Biomedical subjects

D Boldy

Publications and source records attributed to D Boldy.

At least 19 recordsLinked to original sources

PubMed1999

Patient perceived quality-of-care in hospital in the context of clinical pathways: development of an approach.

Clinical pathways have been introduced in many hospitals with the aims of improving efficiency, reducing costs, and improving the quality and outcomes of care. However, there is a shortage of research evidence regarding the extent to which they do in fact achieve such aims. This paper describes the development and testing of a patient-perceived quality-of-care questionnaire for use in relation to the assessment of clinical pathways. Issues of validity and reliability are addressed and illustrative examples of results for two pilot hospitals are presented.

Adult↗

PubMed1997

Comparing patient satisfaction, outcomes and costs between cataract day surgery and inpatient surgery for elderly people.

The study reported in this paper examined the characteristics of elderly people undergoing cataract surgery and compared patient perspectives and satisfaction, outcome, costs, reported health problems and social circumstances of day surgery patients and hospital inpatients. The study sample was drawn from the client database of a health insurance fund and covered 291 people aged 60 years or more who had recently undergone cataract surgery. Overall, both day surgery patients and inpatients indicated a high level of satisfaction with their eye surgery (about 80 per cent for both groups). The majority of patients from both groups reported an improved level of vision, with vision outcome in the day surgery group being as good as in the inpatient group. Overall, inpatient treatment was more costly and involved higher out of pocket expenses. The study results indicate a potential to increase the number of patients undergoing cataract surgery as a day patient procedure. Pre-operative preparation contributed to patient satisfaction and the availability of family and/or social support was an important factor influencing day surgery admission. Whilst patients reporting health problems were less inclined to have cataract surgery than were day patients, this only accounted for one-fifth of the total inpatient group. Developing systematic and appropriate case selection criteria and effective case management will contribute to more efficient use of hospital resources, an increased use of day surgery facilities, and hence a more cost-effective overall cataract surgery service for elderly people.

Aged↗

PubMed1996

Comparative attributes of effective health services managers and definitions of organizational effectiveness in Australia, the UK and the USA.

This paper explores and contrasts the perceptions of 855, mainly health services managers and 1452 students from three major English-speaking countries regarding the attributes needed for becoming effective managers in their country. Also addressed are country differences and similarities in the perceived relevance of particular indicators of organizational effectiveness. Despite Australia's British heritage, respondents from this country were found to be more similar to those from the USA, than those from the UK, in their views regarding the attributes of effective managers. Australian and American respondents rated 'nurturing' personality skills relatively highly, as they did 'classical' management skills. UK respondents rated 'classical' management skills as more important than 'political' skills.

Administrative Personnel↗

PubMed1994

Attributes of effective managers and implications for health care management education in the Asia-Pacific region.

This paper explores the perceptions of managers and students from 11 countries in the Asia-Pacific region regarding the attributes needed for becoming effective managers and the broad implications of these findings for health care management education. The study forms part of a wider international project aimed at exploring the role of national culture in managerial behavior and effectiveness.

Administrative Personnel↗

PubMed1993

A review of hospital boards of management in rural Western Australia.

The primary aim of the study described in this paper was to review the place of hospital boards in the delivery of public sector health services in rural Western Australia. Specific issues explored included the demographic characteristics of country hospital boards, board roles and functions, and mechanisms for evaluating performance. While most board members and administrators perceived management control of boards to be about equally shared between them, over 90 per cent of board members felt they did not have sufficient skills to adequately discharge their board responsibilities.

Data Collection↗

PubMed1991

Educational implications of developments in the care and management of elderly people in Australia.

A current feature of Western nations is the attention governments are giving to the interests and needs of their aged populations. This is mainly due to the aging of these societies, but also acknowledges that to be effective, policies often need to address specific groups. This paper considers the aging of the population within Australia, the related development of government policy on care services and the educational implications for the caring professions. Particular mention is made of the role of postgraduate multidisciplinary courses in gerontology and brief descriptions are given of the three such programs currently available in Australia.

Aged↗

PubMed1990

Public health and health administration: collaboration or competition? An Australian perspective.

The Review of Postgraduate Public Health Training in Australia 1988, commissioned by the Australian Public Health Association, identified as a major issue the degree of collaboration between independent postgraduate courses in health administration and courses in public health. This paper suggests that the two fields share the common goal of health service education, which they pursue by the respective pathways of effectiveness and efficiency. We argue that the identity and the complementarity of the disciplines are best served by a collaborative model and discuss ways to encourage and achieve this aim.

Australia↗

PubMed1990

What makes an effective manager?--health care and general management perceptions.

This paper explores the perceptions of Australian health service managers (and health service management students) regarding the qualities of effective managers, comparing and contrasting these views with those of Australian general managers (and general management students). The study forms part of a wider international project aimed at exploring the role of national culture in managerial behaviour and effectiveness. Overall, the skills dimension was perceived to be more important in terms of managerial effectiveness, particularly amongst health service managers, compared to the other main dimensions of knowledge and learning, beliefs and values and personality characteristics. Decision-making and planning and evaluation were considered to be the most important amongst the range of skills listed, followed by negotiation and conflict resolution. Health service managers rated pertinent technical knowledge more highly than any other aspect in the knowledge and learning dimension, indicating the importance of specialist education for health service managers. Some implications of these and other findings are discussed.

Attitude of Health Personnel↗

PubMed1989

Management problems and professional development needs of Australian health executives.

This paper summarises the key results and recommendations from a major study of the management problems and professional development needs of Australian health executives. Key issues of major concern to a nationally representative sample of senior nursing, medical and general administrators, included the following: change, information, financial constraints, evaluation, corporate planning, human resources, conflict and staff development. Over 80% of respondents considered that they were not sufficiently involved in executive development activities and the paper addresses their preferences as to learning styles, settings, timing and location. Specific recommendations are made regarding desirable responses to the key issues of information and corporate planning.

Attitude of Health Personnel↗

PubMed1989

Economic appraisal in health care with particular reference to hospice and palliative care.

This paper provides an outline of the main principles of economic appraisal in health care, illustrating these by reference to hospice and palliative care programs. A specific distinction is made between "cost-saving" and "economic efficiency", the latter being concerned with making choices which maximise the net benefit to society from available resources. The three essential stages of assessing costs and benefits of health care alternatives, namely enumeration, measurement and explicit valuation, are discussed. A recent study in Perth has found that the costs of an extensive GP based hospice program are no greater than if the patient had gone to hospital and that a variety of additional benefits are derived, not least being increased choice for the patient and their family.

Australia↗

PubMed1987

A comparative cost analysis of terminal cancer care in home hospice patients and controls.

A comparison is made between the expenditure during the last 90 days of life on 98 terminal cancer patients cared for by a home based hospice service and that on matched patients dying without the home hospice service. The control patients were matched for site of primary cancer, age and sex. The individual records of both groups of patients were analyzed and costed. It was found that the costs of providing 24 hour comprehensive medical and nursing care at home to those dying of cancer and support for their families was no more expensive than traditional institutional care.

Australia↗

PubMed1986