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Article
Publication date: 31 December 2020

Risha Fayyaz, Fasih Ali Ahmed, Adeel Abid, Afshan Akhtar, Rabail Jarwar, Anila Jasmine, Sameer Ahmad Khan, Shahira Shahid, Iraj Khan, Aneeq Muhammad Yousuf and Imtiaz Jehan

This study aims to assess the quality of care among adult oncology patients in tertiary care hospitals in Karachi by using an international standard of quality of care and to…

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Abstract

Purpose

This study aims to assess the quality of care among adult oncology patients in tertiary care hospitals in Karachi by using an international standard of quality of care and to identify domains where improvement is needed.

Design/methodology/approach

This is a cross-sectional study carried out at two tertiary care hospitals of Karachi, Pakistan, belonging to private and public sector, respectively, between February and April 2018. Face-to-face interviews were conducted using a modified questionnaire having five-point Likert scale questions regarding satisfaction of patients with doctors, nursing staff, information provided and the hospital standards. SPSS 20 was used for statistical analysis, and the results were expressed using mean, frequencies, percentages and p-values.

Findings

The authors approached 415 patients, out of which 389 patients agreed to participate in the study. For both hospitals, the lowest mean scores were for sections pertaining to satisfaction with psychosocial support and information provided. The mean satisfaction score of patients from the private hospital were found to be significantly higher as compared to patients from the public hospital for all domains of patient care (p-value < 0.01 using t-test for two independent samples). The data showed an increasing trend of “satisfied” responses as the household income increased.

Research limitations/implications

A comparative study should be conducted with the aim of pinpointing the differences in areas in which there is a significant difference in positive satisfaction levels between private and public sectors. Similar research could also be expanded adding other variables that affect quality of care such as doctor's approach to their patients, time given during each consultation and patient's understanding of doctor's knowledge. Further studies can be done to bridge the gaps between what a doctor views as standard care and what the patient knows will help them receive a more holistic approach to care.

Practical implications

Assessing the quality of care helps determine gaps in care and allocating health resources accordingly. In clinical practice, emphasis needs to be given on increased duration and improved quality of patient counselling to improve the low satisfaction levels of patients regarding the psychosocial support. Addressing patients' concerns should be made part of clinical teaching from an undergraduate level. As far as patient access to doctors of the specific speciality is concerned, hospital managements should adopt systems to ensure continuum of care and come up with mechanisms to bridge the discrepancy between a patient's needs and doctor availability.

Social implications

After being identified as a major deficiency, training doctors in the sensitivities of the population and demographics, especially with respect to socio-economic statuses, can aid in enhancing patient satisfaction to the treatment. Implementation of patient-centred care leads to greater satisfaction with care, which, in turn, increases a patient's self efficacy in managing important aspects of their care and improves health care-related quality of life.

Originality/value

Cancer patients have long-term exposure to the hospital environment. A patient's satisfaction with the quality of care is an important determinant in patient compliance to the treatment protocol and required hospital visits. There is a dearth of research on the outpatient quality of care in the oncology departments in Karachi. This study provides an overview of the quality of care available to cancer patients in Karachi both in public and private sectors. The results of our study identify the gaps in the quality of care being provided to the patients in a developing country like Pakistan, which can be used to improve the quality of care, leading to better patient outcomes.

Details

International Journal of Health Care Quality Assurance, vol. 34 no. 1
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 15 August 2019

Sibanjan Mishra and Ranjan Dasgupta

The purpose of this paper is to investigate the cross-impact of leverage and performance for firms operating in the developed and frontier bank-based economies.

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Abstract

Purpose

The purpose of this paper is to investigate the cross-impact of leverage and performance for firms operating in the developed and frontier bank-based economies.

Design/methodology/approach

This study uses annual panel data for a sample of 400 firms over a period of 27 years from 1990 to 2016. The sample sample firms consist of developed, Germany, France and Japan, and frontier including Argentina and Sri Lanka bank-based economies firms. The authors employ a simultaneous equation modeling consisting of two equations estimated using the two-stage least squares procedure to examine the cross-relationships between leverage and performance after controlling for other firm-level variables like size, growth and liquidity.

Findings

The empirical results are presented in two sets. First, in the case of firms in the developed bank-based sample, the authors find a negative debt-to-performance relationship and a negative performance-to-debt relationship. This inconsistent negative debt–performance relationship implies that firms operating in these economies use debt beyond a threshold limit, which, in turn, increases agency issues between the managers and debt-holders, thereby influencing firm performance adversely. Second, for frontier economies firms, the authors find a positive debt-to-performance relationship in line with the “trade-off theory.” Furthermore, the authors find a negative performance-to-debt relationship for both sub-samples in line with the “pecking-order theory.”

Originality/value

The study is distinct from earlier empirical studies and contributes largely to the existing literature. First, it emphasizes whether financial leverage influences firm performance in bank-based economies as firms operating in such systems are exposed directly to the strict regulatory environment. Second, it investigates whether any reverse relationship emanating from firm performance to capital structure holds for firms of these countries. This issue, to the best of author knowledge, is unanswered in previous research, more specifically for developed and frontier bank-based economies. Moreover, the results are relevant, as firm managers, analysts and policymakers must consider the importance of such cross-debt-performance relationships, while determining the optimal capital structure, in the bank-based economies.

Details

Managerial Finance, vol. 45 no. 8
Type: Research Article
ISSN: 0307-4358

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Article
Publication date: 16 December 2024

Muhammad Irfan, Shahira Suman, Shiza Zainab, Javeria Shahid and Yumna Nayab

This study uncovers interdependent mechanisms triggered by excessive use of mobile phones which lower the performance of individuals in business organizations. The quantum of…

28

Abstract

Purpose

This study uncovers interdependent mechanisms triggered by excessive use of mobile phones which lower the performance of individuals in business organizations. The quantum of cognitive and attentional fluctuations caused by Nomophobia-induced impulsive use of mobile phone that degrades job performance is the focus of this study for suggesting realistic regulatory measures. Similarly, the threshold of allowable smartphone use was determined as a foundation to strike balance between adverse psycho-behavioral implications of blanket ban policy and the cognitive overload of unregulated mobile phone usage.

Design/methodology/approach

Adopting the quasi-experimental design, a sample of 159 individuals working in six different organizations was tested under dissimilar conditions using a variety of experimental interventions. Participants were subjected to different intensity of planned interruptions inciting responses through sets of short message services (SMS), messages on Whatsapp, X (formerly twitter), Instagram and emails. The main data obtained from the experiment comprised 636 test performances and 5,724 reactive responses on smartphones along with 642 video recordings as supplementary evidence.

Findings

The analysis of data revealed five underlying inter-related mechanisms impacting performance of individuals, i.e. slow-down of cognitive processing, increased temptation for peripheral activities/side scrolling, widened lag between focus and refocus, depletion of short-term working memory and reduced attention span. The strength of relationships between the mechanisms and intensity of Nomophobia significantly varied with the experimental interventions. Based on the identified mechanisms, organizations were suggested certain regulatory measures to minimize negative effects of Nomophobia-induced impulsive mobile phone usage.

Research limitations/implications

The study is based on a comparatively smaller sample size (total 159, 27 from each of the six organizations). Though sufficient, yet, the sample size could have been a little larger.

Practical implications

The blanket ban policy adopted by organizations for regulating use of mobile phone has been found to adversely affect performance more than the excessive use of mobile phone. Using mobile phone thrice an hour (1–2 min each) was found to have negligible effects on job performance. Allowing use of mobile phones at workplace (except in highly hazardous areas) can reduce stress, anxiety and depression caused by Nomophobia.

Social implications

To meeting social need, workers may not be denied the facility of mobile phone at workplace, except highly hazardous areas to allow them to remain connected and accessible. This study suggests viable measures to regulate use of mobile phones without depriving them of this vital facility.

Originality/value

The study is unique as it is based on experimental data, contrary to most of the studies relying on self-report methods of data collection. The mechanisms which degrade performance of workers due to excessive use of mobile phones (induced by Nomophobia) have not been explored and how the impact is propagated to the performance of workers is not known. This study has identified the five mechanisms and based on the mechanisms has suggested measures for the organizations to regulate the use of mobile phones in the organizations. This study has found that use of mobile phone thrice in an hour (1–2 min each) affects performance of individuals negligibly. Organizations adopting a blanket ban policy on use of mobile phone increase stress of workers (Nomophobia) that is more harmful for job performance.

Details

Journal of Economic and Administrative Sciences, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2054-6238

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