Milad Shafii; Roholah Asqari; Mohammad Kazem Rahimi; Mohammad Ranjbar; Farzan Madadizadeh; Fatemeh Jafarian
Abstract
Introduction: Today, the medical tourism market has been raised as one of the revenue industries in the world. In the tourism industry, factors have a direct and important impact on boom and expansion that causes some countries to become a medical tourism pole. This study aimed at prioritizing factors ...
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Introduction: Today, the medical tourism market has been raised as one of the revenue industries in the world. In the tourism industry, factors have a direct and important impact on boom and expansion that causes some countries to become a medical tourism pole. This study aimed at prioritizing factors related to the absorption of medical tourists in Yazd City, Iran.Methods: In the first step, using the keywords such as "medical tourism, effective factors and absorption factors", Web of Science, PubMed, Scopus, ScienceDirect, Google Scholar, Scientific Information Database (SID), Magiran, Medlib, Civilica, and Irandoc were reviewed, and related factors with the absorption of tourists were extracted; and in the second stage, using the hierarchical analysis model, by the research community consisting medical tourists and experts in this area, these factors were prioritized.Results: Factors were identified in the two themes, seven subthemes, and 27 items; among them, the subtheme of the quality of health services, and item of the quality of the treatment staff had the most importance and priority from the viewpoint of medical tourists and experts in this area.Conclusion: One of the ways to increase tourists attracting and influencing tourists to choose Iran as a destination country, is to increase the quality of services, especially medical services, along with reducing costs, and making them competitive.
Sayed Aliakbar Mousavinezhad-Naini; Mohammad Tamimi; Allahkaram Salehi
Abstract
Introduction: Productivity is one of the indicators for assessing the status quo regarding use of production factors, including financial resources, and the health management systems, especially hospitals, are no exception. This study endeavored to evaluate the financial productivity of social security ...
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Introduction: Productivity is one of the indicators for assessing the status quo regarding use of production factors, including financial resources, and the health management systems, especially hospitals, are no exception. This study endeavored to evaluate the financial productivity of social security hospitals in Iran using the Malmquist Productivity Index (MPI).Methods: This study was a survey research. To calculate the MPI in all social security hospitals during 2015 to 2018, initially, through interviews with 10 experts in this field, the most important criteria for evaluating financial productivity in hospitals were identified (10 criteria). Seeing as the specified criteria had some special features, they required mathematical modeling; in such a way that some of these criteria were uncontrollable and others were among the undesirable criteria. The proposed mathematical model was a network data envelopment analysis (DEA) model with correct input and output, fixed input, and undesirable output for use in calculating the MPI.Results: The calculation of financial productivity of hospitals was possible using MPI and DEA method with the help of 10 main criteria including personnel cost, administrative cost, cost of transfer payments, number of active beds, cost of physicians’ benefits and perks, cost of staff’s motivational benefits and perks, the amount of invoices for hospitalized patients, the amount of invoices for outpatients, the sum of medical functions, and the number of days of hospitalization. The results confirmed those obtained in the previous studies.Conclusion: Knowing the financial productivity of hospitals during different periods can lead to the optimal allocation of financial resources to increase the financial productivity of hospitals.
Hossein Sayyadi-Tooranloo; Reihaneh Hafizi-Atabak
Abstract
Introduction:Applying an integration approach to green supply chain management in health care centers can improve its performance, as integration enables coordinated efforts to regulate different resources within organization and across supply chains for implementing best practices in environmental management. ...
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Introduction:Applying an integration approach to green supply chain management in health care centers can improve its performance, as integration enables coordinated efforts to regulate different resources within organization and across supply chains for implementing best practices in environmental management. This study endeavors to investigate the relationship between green supply chain integration and sustainable performance in healthcare centers of Yazd, Iran.Methods: The participants of this quantitative-qualitative study were 10 specialists and 59 experts from the supply chain of public hospitals in Yazd. Initially, library studies, and content analysis were conducted, and the initial indicators were identified. Then, based on semi-structured interviews with 10 university experts and healthcare centers, these indicators were reviewed. According to the final indicators, a questionnaire was distributed among managers and health service experts of six public hospitals in Yazd to evaluate the study variables. Finally, 59 questionnaires were collected and employed to analyze the data through the SmartPLS software.Results: The final output of the study was a model for measuring the relationship between green supply chain integration and improving the sustainable performance of health care centers in Yazd, which will be useful for health experts to plan to improve sustainability in healthcare centers.Conclusion: Supply chain integration expressed 78%, 75%, and 68% of the changes in the dimensions of sustainable social, economic, and environmental performance, respectively. In effect, the integration of the green supply chain in these centers will reduce environmental pollution, improve the social facets, and elevate the quality of services, and ultimately improve the economic performance of healthcare service centers.
Mohammad Hossein Moshtaghi; Somayeh Hessam; Abasat Mirzaei
Abstract
Introduction: Increasing pressure on available funds in health care section, especially hospitals, underlines the for analyzing different strategies in economic terms. One of the solutions for the optimal use of financial resources and potentials in hospitals and healthcare centers is using components ...
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Introduction: Increasing pressure on available funds in health care section, especially hospitals, underlines the for analyzing different strategies in economic terms. One of the solutions for the optimal use of financial resources and potentials in hospitals and healthcare centers is using components of the marketing mix. This study endeavored to determine the related factors on patients' preference in choosing a hospital based on the mixed marketing model.Methods: This study was conducted in Farhikhtegan Hospital in Tehran, Iran, in the year 2020. Simple random sampling was employed to select the sample from among 243 inpatients, outpatients, and clients of the hospital. A bi-part researcher-made questionnaire was used to gather the data (demographics and seven aspects of marketing mix); whose validity and reliability were deemed appropriate. To analysis the data, one-sample t-test and Friedman test to rank dimensions and components as well as the analysis of variance (ANOVA) to compare the views of different classes of society were employed.Results: All seven dimensions of the mixed marketing had a significant and different effect on the preference of the patients in choosing the Farhikhtegan Hospital. Manpower and promotion dimensions were the most and the least important dimensions. Among the components of mixed marketing, sufficient expertise, family income, hospital’s reputation, physicians’ attitude, pacing of services’ provision, doctors' advice and degree of diversity, novelty, and advanced equipment came out to be the most effective components of every dimension of mixed marketing.Conclusion: Considering the change in the needs of the audiences in the health field, hospital managers can identify the patients' needs in keeping with the principles of marketing mix. Regarding the importance of manpower in the findings of this study, managers can attract the attention of patients with culture making and preparing practical guidance in appropriate treatment of employees.
Ahmadreza Raiesi; Nasrin Sharbafchizade; Fatemeh Mohammadi
Abstract
Introduction: Accreditation is one of the evaluation tools of health care systems, especially hospitals, which is one of the priorities of the Ministry of Health in Iran as well. The third generation of accreditation of Iranian hospitals was developed in the academic year 2016. This study endeavored ...
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Introduction: Accreditation is one of the evaluation tools of health care systems, especially hospitals, which is one of the priorities of the Ministry of Health in Iran as well. The third generation of accreditation of Iranian hospitals was developed in the academic year 2016. This study endeavored to determine the challenges of the third generation of hospital accreditation from the perspective of accreditation officials in Isfahan City, Iran.Methods: The qualitative study was conducted through semi-structured interviews with accreditation officials in academic year of 2018 in Isfahan. Ten individuals (due to data saturation) were interviewed in a targeted manner. Data analysis was performed through guided content analysis.Results: Third-generation accreditation challenges were categorized into three areas: structural, process, and outcome challenges. The structural challenges were related to requirements, culture building, localization, training, metrics, and evaluators. Process challenges were related to how to evaluate, commit, and do teamwork and staff work processes during accreditation, and the resulting challenges were related to service quality and patient satisfaction after accreditation.Conclusion: In the third generation of accreditation, structural challenges were especially emphasized by the interviewees, especially in terms of program requirements. Removing these obstacles and challenges can make this plan more successful.
Mandana Sahebzadeh; Forouzandeh Mansouri-Boroujeni; Nasrin Shaarbafchizadeh
Abstract
Introduction: Health literacy is defined as the capacity of individuals to obtain, process, and understand health information and services as the basis for appropriate health decisions, and low-health literacy has a variety of adverse outcomes. On the other hand, the importance of measuring the satisfaction ...
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Introduction: Health literacy is defined as the capacity of individuals to obtain, process, and understand health information and services as the basis for appropriate health decisions, and low-health literacy has a variety of adverse outcomes. On the other hand, the importance of measuring the satisfaction of patients' companions is considered as one of the important and basic criteria determining the quality of care services. In view of this, the study was conducted to determine the relationship between health literacy of patients in psychiatric wards and their satisfaction with service providers in the hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran.Methods: To conduct this descriptive-applied study, 330 patients from psychiatric wards of hospitals affiliated to Isfahan University of Medical Sciences in the second semester of academic year of 2019 were selected using available sampling method. To collect the data, two standard questionnaires, Health Literacy for Iranian Adults (HELIA) and a researcher-made satisfaction questionnaire (95% Cronbach's alpha), were used. Kolmogorov-Smirnov test, Pearson correlation test, and Shapiro Wilk test were used to analyze the data.Results: 33.95% of the participants were at level of not-enough health literacy, 22.72% had inadequate health literacy, 18.28% sufficient health literacy, and 15.15% had excellent health literacy. The highest score of satisfaction with hospital services was 3.89 for the guard unit and the lowest score was 3.55 for the writing unit. There was a direct and significant relationship between health literacy of peers and their satisfaction.Conclusion: The results revealed that the patients with higher health literacy were more satisfied with the services provided by the hospitals. Accordingly, planning to increase the level of health literacy of companions to increase their satisfaction seems necessary. Taking measures such as providing brochures and information pamphlets (during admission and discharge) can help to increase their level of health literacy of patients.
Shiva Onegh; Shaghayegh Vahdat
Abstract
Introduction: Health promotion services has a significant impact on health system, and hospitals are the best places for health promotion and preventive services. Therefore, this study aimed to determine the level of implementation of standards and activities of health promotion in hospitals (HPH) in ...
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Introduction: Health promotion services has a significant impact on health system, and hospitals are the best places for health promotion and preventive services. Therefore, this study aimed to determine the level of implementation of standards and activities of health promotion in hospitals (HPH) in four areas of health promotion.Methods: This was a descriptive-survey study, and the research environment of hospitals in Golestan Province, Iran. The managers, authorities, and experts being in contact with the process of HPH standards and activities (n = 80) were our sample population. A researcher-made questionnaire was employed to gather data, and analysis was performed using one-sample t-test.Results: Standards and activities were implemented in hospitals with good and desirable level in the dimensions of staff (6.01) and patients (5.60), and moderate level in the dimensions of environment (4.22) and society (4.03); the efficacy was in a significant level (P < 0.01). Moreover, the comparison of dimensions with Friedman test showed that the dimension of the staff and society had the highest and lowest level of implementation.Conclusion: Some of the standards and activities of the health promotion hospital are being carried out in hospitals. Therefore, achieving and fully implementing of these standards and activities for improving the quality of health services and improving the situation of hospitals require to encourage policymakers and healthcare managers, create consistent policies for the knowledge promotion and train of health promotion skills (patients, staff, and community), and promote health centers and turn it into a healthy work environment, cooperation, coordination, and interaction with all stakeholders (internal and external).
Zari Rahmatpasand-Fatide; Seyed Mojtaba Hosseini; Khalil Alimohammadzadeh
Abstract
Introduction: The emergency ward is an important part of a hospital given its central role in the health system. Undoubtedly, the use of efficient human resources in this field can boost the quality of services provided and thus patients' satisfaction. Therefore, this study is carried out aiming to determine ...
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Introduction: The emergency ward is an important part of a hospital given its central role in the health system. Undoubtedly, the use of efficient human resources in this field can boost the quality of services provided and thus patients' satisfaction. Therefore, this study is carried out aiming to determine the attitudes of physicians and nurses towards the role of the emergency medicine specialists on the performance of the emergency wards.Methods: This cross-sectional descriptive study was conducted in the emergency department of educational hospitals in Tehran in 2019. Based on the cluster sampling method, 9 hospitals were selected and 501 nurses and physicians working in the emergency department participated in this study. A researcher-made questionnaire was employed to gather data and analyses were performed using t-test, analysis of variance (ANOVA), and Pearson correlation coefficient tests.Results: Based on the findings, the attitude of the participants towards the role of the emergency medicine specialists on patient safety, emergency performance indicators, quality of emergency services, and emergency ward management were favorable. In addition, expertise, organizational position, gender, and age were effective on the attitude of the participants towards the role of the emergency medicine specialists in the emergency ward (P = 0.001).Conclusion: The results revealed that the attitude of physicians and nurses of emergency ward towards the role of the emergency medicine specialist was desirable. According to the results, physicians showed more favorable attitude compared to nurses towards the presence of an emergency medicine specialist.
Diba Norozi; Shaghayegh Vahdat; Somayeh Hesam
Abstract
Introduction: A green hospital is established to increase competitiveness, productivity, and cost savings to save resources and energy. This study is performed to identify and classify factors determining a green hospital.Methods: The five-step guideline of the University of York, York, England, for ...
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Introduction: A green hospital is established to increase competitiveness, productivity, and cost savings to save resources and energy. This study is performed to identify and classify factors determining a green hospital.Methods: The five-step guideline of the University of York, York, England, for conducting systematic scoping reviews of the field of study was employed in this study. Searching for foreign and domestic scientific databases in both English and Persian, with a time limit from 2015 to 2019 was performed using keywords including criteria, dimensions, components, and approaches to green or eco-friendly hospitals. Finally, this study was carried out by reviewing 25 articles published in Iran and abroad in the field of green hospital which were selected out of 10493 articles.Results: Green criteria were identified in 15 dimensions and five environmental, economic, social, health, and novelty categories. The data collection indicated the method for collecting data and the data interpretation addressed analyzing and processing the data collected.Conclusion: In this study, different criteria for a green hospital deployment pattern in five environmental, economic, social, health, and innovation categories were obtained. Green hospital standards are a good model for establishing an environmentally sound health care.
Mohammdreza Emtehani; Hadi Abodolazimi; Hamidreza Shahinifar
Abstract
Introduction: Today, population growth and the consequent physical development of cities have led to a shortage of urban infrastructure and services in new urban areas. The purpose of the present study was to determine the areas deprived of medical services in zone 10, Shiraz municipal, Iran, and to ...
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Introduction: Today, population growth and the consequent physical development of cities have led to a shortage of urban infrastructure and services in new urban areas. The purpose of the present study was to determine the areas deprived of medical services in zone 10, Shiraz municipal, Iran, and to find the optimal locations for use.Methods: The descriptive study was conducted with a citizen-centered approach. The required information was also obtained from the detailed plan of the region. By designing the questionnaire, experts in the field of health and urban planning were asked to rate 3 criteria and 10 sub-criteria, and determine the preference of each criterion. For optimal site selection, hierarchical analysis and geographic information system (GIS) were used.Results: The high concentration of health care use in the center of Shiraz City had caused the northwestern and southeastern regions to face a shortage of medical use. After reviewing the criteria and sub-criteria, the best spatial locations were proposed for the construction of the hospital.Conclusion: The distribution of urban services, especially medical services, must be such that spatial justice is respected. Barren and endowment lands, proximity to first-class passages and densely populated areas, have been suggested as top locations for hospitals.
Mohammad Dehghani; Yuosef Nooshiravani; Kobra Shokrizadeh-Bezenjani; Azadeh Asgarian
Abstract
Introduction: Due to the importance of information in health care organizations, the problems of health information management departments can play an important role in managing these organizations. Therefore, we attempted to investigate health information management problems and their causes In Iran.Methods: ...
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Introduction: Due to the importance of information in health care organizations, the problems of health information management departments can play an important role in managing these organizations. Therefore, we attempted to investigate health information management problems and their causes In Iran.Methods: This practical study was conducted in 2016, using qualitative approach and Delphi technique. First, the problems of health information management departments and their causes were identified via qualitative study using Corbin-Strauss methodology. Then, two rounds of Delphi technique was used to validate the findings.Results: From the perspective of participants, organizational justice problems (89%), building and work environment (86%), and laws and processes (85%) were the main challenges of the health information management departments in hospitals. Lack of a guild system (95%), and finance problems (92%) were the main reasons behind these problems.Conclusion: Health information management departments in hospital are faced with a number of challenges. The main reason for these challenges are macro policies, lack of laws and regulations, and attitudes of hospital managers toward these departments.
Zahra Rostami; Amir Ashkan Nasiripour
Abstract
Introduction: Health care reform affects the hospital activities from various ways. According to the important effect of insurance bill deductions on hospitals revenue, this study was aimed to compare the deductions from the insurance bills of Alzahra hospital affiliated to Isfahan University of Medical ...
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Introduction: Health care reform affects the hospital activities from various ways. According to the important effect of insurance bill deductions on hospitals revenue, this study was aimed to compare the deductions from the insurance bills of Alzahra hospital affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, before and after of health care reform.Methods: This descriptive-analytic study was carried out by examining data about insurance bill deductions among 50288 and 51699 inpatient cases in 2013 and 2015, respectively, in Alzahra hospital covered by Social Security Insurance Organization and Health Services Insurance. To data collection, information technology (IT) staff reports and Health Information System reports were used and exported to electronic files. Data were analyzed using t and paired t tests at a significant level of 0.05.Results: The ratio of deductions to total hospital income significantly reduced in 2015 compared to 2013 (P = 0.010). This significant reduction was seen in visiting, anesthesia, surgery, bed-day costs, and para-clinic services. There was a significant increase in load of para-clinic, consulting, anesthesia, surgery, and total services.Conclusion: Insurance bill deductions in Alzahra hospital decreased after health care reform. The most rate of deductions referred to para-clinic services of Social Security Insurance Organization; that was because of great load of documents of this organization or inequity of patients covered by different insurers. But it is necessary to investigate the causes of insurance bill deductions according to insurance types to find approaches to reduce Social Security Insurance Organization bill deductions.
Azita Balaghafari; Mohammad Fallah-Kharyeki; Afieh Pangh
Abstract
Introduction: The aim of the present study was to develop a hospital management information system (HMIS) as the infrastructure for establishing and deploying an electronic HMIS (eHMIS). Its deployment can lead to the achievement of integrated hospital information as well as reliable and timely statistical ...
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Introduction: The aim of the present study was to develop a hospital management information system (HMIS) as the infrastructure for establishing and deploying an electronic HMIS (eHMIS). Its deployment can lead to the achievement of integrated hospital information as well as reliable and timely statistical indicators of the current information system using efficient, new, and effective technology in the field of hospital management.Methods: This research was conducted in a mixed method in two parts of qualitative-comparative and qualitative-two-steps Delphi in year 2017. The research population was selected based on non-random sampling through a targeted sampling method among 30 experts in Mazandaran University of Medical Sciences, Sari, Iran.Results: The 10-step WHO-based HMIS development strategy consisted of 12 principles, 62 steps, and 28 worksheets. Experts agreed on the principles and steps in the initial model and the final model, and no changes were made. Corrections were made only in the worksheets section, and the number of worksheets increased in steps 1, 2, 6, and 9.Conclusion: In order to establish an eHMIS, there is a need to design the infrastructure of the current hospital information system. The proposed solution can be used as a simple and quick manual and mechanized application to provide the infrastructure of the current hospital information system.
Zahra Nezamabadi; Siyamak Eslami
Abstract
Introduction: Organizational citizenship behavior is an effective factor in the performance of organizations. This study determined organizational citizenship behavior among nurses in hospitals in Tehran City, Iran.Methods: This survey study was performed on 200 nurses in hospitals in Tehran City. Data ...
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Introduction: Organizational citizenship behavior is an effective factor in the performance of organizations. This study determined organizational citizenship behavior among nurses in hospitals in Tehran City, Iran.Methods: This survey study was performed on 200 nurses in hospitals in Tehran City. Data were collected using library resources and a standard questionnaire (α = 0.77). The data were then analyzed using independent t test.Results: There was no statistically significant difference between nurses in state and non-governmental hospitals.Conclusion: In Tehran City, nurses' organizational citizenship behavior was desirable, and there was no difference in organizational citizenship behavior among nurses in state and private hospitals.
Milad Shafii; Fatemeh Sadat Hashemi; Rouhollah Askari; Mohsen Pakdaman; Sajjad Bahariniya
Abstract
Introduction: Considering that human capital is the most important part of health care, planning for distributing human resources in the health sector should be considered as an integral part. The aim of this study was to evaluate the required maternal force in selected hospitals in Yazd City, Iran, ...
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Introduction: Considering that human capital is the most important part of health care, planning for distributing human resources in the health sector should be considered as an integral part. The aim of this study was to evaluate the required maternal force in selected hospitals in Yazd City, Iran, according to the standards of Iranian Ministry of Health and Medical Education in year 2017. Method: In this descriptive cross-sectional stud, the maternal strength of the Shahid Sadoughi and Shahid Rahnemoon hospitals were estimated according to the standards of the Iranian Ministry of Health and Medical Education in year 2017. Researcher-made checklists were used to assess general specifications and performance indicators of the hospital, the status of administrative, financial, supportive, and paraclinical sections of the hospitals. After collecting data, information was analyzed through simple tables.Results: Out of 37 departments in Shahid Sadoughi and Shahid Rahnemoon hospitals, 28 (75%) had shortage and 9 (25%) had excess of personnel.Conclusion: The distribution of power was not in good condition. In order to improve the quality of hospital services, having the right information about the number of required human resources is an essential step for managers to make the necessary plans for fair distribution based on human resource requirements, and delivering the sectors to the standard level. The results of the study can be used by authorities, hospital managers, and policymakers of the health sector.
Mahdi Ebrahimi; ُSeyed Amirhossein Tayebi-Abolhasani; Morvarid Rostami
Abstract
Introduction: Due to the current role of medical tourism as an industry, better understanding of its market can be important. One way to understand the market and its targets is through clustering them, and understanding the characteristics of each cluster. The present study was conducted to determine ...
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Introduction: Due to the current role of medical tourism as an industry, better understanding of its market can be important. One way to understand the market and its targets is through clustering them, and understanding the characteristics of each cluster. The present study was conducted to determine and analyze the demographic, geographic, and behavioral variables within the clusters of medical tourism market.Methods: This was a descriptive-survey conducted using a questionnaire. 151 questionnaires were completed by foreigner patients in selected hospitals in Tehran City, Iran, who were selected using one-stage cluster sampling. The results of the questionnaires were examined using K-means and chi-square correlation coefficient via SPSS software.Results: The findings identified four different clusters of medical tourists, namely first, second, third, and fourth clusters, with significant differences in terms of the studied variables. In other words, the examined demographic variables included gender, age, education and income, the country of origin of tourists was considered as a geographical variable, as well as behavioral variables including the number of trips, the length of stay in Iran, the type of medical service received, the main source of information for travel in Iran, the method of regulating treatment, doing side activity, and the type of side activity. All the variables had significant differences in different clusters.Conclusion: The differences in clusters should be considered by policymakers and activists in this area. It is important to provide a regular and systematic program for recognizing and planning of Iraqi medical tourists. Furthermore, medical tourism managers can provide an increasing number of side plans in cooperation with hospitals and agencies for this potential market.
Maryam Jahanbakhsh; Asghar Ehteshami; Mehrnaz Hosein-Zehi
Volume 14, Issue 4 , November 2017, , Pages 150-154
Abstract
Introduction: Over the past several years, outsourcing services has received attention from managers in health sector in order to improve the quality of services and reduce costs; managers of the health information systems have also used outsourcing in information management departments. In this study, ...
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Introduction: Over the past several years, outsourcing services has received attention from managers in health sector in order to improve the quality of services and reduce costs; managers of the health information systems have also used outsourcing in information management departments. In this study, the frequency of observing legal dimensions in outsourcing for health information management departments of educational hospitals of Isfahan University of Medical Sciences, Iran, was investigated.Methods: In this descriptive, cross-sectional study, the frequency of observing legal elements in the outsourcing contracts for health information management services in five educational hospitals of Isfahan University of Medical Sciences in four areas including provisions of contract, assignment contracts, confidentiality of patient information, and the status of the essentials and tools was investigated by using a check list. These areas were examined by coordinating with university's legal affairs based in order to study the contracts related to health information management department. The data were analyzed using central indexes at the frequency.Results: The highest frequency of legal elements observance in outsourcing contracts of various hospitals was related to the confidentiality of patient information with a frequency of 47.1% and the least frequency related to the elements of tools and necessities, which showed that, unfortunately, none of the dimensions of this element were observed. In addition, among five hospitals surveyed, the hospital with the most frequent observation of legal dimensions (B) only had a score of 35.5%, indicating that hospitals and contractors were not paying attention to the legal dimensions of outsourcing.Conclusion: The findings showed that the overall observance of legal elements in outsourcing contracts for health information management services in hospitals is significantly lower than the ideal. The results can be used by Isfahan University of Medical Sciences to protect the confidentiality and privacy of patients by observing legal dimensions during outsourcing health information services.
Leila Shahmoradi; Mohammad Hosseini-Ravandi; Marzieh Saremian
Volume 14, Issue 4 , November 2017, , Pages 161-166
Abstract
Introduction: Picture Archiving and Communication System (PACS) process, archive and transmit the medical images, so it has created a revolutionary in the field of medical images. In this study, after determining features related to the use of PACS, the status of this system in the teaching hospitals ...
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Introduction: Picture Archiving and Communication System (PACS) process, archive and transmit the medical images, so it has created a revolutionary in the field of medical images. In this study, after determining features related to the use of PACS, the status of this system in the teaching hospitals of Tehran City, Iran, was investigated.Methods: In this descriptive study, through searching the databases, the features of a comprehensive PACS were identified and a checklist was designed. The validity of checklist was approved by 5 specialists and Kappa formula was used to examine the inter-rater reliability (0.74). The study population consisted of 27 Tehran teaching hospitals which had PACS and were evaluated through census method in 2016. PACS features in the studied hospitals then were assessed and the results were presented.Results: There were some similarities and differences in the following features: storing images in Digital Imaging and Communications in Medicine (DICOM) format, using Health Level Seven International (HL7) standard, image optimization, automatic image compression, support of teleradiology, integration with radiology information system, type of relationship with other systems, network type to exchange images, and the way of sending images.Conclusion: The results showed that to gain benefits from this technology, designing or choosing systems that have the highest performance appropriate to users' circumstances and needs in essential. Thus, more studies to investigate PACS features used in medical diagnostic centers can underlie the designing or selecting high-quality systems by producers and managers.
Azam Sadat Hashemi; Leila Riahi; Leila Nazarimanesh
Volume 14, Issue 5 , October 2017, , Pages 194-198
Abstract
Introduction: The full and timely documentation of medical records plays an important role in the improvement of medical, legal, educational, treatment and research processes. Incomplete record keeping is indicative of defective care and treatment. The purpose of this study was to determine the effect ...
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Introduction: The full and timely documentation of medical records plays an important role in the improvement of medical, legal, educational, treatment and research processes. Incomplete record keeping is indicative of defective care and treatment. The purpose of this study was to determine the effect of implementation of the instructions on filling the patients' records by physicians on the incompleteness of medical records of Ziaeian Hospital, Tehran, Iran.Methods: This descriptive applied study was carried out at Ziaeian Hospital in 2016. The study population included 2413 medical files filled out in August and December. The sample included 324 incomplete medical files from August (before the implementation) and 288 incomplete medical records in December (after implementation). The medical record checklist was used to collect data. SPSS and Wilcoxon signed-rank tests were employed for data analysis.Results: The mean number of defects was 12.4 and 9.9 before and 9.9 after the intervention, respectively. Number of defects in the admission document (P = 0.012), counseling request (P = 0.048), surgery report (P = 0.001), case summary (P = 0.001) and anesthesia (P = 0.012) showed a significant reduction in the number of defects and the effectiveness of the intervention. However, in total medical record documentation, the intervention was not effective (P = 0.238).Conclusion: It appears that reducing the defects in medical records of Ziaeian Hospital has not been significant which can affect the treatment of patients, the quality of transmission of information and also use of medical records by legal authorities. The results of this research can be useful for hospital directors and managers for a more optimal planning approach.
Yousef Ramezani; Fariborz Rahimnia
Volume 14, Issue 3 , September 2017, , Pages 110-115
Abstract
Introduction: Many public and service-providing organizations use the Internet in order to provide their clients with optimal services. For this purpose, this study aimed to determine the factors associated with returning of hospital patients to hospital web services.Methods: The survey research method ...
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Introduction: Many public and service-providing organizations use the Internet in order to provide their clients with optimal services. For this purpose, this study aimed to determine the factors associated with returning of hospital patients to hospital web services.Methods: The survey research method was used in this study. The population of this study included all returning patients to the Internet services of hospitals in Mashhad, Iran. Convenience sampling method was used to select 160 participants. The required data were collected through questionnaires. Data were analyzed using structural equation modeling.Results: The path coefficient of patients’ attitude toward using the Internet on their orientation was equal to 0.389, which shows a significant positive impact. The path coefficients of perceived usefulness and perceived ease of use of clients of hospitals’ Internet services were 0.314 and 0.403, respectively, which show a positive and significant effect. The path coefficient of clients’ tendency toward using hospitals’ Internet services over the patients’ reuse of online services was 0.354, which indicates a positive and significant impact. The research findings also indicated the significant and positive impact of perceived ease of use on perceived usefulness with the path coefficient of 0.563.Conclusion: Facilitating the use of hospital electronic systems and providing the necessary training is recommended to increase the use of hospitals’ Internet services, reduce the number of hospital visitors, and familiarize clients with the advantages of these Internet-based services.
Seyyed Majid Shirzadi; Pouran Raeissi; Amir Ashkan Nasiripour; Seyed Jamaleddin Tabibi
Volume 14, Issue 3 , September 2017, , Pages 130-137
Abstract
Introduction: Considering the importance of the quality of hospital hoteling services in healthcare system’s outcomes, and lack of a valid assessment method for determining and implementing required strategies for evaluation and improvement of the service quality, the aim of the present study was to ...
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Introduction: Considering the importance of the quality of hospital hoteling services in healthcare system’s outcomes, and lack of a valid assessment method for determining and implementing required strategies for evaluation and improvement of the service quality, the aim of the present study was to determine factors affecting the hoteling services quality in public hospitals of Iran.Methods: The present quantitative-qualitative study was conducted in two phases. In the first phase, factors affecting hospitals hoteling services’ quality were extracted from the literature as well as from in-depth interviews with 11 experts (i.e., 6 specialists in healthcare administration and 5 in hoteling industry). In the second phase, the data from the first phase were integrated and a model for improving the quality of hospitals’ hoteling services was designed resulting in a researcher-made questionnaire. The model was validated through qualitative (i.e., expert opinion), and quantitative approaches (i.e., exploratory and confirmatory factor analysis). The data for the factor analysis was collected from 960 patients and specialists in 10 teaching hospitals in 10 different cities across the country. Confirmatory factor analysis and multiple regression were used to analyze the data.Results: The findings of present study indicated that 11 factors (physical, functional, economical, human factor, social welfare services, clinical welfare services, safety, cultural, personnel identification, patient guiding factors, and healthcare services) were able to explain 65.81% of the hoteling services’ quality variances. Based on conformity factor analysis, functional and personnel identification factors with a coefficient of 0.953 and 0.779, respectively, had the highest and lowest impact on improvement of the quality of hoteling services in Iranian teaching hospitals.Conclusion: For the improvement of the hoteling services status of Iranian hospitals and considering the 11 factors found in this study, the functional factor must be emphasized and the technical quality of health services be evaluated in the planning of hoteling services.
Najmeh Ghandehari; Majid Esmaelian; Hadi Teimouri; Shermineh Ghalamkari
Volume 14, Issue 2 , July 2017, , Pages 58-64
Abstract
Introduction: The balanced scorecard (BSC) is a performance measurement tool for managers to obtain a comprehensive overview of their company’s performance. The purpose of this study was to integrate BSC with Measuring Attractiveness by a Categorical Based Evaluation Technique (MACBETH) for performance ...
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Introduction: The balanced scorecard (BSC) is a performance measurement tool for managers to obtain a comprehensive overview of their company’s performance. The purpose of this study was to integrate BSC with Measuring Attractiveness by a Categorical Based Evaluation Technique (MACBETH) for performance measurement in Noor-Ali Asghar Hospital, Isfahan, Iran.Methods: This applied, descriptive, and cross-sectional study was carried out in Noor-Ali Asghar Hospital in 2015. The study population included matrons, educational supervisors, and nursing managers of the hospital. The subjects were selected using stratified random sampling method. Data collection tool was the paired comparisons questionnaire which has an acceptable validity. According to MACBETH, each decision maker specified attractiveness difference of BSC perspective indicators and comments were merged through arithmetic mean. Weights of indicators were identified by M-MACBETH software and the weight of each perspective of the BSC was calculated in Excel environment.Results: The results show that, among the BSC perspectives, customer perspective, and among all indicators, employee satisfaction and customer satisfaction, respectively, had the greatest importance.Conclusion: This present study aimed to resolve the defects of BSC in prioritization of perspectives by integrating BSC with MACBETH. Attention to priorities of BSC perspectives in evaluating performance helps managers to improve performance by focusing on perspectives with higher priority and implementing programs to improve employee and customer satisfaction.
Masoud Ferdosi; Ahmadreza Raeisi; Hamid Ganji; Sahar Vesal; Amir Jannesari; Hamzeh Yazdi
Volume 13, Issue 4 , November 2016, , Pages 292-296
Abstract
Introduction: One of the 8 service packages in the first phase of Iran health transformation plan (HTP) is dedicated to improving the quality of outpatient visits. We investigated the average visits/hour criterion at the Alzahra university hospital, Isfahan, Iran, as the biggest province health center, ...
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Introduction: One of the 8 service packages in the first phase of Iran health transformation plan (HTP) is dedicated to improving the quality of outpatient visits. We investigated the average visits/hour criterion at the Alzahra university hospital, Isfahan, Iran, as the biggest province health center, after implementation of health transformation plan.Methods: This descriptive cross-sectional study, conducted in all 26 clinics of Alzahra hospital using visit/hour as the main indicator for evaluating the quality of outpatient services. Data gathered from June 2014 to July 2015 from clinic secretaries with the help of a checklist. Gathered data were analyzed via calculating the quarterly mean and standard deviation of visits/hour separately for internal and surgical clinics using SPSS18 software.Results: Considering 8 visits/hour as the desired standard number, the mean visits/hour in the internal clinics in the first, second, third and fourth quarter were 6.06 ± 2.27, 7.76 ± 4.80, 7.02 ± 4.18 and 6.37 ± 2.52, respectively. For the Surgical clinics, the mean visit/hour was 9.88 ± 6.09, 10.11 ± 5.47, 9.40 ± 6.26 and 7.63 ± 2.93 for first, second, third and fourth quarters, respectively. Conclusion: After implementation of health transformation plan in Alzahra hospital in May 2014, the visits/hour criterion worsened during the second quarter but improved in the third and fourth quarters. This can be due to the increase in the number of patients at the start of the plan or financial issues and the effects of which was reduced due to better supervision later on. We suggest using different standards for surgical and internal clinics in order to improve the effectiveness of the plan.Keywords: Hospitals; Visit; Outpatients; Health Transformation Plan; Iran
Mohammadreza Hamidizadeh; Hamid Javidi; Fayegh Mojarrad
Volume 13, Issue 5 , October 2016, , Pages 373-379
Abstract
Introduction: Medical tourism is travelling overseas to obtain medical care. Obtaining competitive advantage in this industry is crucial in many destinations particularly Asian countries. This study investigated the factors contributing to the competitive advantage of Iranian medical tourism marketing.Methods: ...
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Introduction: Medical tourism is travelling overseas to obtain medical care. Obtaining competitive advantage in this industry is crucial in many destinations particularly Asian countries. This study investigated the factors contributing to the competitive advantage of Iranian medical tourism marketing.Methods: This was a descriptive case study research. To gather the data, a questionnaire consisted of 15 Likert-scaled questions with an 80 percent reliability on Cronbach's alpha test was randomly distributed among 67 Iranian heart surgeons, ophthalmologists and medical tourists using screening sampling. The collected data was analyzed using t and chi-square tests utilized with SPSS software.Results: There was a statistically significant dependency between competitive advantage and factors like physician’s skills, treatment and travel costs, waiting list and hospital technology and services. Physician’s skills included success in surgery, right and timely diagnostics and prescription. Cost included items such as doctor’s visit cost, medicine, visa, accommodation, hospital and surgery. Waiting list consisted of required time for doctor’s visit and visa processing. Regarding hospital technology and services, items such as operating room equipment, service quality and accommodation facilities were considered.Conclusion: The results show that Iran has a strong competitive advantage in physician’s skills, low costs of treatment, travel and short waiting lists, respectively. Nevertheless, Iran is not highly advantageous in utilizing latest hospital technology and providing high-quality services to medical tourists.
Azam Sabahi; Reza Khajouei
Volume 13, Issue 3 , September 2016, , Pages 155-162
Abstract
Introduction: A geographic information system (GIS) can help in locating facilities and medical centers, and in crisis management during accidents. One of the appropriate information sources for using this system is the medical records of victims of traffic accidents. Since these records have not ...
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Introduction: A geographic information system (GIS) can help in locating facilities and medical centers, and in crisis management during accidents. One of the appropriate information sources for using this system is the medical records of victims of traffic accidents. Since these records have not been used in designing GIS until now, the aim of this study was the implementation of a GIS using data from the medical records of injured patients.Methods: In this applied study, the medical records of victims of traffic accidents hospitalized in Chamran Hospital in Ferdows, Iran, from June to November 2014 were reviewed. The GIS was used to identify hot spots of accidents (black spots), and the distribution of injuries and health services in these spots, in terms of urban and suburban accidents.Results: From the total of 470 road accidents, 216 had occurred in urban and 256 in suburban areas. In terms of distribution of injuries, in the urban areas, abdominal injury in Islamiyeh, Iran, and in suburban areas, head and hand injuries in Sarayan, Iran, were the most prevalent. In urban accidents, most injured patients (46.75%) were referred to the emergency ward, and in suburban accidents, most patients (53.93%) were referred to the general surgery ward. The longest time for arriving at the hospital from urban areas was 5 hours for face injuries and 2.8 hours from suburban areas for foot injuries and those with multiple injuries.Conclusion: The medical records of victims of traffic accidents showed that at least 5 other emergency stations are needed. It seems that by establishing more stations the duration of moving injured patients to a hospital could be shortened. Since the distribution of injury type on the roads was determined in the present study, the emergency stations could be equipped with the required personnel and facilities based on injury types.
