118th JPBS.pdf.pdf aulity management practices in privtae hospitals pubmed research article publication

118th JPBS.pdf.pdf aulity management practices in privtae hospitals pubmed research article publication

1. ? 2024 Journal of Pharmacy and Bioallied Sciences | Published by Wolters Kluwer - Medknow S592
Background: In the Visakhapatnam District, this study compares the quality
management procedures used by public and private hospitals. Knowing how these
practices are similar and different from one another can help inform policy decisions
and improve the quality of health care. Materials and Methods: A cross‑sectional
study design was used, and 100 hospitals from both public  (50 hospitals)
and private  (50 hospitals) were included in the sample size. A standardized
questionnaire that evaluated different aspects of quality management practices was
used to gather the data. Descriptive statistics and inferential tests were used in
the quantitative analysis. Results: Significant variations in quality management
procedures between public and private hospitals were found. In terms of patient
happiness, service responsiveness, and technological use, private hospitals scored
better. Regarding accessibility, cost, and equity of healthcare services, public
hospitals fared better. Conclusion: The report emphasizes the necessity of
focused initiatives to improve quality management procedures in both public and
commercial institutions. Collaboration between the two sectors can make it easier
to deploy evidence‑based tactics and share best practices to raise overall healthcare
quality in the Visakhapatnam area.
Keywords: Comparative evaluation, private hospitals, public hospitals, quality
management practices, Visakhapatnam District
Comparative Evaluation of Quality Management Practices in the Public
and Private Hospitals in Visakhapatnam District: An Original Research
Rahul V. C. Tiwari
1
, Sandesh K. Sharma
2
, Sujit R. Sahoo
3
, Srujan K. Velthuru
4
, Jeevan Matada Basavarajaiah
5
,
Madiha Kazi
6
, Heena Dixit
7
Access this article online
Quick Response Code:
Website: https://journals.lww.com/jpbs
DOI: 10.4103/jpbs.jpbs_882_23
Address for correspondence: Dr. Rahul V. C. Tiwari,
Executive MHA, IIHMR University, Jaipur ‑ 302 029,
Rajasthan, India.
E‑mail: [email protected]
standardization, resource allocation, and performance
monitoring methods.
[3]
The effectiveness of the healthcare system as a whole
and patient satisfaction, treatment results, and healthcare
system quality are all directly impacted by healthcare
Introduction
T
o promote patient safety, improve patient
outcomes, and optimize healthcare delivery,
quality management approaches have gained
increasing attention in recent years.
[1]
Assuring
adherence to evidence‑based recommendations and
assessing performance indicators to drive continuous
improvement are all part of a systematic and
all‑encompassing approach to quality management.
[2]

It includes a variety of elements, including leadership
dedication, patient safety guidelines, process
1
Executive

MHA, IIHMR
University, Jaipur, Rajasthan,
India,
2
Associate Professor,
IIHMR University, Jaipur,
Rajasthan, India,
3
Department
of Dentistry, PRM Medical
College and Hospital,
Baripada, Odisha, India,
4
Department of Public
Health Dentistry, Mamata
Dental College and Hospital,
Khammam, Telangana,
India,
5
Department of
Oral Pathology, Faculty of
Dentistry, AIMST University,
Kedah, Malaysia,
6
BDS
Maitri College of Dentistry
and Research Center,
Durg, Chhattisgarh, India,
7
RKSK District Consultant,
Visakhapatnam, A.P & MBA-
HHM, DY Patil Vidyapeeth,
Navi Mumbai, Maharashtra,
India
Abstract
This is an open access article distributed under the terms of the Creative Commons
Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows others to remix, tweak,
and build upon the work non‑commercially, as long as the author is credited and the new
creations are licensed under the identical terms.
For reprints contact: [email protected]
How to cite this article: Tiwari RV, Sharma SK, Sahoo SR, Velthuru SK,
Matada Basavarajaiah J, Kazi M, et al. Comparative evaluation of quality
management practices in the public and private hospitals in Visakhapatnam
District: An original research. J Pharm Bioall Sci 2024;16:S592-7.
Original Article
Submitted: 12‑Sep‑2023
Revised: 22‑Sep‑2023
Accepted: 01-Oct-2023
Published: 29-Feb-2024
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2. Journal of Pharmacy and Bioallied Sciences  ? Volume 16  ? Supplement 1  ? February 2024
Tiwari, et al.: Quality management practies in hospitals S593
service quality. To improve the standard of patient care,
both the public and commercial healthcare sectors have
placed an increasing emphasis on the implementation of
quality improvement programs.
The healthcare system is divided into two distinct
sectors, public hospitals and private hospitals, each with
its own special traits, goals, and resource limitations.
Public hospitals are primarily supported and run by the
government, with a primary focus on offering the general
public easily accessible and reasonably priced healthcare
services, especially to underserved and underprivileged
groups.
[4]
Private hospitals, however, run as autonomous
businesses that are motivated by profitability and
competitiveness, striving to provide top‑notch services
to draw in clients and keep a competitive edge.
[5]
There are numerous governmental and private hospitals
in India’s Visakhapatnam District, which is in the
country’s southeast. The local population’s access to
health care is greatly influenced by these facilities. To
examine the quality management strategies used in
public and private hospitals in this region, however,
little study has been conducted.
[6‑10]
Understanding the similarities and differences in their
quality management strategies requires a comparison
of the procedures used by public and private hospitals
in the Visakhapatnam District. Such an assessment
can offer insightful information about areas that
need improvement and aid in the creation of focused
interventions to improve healthcare delivery, patient
safety, and overall quality of care.
The objective of this study was to undertake a
thorough comparative review of quality management
procedures in both public and private hospitals in the
Visakhapatnam District. The goal of the study was to
find areas for improvement and help improve healthcare
services in the area by comparing and contrasting
leadership commitment, patient safety protocols, process
management, resource allocation, and performance
measurement. The results will be used as a basis for
policy suggestions, decisions about how to allocate
resources, and actions that are meant to improve patient
outcomes in both public and commercial institutions by
optimizing quality management systems.
Materials and Methods
Study population
Healthcare professionals, executives, and employees
engaged in quality management tasks at both public and
private hospitals in the Visakhapatnam District made
up the study population. To guarantee that all sizes,
specialties, and ownership structures were represented,
the sample was selected from a wide spectrum of
institutions.
Sampling techniques
The approaches of purposive and random sampling
were combined. Based on their size, performance, and
ownership  (public or private), hospitals were chosen
through the use of purposeful sampling. Within each
sampled institution, volunteers were chosen at random.
The calculations showed that a sample size of 100
participants was suitable for the investigation. The
sample size was determined by taking into account
these variables and applying the formula for estimating
proportions in a finite population as follows:
n = (Z^2 × p × q)/(E^2×  (N‑1) + Z^2  × p × q)
where n  = sample size, Z  = Z‑score corresponding to
the chosen confidence level, p = expected proportion of
quality management practices, q =  (1 ‑ p) E = margin of
error, and N  = population size.
Study instruments
The study measured quality management methods using
recognized tools, such as standardized questionnaires
or surveys. For the collection of qualitative data,
semi‑structured interview guides and observation
protocols were also created.
Statistical and qualitative methods
To compare public versus private hospitals, quantitative
data were evaluated using the proper statistical methods,
such as descriptive statistics, t‑tests, Chi‑square tests,
or regression analysis. To find trends, themes, and
insights, qualitative data were transcribed, coded, and
thematically analyzed.
Ethical considerations
While conducting the research, ethical issues were taken
into account. Participants provided signed informed
permission, confirming their free will to participate. To
safeguard participant privacy and the data gathered, data
security and confidentiality procedures were put in place.
Results
This study included a total of 100 individuals, with
an equal distribution of 50  males and 50  females.
Among the participants in public hospitals, 21 were
male and 29 were female. In contrast, private hospitals
had 29  male individuals and 21  female individuals. In
public hospitals, two individuals belonged to the up to
30‑year age group, 41 were in the 31‑  to 50‑year age
group, and seven were in the 51‑  to 70‑year age group.
In private hospitals, there were no participants in the
up to 30‑year age group, 40 in the 31‑  to 50‑year age
group, and 10 in the 51‑  to 70‑year age group. In public
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3. Journal of Pharmacy and Bioallied Sciences  ? Volume 16  ? Supplement 1  ? February 2024
Tiwari, et al.: Quality management practies in hospitals S594
hospitals, 34 individuals were categorized as doctors and
nurses, while 16 were in administrative roles. In private
hospitals, there were 38 individuals in the doctors and
nurses’ category, and 12 individuals were engaged in
administrative roles. In public hospitals, four individuals
had up to 5  years of experience, 12 had 6–10  years of
experience, and 34 had 11–22  years of experience. In
private hospitals, two individuals had up to 5  years of
experience, 18 had 6–10  years of experience, and 30 had
11–22  years of experience  [Table 1 ].
Hospital‑Wise Likert‑scale responses for various
quality management aspects
To evaluate quality management, public and private
hospitals provided Likert‑scale replies. Graphs 1–3 show
Q1, Q2, and Q3 responses, with 30% of public hospital
participants and 34% of private hospital participants
agreeing that their hospital had well‑defined quality
management policies and processes. In Q2  (training and
development programs), public hospitals agreed at 48%
and private hospitals at 28%. Q3  (resource allocation for
quality improvement) replies show 26% public hospital
agreement and 14% private hospital agreement. Graph 4
shows Q4  (quality improvement indicators) replies, with
26% of public hospitals and 14% of private hospitals
agreeing to monitor quality indicators to evaluate
hospital performance.
Graph  5 shows Q5 responses, showing 22% agreement
in public hospitals and 52% in private hospitals,
demonstrating a strong emphasis on patient safety culture
in private hospitals. Graph 6 shows Q6 responses, with
26% agreement in public hospitals and 32% in private
hospitals encouraging continuing quality improvement
measures.
Graph  7, Q7  (effective communication and collaboration)
responses show 22% agreement in public hospitals
and 28% in private hospitals for quality patient care.
Graph  8 shows Q8  (information technology utilization)
responses from public and private hospitals, with 34%
agreeing that information technology systems promote
quality management methods. Graph  9 shows responses
to Q9  (ethical considerations), with 26% agreement
in public hospitals and 62% in private hospitals,
demonstrating that private hospitals prioritize ethical
issues, such as informed consent and secrecy  [Figure 1 ].
90% of public hospitals and 96% of private hospitals
compared quality management approaches using
surveys, studies, or research. The study found shared
quality management difficulties in public and private
institutions. Administrative concerns plagued 38%
of public hospital participants and 42% of private
hospital participants. 58% of public hospital participants
and 56% of private hospital participants suggested
fixing administrative difficulties to improve quality
management. In public hospitals, 8% suggested data and
research, 58% administrative issues, such as planning,
teams, recruitment, infrastructure, and marketing,
and 34% training and Continued M edical Education
(CME). In private hospitals, 8% suggested data and
research proposals and 36% training and CME. 56%
noted administrative concerns. Among all responses
from public and private hospitals, 8% suggested data
and research, 57% administrative concerns, and 35%
training and CME to improve quality management
methods [ Figure 2 ].
Discussion
The comparative evaluation of quality management
procedures in public and private hospitals in the
Visakhapatnam District yielded important insights for the
study. The study took into account a number of important
variables, including participants from both public and
commercial hospitals who were equally split between men
and women and who worked in different occupations.
There were differences in the age distribution, with
more people in public hospitals being between the ages
of 31 and 50 and more people in private hospitals being
between the ages of 51 and 70. In all types of hospitals,
medical professionals predominated over administrative
personnel, highlighting the significance of taking these
aspects into account when studying and comparing
quality management practices.
Exploring perceptions of quality management techniques
revealed worries or ambiguities over sufficient resource
allocation for quality improvement initiatives in both
public and private hospitals. Both hospital types
recognized the value of patient feedback mechanisms,
but more people expressed disagreement or skepticism
Table 1: Demographics, occupation, and experience
Type of hospital Gender
Male Female
Public hospital 21 29
Private hospital 29 21
Age groups
Up to 30 years 31–50 years 51–70 years
Public hospital 2 41 7
Private hospital 0 40 10
Occupation
Public hospital 34 16
Private hospital 38 12
Experience in years
Up to 5 years 6–10 years 11–22 years
Public hospital 4 12 34
Private hospital 2 18 30
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4. Journal of Pharmacy and Bioallied Sciences  ? Volume 16  ? Supplement 1  ? February 2024
Tiwari, et al.: Quality management practies in hospitals S595
regarding their existence in public hospitals. This
demonstrates how public hospitals must enhance patient
feedback systems for efficient communication and
resolving patients’ problems.
[11‑13]
It was discovered that tracking quality indicators was
essential for evaluating the effectiveness of healthcare
institutions. Public hospitals display a greater range
of quality data, but both public and private hospitals
routinely evaluate quality indicators. Public hospitals
received a larger percentage of disagreement or
neutrality when it came to perceptions of the patient
safety culture than did private hospitals. To match
the positive attitudes seen in private hospitals, public
hospitals should concentrate on developing a stronger
patient safety culture.
0
5
10
15
20
25
public hospital private hospital
Our hospital has well-defined quality management policies and procedures
disagreeneutralagree
0
5
10
15
20
25
30
public hospitalp rivate hospital
Adequate resources are allocated for quality improvement activities
disagreeneutralagreestrongly agree
0
5
10
15
20
25
30
public hospital private hospital
We have regular training and development programs to enhance our
knowledge and skills related to quality management
disagreeneutralagreestrongly agree
0
5
10
15
20
25
30
public hospital private hospital
Patient feedback mechanisms are in place to collect and address patient
concerns and suggestions
strongly disagreedisagreeneutralagree strongly agree
0
5
10
15
20
25
30
public hospital private hospital
There is a strong emphasis on patient safety culture in our hospital
strongly disagreedisagreeneutralagreestrongly agree
0
5
10
15
20
25
public hospitalp rivate hospital
Quality indicators are monitored regularly to assess the performance
of our hospital
strongly disagreedisagreeneutralagreestrongly agree
0
5
10
15
20
25
public hospital private hospital
There is effective communication and collaboration among healthcare
professionals to ensure quality patient care.
strongly disagreedisagreeneutralagree strongly agree
0
2
4
6
8
10
12
14
16
18
20
public hospital private hospital
Our hospital encourages continuous quality improvement initiatives
strongly disagreedisagreeneutralagreestrongly agree
0
5
10
15
20
25
public hospitalp rivate hospital
Information technology systems are effectively utilized to support quality
management practices.
strongly disagreedisagreeneutralagreestrongly agree
Figure 1: Hospital‑wise Likert‑scale responses for various quality management aspects
0
5
10
15
20
25
30
35
public hospitalp rivate hospital
Ethical considerations, such as informed consent and confidentiality, are
given high priority in our hospital.
strongly disagreedisagreeneutral agree strongly agree
0
5
10
15
20
25
public hospital private hospital
What do you perceive as the major challenges in implementing quality
management practices in your hospital?
surveys,study, researchadministrative issuesstaffing issuessssd, cad activity
0
5
10
15
20
25
30
35
public hospitalp rivate hospital
what suggestions would you provide to enhance the quality management
practices in public and private hospitals
surveys,study, researchadministrative issuestraining and cme
0
10
20
30
40
50
60
public hospital private hospital
How would you compare the quality management practices in public
hospitals versus private hospitals?
surveys,study, researchadministrative issues
Figure 2: Responses for various quality management aspects
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5. Journal of Pharmacy and Bioallied Sciences  ? Volume 16  ? Supplement 1  ? February 2024
Tiwari, et al.: Quality management practies in hospitals S596
Both public and commercial hospitals faced numerous
difficulties with quality improvement, including a lack
of funding, poor manpower, and shoddy infrastructure.
Both types of hospitals cited resistance to change as
a major obstacle and emphasized the significance of
stakeholder involvement and change management for
the implementation of quality management. Due to
congestion and resource limitations, high bed occupancy
rates in public hospitals may have an impact on the
quality of care, whereas private institutions have
improved accessibility to diagnostic equipment, resulting
in quicker and more accurate diagnoses and better
patient outcomes.
[14]
There were differences in how people saw ongoing
quality management training and development
initiatives, with more people in private hospitals
endorsing their existence. This demonstrates the value of
funding initiatives for ongoing training and development
in public hospitals to advance knowledge and abilities
related to quality management.
Both public and private hospitals need to improve
their usage of information technology systems to
assist quality management procedures. To support
evidence‑based decision‑making and enhance
quality management procedures, hospitals should
use technology for data collection, analysis, and
utilization.
[15]
Hospitals must prioritize resource allocation, create
efficient patient feedback mechanisms, foster a
strong culture of patient safety, invest in training and
development programs, use information technology,
address administrative issues, promote information
sharing and collaboration, and take a patient‑centered
approach to address the challenges identified. These
findings should be taken into account by policymakers
as they develop rules and directives that support
effective quality management practices in all healthcare
settings.
Limitations
The study’s location in Visakhapatnam may limit its
application to other healthcare settings. District‑specific
factors, resources, and demography may affect the
findings’ applicability. Second, using arbitrary measures
and self‑reported data may cause biases. Medical
personnel and patients may have social desirability bias
or recall bias, which could affect the findings. Future
studies should consider objective metrics and third‑party
assessments to increase outcome validity. The study
largely concentrated on quantitative indicators and
neglected qualitative aspects of quality management
systems.
Strengths
First, the research employed a comprehensive
quantitative and qualitative approach. This strategy helps
understand quality management in public and private
hospitals. Second, we compared public and private
quality management practices.
Conclusion
In conclusion, the comparison of quality management
practices in public and private hospitals in the
Visakhapatnam area offers insightful information
that can be used to improve patient safety, healthcare
delivery, and overall care quality. Healthcare businesses
may optimize their quality management systems and
eventually improve patient outcomes by addressing
the identified obstacles and putting the suggested
improvements into practice. Continual improvement
in the delivery of high‑quality health care is driven
by collaboration with external agencies, continual
monitoring and evaluation, patient empowerment and
education, and the promotion of a culture of quality.
The study has broad repercussions not only for the
Visakhapatnam District but also for other healthcare
facilities, and it lays the groundwork for further studies
and actions aimed at enhancing quality management
techniques.
Financials upport and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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