DOCSLIB.ORG

Study of Quality of Care in Public and Private Sectors

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Study of Quality of Care in Public and Private Sectors Study of Quality of Care in Public and Private Sectors Research Symposium Quality of Healthcare in Sri Lanka Hosted by SLMA, CMASL and IHP 30 August 2013 Study Organization *Study Team – Isurujith K Liyanage, Janaki Jayanthan, Nilmini Wijemanne, Sanil de Alwis, Sarasi Amarasinghe, Indika Siriwardana, Shanti Dalpatadu, Prasanna Cooray, R P Rannan-Eliya Study Objective – To assess levels and differences in quality of care in public and private medical sectors in Sri Lanka Funding – World Bank contract to IHP, IHP Public Interest Research Fund Grant PIRF-2012-03, IDRC Grant 106439-003 Ethical Review – Ethical review and clearance of study design and survey instruments by IHP Ethical Review Committee (IHP ERC Approval Nos. 2012/006A, 2012/006B) 2 Outline • Study Organization • Background • Methodology • Findings • Conclusions 3 Background - Importance of measuring quality - Background on Sri Lanka 4 Why did we measure quality? • How to optimise the contribution of the private sector within Sri Lanka’s mixed health system? – Who they treat – Relative costs – Quality of care provided • Research questions – Does clinical quality differ between the public and private sectors in Sri Lanka – Does interpersonal quality differ between the public and private sectors in Sri Lanka 5 Concepts What is quality? • “The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” – Institute of Medicine 1991 Dimensions of quality (Donabedian 1980) • Structure – Whether providers have correct inputs, equipment, training, etc. • Process – Whether good practices are followed • Outcomes – Impact of medical services on patients, including health outcomes and patient satisfaction 6 Measuring process quality • No widely accepted approach • Methods differ – Developing countries: • Single conditions • Little relevance to Sri Lanka (tuberculosis, HIV, malaria) – Developed countries • Broader methods (range of conditions) 7 Utilization of healthcare services CBSL CFS 2003/04 Inpatient Outpatient 4% 45% 55% 96% 8 Key indicators of hospitals in Colombo, Gampaha, Galle (2011) Inpatient spending Category Hospitals Beds Admissions per admission n n n rupees !"#$%&'()*+%,-$* ./ /01232 456'7%$$%)8 401/2. !9%:-,;'()*+%,-$* 63 /1<2= 05/'7%$$%)8 231643 Sources: Management Development and Planning Unit (2011) and Institute for Health Policy (2013) 9 Inpatient quality of care Comparison between public and private sectors Methodology - Study design - Tracer indicators & inclusion criteria - Sampling 11 Study design – inpatient care Overview • Study object – Process quality, i.e., what providers actually do • Approach – Retrospective review of inpatient medical records – Analysis of care using tracer conditions 12 Inpatient tracer conditions Criteria for selection • Conditions should be relatively frequent • Feasible quality indicators should exist with support in literature • Should be representative of a range of conditions and patient populations Tracer conditions (initial) 1. Acute Myocardial Infarction (AMI) (1% of discharges) 2. Acute Asthma (4% of discharges) 3. Childbirth (6% of discharges) 13 Selecting quality indicators • Identified possible quality indicators – Quality clearing houses – Quality assessment agencies – Studies: developed and developing countries – Clinical guidelines • Review by panel of doctors • Subsequent review of RAND quality assessment tool – Identification of additional tracer conditions and quality indicators – Choice of method to aggregate quality indicators 14 Inpatient Quality Indicators 55 Quality Indicators Resource Drug Condition Clinical area Intensity prescribing All drug Assessment and Asthma (7) Low (12) prescribing (36) investigations (10) Medium DVT AMI (15) prophylaxis Management (39) (33) (9) Childbirth Surgical High (4) antibiotics Outcome (6) (10) (4) Other (TIA, Dengue, COPD, Heart Failure, Pneumonia) 15 Inpatient quality indicators – examples Resource Indicator Condition Clinical area Drug prescribing intensity Neonatal APGAR score Childbirth Assessment / Low - recorded Investigations Prophylactic antibiotics Childbirth Management Medium All drug prescribing, given during LSCS surgical antibioitics Live discharge, AMI AMI Outcome - - AMI patient underwent PCI AMI Management High - / stenting Oxygen saturation Acute asthma Assessment / High - measured in acute asthma Investigations 16 Sampling Distribution of sampled facilities Sampled facilities Hospital type Colombo Gampaha Galle Total Public Large 2 1 1 4 Intermediate 2 1 1 4 Obstetric 1 0 1 2 Paediatric 1 0 0 1 Other specialist 0 0 0 0 Total 6 2 3 11 Private Large 3 1 0 4 Intermediate / small 1 2 2 5 Obstetric 1 0 0 1 Paediatric 0 0 0 0 Other specialist 0 0 0 0 Total 5 3 2 10 17 Gampaha Geographic distribution of sampled providers Galle Colombo 18 Distribution of private hospitals, Sri Lanka 2012 19 Data collection and processing Patient sampling • Systematic sample of patient records from 2011 discharges • Supplementary samples of tracer conditions Data collection • Data extraction and entry by pre-intern medical graduates using Apple iPads. Drug name entry using pre-coded listing of brand and generic names. Data analysis • Diagnoses coded to ICD-10 by physician. • All analysis using Stata 12.0. 20 Data collection and processing Quality and satisfaction scores Adapted method used by RAND quality study (McGlynn et al) • Quality instance = each opportunity a patient could potentially receive recommended care !"!#$%&'()*+%",%!-(*.%+*/"((*&0*0%/#+*% !""#$"%&$' 1#.%2-3*&%,"+%*#/4%5'#$-!6%-&.!#&/* 7 ()*#$ &'()*+%",%5'#$-!6%-&.!#&/*. 21 Data collection and processing Quality scores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indings - Inpatient quality of care 23 Characteristics of patient sample Weighted, standardized Standardized Characteristic Public Sector Private Sector (n = 2,523) (n = 1,815) p value Average age, years 36.8 37.0 1.0 Male sex, % 47.9 47.8 1.0 Discharge diagnoses Asthma, % 1.0 1.2 0.7 AMI, % 0.6 0.7 0.8 Childbirth, % 6.9 6.2 0.9 Average length of stay, days 3.6 3.0 0.1 24 Quality by condition 100 89 89 90 80 69† 68 68 70 63 60 50 40 30 Percentageof patients (%) 20 10 0 Asthma AMI Childbirth Public Private Resource Condition Drug prescribing Clinical area limitation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esource Condition Drug prescribing Clinical area limitation 26 Quality by resource limitation 100 94** 90 81 80 70 60 58* 50 48 40 31** 30 Percentageof patients (%) 20 10 10 0 Low Medium High Public Private Resource Condition Drug prescribing Clinical area limitation 27 Drug prescribing 80 68* 70 68* 60 60 58 50 40 30 20 Percentageof patients (%) 10 0 1 0 Drug indicators (all) DVT prophylaxis Perioperative antibiotics Public Private Resource Condition Drug prescribing Clinical area limitation 28 Difference in scores by clinical area !*"+,$- !"#$#%&"'&()& !""#""$#%&'(%)'*%+#"&*,(&*-%" ./#(&$#%&'(%)'$(%(,#$#%& 01&2-$#'*%)*2(&-/" 0+#/(33 4567' 4867' 67' 867' 567' 967' .(#/&0)''''''''''''''''''''''''''''''''.+1"#%' Resource Condition Drug prescribing Clinical area limitation 29 Quality scores by hospital size Is quality better in small/intermediate hospitals than large hospitals? !"#$#%&"'&()& '''''''*+,"#% '''''''''''''''''''''''''*(#7&/) -#.)&.)'%&/)01(2 !"#$%& !'( )$*+,-*.#$ 3).1+(%)'"#4#/&/#1$ /01 '2,*3% 4*5$ -(+0'#$5#%&/1(. 6.3578.2"9.*-*:5 6;<78.08$=+&>*" ?3.5*9&+7&:#*-*0#*978.2"9.*-*:5 !"#$#%&"'&()& !""2""%2:#7&:,7*:@2"#*5&#*0:" <.2&#%2:#7&:,7%&:&52%2:# A3#90%27*:,*9&#0." 67)(&"" BCDDE7 BFGE7 BGDE7 BHGE7 HGE7 GDE7 FGE7 CDDE7 BCDDE7 BFGE7 BGDE7 BHGE7 HGE7 GDE7 FGE7 CDDE7 -#8)()$%)'#$'.%1()'9(14'"&(0)':1.;#/&".' -#8)()$%)'#$'.%1()'9(14'"&(0)':1.;#/&".' 30 Quality scores by hospital size and resource limitation Difference in scores compared to large hospitals !"#$%&'()#%*+ ,+#"-./+)(%0%&'&%"1 )))))))))2-3(%/ ))))))))))))))))))))))))))))))))2.%4'&+ !"#$$%&%'()*+"*,-#)* ./0 1*,-2" 3-45 54+.'(( 6789% 6:79% :79% 789% 6789% 6:79% :79% 789% 6%7+.+1/+)%1)#/".+)8."0)('.9+):"#$%&'(#) 6%7+.+1/+)%1)#/".+)8."0)('.9+):"#$%&'(#) Resource Condition Drug prescribing Clinical area limitation 31 Conclusions 32 Key findings Public vs. private • Quality is fairly similar, although the public sector is slightly better • Private sector performs better in indicators that are resource intensive • Smaller hospitals tend to do
Load more

Recommended publications
  • Paradox of Healthcare in Sri Lanka
    Paradox of healthcare in Sri Lanka Paradox of healthcare in World Health Organization World Sri Lanka A snapshot of the last decade from a partnership of sixty years Paradox of healthcare in Sri Lanka 1 Paradox of healthcare in Sri Lanka A snapshot of the last decade from a partnership of sixty years September 2014 ISBN 978-955-0261-05-5 World Health Organization Colombo - Sri Lanka First Print - September 2014 © World Health Organization 2014 This document is not a formal publication of the World Health Organization (WHO) and all rights are reserved by the Organization. The document may, however be freely reviewed, abstracted, reproduced or translated, in part or in whole, but not for use in conjunction with commercial purposes. Contents Communicable Diseases 8 Non-Communicable Diseases, Injuries and Mental Health 20 Maternal, Child and Adolescent Health and Nutrition 38 Health Systems 48 Emergency Preparedness and Response 56 Enhanced Partnerships and Resource Mobilisation for Health 64 Message from the Minister of Health I am pleased to send this message of WHO was designated as health coordinator within the UN family by the appreciation for the publication, reminiscing the Government of Sri Lanka and its role was clearly demonstrated when Sri Lanka achievements of the World Health Organization faced major disasters such as the tsunami in 2004 and the humanitarian operations in Sri Lanka over the last decade. in 2009 and was able to maximise on long established knowledge gathered from decades of helping member states respond to large scale disasters, with support Since the establishment of the WHO Country from the Regional Office and Headquarters of WHO.
    [Show full text]
  • Review Health Technology Assessment (HTA)
    Gamage AU & Abeysena C. JCCPSL 2020, 26 (1) Review Health Technology Assessment (HTA) and health policy making: a narrative review Anuji Upekshika Gamage1* & Chrishantha Abeysena2 1 Faculty of Medicine, General Sir John Kotelawala Defence University, Sri Lanka; 2 Department of Public Health, Faculty of Medicine, University of Kelaniya, Sri Lanka *Correspondence: [email protected] https://orcid.org/0000-0002-4713-9283 DOI: https://doi.org/10.4038/jccpsl.v26i3.8271 Received on 25 February 2020 Accepted on 17 June 2020 Abstract Introduction: Health Technology Assessment (HTA) is a policy tool for informed decision making that supports the entry and use of health-technologies. Three main forces have driven the development of HTA; rising healthcare demands and expectations, scarcity of resources, and increasing entry of new technologies to the healthcare market. With a commitment to Universal Health Coverage (UHC), decisions on allocations considering cost-effectiveness is crucial. Objectives: To evaluate the global evidence on the process, outcome and importance of HTA and evidence-based decision making in health policymaking and the potential way forward in Sri Lanka Methods: A narrative review on HTA and policy making was undertaken using the databases Medline, Embase, Biomed- central, Science Direct, Web of Science. Useful websites, reports were looked up. The search was conducted during July- December 2019. The search strategy for scientific literature consisted of free text and MeSH terms related to keywords, namely, HTA, evidence-informed decision making, HTA-report and health policy. For the SWOT analysis and the way forward, literature review and expert opinion were obtained. Results: HTA studies the medical, social, ethical, and economic implications of development and use of health-technology and guides the healthcare system in evidence-based decision making that is patient-centred and achieves the highest value for money.
    [Show full text]
  • 2018-Report.Pdf
    ASIRI HOSPITAL HOLDINGS PLC ANNUAL REPORT 2018/19 Within Reach...Beyond Imagination In offering world class healthcare across a rapidly expanding footprint, we’re bringing an outstanding proposition within reach of more of Sri Lanka...with the propensity for “beyond imagination” outcomes. 1 ASIRI HOSPITAL HOLDINGS PLC ANNUAL REPORT 2018/19 About this Report REPORT PROFILE COMPLIANCE This is the fourth consecutive Integrated Annual Report of Asiri Hospital The Financial Statements of Asiri Health has been prepared in Holdings PLC (Asiri Health). accordance with the Sri Lanka Accounting Standards issued by The Institute of Chartered Accountants of Sri Lanka. The Company has The report presents a detailed yet concise account of Asiri Health’s value followed additional guidelines as established by the Companies creation process over the short, medium, and long term towards its Act No. 07 of 2007. In particular, we have drawn on concepts, stakeholders. It offers a detailed view of strategy, governance, and capital principles and guidance of the Global Reporting Initiative (GRI) for management; and detailed information about the financial performance sustainability reporting. in the context of surrounding operating environment in 2018/19. The Report addresses all queries pertaining to making sound decisions For governance-related matters, where applicable, we voluntarily about the Group and its activities. comply with the Code of Best Practice on Corporate Governance issued jointly by The Institute of Chartered Accountants of Sri Lanka and the REPORT STRUCTURE Securities and Exchange Commission of Sri Lanka. The Annual Report 2018/19 covers the 12-month period from 1 April 2018 to 31 March 2019, which is consistent with the usual annual BOARD RESPONSIBILITY reporting cycle for financial and sustainability reporting.
    [Show full text]
  • Medical Treatment and Healthcare
    Country Policy and Information Note Sri Lanka: Medical treatment and healthcare Version 1.0 July 2020 Preface Purpose This note provides country of origin information (COI) for decision makers handling cases where a person claims that to remove them from the UK would be a breach Articles 3 and / or 8 of the European Convention on Human Rights (ECHR) because of an ongoing health condition. It is not intended to be an exhaustive survey of healthcare in Jamaica. Country of origin information The country information in this note has been carefully selected in accordance with the general principles of COI research as set out in the Common EU [European Union] Guidelines for Processing Country of Origin Information (COI), dated April 2008, and the Austrian Centre for Country of Origin and Asylum Research and Documentation’s (ACCORD), Researching Country Origin Information – Training Manual, 2013. Namely, taking into account the COI’s relevance, reliability, accuracy, balance, currency, transparency and traceability. The structure and content of the country information section follows a terms of reference which sets out the general and specific topics relevant to this note. All information included in the note was published or made publicly available on or before the ‘cut-off’ date(s) in the country information section. Any event taking place or report/article published after these date(s) is not included. All information is publicly accessible or can be made publicly available, and is from generally reliable sources. Sources and the information they provide are carefully considered before inclusion. Factors relevant to the assessment of the reliability of sources and information include: • the motivation, purpose, knowledge and experience of the source • how the information was obtained, including specific methodologies used • the currency and detail of information, and • whether the COI is consistent with and/or corroborated by other sources.
    [Show full text]
  • Annual Report 2018/19
    Nawaloka Hospitals PLC | Annual Report 2018/19 Nawaloka Hospitals PLC Annual Report 2018/19 2 Nawaloka Hospitals PLC Annual Report 2018/19 iqÿ ySkeá Sudu Heenati fmdlald,s Pokkali l=re`M ;=v Kurulu Thuda Èla Dik ù Vee Maeud Veeù iqj`±,a Suwandel fnfy;aBeheth Heenati ySkeá Kalul`M Heenati ySkeá uv;jd¨ Madathawalu 3 Healthcare in Sri Lanka is encouragingly setting its sights on pre-emptive health protocols that promote healthy living whilst state of the art medical and surgical interventions continue to be offered to fortify these the new trends. This “repository” of holistic healthcare makes Sri Lanka a potential “granary” of wellbeing. History tells us that, during the reign of King Parakramabahu the Great, Sri Lanka was known as the “Granary of the East”. The land was bountiful and food plentiful, particularly indigenous strains of rice, of which there were over 500 varieties. Today, indigenous grain is making a “comeback” in market places around the country, with all their attendant nutritional benefits. 4 Nawaloka Hospitals PLC Annual Report 2018/19 Our Integrated Report 2018/19 Report structure Compliance For the seventh consecutive year Nawaloka Hospitals PLC is This Report reflects the Companies’ compliance with the following presenting its performance in the form of an integrated report. The regulatory and legislative enactments and guidelines. Report concisely covers all aspects of the Company’s performance, • The Companies Act No. 07 of 2007 and the subsequent amendments including key functions, main business lines, business processes, and strategic investments. It also includes materiality analysis, value • The listing rules of the Colombo Stock Exchange (CSE) creation process, approach to strategy, governance, compliance, and • Recommendations and guidelines of the Sri Lanka Accounting sustainability.
    [Show full text]
  • Impact Review Report” Submitted to the Minister of Health
    imPACT Review Cancer Control Capacity and Needs Assessment Report submitted to the Ministry of Health, Nutrition and Indigenous Medicine Sri Lanka November 2019 Table of Contents ACRONYMS AND ABBREVIATIONS............................................................................. 3 EXECUTIVE SUMMARY ................................................................................................. 4 PRIORITY RECOMMENDATIONS ................................................................................ 10 1. THE REVIEW.............................................................................................................. 16 1.1. PURPOSE............................................................................................................................................................ 16 1.2. REVIEW TEAM COMPOSITION .......................................................................................................................... 16 2. REVIEW FINDINGS AND RECOMMENDATIONS ................................................... 18 2.1. HEALTH SYSTEM OVERVIEW ........................................................................................................................... 18 2.2. BURDEN OF DISEASE ........................................................................................................................................ 21 2.3. NATIONAL CANCER CONTROL PLANNING AND GOVERNANCE ...................................................................... 23 2.4. REGISTRATION AND SURVEILLANCE...............................................................................................................
    [Show full text]
  • Asiri Hospital Holdings Plc 2017 / 18 Annual Report
    It’s HERE ASIRI HOSPITAL HOLDINGS PLC ANNUAL REPORT 2017 / 18 AN EXPERT MEdical TEAM... TEchnologY that ENABLES accUratE diagnosis... EVIDENCE BASED CARE BY SKILLED PROFESSIONALS... AND THE BEST patiENT OUtcoMES... HERE About Us Asiri Hospital Holdings PLC is the largest hospital chain in Sri The commitment to quality is at the very core of the Asiri Health DNA. Lanka’s private sector healthcare industry. Since first commencing Testifying to this, Asiri Central Hospital is JCI (Joint Commission operations in 1986, the Group has evolved rapidly over the past International) accredited, earning the Gold Seal of Approval in three decades. quality and patient safety, while Asiri Surgical, Asiri Medical and Asiri Hospital - Matara are all working towards obtaining the ACHS Today, the Group’s flagship brand; Asiri Health is represented by (Australian Council on Healthcare Standards) accreditation. four fully-fledged hospitals; Asiri Medical Hospital, Asiri Surgical Hospital PLC, Asiri Central Hospital, Asiri Hospital – Matara, as well as Asiri Laboratories, the country’s largest island-wide private laboratory service, all of which are dedicated to serve the people of Sri Lanka in line with the Group’s mission “To care for and improve the quality of human life, through the provision of ethical healthcare solutions together with cutting–edge technology”. The Asiri Health Centres of Excellence offer some of the most advanced clinical programmes in Sri Lanka and the wider Asian region. Focusing on certain critical disciplines such as Cardiac, Brain & Spine, Oncology, Bone Marrow Transplant and Stroke Care, these Centres of Excellence bring new hope to thousands of patients each year.
    [Show full text]
  • Overseas Medical Treatment of Sri Lankan Medical Travellers
    E-ISSN: 2378-654X Recent Advances in Biology and Medicine 1 Overseas Medical Treatment of Sri Lankan Medical Travellers *Pamila S Adikari, Dileep De Silva, Sunil De Alwis Human Resource Management and Coordination Unit, Ministry of Health, Colombo, Sri Lanka. *Correspondence: [email protected] Received: Dec 06, 2020; Accepted: Feb 16, 2021 COPYRIGHT: Adikari et al. This is an open-access article published under the terms of Creative Commons Attribution License (CC BY). This permits anyone to copy, distribute, transmit, and adapt the work, provided the original work and source are appropriately cited. CITATION: Adikari PS, Silva DD, Alwis SD. Overseas Medical Treatment of Sri Lankan Medical Travellers. Recent Adv Biol Med. 2021; 7(1): 1-5. Article ID: 1234879. DOI: 10.18639/RABM.2021.1234879 ABSTRACT More and more Sri Lankans reach for overseas medical treatment with the raising standards of living in the country. However, it is largely an unexplored area. Economic burden of overseas medical treatment is largely an out-of-the-pocket expenditure. Considering the economic burden and low health insurance penetration among Sri Lankans, healthcare decision-makers should explore the clinical dynamics of this subset of patients to improve the services within the country. The study aimed to describe the clinical characteristics and cost of medical treatment by medical travellers for treatment overseas. A descriptive study was carried out by a team of experts analyzing the data of estimated overseas medical expenditure recorded at the President Fund, a body established to assist Sri Lankans who need financial assistance for the said purpose. The team studied the deidentified databases for 2018 and 2019.
    [Show full text]
  • Doc990 – Enhancing Patient Access to Healthcare Services in Sri Lanka Through Mobile Contents
    Doc990 Enhancing Patient Access to Healthcare Services in Sri Lanka through Mobile © GSM Association 2018 mHealth The GSMA represents the interests of mobile By forging stronger connections between the operators worldwide, uniting more than 750 mobile and healthcare industries, the GSMA mHealth operators with over 350 companies in the broader Programme is supporting commercially sustainable mobile ecosystem, including handset and device health services that transform the lives of people makers, software companies, equipment providers in need and promote the wellbeing of mothers and and internet companies, as well as organisations in families in developing countries. adjacent industry sectors. The GSMA also produces industry-leading events such as Mobile World Mobile can increase the quality, reduce the cost Congress, Mobile World Congress Shanghai, Mobile and extend the reach of healthcare to benefit World Congress Americas and the Mobile 360 millions. mHealth services have the potential to Series of conferences. generate significant impact by reaching women and children who lack access to essential healthcare and For more information, please visit the GSMA nutritional information. corporate website at www.gsma.com Learn more at www.gsma.com/mobilefordevelopment/ Follow the GSMA on Twitter: @GSMA mhealth/ or contact us at [email protected] Follow GSMA Mobile for Development on Twitter: @GSMAm4d This publication is the output of a project funded by Authors: UK aid, Department for International Development Kim Viljoen (DFID), for the
    [Show full text]
  • Health System Enhancement Project: Project Administration Manual
    Project Administration Manual Project Number: 51107-002 Loan and Grant Number(s): {LXXXX; GXXXX; TAXXXX} October 2018 Sri Lanka: Health System Enhancement Project ABBREVIATIONS ADB Asian Development Bank AGD Auditor General’s Department APFS audited project financial statements ATR action taken report BCCM behavior change communication and community mobilization CBSL Central Bank of Sri Lanka CIGAS computerized integrated government accounting system DMF design and monitoring framework EARF environment assessment and review framework EGM effective gender mainstreaming EMP environment management plan EMR electronic medical record ERD Department of External Resources ERTU education, training and research unit ESP essential service package FHB Family Health Bureau FHC field health center FMA financial management assessment GAP gender action plan GBV gender-based violence GOSL Government of Sri Lanka HCWM healthcare waste management HIT health information technology HPB Health Promotion Bureau HRH human resources for health HSEP Health System Enhancement Project IEC information, education and communication IHR International Health Regulations MIS management information system MOFMM Ministry of Finance and Mass Media MOH medical officer of health MOHNIM Ministry of Health, Nutrition and Indigenous Medicine MOMCH medical officer maternal and child health NCD noncommunicable disease OCB open competitive bidding PBS patient based system PCC project coordination committee PCR project completion report PDHS provincial director health services PFM public financial management PHC primary health care PHI public health inspector PHM public health midwife PHN patient healthcare number PIU project implementation unit PMCU primary medical care unit PMU project management unit POE point of entry PPER project performance evaluation report PPTA project preparatory technical assistance PSC project steering committee QCBS quality- and cost-based selection RDHS regional director of health services SOE statement of expenditure TOT training of trainers CONTENTS I.
    [Show full text]
  • Patient Perspectives on Hypertension Management in Health System of Sri Lanka: a Qualitative Study
    Open access Original research BMJ Open: first published as 10.1136/bmjopen-2019-031773 on 7 October 2019. Downloaded from Patient perspectives on hypertension management in health system of Sri Lanka: a qualitative study Manuja Perera,1 Chamini Kanatiwela de Silva,2 Saeideh Tavajoh,3 Anuradhani Kasturiratne,1 Nathathasa Vihangi Luke,2 Dileepa Senajith Ediriweera,4 Channa D Ranasinha,5 Helena Legido-Quigley,6 H Asita de Silva,2,7 Tazeen H Jafar 3,8 To cite: Perera M, de ABSTRACT Strengths and limitations of this study Silva CK, Tavajoh S, et al. Introduction Uncontrolled hypertension is the leading Patient perspectives on risk factor for mortality globally, including low-income and ► A strength of this paper is that in-depth interviews hypertension management in middle-income countries (LMICs). However, pathways for health system of Sri Lanka: a allowed us to explore patient pathways through the seeking hypertension care and patients’ experience with qualitative study. BMJ Open healthcare system and their various experiences in the utilisation of health services for hypertension in LMICs 2019;9:e031773. doi:10.1136/ seeking care for hypertension. are not well understood. bmjopen-2019-031773 ► The strength of the conceptual framework is en- This study aimed to explore patients’ Objectives abling the identification of facilitators and barriers ► Prepublication history for perspectives on different dimensions of accessibility this paper is available online. to the health system accessibility and availability for and availability of healthcare for the management of To view these files, please visit the people. uncontrolled hypertension in Sri Lanka. the journal online (http:// dx. doi.
    [Show full text]
  • Hospital Industry
    JB Securities (Pvt) Ltd Hospital Industry Hospital Industry JB Securities (Pvt) Ltd Sri Lanka Our report on the Hospital Industry intends to provide investors October 2007 with a basic understanding of the industry, in order to assist them in their decision-making. The report provides our investment thesis, a Address: 150, St. Josephs Street, discussion of the key attributes and economics of the industry. Colombo 14, Sri Lanka Web: www.jbs.lk Telephone No: 94.11.2490900 Hospital Industry Content • Overview • Investment thesis • Key attributes of the industry o Consumer behaviour o Market regulation o Clustering • Economics of the private hospital industry o Hospital industry and competition o Industry attractiveness: Five forces analysis JB Securities (Pvt) Ltd does and seeks to do business with companies covered in its research reports. As a result, investors should be aware that the firm may have a conflict of interest that could affect the objectivity of this report. Investors should consider this report as only a single factor in JBS Research making their investment decision. 1 JB Securities (Pvt) Ltd Overview JBS Research 2 JB Securities (Pvt) Ltd Hospital Industry Overview Investment Thesis Demand for hospital care Demand for healthcare has increased over the past five years with hospital visits has increased, primarily increasing by 3.2% on average. This growth is driven by a multitude of factors, driven by shifts in among which the change in disease patterns, change in health seeking behaviour disease patterns. life styles and change in the environement take center stage. Shift in demographics The shift in demographics is the main driver of the shift in disease patterns with and the increased diseases impacting the old age showing marked increases.
    [Show full text]