How do policy levers shape the quality of a national health system?

Poor quality of care may have a detrimental effect on access and take-up and can become a serious barrier to the universality of health services. This consideration is of particular interest in view of the fact that health systems in many countries must address a growing public-sector deficit and respond to increasing pressures due to COVID-19 and aging population, among other factors. In line with a rapidly emerging literature, we focus on patient satisfaction as a proxy for quality of health care. Drawing on rich longitudinal and cross-sectional data for Spain and multilevel estimation techniques, we show that in addition to individual level differences, policy levers (such as public health spending and the patient-doctor ratio, in particular) exert a considerable influence on the quality of a health care system. Our results suggest that policymakers seeking to enhance the quality of care should be cautious when compromising the level of health resources, and in particular, health personnel, as a response to economic downturns in a sector that traditionally had insufficient human resources in many countries, which have become even more evident in the light of the current health crisis. Additionally, we provide evidence that the increasing reliance on the private health sector may be indicative of inefficiencies in the public system and/or the existence of features of private insurance which are deemed important by patients.     

Non-government organization study awards: enhancing successful completion of social work qualification

ABSTRACT

The current study used a sequential, exploratory mixed-method design to explore how a social work study scholarship implemented in Aotearoa New Zealand impacted on recipients’ qualification completion and their professional and practice competence. Phase one involved 13 individual interviews with past award recipients which described how the study award impacted on their qualification completion. Thematic analysis was used to extract themes. These themes were examined in the second phase through a quantitative battery completed by 107 past recipients to examine their professional and practice competence. The findings from interviews showed the award enabled recipients to complete their studies and improve their social work practice without causing undue stress or financial pressure on the recipient and their family. Quantitative analysis corroborated and extended these findings to demonstrate that the award contributed to lifting the level of social work knowledge, competence, and skills in the recipients. Accompanying the successful qualification completion, these qualified social workers were equipped with essential skills, promoting social work values and competence to contribute and safeguard the benefit of children, families, and communities. The awards offered a ‘wrap around’ support and was not limited by age or ethnicity but provided a support system to achieve qualification completion.     

乡村振兴背景下乡村教师工作满意度研究 ——基于心理契约的视角

乡村教师队伍建设是乡村振兴战略的重要内容，工作满意度是乡村教师队伍稳定性的“晴雨表”。从心理契约视角出发，以工作满意度为工具研究乡村振兴背景下乡村教师队伍建设问题。基于对224名乡村教师的问卷调查数据，分析当前乡村教师工作满意度及心理契约达成水平。研究表明：当前乡村教师工作满意度居于中等水平；乡村教师心理契约总体达成水平较高，但存在结构失衡问题，其中教师责任达成水平高于学校责任达成；心理契约对乡村教师工作满意度有显著正向影响，心理契约学校责任对工作满意度的影响力大于心理契约教师责任。提出双向互动，构建良好心理契约；主动干预，强化心理契约引导；分类施策，满足教师差异需求；协同发展，均衡心理契约结构等建议。     

‘One MBA?’ How context impacts the development of post-MBA career outcomes

Using survey data from alumni of one of the UK's earliest and largest MBA programmes we explore how career capital, career outcomes and career satisfaction are impacted by learner context. We adopt comparative capitalisms theory to investigate whether graduates from a standardised programme marketed as ‘One MBA’ report broadly similar career outcomes irrespective of their work and study location. We find that despite the rhetoric around globalisation in management education there are differences that fit the theories of comparative capitalisms literature; thus supporting the view that, despite the global nature of MBA branding, context still plays a role in shaping learning and career outcomes as evidenced by differences reported here. Significant findings are reported in terms of the reported development of career capital ‘knowing how’; career satisfaction and perceived organisational support, however differences in terms of the achievement of objective career success (promotion and career mobility) were less pronounced.     

Quality management as a tool for job satisfaction improvement in low-level technology organizations: the case of Ethiopia

Human resources are an important determinant of operational performances as it is crucial for quality improvement. Research suggests that issues related to quality of work life of employees are often overlooked in low technology level organizations in the developing countries. This article aims to investigate the relationship between quality management (QM) practices and job satisfaction (JS) in relation with the Ethiopian manufacturing organizations. Data were collected using a structured survey questionnaire and face-to-face interviews of shop-floor workers. Exploratory and confirmatory factor analysis was used to validate the survey instrument and structural equation modelling was used for the analysis. The findings provide evidence that top management commitment, participation of employees and continuous improvement are significantly and positively associated with JS. However, customer focus has insignificant relationship and surprisingly, teamwork showed unexpected negative relationship with JS. The study provides important insights into the true worth of QM implementation in which it enforces the belief that its practices are the decisive factor in enhancing workplace satisfaction of employees.     

新型农村合作医疗参合农民满意度影响因素辨析及其政策优化:一个基于L市的案例分析

参合农民的满意度是评价新农合基金绩效的重要指标。对L市2015年592位参合农民的样本数据进行分析，发现就医过程对参合农民满意度影响最为显著，其中，农民满意度与新农合定点医疗机构的医疗水平和综合费用有很强的相关度；新农合基金管理水平对参合农民满意度有较为显著的影响，制度设计对参合农民满意度影响最小。因此，为优化新农合基金政策绩效、提升参合农民满意度水平，应构建高质量医疗服务供给机制、强化农民主动参与机制、推进新农合政府管理机构能力建设以及对新农合基金绩效开展持续评价。     

Finding your way into employment against all odds? Successful job search of refugees in Austria

Labour market entry poses enormous challenges for recently arrived refugees, ranging from language barriers, devaluation of human capital, unfamiliarity with customs of the job search process to outright discrimination. How can refugees overcome these challenges and quickly enter gainful employment? In this paper, we draw on interviews with 26 male and female refugees from Syria, Afghanistan, Iraq and Iran, conducted in 2017 and 2018, who came to Austria in 2015 and 2014 and who have successfully entered employment. We depict refugees’ own perspectives on and strategies for fast job entry and integration. Personal agency and a proactive approach of seeking and seizing opportunities are key for overcoming initial barriers and entering upon positive integration pathways. At the same time, refugees’ personal agency is essential for establishing social ties to the host society, which also play a crucial role in early labour market integration. Finally, institutions of the Austrian labour market (the ‘apprenticeship’-system) interact with refugees’ agency in most intricate ways, both setting up nearly insurmountable barriers but also providing specific opportunities for refugees.     

Leader-employee congruence of expected contributions in the employee-organization relationship

Employees' expected contributions can be incongruent with those of their leader. We examine the congruence effect of leaders' and employees' expected contributions on job satisfaction. Results of cross-level polynomial regressions on 947 employees and 224 leaders support the congruence effect. When expected contributions are congruent, employees are more satisfied with their job. Our findings suggest that employees enjoy high challenges, as long as these challenges are in harmony with the expected contributions of their leaders. Employees are less satisfied with their jobs both when their expected contributions were higher than their leaders' and when their expected contributions were lower than those of their leaders. Beyond the relevance of having high expected contributions, the findings highlight the crucial role played by the congruence of expected contributions of leaders and employees.     

南京中山植物园游憩功能满意度评价研究

随着植物园"旅游经济"的发展,植物园在承担植物科学研究及科普功能的同时,也成为公众日常休闲的重要绿地。本文选取南京中山植物园作为研究对象,建立评价体系并运用模糊综合评价法对游客满意度进行研究,探寻影响植物园游憩功能的显著因子,为未来植物园规划设计提供参考。结果表明:游客对南京中山植物园的游憩功能达到基本满意水平。其中,植物物种多样性、景区分布、建筑景观、声景观的满意度较高,滨水景观的满意度评价值较低。通过Pearson相关系数发现植物色彩丰富度、科普场所、科普内容是影响游客满意度的显著因子。运用IPA图对16项评价因子进行重要度-满意度分析,并对各象限内的因子提出改进方向。最后基于游憩功能满意度评价结果,提出改进策略:加大对植物园休息设施、卫生设施、娱乐设施和商业服务设施的投入;更新科普方式,增添特色游憩主题园区;完善现有道路体系,增强对北部专类园的可达性;增加色叶植物的种类、提高色彩丰富度等。以期为中山植物园游憩功能的优化及其他植物园的规划设计提供借鉴。     

Variables related to maternal satisfaction with intrapartum care in Northern Italy

BackgroundThe experience of labour and birth is complex, multidimensional and subjective and has the potential to affect the women and their families physically and emotionally. However, there is a lack of research around maternal satisfaction in Italy.AimTo evaluate mothers’ satisfaction with their childbirth experience in relation to socio-demographic characteristics, obstetric history and intrapartum care variables.MethodsA cross-sectional study involving 277 women who had given birth in a low risk maternity unit in Northern Italy was undertaken. Satisfaction with birth was measured using the Italian version of the Birth Satisfaction Scale-Revised (I-BSS-R). The scale comprises three Sub-Scales: quality of care provided, personal attributes of women and stress experienced during childbirth.FindingsNo socio-demographic variables were related to maternal satisfaction. Multiparous women had a higher satisfaction score (p = 0.020; CI:0.23;2.75). Antenatal class attendance was negatively associated with maternal satisfaction (p = 0.038; CI:−2.58; −0.07). Intrapartum variables that significantly reduced maternal satisfaction were: epidural usage (p = 0.000; CI:−4.66; −2.07), active phase >12 h (p = 0.000; CI:−6.01; −2.63), oxytocin administration (p = 0.000; CI:−5.08; −2.29) and vacuum assisted birth (p = 0.001; CI:−6.50; −1.58). Women with an intact perineum were more likely to be satisfied (p = 0.008; CI:−4.60; −0.69).DiscussionIn accordance with other research, we showed that intrapartum interventions are negatively associated with maternal outcomes and therefore also with maternal satisfaction with birth. The sub-scale that measured Quality of Care provided scored higher than the other two Sub-Scales.ConclusionFurther studies on maternal satisfaction in Italy should be conducted, using the I-BSS-R with the aim to compare outcomes and understand what matters to women during childbirth.