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发展中国家公共部门卫生机构的信息技术系统:以南非为例。

Information technology systems in public sector health facilities in developing countries: the case of South Africa.

机构信息

Graduate School of Business, University of Cape Town, Cape Town, South Africa.

出版信息

BMC Med Inform Decis Mak. 2013 Jan 24;13:13. doi: 10.1186/1472-6947-13-13.

Abstract

BACKGROUND

The public healthcare sector in developing countries faces many challenges including weak healthcare systems and under-resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Global references demonstrate that information technology has the ability to assist in this regard through the automation of processes, thus reducing the inefficiencies of manually driven processes and lowering transaction costs. This study examines the impact of hospital information systems implementation on service delivery, user adoption and organisational culture within two hospital settings in South Africa.

METHODS

Ninety-four interviews with doctors, nurses and hospital administrators were conducted in two public sector tertiary healthcare facilities (in two provinces) to record end-user perceptions. Structured questionnaires were used to conduct the interviews with both qualitative and quantitative information.

RESULTS

Noteworthy differences were observed among the three sample groups of doctors, nurses and administrators as well as between our two hospital groups. The impact of automation in terms of cost and strategic value in public sector hospitals is shown to have yielded positive outcomes with regard to patient experience, hospital staff workflow enhancements, and overall morale in the workplace.

CONCLUSION

The research provides insight into the reasons for investing in system automation, the associated outcomes, and organisational factors that impact the successful adoption of IT systems. In addition, it finds that sustainable success in these initiatives is as much a function of the technology as it is of the change management function that must accompany the system implementation.

摘要

背景

发展中国家的公共医疗部门面临着许多挑战,包括医疗体系薄弱和资源配置不足,导致相对于总医疗支出而言,医疗效果不佳。全球参考资料表明,信息技术有能力通过流程自动化来提供帮助,从而减少手动流程的低效性并降低交易成本。本研究考察了医院信息系统在南非两个医院环境中对服务提供、用户采用和组织文化的影响。

方法

在两个公立三级医疗保健机构(两个省份)中对医生、护士和医院管理人员进行了 94 次访谈,以记录最终用户的看法。采用结构化问卷对医生、护士和管理人员进行了访谈,获取定性和定量信息。

结果

观察到医生、护士和管理人员三个样本组之间以及我们的两个医院组之间存在显著差异。在公立医院中,自动化在成本和战略价值方面的影响在提高患者体验、医院工作人员工作流程改进以及工作场所整体士气方面产生了积极的结果。

结论

研究提供了对投资系统自动化的原因、相关结果以及影响 IT 系统成功采用的组织因素的深入了解。此外,研究还发现,这些举措的可持续成功不仅取决于技术,还取决于伴随系统实施的变革管理功能。

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