There is a widely held view that good management improves organisational performance. However, hospitals are complex organisations and the relationship between management practices and health service delivery is not straightforward. We conducted a global, systematic literature review of the quantitative evidence on the link between the adoption of management practices and quality of care in hospitals. We searched in PubMed, EMBASE, EconLit, Global Health and Web of Science on 16th October 2024, without language or country restrictions. We included empirical studies from January 1, 2000, onward, examining the quantitative association between hospital management practices and quality of care. Outcomes included structural quality (availability of resources such as drugs and equipment), clinical quality (adherence to guidelines), health outcomes and patient satisfaction or experience with care. In every study, each tested association was categorised as significantly positive (at the 5 percent level), null or significantly negative. The study was registered with PROSPERO (CRD42022301462). Of 11,731 articles, 25 studies met the inclusion criteria and had acceptable risk of bias. Studies were equally distributed between high-income and low- and middle-income countries, with 22 cross-sectional and three intervention studies. Of 111 associations, 55 (49.5%) were significantly positive, 1 (1%) was significantly negative, and 55 (49.5%) were null. Among associations tested, the majority were significantly positive for structural quality (79%), clinical quality (60%) and health outcomes (57%), while most associations between hospital management and patient satisfaction (80%) were null. The findings are mixed, with a similar proportion of positive and null associations between management practices and quality of care across studies. The evidence is limited by risk of bias introduced by non-randomised study designs. Evidence of positive associations in some settings warrants further investigation of the association through intervention studies or natural experiments. This could leverage methodological developments in quantitatively measuring management, highlighted by this review.
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http://dx.doi.org/10.1093/heapol/czae112 | DOI Listing |
Rheumatol Int
January 2025
Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University, Salzburg, Austria.
Rheumatoid arthritis (RA) is a chronic autoimmune disease marked by systemic inflammation. While RA primarily affects the joints, its systemic effects may lead to an increased cerebro- and cardiovascular risk. Atherosclerosis of the carotid arteries is a significant risk factor for cerebrovascular events and serves as a surrogate marker for cardiovascular risk.
View Article and Find Full Text PDFAppl Microbiol Biotechnol
January 2025
National Engineering Research Center of Green Feeds and Healthy Livestock Industry, Hangzhou, 310058, Zhejiang, China.
The widespread use of antibiotics has led to the emergence of multidrug-resistant bacteria, which pose significant threats to animal health and food safety. Host defense peptides (HDPs) have emerged as promising alternatives because of their unique antimicrobial properties and minimal resistance induction. However, the high costs associated with HDP production and incorporation into animal management practices hinder their widespread application.
View Article and Find Full Text PDFHealth Informatics J
January 2025
Department of Computer Science and Information Technology, La Trobe University, Melbourne, VIC, Australia.
The HIV epidemic in Indonesia is one of the fastest growing in Southeast Asia and is characterised by a number of geographic and sociocultural challenges. Can large language models (LLMs) be integrated with telehealth (TH) to address cost and quality of care? A literature review was performed using the PRISMA-ScR (2018) guidelines between Jan 2017 and June 2024 using the PubMed, ArXiv and semantic scholar databases. Of the 694 records identified, 12 studies met the inclusion criteria.
View Article and Find Full Text PDFUltrasound Obstet Gynecol
January 2025
Discipline of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Objective: To assess the performance of the Fetal Medicine Foundation (FMF) first-trimester competing-risks screening model for small-for-gestational-age (SGA) fetuses requiring delivery at < 37 weeks' gestation, in a large cohort of women receiving maternity care in Australia.
Methods: This was a retrospective analysis of prospectively collected data from a cohort of women attending one of two private multicenter fetal medicine practices for first-trimester screening for preterm pre-eclampsia (PE), defined as PE requiring delivery before 37 weeks' gestation. Risk for preterm SGA, defined as SGA requiring delivery before 37 weeks, was calculated but was not disclosed to the patient or referring physician.
Eur J Cardiovasc Nurs
January 2025
Professor, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Aims: A randomized controlled trial was conducted to examine the effects of a home-based multicomponent exercise programme on frailty in patients who underwent cardiac surgery.
Methods And Results: A convenience sample of 92 patients who underwent cardiac surgery at two medical centres in Taiwan were recruited and randomly allocated to the intervention (n = 46) and control (n = 46) groups. The intervention group underwent a 12-week home-based multicomponent exercise programme, including individual nursing consultation, home-based exercise intervention, nutritional assessment and guidance, and continuous support.
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