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Measuring health care quality with the Servqual method: a comparison in public and private hospitals
No full textHospitals are increasingly realizing the need to focus on service quality as a measure to improve their competitive position in today's highly competitive environment. The aim of the study is to evaluate the service quality of hospitals from the customers' perspective and comparing public and private hospitals. In this study, a total of 610 customers were selected randomly and asked to complete a questionnaire that was designed according to SERVQUAL methods. This questionnaire measured customers' perceptions and expectations in five dimensions of service quality that consists of tangibles, reliability, responsiveness, assurance and empathy. The quality gap of hospital services was determined based on differences between customers' perceptions and expectations. In general, the evaluation of the service quality of the hospitals that the customers preferred are negative (SERVQUAL Score = -0,328). When we examine the hospitals' SERVQUAL scores according to their type of property, public hospitals (SERVQUAL score = -0,394) are negatively evaluated by consumers in comparison to private sector hospitals (SERVQUAL score = -0,246). The results of this research suggest that the SERVQUAL instrument is a useful measurement tool in assessing and monitoring service quality in hospitals, enabling the staff to identify where service improvements are needed from the customers' perspectives
Charismatic leadership: impulse factor for initiative-oriented health care personnel in the Turkish public hospitals
No full textMethodology: We sampled 402 members of medical staff (physicians, medical technicians and nurses) in four Turkish public hospitals by using a questionnaire. Structural Equation Modeling (SEM) was used to test hypothesized relationships between charismatic leadership, stress, job autonomy and initiative-oriented behavior. Results: We found a significant and positive relationship between charismatic leadership and initiative-oriented behavior. Stress produced a significant negative relationship with initiative-oriented behavior. However, the interaction between charismatic leadership and job autonomy was not significant. We concluded that charismatic leadership is the strongest predictor of initiative-oriented behavior followed by strain
The influence of patient-physician communication on physician loyalty and hospital loyalty of the patient
Get PDFConclusion: According to the result of the study, physician-patient communication could be used as an important tool in creating physician loyalty and hospital loyalty. This study helps physicians and health service providers to formulate strategies and tactics that will effectively develop the loyalty of patients
Medical waste management practices in Turkey: A case study in Sakarya
No full textObjective: To determine the knowledge levels of hospital administrators about the process of collection, temporary storage and delivery to the authorities about disposal of medical wastes. Methodology: This descriptive study was conducted in Turkey in June 2010. Questionnaire technique was used as the data collection tool in the study. Data were analyzed using descriptive statistical methods. The results were assessed at significance level of p < 0.05. Results: There was at least one manager responsible for waste management at each healthcare institution and all institutions had a medical waste management plan. Majority of institutions had a temporary storage for medical wastes. Genotoxic pharmaceutical chemical and heavy metal-containing wastes, as well as pressurized vessels were collected separately from other medical wastes. Average 1697 Kg medical waste per/day, and average 1.39 Kg medical waste per/bed were produced in healthcare institutions. Conclusion: Effective medical waste management depends on active support of hospital administration and training of staff which are responsible for segregation, collection, storage, transportation and disposal of medical wastes
THE EFFECT OF TRUST COMMUNICATION IN PATIENT-PHYSICIAN RELATIONSHIP ON SATISFACTION AND COMPLIANCE TO TREATMENT
No full textConclusion: According to the research findings, establishing a trust-based communication between patients and physicians is important for patient satisfaction and compliance to treatment. To better the communication between patients and physicians, courses for improving physicians' communication skills should be included in formal education, and its importance should be emphasized. Any deficiencies in this matter should be eliminated through in-service training
The mediating role of work alienation in the effect of workplace loneliness on nurses' performance
No full textAim The purpose of this study was to determine the mediating role that work alienation has in the effect of loneliness at the workplace on nurses' job performance. Background The literature includes no research on the relationship between nurses' workplace loneliness, work alienation and job performance. The study used work alienation as a mediating variable, which adds to the originality of the study. This study was carried out to contribute to relevant field research. Methods The study used a cross-sectional research design and surveyed 138 nurses working in a public hospital in Turkey. The data were analysed using descriptive statistical methods, Pearson correlation analysis and the PROCESS macro Model 4 in the regression analysis. Results Workplace loneliness has a negative effect on job performance. This negative effect is magnified when work alienation is used as a mediating variable. Conclusion Nurses' loneliness at the workplace and work alienation leads to a decline in their job performance. Implications for Nursing Management Nursing managers should take into consideration that nurses' feelings of workplace loneliness and alienation can reduce the nurses' job performance. When managers create formal and informal support networks, it can reduce nurses' negative feelings of loneliness and alienation. Thus, helping nurses to perform better at work
Türkiye sağlık sektöründe rekabet stratejileri : hastaneler üzerine bir araştırma
Get PDF06.03.2018 tarihli ve 30352 sayılı Resmi Gazetede yayımlanan “Yükseköğretim Kanunu İle Bazı Kanun Ve Kanun Hükmünde Kararnamelerde Değişiklik Yapılması Hakkında Kanun” ile 18.06.2018 tarihli “Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” gereğince tam metin erişime açılmıştır.Sağlık hizmetleri sunumunda rekabet kavramı 1980'li yıllarla birlikte uluslararası literatürde, özellikle ABD'de ilgi görmesine karşılık, ülkemizde bu alana yeterli ilgi gösterilmemiştir. Ancak Türkiye 1980'lerin ABD'sindekine benzer bir sürece girmiştir ve bu bakımdan sağlık sektöründe, özellikle de hastanelerde rekabet önem kazanmıştır.Çalışmanın ana amacı, Türkiye'de hastanelerin hangi stratejileri uyguladıklarının belirlenmesi ve uyguladıkları stratejilere göre hastaneler arasında bir performans farkının olup olmadığını ortaya koymaktır. Bu bağlamda çalışmanın amaçlarını şu şekilde ifade etmek mümkündür:-Özel ve kamu hastanelerinin rekabet stratejilerini algılama ve uygulama yeteneklerini ölçmek ve bu bağlamda hastanelerin rekabet gücünü etkileyen faktörleri belirlemek,-Özel ve kamu hastanelerin hangi stratejileri uyguladıklarını belirlemek,-Farklı rekabet stratejilerini uygulayan hastanelerin uyguladıkları stratejiye göre varsa performans farklılıklarını ortaya koymaktır.Çalışmada literatür çalışmasından sonra bu literatürden yararlanılarak bir anket oluşturulmuştur. Ankette hastanelerin genel özelliklerinin yanı sıra, sağlık yöneticilerinin sağlık sektörüne giriş engelleri, hastanelerin stratejik kararlar alırken rakipleri ve çevrelerini ne oranda dikkate aldıkları, Porter'ın jenerik stratejileri, Miles ve Snow'un stratejik tipolojisi ve büyüme stratejilerinden çeşitlendirme, dikey bütünleşme ve yatay bütünleşme faktörlerini nasıl değerlendirildiklerine ilişkin sorular sorulmuştur.Anketin geçerlilik ve güvenilirlik analizi yapılmıştır. Elde edilen sonuçlardan sonra tanımlayıcı istatistiksel metotların yanı sıra soruların arasındaki farkların ve hipotezlerin test edilmesinde iki ortalama arasındaki farkın önem kontrolü, tek yönlü varyans analizi ve Ki-Kare testleri kullanılmıştır. Ayrıca hastanelerin uyguladıkları stratejiler esas alınarak performans farklılıkları karşılaştırılmıştır.Elde edilen bulgulara göre; özel hastaneler daha önde olmak üzere hastaneler daha çok farklılaştırma ve çeşitlendirme stratejisi uygulamakta ve atılgan ve analizci strateji tipini benimsemektedirler. Buna karşılık kamu hastaneleri arasında toplam maliyet liderliği ve dikey bütünleşme stratejileri uygulayan ve savunmacı tip geliştiren hastaneler özel hastanelerden daha fazladır. Özel hastaneler yatay bütünleşmeye daha eğilimli bulunmuştur. Farklılaştırma, çeşitlendirme ve dikey bütünleşme gibi daha agresif strateji izleyen hastanelerin kapasite kullanım oranları pozitif yönde gelişmektedir. Buna karşılık toplam maliyet liderliği ve yatay bütünleşme stratejisi gibi agresif olmayan stratejiler izeleyen hastanelerin hizmet hacimlerinde büyüme meydana gelmektedir. Savunmacı tipte olan ve odaklanma stratejisi izleyen hastaneler bazı alanlarda başarılı olmakla birlikte, hiçbir zaman öne çıkamamaktadırlar. Hiçbir strateji uygulamadığını bildiren hastaneler ve tepkici tipteki hastanelerin performansı tüm hastanelerden daha düşüktür.Hastanelerin kendi nitelikleri ve çevresel değişkenleri dikkate alarak strateji seçmeleri ve sektörde meydana gelen değişime uyum sağlamak için esnek bir yapı geliştirmeleri önerilmektedir.With the 1980?s concept of competition on health care supply in international literature, especially in USA was drawn attention, but it wasn?t in Turkey sufficiently. However, Turkey entered a process that like USA in 1980?s, and competition began important in health sector, and hospitals.The main aim of this study is to determine which strategies have been put into practice hospitals in in Turkey, and to expose differences of performance. With reference to aims of study can explain in this way:-To Measure perception and application of competition strategies by state hospitals and private hospital, and to determine factors that force of competition of hospitals,-To determine which strategies have been put into practice by state hospitals and private hospitals,-To expose differences, if there are differentiations with hospitals that have been put into practice different strategies.After act of writing literature, a questionnaire was formed benefit from this literature. The questionnaire comprise to questions relating to general characteristics of hospitals, and barriers of entering health sector, and effect of environment and competitors on strategic decisions, and Generic strategies of Porter, and strategic typology of Miles and Snow, and diversification, and horizontal integration, and vertical integrationValidity and reliability analysis of questionnaire was accomplished. After that, data was analyzed under cover of descriptive statistics, Independent Samples T Test, and One way ANOVA, and Chi Square. In addition differences of performance of hospitals confronted with strategies that hospitals were put into practice.According to findings, hospitals have been put into practice differentiation and diversification strategies, and improve to prospector analyzer strategy types that private hospitals are further than state hospitals. Total cost leadership and vertical integration and defender strategy type are more widespread among state hospital than private hospitals. Private hospitals are having a tendency to horizontal integration. Hospitals that follow aggressive strategies like differentiation, diversification and vertical integration have higher level of capacity use. On the other hand hospitals that follow nonaggressive strategies like total cost leadership and horizontal integration strategies have larger capacity of services. Hospitals that follow niching strategy and improve defenders structure are successful some areas, but they aren?t leaders in sector. Hospitals that don?t follow a strategy and improve reactor structure have lowest performance.Hospitals performances are effected by their characteristics. Therefore, hospitals have to choose strategies to take into consideration environmental factors and their characteristics, and improve a flexible structure that can orientate oneself changing in sector
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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