Human Resources for Health最新文献

{"title":"Cost-effectiveness of severe acute malnutrition treatment delivered by community health workers in the district of Mayahi, Niger.","authors":"Elisa M Molanes-López, José M Ferrer, Abdias Ogobara Dougnon, Abdoul Aziz Gado, Atté Sanoussi, Nassirou Ousmane, Ramatoulaye Hamidou Lazoumar, Pilar Charle-Cuéllar","doi":"10.1186/s12960-024-00904-1","DOIUrl":"10.1186/s12960-024-00904-1","url":null,"abstract":"<p><strong>Background: </strong>A non-randomized controlled trial, conducted from June 2018 to March 2019 in two rural communes in the health district of Mayahi in Niger, showed that including community health workers (CHWs) in the treatment of severe acute malnutrition (SAM) resulted in a better recovery rate (77.2% vs. 72.1%) compared with the standard treatment provided solely at the health centers. The present study aims to assess the cost and cost-effectiveness of the CHWs led treatment of uncomplicated SAM in children 6-59 months compared to the standard national protocol.</p><p><strong>Methods: </strong>To account for all relevant costs, the cost analysis included activity-based costing and bottom-up approaches from a societal perspective and on a within-trial time horizon. The cost-effectiveness analysis was conducted through a decision analysis network built with OpenMarkov and evaluated under two approaches: (1) with recovery rate and cost per child admitted for treatment as measures of effectiveness and cost, respectively; and (2) assessing the total number of children recovered and the total cost incurred. In addition, a multivariate probabilistic sensitivity analysis was carried out to evaluate the effect of uncertainty around the base case input data.</p><p><strong>Results: </strong>For the base case data, the average cost per child recovered was 116.52 USD in the standard treatment and 107.22 USD in the CHWs-led treatment. Based on the first approach, the CHWs-led treatment was more cost-effective than the standard treatment with an average cost per child admitted for treatment of 82.81 USD vs. 84.01 USD. Based on the second approach, the incremental cost-effectiveness ratio of the transition from the standard to the CHWs-led treatment amounted to 98.01 USD per additional SAM case recovered.</p><p><strong>Conclusions: </strong>In the district of Mayahi in Niger, the CHWs-led SAM treatment was found to be cost-effective when compared to the standard protocol and provided additional advantages such as the reduction of costs for households.</p><p><strong>Trial registration: </strong>ISRCTN with ID 31143316. https://doi.org/10.1186/ISRCTN31143316.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10979590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140327227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative assessment of barriers and facilitators of telemedicine volunteerism during the COVID-19 pandemic in India.","authors":"Karishma D'Souza, Saksham Singh, Christopher M Westgard, Sharon Barnhardt","doi":"10.1186/s12960-024-00897-x","DOIUrl":"10.1186/s12960-024-00897-x","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic further propelled the recent growth of telemedicine in low-resource countries, with new models of telemedicine emerging, including volunteer-based telemedicine networks. By leveraging existing infrastructure and resources to allocate health personnel more efficiently, these volunteer networks eased some of the pandemic burden placed on health systems. However, there is insufficient understanding of volunteer-based telemedicine models, especially on the human resources engagement on such networks. This study aims to understand the motivations and barriers to health practitioner engagement on a volunteer telemedicine network during COVID-19, and the mechanisms that can potentially sustain volunteer engagement to address healthcare demands beyond the pandemic.</p><p><strong>Methods: </strong>In-depth qualitative interviews were conducted with health practitioners volunteering on an Indian, multi-state telemedicine network during the COVID-19 pandemic. Data were analyzed using thematic content analysis methods.</p><p><strong>Results: </strong>Most practitioners reported being motivated to volunteer by a sense of duty to serve during the pandemic. Practitioners suggested organizational-level measures to make the process more efficient and facilitate a more rewarding provider-patient interaction. These included screening calls, gathering patient information prior to consultations, and allowing for follow-up calls with patients to close the loop on consultations. Many practitioners stated that non-financial incentives are enough to maintain volunteer engagement. However, practitioners expressed mixed feelings about financial incentives. Some stated that financial incentives are needed to maintain long-term provider engagement, while others stated that financial incentives would devalue the volunteer experience. Most practitioners highlighted that telemedicine could increase access to healthcare, especially to the rural and underserved, even after the pandemic. Practitioners also expressed an interest in continuing to volunteer with the network if the need arose again.</p><p><strong>Conclusion: </strong>Our study findings suggest that practitioners are highly intrinsically motivated to volunteer during large healthcare emergencies and beyond to address the healthcare needs of the underserved. Following the recommendations presented in the study, telemedicine networks can more successfully engage and maintain volunteer practitioners. Volunteer-based telemedicine networks have the potential to bridge shortages of health personnel in resource-constrained settings both in times of crises and beyond.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10958920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary care providers' preferences for pay-for-performance programs: a discrete choice experiment study in Shandong China.","authors":"Wencai Zhang, Yanping Li, BeiBei Yuan, Dawei Zhu","doi":"10.1186/s12960-024-00903-2","DOIUrl":"10.1186/s12960-024-00903-2","url":null,"abstract":"<p><strong>Background: </strong>Pay-for-performance (P4P) schemes are commonly used to incentivize primary healthcare (PHC) providers to improve the quality of care they deliver. However, the effectiveness of P4P schemes can vary depending on their design. In this study, we aimed to investigate the preferences of PHC providers for participating in P4P programs in a city in Shandong province, China.</p><p><strong>Method: </strong>We conducted a discrete choice experiment (DCE) with 882 PHC providers, using six attributes: type of incentive, whom to incentivize, frequency of incentive, size of incentive, the domain of performance measurement, and release of performance results. Mixed logit models and latent class models were used for the statistical analyses.</p><p><strong>Results: </strong>Our results showed that PHC providers had a strong negative preference for fines compared to bonuses (- 1.91; 95%CI - 2.13 to - 1.69) and for annual incentive payments compared to monthly (- 1.37; 95%CI - 1.59 to - 1.14). Providers also showed negative preferences for incentive size of 60% of monthly income, group incentives, and non-release of performance results. On the other hand, an incentive size of 20% of monthly income and including quality of care in performance measures were preferred. We identified four distinct classes of providers with different preferences for P4P schemes. Class 2 and Class 3 valued most of the attributes differently, while Class 1 and Class 4 had a relatively small influence from most attributes.</p><p><strong>Conclusion: </strong>P4P schemes that offer bonuses rather than fines, monthly rather than annual payments, incentive size of 20% of monthly income, paid to individuals, including quality of care in performance measures, and release of performance results are likely to be more effective in improving PHC performance. Our findings also highlight the importance of considering preference heterogeneity when designing P4P schemes.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10936064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ophthalmology workforce over a decade in the Kingdom of Saudi Arabia: demographics, distribution, and future challenges.","authors":"Tariq Aldebasi, Abdullah M Alhejji, Bushra H Bukhari, Nawaf K Alawad, Sarah M Alghaihab, Raghad M Alakel, Albanderi Alhamzah, Tariq Almudhaiyan, Shatha Alfreihi, Malek Alrobaian, Shiji Gangadharan","doi":"10.1186/s12960-024-00902-3","DOIUrl":"10.1186/s12960-024-00902-3","url":null,"abstract":"<p><strong>Background: </strong>The ophthalmology workforce is an integral component of any health care system. However, the demand for eye care has imposed a heavy burden on this system. Hence, this study aimed to estimate the trends, demographic characteristics, distribution, and variation between Saudi and non-Saudi ophthalmologists and the future challenges of the ophthalmology workforce in the Kingdom of Saudi Arabia (KSA).</p><p><strong>Methods: </strong>This study was conducted in the KSA and included ophthalmologists practicing from 2010 to 2023. From the Saudi Commission for Health Specialties, we obtained the number, gender, nationality, and rank of ophthalmologists. The geographic distribution of ophthalmologists in the KSA was obtained from the Ministry of Health Statistical Yearbook 2021.</p><p><strong>Results: </strong>As of January 2023, the KSA had a total of 2608 registered ophthalmologists, with approximately 81.06 ophthalmologists per 1,000,000 people. Only 38% of all ophthalmologists in the country were Saudis. The percentage of Saudi female graduates increased from 13.3% to 37.2% over 12 years [Sen's estimator of slope for median increase per year = 1.33 (95% CI 1.22-1.57) graduates; trend test P < 0.001). Additionally, we found that the geographic distribution of ophthalmologists varied (test for homogeneity of rates, P < 0.0001), with the larger regions having a higher concentration of ophthalmologists than the smaller regions (75.6 in Riyadh versus 42.8 in Jazan per 1,000,000 people). However, the World Health Organization's target for the ophthalmologist-to-population ratio has been achieved in all 13 health regions of KSA.</p><p><strong>Conclusion: </strong>The recommended ophthalmologist-to-population ratio has been achieved in the KSA, and the number of Saudi ophthalmologists has almost doubled over the past 8 years. However, the majority of ophthalmologists are still non-Saudi, as Saudi ophthalmologists constitute approximately one-third of the ophthalmology workforce in the KSA. The geographical distribution of ophthalmologists varies, which might affect access to care in peripheral regions. In response to the growing demand for eye care in the KSA, several more effective measures might need to be considered.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10913636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Family doctors are also people\": a qualitative analysis of how family physicians managed competing personal and professional responsibilities during the COVID-19 pandemic.","authors":"Sarah Spencer, Julia Lukewich, Emily Gard Marshall, Maria Mathews, Shabnam Asghari, Judith B Brown, Thomas R Freeman, Paul Gill, Samina Idrees, Rita K McCracken, Sudit Ranade, Steve Slade, Amanda L Terry, Jamie Wickett, Eric Wong, Richard Buote, Leslie Meredith, Lauren Moritz, Dana Ryan, Lindsay Hedden","doi":"10.1186/s12960-024-00901-4","DOIUrl":"10.1186/s12960-024-00901-4","url":null,"abstract":"<p><strong>Background: </strong>Family physicians (FPs) fill an essential role in public health emergencies yet have frequently been neglected in pandemic response plans. This exclusion harms FPs in their clinical roles and has unintended consequences in the management of concurrent personal responsibilities, many of which were amplified by the pandemic. The objective of our study was to explore the experiences of FPs during the first year of the COVID-19 pandemic to better understand how they managed their competing professional and personal priorities.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with FPs from four Canadian regions between October 2020 and June 2021. Employing a maximum variation sampling approach, we recruited participants until we achieved saturation. Interviews explored FPs' personal and professional roles and responsibilities during the pandemic, the facilitators and barriers that they encountered, and any gender-related experiences. Transcribed interviews were thematically analysed.</p><p><strong>Results: </strong>We interviewed 68 FPs during the pandemic and identified four overarching themes in participants' discussion of their personal experiences: personal caregiving responsibilities, COVID-19 risk navigation to protect family members, personal health concerns, and available and desired personal supports for FPs to manage their competing responsibilities. While FPs expressed a variety of ways in which their personal experiences made their professional responsibilities more complicated, rarely did that affect the extent to which they participated in the pandemic response.</p><p><strong>Conclusions: </strong>For FPs to contribute fully to a pandemic response, they must be factored into pandemic plans. Failure to appreciate their unique role and circumstances often leaves FPs feeling unsupported in both their professional and personal lives. Comprehensive planning in anticipation of future pandemics must consider FPs' varied responsibilities, health concerns, and necessary precautions. Having adequate personal and practice supports in place will facilitate the essential role of FPs in responding to a pandemic crisis while continuing to support their patients' primary care needs.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10913223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global migration and factors influencing retention of Asian internationally educated nurses: a systematic review.","authors":"Danny Shin Kai Ung, Yong Shian Goh, Ryan Yuan Sheng Poon, Yongxing Patrick Lin, Betsy Seah, Violeta Lopez, Kristina Mikkonen, Keng Kwang Yong, Sok Ying Liaw","doi":"10.1186/s12960-024-00900-5","DOIUrl":"10.1186/s12960-024-00900-5","url":null,"abstract":"<p><strong>Background: </strong>Given nurses' increasing international mobility, Asian internationally educated nurses (IENs) represent a critical human resource highly sought after within the global healthcare workforce. Developed countries have grown excessively reliant on them, leading to heightened competition among these countries. Hence, this review aims to uncover factors underlying the retention of Asian IENs in host countries to facilitate the development of more effective staff retention strategies.</p><p><strong>Methods: </strong>A mixed-methods systematic review was conducted using the Joanna Briggs Institute methodology for mixed-method systematic review. A search was undertaken across the following electronic databases for studies published in English during 2013-2022: CINAHL, Embase, PubMed, Scopus, Web of Science and PsycINFO. Two of the researchers critically appraised included articles independently using the Joanna Briggs Critical Appraisal Tools and Mixed Methods Appraisal Tool (version 2018). A data-based convergent integrated approach was adopted for data synthesis.</p><p><strong>Results: </strong>Of the 27 included articles (19 qualitative and eight quantitative), five each were conducted in Asia (Japan, Taiwan, Singapore and Malaysia), Australia and Europe (Italy, Norway and the United Kingdom); four each in the United States and the Middle East (Saudi Arabia and Kuwait); two in Canada; and one each in New Zealand and South Africa. Five themes emerged from the data synthesis: (1) desire for better career prospects, (2) occupational downward mobility, (3) inequality in career advancement, (4) acculturation and (5) support system.</p><p><strong>Conclusion: </strong>This systematic review investigated the factors influencing AMN retention and identified several promising retention strategies: granting them permanent residency, ensuring transparency in credentialing assessment, providing equal opportunities for career advancement, instituting induction programmes for newly employed Asian IENs, enabling families to be with them and building workplace social support. Retention strategies that embrace the Asian IENs' perspectives and experiences are envisioned to ensure a sustainable nursing workforce.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10905872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Superheroes? No, thanks.\" Accepting vulnerability in healthcare professionals.","authors":"Dolores Morera, Janet Delgado, Elena Lorenzo, María Elisa de Castro-Peraza, Naira Delgado","doi":"10.1186/s12960-024-00899-9","DOIUrl":"10.1186/s12960-024-00899-9","url":null,"abstract":"<p><p>In this commentary, we develop a conceptual proposal aimed to explain why a discourse of praise and admiration for healthcare professionals´ limitless dedication can trigger a general indifference to the burnout and suffering they experience. Ultimately, this can lead to the justification of the lack of resources dedicated to preventing these problems. We first start by pointing out the stigmatisation of healthcare professionals suffering from burnout and showing their vulnerability, highlighting the complex interactions that occur in the healthcare context and that increase the risk of perpetuating their suffering. Then, we appeal to the recognition of one's own vulnerability as a key element towards the creation of a culture more focused on the duty of care for those who care for others. We conclude with several proposals for action to cope with burnout-related stigma, trying to change the superhuman image of health personnel and incorporating the vulnerability inherent to human beings.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10877781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feminization of the health workforce in China: exploring gendered composition from 2002 to 2020.","authors":"Mingyue Li, Joanna Raven, Xiaoyun Liu","doi":"10.1186/s12960-024-00898-w","DOIUrl":"10.1186/s12960-024-00898-w","url":null,"abstract":"<p><strong>Background: </strong>Feminization of health workforce has been globally documented, but it has not been investigated in China. This study aims to analyze changes in the gendered composition of health workforce and explore the trend in different types of health workforce, health organizations and majors within China's health system.</p><p><strong>Methods: </strong>The data were collected from China Health Statistical Yearbook from 2002 to 2020. We focused on health professionals including doctors, nurses, and pharmacists in health organizations. Trend analysis was employed to examine the change in the ratio of female health workforce over 18 years. The estimated average annual percent change (AAPC) was estimated, and the reciprocals of variances for the female ratios were used as weights.</p><p><strong>Results: </strong>In China, health professionals increased from 4.7 million in 2002 to 10.68 million in 2020. Health professionals per 1000 population increased from 3.41 in 2002 to 7.57 in 2020. The ratio of female health professionals significantly increased from 63.85% in 2002 to 72.4% in 2020 (AAPC = 1.04%, 95% CI 0.96-1.11%, P < 0.001). Female doctors and pharmacists increased 4.7 and 7.9 percentage points from 2002 to 2020. Female health workers at township health centers, village clinics, centers for disease control and prevention had higher annual increase rate (AAPC = 1.67%, 2.25% and 1.33%, respectively) than those at hospital (0.70%) and community health center (0.5%). Female doctors in traditional Chinese medicine, dentistry and public health had higher annual increase rate (AAPC = 1.82%, 1.53% and 1.91%, respectively) than female clinical doctor (0.64%).</p><p><strong>Conclusions: </strong>More women are participating in the healthcare sector in China. However, socially lower-ranked positions have been feminizing faster, which could be due to the inherent and structural gender norms restricting women's career. More collective and comprehensive system-level actions will be needed to foster a gender-equitable environment for health workforce at all levels.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10877893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139906632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotional labor and burnout among nurses in Iran: core self-evaluations as mediator and moderator.","authors":"Elham Saei, Soheil Sarshar, Raymond T Lee","doi":"10.1186/s12960-024-00896-y","DOIUrl":"10.1186/s12960-024-00896-y","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the mediating and moderating impact of core self-evaluations in the path from emotional labor to burnout. Our hypothesized associations are based on Hobfoll (Rev Gen Psychol 6:307-24, 2002) conservation of resources theory.</p><p><strong>Method: </strong>Three hundred nurses from four hospitals in Abadan, Iran, were invited to participate in our study. Of the 300, 255 completed all sections and questions in our survey for an 85% response rate. The posited direct and indirect effects were evaluated with structural equation modeling and the interaction effects were evaluated with hierarchical moderated regression and simple regression slope plots.</p><p><strong>Result: </strong>Deep acting has indirect effects on burnout through core self-evaluations. Though unrelated to surface acting, core self-evaluations moderate its impact: under low core self-evaluations, surface acting is strongly related to emotional exhaustion and inversely related to personal accomplishment, whereas, under high core self-evaluations, surface acting is unrelated to these burnout dimensions.</p><p><strong>Conclusion: </strong>Our findings reveal the dual functions of CSE as a psychological resource and buffer to offset the interpersonal demands of patient care. Limitations, directions for future research, and practical implications are discussed.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10858547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139713225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of intensive care unit quality assessment on changes in medical staff in medical institutions and in-hospital mortality.","authors":"Seungju Kim, Gui Ok Kim, Syalrom Lee, Yong Uk Kwon","doi":"10.1186/s12960-024-00893-1","DOIUrl":"10.1186/s12960-024-00893-1","url":null,"abstract":"<p><strong>Background: </strong>Quality assessments are being introduced in many countries to improve the quality of care and maintain acceptable quality levels. In South Korea, various quality assessments are being conducted to improve the quality of care, but there is insufficient evidence on intensive care units (ICUs). This study aims to evaluate the impact of ICU quality assessments on the structural indicators in medical institutions and the resulting in-hospital mortality of patients.</p><p><strong>Methods: </strong>This study used data collected in the 2nd and 3rd ICU quality assessments in 2017 and 2019. A total of 72,879 patients admitted to ICUs were included during this period, with 265 institutions that received both assessments. As for structural indicators, changes in medical personnel and equipment were assessed, and in-hospital deaths were evaluated as patient outcomes. To evaluate the association between medical staff and in-hospital mortality, a generalized estimating equation model was performed considering both hospital and patient variables.</p><p><strong>Results: </strong>Compared to the second quality evaluation, the number of intensivist physicians and experienced nurses increased in the third quality evaluation; however, there was still a gap in the workforce depending on the type of medical institution. Among all ICU patients admitted during the evaluation period, 12.0% of patients died in the hospital. In-hospital mortality decreased at the 3rd assessment, and hospitals employing intensivist physicians were associated with reduced in-hospital deaths. In addition, an increase in the number of experienced nurses was associated with a decrease in in-hospital mortality, while an increase in the nurse-to-bed ratio increased mortality.</p><p><strong>Conclusions: </strong>ICU quality assessments improved overall structural indicators, but the gap between medical institutions has not improved and interventions are required to bridge this gap. In addition, it is important to maintain skilled medical personnel to bring about better results for patients, and various efforts should be considered. This requires continuous monitoring and further research on long-term effects.</p>","PeriodicalId":39823,"journal":{"name":"Human Resources for Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10835892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}