융합적 요소를 고려한 의료서비스 질 인식도와 의료이용의 관련성: 서울시 보건소를 이용하는 노인을 대상으로

Background : Being one of the most important elements in healthcare system, Community Health Center has been promoted to improve its quality and capacity of services. Accreditation is a method that can be used to improve and measure the quality of health service. Quality service improvement is expected to enhance patient satisfaction. This study aimed to investigate the asssociations between accreditation status, patient socio-economic factors, insurance type, patient perceived quality of service, and satisfaction at Community Health Center. Subje cts and Met h od: This was an analytic observational study with cross-sectional design. This study was conducted at Community Health Center in Surakarta, Central Java from June to July 2017. A total of 8 Community Health Centers with different accreditation status (not accredited, lowest, medium, and highest) were selected for this study. A sample of 200 patients were selected from the 8 Comunity Health Centers by proportional random sampling. The independent variables were accreditation status, patient education level, family income, and insurance type. The dependent variables were perceived quality of service and patient satisfaction. The data were collected by a set of pre-tested questionnaires. Accreditation status was identified from the record at District Health Office. Data were analyzed by path analysis. Results : Patient satisfaction was associated with Commuity Health Center acrreditation status (b=0.39; SE=0.22; p=0.069), perceived quality of service (b=0.05; SE=0.02; p=0.022), patient education level (b=-1.16; SE=0.48; p=0.017), and insurance type (b=0.61; SE=0.31; p=0.044). Perceived quality of health services was associated by accreditation status (b=2.22; SE=0.74; p=0.003), patient education level(b=-4.51; SE=1.68; p=0.007), and insurance type (b=2.79; SE=1.06; p=0.008). Family income did not show statistically significant association with perceived quality of health service (b=-0.17; SE=0.11; p=0.123). Conclusion : Patient satisfaction is associated with Commuity Health Center acrreditation status, perceived quality of service, patient education level, and insurance type. Perceived quality of health services is associated with accreditation status, patient education level, and insurance type. Keywords : patient satisfaction, perceived quality of service, accreditation status, Commuity Health Center Correspondence : Farahdila Mirshanti. Masters Program of Public Health, Sebelas Maret University, Jl. Ir. Sutami 36A, Surakarta, Central Java. Email: fmirshanti@gmail.com. Mobile: +628121534393. Journal of Health Policy and Management (2017), 1(1): 91-101 https://doi.org/10.26911/thejhpm.2017.02.01.08

True believers? Characteristics of general practitioners in Victorian community health centres

The quality of health services is very important to measure how far the Community Health Center is in providing services to patients by looking at the number of BPJS patient visits at the Bukit Lawang Community Health Center, Langkat Regency, which only reached 82.00% in 2020, 77.9% in 2022 and 76.9% in 2023 compared to the target of 95%. Data from the Bukit Lawang Community Health Center, Langkat Regency for the period 2021-2023 showed fluctuations in the number of BPJS patient visits every month. The purpose of this study was to analyze the effect of the quality of public health services on patient satisfaction at the Bukit Lawang Health Center, Langkat Regency in 2023. The research design used a quantitative method with a cross-sectional study approach. The population in this study were all patients who visited the Bukit Lawang Health Center, Langkat Regency in 2023 with an average number of visits of 292 patients per month, the number of samples of 75 people was obtained using a purposive sampling technique. Data analysis used univariate, bivariate and multivariate analysis with logistic regression tests. The results of the study using the chi-square test showed that the variables reliability, assurance, tangible, empathy and responsiveness had a p-value <0.05. The results of the study using the logistic regression test showed that the variables reliability, empathy and responsiveness had a sig. <0.05 and the variables assurance and tangible had a sig.> 0.05. The conclusion of the study is that the variables that significantly affect patient satisfaction are the variables reliability, empathy and responsiveness and the variable that most significantly affects patient satisfaction is the variable reliability.

This study aims to determine the relationship between the quality of health services and the level of satisfaction of outpatients at the Pati 1 Community Health Center (UPTD Puskesmas Pati 1). The quality of health care services is a key determinant in shaping the level of patient satisfaction. The assessment of this quality is not solely based on the achievement of medical interventions, but also includes the attitudes of health care personnel, the timeliness of service delivery, as well as the condition and comfort of the facilities. This study used a quantitative method with a cross-sectional design. The study population consisted of all outpatients at the Pati 1 Community Health Center in April 2025, totaling 173 patients, with a sample of 121 respondents determined using the Slovin formula and accidental sampling technique. The research instruments were a health service quality questionnaire and a patient satisfaction questionnaire. Data analysis was performed using the Spearman Rank correlation test. The results showed that most respondents rated the quality of health services as good (62.8%) and patient satisfaction as satisfied (53.7%). The Spearman Rank test results showed a p-value of 0.000 (<0.05) with a correlation coefficient of 0.692, indicating a strong and positive relationship between the quality of health services and the level of patient satisfaction. The better the quality of services provided, the higher the level of outpatient satisfaction.

Background: Being one of the most important elements in healthcare system, Community Health
\nCenter has been promoted to improve its quality and capacity of services. Accreditation is a method
\nthat can be used to improve and measure the quality of health service. Quality service improvement
\nis expected to enhance patient satisfaction. This study aimed to investigate the asssociations
\nbetween accreditation status, patient socio-economic factors, insurance type, patient perceived
\nquality of service, and satisfaction at Community Health Center.
\nSubjects and Method: This was an analytic observational study with cross-sectional design. This
\nstudy was conducted at Community Health Center in Surakarta, Central Java from June to July
\n2017. A total of 8 Community Health Centers with different accreditation status (not accredited,
\nlowest, medium, and highest) were selected for this study. A sample of 200 patients were selected
\nfrom the 8 Comunity Health Centers by proportional random sampling. The independent variables
\nwere accreditation status, patient education level, family income, and insurance type. The
\ndependent variables were perceived quality of service and patient satisfaction. The data were
\ncollected by a set of pre-tested questionnaires. Accreditation status was identified from the record
\nat District Health Office. Data were analyzed by path analysis.
\nResults: Patient satisfaction was associated with Commuity Health Center acrreditation status
\n(b=0.39; SE=0.22; p=0.069), perceived quality of service (b=0.05; SE=0.02; p=0.022), patient
\neducation level (b=-1.16; SE=0.48; p=0.017), and insurance type (b=0.61; SE=0.31; p=0.044).
\nPerceived quality of health services was associated by accreditation status (b=2.22; SE=0.74;
\np=0.003), patient education level(b=-4.51; SE=1.68; p=0.007), and insurance type (b=2.79;
\nSE=1.06; p=0.008). Family income did not show statistically significant association with perceived
\nquality of health service (b=-0.17; SE=0.11; p=0.123).
\nConclusion: Patient satisfaction is associated with Commuity Health Center acrreditation status,
\nperceived quality of service, patient education level, and insurance type. Perceived quality of health
\nservices is associated with accreditation status, patient education level, and insurance type.
\nKeywords: patient satisfaction, perceived quality of service, accreditation status, Commuity
\nHealth Center
\nCorrespondence:
\nFarahdila Mirshanti. Masters Program of Public Health, Sebelas Maret University, Jl. Ir. Sutami
\n36A, Surakarta, Central Java. Email: fmirshanti@gmail.com. Mobile: +628121534393.

Indonesia's healthcare system is in progress, and has tried to make many improvements in its healthcare delivery system and has brought out many reforms. Several studies show the relationship between patient satisfaction and quality of health services, but none sufficiently analyze the association between acrreditation status and health insurance with satisfaction among patients. This study aimed to investigate the effect of acrreditation status and health insurance on satisfaction of quality in Community Health Care services (PUSKESMAS) in Ngawi, East Java. We conducted a cross-sectional study in all community health care services in Ngawi, East Java. A total 200 outpatients selected by simple random sampling. We analyze the association of community health care accreditation status, and health insurance adjusted with age, education level, and income of respondents with the satisfaction of quality of care from community health care services using multivariate logistic regression by STATA 16. Respondents visited accredited community health care (aOR= 1.60; 95% CI= 1.13 to 2.27; p<0.07) have higher odds of satisfaction with the quality of care in community health care services compared to respondents visited non-accredited community health care and with age less than 35 years, respectively.

Background: One common governance issue faced by developing countries is the establishment and maintenance of infrastructure to support the delivery of primary health services. This qualitative study explores the perspective of maternal health workers on how infrastructure impacts the provision of maternity services in rural areas in Vietnam.
 Methods: Forty-one health workers and health managers at the commune, district and provincial levels of the Vietnamese public health system were interviewed. Questions focused on the impact of various organisational factors, including the impact of infrastructure on the performance of the health workforce, which provides publicly funded primary care. All interviews were recorded, transcribed and coded for thematic analysis.
 Findings: Participants noted that infrastructure directly affected their ability to perform certain tasks and could both directly and indirectly negatively impact their motivation. In general, participants noted a lack of investment in infrastructure for the provision of primary care services in rural areas. They identified that there were deficits in the availability of utilities and the adequacy of facilities.
 Conclusion: This research contributes to understanding the barriers to the provision of primary care in developing countries and in particular. The current inadequacy of facility buildings and inadequacy of clean water supply are issues for health workers in meeting the technical requirements of the standards as set out in the National Guidelines on reproductive health, and lead to safety concerns for the quality of maternal health services provided in commune health centres and District Health Centres.
 Abbreviations: CHC – Commune Health Centres; DHC – District Health Centre; HW – Health Worker.

Good quality social and health services, accessible to all communities, be they in the rural or urban area, are the nucleus of an autonomous life for the community members and the development of the community health care network must offer a real answer to the existing needs of the community. The present paper compares the differences in health status and distribution of health services, in two of Romania’s regions, West and Centre, with a focus on primary care and coverage with nurses and health mediators. The analysis revealed inequalities in the distribution of services, bigger in the Western region, especially regarding primary care services. Keywords: community health care, Central and Western development regions, average number of inhabitants/health unit, access to health services

PHP54 - A Time-Driven Activity-Based Cost Study of Primary Care Pharmacy Service of Chronic Diseases Among The Elderly at Community Health Center, Krabi Hospital and Sai Thai Contract Units Of Primary Care, Krabi Province, Thailand

ObjectiveReform of the health care system in urban areas of China has prompted concerns about the utilization of Community Health Centers (CHC). This study examined which of the dominant primary care delivery models, i.e., the public CHC model, the ‘gate-keeper’ CHC model, or the hospital-owned CHC models, was most effective in enhancing access to and quality of care for patients with chronic illness.MethodsThe case-comparison design was used to study nine health care organizations in Guangzhou, Dongguan, and Shenzhen cities within Guangdong province, China. 560 patients aged 50 or over with hypertension or diabetes who visited either CHCs or hospitals in these three cities were surveyed by using face-to-face interviews. Bivariate analyses were performed to compare quality and value of care indicators among subjects from the three cities. Multivariate analyses were used to assess the association between type of primary care delivery and quality as well as value of chronic care after controlling for patients’ demographic and health status characteristics.ResultsPatients from all three cities chose their current health care providers primarily out of concern for quality of care (both provider expertise and adequate medical equipment), patient-centered care, and insurance plan requirement. Compared with patients from Guangzhou, those from Dongguan performed significantly better on most quality and value of care indicators. Most of these indicators remained significantly better even after controlling for patients' demographic and health status characteristics. The Shenzhen model (hospital-owned and -managed CHC) was generally effective in enhancing accessibility and continuity. However, coordination suffered due to seemingly duplicating primary care outpatients at the hospital setting. Significant associations between types of health care facilities and quality of care were also observed such that patients from CHCs were more likely to be satisfied with traveling time and follow-up care by their providers.ConclusionThe study suggested that the Dongguan model (based on insurance mandate and using family practice physicians as ‘gate-keepers’) seemed to work best in terms of improving access and quality for patients with chronic conditions. The study suggested adequately funded and well-organized primary care system can play a gatekeeping role and has the potential to provide a reasonable level of care to patients.

BackgroundThe goal of this paper was to assess the quality of primary healthcare services at community health centres (CHCs) from the demand (patient) and supplier (healthcare service institution) angles.MethodsThis study was conducted at six CHCs in the Greater Bay Area of China. Between August and October 2019, 1,568 patients were recruited (55.8% women and 44.2% men). We evaluated the service quality of CHCs using the National Committee for Quality Assurance Patient-Centred Medical Home (NCQA-PCMH) recognition questionnaire. We assessed patients’ experiences with medical and health services using the Primary Care Assessment Tools (PCAT).ResultsPCAT total and sub-domains scores were significantly difference at the six CHCs (P < 0.001). Among the six CHCs, Shayuan CHC had the highest PCAT total and sub-domain scores and the highest NCQA-PCMH total and sub-domain scores, as well. Older (> 60 years), female, lower education, and employee medical-insured individuals had better patient experiences.ConclusionsOur results indicate that CHCs could improve their service quality by improving both institutional health service quality based on NCQA-PCMH assessment and patient experiences based on PCAT scales. These findings can help inform patient-centred primary healthcare policy and management.

Introduction(Dame) Cicely Saunders, founder of the first real hospice, was clearly an entrepreneur (Thompson, 1999: 209).As the U.S. population continues to age, an increasing number of patients and families will be facing end-of-life care. Hospice and palliative care programs are uniquely designed to offer a continuum of care to serve the physical, emotional and spiritual needs of patients and families in the last months of life. According to the National Hospice and Palliative Care Organization (NHPCO), hospice care is a model for quality compassionate care for individuals who are medically defined as terminally ill or facing life-limiting illnesses. Hospice services are directed towards caring versus curing in a variety of settings to include the patient's home, freestanding hospice centers, hospitals, nursing homes, as well as other long-term care facilities (NHPCO, 2010). As a larger proportion of the U.S. population continues to age, clearly the need and demand for hospice services in all settings will continue to accelerate over the next decade. Indeed the magnitude of this challenge is significant and growing, and has important implications for healthcare recipients, providers, and policymakers alike. A fundamental question of interest across various stakeholders is how prospective entrepreneurs and strategists in established organizations can leverage various sources of entrepreneurial opportunities these dynamic changes represent and, innovate to meet the challenge of the changing hospice care landscape (Carr, Topping, Woodard, & Burcham, 2004).This study seeks to inform both members of the hospice community and broader healthcare reform discussions by examining family perceptions of the overall satisfaction with service quality in hospice care in contrasting geographical settings. Prior research suggests there are specific factors that contribute to the patient and family members' perceptions of service quality provided during the hospice episode of care. This study extends that prior work by theoretically developing and empirically testing the central thesis that geographic disparity of services and resources (i.e., urban versus rural) influences family members' perceptions within the delivery areas for hospice services differently in urban versus rural settings. Further, it extends prior work by suggesting that the type of setting in which hospice patients are treated (and ultimately die) may also influence the perceptions of the quality of care provided. It also suggests other factors such as the lapse of time between identifying the need for hospice services and the actual delivery of the hospice services can affect the perceptions of quality care. Finally, it suggests the length of time the patient receives hospice services may also influence the perceptions of care delivered during the hospice episode.Literature ReviewEntrepreneurial OpportunityThe notion ?? entrepreneurial opportunity is at the heart of entrepreneurship theory (Stevenson & Gumpert, 1985). Entrepreneurial opportunity is defined as external environmental conditions suggesting the introduction and sale of new products, services, raw materials, and/or organizing methods at prices in excess of their production costs will be feasible (Casson, 1982; Shane & Venkataraman, 2000). Such conditions change over time, impacted in part by large shifts in attitudes, government policy, economic conditions, and technology (Hills & LaForge, 1992). Environmental conditions also change as a function of the competition. Hitt, Ireland, Camp, and Sexton (2002) observe that a new competitive landscape began to develop in the 1990s, emerged in earnest in the 21st century, and is characterized by substantial and frequently frame-breaking change, a series of temporary, rather than sustainable competitive advantages for individual firms, short product life cycles, and new forms of competition. As a result, they argue an entrepreneurial mindset is required that emphasizes carefully selected and implemented entrepreneurial strategies to compete successfully. …

The growing prevalence of non-communicable diseases (NCDs) such as hypertension, stroke, diabetes, joint disorders, lack of physical activity, injury, and disability has resulted in an increasing need for physiotherapy services within healthcare facilities, especially at community health centers. Despite many unresolved public health issues, the rise of NCDs continues to pose significant challenges. According to the Minister of Health Regulation No. 65 of 2015, physiotherapy services are crucial in primary healthcare as part of promotive and preventive efforts, without neglecting curative and rehabilitative functions. This study aims to highlight the importance of physiotherapy in community health centers in providing both preventive and supportive care to address the public's increasing healthcare demands. The findings emphasize the strategic role of physiotherapists in disease prevention and health promotion at the primary level. The novelty of this research lies in its focus on the integration of physiotherapy into primary care services as a proactive approach to managing NCDs. The contribution of this research is to support healthcare policy and practices that prioritize physiotherapy services to improve public health outcomes, particularly in the prevention and management of NCDs.

One of the efforts to improve the quality health service of community health centers in the implementation of the national health insurance program is to implement a commitment-based capitation payment, but in its implementation there are many community health center that cannot achieve the capitation payment target that must be received by the community health center as the first health facility. KBPK implementer A qualitative descriptive research has been carried out with a case study approach at the community health centers in Langkat Regency, with the aim of providing the availability of human resources at the community health centers in the context of implementing the KBPKP by utilizing information, including: Head of community health centesr, P-Care Officer, and Person in Charge at the Office Health and BPJS Health Langkat Regency. The results of the study indicate that human resources are sufficient in terms of numbers, but inadequate in terms of expertise and time. It is recommended to conduct an assessment of the performance of community health centers officers related to the implementation of KBPKP in community health centers and other variables that need to be investigated. Keywords : power, human capitation, resources

The quality of health services is important and a concern throughout level health services in a way global. Matter this is appropriate with commitment world one of them reach scope health universal or Universal Health Coverage (UHC) on in 2030 (WHO, 2018). Indonesia continues to strive to improve access and quality of health services base and references (Indonesian Ministry of Health, 2016). Effort strengthening health services primary (primary health care) is Wrong One pillar main in agenda transformation system national health through the Community Health Center accreditation system (RI Ministry of Health, 2023). Study design in research This use study observation analytic with design study Cross Sectionals. The population and sample are all employees at the Megang Community Health Center, LubukLiggau City, totaling 66 people, and this number will be used as the total population. Univariate, bivariate and multivariate data analysis using Chi-square analysis techniques. This research begins since April until May 2024. Based on characteristics respondent, Performance Employee work More health centers are good, with an average employee age ≥ 45 year, with female gender and college education, with physical evidence variable service quality Good, fpower responsive Which Good, faya reliable Which Good, guarantee Which Good even empathy the good one. There is connection proof physique with performance Work (p-value 0.009), Power Responsive (p-value 0.005), Reliability (p-value 0.040), Assurance (p-value 0.017), Empathy (p-value 0.014). Physical Evidence is the most dominant factor in Service Quality on Employee Work Performance in the Lubuk Linggau City Health Center Work Area in 2024. Repair or replace tool health Which damaged so that expedite activity treatment And maintenance which exists in Public health center holding, as well as do renovation building or room Which Already No Can used again.