Jafar Sadegh Tabrizi; Kamal Gholipour; Mohammad Asghari Jafarabadi; Mojtaba Mohammad Zadeh; Mostafa Farahbakhsh
Volume 10, Issue 1 , May 2014, , Pages 128-137
Abstract
Introduction: Evaluation is a suitable way to improve the healthcare quality. At the other hand, qualityand validity of information is an important factor in this process. The aim of this study was to assessadjustment and agreement between medical records data and pregnant women reported healthcare data ...
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Introduction: Evaluation is a suitable way to improve the healthcare quality. At the other hand, qualityand validity of information is an important factor in this process. The aim of this study was to assessadjustment and agreement between medical records data and pregnant women reported healthcare data inprenatal maternity care.Methods: A cross-sectional study was conducted on 185 pregnant women who were selected randomlyand received maternity care from 40 urban health centers and health posts in Tabriz, Iran. Technicalquality data were obtained from two different sources medical record and pregnant women reported data.Questionnaire’s content validity was reviewed and confirmed by 10 experts and its reliability wasconfirmed based on Cronbach's alpha (α = 0.748). Weighted Kappa and ICC (intra-class correlationcoefficient) were used to analyze each item. Data were analyzed using the STATA ver.10 and SPSSver.17 statistical packages.Results: There was a weak agreement between the two data sources. Only in some services there was amoderate agreement such as number of care (Kappa = 0.56), blood pressure and weight measurement(Kappa = 0.55). In registration time to health center (P = 0.95, 95%CI 0.931-0.962) and awareness ofpregnancy (P = 0.87, 95%CI 0.824-0.903) there was a strong agreement between medical document andcustomers reported data.Conclusion: For some services such as pregnancy education, it is preferred to use pregnant womenreported data, because such data are a form of output assessment. Furthermore, due to a defect in therecording services, customers’ reported data were more valid than the health records.
Saeid Pourdoulati; Kazem Ashjaei; Simin Khaiatzadeh; Mostafa Farahbakhsh; Mehran Sayffarshd; Ahmad Kousha
Volume 8, Issue 2 , May and June 2011
Abstract
Introduction: Private health care providers (PPs) considered a major gateway to the health services for TB (Tuberculosis) patients. However, TB management practices by PPs is inadequate. National TB program need to collaborate with private health care providers. This paper is aimed to provide a comprehensive ...
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Introduction: Private health care providers (PPs) considered a major gateway to the health services for TB (Tuberculosis) patients. However, TB management practices by PPs is inadequate. National TB program need to collaborate with private health care providers. This paper is aimed to provide a comprehensive management program for public private mix (PPM) in TB DOTS (directly observed treatment short course) for effective case management of TB patients and reporting through a proper referral and information system in Tabriz, Iran.Methods: Mixed quantitative and qualitative methods in 5 stages have been used including: 1) Cross sectional study of current TB situation in Tabriz, Iran and a comparative study of various PPM TB DOTS programs worldwide. 2,3) Stakeholder analysis and SWOT (Strengths, weaknesses, opportunities and threats) analysis using qualitative directed content analysis method 4) Adaptation of WHO’s recommended tools for PPM TB DOTS to local situation 5) Development of action plan using eight steps in leading change method.Results: 3.4% of new TB cases have been detected by public health network system and 96.6% by other health care providers. New smear positive case finding in Tabriz and East Azerbaijan province, Iran was 25% and 28.5% respectively. Treatment success rate in Tabriz and East Azerbaijan province, Iran was 94.8% and 87% respectively. All PPM DOTS findings showed that this program can significantly accelerate case finding while maintaining high cure rates.Conclusion: Cure rate in TB patients whom have been found in Tabriz, Iran is favorable, but case detection rate is less than expected. It is necessary to involve PPs with more sensitivity in case detection and more alliance with national TB program in treatment and patient follow up. Regarding improving case detection rate, promoting patient satisfaction, providing more accessibility and affordability the mentioned program would be an effective approach in management of TB control program.Key words: Partnership; Public Sector; Private Sector; Tuberculosis.
