“Improvement of National Healthcare System in Myanmar” Presented By: So Pyay (571-9661) Batch - 11
“Improvement of National Healthcare System in Myanmar”
Presented By:
So Pyay (571-9661)
Batch - 11
Content
• Introduction
• Research Objective
• Significance of the Study
• Literature Review
• Conceptual Framework
• Hypotheses
• Research Methodology
• Descriptive Analysis
• Hypotheses Testing
• Conclusion
• Recommendation
• Limitations of the study
• References
• The death rate is increased by the several types of disease since the
population is rising up in Myanmar compare to the last years.
• Healthcare System plays an important role in saving the lives of
people.
• Since the technologies and treatment methods are advancing rapidly
and appearances of new diseases are occurring, health care system
and providers of Myanmar are needed to improve.
• It is the workload for the Ministry of Health and needed to develop
the current Healthcare System.
Introduction
• To find out the factors which will strongly affect the improvement of
National Healthcare System in Myanmar and is relied on the
healthcare providers such as doctors, nurses, pharmacists, dentists,
physicians, surgeon and medical students etc.
• To examine which factors among technology, budget, training, work
environment, Healthcare providers-patients communication, hospitals
& clinics' facilities availability, Medical Training Institute & facilities
and patients' safety are strongly related to the improvement of
National Health Care System in Myanmar.
Research Objective
• It could find out what are the possible factors which can affect the
improvement of National Healthcare System.
• It can be beneficial to the medical students and healthcare providers
in Healthcare Services and also for the Ministry of Health as well.
• It can also provide recommendations on how to implement and
develop the National Healthcare System in Myanmar.
• It will also give the baseline information to the further researchers on
the topic of improvement of National Healthcare System.
Significance of the Study
• Compared to the manufacturing sector, the service sector –
particularly the healthcare sector–is widely regarded as lagging in
terms of adopting new management innovations (Christensen et al.,
2009; Greenhalgh et al., 2004; Walley, 2003).
• The question of how to improve healthcare system performance leads
to multiple possibilities. Strategies can be aimed at different levels
and components of a healthcare system such as how the system is
regulated and financed, and how services are organized and provided
(Evans et al., 2001; Rothgang et al., 2010).
Literature Review
• Some of the current issues in healthcare provision involve the training
for the adoption of progressive information technology (IT) systems.
There appear to be barriers in providing technical support and in the
computer skills of hospital staff including doctors and nurses together
with additional costs of transferring the traditional system of medical
records (Khalifa, 2013; Al-shorbaji, 2008).
• First, a system, which produces healthcare within a fixed frame of
money, will not produce care in proportion to demand (Berry and
Bendapudi, 2007).
• Health care systems have undergone major technological,
organizational and financial changes in many countries during the last
decades. These changes have had a substantial effect on the work
environment for employees, not the least for physicians (Axelsson,
2000).
• A comprehensive specification of public health education and training
requirements which is purposely designed for the new agenda would
require a full research program. This research would include task, job
and role analysis (Pearn and Kandola, 1988).
• New health care systems, the development of medical and
information technologies, multicultural medical staff and patients as
well as other changes in society have influenced the doctor-patient
relationship, and new consultation styles have emerged (Elwyn,
2004).
• Creating a positive patient safety climate inside an organization can
only be accomplished through managerial commitment, strong
communication, dedicated organizational resources and mutual trust
shared by organizational members (Fleming, 2005; Singer et al.,
2003).
Conceptual Framework
No. Description
1.H1o : There is no relationship between age and the improvement of National Healthcare System in Myanmar.H1a : There is a relationship between age and the improvement of National Healthcare System in Myanmar.
2.
H2o : There is no relationship between gender and the improvement of National Healthcare System in Myanmar.H2a : There is a relationship between gender and the improvement of National Healthcare System in Myanmar.
3.
H3o : There is no relationship between marital status and the improvement of National Healthcare System in Myanmar.H3a : There is a relationship between marital status and the improvement of National Healthcare System in Myanmar.
4.
H4o : There is no relationship between education level and the improvement of National Healthcare System in Myanmar.H4a : There is a relationship between education level and the improvement of National Healthcare System in Myanmar.
Hypotheses
No. Description
5.
H5o : There is no relationship between profession and the improvement of National Healthcare System in Myanmar.H5a : There is a relationship between profession and the improvement of National Healthcare System in Myanmar.
6.
H6o : There is no relationship between technology, budge, work environment, training, healthcare providers & patients’ communication, medical training institutes and patients’ safety and the improvement of National Healthcare System in Myanmar.H6a : There is a relationship between technology, budge, work environment, training, healthcare providers & patients’ communication, medical training institutes and patients’ safety and the improvement of National Healthcare System in Myanmar.
Hypotheses(Continued)
Data Collection Procedure
• Self-administered and structured questionnaires.
• 300 Respondents within two weeks.
• Target Population - People who are working as healthcare providers such as
doctors, nurses, pharmacists, dentists, surgeons, physicians, medical
technicians, etc. in hospitals and other healthcare settings, students who are
studying in the Medical Universities.
• Medical University, University of Dental Medicine, University of Medical
Technology, University of Traditional Medicine, University of Pharmacy,
Mandalay General Hospitals, Mandalay Children Hospitals, Universities
Hospitals and Mandalay Orthopedic Hospitals. (Mandalay)
Research Methodology
• Statistical Package for the Social Sciences (SPSS)
• One-way Analysis of Variance (ANOVA) for Age, Marital Status, Education
level & Profession.
• Independent Sample T-test for Gender.
• Likert Scale (Five Points) ranging from strongly disagree to strongly agree.
• Multiple Regression Analysis for the independent factors affecting the
Improvement of National Healthcare System in Myanmar.
• Pilot Testing is done by 10 respondents.
• Reliability Test is done by 30 respondents.
Statistical Analysis Methods
Section Variables No. of Questionnaires Questionnaires No.
1.
Demographic Variables• Age• Gender• Marital Status• Education Level• Profession
1 Questionnaire1 Questionnaire1 Questionnaire1 Questionnaire1 Questionnaire
12345
2.
Independent Variables• Technology• Budget• Work Environment• Training• Healthcare Providers & Patients’
Communication• Medical Training Institutes &
Facilities• Patients’ Safety
3 Questionnaires3 Questionnaires3 Questionnaires3 Questionnaires3 Questionnaires
2 Questionnaires
2 Questionnaires
6,7,89,10,11
12,13,1415,16,1718,19,20
21,22
23,24
3.
Dependent Variable• Improvement of National
Healthcare System in Myanmar.2 Questionnaires 25,26
Questionnaires Format
20-30 years51%
31-40 years20%
41-50 years23%
51-60 years5%
Age
20-30 years 31-40 years41-50 years 51-60 years
Descriptive Analysis
Male48%Female
52%
GenderMale Female
Single Married0
20
40
60
80
100
120
140
160
180 169
131
Marital Status
Graduate
Post Grad
uate MD
MRCP/MRCOG/M
RCS
Others0
102030405060708090
100 9585
20
4555
Education Level
Doctor Nurse Pharmacist Dentist Others0
20
40
60
80
100
120 112
76
44 48
20
Profession
Descriptive Statistics of Independent Variables
Descriptive Statistics
N Minimum Maximum Mean Std. DeviationTechnology 300 2.00 5.00 3.9000 .60929Budget 300 3.00 5.00 3.3000 .65684Work Environment 300 3.00 5.00 3.4000 .67937Training 300 2.00 5.00 3.9433 .66453Healthcare Providers-Patient Communication 300 2.00 5.00 3.0867 .72762
Medical Institutes 300 2.00 5.00 3.9833 .78669Patients' Safety 300 2.00 5.00 3.5967 .81005Valid N (listwise)
300
The Reliability Test
Variables Cronbach's Alpha Value No. of items
Improvement of National Healthcare system 0.720 2
Technology 0.655 3
Budget 0.639 3
Work Environment 0.808 3
Training 0.621 3Healthcare Providers-Patients' Communication 0.623 3
Medical Institutes & its Facilities 0.890 2
Patients' Safety 0.730 2
Hypotheses Testing
Hypotheses (1)- ANOVA Analysis of Age
ANOVA
Improvement of National Healthcare System Sum of Squares df Mean Square F Sig.Between Groups 1.302 3 .434 .934 .424Within Groups
137.534 296 .465 Total
138.837 299
There is no significant relationship between Age and the Improvement of National Healthcare System. (H1a is rejected)
Hypotheses Testing
Hypotheses (2)- Independent Sample T-test for Gender
There is no significant relationship between Gender and the Improvement of National Healthcare System. (H2a is rejected)
Group Statistics
Gender Group N Mean Std. Deviation
Std. Error Mean
Improvement of National Healthcare System
Male 145 3.9724 .70656 .05868Female
155 4.0710 .65574 .05267
Hypotheses Testing
Hypotheses (3)- ANOVA Analysis of Marital Status
There is no significant relationship between Marital Status and the Improvement of National Healthcare System. (H3a is rejected)
ANOVA
Improvement of National Healthcare System Sum of Squares df Mean Square F Sig.Between Groups 1.111 1 1.111 2.405 .122Within Groups
137.725 298 .462 Total
138.837 299
Hypotheses Testing
Hypotheses (4)- ANOVA Analysis of Education Level
There is no significant relationship between Education Level and the Improvement of National Healthcare System. (H4a is rejected)
ANOVA
Improvement of National Healthcare System Sum of Squares df Mean Square F Sig.Between Groups .853 4 .213 .456 .768
Within Groups137.984 295 .468
Total138.837 299
Hypotheses Testing
Hypotheses (5)- ANOVA Analysis of Profession
There is no significant relationship between Profession and the Improvement of National Healthcare System. (H5a is rejected)
ANOVA
Improvement of National Healthcare System
Sum of Squares df Mean Square F Sig.Between Groups
.181 4 .045 .096 .984
Within Groups138.656 295 .470
Total138.837 299
Hypotheses Testing
Hypotheses (6)- Multiple Regression Analysis for Independent Variables
Model Summary
Model R R Square Adjusted R Square Std. Error of the Estimate1 .625a .391 .376 .53824a. Predictors: (Constant), Patient Safety, Training, Medical Institutes, Budget, Technology, Work Environment, Healthcare Providers-Patient Communication
ANOVAb
ModelSum of Squares df Mean Square F Sig.
1 Regression 54.244 7 7.749 6.749 .000a
Residual 84.592 292 .290 Total 138.837 299
a. Predictors: (Constant), Patient Safety, Training, Medical Institutes, Budge, Technology, Work Environment, Healthcare Providers-Patient Communication
b. Dependent Variable: Improvement of National Healthcare System
Coefficientsa
Model
Unstandardized CoefficientsStandardized Coefficients
t Sig.B Std. Error Beta1 (Constant) .215 .397 .542 .038
Technology .463 .057 .414 8.124 .000Budget .075 .063 .072 1.197 .232Work Environment -.087 .059 -.086 -1.477 .141Training .111 .054 .108 2.058 .040Healthcare Providers-Patients' Communication
.115 .044 .173 2.587 .010
Medical Institutes .239 .057 .205 4.216 .002Patient’s Safety .085 .065 .101 1.303 .193
a. Dependent Variable: Improvement of National Healthcare System
Technology, Budget, Work Environment, Training, Healthcare Providers-Patients’ Communication, Medical Institutes and Patients’ Safety
Hypotheses
Statement Significant Level Result
H1oThere is no significant relationship between age and the improvement of National Healthcare System in Myanmar. 0.424 > 0.05
Null Hypotheses is accepted
H2oThere is no significant relationship between gender and the improvement of National Healthcare System in Myanmar. 0.857 > 0.05
Null Hypotheses is accepted
H3oThere is no significant relationship between marital status and the improvement of National Healthcare System in Myanmar. 0.122 > 0.05
Null Hypotheses is accepted
H4oThere is no significant relationship between Education Level and the improvement of National Healthcare System in Myanmar. 0.768 > 0.05
Null Hypotheses is accepted
H5oThere is no significant relationship between profession and the improvement of National Healthcare System in Myanmar. 0.984 > 0.05
Null Hypotheses is accepted
H6aThere is a significant relationship between Technology and the improvement of National Healthcare System in Myanmar. 0.000 < 0.05
Null Hypotheses is rejected
Summary of Hypotheses Testing
Hypotheses
Statement Significant Level Result
H6obThere is no significant relationship between budget and the improvement of National Healthcare System in Myanmar. 0.232 > 0.05
Null Hypotheses is accepted
H6ocThere is no significant relationship between work environment and the improvement of National Healthcare System in Myanmar. 0.141 > 0.05
Null Hypotheses is accepted
H6dThere is a significant relationship between training and the improvement of National Healthcare System in Myanmar. 0.04 < 0.05
Null Hypotheses is rejected
H6eThere is a significant relationship between Healthcare Providers & Patient' Communication and the improvement of National Healthcare System in Myanmar.
0.01 < 0.05Null Hypotheses is
rejected
H6fThere is a significant relationship between Medical Institutes and the improvement of National Healthcare System in Myanmar. 0.002 < 0.05
Null Hypotheses is rejected
H6ogThere is no significant relationship between Patients' Safety and the improvement of National Healthcare System in Myanmar. 0.193 > 0.05
Null Hypotheses is accepted.
Conclusion
Demographic Variables
Age, Gender, Marital Status, Education Level and Profession do not have significant relationship with the Improvement of National Healthcare System in Myanmar.
Independent Variables
Budget, Work Environment and Patients’ Safety do not have significant relationship with the Improvement of National Healthcare System in Myanmar.
Technology, Training, Healthcare Providers & Patient’s Communication and Medical Institutes & its facilities have significant relationship with the Improvement of National Healthcare System in Myanmar.
Recommendation
• Corporate with the Healthcare Organizations in other countries
and innovate technology development system and send the local
healthcare providers to get proper training on how to use the high
technology facilities effectively.
• Develop an advancing technology and contribute it to the public
and private Hospitals efficiently.
• Analyze what healthcare providers' skills & knowledge are needed
in the country and make implementation of the training models
required.
• Hire the healthcare trainers from overseas if there are no skillful and well-
experienced trainers in local or send the local healthcare providers to
overseas for training programs in order to provide the efficient and
effective training to the healthcare providers.
• Invest in training healthcare providers in effective communication skills and
related topics. Provide the role-play with 4 or 5 members in group
depending on the most encountered scenarios.
• Medical Institutes should provide high technology facilities for the future
generation of medical students to learn and develop the use of best
technology medical facilities.
• A sample setting of 300 total respondents.
• Time Constraints
• Could not reach the whole targeted areas.
• All the possible independent factors are not considered.
• Focused only on Mandalay, Myanmar.
Limitations of the Study
• Daniel P. Kessler, Deirdre Mylod, (2011),"Does patient satisfaction affect patient loyalty?", International Journal of Health Care Quality Assurance, Vol. 24 Iss 4 pp. 266-273
• Piyali Ghosh, Jagdamba Prasad Joshi, Rachita Satyawadi, Udita Mukherjee, Rashmi Ranjan, (2011),"Evaluating effectiveness of a training programme with trainee reaction", Industrial and Commercial Training, Vol. 43 Iss 4 pp. 247-255
• Jane Cowan, (2000),"Consent and clinical governance: improving standards and skills", British Journal of Clinical Governance, Vol. 5 Iss 2 pp. 124 – 128
• Vineet Sarode, Deborah Sage, Jenny Phong, John Reeves, (2015),"Intensive care patient and family satisfaction", International Journal of Health Care Quality Assurance, Vol. 28 Iss 1 pp. 75-81
• Muslim Amin, Siti Zahora Nasharuddin, (2013),"Hospital service quality and its effects on patient satisfaction and behavioural intention", Clinical Governance: An International Journal, Vol. 18 Iss 3 pp. 238-254
Reference
• Williams, S., Weinman, J. and Dale, J. (1998), “Doctor-patient communications and patient satisfaction: a review”, Family Practice, Vol. 15 No. 5, pp. 480-492.
• Baker, J. (1998), ``Education, training and development'', Public Health Forum, Vol. 2 No.1, p. 7.
• Wilson, T., Butler, F. and Watson, M. (1998), ``Establishing educational needs in a new organization'', Career Focus, BMJ Classified,19/26 December, pp. 2-3.
• Abrams, H.L. and Hessel, S., “Health technology assessment: problems and challenges”, American Journal of Radiology, Vol. 149, 1987, pp. 1127-31
• Shani, M., “High technology: the Israeli perspective”, Israel Journal of Medical Sciences, Vol. 22, 1982: pp. 169-72.
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