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首页> 美国卫生研究院文献>International Journal of Health Policy and Management >Assessing performance of Botswana’s public hospital system: the use of the World Health Organization Health System Performance Assessment Framework
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Assessing performance of Botswana’s public hospital system: the use of the World Health Organization Health System Performance Assessment Framework

机译：评估博茨瓦纳公立医院系统的绩效：使用世界卫生组织卫生系统绩效评估框架

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>Background: Very few studies have assessed performance of Botswana public hospitals. We draw from a large research study assessing performance of the Botswana Ministry of Health (MoH) to evaluate the performance of public hospital system using the World Health Organization Health Systems Performance Assessment Framework (WHO HSPAF). We aimed to evaluate performance of Botswana public hospital system; relate findings of the assessment to the potential for improvements in hospital performance; and determine the usefulness of the WHO HSPAF in assessing performance of hospital systems in a developing country. >Methods: This article is based on data collected from document analysis, 54 key informants comprising senior managers and staff of the MoH (N= 40) and senior officers from stakeholder organizations (N= 14), and surveys of 42 hospital managers and 389 health workers. Data from documents and transcripts were analyzed using content and thematic analysis while data analysis for surveys was descriptive determining proportions and percentages. >Results: The organizational structure of the Botswana’s public hospital system, authority and decision-making are highly centralized. Overall physical access to health services is high. However, challenges in the distribution of facilities and inpatient beds create inequities and inefficiencies. Capacity of the hospitals to deliver services is limited by inadequate resources. There are significant challenges with the quality of care. >Conclusion: While Botswana invested considerably in building hospitals around the country resulting in high physical access to services, the organization and governance of the hospital system, and inadequate resources limit service delivery. The ongoing efforts to decentralize management of hospitals to district level entities should be expedited. The WHO HSPAF enabled us to conduct a comprehensive assessment of the public hospital system. Though relatively new, this approach proved useful in this study.
机译：>背景：很少有研究评估博茨瓦纳公立医院的绩效。我们从一项评估博茨瓦纳卫生部（MoH）绩效的大型研究中，使用世界卫生组织卫生系统绩效评估框架（WHO HSPAF）来评估公立医院系统的绩效。我们旨在评估博茨瓦纳公立医院系统的性能；将评估结果与改善医院绩效的潜力联系起来；并确定世卫组织HSPAF在评估发展中国家医院系统绩效方面的有用性。 >方法：本文基于从文件分析中收集的数据，由卫生部高级经理和工作人员（N = 40）和利益相关者组织的高级官员（N = 14）组成的54名主要信息提供者，以及调查42名医院管理人员和389名卫生工作者。使用内容和主题分析来分析来自文档和成绩单的数据，而用于调查的数据分析则是描述性的确定比例和百分比的方法。 >结果：博茨瓦纳公立医院系统的组织结构，权限和决策高度集中。总体上获得医疗服务的身体较高。但是，设施和住院床位分配方面的挑战造成了不平等和效率低下。医院提供服务的能力受到资源不足的限制。护理质量面临重大挑战。 >结论：尽管博茨瓦纳在全国各地建立医院方面进行了大量投资，导致人们在物理上获得大量服务，但是医院系统的组织和治理以及资源不足限制了服务的提供。应加快将医院管理下放到地区级实体的努力。 WHO HSPAF使我们能够对公立医院系统进行全面评估。尽管相对较新，但这种方法在本研究中证明是有用的。

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