Paul Andrew Bourne
Background and purpose: Despite significant medical and public health advances in Jamaica all too often health care planning lacks the flexibility to respond appropriately to the increased and varied demand of the population due to inadequate or inaccurate information. The accuracy of the information is pertinent to forward effective changes in the health care arena, which is instrumental in the coordination of care leading to cost reduction in health care management. This study sought to investigate: 1) Probabilities of hospitalization at two government hospitals in Jamaica; 2) Elasticities of hospitalization between two government hospitals in Jamaica; 3) Response-ability of patient-sharing between two government hospitals in Jamaica; and 4) The dual effect of patient-sharing in two government hospitals in Jamaica.
Method: The data for this study were taken from a Jamaica Government Publication, the Ministry of Health, and, admission reports from the Jamaican national mental health public hospital for the 2006-2015 periods.
Findings: During the 2011-2015 periods there was a 6.1% increase in hospitalization over two periods for Spanish Town Hospital compared to 14.0% for the Kingston Public Hospital. Although admissions at Kingston Public Hospital have shown signs of trending downwards in the last five years (2011-2015), there was a significant increase in hospitalization primarily due to the Chikungunya virus outbreak in 2014. Furthermore, the Spanish Town Hospital has seen a steady increase in hospitalization in the latter five years (2011-2015) compared to the former five years (2006-2010), with a marginal rise in 2014 over 2013.
Conclusion: The study findings suggest that changes in the use of both major hospitals can be attributed to several factors inclusive of changed policy directives and the outbreak of viruses. Whenever there is an increase in patient load, there is a corresponding increase in staff workload, a strain on the already insufficient physical resources and an increase in patient dissatisfaction. More robust planning and collaboration between and across hospitals can therefore help to alleviate some of the issues unearthed by this study. Policy proposals that will have far reaching social and financial impact on the health sector must be bolstered with the necessary infrastructure and supporting policies if institutions are to respond effectively and efficiently to future demands which are as a direct consequence of the policy. The inability to respond to the needs of the patients increases patient dissatisfaction which proves counter-productive to the goals of the policy. To prevent this, decision makers are being urged to collaborate with researchers to project possible scenarios and determine the most effective pathways and processes for optimal care and response–ability by the institutions. Accurate methods of data collection, effective tracking and monitoring tools to enable the sharing of important health information within and across health care institutions are also needed.
