Background: As fast and accurate techniques, advanced medical imaging technologies (AMIT) allow healthcare professionals to better diagnose and treat various health conditions, which translates into higher use of non-invasive operational procedures. Objectives: The current study intended to investigate the effect of inpatient use of MRI and CT scan on the inpatient mortality and length of stay (LOS) in Tehran general university hospitals. Methods: Data were collected from all general university hospitals in Tehran in 2017. A multiple linear regression model was constructed for each combination of technology and outcomes (i.e., mortality and LOS), and all models were controlled for patients’ demographic and clinical characteristics and structural profile of hospitals. In calculating hospital standardized mortality ratio (HSMR) for each of 72 diagnosis groups related to death, a binary logistic regression model was fitted with predictors including LOS, admission type, comorbidity level, sex, and age. Results: The use of CT varied from 0.39 to 149.35, and MRI from 0.24 to 80.23 exams per 100 discharges. The HSMR ranged from 76.8% to 146%, and the average length of stay (ALOS) was 3 - 8.46 days. MRI and CT had no significant effect on the HSMR and ALOS. Conclusions: Further use of AMIT was not linked with improved efficiency and quality but was associated with better resource management in healthcare organizations. Effective management of the AMIT use requires clear rules and regulations with assertive commitment, in addition to establishing clinical guidelines with the support of insurance companies.
BackgroundThis study aimed at measuring the responsiveness level of inpatient services according to patients’ perspectives, and identifying the factors affecting its performance at the Gazan public general hospitals, particularly in internal medicine and surgical departments, in 2020.MethodsIt was a cross-sectional descriptive study, conducted in 5 public general hospitals in Gaza. Data were collected between October 2019 and June 2020 in a survey included 675 inpatients using an interviewed questionnaire. Data were analyzed using software SPSS 22.0 and by applying descriptive statistics, independent t-test and analysis of variance (ANOVA), and post hoc Scheffé test. ResultsThe overall responsiveness was “above moderate”, 80.15% and 80.9%, for both internal medicine and surgical departments, respectively. Access to social support, confidentiality and dignity were the highest-performing domains, while, choice of provider and quality of basic amenities were the lowest. Dignity and confidentiality were the most important domains based on patients’ viewpoints. Hospital type, medical department, and hospital stay in addition to the educational level, marital status, employment status, income, and insurance status were the most influential factors on the level of responsiveness and its domains. ConclusionThe assessment of the responsiveness of inpatient services at public hospitals is useful in integrating the health system goals. Inpatient care responsiveness was satisfactory in the Gazan public hospitals, however, there is a room for further improvements. Reform strategies should be directed toward the domains of weak performance and the important ones as well. Attention should be given to the supply-side such as hospital characteristics as they significantly affect the level of responsiveness and its domains. Further research is required to carry out mixed-method studies, moreover, the non-public hospitals need to be covered.
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