Soul of Business
United Arab Emirates Government type
Authoritarian – a form of government in which state authority is imposed onto many aspects of citizens’ lives. Communist – a system of government in which the state plans and controls the economy and a single – often authoritarian – party holds power; state controls are imposed with the elimination of private ownership of property or capital while claiming to make progress toward a higher social order in which all goods are equally shared by the people. Confederacy – a union by compact or treaty between states, provinces, or territories, that creates a central government with limited powers; the constituent entities retain supreme authority over all matters except those delegated to the central government. Constitutional – a government by or operating under an authoritative document that sets forth the system of fundamental laws and principles that determines the nature, functions, and limits of that government. Federal – a form of government in which sovereign power is formally divided – usually by means of a constitution – between a central authority and a number of constituent regions so that each region retains some management of its internal affairs; differs from a confederacy in that the central government exerts influence directly upon both individuals as well as upon the regional units.
Federal republic – a state in which the powers of the central government are restricted and in which the component parts retain a degree of self-government; ultimate sovereign power rests with the voters who chose their governmental representatives. Islamic republic – a particular form of government adopted by some Muslim states; although such a state is, in theory, a theocracy, it remains a republic, but its laws are required to be compatible with the laws of Islam. Monarchy – a government in which the supreme power is lodged in the hands of a monarch who reigns over a state or territory, usually for life and by hereditary right; the monarch may be either a sole absolute ruler or a sovereign – such as a king, queen, or prince – with constitutionally limited authority. Parliamentary democracy – a political system in which the legislature selects the government – a prime minister, premier, or chancellor along with the cabinet ministers – according to party strength as expressed in elections; by this system, the government acquires a dual responsibility: to the people as well as to the parliament. Parliamentary government – a government in which members of an executive branch are nominated to their positions by a legislature or parliament, and are directly responsible to it; this type of government can be dissolved at will by the parliament by means of a no confidence vote or the leader of the cabinet may dissolve the parliament if it can no longer function.
Socialism – a government in which the means of planning, producing, and distributing goods is controlled by a central government that theoretically seeks a more just and equitable distribution of property and labor; in actuality, most socialist governments have ended up being no more than dictatorships over workers by a ruling elite. Theocracy – a form of government in which a Deity is recognized as the supreme civil ruler, but the Deity’s laws are interpreted by ecclesiastical authorities; a government subject to religious authority.
Patients’ Perception of Hospital Care in the United States
HCAHPS and the Domains of Patients’ Experiences The HCAHPS survey, developed by the Agency for Healthcare Research and Quality, asks patients 27 questions about their experiences in the hospital and about their demographic characteristics. Other domains reflect individual questions about whether the rooms were clean and whether they were quiet and two overall ratings: a global rating of the hospital on a scale of 0 to 10, with 0 being the worst and 10 being the best a hospital can be, and a question about whether the patient would recommend the hospital to family and friends. Under the CMS’s authority to monitor providers of care and to oversee care for Medicare patients, the CMS and its Quality Improvement Organizations can require that the HCAHPS survey be administered to patients who are being discharged from hospitals that receive Medicare payment. HQA Data on Provision of High-Quality Clinical Care The HQA also provides data on the compliance of hospitals with 24 measures of evidence-based processes with respect to care for three conditions – acute myocardial infarction, congestive heart failure, and pneumonia – and with respect to the prevention of complications from surgery. To create condition-specific summary scores, we used a common method,11 in which the summary score is a percentage derived from the sum of the number of times a hospital performed the appropriate action across all measures for that condition divided by the number of opportunities the hospital had to provide appropriate care.
Composite scores for a condition were calculated only if a hospital had at least 30 patients for at least one measure. Structural Characteristics of Hospitals We linked the HCAHPS data to the annual survey of the American Hospital Association, which collects the following information from hospitals: nurse-staffing levels, profit status, status of membership in the Council of Teaching Hospitals and Health Systems, number of beds, census region, location, percentage of patients receiving Medicaid, and presence or absence of a medical intensive care unit. Statistical Analysis We used chi-square tests and t-tests to compare hospital characteristics between hospitals that reported HCAHPS data and those that chose not to do so. We focused primarily on the fraction of patients who rated the hospital in the highest category as the primary indicator of patient satisfaction. We examined bivariate relationships between each of these characteristics and HCAHPS ratings and subsequently constructed multivariable linear regression models that adjusted for the other two characteristics as well as other characteristics that might be potential confounders: number of beds in the hospital, census region, location, presence or absence of a medical ICU, and percentage of patients receiving Medicaid.
We examined the relationship between a hospital’s performance with respect to the overall experience of the patients and measures of clinical process using the HQA summary scores described above. We then calculated the performance on each of the HCAHPS measures for each hospital-referral region by averaging the ratings for all hospitals in that hospital-referral region, weighted by hospital size.