosphere was measured with five items. Linear regression analyses were performed in which each item of the job satisfaction scale was handled as dependent variables. A stepwise linear regression analysis was performed with overall job satisfaction and the five items of working atmosphere, job satisfaction, and individual characteristics. The response rate was 88.3%. Dental nurses were satisfied with 'colleagues' and least satisfied with 'income.' Different aspects of job satisfaction were mostly associated with the following working atmosphere issues: 'responsibilities within the practice team are clear,' 'suggestions for improvement are taken seriously,' 'working atmosphere in the practice team is good,' and 'made easier to admit own mistakes.' Within the stepwise linear regression analysis, the aspect 'physical working condition' (β = 0.304) showed the highest association with overall job satisfaction. The total explained variance of the 14 associated variables was 0.722 with overall job satisfaction. Working atmosphere within this discrete sample of dental care practice seemed to be an important influence on reported working condition and job satisfaction for dental nurses. Because of the high association of job satisfaction with physical working condition, the importance of paying more attention to an ergonomic working position for dental nurses to ensure optimal quality of care is highlighted. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Patient satisfaction after pulmonary resection for lung cancer: a multicenter comparative analysis.

PubMed

Pompili, Cecilia; Brunelli, Alessandro; Rocco, Gaetano; Salvi, Rosario; Xiumé, Francesco; La Rocca, Antonello; Sabbatini, Armando; Martucci, Nicola

2013-01-01

Patient satisfaction reflects the perception of the customer about the level of quality of care received during the episode of hospitalization. To compare the levels of satisfaction of patients submitted to lung resection in two different thoracic surgical units. Prospective analysis of 280 consecutive patients submitted to pulmonary resection for neoplastic disease in two centers (center A: 139 patients; center B: 141 patients; 2009-2010). Patients' satisfaction was assessed at discharge through the EORTC-InPatSat32 module, a 32-item, multi-scale self-administered anonymous questionnaire. Each scale (ranging from 0 to 100 in score) was compared between the two units. Multivariable regression and bootstrap were used to verify factors associated with the patients' general satisfaction (dependent variable). Patients from unit B reported a higher general satisfaction (91.5 vs. 88.3, p = 0.04), mainly due to a significantly higher satisfaction in the doctor-related scales (doctors' technical skill: p = 0.001; doctors' interpersonal skill: p = 0.008; doctors' availability: p = 0.005, and doctors information provision: p = 0.0006). Multivariable regression analysis and bootstrap confirmed that level of care in unit B (p = 0.006, bootstrap frequency 60%) along with lower level of education of the patient population (p = 0.02, bootstrap frequency 62%) were independent factors associated with a higher general patient satisfaction. We were able to show a different level of patient satisfaction in patients operated on in two different thoracic surgery units. A reduced level of patient satisfaction may trigger changes in the management policy of individual units in order to meet patients' expectations and improve organizational efficiency. Copyright © 2012 S. Karger AG, Basel.

The Relationship between Social Capital in Hospitals and Physician Job Satisfaction

PubMed Central

Ommen, Oliver; Driller, Elke; Köhler, Thorsten; Kowalski, Christoph; Ernstmann, Nicole; Neumann, Melanie; Steffen, Petra; Pfaff, Holger

2009-01-01

Background Job satisfaction in the hospital is an important predictor for many significant management ratios. Acceptance in professional life or high workload are known as important predictors for job satisfaction. The influence of social capital in hospitals on job satisfaction within the health care system, however, remains to be determined. Thus, this article aimed at analysing the relationship between overall job satisfaction of physicians and social capital in hospitals. Methods The results of this study are based upon questionnaires sent by mail to 454 physicians working in the field of patient care in 4 different German hospitals in 2002. 277 clinicians responded to the poll, for a response rate of 61%. Analysis was performed using three linear regression models with physician overall job satisfaction as the dependent variable and age, gender, professional experience, workload, and social capital as independent variables. Results The first regression model explained nearly 9% of the variance of job satisfaction. Whereas job satisfaction increased slightly with age, gender and professional experience were not identified as significant factors to explain the variance. Setting up a second model with the addition of subjectively-perceived workload to the analysis, the explained variance increased to 18% and job satisfaction decreased significantly with increasing workload. The third model including social capital in hospital explained 36% of the variance with social capital, professional experience and workload as significant factors. Conclusion This analysis demonstrated that the social capital of an organisation, in addition to professional experience and workload, represents a significant predictor of overall job satisfaction of physicians working in the field of patient care. Trust, mutual understanding, shared aims, and ethical values are qualities of social capital that unify members of social networks and communities and enable them to act cooperatively. PMID:19445692

A meta-analysis of the variables related to job satisfaction among Korean nurses.

PubMed

Choi, So Eun; Kim, Sang Dol

2016-08-01

The shortage of nursing workforce has been a critical and global issue and associated with job satisfaction. To evaluate the strength of the relationships between job satisfaction and organizational commitment, job stress, and turnover intention among Korean nurses. Preferred Reporting Items for Systematic Reviews and Meta-Analyses; Korean Education & Research Information Service, KISS, DB pia, PubMed, and CINAHL databases were searched. The meta-analysis software package, R program (version 3.0.1), was used. Thirty-eight of 1245 screened studies had appropriate data. The overall relationships were high and significant, and increased organizational commitment (WES = .62), decreased turnover intention (WES = -.47), and decreased job stress (WES = -.37) were associated with job satisfaction. The strongest relationship was identified between organizational commitment and job satisfaction. These findings have important implications for improving organizational commitment to increase job satisfaction among nurses.

Rasch analysis of Stamps's Index of Work Satisfaction in nursing population.

PubMed

Ahmad, Nora; Oranye, Nelson Ositadimma; Danilov, Alyona

2017-01-01

One of the most commonly used tools for measuring job satisfaction in nursing is the Stamps Index of Work Satisfaction. Several studies have reported on the reliability of the Stamps' tool based on traditional statistical model. The aim of this study was to apply the Rasch model to examine the adequacy of Stamps's Index of Work Satisfaction for measuring nurses' job satisfaction cross-culturally and to determine the validity and reliability of the instrument using the Rasch criteria. A secondary data analysis was conducted on a sample of 556 registered nurses from two countries. The RUMM 2030 software was used to analyse the psychometric properties of the Index of Work Satisfaction. The persons mean location of -0.018 approximated the items mean of 0.00, suggesting a good alignment of the measure and the traits being measured. However, at the items level, some items were misfiting to the Rasch model.

Dimensionality of military job satisfaction items: an exploratory factor analysis of data from the spring 1996 Sample Survey of Military Personnel.

PubMed

Schumm, Walter R; Gade, Paul A; Bell, D Bruce

2003-06-01

The Sample Survey of Military Personnel in the spring of 1996 asked detailed questions of Army personnel about job satisfaction. Maximum likelihood factor analysis yielded four factors: satisfaction with supervision, with job environment, with the duty specifically, and with opportunity for development, factors similar to those used in Smith's Job Descriptive Index, 1992. Scales developed from these factors showed acceptable internal consistency reliability and correlated as expected with measures of satisfaction with Army life, retention, morale, combat preparedness, and overall job satisfaction. Some divergent validity was established with measures of personal/family stress and with previous job stress. Demographic data suggested that soldiers with higher education found more satisfying job opportunities while those with higher rank, more years of service, and higher age reported greater satisfaction with job fulfillment, perhaps a consequence of selection effects.

Academics Job Satisfaction and Job Stress across Countries in the Changing Academic Environments

ERIC Educational Resources Information Center

Shin, Jung Cheol; Jung, Jisun

2014-01-01

This study examined job satisfaction and job stress across 19 higher education systems. We classified the 19 countries according to their job satisfaction and job stress and applied regression analysis to test whether new public management has impacts on either or both job satisfaction and job stress. According to this study, strong market driven…

Administrative Staff Members' Job Competency and Their Job Satisfaction in a Korean Research University

ERIC Educational Resources Information Center

Jung, Jisun; Shin, Jung Cheol

2015-01-01

The purpose of this study is to explore the impact of administrative staff's job competency on their job satisfaction in a Korean research university. We conceptualized job satisfaction into three subcomponents: satisfaction in the job field, in the workplace, and with the actual task. In the regression analysis, we included demographics, inner…

A Meta-Analytic Examination of the Construct Validity of the Michigan Organizational Assessment Questionnaire Job Satisfaction Subscale

ERIC Educational Resources Information Center

Bowling, Nathan A.; Hammond, Gregory D.

2008-01-01

Although several different measures have been developed to assess job satisfaction, large-scale examinations of the psychometric properties of most satisfaction scales are generally lacking. In the current study we used meta-analysis to examine the construct validity of the Michigan Organizational Assessment Questionnaire Job Satisfaction Subscale…

Facility Management as Part of an Integrated Design of Civil Engineering Structures

NASA Astrophysics Data System (ADS)

Hyben, Ivan; Podmanický, Peter

2014-11-01

The present article deals about facility management, as still relatively young component of an integrated planning and design of buildings. Attention is focused on the area of the proposal, which can greatly affect to amount of future operating costs. Operational efficiency has been divided into individual components and satisfaction with the solution of buildings already constructed was assessed by workers, who are actually dedicated facility management in these organizations. The results were then assessed and evaluated through regression analysis. The aim of this paper is to determine to what extent is desired update project documentation of new buildings from the perspective of facility management.

Impact of multi-tiered pharmacy benefits on attitudes of plan members with chronic disease states.

PubMed

Nair, Kavita V; Ganther, Julie M; Valuck, Robert J; McCollum, Marianne M; Lewis, Sonya J

2002-01-01

To evaluate the effects of 2- and 3-tiered pharmacy benefit plans on member attitudes regarding their pharmacy benefits. We performed a mail survey and cross-sectional comparison of the outcome variables in a large managed care population in the western United States. Participants were persons with chronic disease states who were in 2- or 3-tier copay drug plans. A random sample of 10,662 was selected from a total of 25,008 members who had received 2 or more prescriptions for a drug commonly used to treat one of 5 conditions: hypertension, diabetes, dyslipidemia, gastroesophageal reflux disease (GERD), or arthritis. Statistical analysis included bivariate comparisons and regression analysis of the factors affecting member attitudes, including satisfaction, loyalty, health plan choices, and willingness to pay a higher out-of-pocket cost for medications. A response rate of 35.8% was obtained from continuously enrolled plan members. Respondents were older, sicker, and consumed more prescriptions than nonrespondents. There were significant differences in age and health plan characteristics between 2- and 3-tier plan members: respondents aged 65 or older represented 11.7% of 2-tier plan members and 54.7% of 3-tier plan members, and 10.0% of 2-tier plan members were in Medicare+Choice plans versus 61.4% in Medicare+Choice plans for 3-tier plan members (P<0.05). Controlling for demographic characteristics, number of comorbidities, and the cost of health care, 2-tier plan members were more satisfied with their plan, more likely to recommend their plan to others, and less likely to switch their current plans to obtain better prescription drug coverage than 3-tier plan members. While members were willing to purchase higher cost nonformulary and brand-name medications, in general, they were not willing to pay more than 10 dollars (in addition to their copayment amount) for these medications. Older respondents and sicker individuals (those with higher scores on the Chronic Disease Indicator) appeared to have more positive attitudes toward their pharmacy benefit plans in general. Higher reported incomes by respondents were also associated with greater satisfaction with prescription drug coverage and increased loyalty toward the pharmacy benefit plan. Conversely, the more individuals spent for either their health care or prescription medications, the less satisfied they were with their prescription drug coverage and less loyalty they appeared to have for their health plans. An inverse relationship also appeared to exist between the out-of-pocket costs for prescription medications and members' willingness to pay for nonformulary medications. Three-tier members had lower reported satisfaction with their plans compared to members in 2-tier plans. The financial resources available to members (which may be a function of being older and having more education and higher incomes), the number of chronic disease states that members have, and other factors may influence their attitudes toward their prescription drug coverage.

Increased Range of Motion Is Important for Functional Outcome and Satisfaction After Total Knee Arthroplasty in Asian Patients.

PubMed

Ha, Chul-Won; Park, Yong-Beom; Song, Young-Suk; Kim, Jun-Ho; Park, Yong-Geun

2016-06-01

Although range of motion (ROM) is considered as an important factor for good outcome after total knee arthroplasty (TKA), the association of the degree of ROM with functional outcome and patient satisfaction is debated. We, therefore, investigated whether increased ROM would affect functional outcome and patient satisfaction after TKA in Asian patients. We reviewed 630 patients who underwent primary TKA with minimum 2-year follow-up. Clinical outcomes were evaluated by Knee Society (KS) score, Western Ontario and McMaster Universities osteoarthritis index, and high-flexion knee score. Patient satisfaction was evaluated using a validated questionnaire. The association of ROM and change in ROM (cROM) with clinical outcomes and satisfaction were analyzed using partial correlation analysis and multiple median regression analysis. All functional scores showed significant correlation with postoperative ROM (r = 0.129, P = .001 in Knee Society score; r = -0.101, P = .012 in Western Ontario and McMaster Universities osteoarthritis index; r = 0.183, P < .001 in high-flexion knee score). cROM correlated with satisfaction (r = 0.192, P = .005). Postoperative ROM and cROM were revealed as predisposing factors affecting function outcome using multivariable regression analysis. cROM was found as a predisposing factor affecting satisfaction. Based on the results of this study, ROM positively associated with functional outcome and cROM positively associated with patient satisfaction after TKA. These findings suggest that increased ROM after TKA is an important factor for functional outcome and satisfaction in Asian patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Scaling Lean in primary care: impacts on system performance.

PubMed

Hung, Dorothy Y; Harrison, Michael I; Martinez, Meghan C; Luft, Harold S

2017-03-01

We examined a wide range of performance outcomes after Lean methodology-a leading strategy to enhance efficiency and patient value-was implemented and scaled across all primary care clinics in a nonprofit, ambulatory care delivery system. Using a stepped wedge approach, we assessed changes associated with the phased introduction of Lean-based redesigns across 46 primary care departments in 17 different clinic locations. Longitudinal analysis of operational metrics included: workflow efficiency, physician productivity, operating expenses, clinical quality, and satisfaction among patients, physicians, and staff. We used interrupted time series analysis with generalized linear mixed models to estimate Lean impacts over time. Projected outcomes in the absence of changes (ie, counterfactuals) were compared with observed outcomes after Lean redesigns were implemented, and mean differences were assessed using 95% bias-corrected bootstrap confidence intervals (CIs). We observed systemwide improvements in workflow efficiencies (eg, 95% CI, 5.8-10.4) and physician productivity (95% CI, 3.9-27.2), with no adverse effects on clinical quality. Patient satisfaction increased with respect to access to care (95% CI, 15.2-20.7), handling of personal issues (95% CI, 2.1-6.9), and overall experience of care (95% CI, 11.0-17.0), but decreased with respect to interactions with care providers (95% CI, -13.4 to -5.7). Departmental operating costs decreased, and annual staff and physician satisfaction scores increased particularly among early adopters, with key improvements in employee engagement, connection to purpose, relationships with staff, and physician time spent working. Lean redesigns can benefit primary care patients, physicians, and staff without negatively impacting the quality of clinical care. Study results may lead other delivery system leaders to innovate using Lean techniques and may further enhance support for Lean learning among public and private payers.

Praise matters: the influence of nurse unit managers' praise on nurses' practice, work environment and job satisfaction: a questionnaire study.

PubMed

Sveinsdóttir, Herdís; Ragnarsdóttir, Erla Dögg; Blöndal, Katrín

2016-03-01

The aim of this study was to investigate the associations between praise from nurse unit managers and job satisfaction, professional practice, workload, work climate and organizational commitment of nurses caring for surgical patients. Praise influences experiences of employees. Web-based, cross-sectional explorative survey design. A structured questionnaire was used to measure praise given by nurse unit managers as perceived by nurses (n = 383; 49% response rate) working with surgical patients. Data were collected between December 2009-January 2010. Several variables assessed the major concepts under study. Binary logistic regression analysis was employed to compare nurses who receive praise very rarely/rarely as compared with very often/rather often. Praise was received often/very often by 31·6% of participants. Compared with nurses receiving praise rarely/very rarely those who received it often/rather showed more job satisfaction, stated they had more opportunities to practice professionally, described a more positive work climate and were more committed to the organization such as being proud to work at and willing to make effort for the unit and hospital. There was no difference between the groups regarding workload. Main findings of the regression analysis were that nurses display their organizational commitment by not thinking about leaving the current workplace and those who value professional recognition are likelier to receive praise than their counterparts. Nurse unit managers should praise their staff in a realistic fashion. Such praise is cost-effective, takes short time, produces positive influences on members of their staff and may improve patient safety. © 2015 John Wiley & Sons Ltd.

Economic Evaluation of Health IT.

PubMed

Luzi, Daniela; Pecoraro, Fabrizio; Tamburis, Oscar

2016-01-01

Economic evaluation in health care supports decision makers in prioritizing interventions and maximizing the available limited resources for social benefits. Health Information Technology (health IT) constitutes a promising strategy to improve the quality and delivery of health care. However, to determine whether the appropriate health IT solution has been selected in a specific health context, its impact on the clinical and organizational process, on costs, on user satisfaction as well as on patient outcomes, a rigorous and multidimensional evaluation analysis is necessary. Starting from the principles of evaluation introduced since the mid-1980s within the Health Technology Assessment (HTA) guidelines, this contribution provides an overview of the main challenging issues related to the complex task of performing an economic evaluation of health IT. A set of necessary key principles to deliver a proper design and implementation of a multidimensional economic evaluation study is described, focusing in particular on the classification of costs and outcomes as well as on the type of economic analysis to be performed. A case study is eventually described to show how the key principles introduced are applied.

The effect of chronic pain on life satisfaction: evidence from Australian data.

PubMed

McNamee, Paul; Mendolia, Silvia

2014-11-01

Chronic pain is associated with significant costs to individuals directly affected by this condition, their families, the healthcare system, and the society as a whole. This paper investigates the relationship between chronic pain and life satisfaction using a sample of around 90,000 observations from the first ten waves of the Household, Income and Labour Dynamics of Australia Survey (HILDA), which is a representative survey of the Australian population that started in 2000. We estimate the negative impact on life satisfaction and examine the persistence of the effect over multiple years. Chronic pain is associated with poor health conditions, disability, decreased participation in the labour market and lower quality of life. We calculate the compensating income variation of chronic pain, based on the measurement of chronic pain, the life satisfaction of individuals and the income of households. Panel data models with random and fixed effects are used to control for characteristics of individuals that do not vary over time. Further, we investigate whether individuals who experience chronic pain exhibit adaptation and recovery in life satisfaction after 3 years. Overall, we find that chronic pain has a large negative association with life satisfaction, and that the compensating income variation is substantial (around 640 US$ per day). Copyright © 2014 Elsevier Ltd. All rights reserved.

Invisible Support: Effects on the Provider's Positive and Negative Affect.

PubMed

König, Claudia; Stadler, Gertraud; Knoll, Nina; Ochsner, Sibylle; Hornung, Rainer; Scholz, Urte

2016-07-01

Social support that goes unnoticed by receivers (i.e. invisible support) seems to be most beneficial for the receivers' well-being. The providers' well-being, however, has been neglected so far. This study examines how invisible support is related to the providers' well-being and whether this association is dependent on the providers' relationship satisfaction. Overall, 97 non-smoking partners of smokers who were about to quit smoking were examined. Invisible support was assessed dyadically: partners' reports on smoking-specific provided social support together with smokers' reports on received support were assessed at baseline. Partners' relationship satisfaction was also assessed at baseline. Partners' positive and negative affect were measured at baseline and six-week follow-up. No main effects of invisible instrumental or emotional support occurred. However, partners' relationship satisfaction moderated the association between invisible instrumental support and change in partners' negative and positive affect: For partners with lower relationship satisfaction more invisible instrumental support was related to increased negative affect and decreased positive affect, whereas for partners with higher relationship satisfaction the inverse effects occurred. The study's results emphasise that invisible instrumental support might have emotional costs for the providers. Relationship satisfaction seems to serve as a protective factor. © 2016 The International Association of Applied Psychology.

Organizational Culture and Its Relationship with Hospital Performance in Public Hospitals in China

PubMed Central

Zhou, Ping; Bundorf, Kate; Chang, Ji; Huang, Jin Xin; Xue, Di

2011-01-01

Objective To measure perceptions of organizational culture among employees of public hospitals in China and to determine whether perceptions are associated with hospital performance. Data Sources Hospital, employee, and patient surveys from 87 Chinese public hospitals conducted during 2009. Study Design Developed and administered a tool to assess organizational culture in Chinese public hospitals. Used factor analysis to create measures of organizational culture. Analyzed the relationships between employee type and perceptions of culture and between perceptions of culture and hospital performance using multivariate models. Principal Findings Employees perceived the culture of Chinese public hospitals as stronger in internal rules and regulations, and weaker in empowerment. Hospitals in which employees perceived that the culture emphasized cost control were more profitable and had higher rates of outpatient visits and bed days per physician per day but also had lower levels of patient satisfaction. Hospitals with cultures perceived as customer-focused had longer length of stay but lower patient satisfaction. Conclusions Managers in Chinese public hospitals should consider whether the culture of their organization will enable them to respond effectively to their changing environment. PMID:22092228

Health-seeking behaviour of people living with HIV/AIDS and their satisfaction with health services provided at a tertiary care hospital, Karachi, Pakistan.

PubMed

Bhutto, Abdul-Qadir; Nisar, Nighat

2017-02-21

Appropriate health-seeking behaviour is important as it allows prompt treatment for a condition and this can reduce complications and improve quality of life. This study aimed to assess the health-seeking behaviour and satisfaction with health care services of people living with HIV/AIDS attending the HIV/AIDS clinic of the Civil Hospital in Karachi. A total of 182 patients were interviewed using a pretested semi-structured questionnaire. Mean age of the participants was 32.31 (SD 7.91) years, 76.9% were male, 81.3% had no education and 75.8% were employed. Only 23.6% showed positive health-seeking behaviour and 57.7% were satisfied with the health care services. In logistic regression analysis, the cost of treatment per visit < US$ 5 and duration of HIV infection < 2 years were significantly associated with health-seeking behaviour. Efforts are needed to improve the health-seeking behaviour of people living with HIV/AIDS at the clinic and the health services offered.

Organizational culture and its relationship with hospital performance in public hospitals in China.

PubMed

Zhou, Ping; Bundorf, Kate; Le Chang, Ji; Huang, Jin Xin; Xue, Di

2011-12-01

To measure perceptions of organizational culture among employees of public hospitals in China and to determine whether perceptions are associated with hospital performance. Hospital, employee, and patient surveys from 87 Chinese public hospitals conducted during 2009. Developed and administered a tool to assess organizational culture in Chinese public hospitals. Used factor analysis to create measures of organizational culture. Analyzed the relationships between employee type and perceptions of culture and between perceptions of culture and hospital performance using multivariate models. Employees perceived the culture of Chinese public hospitals as stronger in internal rules and regulations, and weaker in empowerment. Hospitals in which employees perceived that the culture emphasized cost control were more profitable and had higher rates of outpatient visits and bed days per physician per day but also had lower levels of patient satisfaction. Hospitals with cultures perceived as customer-focused had longer length of stay but lower patient satisfaction. Managers in Chinese public hospitals should consider whether the culture of their organization will enable them to respond effectively to their changing environment. © Health Research and Educational Trust.

Evaluating ecommerce websites cognitive efficiency: an integrative framework based on data envelopment analysis.

PubMed

Lo Storto, Corrado

2013-11-01

This paper presents an integrative framework to evaluate ecommerce website efficiency from the user viewpoint using Data Envelopment Analysis (DEA). This framework is inspired by concepts driven from theories of information processing and cognition and considers the website efficiency as a measure of its quality and performance. When the users interact with the website interfaces to perform a task, they are involved in a cognitive effort, sustaining a cognitive cost to search, interpret and process information, and experiencing either a sense of satisfaction or dissatisfaction for that. The amount of ambiguity and uncertainty, and the search (over-)time during navigation that they perceive determine the effort size - and, as a consequence, the cognitive cost amount - they have to bear to perform their task. On the contrary, task performing and result achievement provide the users with cognitive benefits, making interaction with the website potentially attractive, satisfying, and useful. In total, 9 variables are measured, classified in a set of 3 website macro-dimensions (user experience, site navigability and structure). The framework is implemented to compare 52 ecommerce websites that sell products in the information technology and media market. A stepwise regression is performed to assess the influence of cognitive costs and benefits that mostly affect website efficiency. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

A longitudinal analysis of patient satisfaction with care and quality of life in ambulatory oncology based on the OUT-PATSAT35 questionnaire.

PubMed

Nguyen, Thanh Vân France; Anota, Amélie; Brédart, Anne; Monnier, Alain; Bosset, Jean-François; Mercier, Mariette

2014-01-25

In the oncology setting, there has been increasing interest in evaluating treatment outcomes in terms of quality of life and patient satisfaction. The aim of our study was to investigate the determinants of patient satisfaction, especially the relationship between quality of life and satisfaction with care and their changes over time, in curative treatment of cancer outpatients. Patients undergoing ambulatory chemotherapy or radiotherapy in two centers in France were invited to complete the OUT-PATSAT35, at the beginning of treatment, at the end of treatment, and three months after treatment. This questionnaire evaluates patients' perception of doctors and nurses, as well as other aspects of care organization and services. Additionally, for each patient, socio-demographic and clinical characteristics, and self-reported quality of life data (EORTC QLQ-C30) were collected. Of the 691 patients initially included, 561 answered the assessment at all three time points. By cross-sectional analysis, at the end of the treatment, patients who experienced a deterioration of their global health reported less satisfaction on most scales (p ≤ 0.001). Three months after treatment, the same patients had lower satisfaction scores only in the evaluation of doctors (p ≤ 0.002). Furthermore, longitudinal analysis showed a significant relationship between a deterioration in global health and a decrease in satisfaction with their doctor and, conversely, between an improvement in global health and an increase in satisfaction on the overall satisfaction scale. Global health at baseline was largely and significantly associated with all satisfaction scores measured at the following assessment time points (p < 0.0001). Younger age (<55 years), radiotherapy (versus chemotherapy) and head and neck cancer (versus other localizations) were clinical factors significantly associated with less satisfaction on most scales evaluating doctors. Pre-treatment self-evaluated global health was found to be the major determinant of patient satisfaction with care. The subsequent deterioration of global health, during and after treatment, emphasized the decrease in satisfaction scores, mainly in the evaluation of doctors. Early initiatives aimed at improving the delivery of care in patients with poor health status should lead to improved perception of the quality of care received.

Urban Telemedicine: The Applicability of Teleburns in the Rehabilitative Phase.

PubMed

Liu, Yuk Ming; Mathews, Katie; Vardanian, Andrew; Bozkurt, Taylan; Schneider, Jeffrey C; Hefner, Jaye; Schulz, John T; Fagan, Shawn P; Goverman, Jeremy

Telemedicine has been successfully used in many areas of medicine, including triage and evaluation of the acute burn patient. The utility of telemedicine during the rehabilitative phase of burn care has yet to be evaluated; therefore, we expanded our telemedicine program to link our burn center with a rehabilitation facility. The goal of this project was to demonstrate cost-effective improvements in the transition and quality of care. A retrospective review was performed on all patients enrolled in our telemedicine/rehabilitation program between March 2013 and March 2014. Data collected included total number of encounters, visits, type of visit, physician time, and readmissions. Transportation costs were based on local ambulance rates between the two facilities. The impact of telemedicine was evaluated with respect to the time saved for the physician, burn center, and burn clinic, as well as rehabilitative days saved. A patient satisfaction survey was also administered. A total of 29 patients participated in 73 virtual visits through the telemedicine project. Virtual visits included new consults, preoperative evaluations, and postoperative follow-ups. A total of 146 ambulance transports were averted during the study period, totaling $101,110. Virtual visits saved 6.8 outpatient burn clinic days, or 73 clinic appointments of 30-min duration. The ability to perform more outpatient surgery resulted in 80 inpatient bed days saved at the burn hospital. The rehabilitation hospital saved an average of 2 to 3 patient days secondary to unnecessary travel. Satisfaction surveys demonstrated patient satisfaction with the encounters, primarily related to time saved. The decrease in travel time for the patient from the rehabilitation hospital to outpatient burn clinic improved adherence to the rehabilitation care plan and resulted in increased throughput at the rehabilitation facility. Videoconferencing between a burn center and rehabilitation hospital streamlined patient care and reduced health care costs, while maintaining quality of care and patient satisfaction. This program has improved inpatient burn rehabilitation by maximizing time spent in therapy and avoiding unnecessary patient travel to offsite appointments.

Job Satisfaction among Health-Care Staff in Township Health Centers in Rural China: Results from a Latent Class Analysis

PubMed Central

Wang, Haipeng; Tang, Chengxiang; Zhao, Shichao; Meng, Qingyue; Liu, Xiaoyun

2017-01-01

Background: The lower job satisfaction of health-care staff will lead to more brain drain, worse work performance, and poorer health-care outcomes. The aim of this study was to identify patterns of job satisfaction among health-care staff in rural China, and to investigate the association between the latent clusters and health-care staff’s personal and professional features; Methods: We selected 12 items of five-point Likert scale questions to measure job satisfaction. A latent-class analysis was performed to identify subgroups based on the items of job satisfaction; Results: Four latent classes of job satisfaction were identified: 8.9% had high job satisfaction, belonging to “satisfied class”; 38.2% had low job satisfaction, named as “unsatisfied class”; 30.5% were categorized into “unsatisfied class with the exception of interpersonal relationships”; 22.4% were identified as “pseudo-satisfied class”, only satisfied with management-oriented items. Low job satisfaction was associated with specialty, training opportunity, and income inequality. Conclusions: The minority of health-care staff belong to the “satisfied class”. Three among four subgroups are not satisfied with income, benefit, training, and career development. Targeting policy interventions should be implemented to improve the items of job satisfaction based on the patterns and health-care staff’s features. PMID:28937609

Relationship between the domains of the Multidimensional Students' Life Satisfaction Scale, satisfaction with food-related life and happiness in university students.

PubMed

Schnettler, Berta; Orellana, Ligia; Lobos, Germán; Miranda, Horacio; Sepúlveda, José; Etchebarne, Soledad; Mora, Marcos; Adasme-Berríos, Cristian; Grunert, Klaus G

2015-06-01

To characterize types of university students based on satisfaction with life domains that affect eating habits, satisfaction with food-related life and subjective happiness. A questionnaire was applied to a nonrandom sample of 305 students of both genders in five universities in Chile. The questionnaire included the abbreviated Multidimensional Student's Life Satisfaction Scale (MSLSS), Satisfaction with Food-related Life Scale (SWFL) and the Subjective Happiness Scale (SHS). Eating habits, frequency of food consumption in and outside the place of residence, approximate height and weight and sociodemographic variables were measured. Using factor analysis, the five-domain structure of the MSLSS was confirmed with 26 of the 30 items of the abbreviated version: Family, Friends, Self, Environment and University. Using cluster analysis four types of students were distinguished that differ significantly in the MSLSS global and domain scores, SWFL and SHS scores, gender, ownership of a food allowance card funded by the Chilean government, importance attributed to food for well-being and socioeconomic status. Higher levels of life satisfaction and happiness are associated with greater satisfaction with food-related life. Other major life domains that affect students' subjective well-being are Family, Friends, University and Self. Greater satisfaction in some domains may counterbalance the lower satisfaction in others. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Intercultural comparison of patient satisfaction with physiotherapy care in Australia and Korea: an exploratory factor analysis.

PubMed

Hush, Julia M; Lee, Haejung; Yung, Vivian; Adams, Roger; Mackey, Martin; Wand, Benedict M; Nelson, Roger; Beattie, Paul

2013-05-01

The aim of this study was to conduct a cross-cultural comparison of the factors that influence patient satisfaction with musculoskeletal physiotherapy care in Australia and Korea. Prospective studies were conducted in Australia and Korea. Patient satisfaction data were collected using the MedRisk Instrument for Measuring Patient Satisfaction with Physical Therapy Care (MRPS) from a total of 1666 patients who were attending clinics for physiotherapy treatment of a musculoskeletal condition. Exploratory factor analysis was conducted to identify factors determining patient satisfaction in each cohort. A four-factor solution for the MRPS was found for the Australian and Korean data sets, explaining 61 and 55% of the variance respectively. Communication and respect, convenience and quality time and person-focused care were factors common to both countries. One factor unique to Korea was courtesy and propriety. For both cultures, global patient satisfaction was significantly but weakly correlated with the outcome of treatment. The interpersonal aspect of care, namely effective communication and respect from the therapist, appears to be the predominant and universal factor that influences patient satisfaction with physiotherapy care, although other culturally specific factors were identified. Physiotherapists can maximize patient satisfaction with care by addressing those features that uniquely contribute to patient satisfaction in the cultural context in which they are working.

Patient satisfaction with community pharmacy: comparing urban and suburban chain-pharmacy populations.

PubMed

Malewski, David F; Ream, Aimrie; Gaither, Caroline A

2015-01-01

Patient satisfaction with pharmaceutical care can be a strong predictor of medication and other health-related outcomes. Less understood is the role that location of pharmacies in urban or suburban environments plays in patient satisfaction with pharmacy and pharmacist services. The purpose of this study was to serve as a pilot examining urban and suburban community pharmacy populations for similarities and differences in patient satisfaction. Community pharmacy patients were asked to self-administer a 30-question patient satisfaction survey. Fifteen questions addressed their relationship with the pharmacist, 10 questions addressed satisfaction and accessibility of the pharmacy, and five questions addressed financial concerns. Five urban and five suburban pharmacies agreed to participate. Data analysis included descriptive statistics and chi-square analysis. Most patients reported high levels of satisfaction. Satisfaction with pharmacist relationship and service was 70% or higher with no significant differences between locations. There were significant differences between the urban and suburban patients regarding accessibility of pharmacy services, customer service and some patient/pharmacist trust issues. The significant differences between patient satisfaction in the suburban and urban populations warrant a larger study with more community pharmacies in other urban, suburban and rural locations to better understand and validate study findings. Copyright © 2015 Elsevier Inc. All rights reserved.

Intermittent catheterisation for long-term bladder management (abridged cochrane review).

PubMed

Prieto, Jacqui A; Murphy, Catherine; Moore, Katherine N; Fader, Mandy J

2015-09-01

To review the evidence on strategies to reduce UTI, other complications or improve satisfaction in intermittent catheter (IC) users by comparing: (1) one catheter design, material or technique versus another; (2) sterile technique versus clean; or (3) single-use (sterile) or multiple-use (clean) catheters. We searched Cochrane Incontinence Group Specialised Trials Register, MEDLINE, EMBASE, CINAHL, ERIC, reference lists, and conference proceedings to November 2013. We contacted other investigators for unpublished data or clarification. Trial screening, assessment and data abstraction were all in accordance with the Cochrane handbook. Thirty one trials (13 RCTs and 18 randomized crossover trials), addressed the inclusion criteria comparing method or design and UTI/bacteriuria, other complications or participant assessed outcomes. Studies varied widely in follow-up, UTI definition and attrition; in some, data could not be combined. Where there were data, confidence intervals were wide and hence clinically important differences could neither be reliably identified nor ruled out. Current research evidence is weak and design issues are significant. It has not yet been established whether incidence of UTI, other complications such as haematuria, or user satisfaction are affected by sterile or clean technique, coated or uncoated catheters, single or multiple-use catheters or by any other strategy. For people using IC, choice of catheter will depend on personal preference, cost, portability, and ease of use. Individuals should discuss the catheter options with their healthcare practitioner. Cost-effectiveness analysis and use of the standard definition of UTI are essential in any proposed clinical trial. © 2015 Wiley Periodicals, Inc.

Psychometric properties of the Satisfaction with Life Scale (SWLS): secondary analysis of the Mexican Health and Aging Study.

PubMed

López-Ortega, Mariana; Torres-Castro, Sara; Rosas-Carrasco, Oscar

2016-12-09

The Satisfaction with Life Scale (SWLS) has been widely used and has proven to be a valid and reliable instrument for assessing satisfaction with life in diverse population groups, however, research on satisfaction with life and validation of different measuring instruments in Mexican adults is still lacking. The objective was to evaluate the psychometric properties of the Satisfaction with Life Scale (SWLS) in a representative sample of Mexican adults. This is a methodological study to evaluate a satisfaction with life scale in a sample of 13,220 Mexican adults 50 years of age or older from the 2012 Mexican Health and Aging Study. The scale's reliability (internal consistency) was analysed using Cronbach's alpha and inter-item correlations. An exploratory factor analysis was also performed. Known-groups validity was evaluated comparing good-health and bad-health participants. Comorbidity, perceived financial situation, self-reported general health, depression symptoms, and social support were included to evaluate the validity between these measures and the total score of the scale using Spearman's correlations. The analysis of the scale's reliability showed good internal consistency (α = 0.74). The exploratory factor analysis confirmed the existence of a unique factor structure that explained 54% of the variance. SWLS was related to depression, perceived health, financial situation, and social support, and these relations were all statistically significant (P < .01). There was significant difference in life satisfaction between the good- and bad-health groups. Results show good internal consistency and construct validity of the SWLS. These results are comparable with results from previous studies. Meeting the study's objective to validate the scale, the results show that the Spanish version of the SWLS is a reliable and valid measure of satisfaction with life in the Mexican context.

Chordee and Penile Shortening Rather Than Voiding Function Are Associated With Patient Dissatisfaction After Urethroplasty.

PubMed

Maciejewski, Conrad C; Haines, Trevor; Rourke, Keith F

2017-05-01

To identify factors that predict patient satisfaction after urethroplasty by prospectively examining patient-reported quality of life scores using 3 validated instruments. A 3-part prospective survey consisting of the International Prostate Symptom Score (IPSS), the International Index of Erectile Function (IIEF) score, and a urethroplasty quality of life survey was completed by patients who underwent urethroplasty preoperatively and at 6 months postoperatively. The quality of life score included questions on genitourinary pain, urinary tract infection (UTI), postvoid dribbling, chordee, shortening, overall satisfaction, and overall health. Data were analyzed using descriptive statistics, paired t test, univariate and multivariate logistic regression analyses, and Wilcoxon signed-rank analysis. Patients were enrolled in the study from February 2011 to December 2014, and a total of 94 patients who underwent a total of 102 urethroplasties completed the study. Patients reported statistically significant improvements in IPSS (P < .001). Ordinal linear regression analysis revealed no association between age, IPSS, or IIEF score and patient satisfaction. Wilcoxon signed-rank analysis revealed significant improvements in pain scores (P = .02), UTI (P < .001), perceived overall health (P = .01), and satisfaction (P < .001). Univariate logistic regression identified a length >4 cm and the absence of UTI, pain, shortening, and chordee as predictors of patient satisfaction. Multivariate analysis of quality of life domain scores identified absence of shortening and absence of chordee as independent predictors of patient satisfaction following urethroplasty (P < .01). Patient voiding function and quality of life improve significantly following urethroplasty, but improvement in voiding function is not associated with patient satisfaction. Chordee status and perceived penile shortening impact patient satisfaction, and should be included in patient-reported outcome measures. Copyright © 2017 Elsevier Inc. All rights reserved.

Transportation reliability and trip satisfaction.

DOT National Transportation Integrated Search

2012-10-01

Travel delays and associated costs have become a major problem in Michigan over the : past several decades as congestion has continued to increase, creating significant negative : impacts on travel reliability on many roadways throughout the State. T...

Use of complementary and alternative medicine by patients with cancer in northern Turkey: analysis of cost and satisfaction.

PubMed

Aydin Avci, Ilknur; Koç, Zeliha; Sağlam, Zeynep

2012-03-01

The aims of this study were to determine (1) the prevalence of complementary and alternative medicine use among patients with cancer, (2) the method of use of the particular therapy, (3) the reasons for using complementary and alternative medicine therapies, (4) the benefits experienced by the use of complementary and alternative medicine, (5) the source of information about complementary and alternative medicine therapies and, (6) the satisfaction and cost of complementary and alternative medicine. Complementary and alternative medicine consists of diverse medical and healthcare systems, practices and products that are not considered at present to be a part of conventional medicine. The majority of patients who use complementary and alternative medicine use more than one method. Complementary and alternative medicine use is more common in cases of advanced disease or poor prognosis. This is a descriptive study of complementary and alternative medicine. This study was conducted in the Chemotherapy Unit at Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey, between 18 March 2008-30 June 2008. Two hundred fifty-three patients with cancer, among 281 patients who applied to the chemotherapy clinic between these dates, agreed to take part in the study with whom contact could be made were included. A questionnaire including descriptive characteristics in collecting data, characteristics about diseases and their treatments, complementary and alternative medicine information and implementation situations and a control list about complementary and alternative medicine implementations were given. The collected data were evaluated by computer using descriptive statistics, the chi-square test and Student's t-test. In this study, 94·1% of the patients were content with medical treatment, 58·9% of them used complementary and alternative medicine treatments, 41·1% did not use any complementary and alternative medicine treatments. The satisfaction level of the patients with complementary and alternative medicine methods was slightly above mediocre (2·33 SD 0·64, on a scale of 1-3). The average cost per capita spent by the patients using complementary and alternative medicine for all the different methods was US$288·26. It was determined that although patients did not have enough knowledge about complementary and alternative medicine methods, the prevalence of complementary and alternative medicine and satisfaction levels are high that complementary and alternative medicine users spend substantial sums of money for these methods. To sustain medical treatment and prognosis of cancer, it is important for nurses to consult with their patients regarding the use and potential risks of some complementary and alternative medicine. © 2011 Blackwell Publishing Ltd.

The Effects of Discrimination Experience on Life Satisfaction of North Korean Refugees: Mediating Effect of Stress.

PubMed

Noh, Jin-Won; Park, Hyunchun; Kim, Minji; Kwon, Young Dae; Kim, Jin-Seok; Yu, Shieun

2018-01-01

This study investigated the mediation effect of stress between the experience of discrimination and life satisfaction among North Korean refugees who resettled in South Korea. The findings of the current study provide empirical evidence for the need of social interventions to mitigate adverse effects of stress on North Korean refugees who are subject to social discrimination on a daily basis. In this study, we included 500 subjects among 2,138 North Korean refugees who took refuge in South Korea in 2007. The interview started from April 6th 2009 and finished on May 25th 2009. We conducted moderator effect analysis with Path analysis was conducted because we confirm the experience of discrimination was affected by life satisfaction and stress can affected life satisfaction as a moderator. The experience of discrimination significantly affects stress and stress significantly affects life satisfaction. However, the experience of discrimination was not directly related to life satisfaction. The more stress the study respondents experienced, the lower the life satisfaction they reported. The present finding suggests that the effects of discriminating experiences on the life satisfaction of North Korean refugees in South Korea were mediated by their own perceived stress.

Patient satisfaction with outpatient health care services: evaluation of the components of this service using regression analysis.

PubMed

Vural, Fisun; Ciftci, Seval; Cakiroglu, Yigit; Vural, Birol

2014-01-01

In health care services, patient's expectations, and satisfaction levels are important markers of the services provided. The aim of this study is to determine patient satisfaction level, and its influential factors in patients receiving treatment on an ambulatory basis who applied to a state hospital. In this cross-sectional study a total of 210 patients were face-to-face interviewed, and patient satisfaction questionnaire survey was performed. Socioeconomic characteristics, physical conditions of the hospital, pecularities of the health care providers, and satisfaction from health care services received were questioned independently. Regression analysis was performed to investigate factors effective on patient satisfaction. A significant correlation was not found between sociodemographic factors, and patient satisfaction (p<0.05). Favourable patient acceptance of the health care services received is effected by the duration of the waiting period. Communication skills of the health care professionals have been found to be the fundamental factors effective on the preference or recommendation of a certain health care institute once more (p<0.005). Empowering the communication skills of health care professionals, and decreasing the waiting period were found to be necessary in order to increase the satisfaction levels of ambulatory patients.

Job satisfaction of nurses with master of nursing degrees in Poland: quantitative and qualitative analysis.

PubMed

Brayer, Aneta; Marcinowicz, Ludmila

2018-04-03

Understanding the issue of job satisfaction of nurses with master of nursing degrees may help develop organisational changes necessary for better functioning of health care institutions. This study aimed to evaluate the level of job satisfaction among holders of Masters of Nursing degrees employed at health care institutions and to ascertain its determinants. The cross-sectional study was carried out in randomly selected health care institutions in Poland using the Misener Nurse Practitioner Job Satisfaction Survey and an original survey questionnaire with two open-ended questions. Quantitative data were analysed using descriptive and summary statistics. The participants gave highest satisfaction ratings to their relationships with direct superiors and other nurses, as well as their social contacts at work. The lowest ratings were given to the pension scheme and factors connected with remuneration. A highly statistically significant relationship was found between the job classification and the level of professional satisfaction (p < 0.001). Qualitative analysis of responses to the two open-ended questions supported Herzberg's Two-Factor theory: internal factors promoted satisfaction, whilst external ones caused dissatisfaction. Managers of nurses should strengthen the areas that contribute to higher employee satisfaction, particularly interpersonal relationships, by commendation and recognition of work effects.

The relationship between context, structure, and processes with outcomes of 6 regional diabetes networks in Europe.

PubMed

Mahdavi, Mahdi; Vissers, Jan; Elkhuizen, Sylvia; van Dijk, Mattees; Vanhala, Antero; Karampli, Eleftheria; Faubel, Raquel; Forte, Paul; Coroian, Elena; van de Klundert, Joris

2018-01-01

While health service provisioning for the chronic condition Type 2 Diabetes (T2D) often involves a network of organisations and professionals, most evidence on the relationships between the structures and processes of service provisioning and the outcomes considers single organisations or solo practitioners. Extending Donabedian's Structure-Process-Outcome (SPO) model, we investigate how differences in quality of life, effective coverage of diabetes, and service satisfaction are associated with differences in the structures, processes, and context of T2D services in six regions in Finland, Germany, Greece, Netherlands, Spain, and UK. Data collection consisted of: a) systematic modelling of provider network's structures and processes, and b) a cross-sectional survey of patient reported outcomes and other information. The survey resulted in data from 1459 T2D patients, during 2011-2012. Stepwise linear regression models were used to identify how independent cumulative proportion of variance in quality of life and service satisfaction are related to differences in context, structure and process. The selected context, structure and process variables are based on Donabedian's SPO model, a service quality research instrument (SERVQUAL), and previous organization and professional level evidence. Additional analysis deepens the possible bidirectional relation between outcomes and processes. The regression models explain 44% of variance in service satisfaction, mostly by structure and process variables (such as human resource use and the SERVQUAL dimensions). The models explained 23% of variance in quality of life between the networks, much of which is related to contextual variables. Our results suggest that effectiveness of A1c control is negatively correlated with process variables such as total hours of care provided per year and cost of services per year. While the selected structure and process variables explain much of the variance in service satisfaction, this is less the case for quality of life. Moreover, it appears that the effect of the clinical outcome A1c control on processes is stronger than the other way around, as poorer control seems to relate to more service use, and higher cost. The standardized operational models used in this research prove to form a basis for expanding the network level evidence base for effective T2D service provisioning.

The relationship between context, structure, and processes with outcomes of 6 regional diabetes networks in Europe

PubMed Central

Elkhuizen, Sylvia; van Dijk, Mattees; Vanhala, Antero; Karampli, Eleftheria; Faubel, Raquel; Forte, Paul; Coroian, Elena

2018-01-01

Background While health service provisioning for the chronic condition Type 2 Diabetes (T2D) often involves a network of organisations and professionals, most evidence on the relationships between the structures and processes of service provisioning and the outcomes considers single organisations or solo practitioners. Extending Donabedian’s Structure-Process-Outcome (SPO) model, we investigate how differences in quality of life, effective coverage of diabetes, and service satisfaction are associated with differences in the structures, processes, and context of T2D services in six regions in Finland, Germany, Greece, Netherlands, Spain, and UK. Methods Data collection consisted of: a) systematic modelling of provider network’s structures and processes, and b) a cross-sectional survey of patient reported outcomes and other information. The survey resulted in data from 1459 T2D patients, during 2011–2012. Stepwise linear regression models were used to identify how independent cumulative proportion of variance in quality of life and service satisfaction are related to differences in context, structure and process. The selected context, structure and process variables are based on Donabedian’s SPO model, a service quality research instrument (SERVQUAL), and previous organization and professional level evidence. Additional analysis deepens the possible bidirectional relation between outcomes and processes. Results The regression models explain 44% of variance in service satisfaction, mostly by structure and process variables (such as human resource use and the SERVQUAL dimensions). The models explained 23% of variance in quality of life between the networks, much of which is related to contextual variables. Our results suggest that effectiveness of A1c control is negatively correlated with process variables such as total hours of care provided per year and cost of services per year. Conclusions While the selected structure and process variables explain much of the variance in service satisfaction, this is less the case for quality of life. Moreover, it appears that the effect of the clinical outcome A1c control on processes is stronger than the other way around, as poorer control seems to relate to more service use, and higher cost. The standardized operational models used in this research prove to form a basis for expanding the network level evidence base for effective T2D service provisioning. PMID:29447220

75 FR 40847 - Agency Information Collection Activities: Proposed Collection; Comment Request, 1660-0036...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-14

... Emergency Management Agency Individual Assistance Customer Satisfaction Surveys AGENCY: Federal Emergency..., timeliness and satisfaction with initial, continuing and final delivery of disaster-related assistance. DATES..., Customer Satisfaction Analysis Section, Texas National Processing Service Center, Recovery Directorate...

78 FR 77478 - Agency Information Collection Activities: Proposed Collection; Comment Request, Federal Emergency...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-23

..., Federal Emergency Management Agency Individual Assistance Customer Satisfaction Surveys AGENCY: Federal... concerning the collection of Individual Assistance customer satisfaction survey responses and information for..., Customer Satisfaction Analysis Section of the National Processing Service Center Division, Recovery...

Dimensionality of Community Satisfaction.

ERIC Educational Resources Information Center

Williams, R. Gary; Knop, Edward

Using factor analysis (both principal factor solutions and rotated factor solutions) to search for underlying statistical commonality among 12 indicators of community satisfaction in 6 Colorado communities, the research explores various dimensions of community satisfaction that may be important across different communities. The communities under…

A green vehicle routing problem with customer satisfaction criteria

NASA Astrophysics Data System (ADS)

Afshar-Bakeshloo, M.; Mehrabi, A.; Safari, H.; Maleki, M.; Jolai, F.

2016-12-01

This paper develops an MILP model, named Satisfactory-Green Vehicle Routing Problem. It consists of routing a heterogeneous fleet of vehicles in order to serve a set of customers within predefined time windows. In this model in addition to the traditional objective of the VRP, both the pollution and customers' satisfaction have been taken into account. Meanwhile, the introduced model prepares an effective dashboard for decision-makers that determines appropriate routes, the best mixed fleet, speed and idle time of vehicles. Additionally, some new factors evaluate the greening of each decision based on three criteria. This model applies piecewise linear functions (PLFs) to linearize a nonlinear fuzzy interval for incorporating customers' satisfaction into other linear objectives. We have presented a mixed integer linear programming formulation for the S-GVRP. This model enriches managerial insights by providing trade-offs between customers' satisfaction, total costs and emission levels. Finally, we have provided a numerical study for showing the applicability of the model.

The impact of affect on willingness-to-pay and desired-set-size.

PubMed

Hafenbrädl, Sebastian; Hoffrage, Ulrich; White, Chris M

2013-01-01

What role does affect play in economic decision making? Previous research showed that the number of items had a linear effect on the willingness-to-pay for those items when participants were computationally primed, whereas participants' willingness-to-pay was insensitive to the amount when they were affectively primed. We extend this research by also studying the impact of affect on nonmonetary costs of waiting for items to be displayed and of screening them in a computer task. We assessed these costs by asking participants how many items they desired to see before making their selection. In our experiment, the effect of priming on desired-set-size was even larger than on willingness-to-pay, which can be explained by the fact that the nonmonetary costs, waiting time, were real, whereas willingness-to-pay was hypothetical. Participants also reported their satisfaction with the choosing process and the chosen items; no linear or nonlinear relationship was found between the self-determined desired-set-size and satisfaction. Copyright © 2013 Elsevier B.V. All rights reserved.

Motivational Reasons for Biased Decisions: The Sunk-Cost Effect's Instrumental Rationality.

PubMed

Domeier, Markus; Sachse, Pierre; Schäfer, Bernd

2018-01-01

The present study describes the mechanism of need regulation, which accompanies the so-called "biased" decisions. We hypothesized an unconscious urge for psychological need satisfaction as the trigger for cognitive biases. In an experimental study ( N = 106), participants had the opportunity to win money in a functionality test. In the test, they could either use the solution they had developed (sunk cost) or an alternative solution that offered a higher probability of winning. The selection of the sunk-cost option (SCO) was the most chosen option, supporting the hypothesis of this study. The reason behind the majority of participants choosing the SCO seemed to be the satisfaction of psychological needs, despite a reduced chance of winning money. An intervention, which aimed at triggering self-reflection, had no impact on the decision. The findings of this study contribute to the discussion on the reasons for cognitive biases and their formation in the human mind. Moreover, it discusses the application of the label "irrational" for biased decisions and proposes reasons for instrumental rationality, which exist at an unconscious, need-regulative level.

Sedation for routine gastrointestinal endoscopic procedures: a review on efficacy, safety, efficiency, cost and satisfaction

PubMed Central

2017-01-01

Most gastrointestinal endoscopic procedures are now performed with sedation. Moderate sedation using benzodiazepines and opioids continue to be widely used, but propofol sedation is becoming more popular because its unique pharmacokinetic properties make endoscopy almost painless, with a very predictable and rapid recovery process. There is controversy as to whether propofol should be administered only by anesthesia professionals (monitored anesthesia care) or whether properly trained non-anesthesia personnel can use propofol safely via the modalities of nurse-administered propofol sedation, computer-assisted propofol sedation or nurse-administered continuous propofol sedation. The deployment of non-anesthesia administered propofol sedation for low-risk procedures allows for optimal allocation of scarce anesthesia resources, which can be more appropriately used for more complex cases. This can address some of the current shortages in anesthesia provider supply, and can potentially reduce overall health care costs without sacrificing sedation quality. This review will discuss efficacy, safety, efficiency, cost and satisfaction issues with various modes of sedation for non-advanced, non-emergent endoscopic procedures, mainly esophagogastroduodenoscopy and colonoscopy. PMID:29142513

Evaluation of a regional disease management programme for patients with asthma or chronic obstructive pulmonary disease.

PubMed

Steuten, Lotte; Vrijhoef, Bert; Van Merode, Frits; Wesseling, Geert-Jan; Spreeuwenberg, Cor

2006-12-01

To assess the impact of a population-based disease management programme for adult patients with asthma or chronic obstructive pulmonary disease (COPD) on process measures, intermediate outcomes, and endpoints of care. Quasi-experimental design with 12-month follow-up. Region of Maastricht (the Netherlands) including university hospital and 16 general practices. Nine hundred and seventy-five patients of whom 658 have asthma and 317 COPD. Disease management programme. Endpoints of care are respiratory health, health utility, patient satisfaction, and total health care costs related to asthma or COPD. Quality aspects of care, disease control, self-care behaviour, smoking status, disease-specific knowledge, and patients' satisfaction improved after implementation of the programme. Lung function was not affected by implementation of the programme. For COPD patients, a significant improvement in health utility was found. For patients with asthma, significant cost savings were measured. Organizing health care according to principles of disease management for adults with asthma or COPD is associated with significant improvements in several processes and outcomes of care, while costs of care do not exceed the existing budget.

Motivational Reasons for Biased Decisions: The Sunk-Cost Effect’s Instrumental Rationality

PubMed Central

Domeier, Markus; Sachse, Pierre; Schäfer, Bernd

2018-01-01

The present study describes the mechanism of need regulation, which accompanies the so-called “biased” decisions. We hypothesized an unconscious urge for psychological need satisfaction as the trigger for cognitive biases. In an experimental study (N = 106), participants had the opportunity to win money in a functionality test. In the test, they could either use the solution they had developed (sunk cost) or an alternative solution that offered a higher probability of winning. The selection of the sunk-cost option (SCO) was the most chosen option, supporting the hypothesis of this study. The reason behind the majority of participants choosing the SCO seemed to be the satisfaction of psychological needs, despite a reduced chance of winning money. An intervention, which aimed at triggering self-reflection, had no impact on the decision. The findings of this study contribute to the discussion on the reasons for cognitive biases and their formation in the human mind. Moreover, it discusses the application of the label “irrational” for biased decisions and proposes reasons for instrumental rationality, which exist at an unconscious, need-regulative level. PMID:29881366

Determinants of customer satisfaction with hospitals: a managerial model.

PubMed

Andaleeb, S S

1998-01-01

States that rapid changes in the environment have exerted significant pressures on hospitals to incorporate patient satisfaction in their strategic stance and quest for market share and long-term viability. This study proposes and tests a five-factor model that explains considerable variation in customer satisfaction with hospitals. These factors include communication with patients, competence of the staff, their demeanour, quality of the facilities, and perceived costs; they also represent strategic concepts that managers can address in their bid to remain competitive. A probability sample was selected and a multiple regression model used to test the hypotheses. The results indicate that all five variables were significant in the model and explained 62 per cent of the variation in the dependent variable. Managerial implications of the proposed model are discussed.

Family Satisfaction With Nursing Home Care.

PubMed

Shippee, Tetyana P; Henning-Smith, Carrie; Gaugler, Joseph E; Held, Robert; Kane, Robert L

2017-03-01

This article explores the factor structure of a new family satisfaction with nursing home care instrument and determines the relationship of resident quality of life (QOL) and facility characteristics with family satisfaction. Data sources include (1) family satisfaction interviews ( n = 16,790 family members), (2) multidimensional survey of resident QOL ( n = 13,433 residents), and (3) facility characteristics ( n = 376 facilities). We used factor analysis to identify domains of family satisfaction and multivariate analyses to identify the role of facility-level characteristics and resident QOL on facility-mean values of family satisfaction. Four distinct domains were identified for family satisfaction: "care," "staff," "environment," and "food." Chain affiliation, higher resident acuity, more deficiencies, and large size were all associated with less family satisfaction, and resident QOL was a significant (albeit weak) predictor of family satisfaction. Results suggest that family member satisfaction is distinct from resident QOL but is associated with resident QOL and facility characteristics.

Validation of the Neonatal Satisfaction Survey (NSS-8) in six Norwegian neonatal intensive care units: a quantitative cross-sectional study.

PubMed

Hagen, Inger Hilde; Svindseth, Marit Følsvik; Nesset, Erik; Orner, Roderick; Iversen, Valentina Cabral

2018-03-27

The experience of having their new-borns admitted to an intensive care unit (NICU) can be extremely distressing. Subsequent risk of post-incident-adjustment difficulties are increased for parents, siblings, and affected families. Patient and next of kin satisfaction surveys provide key indicators of quality in health care. Methodically constructed and validated survey tools are in short supply and parents' experiences of care in Neonatal Intensive Care Units is under-researched. This paper reports a validation of the Neonatal Satisfaction Survey (NSS-8) in six Norwegian NICUs. Parents' survey returns were collected using the Neonatal Satisfaction Survey (NSS-13). Data quality and psychometric properties were systematically assessed using exploratory factor analysis, tests of internal consistency, reliability, construct, convergent and discriminant validity. Each set of hospital returns were subjected to an apostasy analysis before an overall satisfaction rate was calculated. The survey sample of 568 parents represents 45% of total eligible population for the period of the study. Missing data accounted for 1,1% of all returns. Attrition analysis shows congruence between sample and total population. Exploratory factor analysis identified eight factors of concern to parents,"Care and Treatment", "Doctors", "Visits", "Information", "Facilities", "Parents' Anxiety", "Discharge" and "Sibling Visits". All factors showed satisfactory internal consistency, good reliability (Cronbach's alpha ranged from 0.70-0.94). For the whole scale of 51 items α 0.95. Convergent validity using Spearman's rank between the eight factors and question measuring overall satisfaction was significant on all factors. Discriminant validity was established for all factors. Overall satisfaction rates ranged from 86 to 90% while for each of the eight factors measures of satisfaction varied between 64 and 86%. The NSS-8 questionnaire is a valid and reliable scale for measuring parents' assessment of quality of care in NICU. Statistical analysis confirms the instrument's capacity to gauge parents' experiences of NICU. Further research is indicated to validate the survey questionnaire in other Nordic countries and beyond.

[Silhouette scales and body satisfaction in adolescents: a systematic literature review].

PubMed

Côrtes, Marcela Guimarães; Meireles, Adriana Lúcia; Friche, Amélia Augusta de Lima; Caiaffa, Waleska Teixeira; Xavier, César Coelho

2013-03-01

The purpose of this study was to summarize studies on adolescents' body satisfaction, focusing on the use of silhouette scales. A systematic review was carried out on MEDLINE, LILACS, SciELO, and in unpublished papers. The final analysis included 36 studies. The majority adopted the scale proposed by Stunkard et al., self-administered, presented in ascending order and on a single sheet of paper. Most studies compared characteristics on satisfaction and dissatisfaction, used the chi-square test, and did not test for confounding. Among 18 studies included in the meta-analysis, prevalence of body dissatisfaction ranged from 32.2% to 83%. The review showed wide heterogeneity between studies (p-value = 0.000; I(2) = 87.39) even after sub-group analysis and the absence of relevant information for proper comparison of studies. The article concludes by recommending greater rigor in application of the scales and presentation of study methods on body satisfaction assessed by silhouette scales, in addition to new methodological studies and those that elucidate factors related to body satisfaction.

Burnout, stress and satisfaction among Australian and New Zealand radiation oncology trainees.

PubMed

Leung, John; Rioseco, Pilar

2017-02-01

To evaluate the incidence of burnout among radiation oncology trainees in Australia and New Zealand and the stress and satisfaction factors related to burnout. A survey of trainees was conducted in mid-2015. There were 42 Likert scale questions on stress, 14 Likert scale questions on satisfaction and the Maslach Burnout Inventory-Human Services Survey assessed burnout. A principal component analysis identified specific stress and satisfaction areas. Categorical variables for the stress and satisfaction factors were computed. Associations between respondent's characteristics and stress and satisfaction subscales were examined by independent sample t-tests and analysis of variance. Effect sizes were calculated using Cohens's d when significant mean differences were observed. This was also done for respondent characteristics and the three burnout subscales. Multiple regression analyses were performed. The response rate was 81.5%. The principal component analysis for stress identified five areas: demands on time, professional development/training, delivery demands, interpersonal demands and administration/organizational issues. There were no significant differences by demographic group or area of interest after P-values were adjusted for the multiple tests conducted. The principal component analysis revealed two satisfaction areas: resources/professional activities and value/delivery of services. There were no significant differences by demographic characteristics or area of interest in the level of satisfaction after P-values were adjusted for the multiple tests conducted. The burnout results revealed 49.5% of respondents scored highly in emotional exhaustion and/or depersonalization and 13.1% had burnout in all three measures. Multiple regression analysis revealed the stress subscales 'demands on time' and 'interpersonal demands' were associated with emotional exhaustion. 'Interpersonal demands' was also associated with depersonalization and correlated negatively with personal accomplishment. The satisfaction of value/delivery of services subscale was associated with higher levels of personal accomplishment. There is a significant level of burnout among radiation oncology trainees in Australia and New Zealand. Further work addressing intervention would be appropriate to reduce levels of burnout. © 2016 The Authors. Journal of Medical Imaging and Radiation Oncology published by John Wiley & Sons Australia, Ltd on behalf of The Royal Australian and New Zealand College of Radiologists.

Assessing physician job satisfaction and mental workload.

PubMed

Boultinghouse, Oscar W; Hammack, Glenn G; Vo, Alexander H; Dittmar, Mary Lynne

2007-12-01

Physician job satisfaction and mental workload were evaluated in a pilot study of five physicians engaged in a telemedicine practice at The University of Texas Medical Branch at Galveston Electronic Health Network. Several previous studies have examined physician satisfaction with specific telemedicine applications; however, few have attempted to identify the underlying factors that contribute to physician satisfaction or lack thereof. One factor that has been found to affect well-being and functionality in the workplace-particularly with regard to human interaction with complex systems and tasks as seen in telemedicine-is mental workload. Workload is generally defined as the "cost" to a person for performing a complex task or tasks; however, prior to this study, it was unexplored as a variable that influences physician satisfaction. Two measures of job satisfaction were used: The Job Descriptive Index and the Job In General scales. Mental workload was evaluated by means of the National Aeronautics and Space Administration Task Load Index. The measures were administered by means of Web-based surveys and were given twice over a 6-month period. Nonparametric statistical analyses revealed that physician job satisfaction was generally high relative to that of the general population and other professionals. Mental workload scores associated with the practice of telemedicine in this environment are also high, and appeared stable over time. In addition, they are commensurate with scores found in individuals practicing tasks with elevated information-processing demands, such as quality control engineers and air traffic controllers. No relationship was found between the measures of job satisfaction and mental workload.

Organizational commitment and job satisfaction among nurses in Serbia: a factor analysis.

PubMed

Veličković, Vladica M; Višnjić, Aleksandar; Jović, Slađana; Radulović, Olivera; Šargić, Čedomir; Mihajlović, Jovan; Mladenović, Jelena

2014-01-01

One of the basic prerequisites of efficient organizational management in health institutions is certainly monitoring and measuring satisfaction of employees and their commitment to the health institution in which they work. The aim of this article was to identify and test factors that may have a predictive effect on job satisfaction and organizational commitment. We conducted a cross-sectional study that included 1,337 nurses from Serbia. Data were analyzed by using exploratory factor analysis, multivariate regressions, and descriptive statistics. The study identified three major factors of organizational commitment: affective commitment, disloyalty, and continuance commitment. The most important predictors of these factors were positive professional identification, extrinsic job satisfaction, and intrinsic job satisfaction (p < .0001). Predictors significantly affecting both job satisfaction and organizational commitment were identified as well; the most important of which was positive professional identification (p < .0001). This study identified the main factors affecting job satisfaction and organizational commitment of nurses, which formed a good basis for the creation of organizational management policy and human resource management policy in health institutions in Serbia. Copyright © 2014 Elsevier Inc. All rights reserved.

Life satisfaction and self-reported problems after spinal cord injury: measurement of underlying dimensions.

PubMed

Krause, James S; Reed, Karla S

2009-08-01

Evaluate the utility of the current 7-scale structure of the Life Situation Questionnaire-Revised (LSQ-R) using confirmatory factor analysis (CFA) and explore the factor structure of each set of items. Adults (N = 1,543) with traumatic spinal cord injury (SCI) were administered the 20 satisfaction and 30 problems items from the LSQ-R. CFA suggests that the existing 7-scale structure across the 50 items was within the acceptable range (root-mean-square error of approximation [RMSEA] = 0.078), although it fell just outside of this range for women. Factor analysis revealed 3 satisfaction factors and 6 problems factors. The overall fit of the problems items (RMSEA = 0.070) was superior to that of the satisfaction items (RMSEA = 0.80). RMSEA fell just outside of the acceptable range for Whites and men on the satisfaction scales. All scales had acceptable internal consistency. Results suggest the original scoring of the LSQ-R remains viable, although individual results should be reviewed for special population. Factor analysis of subsets of items allows satisfaction and problems items to be used independently, depending on the study purpose. (c) 2009 APA

Clinical and cost-effectiveness of non-medical prescribing: A systematic review of randomised controlled trials

PubMed Central

Marriott, John; Graham-Clarke, Emma; Shirley, Debra; Rushton, Alison

2018-01-01

Objective To evaluate the clinical and cost-effectiveness of non-medical prescribing (NMP). Design Systematic review. Two reviewers independently completed searches, eligibility assessment and assessment of risk of bias. Data sources Pre-defined search terms/combinations were utilised to search electronic databases. In addition, hand searches of reference lists, key journals and grey literature were employed alongside consultation with authors/experts. Eligibility criteria for included studies Randomised controlled trials (RCTs) evaluating clinical or cost-effectiveness of NMP. Measurements reported on one or more outcome(s) of: pain, function, disability, health, social impact, patient-safety, costs-analysis, quality adjusted life years (QALYs), patient satisfaction, clinician perception of clinical and functional outcomes. Results Three RCTs from two countries were included (n = 932 participants) across primary and tertiary care settings. One RCT was assessed as low risk of bias, one as high risk of bias and one as unclear risk of bias. All RCTs evaluated clinical effectiveness with one also evaluating cost-effectiveness. Clinical effectiveness was evaluated using a range of safety and patient-reported outcome measures. Participants demonstrated significant improvement in outcomes when receiving NMP compared to treatment as usual (TAU) in all RCTs. An associated cost analysis showed NMP to be more expensive than TAU (regression coefficient p = 0.0000), however experimental groups generated increased QALYs compared to TAU. Conclusion Limited evidence with overall unclear risk of bias exists evaluating clinical and cost-effectiveness of NMP across all professions and clinical settings. GRADE assessment revealed moderate quality evidence. Evidence suggests that NMP is safe and can provide beneficial clinical outcomes. Benefits to the health economy remain unclear, with the cost-effectiveness of NMP assessed by a single pilot RCT of low risk of bias. Adequately powered low risk of bias RCTs evaluating clinical and cost effectiveness are required to evaluate NMP across clinical specialities, professions and settings. Registration PROSPERO (CRD42015017212). PMID:29509763

Framing the construct of life satisfaction in terms of older adults' personal goals.

PubMed

Rapkin, B D; Fischer, K

1992-03-01

Older adults' life satisfaction can be better understood in light of their personal goals. This study of 179 elders examined (a) how goals correlate with satisfaction, (b) whether elders maintain satisfaction by accommodating goals to past losses, and (c) how correlations between satisfaction and key predictors differ among groups with different goals. Satisfaction was related positively to social maintenance and energetic life-style goals and negatively to concerns for improvement, disengagement, stability, and reduced activity. Past losses were correlated with current goals but not with satisfaction, consistent with the notion of accommodation. A cluster analysis identified 5 patterns of goals: high demand, age prescribed, self-focused, socially engaged, and low demand. Correlations between satisfaction and other predictors differed by cluster, suggesting that the determinants of elders' satisfaction depend on personal goals.

Early father–daughter relationship and demographic determinants of spousal marital satisfaction

PubMed Central

Alsheikh Ali, Ahmad; Daoud, Fawzi Shaker

2016-01-01

This study examined several dimensions of early father–daughter relationship as predictors of marital satisfaction among 494 respondents. Descriptive comparative approach was used in result analysis. The Father Presence Questionnaire and Marital Satisfaction Questionnaire were used, in addition to a number of demographic variables. Results showed that only physical relationship with the father, and perceptions of father’s influence, had a positive significant impact on wives’ marital satisfaction. Of all domains, only positive feelings about the father had a negative impact on the husband’s marital satisfaction. Most demographic variables had statistically significant effect on marital satisfaction. Sociocultural implications for marital satisfaction for wives and husbands are discussed. PMID:27114719

Analysis of NPS Contracting Service Quality

DTIC Science & Technology

2014-12-01

customer expectations is what they “hear from other customers ” or word of mouth communications (Zeithaml et al., 1990). The second factor... satisfaction and customer satisfaction (Hallowell et al., 1996). If a service quality gap exists between the provider and the customer , that gap could...identify a problem with provider job satisfaction , customer satisfaction , or both. In turn, by identifying potential problems in these areas, it could

The Relationship of Family Satisfaction to Satisfaction with the Military Way of Life among Soldiers. Technical Report 864.

ERIC Educational Resources Information Center

Bowen, Gary L.

This study investigated the relationship between soldiers' satisfaction with the environment for families in the Army and satisfaction with the military way of life. The report is based on a secondary analysis of the responses of a stratified random sample of 9,198 Army personnel, a sample that participated in the 1985 Department of Defense…

Differences in reported satisfaction ratings by consumptive and nonconsumptive recreationists: A comparative analysis of three decades of research

Treesearch

Jennifer M. Roemer; Jerry J. Vaske

2012-01-01

This paper updates a previous comparative analysis article (Vaske et al. 1982) by analyzing differences in satisfaction ratings reported by consumptive and nonconsumptive recreationists over a 30-year period.

Transdisciplinary collaboration of academia and practice in the area of serious mental illness.

PubMed

Connolly, P M

1995-12-01

The Transdisciplinary Collaboration Project at San Jose State University in San Jose, California, focuses on providing high-quality services for persons with serious mental illness living in the community while preparing future mental health professionals to practise in an environment of cultural diversity and cost containment. Rehospitalization and emergency psychiatric services were decreased and community tenure increased at two board and care sites. The total cost savings for 1 year for 25 individuals was $373,830. Nursing, communication disorders, occupational therapy, social work, and therapeutic recreation students and faculty provided over 5000 hours of direct care during the 1993-95 academic years. Studies on client and student satisfaction revealed high levels of satisfaction. Unique components of the project include university organized transdisciplinary seminars for students, agency personnel and, when appropriate, residents, faculty practice, faculty led groups, employment for former clients/consumers and faculty consultation services.