Diagnosis-related group (DRG) system is patient classification system designed to produce limited number of classes
which are relatively similar in terms of resource consumption and clinical characteristics. The aim of this study was to
assess the level of knowledge, attitude and practice (KAP) of Turkish health care providers toward DRG system
implemented in Turkey.A total of 238 healthcare providers were randomly selected from two urbanand one rural hospital
in Turkey.A questionnaire was used for data collection; contacting 32 items (10 items about knowledge, 12 items about
attitude and 10 items about the practice) and its validity and reliability were confirmed. Data analysis was performed
using chi-square and multivariate logistic regression.In this study,only one third of healthcare providers showed good
knowledge (35.7%) and good practice (37.4%) about DRG system,compared to 54.2% of them showed good attitude.There
was significant difference between age, gender, occupation groups and whether the respondents have attended a
workshop for DRG system in terms of KAP (p > 0.05).These results indicated the need for further actions to implement
DRG system in terms of creation of suitable environment and increasing awareness among healthcare providers,
especially male, medical doctors, nurses, elderly, and those who have never attended a workshop, in addition to regular
review to ensure the program would reach its targets.
Objectives: This study was aimed to assess validation and reliability of knowledge of, attitude toward and practice (KAP) of a Case-mix and Diagnosis Related Group (DRG) system questionnaire. Methods: A sample of 238 health care providers selected conveniently from three public hospitals in Turkey was enrolled in a cross-sectional study from September 1 until November 30, 2012. The mean age was 38.63 years (standard deviation [SD] 10.52), ranging from age 21 to 60 years. More than one-half were males (52.1%), nearly two-fifths were medical doctors (39.9%), one-third were nurses (33.2%), one-sixth were auxiliary staff (16.4%) and the remaining were coders (10.5%). Only one-third (33.6%) of respondents attended a workshop or training program in the Case-mix or DRG system. After examining content validity, factor analysis was conducted, internal consistency of the questionnaire was assessed by Cronbach's alpha estimate, and test-retest reliability was evaluated. Results: The sample adequacy for extraction of the factors was confirmed by the Kaiser-Meyer-Olkin test (0.915) and the Bartlett test (1052). Factor analysis showed three factors, including attitude (36.43%), practice (23.39%) and knowledge (17%), with a total variance of 76.82%. The reliability of each section of the questionnaire was as follows: knowledge (0.963), attitude (0.964) and practice (0.973). Cronbach's alpha total was 0.941, which showed excellent internal consistency. Conclusions: This study demonstrated that the designed questionnaire provided high construct validity and reliability, and could be adequately used to measure KAP among health care staff of the Case-mix and DRG system in Turkey.
BACKGROUND: During the last two decades, the Iraqi human resources for health was exposed to an unprecedented turnover of trained and experienced medical professionals. This study aimed to explore prominent factors affecting turnover intentions among Iraqi doctors.
METHODS: A descriptive cross-sectional multicentre study was carried out among 576 doctors across 20 hospitals in Iraq using multistage sampling technique. Participants completed a self-administered questionnaire, which included socio-demographic information, work characteristics, the 10-item Warr-Cook-Wall job satisfaction scale, and one question on turnover intention. Descriptive and bivariate and multiple logistic regression analyses were conducted to identify significant factors affecting turnover intentions.
RESULTS: More than one half of Iraqi doctors (55.2%) were actively seeking alternative employment. Factors associated with turnover intentions among doctors were low job satisfaction score (odds ratio (OR) = 0.97; 95% confidence interval (CI): 0.95, 0.99), aged 40 years old or less (OR = 2.9; 95% CI: 1.74, 4.75), being male (OR = 4.2; 95% CI: 2.54, 7.03), being single (OR = 5.0; 95% CI: 2.61, 9.75), being threatened (OR = 3.5; 95% CI: 1.80, 6.69), internally displaced (OR = 3.1; 95% CI: 1.43, 6.57), having a perception of unsafe medical practice (OR = 4.1; 95% CI: 1.86, 9.21), working more than 40 h per week, (OR = 2.3; 95% CI: 1.27, 4.03), disagreement with the way manager handles staff (OR = 2.2; 95% CI: 1.19, 4.03), being non-specialist, (OR = 3.9, 95% CI: 2.08, 7.13), and being employed in the government sector only (OR = 2.0; 95% CI: 1.09, 3.82).
CONCLUSION: The high-turnover intention among Iraqi doctors is significantly associated with working and security conditions. An urgent and effective strategy is required to prevent doctors' exodus.