2026-09-24T18:17:19Zhttps://bura.brunel.ac.uk/oai/requestoai:bura.brunel.ac.uk:2438/78732014-11-01T13:20:19Zcom_2438_23com_2438_58col_2438_3672col_2438_206
Kogan, M
Lam, Zarina
2014-01-14T11:00:41Z
2014-01-14T11:00:41Z
2000
http://bura.brunel.ac.uk/handle/2438/7873
This thesis was submitted for the degree of Doctor of Philosophy and was awarded by Brunel University.
A concept of "total patient care" was developed in Hong Kong to enhance public
hospital services. The development of this concept aimed to resolve two major
concerns about patient care delivery. First, for historical reasons, there were
differences among public hospitals in their emphases on the scientific medicine
and social aspects of caring. Secondly, the health care system was under pressure
to change due to rising expectations, in particular to an increasing number of
patients requiring complex care in the community.
The purposes of this study were (1) to investigate the historical influence on the
development of patient services and (2) to examine the determinants affecting the
development of new initiatives. The path-finding process to shift care practice
from a traditional institutional orientation to a person-centred approach was
studied through a focal point of study in all 38 public hospitals, serving a
population of 6.3 millions. An analysis of the "successful" examples of the
implementation of the concept of total patient care was initially conducted. The
subsequent development of a variety of hospital patient care models was traced
back to the different origins of patient care orientations through collecting views
of hospital stakeholders and the support provided for patients outside the
hospitals. A pluralistic approach, which involved site visits, interviews, focus
group discussion and survey, was chosen to understand the complexity of
historical influence and contemporary determinants in the development of the
totality of patient care. A "mapping" method was adopted to analyse the data
reflected different levels of concerns.
The findings in this study indicated that, technological and financial factors
often identified as the more important determinants in development of health
care system, might have ignored the historical development of the hospitals and
health traditions in the community in the development of totality of patient
care. This study suggested that influences of these informal factors, as
experienced in a Chinese community, would likely to continue and diffuse the
goal of a planned policy. Formalisation of the informal and community
involvement in formal hospital settings, through a concept of total patient care,
had resulted in the consolidation of some diversified experience in the support of
a diversified range of patient needs. The strengthening of a hospital-community
linkage was highlighted as a possible solution to bring a full transformation of
patient care into a model of totality.
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en
http://bura.brunel.ac.uk/bitstream/2438/7873/1/FulltextThesis.pdf
Patient care
Hospital services
Health care policy
Hong Kong
The hospital patient service in transition: A study of the development of totality of care
Thesis