How nurses behave online?

Registered nurses constitute the largest group of healthcare professionals with a rather distinctive and crucial role in healthcare services provision. For keeping up with their professional advances and follow the rapid and multifaceted scientific advances of medical practices they constantly require high quality of information. Internet and the online information resources play an important role towards the satisfaction of continual online information needs of nurses. This paper aims to investigate the online information needs of nurses and their internet seeking behaviour. Moreover, their perceptions for the role of information in nursing profession are studied. A survey informed by the Wilsons macro-model for information seeking behaviour is developed and included 87 registered nurses working at a public hospital. Data analysis involves descriptive statistics and non-parametric tests of correlation and differences between groups

A smartwater metering deployment based on the fog computing paradigm

In this paper, we look into smart water metering infrastructures that enable continuous, on-demand and bidirectional data exchange between metering devices, water flow equipment, utilities and end-users. We focus on the design, development and deployment of such infrastructures as part of larger, smart city, infrastructures. Until now, such critical smart city infrastructures have been developed following a cloud-centric paradigm where all the data are collected and processed centrally using cloud services to create real business value. Cloud-centric approaches need to address several performance issues at all levels of the network, as massive metering datasets are transferred to distant machine clouds while respecting issues like security and data privacy. Our solution uses the fog computing paradigm to provide a system where the computational resources already available throughout the network infrastructure are utilized to facilitate greatly the analysis of fine-grained water consumption data collected by the smart meters, thus significantly reducing the overall load to network and cloud resources. Details of the system's design are presented along with a pilot deployment in a real-world environment. The performance of the system is evaluated in terms of network utilization and computational performance. Our findings indicate that the fog computing paradigm can be applied to a smart grid deployment to reduce effectively the data volume exchanged between the different layers of the architecture and provide better overall computational, security and privacy capabilities to the system

Development and preliminary validation of a Greek-language outpatient satisfaction questionnaire with principal components and multi-trait analyses

BACKGROUND: In the recent years there is a growing interest in Greece concerning the measurement of the satisfaction of patients who are visiting the outpatient clinics of National Health System (NHS) general acute hospitals. The aim of this study is therefore to develop a patient satisfaction questionnaire and provide its preliminary validation. METHODS: A questionnaire in Greek has been developed by literature review, researchers' on the spot observation and interviews. Pretesting has been followed by telephone surveys in two short-term general NHS hospitals in Macedonia, Greece. A proportional stratified random sample of 285 subjects and a second random sample of 100 outpatients, drawn on March 2004, have been employed for the analysis. These have resulted in scale creation via Principal Components Analysis and psychometric testing for internal consistency, test-retest and interrater reliability as well as construct validity. RESULTS: Four summated scales have emerged regarding the pure outpatient component of the patients' visits, namely medical examination, hospital environment, comfort and appointment time. Cronbach's alpha coefficients and Pearson, Spearman and intraclass correlations indicate a high degree of scale reliability and validity. Two other scales -lab appointment time and lab experience- capture the apparently distinct yet complementary visitor experience related to the radiographic and laboratory tests. Psychometric tests are equally promising, however, some discriminant validity differences lack statistical significance. CONCLUSION: The instrument appears to be reliable and valid regarding the pure outpatient experience, whereas more research employing larger samples is required in order to establish the apparent psychometric properties of the complementary radiographic and laboratory-testing process, which is only relevant to about 25% of the subjects analysed here

Socioeconomic inequalities in general and psychological health among adolescents: a cross-sectional study in senior high schools in Greece

BACKGROUND: Socioeconomic health inequalities in adolescence are not consistently reported. This may be due to the measurement of self-reported general health, which probably fails to fully capture the psychological dimension of health, and the reliance on traditional socio-economic indicators, such as parental education or occupational status. The present study aimed at investigating this issue using simple questions to assess both the physical and psychological dimension of health and a broader set of socioeconomic indicators than previously used. METHODS: This was a cross-sectional survey of 5614 adolescents aged 16-18 years-old from 25 senior high schools in Greece. Self-reported general and psychological health were both measured by means of a simple Likert-type question. We assessed the following socio-economic variables: parents' education, parents' employment status, a subjective assessment of the financial difficulties experienced by the family and adolescents' own academic performance as a measure of the personal social position in the school setting. RESULTS: One out of ten (10%) and one out of three (32%) adolescents did not enjoy good general and psychological health respectively. For both health variables robust associations were found in adolescents who reported more financial difficulties in the family and had worse academic performance. The latter was associated with psychological health in a more linear way. Father's unemployment showed a non-significant trend for an association with worse psychological health in girls only. CONCLUSIONS: Socioeconomic inequalities exist in this period of life but are more easily demonstrated with more subjective socioeconomic indicators, especially for the psychological dimension of health.Int J Equity Healt

Assessment of health care needs and utilization in a mixed public-private system: the case of the Athens area

BACKGROUND: Given the public-private mix of the Greek health system, the purpose of this study was to assess whether variations in the utilisation of health services, both primary and inpatient care, were associated with underlying health care needs and/or various socio-economic factors. METHODS: Data was obtained from a representative sample (N = 1426) residing in the broader Athens area (response rate 70.6%). Perceived health-related quality of life (HRQOL), as measured by the physical and mental summary component scores of the SF-36 Health Survey, was used as a proxy of health care need. Health care utilization was measured by a) last-month visits to public sector physicians, b) last-month visits to private sector physicians, c) last-year visits to hospital emergency departments and d) last-year hospital admissions. Statistical analysis involved the implementation of logistic regression models. RESULTS: Health care need was the factor most strongly associated with all measures of health care utilization, except for visits to public physicians. Women, elderly, less wealthy and individuals of lower physical health status visited physicians contracted to their insurance fund (public sector). Women, well educated and those once again of lower physical health status were more likely to visit private providers. Visits to hospital emergency departments and hospital admissions were related to need and no socio-economic factor was related to the use of those types of care. CONCLUSION: This study has demonstrated a positive relationship between health care need and utilisation of health services within a mixed public-private health care system. Concurrently, interesting differences are evident in the utilization of various types of services. The results have potential implications in health policy-making and particularly in the proper allocation of scarce health resources

Developing and testing an instrument for identifying performance incentives in the Greek health care sector

BACKGROUND: In the era of cost containment, managers are constantly pursuing increased organizational performance and productivity by aiming at the obvious target, i.e. the workforce. The health care sector, in which production processes are more complicated compared to other industries, is not an exception. In light of recent legislation in Greece in which efficiency improvement and achievement of specific performance targets are identified as undisputable health system goals, the purpose of this study was to develop a reliable and valid instrument for investigating the attitudes of Greek physicians, nurses and administrative personnel towards job-related aspects, and the extent to which these motivate them to improve performance and increase productivity. METHODS: A methodological exploratory design was employed in three phases: a) content development and assessment, which resulted in a 28-item instrument, b) pilot testing (N = 74) and c) field testing (N = 353). Internal consistency reliability was tested via Cronbach's alpha coefficient and factor analysis was used to identify the underlying constructs. Tests of scaling assumptions, according to the Multitrait-Multimethod Matrix, were used to confirm the hypothesized component structure. RESULTS: Four components, referring to intrinsic individual needs and external job-related aspects, were revealed and explain 59.61% of the variability. They were subsequently labeled: job attributes, remuneration, co-workers and achievement. Nine items not meeting item-scale criteria were removed, resulting in a 19-item instrument. Scale reliability ranged from 0.782 to 0.901 and internal item consistency and discriminant validity criteria were satisfied. CONCLUSION: Overall, the instrument appears to be a promising tool for hospital administrations in their attempt to identify job-related factors, which motivate their employees. The psychometric properties were good and warrant administration to a larger sample of employees in the Greek healthcare system

Payments and quality of care in private for-profit and public hospitals in Greece

<p>Abstract</p> <p>Background</p> <p>Empirical evidence on how ownership type affects the quality and cost of medical care is growing, and debate on these topics is ongoing. Despite the fact that the private sector is a major provider of hospital services in Greece, little comparative information on private versus public sector hospitals is available. The aim of the present study was to describe and compare the operation and performance of private for-profit (PFP) and public hospitals in Greece, focusing on differences in nurse staffing rates, average lengths of stay (ALoS), and Social Health Insurance (SHI) payments for hospital care per patient discharged.</p> <p>Methods</p> <p>Five different datasets were prepared and analyzed, two of which were derived from information provided by the National Statistical Service (NSS) of Greece and the other three from data held by the three largest SHI schemes in the country. All data referred to the 3-year period from 2001 to 2003.</p> <p>Results</p> <p>PFP hospitals in Greece are smaller than public hospitals, with lower patient occupancy, and have lower staffing rates of all types of nurses and highly qualified nurses compared with public hospitals. Calculation of ALoS using NSS data yielded mixed results, whereas calculations of ALoS and SHI payments using SHI data gave results clearly favoring the public hospital sector in terms of cost-efficiency; in all years examined, over all specialties and all SHI schemes included in our study, unweighted ALoS and SHI payments for hospital care per discharge were higher for PFP facilities.</p> <p>Conclusions</p> <p>In a mixed healthcare system, such as that in Greece, significant performance differences were observed between PFP and public hospitals. Close monitoring of healthcare provision by hospital ownership type will be essential to permit evidence-based decisions on the future of the public/private mix in terms of healthcare provision.</p