“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.

Thank You For Your Attention