Association between efficiency and quality of care of public healthcare facilities: Evidence from Pakistan

Bashir, Saima; Nasir, Muhammad; Grasic, Katja; Moulin, Marc S; Ali, Shehzad

doi:10.1002/hpm.3465

Cited by 7 publications

(5 citation statements)

References 30 publications

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“…Additionally, a decentralized health care system paired with political instability and poor governance frequently results in inadequate funding [ 37 ] and a dearth of regulations for implementing patient safety protocols effectively. Consequently, health care providers in Pakistan continually navigate these multifaceted challenges while striving for the provision of safe, effective, and quality care for their patients [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of Patient Safety in a Low-Resource Health Care System: Proposal for a Multimethod Study

Haque,

Asif,

Ahmed

et al. 2024

JMIR Res Protoc

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Background The high prevalence of adverse events (AEs) globally in health care delivery has led to the establishment of many guidelines to enhance patient safety. However, patient safety is a relatively nascent concept in low- and middle-income countries (LMICs) where health systems are already overburdened and underresourced. This is why it is imperative to study the nuances of patient safety from a local perspective to advocate for the judicious use of scarce public health resources. Objective This study aims to assess the status of patient safety in a health care system within a low-resource setting, using a multipronged, multimethod approach of standardized methodologies adapted to the local setting. Methods We propose purposive sampling to include a representative mix of public and private, rural and urban, and tertiary and secondary care hospitals, preferably those ascribed to the same hospital quality standards. Six different approaches will be considered at these hospitals including (1) focus group discussions on the status quo of patient safety, (2) Hospital Survey on Patient Safety Culture, (3) Hospital Consumer Assessment of Healthcare Providers and Systems, (4) estimation of incidence of AEs identified by patients, (5) estimation of incidence of AEs via medical record review, and (6) assessment against the World Health Organization’s Patient Safety Friendly Hospital Framework via thorough reviews of existing hospital protocols and in-person surveys of the facility. Results The abovementioned studies collectively are expected to yield significant quantifiable information on patient safety conditions in a wide range of hospitals operating within LMICs. Conclusions A multidimensional approach is imperative to holistically assess the patient safety situation, especially in LMICs. Our low-budget, non–resource-intensive research proposal can serve as a benchmark to conduct similar studies in other health care settings within LMICs. International Registered Report Identifier (IRRID) PRR1-10.2196/50532

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Section: Discussionmentioning

confidence: 99%

Assessment of Patient Safety in a Low-Resource Health Care System: Proposal for a Multimethod Study

Haque,

Asif,

Ahmed

et al. 2024

JMIR Res Protoc

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“…To the best of our knowledge, the research on combining Shannon entropy and the DEA method is divided into two main areas. The first one uses Shannon entropy to integrate the different DEA model measurements [ 37 , 38 ]. The second one obtains the CES by evaluating the importance of each combination of variables to improve the DEA identification and provides a complete ranking [ 11 , 39 ].…”

Section: Methodsmentioning

confidence: 99%

“…In terms of the efficiency measurement of healthcare institutions, Sherman [ 37 ] was the first to use the DEA method, and afterwards, numerous scholars enriched this field of research [ 38 , 39 , 40 , 41 ]. In particular, the DEA method has also made great progress in evaluating the efficiency of Chinese healthcare organizations.…”

Section: Introductionmentioning

confidence: 99%

Using Shannon Entropy to Improve the Identification of MP-SBM Models with Undesirable Output

Zhan-xin

Yin

Yang

et al. 2022

Entropy

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In the context of the COVID-19 global epidemic, it is particularly important to use limited medical resources to improve the systemic control of infectious diseases. There is a situation where a shortage of medical resources and an uneven distribution of resources in China exist. Therefore, it is important to have an accurate understanding of the current status of the healthcare system in China and to improve the efficiency of their infectious disease control methods. In this study, the MP-SBM-Shannon entropy model (modified panel slacks-based measure Shannon entropy model) was proposed and applied to measure the disposal efficiency of the medical institutions responding to public health emergencies (disposal efficiency) in China from 2012 to 2018. First, a P-SBM (panel slacks-based measure) model, with undesirable outputs based on panel data, is given in this paper. This model measures the efficiency of all DMUs based on the same technical frontier and can be used for the dynamic efficiency analysis of panel data. Then, the MP-SBM model is applied to solve the specific efficiency paradox of the P-SBM model caused by the objective data structure. Finally, based on the MP-SBM model, undesirable outputs are considered in the original efficiency matrix alignment combination for the deficiencies of the existing Shannon entropy-DEA model. The comparative analysis shows that the MP-SBM-Shannon model not only solves the problem of the efficiency paradox of the P-SBM model but also improves the MP-SBM model identification ability and provides a complete ranking with certain advantages. The results of the study show that the disposal efficiency of the medical institutions responding to public health emergencies in China shows an upward trend, but the average combined efficiency is less than 0.47. Therefore, there is still much room for improvement in the efficiency of infectious disease prevention and control in China. It is found that the staffing problem within the Center for Disease Control and the health supervision office are two stumbling blocks.

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“…There is indeed a significant amount of literature on healthcare efficiency, and there have been current discussions about how to quantify a hospital's quality efficiency and effectiveness in order to meet patient satisfaction and commitment. Service quality is a strategy for developing a vision of the organization's objectives and mission, as well as understanding and assisting each specific employee and recognizing their progress in improving quality performance and customer experience to achieve maximum utility [18][19][20][21][22][23][24]. Authors Lai and Cheng state that aside from the described definition of service quality, customer engagement rates and the expense of losing a client can be used to assess the effectiveness of service [25].…”

Section: Literature Reviewmentioning

confidence: 99%

A Study on the Effectiveness and Efficiency of Public or Private Hospitals within Pakistan

Islam,

Raees,

Syed

2024

SSURJET

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Hospitals play a very important role in human lives. People are in search of quality and timely healthcare facilities. This paper talks about the efficiency and effectiveness of healthcare services. One needs to identify the factors and mechanisms to enhance the performance of government and private hospitals. This study aims to find the important variables that were required to find the best solution for public and private hospitals in Pakistan. The major contributions of the paper are as follows. The paper first deliberates on the need for technical excellence as compared to interpersonal excellence for hospital management. It also performs a qualitative review of the literature on the important variables for determining the effectiveness and efficiencies of the hospital. Then, the paper presents a public survey about the effectiveness and efficiency of public and private hospitals using different questionnaires. These questionnaires were filled by the relatives of patients or patients themselves when they visited hospitals. On this dataset, the paper applies a machine learning algorithm i.e., random forest, to predict which hospital type is suitable for them while considering the variables. These variables include; the services of the hospital, admission process, treatment, doctor's behavior, timely treatment, and knowledge of the staff about SOPs. The data was split into 75 % training and 25 % testing dataset. Python’s Library SK-learn was used for implementation. The accuracy of the classifier on the test dataset is 96.91 %. The paper then determines the variables that are contributing the most to the measure of effectiveness and efficiencies of hospitals. The algorithm also ranks these features that can be used to improve a hospital's performance. It also provides a benchmark to the patients in the selection of hospitals for healthcare facilities.

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Association between efficiency and quality of care of public healthcare facilities: Evidence from Pakistan

Cited by 7 publications

References 30 publications

Assessment of Patient Safety in a Low-Resource Health Care System: Proposal for a Multimethod Study

Assessment of Patient Safety in a Low-Resource Health Care System: Proposal for a Multimethod Study

Using Shannon Entropy to Improve the Identification of MP-SBM Models with Undesirable Output

A Study on the Effectiveness and Efficiency of Public or Private Hospitals within Pakistan

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