Indian Journal of Health and Wellbeing

Ravinder Yadav ¹, Raman Sharma ², Meenakshi Sharma ³, Varinder Saini ⁴, Vipin Koushal ²

Affiliations
1 GMCH, Chandigarh, IN
2 Department of Hospital Administration, GMCH, Chandigarh, IN
3 School of Public Health PGIMER, Chandigarh, IN
4 Department of Medical Records, GMCH, Chandigarh, IN

Abstract

Due to costlier and unaffordable health care, Government has been introducing various measures time to time. Similarly, a newer health insurance scheme was introduced for Below-Poverty-Line population, called Rashtriya Swasthya Bima Yojana. A descriptive study was conducted in a multispecialty tertiary level institute of North India to understand the awareness level and utilization of the scheme and Out of pocket expenditure borne by the beneficiaries and impact of financial burden and quality of care provided by institute. 53 (42.7%) respondents got awareness about scheme through media while 39 (31.4%) through political gatherings. Satisfaction level was more than 75% with respect to clinicians' clinical and behavioural characteristics, while satisfaction was 70.0% with nursing cooperative care and sympathetic nature. The hospital had spent about 4.85 lakhs for treatment against the total incentives of Rs 5.72 lakhs. None of beneficiary made any expenditure from Out of Pocket. These findings are an eye opener to know where the patients stand with regard to their knowledge and awareness about insurance schemes. As catastrophic health expenditures are a major cause of impoverishment and protection can be further enhanced if government design changes as incorporated by RSBY or make the premium affordable, especially for the poorer sections.

Keywords

Below Poverty Line Patients, Awareness, Utilization, Expenditure, Patient Satisfaction, Out of Pocket Payment.

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Raman Sharma ¹, Vipin Koushal ¹, Meenakshi Sharma ², Ravinder Yadav ³

Affiliations
1 Department of Hospital Administration GMCH, Chandigarh, IN
2 School of Public Health, PGIMER, Chandigarh, IN
3 Department of Medical Records, GMCH, Chandigarh, IN

Abstract

Bathing is an important activity of daily living and should be a pleasurable experience. Adequate and suitable bathing and washing facilities can help to ensure that patients are bathed in private and with dignity. The study was conducted in a Government Multispecialty Hospital with the objective to assess and analyze the inadequacies in public health facilities. Poor access and inadequate adaptations for wheelchair users were also highlighted. A total of 74 baths, 142 washrooms and 124 washbasins (both in IPD and OPD of Hospital) were surveyed. None such studies had been conducted to assess the inadequacies in the public health facilities in health care organizations. All bathrooms and washrooms had proper location and were spacious. 99.5% of the baths had dual water supply; cold and hot. 99.5% baths were clean and non slippery. No bath hoists and non slip mats were present in any of the bath, while 37.8% (28) didn't have bath rods. There were separate male and female washrooms with having appropriate signage (98.0%). About 15.5% (22) washrooms were not properly clean and 17.6% (25) were foul smelling. The facilities for the handicapped and wheelchairs users were not appropriate. 97.0% (121) of the washbasins have mirrors, while towel rods and soap cases were found in 88.7% (110) and 97.5% (121) respectively. So, lot emphases need to be given to improve the decor, cleanliness, and general environment for making washing and bathing a dignified and relaxing experience. Hospital managers, doctors, and matrons should focus on these important issues and it might be a good idea to make these facilities a key factor in star ratings of hospitals.

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Raman Sharma ¹, Meenu Singh ², R. K. Sharma ³, A. K. Gupta ³

Affiliations
1 Department of Hospital Administration, GMCH-32, Chandigarh, Punjab, IN
2 Department of Pediatrics PGIMER, Chandigarh, Punjab, IN
3 Department of Hospital Administration, PGIMER, Chandigarh, Punjab, IN

Abstract

Telemedicine is aimed to provide health care to rural populations, especially where there is a scarcity of resources. As telemedicine is unique among health care services, especially in developing countries, in lacking evidence of its effectiveness; the increasing demand advocates the clinical telemedicine to undertake more and better evaluations of its practicality, value, and affordability. To analyze the completeness and practicality of EMR Performa for making diagnosis at provider end during Tele-consultations, a study was conducted in PGIMER, a tertiary multispecialty referral institute that has been providing Tele-consultations to twenty partner sites in the Northern India. Service utilization data, patient demographics and diagnoses were collected for the period from July, 09 till December 09. The clinicians were requested to fill up a Pre-tested close ended Questionnaire after their Teleconsultation session was over. Out of 367 Tele-consultations received during study period, it was found that in 231 (62.9%) cases diagnosis could be made, while 136 (37.1%) cases remained un-diagnosed. On further analysis, it was found, that chief complaints were enumerated appropriately in 232 (63.2%) cases, History explained completely in 166 (45.2%) cases and Personal history in 194 (52.9%) cases. In 74 (20.1%) Tele-consultations, Vitals had been recorded, filled and General Physical Examinations done in 164 (44.5%) of cases. Investigations and diagnostic tests had been done in just 194 (52.9%) of cases. Pediatricians referred to this Telemedicine service (19.5% cases) more frequently than other specialties. Thus, stress need to focused on developing an appropriate and simple EMR Performa which may be filled easily and need modifications specialty wise, and, the referring physician need to be motivated to supply all the necessary clinical details to facilitate the Tele-consultant in making correct diagnosis.

Keywords

No Keywords

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Raman Sharma ¹, Ravinder Yadav ², Vipin Koushal ¹, Pallvi Aggarwal ³, Meenakshi Sharma ⁴, Varinder Saini ⁵

Affiliations
1 Department of Hospital Administration, GMCH, Chandigarh, IN
2 Department of Hospital Administration, GMCH, Chandigarh
3 Department of Psychiatry, GMCH, Chandigarh, IN
4 Department of Pediatrics, GMCH, Chandigarh, IN
5 Department of Medical Records, GMCH, Chandigarh, IN

Abstract

Needle stick and sharp injuries (NSSI) among Health Care have a significant impact on the morbidity and mortality. Preventing NSSI is an essential part and every healthcare facility should have an infection control program in work place. A two months descriptive study was conducted in city hospital, Chandigarh to evaluate NSSI among Housekeeping Workers (HkW) specifically to determine the occurrence of NSSI, circumstances under which NSSI occur and measures to prevent NSSIs. Out of 434 HkW, 244 were identified at risk of NSSI. The self structured questionnaire were administered to participants to assess awareness and importance of handling BMW, education and training of BMW handling, causes of injuries etc. 93.0% (214) of HkW had knowledge of segregation, categorization and significance of color coding, 96.5% (222) were well aware of the efforts taken by the hospital authorities in the BMW management. No HkW has ever been imparted training regarding BMW management and all came to know while working in the hospital only. After NSSI exposure 32% (74) of HkW responded immediately, 10 per cent took action later on the same day while the rest did not take any action. When asked about factors for NSSI, 94% (214) responded that they themselves were responsible. NSSIs are observed in all categories of Healthcare workers (HCW) and there is a scope for improvement in safety protocols. Preventive strategies have to be devised and reporting must be made mandatory. Such programs and innovations are necessary for all HCW safety and security.

Keywords

Sharp Injuries, Needle Stick, Housekeeping Workers.

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