نوع مقاله : مقاله پژوهشی
نویسندگان
1 دانشجوی دکتری تخصصی، مدیریت خدمات بهداشتی درمانی، گروه مدیریت خدمات بهداشتی درمانی، واحد شیراز، دانشگاه آزاد اسلامی، شیراز، ایران
2 دانشیار، مدیریت خدمات بهداشتی درمانی، مرکز تحقیقات بهره‌برداری از دانش سلامت، دانشگاه علوم پزشکی تهران، تهران، ایران
3 استادیار، مدیریت خدمات بهداشتی درمانی، مؤسسه ملی تحقیقات سلامت جمهوری اسلامی ایران، دانشگاه علوم پزشکی تهران، تهران، ایران
4 دانشیار، مدیریت خدمات بهداشتی و درمانی، گروه مدیریت خدمات بهداشتی و درمانی، دانشکده مدیریت و علوم اجتماعی، واحد تهران شمال، دانشگاه آزاد اسلامی، تهران، ایران
چکیده
مقدمه: تأمین و نگهداشت منابع انسانی سلامت در مناطق محروم، چالشی جهانی به ویژه در کشورهایی است که پراکندگی جغرافیایی بالایی دارند. هدف از انجام پژوهش حاضر، شناسایی و اولویت‌بندی سیاست‌های تشویقی نظام سلامت ایران برای ماندگاری پزشکان و پرستاران در مناطق محروم بود.روش بررسی: این مطالعه در دو مرحله مروری و کیفی انجام شد. در بخش مروری، سیاست‌ها و مداخلات نظام سلامت برای ماندگاری پزشکان و پرستاران در مناطق محروم ایران شناسایی و تدوین گردید. فهرست تدوین شده جهت اعلام نظر و تکمیل سیاست‌ها و مداخلات نظام سلامت برای ماندگاری پزشکان و پرستاران در مناطق محروم، در اختیار 18 صاحب‌نظر حوزه منابع انسانی سلامت قرار گرفت. در مرحله دوم، این سیاست‌ها با استفاده از پرسشنامه الکترونیکی توسط 44 نفر خبره اولویت‌بندی شد. داده‌های به دست آمده از پاسخنامه‌ها با استفاده از آماره‌های فراوانی، درصد و میانگین توصیف گردید.یافته‌ها: پس از انقلاب اسلامی، 8 بسته سیاستی در قالب طرح یا برنامه مشتمل بر 40 مداخله یا سیاست طراحی و اجرا شد. طرح خدمت پزشکان و پیراپزشکان، طرح پزشک خانواده، طرح توزیع فارغ‌التحصیلان رشته‌های تخصصی پزشکی و طرح تحول سلامت در ماندگاری پزشکان و طرح خدمت پزشکان و پیراپزشکان، قانون ارﺗﻘﺎی ﺑﻬﺮه‌وری کارکنان بالینی و طرح تحول سلامت بر ماندگاری پرستاران در مناطق محروم ایران، از جمله تأثیرات بیشتر و طولانی‌تری برخوردار می‌باشد.نتیجه‌‌گیری: با وجود دستاوردهایی در جذب و ماندگاری پزشکان و پرستاران در مناطق محروم، هر یک از سیاست‌ها با چالش‌ها و نارسایی‌هایی مواجه می‌باشند و قوانین و سیاست‌های مبتنی بر الزام، مشوق‌های مالی و استخدامی و طرح‌های حمایتی منطبق بر نیاز و مشارکت ذی‌نفعان بر جذب و نگهداشت پزشکان و پرستاران در مناطق محروم و کم‌برخوردار جمهوری اسلامی ایران مؤثرتر می‌باشد.
کلیدواژه‌ها
عنوان مقاله [English]
Incentive Policies for the Retention of Physicians and Nurses in Deprived Areas of the Islamic Republic of Iran
نویسندگان [English]
- Fereshteh Davari 1
- Haniyeh Sadat Sajadi 2
- Elham Ehsani-Chimeh 3
- Khalil Alimohammadzade 4
1 PhD Student, Health Services Management, Department of Health Services Management, Shiraz Branch, Islamic Azad University, Shiraz, Iran
2 Associate Professor, Health Services Management, Knowledge Utilization Research Center, University Research and Development Center, Tehran University of Medical Sciences, Tehran, Iran
3 Assistant Professor, Health Services Management, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
4 Associate Professor, Health Services Management, Department of Health Services Management, School of Management and Social Sciences, North Tehran Branch, Islamic Azad University, Tehran, Iran
چکیده [English]
Introduction: The retention of health human resources in the deprived areas is a global challenge, especially in countries with high geographic dispersion. This study endeavored to identify incentive policies for the retention of physicians and nurses in deprived areas of Iran.Methods: The study was conducted in two stages of review and qualitative. In the review stage, health system policies and interventions for the retention of physicians and nurses in deprived areas of Iran were identified. The list compiled to announce the opinion and complete the policies and interventions of the health system for the retention of physicians and nurses in the deprived areas was provided to 18 experts in the field of health human resources. In the second stage, these policies were prioritized by 44 experts using an electronic questionnaire. Data obtained from the responses were described using frequency, percentage, and mean. The compiled list was approved using the opinions of 18 experts in the field of health human resources. Second, these policies were prioritized through an electronic questionnaire by 44 experts. The data were described through frequency, percentage, and mean.Results: Following the Islamic Revolution, the Iranian health system designed and implemented eight policies, including 40 interventions, for the retention of physicians and nurses in deprived areas. Prioritization findings indicated that the Law of Service of Physicians and Paramedics, Family Physician Program, Instructions on how to distribute medical graduates, and the health transformation plan have greater and longer-term impact on retention of physicians; and the Law of Service for Physicians and Paramedics, the Law on Promoting Clinical Staff Productivity, and the health transformation plan had longer-term effects on retention of nurses.Conclusion: Although policies have been effective in attracting and retaining physicians and nurses in deprived areas, they face challenges and failures. Therefore, it seems necessary for policymakers to review the overall incentive policies, and take serious action to address program challenges by creating cross-sectional coordination, sustainable funding and cost management, and awareness of physicians, nurses and patients' preferences as well as aligning policies with their services and demands.
کلیدواژه‌ها [English]
- Policy
- Survival
- Physicians
- Nurses
- Rural Health Services
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