Volume 8, Issue 7 , January and February 2012
Abstract
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نامه به سردبیر
m davari
Volume 8, Issue 7 , January and February 2012, Pages 915-917
Original Article
Mostafa Emadzadeh; Morteza Sameti; Davoud Safi Dastjerdi
Volume 8, Issue 7 , January and February 2012, Pages 918-928
Abstract
Introduction: Economic growth has always been known as one of the fundamental ideals of governments and an indicator to assess their performance. Achieving economic growth more than anything, depends on right recognition of potential pathways and the factors influencing it. One of the ...
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Introduction: Economic growth has always been known as one of the fundamental ideals of governments and an indicator to assess their performance. Achieving economic growth more than anything, depends on right recognition of potential pathways and the factors influencing it. One of the factors affecting economic growth is workforce health which forms the basis of human capital in combination with education. Aim of Study was to identify the effects of household health expenditure on economic growth and evaluated some other impressive factors on growth of Iranian provinces. Methods: This theoretical, scientific study used a method derived from Romer's endogenous growth model. The mentioned model was selected after technical studies and econometric tests using panel data approach, i.e. blending time series of 2000-2007 with cross-sectional data from 27 provinces of Iran. Results: Findings of this survey proved the positive effect of household health expenditure growth and government investment expenditure on economic growth of provinces of Iran. Moreover, the results showed a negative relationship between consumer price index (CPI) and the economic growth of each province. Conclusion: Household health care expenditure had a significant effect on economic growth of Iranian provinces. Considering the proportion of this expenditure of household budget compared to other countries, economic growth and development of different provinces can be achieved through improving health care.
Original Article
Majid Davari; Shahnaz Kohan; Behnaz Enjezab; Mojgan Javadnoori
Volume 8, Issue 7 , January and February 2012, Pages 929-937
Abstract
Introduction: Effective use of human resources is considered as a key factor in the efficiency of health systems. Accessibility to affordable services for individuals according to their needs is also regarded as a sign of equitable health care system. Providing health services, particularly reproductive ...
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Introduction: Effective use of human resources is considered as a key factor in the efficiency of health systems. Accessibility to affordable services for individuals according to their needs is also regarded as a sign of equitable health care system. Providing health services, particularly reproductive health, for women as a vulnerable population is one of the main priorities for health policy makers. Gynecologists and midwives are well-trained and have some common skills to provide women with reproductive health services. The aim of this study was to undertake a costservice analysis of these services from efficiency perspective. Methods: This study was performed in three phases. The educational curricula of midwifery and gynecology were first reviewed and compared. Then, a 20-item questionnaire was designed and its validity and reliability were confirmed. Finally, the questionnaire was used to collect data from 261 randomly selected women in reproductive age who were visited by gynecologists or midwives in their offices. The collected data was analyzed by SPSS. Results: Overall, 14 common services which could be provided by both gynecologists and midwives were identified. Mean age of patients was 28 years and 65% of them were covered by health insurance services. Genital infection and pregnancy care were the most common causes why women referred to gynecologists or midwives. While the most common reason for choosing gynecologists was their confidence in their skills, it was the affordable fee for selecting midwifes. Midwifery patients had shorter waiting time, longer visit length and lower payment rates in all 14 services. Conclusion: The results of this study showed that spending specialists' time for common cases with longer waiting time and higher payment rate could be considered as an important source of inefficiency in reproductive health services. Therefore, development of an effective referral system from midwives to gynecologists and providing insurance coverage for midwifery services could improve the efficiency of reproductive health services and save more than 250 million dollars annually for the country.
Elaheh Azad; Saeedeh Ketabi; Iraj Soltani; Majid Bagherzade
Volume 8, Issue 7 , January and February 2012, Pages 938-947
Abstract
Introduction: Hospitals are considered as the most important resource consuming units in health sector. They are also one of the main organizations providing health services. Hence, paying full attention to the efficiency of different wards of a hospital is of great importance. The aim of this study ...
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Introduction: Hospitals are considered as the most important resource consuming units in health sector. They are also one of the main organizations providing health services. Hence, paying full attention to the efficiency of different wards of a hospital is of great importance. The aim of this study was to analyze the efficiency of different wards of Shariati Hospital, Isfahan, Iran, by the use of Data Envelopment Analysis (DEA). Methods: This study evaluated and analyzed the efficiency of clinical wards of Shariati Hospital (15 wards) in 2010 using DEA. For this purpose, input-oriented model of DEA based on variable return to scale was applied. Two inputs, i.e. number of beds and personnel, and three outputs, i.e. inpatient bed occupancy ratio, performance and activity of ward were considered. To analyze the data, "DEA-Solver" was used. Results: The results obtained from DEA showed that different wards of Shariati Hospital had at least an 8% capacity for increasing efficiency without any increased costs. In other words, the existence of surplus production was clear in the hospital. Conclusion: In the process of study, efficient and inefficient wards have been recognized. Out of 15 wards, 7 wards were efficient and the others were inefficient. For inefficient wards, reference sets were appointed based on a combination of efficient units and some suggestions for reallocating the resources to these wards.
Saeed Samadi; Minoo Nazifi Naeini; Sahar Abbaspour
Volume 8, Issue 7 , January and February 2012, Pages 948-957
Abstract
Introduction: Using neural networks and genetic algorithms in evaluating health-related variables has increased recently. Employing intelligent tools for diagnosis and treatment of diseases can reduce medical errors and human and financial losses. In this paper, medical applications of ...
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Introduction: Using neural networks and genetic algorithms in evaluating health-related variables has increased recently. Employing intelligent tools for diagnosis and treatment of diseases can reduce medical errors and human and financial losses. In this paper, medical applications of neural networks have been studied in order to help both medical and artificial intelligence researchers. Methods: We used an existing sample in SPSS (patient_los.sav). The sample consisted of patients who received treatment for heart disease. Multilayer perceptron (MLP) was employed to build a neural network to predict the cost and length of treatment. Duration of hospitalization and treatment cost were considered as dependent variables. Other variables were entered into the model as agents or factors. Results: Neural networks can evaluate the outcomes of patients who have or have not undergone surgery. Separate networks can then be used to predict treatment and hospitalization costs and duration provided that the patients who had surgery had been identified. Conclusion: Neural networks designed in this paper can well forecast the usual outcomes of patients. Multilayer neural networks can precisely identify patients who would die after surgery. Non-linear properties of neural networks can help in modeling and forecasting.
Majid Davari; Mohammadreza Maracy; Zohreh Ghorashi; Mitra Mokhtari
Volume 8, Issue 7 , January and February 2012, Pages 958-965
Abstract
Introduction: In the last decades, the increased rate of cesarean section has challenged its primary goals seriously. Many researchers showed the positive relationship between socioeconomic status and prevalence of cesarean delivery. However, it seems that the prevalence of elective cesarean ...
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Introduction: In the last decades, the increased rate of cesarean section has challenged its primary goals seriously. Many researchers showed the positive relationship between socioeconomic status and prevalence of cesarean delivery. However, it seems that the prevalence of elective cesarean is increasing in low socioeconomic classes, too. The aim of this study was to evaluate the relationship between socioeconomic status and the prevalence of elective cesarean in nulliparous women in Niknafs Teaching Centre, Rafsanjan, Iran. Methods: This cross-sectional study was carried out in Niknafs Teaching Center, Rafsanjan, Iran during 8 months. A total number of 459 nulliparous women registered in the study. A valid questionnaire was completed during a short time interview with the subjects. It included the demographic, economic, and educational status of the subjects as well as information about the delivery type. The collected data was analyzed using chi-square and Fisher's exact tests in SPSS16. Results: Five socioeconomic groups were defined as very poor, poor, fair, good, and very good. Overall, 74% of the subjects were placed in fair and lower groups. Significant relations were observed between socioeconomic status and primary elective cesarean delivery (P < 0.001) and also the final rate of cesarean delivery (P = 0.02). However, there was no statistically significant relationship between the reason of cesarean delivery and socioeconomic classes of the mothers. Conclusion: The improvement of socioeconomic status of the subjects showed a linear relationship with increased demand for elective cesarean delivery. However, this type of cesarean was also commoner than standard rates in low socioeconomic classes. This rate could impose lots of financial pressure to the health system and could be considered as a cause of inefficiency in the health care delivery system.
Nafiseh Hajrahimi; Tahereh Yaghoobi; Seyed Saeed Ayat
Volume 8, Issue 7 , January and February 2012, Pages 966-975
Abstract
Introduction: The ever-growing technology is unquestionably indispensable in today’s world. Software industry has had a quite outstanding progress in recent years. The life cycle of software consists of production and maintenance. This study aimed to determine the effective factors on costs ...
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Introduction: The ever-growing technology is unquestionably indispensable in today’s world. Software industry has had a quite outstanding progress in recent years. The life cycle of software consists of production and maintenance. This study aimed to determine the effective factors on costs of producing a health information system (HIS) software. Methods: This applied survey used descriptive analysis to evaluate 15 HISs in Isfahan University of Medical Sciences, Isfahan, Iran, during 2009. Due to the low number of available systems, all HISs were studied through a census method. A researcher developed checklist with confirmed validity and reliability (Cronbach’s α = 0.877) was used to collect data. Using frequency percentage, the most and least important factors in experts’ opinions were determined. All factors were ranked by Freidman test. Statistical analyses were performed in SPSS. Results: We found 29 factors to be effective on production costs. The factors were classified into 5 groups in each of which the most important factor was determined. Conclusion: In order to manage a software project and to obtain desirable results, a managerneeds to identify factors effective on costs and how they can influence the project.
Susan Bahrami; Saeed Rajaeepour; Mohammad Hossein Yarmohammadian
Volume 8, Issue 7 , January and February 2012, Pages 976-983
Abstract
Introduction: During the past two decades, higher education has played an important role as one of the most important elements of advanced societies in development of science, information technology and internet communications. In the knowledge-based world of 21st century, the need for ...
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Introduction: During the past two decades, higher education has played an important role as one of the most important elements of advanced societies in development of science, information technology and internet communications. In the knowledge-based world of 21st century, the need for professionals and managers is growing which in turn increases the importance of higher education in the society and the international community. This article sought to review intellectual capital components in public higher education medical and non-medical systems in Isfahan, Iran. Methods: In an analytical study, stratified random sampling was used to select 480 subjects from all faculty members (n = 1830) of Isfahan University, Isfahan University of Technology, Kashan University, and Isfahan and Kashan Universities of Medical Sciences. A questionnaire was designed according to Torres (2006). The validity and reliability of the questionnaire were confirmed by face and content validity and Cronbach's alpha (r = 0.97), respectively. Using SPSS18, data was analyzed at two levels of descriptive and inferential statistics. Results: Intellectual capital and its components, including human capital, structural capital and relational capital, in public universities of the province were lower than the average level. A significant positive relation was observed between human capital, structural capital and relational capital. Moreover, a significant difference was found between mean values of intellectual capital components of universities in terms of location and duration of experience. In fact, structural capital in universities of Isfahan was higher than other public universities in the province. Likewise, faculty members with a work experience of 1-10 years had higher structural capital than those with 11-20 years of experience. On the other hand, human capital and relational capital were higher in faculty members with more than 21 years of experience. However, differences based on other demographic characteristics were not significant. Conclusion: Using intellectual capital framework as a heuristic tool would enable universities to solve the new management problems, to disseminate intangible resources, and to cooperate with multiple stakeholders.
Saeid Karimi; ; Marzieh Javadi; Fatemeh Jafarzadeh
Volume 8, Issue 7 , January and February 2012, Pages 984-996
Abstract
Introduction: Non-communicable diseases (NCDs) annually kill over 35 million people worldwide. They are responsible for nearly two-thirds of the world's deaths. Global health is facing a dramatic change. For the first time in human history, more than 80% of NCD-related deaths are in low- ...
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Introduction: Non-communicable diseases (NCDs) annually kill over 35 million people worldwide. They are responsible for nearly two-thirds of the world's deaths. Global health is facing a dramatic change. For the first time in human history, more than 80% of NCD-related deaths are in low- and middle-income countries. Countries throughout the world are expected to lose significant amounts of national income as a result of chronic diseases. The World Health Organization (WHO) announced that NCDs are expected to threaten the lives of 25 million people across the Middle East by 2015. The increased incidence of chronic diseases and epidemiological transition phenomenon in Iran would impose the country with the economic burden of chronic disease. This study aimed to review health and economic burden caused by this global problem. Methods: This study evaluated challenges and strategies to combat NCDs through reviewing available literature in digital and printed libraries from various scientific journals and reputable websites including Center for disease Control and prevention (CDC) and the WHO. Results: NCDs kill over 35 million people each year and thus threaten the development of countries. NCDs affect the poor and vulnerable population and make them even poorer. NCDS can be controlled through preventing their risk factors and benefiting from experiences of other countries.
