Empatía con el paciente en médicos especialistas que trabajan en un Hospital de Cuenca (Ecuador) / Empathy with the Patient in Medical Specialists Working in a Hospital in Cuenca ­ Ecuador / Empatia com o paciente em médicos especialistas que trabalham em um hospital em Cuenca, Equador

ntroducción: la empatía es uno de los componentes de la estructura de la humanización en la atención de los pacientes. Los médicos especialistas deben tener mucha empatía. El objetivo del artículo es des-cribir los índices de empatía en médicos que trabajan en un hospital de alta complejidad y explorar si existen diferencias entre las especialidades estudiadas. Métodos: se accedió a una muestra por conve-niencia de 237 médicos que representa el 53.55 % del total poblacional (n = 443). La empatía se midió con la Escala de Empatía para Profesionales de la Salud (hp), junto con análisis factorial confirmatorio y análisis multigrupo (para examinar la invarianza del modelo entre los sexos) y análisis de confia-bilidad (α de Cronbach, coeficiente de correlación intraclase y ω de McDonald). Resultados: la espe-cialidad de pediatría tuvo los mayores índices de empatía general y en las dimensiones "cuidado con compasión" y "caminando en los zapatos del paciente", no así en la dimensión "toma de perspectiva", donde es semejante a las especialidades de anestesiología, medicina crítica y terapia intensiva, y gine-cología. Conclusión: los valores de la empatía y los valores en las subescalas "cuidado con compasión" y "caminando en los zapatos del paciente" fueron (en valores absolutos, pero no estadísticos) mayores en la especialidad de pediatría. En la subescala "toma de perspectiva", las especialidades de pediatría, anestesiología, cirugía y clínica se observaron puntuaciones prácticamente iguales. Se requieren otros estudios que permita arribar a una explicación que permita entender por qué algunas especialidades tienen valores de empatía mayores que otras

Introduction: Empathy is one of the components of the structure of humanization in patient care. Medical specialists must have high levels of empathy. Objective: The aim of this paper is to describe the levels of empathy in doctors working in a highly complex hospital and to explore whether there are differ-ences between the specialties studied. Methods: A convenience sample of 237 physicians representing 53.55% of the total population (n = 443) was accessed. Empathy was measured using the Empathy Scale for Health Professionals (hp). Confirmatory factor analysis and multigroup analysis were performed to examine the invariance of the model between the sexes and reliability analyzes (Cronbach's α, intraclass correlation coefficient and McDonald's ω). Results: The specialty of pediatrics had the highest levels in general empathy and in the Compassionate Care and Walking in Patient Shoes subscales, but not in the Perspective Taking subescale where it presents levels similar to the specialties of anesthesiology, critical medicine and intensive care. and gynecology. Conclusions: The empathy values and the values in the compassionate care and "Walking in the patient's shoes" subscales were (in absolute values, but not sta-tistically) higher in the Pediatrics specialty. In the subscale Perspective Taking, Pediatrics, Anesthesiology, Surgery, and Clinic, practically the same scores were observed. Other studies are required to arrive at an explanation that allows us to understand why some specialties have higher empathy values than others.

Introdução: a empatia é um dos componentes da estrutura de humanização no atendimento ao paciente. Os médicos especialistas devem ter altos níveis de empatia. Objetivo: o objetivo deste artigo é descre-ver os níveis de empatia em médicos que trabalham em um hospital de alta complexidade e explorar se há diferenças entre as especialidades estudadas. Materiais e métodos: foi acessada uma amostra de conveniência de 237 médicos, representando 53,55% da população total (n = 443). A empatia foi medida usando a Escala de Empatia para Profissionais de Saúde. A análise fatorial confirmatória e a análise mul-tigrupo foram realizadas (para examinar a invariância do modelo entre os sexos) e a análise de confia-bilidade (α de Cronbach, coeficiente de correlação intraclasse e ω de McDonald). Resultados: a pediatria apresentou os níveis mais altos de empatia geral e nas dimensões "cuidado compassivo" e "estar no lugar do paciente", mas não na dimensão "tomada de perspectiva", em que os níveis foram semelhantes aos da anestesiologia, da medicina crítica e da terapia intensiva, e da ginecologia. Conclusões: os valores de empatia e os valores das subescalas "cuidado compassivo" e "estar no lugar do paciente" foram (em valo-res absolutos, mas não estatisticamente) mais altos na especialidade de pediatria. Na subescala "tomada de perspectiva", as especialidades de pediatria, anestesiologia, cirurgia e clínica tiveram pontuações quase iguais. São necessários mais estudos para explicar por que algumas especialidades têm valores de empatia mais altos do que outras

Prevalence and determinants of burnout among South African doctors during the COVID-19 pandemic

Background: Burnout, resulting from chronic workplace stress that has been unsuccessfully managed, has previously been documented in doctors. The coronavirus disease 2019 (COVID-19) pandemic has increased occupational challenges faced by doctors, potentiating their risk for burnout. Aim: This study aimed to determine the prevalence and determinants of burnout among medical doctors during the COVID-19 pandemic. Setting: Three public sector hospitals in Gqeberha, South Africa. Methods: A cross-sectional study of 260 voluntary participants was conducted. Participants completed self-administered electronic questionnaires. Logistic regression analysis was performed to explore the determinants of burnout. Results: The prevalence of burnout in this study was 78%. Burnout was significantly associated with being a medical intern or community-service medical officer (adjusted odd ratio [AOR] = 6.72, 1.71­26.40), being in the lowest income band (AOR = 10.78, 2.55­45.49), and using alcohol to manage work-related stress (AOR = 3.01, 1.12­8.04). Job-related factors associated with burnout were experiencing high conflict at work (AOR = 5.04, 1.92­13.20) and high role ambiguity and role conflict (AOR = 4.49, 1.98­10.18). Low support at work (AOR = 9.99, 3.66­27.23), medium job satisfaction (AOR = 5.38, 2.65­10.93) and medium support at work (AOR = 3.39, 1.71­6.73) were positively associated with burnout. Participants with medium (AOR = 0.28, 0.10­0.80) and high levels of resilience (AOR = 0.08, 0.03­0.25) were protected against burnout. Coronavirus disease 2019-related factors were not significantly associated with burnout. Conclusion: The burnout prevalence among South African medical doctors at public hospitals during the COVID-19 pandemic was high and strongly associated with job stress factors. Contribution: Given the increased prevalence of burnout among doctors and the strong associations with job stress factors, mitigation of burnout requires targeted organisational interventions.

Operational nursing managers' experiences of clinical supervision at a Johannesburg Hospital

Background: Clinical supervision is pivotal in supporting nurses in rendering quality, safe patient care. Therefore, it is essential to understand clinical supervision from operational nursing managers' context to define existing challenges and propose suitable recommendations. Objectives: This study aimed to explore and describe operational nursing managers' experiences of clinical supervision within the context of an academic hospital in Gauteng province and propose evidence-based practice recommendations to improve patient safety and the quality of clinical supervision. Method: An exploratory, sequential, mixed-method design was used and implemented over two phases to take advantage of the strengths of both the qualitative and quantitative research designs. Unstructured individual interviews were conducted to collect data in phase one, and an adapted Manchester Clinical Supervision Scale (MCSS) questionnaire was used to collect data in phase two. Results: Operational nursing managers work in stressful conditions and environments with a gross shortage of staff and tools of the trade while being expected to deliver high-quality and safe nursing care. Of the sampled respondents, 36% (n = 17) were dissatisfied with the supervision they received, while 64% (n = 30) were indifferent in the sense that they did not think it was adequate or inadequate. Conclusion: Clinical supervisors should be trained and supported in clinical supervision, with regular workshops on interpersonal relations. Contribution: A clearer understanding of clinical supervision within the hospital context and evidence-based practice recommendations to improve patient safety and the quality of clinical supervision.

Explorationand practice of project management of voluntary service in public hospitals / 现代医院

Voluntary service is an important symbol of social civilization and progress.The project-based operation of volunteer service in public hospitals can accurately enrich the service content,improve the patient's medical experience,and give full play to the social effect of the brand,which is an important implementation process in the institutionalization and stand-ardized development of volunteer service in medical institutions.Starting from the four aspects of project development,implemen-tation,monitoring and evaluation,this paper systematically expounds on how to build the project-based management model of public hospital voluntary service,and analyzes the difficulties and solutions of project-based construction in combination with the actual situation,so as to provide references for the project-based management and brand building of public hospital voluntary serv-ice,and advance the high-quality development of public hospitals.

Pathways to enhancing the professional competency of young talents in large public hospitals amid new medical reform:a case study of the middle and young-aged cadre training program at Guangdong sec-ond provincial general hospital / 现代医院

As the medical reform deepens,it becomes imperative for public hospitals to construct acadre of high-level,high-quality young talents and intensify the cultivation of professional competency among them for the continuous promotion of high-quality development.In response to new journeys,new situation and new requirements,Guangdong Second Provincial Gen-eral Hospital pioneered the Middle and Young-Aged Cadre Training Program.Based on this novel talent cultivation and reserve model,the hospital established a comprehensive job management system and staff employment system.With the system,the hos-pital highlighted a persistent optimization of talent teams by equally emphasizing the introduction and cultivation of talents and up-grading the talent team structure,and explored the innovative mechanisms to enhance the professional competency of young tal-ents,providing sustained impetus for the hospital's developmental construction and contributing to the realization of Healthy Chi-na and Healthy Guangdong.

Construction of a personnel highland in prefecture-level hospitals / 现代医院

Professional personnel stands as not only a crucial indicator of a hospital's comprehensive strength but also the primary resource driving high-quality development.In constructing the hospital's personnel highland,Chenzhou First People's Hospital adhered to the principle of"Party exercising leadership over personnel",improved its management mechanism,and pro-posed a new policy of 20 articles for the personnel.These means intensified a clear categorization of personnel,emphasized the integrity,capability,and contribution,and established a comprehensive personnel categorization evaluation system.With these efforts,the hospital is actively constructing a personnel highland in prefecture-level hospitals to provide talent support for the high-quality development of the hospital.

High-quality development driven by the Party building"115 project" / 现代医院

The Party committee of Ordos Central Hospital has effectively utilized its leadershipby steering direction,over-seeing the broader context,making strategic decisions,fostering reform,and ensuring execution.In alignment with the hospital's specific context,the innovative"115 Project"for Party building has been implemented.This initiative reaffirms the comprehen-sive leadership of the Party,aiming to build a high-quality regional medical center.The execution of five major projects has been instrumental in driving the high-quality development of the hospital,guided by Party building.Focusing on the clinical demands of major diseases and aiming to substantially enhance the capacity for emergency and critical care management,the hospital Party committee have made concerted efforts to bolster the hospital's personnel,key disciplines,scientific research,medical quality and safety,and information systems.These efforts have culminated notable advancements in the hospital's developments.

Handling health emergency in public hospitals / 现代医院

Public hospitals play a dominant role in providing medical services.Meanwhile,they are also critical for un-dertaking missions to handle health emergencies.This paper analyzes the necessity,current situation,and existing weaknesses of the health emergency capacity of public hospitals.It also conducts a comparative study of the emergency response mechanisms of foreign medical institutions.This paper aims to explore a well-developed design for health emergency in public hospitals that is suitable for China's medical conditions and to provide a feasible model for promoting high-quality health emergency management.

Empirical Study on the Monitoring and Evaluation Index System for Economic Operation of Public Hospitals in Guangzhou / 中国卫生经济

Objective:To conduct empirical research on the economic operation monitoring and evaluation index system of public hospitals in Guangzhou,and analyze the economic operation of sample public hospitals based on the comprehensive evaluation re-sults.Methods:A total of 15 public hospitals in Guangzhou are selected as samples,and their data from 2020 to 2022 are selected for standard deviation standardization.The standardized scores of each hospital were calculated and summarized by multiplying the standardized values of each index by its weight,and analyzed and compared.Results:The economic performance of these three types of hospitals in 2022 is not ideal,and there is room for improvement in risk management and development management.Among them,comprehensive hospitals and specialized hospitals have the highest scores in 2021,followed by 2022,and the lowest scores in 2020;traditional Chinese medicine hospitals have the highest score in 2021,followed by 2020,and the lowest score in 2022.Conclusion:The indicator system meets the development requirements of public hospitals,and the indicator data can be obtained,which is suit-able for monitoring and evaluating the economic operation of public hospitals.

Study on the Impacts of the Professional Background of the Director of Public Hospital on the Economic Operation of Hospital / 中国卫生经济

Objective:To analyze and explain the influences of the professional background of the directors of public hospitals on the economic operation of the hospital,and to provide research support for training compound hospital management talents and improving the relevant policies of public hospital director management.Methods:The fixed effect model was used to conduct a quantitative analysis based on the data of individual directors and hospital economic performance of public hospitals in Guangdong from 2005 to 2018.Results:Compared with hospitals whose directors without clinical medical backgrounds,the medical income,the number of admissions and medical expenditure of the hospitals whose directors with clinical medical backgrounds were lower,and turnover of bed rate was higher,the differences were statistically significant(P＜0.05).Compared with hospitals where the directors had not obtained a degree related to management and did not participate in management training,the asset-liability ratio and management cost of the hospital where the directors had obtained a degree or participated in the training were lower,and the liquidity ratio was higher,with statistical significance(P＜0.05).Conclusion:For the economic operation indicators closely related to clinical work,directors with clinical medical background have a more significant impact because of their advantages in clinical front-line learning and work experience.For the economic operation indicators closely related to asset management,administration and cost management,directors with management learning experience can better reveal and exert their advantages in applying advanced management concepts,methods and tools,and have a more significant impact.

Function Positioning and Implementation Path of Internal Control in Public Hospitals from the Perspective of Finan-cial and Accounting Supervision / 中国卫生经济

With the reform of the medical and health system entering a critical period,public hospitals have also exposed new risks and challenges in economic operation.As an important means of hospital standardized management,internal control can better prevent and resolve the risk of hospital economic operation and ensure the sustainable operation of the hospital.By interpreting the requirements of current national policies on hospital internal control,it analyzes the functional positioning of financial and accounting supervision in hospital internal control,shares the internal control implementation path of sample hospitals from the perspective of financial and accounting supervision,and puts forward suggestions on strengthening internal control construction of public hospitals in the new era,in order to lay a good foundation for the high-quality development of hospitals.

Game Model Analysis of Fraud Audit in Public Hospitals / 中国卫生经济

Preventing fraud is an important goal and urgent task of internal control in public hospitals.Using game model to study the effective path for internal audit department to reduce management fraud.Increasing the reward of staff in internal audit department after discovering fraud,reducing the cost of fraud audit and increasing the probability of fraud audit can reduce the possibility of fraud by management.

Evolutionary Game Analysis of Financial Compensation Policy on Competitive Strategy Selection of Two-level Public Hospitals / 中国卫生经济

Objective:To study the impact of financial compensation on the competitive strategy selection of public hospitals.Methods:Based on the quality and cost strategy selection framework of public hospitals,the evolutionary game model of strategy selection of secondary and tertiary public hospitals was established,and the influence of different financial compensation methods on the competitive strategy selection of public hospitals was analyzed by matlab simulation.Results:The more public hospitals choose the optimal strategy,the faster they reach the evolutionary stable state of the optimal strategy.The financial compensation of the same unit can change the competitive strategy choice tendency of the secondary hospitals.Regardless of the tertiary or secondary public hospitals,the impact of the compensation quality strategy is greater than the compensation cost policy,but the over-compensation quality strategy will cause the secondary hospitals to deviate from the optimal strategy.The impact of hospital competition costs on secondary public hospitals is much greater than that of tertiary public hospitals.Conclusion:To clarify the positioning and strategy of secondary and tertiary hospitals from the policy;financially increase the investment in the quality construction of tertiary public hospitals and increase the investment in the management level of secondary hospitals;strengthen supervision and management,guide the hospital reasonable competition.

Analysis of the Economic Operation Status of Public Hospitals at All Levels and Types in Beijing / 中国卫生经济

Objective:To analyze the current economic operation status of public hospitals at all levels and types in Beijing,and propose corresponding policy recommendations.Methods:Quantitative analysis was conducted on the economic operation status of public hospitals at all management levels,levels,and types in Beijing from 2019 to 2021.Results:The efficiency of inpatient services in tertiary hospitals is higher than that in secondary hospitals,while the efficiency of outpatient services in tertiary hospitals is lower in secondary hospitals.The proportion of financial allocation revenue and personnel expenses in central level hospitals is relatively low,and the balance of income and expenditure is better than that of municipal and district level hospitals.The income structure of comprehensive hospitals is gradually optimized,and the balance of income and expenditure in specialized hospitals is relatively good.Conclusion:The government plays a"baton"role in policy guidance,combining the functional positioning and disciplinary characteristics of public hospitals,optimizing the allocation of medical resources,and improving operational efficiency.The pricing authority will further improve the dynamic adjustment mechanism for medical service prices.The hospital formulates cost management goals based on the characteristics of the department,achieving"one policy for one department".Hospitals adhere to the principle of suitability,while ensuring medical quality,reasonably control costs and achieve maximum resource efficiency.

Debt Risk Model Construction and Empirical Study of Public Hospitals Based on Factor Analysis / 中国卫生经济

Objective:In order to develop a comprehensive hospital debt risk model,it is imperative to conduct an analysis of the present debt risk landscape within public hospitals,so as to furnish hospitals with recommendations to avert potential debt risks.Methods:A debt risk model was constructed based on 7 common factors through the extraction and standardization of data from 25 indicators,using 600 public hospitals in a specific province as samples,followed by factor analysis.Results:The model's calculation of the comprehensive score of public hospitals aligns with professional explanations and provides a more accurate representation of the factors influencing the debt risk level of public hospitals,such as financial investment level,hospital type,hierarchy,and others.Conclusion:In conclusion,the model is efficient.It is imperative to adopt a comprehensive perspective on the matter of hospital debt and efficiently address the associated financial risks faced by public hospitals by fostering collaboration among multiple stakeholders and upholding fundamental principles.

Construction and Implementation of the Competency Framework for Management Accounting Talents in Public Hospi-tals in the Context of Industry-Finance Integration / 中国卫生经济

Public hospitals are facing higher operational management requirements in the new medical reform process.In order to improve management levels and achieve sustainable development,management accounting based on industry-finance integration is considered an important tool.It firstly emphasizes the important role of management accounting talents in realizing industry-financial integration and improving management efficiency.On the basis of analyzing the current situation and needs of management accounting capabilities in public hospitals,it builds management accounting talents covering three types of ability elements and four levels.It proposes the implementation of a competency framework for management accounting personnel in public hospitals,so as to enhance the competency of management accounting personnel and assist high-quality development of hospitals.

Exploring the Path of Strengthening Internal Financial and Accounting Supervision in Public Hospitals / 中国卫生经济

Different from accounting supervision and audit supervision,financial supervision pays more attention to the standardization of economic behavior from the management and governance level,financial supervision has the characteristics of comprehensiveness,foresightedness and guidance,which is very important for the healthy development of public hospital.By analyzing the main problems and challenges faced by the internal financial supervision in public hospitals,it discusses the construction of supervision system,the perfection of working mechanism,the optimization of supervision means and the construction of supervision environment,to explore the concrete ways and suggestions of improving the efficiency of internal financial supervision in public hospitals.

Structural Equation Modeling Analysis of the Influence Mechanism of Professional Innovation Performance in Public Hospitals / 中国卫生经济

Objective:To examine the impact of Developmental Human Resource Management Practices(D-HRMPs)on innova-tive performance of health professionals from the public hospitals.Methods:A questionnaire survey was conducted to collect data from health professionals in the public hospitals in Beijing,including D-HRMPs scale,innovation performance scale,inclusive lead-ership scale and team innovation atmosphere scale.Descriptive statistics and structural equation model were used for the analysis.Results:D-HRMPs had a direct effect on the innovation performance of public hospital health professionals.Inclusive leadership can positive-ly affect the implementation of D-HRMPs and the formation of team innovation atmosphere.Meanwhile,team innovation atmo-sphere plays a mediating effect,that is,D-HRMPs can actively promote the formation of team innovation climate,and further indi-rectly affect the innovation performance of employees.Conclusion:The directors of public hospitals can further explore the im-plementation of D-HRMPs,and pay attention to adopting inclusive leadership to deepen the reform of personnel management system,and promote high-quality development of public hospitals.

Practice and Exploration on the Specialist Operation Evaluation in Public Hospitals / 中国卫生经济

Literature analysis,expert consultation,case analysis and other methods were used to establish a public hospital specialty operation evaluation system suitable for high-quality development,including 2 first-level indicators of medical ability and economic operation and 13 second-level indicators.Urology surgery in the pilot hospital was taken as an example to carry out surgical operation effect evaluation.To strengthen the evaluation of public hospital specialized operation,it should pay attention to the evaluation of medical capacity,strengthen the cooperation of functional departments,and improve the supporting policies of operation,for better promoting the development of high-quality operation of hospitals.

Application and Practice of SWOT and PDCA in the Special Project of Improving the Quality and Efficiency of Operating Room in a Public Hospital / 中国卫生经济

Through the SWOT analysis of the operating room of a public hospital,it finds out the blocking points and pain points in the operating room during the operation process.Combined with PDCA circular management,it breaks the difficulties in the operating room process,and truly penetrates the concept and essence of"improving quality and efficiency"into the daily operation and management of the operating room,further implements refined management,and promotes the high-quality and sustainable development of the hospital.