Browsing by Author "Yitambe, Andre"

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    An Analysis of Patients’ Spinal Injury Costs at the National Spinal Injury Hospital in Nairobi County, Kenya
    (Global scientific journal, 2024) Korir, julius k.; Karanja, Lorna Wangari; Yitambe, Andre
    Global statistics indicate that based on the extent of spinal cord injury, the first-year cost ranges between $300,000 and $1,000,000. [1]. A review of 68 studies [2], indicated the cost of injury varied widely with mean costs ranging from $14 to $17, 400 and the cost per disability-adjusted life year averted for injury-prevention interventions ranged from $10.90 for speed bump installation to $17,000 for drunk driving and breath testing campaigns in Africa. Health economists are interested in evaluating spinal cord treatment interventions as economic investments. For these stakeholders, a key question is the relationship between the reduction of spinal cord injuries and national income growth as measured by GDP metrics. Public health officials are more focused on promoting health, preventing spinal injuries and related mortalities as well as reducing their health and social burden. The general objective of this study was to analyze the patient costs of spinal cord injury at the National Spinal Injury Hospital, Nairobi County, Kenya. The four specific objectives of the study were to determine the total costs of spinal cord injury in the first year of diagnosis and treatment at the National Spinal Injury Hospital, to determine the variations in total costs of spinal cord injury due to ownership of health insurance, to establish the variations in total costs of spinal cord injury based on extent of the injury and to establish the variations in total costs of spinal cord injury based on the employment status of the patients at National Spinal Injury Hospital.This was an analytical cross-sectional study utilizing quantitative methods on a sample of n=169. Purposive sampling was also employed to recruit participants comprising spinal injury patients in the first year of diagnosis and data were collected using structured questionnaires and secondary data review. Data was analyzed using SPSS version 25 where descriptive statistics were used to show frequencies and percentages for variables. ANOVA test was used to test the statistical mean differences in the total SCI costs among the SCI patients at NSIH based on their employment status and extent of the spinal injury while paired t-test was used for health insurance status. Findings indicate that it average costs the spinal cord injury patient KSh. 928,326.73 in treatment costs in the first year of diagnosis. The average of sum of the annual direct medical costs, direct non-medical costs and indirect costs of productivity losses for the 169 patients was KSh 187,048, KSh 173,541 and KSh 567,738 per patient respectively. Further, it shows that the employment status of the patients do result in significant differences in the total SCI costs among the different groups ( P=0.000) while the extent of injury and health insurance status does not result in significant differences in the total SCI costs( P=0.6617 and t=-0.6129 respectively). This study will inform the National Spinal Injury Hospital on the importance of health economic studies in the management of SCI patients.
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    Nurses’ Perception on Healthcare Services Quality in Mission Hospitals in Kiambu County, Kenya
    (AJOL, 2019-02) Miriti, Kenneth; Yitambe, Andre; Nyamari, Jackim; Koome, Gilbert
    BACKGROUND Despite adoption of quality improvement initiatives in Kenyan Health facilities, quality gains are not yet optimal in both public and private sector. The private sector, which includes mission hospitals, face myriad of challenges ranging from perception of poor regulation to unqualified staff and gaps in quality of care. PURPOSE To assess nurses’ perception on healthcare services' quality in mission hospitals in Kenya. METHOD A descriptive cross-sectional study using quantitative and qualitative methods of data collection. Simple random sampling was used to select 188 nurses for administration of selfadministered questionnaire. A total of 20 in-depth interviews and 4 focus group discussions were conducted. Descriptive statistics and linear regression analysis were used to analyze quantitative data using SPSS v20. Qualitative data was analyzed thematically using Nvivo v11. RESULTS Overall nurses' perception of quality of services was 3.62. The perceived quality of services processes was 3.5187. Length of patient-provider interaction (β=0.225, t=4.761, p=0.001), teamwork (β=0.170, t=3.550, p=0.001), upholding patients’ rights (β=0.178, t=3.773, p=0.001), capacity to conduct quality assessment (β =0.125, t=2.510, 0.013) and availability of effective quality improvement teams (β=0.550, t=12.556, p=0.001). CONCLUSION Nurses' perceived quality of services to be fair with a substantial room for improvement. To achieve a competitive edge, it is imperative for the hospital's management to engage visionary and quality conscious leaders, capable of identifying quality gaps and implementing improvement initiatives. The initiatives should focus on institutionalizing team-based quality audits, developing a quality patient-focused culture in service delivery.
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    The Physician-Patient Relationship: A Review of Two Theoretical Approaches and Health Regulation Implications
    (Institute of Research Advances, 2016) Yitambe, Andre; Warutere, Peterson N.; Kibaara, Kenneth R.
    Recent development in the organization of healthcare has impacted on physician and patient relationship. The physician-patient relationship is becoming more and more a universalistic concern. Since Hippocrates, the physician-patient relationship remains the corner stone of medical practice. A number of disciplines have questioned the interaction between physician and patient (from pure sciences and clinical sciences to social sciences). This paper uses a de-centered comparative method to examine how different theoretical approaches shape the understanding of doctor-patient interaction and health regulation implications. In particular, the article looks at two theoretical models: health economics and medical socio-anthropology. The findings show that the difference between the two approaches is based upon the background of each discipline. Nevertheless, there are some similarities. The paper concludes that no theoretical approach is totally privileged to understand the interaction.