عوامل عملکردی– اطلاعاتی مؤثر در یکپارچگی نظام سلامت

نوع مقاله : مقاله پژوهشی

نویسندگان
به‌یانه سیدامینی 1
لیلا ریاحی 2
محمود محمودی مجدآبادی‌فراهانی 3
سید جمال‌الدین طبیبی 4
ایروان مسعودی اصل 5
1 دانشجوی دکتری، مدیریت خدمات بهداشتی و درمانی، گروه مدیریت خدمات بهداشتی و درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
2 استادیار، مدیریت خدمات بهداشتی و درمانی، گروه مدیریت خدمات بهداشتی و درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
3 استاد، آمار زیستی، گروه مدیریت خدمات بهداشتی و درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
4 استاد، برنامه‌ریزی و توسعه آموزش عالی، گروه مدیریت خدمات بهداشتی و درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
5 دانشیار، مدیریت خدمات بهداشتی و درمانی، مرکز پژوهش‌های مجلس شورای اسلامی، تهران، ایران
10.22122/him.v15i3.3591
چکیده
مقدمه: یکپارچگی نظام سلامت منافع زیادی برای بیماران، ارایه‌دهندگان و نظام سلامت دارد. تحقیق حاضر با هدف شناسایی متغیرهای عملکردی و اطلاعاتی مؤثر بر یکپارچگی نظام سلامت ایران در سال 1396 صورت گرفت.روش بررسی: این مطالعه از نوع توصیفی- پیمایشی بود که در دو بخش کلی انجام شد. در بخش اول، با بررسی ادبیات پژوهش و مصاحبه با متخصصان عرصه بهداشت و درمان، مهم‌ترین مؤلفه‌های یکپارچگی نظام سلامت استخراج گردید. در بخش دوم، داده‌های حاصل از بخش اول جهت تدوین الگوی یکپارچگی مورد استفاده قرار گرفت و متغیرهای طراحی پرسش‌نامه پژوهش آماده شد. الگوی به دست آمده از طریق نظرات متخصصان و تحلیل عاملی اکتشافی و تأییدی اعتبارسنجی گردید. داده‌های مورد نیاز برای تحلیل عاملی، از طریق توزیع پرسش‌نامه میان 506 نفر از متخصصان بیمارستان‌های پنج استان در ایران جمع‌آوری شد و در نهایت، با استفاده از آزمون تحلیل عاملی تأییدی مورد تجزیه و تحلیل تحلیل قرار گرفت.یافته‌ها: بر اساس نتایج تحلیل عاملی اکتشافی، «مدیریت اطلاعات» در بعد عملکردی- اطلاعاتی با بار عاملی 665/0، بیشترین اهمیت را به خود اختصاص داد. با توجه به ضرایب استاندارد تحلیل عاملی تأییدی، میزان تأثیر عامل عملکردی- اطلاعاتی در یکپارچگی، 95/0 بود. همچنین، «وجود سیستم ارجاع»، «وجود سیستم پشتیبانی تصمیم‌گیری»و «مدیریت منابع مالی» با بار عاملی 79/0، بیشترین اهمیت را در یکپارچگی نظام سلامت داشتند.نتیجه‌گیری: نظام سلامت می‌تواند از طریق مدیریت منابع مالی، انسانی و اطلاعاتی و توسعه سیستم‌های اطلاعاتی و پرونده‌های سلامت الکترونیکی و سیستم نظارت بر عملکرد، پشتیبانی لازم را برای یکپارچگی نظام سلامت به عمل آورد و اطلاعات بالینی، مالی و مدیریتی را در راستای بهبود کیفیت مراقبت، ادغام نماید.

کلیدواژه‌ها

عنوان مقاله English

Functional-Informational Factors Affecting Health System Integration

نویسندگان English

Bayaneh Seyedamini 1
Leila Riahi 2
Mahmoud Mahmoudi-Majdabadifarahani 3
Seyed Jamaleddin Tabibi 4
Iravan Masoudi-Asl 5
1 PhD Candidate, Health Services Management, Department of Health Services Management, Sciences and Research Branch, Islamic Azad University, Tehran, Iran
2 Assistant Professor, Health Services Management, Department of Health Services Management, Sciences and Research Branch, Islamic Azad University, Tehran, Iran
3 Professor, Biostatistics, Department of Health Services Management, Sciences and Research Branch, Islamic Azad University, Tehran, Iran
4 Professor, Planning and Development in Higher Education, Department of Health Services Management, Sciences and Research Branch, Islamic Azad University, Tehran, Iran
5 Associate Professor, Health Services Management, Majlis Research Center, Tehran, Iran
چکیده English

Introduction: Integration in the health system has many benefits for patients, providers, and the system itself. This research was conducted to determine the functional and informational variables affecting the integration of Iranian health system in period of years 2017-18.Methods: The present exploratory study was conducted in two phases. In the first phase, factors affecting health system integration were extracted from the literature as well as from interviews with experts in healthcare administration. In the second phase, data from the first phase were integrated, and a model of health system integration was designed resulting in a researcher-made questionnaire. The model was validated through qualitative (i.e., expert opinion), and quantitative (i.e., exploratory and confirmatory factor analysis) approaches. The data were collected from 506 specialists in hospitals in 5 provinces of Iran. Exploratory and confirmatory factor analysis was used to analyze the data.Results: According to the results of exploratory factor analysis in the functional-information dimension, "information management" was the most important item with 0.665 of factor load. Regarding the standard coefficient of confirmatory factor analysis, the effect of the functional-information factor on integration was 0.95. The existence of a referral system, the existence of a decision supporting system, and the management of financial resources, also had the greatest importance in the integration of the health system with 0.79 of factor load.Conclusion: The health system can provide the necessary support for health system integration through management of financial, human, and information resources, as well as the development of information systems and electronic health records, and performance monitoring. It can also integrate clinical, financial, and management information in order to improve the quality of care.

کلیدواژه‌ها English

Systems Integration
Integrated Health Care Systems
Integrated Advanced Information Management Systems
Healthcare Systems
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