Analysis of the multi-item dimensionality of patients' perceived value in hospital services.

The purpose of this research is to analyse the multi-item dimensionality of patients' perceived value in hospital service. A total of 564 patients administered to Gulhane Military Medical Academy were surveyed. Sample population was specified through convenience sampling procedure. A face to face survey was conducted by three interviewers in August 2008. Confirmatory Data Analysis was carried out to reach the final data analysis. A scale of overall perceived value in health service was developed, which was composed of three dimensions and represented by 21 items. These dimensions were: Functional value, emotional value, and social value. The results indicated that perceived value was a multidimensional construct that affects the whole process of service purchasing. If the hospitals managers give importance to the sub-dimensions of the patient value inclined to their own hospitals and they regularly examine the situation of these dimensions, they can move one step ahead in achieving patient satisfaction and loyalty.

Organizational commitment of military physicians.

An individual's loyalty or bond to his or her employing organization, referred to as organizational commitment, influences various organizational outcomes such as employee motivation, job satisfaction, performance, accomplishment of organizational goals, employee turnover, and absenteeism. Therefore, as in other sectors, employee commitment is crucial also in the healthcare market. This study investigates the effects of organizational factors and personal characteristics on organizational commitment of military physicians using structural equation modeling (SEM) on a self-report, cross-sectional survey that consisted of 635 physicians working in the 2 biggest military hospitals in Turkey. The results of this study indicate that professional commitment and organizational incentives contribute positively to organizational commitment, whereas conflict with organizational goals makes a significantly negative contribution to it. These results might help develop strategies to increase employee commitment, especially in healthcare organizations, because job-related factors have been found to possess greater impact on organizational commitment than personal characteristics.

Factors affecting satisfaction level with the food services in a military hospital.

OBJECTIVE: To determine the factors affecting general satisfaction level of patients with the food services in a military hospital in Turkey. STUDY DESIGN: The study was carried out in a military hospital providing tertiary health care services with the capacity of 1000 hospital bed. A questionnaire was used as data collection tool on measuring satisfaction of the patients with the food services. RESULTS: The results showed that of 374 patients 51.3% evaluated food service quality adequate, 32.4% said that the food quality was inadequate, and 16.3% stated that they were uncertain. A logistic regression model was estimated in determining the most important and statistically significant factors affecting patient satisfaction with hospital foods and food services. The results showed that patient-specific demographic characteristics were insignificant in explaining satisfaction level with food services, but the variables of taste (OR = 9.853, p = 0.000) and appearance (OR = 2.687, p = 0.014) of the food were statistically significant and important determinants of patient satisfaction with the foods served at the hospital. CONCLUSIONS: The results of this study would be helpful in making decision on increasing the level of satisfaction of patients with the food services for hospital managers and the food (nutrition) departments. On the other hand, the results can also be used in benchmarking the hospital's food services quality with other hospitals, and in monitoring improvements in food services quality in the future.

An evaluation of the leadership attitudes of managers in Turkish Armed Forces' hospitals.

BACKGROUND: As in any other institution, the success of hospitals, which use approximately one-half of all resources in the health sector, depends on moving human resources toward the institution's goals. Ensuring that the workers are used intentionally for specific, predetermined goals, and that the workers are motivated toward achieving these institutional goals are the responsibilities of the managers. OBJECTIVE: In this study, the leadership attitudes of the higher rank executive officers in Turkish Armed Forces' military hospitals were evaluated. METHODS: The managerial grid developed by Blake and Mouton was used to evaluate the leadership attitudes of the officers. A total of 172 questionnaires was sent out to managers, but only 142 (82.6%) were returned completed. RESULTS: The study results show that the managers substantially preferred team leadership styles in terms of leadership philosophy, planning, and evaluation functions, but preferred task-oriented leadership and mid-way leadership styles in terms of execution. Also, it was found that 72% of all managers practiced team leadership in terms of the overall leadership manner. CONCLUSIONS: It seems as if the type of leadership participants preferred was team leadership, and the least was passive leadership. From this finding, we suggest that the managers in Turkish Armed Forces' hospitals are not only interested in their work and goals, but also in the interests of their workers as human beings.

Appropriateness of admission and length of stay in a Turkish Military Hospital.

The purpose of this study was to determine the extent of inappropriate days of stay in a Turkish military hospital, and to explore the variables correlated with these. A review was made of the medical records of surgery patients admitted to the hospital of Gülhane Military Medical Academy. To determine the appropriateness of lengths of hospitalization, a Turkish version of the Appropriateness Evaluation Protocol (AEP) was applied retrospectively. A total of 375 patients'files were reviewed; and 21.3% of the hospital admissions were evaluated as inappropriate. Multiple logistic regression analysis showed that inappropriate length of stay was significantly increased with relation to age, emergency status, military rank, and distance from the hospital to the patient's home. The results of the study suggest that changes in physicians' behavior and in the organization of hospital activities may be effective in improving the quality and efficiency of hospital care.

Relation between Machiavellianism and job satisfaction in a sample of Turkish physicians.

Job satisfaction is affected by many factors. A consistent negative correlation between Machiavellianism and Job satisfaction was shown by many previous studies. To estimate this association in a sample of Turkish people, 361 physicians were selected among the total number of 5,959 working in Ankara City Center. A self-administered questionnaire including the Mach IV scale and Job Satisfaction scale developed by Kasapoglu was applied to the subjects. Student t test and Pearson correlation were used for analysis. The correlation of -.25 between Job Satisfaction and Machiavellianism scores was significant and consistent with the mean scores on Job Satisfaction between the Machiavellian and Nonmachiavellian groups. Although the present association is small, the inverse value is consistent for Mach IV scale scores with job satisfaction in the literature.

Investigation of the correlation between inappropriate hospitalization and hospital stay rate: an application in medical clinics of a military hospital.

BACKGROUND: Medical services play a major role in hospital facilities. Along with the medical applications and diagnoses, physicians affect the hospital costs by 70% to 80%. Therefore, the hospital administrators should establish some systems that can modify the current application models of physicians. OBJECTIVE: This study aimed to investigate the appropriateness of hospitalization days and length of stay of the patients in 13 internal clinics in a military hospital. STUDY DESIGN: 5,205 patient days belonging to 416 patients were evaluated by Appropriateness Evaluation Protocol. Patients' data were retrospectively collected by using a "data collection form" through patients' files and then were evaluated by frequencies and percentage distributions. RESULTS: The unnecessary hospitalization rate and unnecessary stay rate were 4.8% and 15.75%, respectively. The highest unnecessary hospitalization rates were in nuclear medicine (50%). CONCLUSION: It was concluded that the inappropriate hospitalization rate and inappropriate stay rates were 4.8% and 15.75%, respectively.

Determining the level of job satisfaction of nurses working at Turkish military forces hospitals.

The purpose of this study was to determine the level of job satisfaction of nurses working at Turkish military hospitals. A questionnaire was prepared as a data-gathering tool. This study measured the job satisfaction level at two stages. At the first stage, nurses' expectations for their jobs were measured with a Likert-type scale; at the second stage, the current level of satisfaction was determined. The differences between expectations and current level of satisfaction was calculated as the level of job satisfaction.

Determinants of patient satisfaction in a military teaching hospital.

The purpose of this study was to determine the aspects of hospital services that are most likely to affect patient satisfaction in a military teaching hospital in Turkey. Although there have been many studies on patient satisfaction in Turkey and other countries, few studies have been done in military hospitals. A patient satisfaction questionnaire using a 4-point Likert scale was mailed to 500 patients after discharge, and 316 questionnaires were returned. The findings indicated that satisfaction with physician, nursing, physical plant, and food services were the main determinants of overall satisfaction with the hospital. The type of clinic in which the patients stayed also was an important determinant. The effect of patients' demographic characteristics on overall satisfaction with the hospital was also examined, and only lower education level was a statistically significant determinant.