Search results

Although India has a number of health issues, the healthcare facilities in India are insufficient due to poor quality of care. The purpose of this paper is to examine the factors affecting the structural quality of healthcare facilities in India.

This study used the medical facility data from the India Human Development Survey-II, 2011–2012 (ICPSR 36151) (n=4,218). Logistic regression was conducted to predict structural quality of healthcare facilities.

The results suggest that it is difficult to have all standard resources available at health care facilities in India. Surprisingly, having a drinking water source inside the health facility appears to be an indicator of poor structural quality of health care facilities. Having a water source inside a health care facility is associated with not having a separate exam room and not having a sink to wash hands. A higher registration fee was associated with good structural quality and with having a separate exam room and having a sink to wash hands.

This study shows the complexity of providing quality health care to the poor, particularly in developing countries. Research on quality of healthcare facilities in India is needed to improve the health of the population. Little research has been done on the factors influencing the structural quality of the healthcare facilities in India. This study is an important contribution to the current knowledge of structural healthcare facility standards and its influences in India.

To achieve Goal 5 of the MDGs, the Government of Ghana introduced the free maternal health service system to break financial barriers of access to maternal care services. In spite of this, facility‐based deliveries continue to be low due partly to poor quality of antenatal care that prevents pregnant women from giving birth in hospitals. The aim of this study is to examine factors shaping quality of antenatal care in selected public hospitals in the country.

363 expectant mothers were randomly selected for interview. Women who have previously received antenatal care in the health facilities for at least two occasions were interviewed. Multivariate logistic regression model were computed to examine correlates of antenatal care quality.

The odds of reporting quality of antenatal care as good was higher among women aged between 30 and 34 years. Similarly women with junior/senior high education were more likely to report antenatal care quality as good. Distance to the health facilities generally influence women perception of antenatal care quality but the relative odds of reporting quality of care as good attenuated with proximity to the health facility. Five factors (pleasant interaction with providers, privacy during consultation, attentiveness of providers, adequate facilities and availability of drugs) emerged as statistically significant in explaining antenatal care quality after controlling for selected demographic variables.

Results of the study generally demonstrate the need to improve maternal services in public facilities to stimulate utilisation and facility‐based deliveries.

Patient-centred strategies should be applied in health-care facilities management (HcFM) to guarantee service quality to meet patients’ needs and ensure quality patient health-care experience. This paper aims to examine the intervening influence of the quality of health-care administrative process (QAP) on the association between health-care facilities service quality and patients’ experiences with medical care.

A quantitative technique was used for this cross-sectional study in three Ghanaian teaching hospitals. A total of 622 relevant questionnaires were used for the analysis of the study using SEM-PLS.

The intervening influence of the QAP on the relationship between HcFM service quality (empathy and tangibility) and patients’ health-care experience (PHcE) were reinforced whilst that of reliability, responsiveness and assurance were not reinforced. The association between the QAP and PHcE was also established.

A high-quality health-care workforce (both core and supporting) and quality work environment provided by the FM department and QAP are essential during quality-of-care delivery, to reduce threats to patient safety to achieve exceptional PHcE. The constraint on the study is that information was gathered from only Ghana. Hence, the generalisation of the findings will be a challenge. Thus, in future, it is proposed that a comparative study across a developed country and a developing country can be conducted. Future research can assess the influence of the health-care internal appearance on patients’ satisfaction.

Practically, the administrative system can be improved by reducing patients overall waiting time. Steps must also be taken to reduce the problem of needless administrative tasks and practices to simplify administrative practices and improve patients’ total health-care experience (core health-care delivery and HcFM), as this influence patients’ total health-care experience.

To the best of the authors’ knowledge, this empirical validation is one of the initial studies in service quality and FM to examine how health-care administrative process quality affects the relationship between FM service quality and patients’ experiences with medical care. This framework can be adapted for research in different countries to extend knowledge.

Over the past two decades, Community-Based Health Planning and Services (CHPS) has been a pragmatic strategy towards universal Primary Health Care (PHC) in Ghana. However, the ability and capacity of these facilities to deliver quality primary health care remain an illusion as they are still crumbling in myriad challenges. These challenges are translated to the poor-quality services provision and low community utilization of CHPS facilities. The study presents a comparative analysis of three communities in the Kassena-Nankana East Municipality, Ghana.

Using a mixed-method research design, the study gathered and analysed data from 110 households, three community health officers (CHOs) and three community leaders using semi-structured questionnaires and interview guides.

The findings indicated that the facilities do not have the requisite inputs such as drugs and supplies, logistics, appropriate health personnel, good infrastructure, funding support necessary to deliver quality and appropriate healthcare services that meet the health needs of the communities. For the CHPS to realize their full potentials as PHC facilities, it is required that the needed inputs such as logistics, drugs and appropriate staff are in place to facilitate the activities of CHOs.

Due to the limited number of participants and selection of the study communities, the results may generalization. Also, the researchers acknowledged the inability to interview the district level health officials and the Kassena-Nankana Municipal Assembly during the field visits. This could have provided in-depth knowledge on the findings of this research as well as the validation of the results from the communities' perspective. Several attempts were made to contact and interview district-level authorities which proven futile due to the unavailability of targeted respondents. This resulted in limiting the studies at the community level. However, this limitation does not disprove the findings of this study.

The article implications for planning primary health care strategies include a keen assessment of community health needs and institutional management of primary health care facilities, equip PHC facilities with adequate resources such as drugs and appropriate staffing to provide the health needs of the communities.

The paper fulfils the gap in the literature by providing empirical data on how the challenges of primary health care facilities affected the provision of high quality service and how this can affect community’s use of the facilities.

With challenges in health-care facilities management (FM) and adequacy of health-care resources constraints in most developing countries, improving patient’s health-care experience has become of strategic importance in public health-care delivery. This paper aims to investigate the mediating effect of adequacy of health-care resources on the relationship between the quality of health-care FM services and patient’s health-care experience.

This cross-sectional study adopts a quantitative approach based on a questionnaire survey conducted on 660 patients of three teaching hospitals in Ghana. In total, 622 valid questionnaires were used for data analysis using partial least squares structural equation modelling.

The mediating effect of adequacy of health-care resources on the relationship between responsiveness and tangibility and patients’ health-care experience were supported, while that of empathy, reliability and assurance were not supported. The relationship between and adequacy of health-care resources and patients’ health-care experience was also supported.

The study limitation is that it was only the teaching hospitals that were surveyed. In future studies, a comparative analysis can be conducted between both public and private hospitals. Other constructs and relationships such as the mediating effect of the quality of health-care administrative process on the relationship between FM service quality and patients’ health-care experience as well as the moderation effect of adequacy of health-care resource on the relationship between FM service quality and patients’ health-care experience can also be tested. Future studies on the same subject can use health-care workers as the respondents of the study.

The result should inspire health-care managers to prioritize attention on health-care FM to create and sustain a decent health-care environment. Facilities managers should ensure standards are not compromised by keeping health-care resources in good condition through the organisation and management of resources.

To the best of the authors’ knowledge, this paper is one of the pioneer studies to test the mediating effect of adequacy of health-care resources on the relationship between patient’s health-care experience and health-care FM service quality. The proposed framework can be adapted to various sectors and countries as this empirical validation extends knowledge.

Federal and state governments collaborate on state Medicaid nursing facility long-term care (SMNF-LTC) programs. These programs are increasingly expensive as the baby-boomers retire. Yet serious resident outcome problems continue in spite of the Centers for Medicare and Medicaid Services’ (CMS) extensive process-focused regulatory efforts. This study identifies a promising and simpler auxiliary path for improving resident outcomes.

Drawing on a longitudinal (1997–2005), 48-state data set and panel-corrected, time-series regression, we compare the effects on resident outcomes of CMS process-focused surveys and four minimally regulated program structural features on which the states vary considerably.

We find that each of these four structural features exerts a greater effect on resident outcomes than process quality.

We suggest augmenting current process-focused regulation with a less arduous approach of more extensive regulation of these program features.

To date SMNF-LTC program regulation has focused largely on member facility processes. While regulating processes is appropriate, we show that regulating program structural features directly, an arguably easier task, might well produce considerable improvement in the quality of resident outcomes.

The purpose of this study was to examine patient satisfaction with the quality of care in Ghana’s health-care facilities using a disaggregated approach.

The study was a cross-sectional national survey. A sample of 4,079 males and females in the age group of 15-49 years were interviewed. Descriptive statistics, principal component analysis and t-tests were used in statistical analysis.

About 70 per cent of patients were satisfied with the quality of care provided in health-care facilities in Ghana, whereas about 30 per cent of patients were fairly satisfied. Females and insured patients were more likely to be satisfied with the quality of care, compared with males and uninsured patients.

Because data were obtained from a national survey, the questionnaire did not include the type of facility patients attended to find out whether satisfaction with the quality of care varied by the type of health facility. Future studies may, therefore, include this.

The study contributes to the literature on patient satisfaction with the quality of care. It highlights that long waiting time remains an intractable problem at various service delivery units of health facilities and constitutes a major source of patient dissatisfaction with the quality of care. Innovative measures must, therefore, be adopted to address the problem.

There is a paucity of research that uses a disaggregated approach to examine patient satisfaction with the quality of care at various service delivery units of health facilities. This study is a modest contribution to this research gap.

Quality of care in the residential aged sector has changed over the past decade. The purpose of this paper is to examine these changes from the perspectives of staff to identify factors influencing quality of residential aged care, and the role and influence of an aged care accreditation programme.

Focus groups were held with 66 aged care staff from 11 Australian aged care facilities. Data from semi-structured interviews were analysed to capture categories representing participant views.

Participants reported two factors stimulating change: developments in the aged care regulatory and policy framework, and rising consumer expectations. Four corresponding effects on service quality were identified: increasing complexity of resident care, renewed built environments of aged care facilities, growing focus on resident-centred care and the influence of accreditation on resident quality of life. The accreditation programme was viewed as maintaining minimum standards of quality throughout regulatory and social change, yet was considered to lack capacity of itself to explicitly promote or improve resident quality of life.

For an increasingly complex aged care population, regulatory and societal change has led to a shift in service provision from institutional care models to one that is becoming more responsive to consumer expectations. The capacity of long-established and relatively static accreditation standards to better accommodate changing consumer needs comes into question.

This is the first study to examine the relationship between accreditation and residential aged care service quality from the perspectives of staff, and offers a nuanced view of “quality” in this setting.

Indoor environmental quality (IEQ) in buildings has an impact on people’s health, productivity and comfort. Maintaining the highest possible IEQ level in complex buildings, such as health care, is difficult due to economic and organizational constraints. This study aims to categorize the vicinities in a typical health-care facility in terms of importance and criticality in relation to the various IEQ factors, as well as to develop an IEQ assessment procedure.

A comprehensive literature review, established standards and structured interviews with industrial hygiene professionals in health-care settings were used in this study. To test the applicability of the developed IEQ assessment procedure, a pilot study was conducted in an existing health-care facility.

This study categorized health-care facilities into various vicinities and discovered three respondents group had varying IEQ perceptions (facility managers, environmental health specialists and nurses). According to the findings, indoor air quality is the most important and dominant factor influencing overall IEQ in health-care facilities. The trial application of the framework shows that much work is needed to improve the level of response and readiness of facility management and occupants to allow for the effective use of the developed procedure.

Previous research did not include a detailed categorization of vicinities in health-care buildings based on IEQ requirements. The findings of this study will help to close this knowledge gap and guide facility managers and operators in recognizing the relative importance of different IEQ factors, maintaining functional requirements and identifying priorities when developing maintenance and operational procedures and allocating resources.

This paper aims to examine briefing practices and whether these are related to the quality of brief documents and client satisfaction in constructed health-care facilities in South Africa. The rational for the examination stems from the view held by scholars that the briefing process is critical to the success of projects, as well as client/user satisfaction in the constructed facility, and also because of undocumented reports of client/end-user dissatisfaction in constructed health-care facilities in South Africa.

The research process consisted of a literature review to identify existing briefing framework and practices in use applicable to facilities. This was supported by an exploratory case study of a recently completed public hospital in East London, South Africa. Data collection for the study was undertaken by means of conducting semi-structured interviews with two groups consisting of client representatives and the technical design team on the project.

The research established that in the context of this case study, inadequate client consultation took place, not all design consultants were adequately involved in the development of the project brief, limited use was made of a specific briefing framework in developing the project brief and that despite these shortcomings in the briefing process followed, a comprehensive good quality briefing document was produced and the client was satisfied with the health-care facility constructed.

The results of this study are generalizable with health-care facilities only. As such, research inferences and projections can only be made within this set and may not necessarily be applicable to the wider construction sector or to all projects within this sector.

The implications of this research are applicable to constructed health-care facilities. Practical inferences include the need to acknowledge that there is a need for a briefing framework, which should outline the involvement of all design consultants and client representatives when developing the project briefs for health-care facilities. The briefing framework is proposed for use in addressing the shortcomings in the briefing processes and practices and will also help the client in the choice of a brief process and practice which will comprehensively capture their requirements, give clear directives/information to the design consultants and will result in higher levels of end-user/patient satisfaction in the constructed health-care facility.

Clients and allied professionals in charge of health-care facilities’ construction are encouraged to consider the implementation of a standard framework for use in the briefing process. This reflection should encourage engagement through formative legislative provision and transparent awareness campaigns.

This work is original insofar, as it directly addresses the alignment of briefing practices to quality of brief documents and client satisfaction in constructed health-care facilities within the context of the South African construction industry. However, similar exercises have been undertaken on briefing practices in the wider construction sector.