ایندکس
Journal Index
Volume 10, Issue 4 , November 2013
Abstract
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Original Article
Sayed Masoud Shajari Pour Mosavi
Abstract
Introduction: This study has researched revenue cycle in emergency department (ED) of Kashani educational hospital in Isfahan in 2009 (1388). In revenue cycle, the point which has not added value was measured in IS MAP by research team, that composed of the own personnel with different level of skills ...
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Introduction: This study has researched revenue cycle in emergency department (ED) of Kashani educational hospital in Isfahan in 2009 (1388). In revenue cycle, the point which has not added value was measured in IS MAP by research team, that composed of the own personnel with different level of skills and knowledge. In the next phase of research, the team designed SHOULD MAP and COULD MAP with study of added value in sub process and points in IS MAP. The goal of the study was identification, measurement, and improvement of ED IS MAP and converted to SHOULD or COULD MAP. Methods: This study was a qualitative study in type of action research and performed by the recommended 8th phase methodology of HFMA (Heath Care Financial Management Association) for improvement revenue cycle of ED process. Results: The result of this study composed of 8 goals which have described the details in the final report. It was included of determining: ED flowchart, ED flow diagram, ED process analysis, ED cost centers, ED revenue centers, centers which need to improve, methods which decrease cost, methods which increase revenue. Conclusion: This study had the effect on quality care in ED for achievement to Do it right, DO right things every time. Keywords: Emergencies; Income; Added Value; Hospitals
Original Article
Izet Masic; Rusmir Baljic; Jasmin Alajbegovic; Sebija Izetbegovic
Volume 10, Issue 4 , November 2013, Pages 528-537
Abstract
Introduction: With all the progress that is happening today in the field of medicine, the biggest benefit is the possibility of using modern information technology. Medicine today is characterized by widespread use of new information and communication technologies (ICT) - mobile phones, teletext, fax ...
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Introduction: With all the progress that is happening today in the field of medicine, the biggest benefit is the possibility of using modern information technology. Medicine today is characterized by widespread use of new information and communication technologies (ICT) - mobile phones, teletext, fax and electronic mail (e-mail). Global computer network allows access to a number of databases with bibliographic, epidemiological, image and other information, which increasingly emphasizes the importance of the application of the Internet in medicine. Systems to assess health status, to diagnose diseases and systems to support clinical practice have become available over the Internet. Methods: The survey was conducted among the students of the sixth year of the Medical Faculty of the University of Sarajevo, generation of 2009/10 and 2012/13, through specifically created questionnaire. The questionnaire was entirely anonymous. The questionnaire consists of five classes of data that are consisted of created relevant variables from the first author of this article. For evaluation of opinions modified Likert scale of measurement was used. Results: Student feedback on what should be added to the teaching in the field of Medical Informatics is such that students in 2008/09 twice as much thought that there should be more practical work on PC, more education via the Internet and distance learning is present in 2012. Students from both surveys agree that they should improve their knowledge about the databases, but in 2009 there was even twice more students than there is today which considered that they need to improve their knowledge about MS Office and Internet. As the future of information technology students listed in both surveys using the Internet, followed by the databases and multimedia applications. Conclusion: Easier access to useful biomedical information is provided in almost every part of the planet Earth, as to users of health care (patients), as well to physicians and other health care personnel in health institutions. They all have the power to quickly and easily collect and share information from their local and wider environment. Keywords: Medical Informatics; Information Technology; Knowledge, Attitudes, Practices; Schools, Medical; Students
Original Article
Mahmoud Keyvanara; Saeed Karimi; Elahe Khorasani; Marzie Jafarian jazi
Volume 10, Issue 4 , November 2013, Pages 538-548
Abstract
Introduction: Induced demand is one of the challenges of health care systems in different countries. It increases health care costs and also increases catastrophic cost index. This article seeks to examine the challenges of induced demand with the use of expert’s experiences of Isfahan University ...
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Introduction: Induced demand is one of the challenges of health care systems in different countries. It increases health care costs and also increases catastrophic cost index. This article seeks to examine the challenges of induced demand with the use of expert’s experiences of Isfahan University of Medical Sciences. Methods: The research is applied a qualitative method which done in Isfahan in 2012. Semi-structured interview was used for data gathering. For validity and reliability criteria such as data reliability of information and stability were considered. Participants in this study were people who had been informed in this regard and had to be experienced and were known as experts. Purposive sampling was done for data saturation. 17 people were interviewed. The anonymity of the interviewees was preserved. The data are transcribed, categorized and then used the thematic analysis. Results: In this study thematic analysis was conducted and 41 sub-themes and three themes were extracted. The three main themes include insurance organizations challenges, health systems challenges and patient’s challenges. Each of them has some sub-themes. Conclusion: the results of this study provide challenges due to induced demand. The most notable findings include insurance organizations challenges, health care system challenges and patient challenges. These findings will help health policymakers consider challenges to design appropriate strategies to reduce them. Keywords: Healthcare; Healthcare System; Insurance; Patients; Healthcare Costs
Original Article
saeed karimi; Sima Nejadlabbaf; Taha Nasiri; lida shams
Volume 10, Issue 4 , November 2013, Pages 549-557
Abstract
Introduction: Using economic principles and after that evaluating economical operation of hospitals cause the correction of procedures and continuation of activities and provide economic managing of hospital’s industry. The aim of this study was estimation production function in selected public ...
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Introduction: Using economic principles and after that evaluating economical operation of hospitals cause the correction of procedures and continuation of activities and provide economic managing of hospital’s industry. The aim of this study was estimation production function in selected public hospitals of Isfahan University of Medical Sciences to assessment economical behavior of these hospitals in use of resources. Methods: This study was a kind of application studies that perform in descriptive-analytic manner in 2011. In this study bilateral logarithmic Cab-Douglas production function used to assessment economical behavior of hospitals. Research society was 5 selected military hospitals of Isfahan University of Medical Sciences. Data collected in form of Panel (Composition of cross-sectional and time series) for a 6 years period by survey method. Finally EVIEWS 5 econometrical software used for estimation the model. Results: study findings showed that active beds (0/91), nurse (0/11), physician (0/01) and other personnel (0/008) inputs respectively have greater impact on production (number of Inpatient admission) of hospitals. The Coefficient of all inputs -except hospital beds- were significant (P<0.05). All of inputs were in economic area. Amount of appointment coefficient were in excellent range (R2=0.98). Summations of coefficients were more than 1 that shows increasing return to scale. Conclusion: the findings show great important of bed in rise of production (number of Inpatient admission). Thus the productivity of beds is high in hospitals and the greater role for production of hospital (number of inpatient discharge). Also we can say use of current hospitals capacity and investment in increasing production inputs can be an effective solution rather than building new hospitals because of increasing return to scale. Keywords: Economics, Hospital; Economics, Behavioral; Hospitals
Original Article
Nooshin Mohebbi; Mohammad Hossein Yarmohammadian
Volume 10, Issue 4 , November 2013, Pages 558-570
Abstract
Introduction: Evaluation is a systematic process for collecting, analyzing and interpretation of the obtained information for the purpose of investigating how many the objectives in mind can be achieved. Education in an academic educational system means bringing about proper and increasing changes that ...
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Introduction: Evaluation is a systematic process for collecting, analyzing and interpretation of the obtained information for the purpose of investigating how many the objectives in mind can be achieved. Education in an academic educational system means bringing about proper and increasing changes that affect the outcome of this system, that is affecting the students, and the aim of such evaluation was promotion of the quality of an education process. This study developed and reviewed the evaluation criteria of health information technology course at Master of Science level in Tehran, Shahid Beheshti, Isfahan, Shiraz and Kashan medical sciences universities in 2012 based on CIPP model. Methods: This was an applied and descriptive research with statistical population included faculty members, students, graduates and library staff of health information technology course at Master of Science level in Tehran, Shahid Beheshti, Isfahan, Shiraz and Kashan medical sciences universities in 2012 (130 people in total). In order to collect data four questionnaires were used based on Likert scale rating. Questionnaires' validity was confirmed by consulting with experts and questionnaires' reliability of directorates, faculty, students and library staff through the Coronbach's Alpha coefficient formula calculated α= 0.74, α= 0.93, α= 0.98, α= 0.80, respectively. SPSS software for data analysis and descriptive statistics were used. Results: 139 indicators were determined and then evaluated which associated with this course based on three factors of context, input, process in the areas of human recourses professional, academic services which are required for the society, students, directors, faculty, curriculum, budget, facilities, teaching- learning activities and scientific research activities of students and faculty, and the activities of the library staff. Conclusion: Results showed that in total the health information technology course at Master of Science level is relatively well, but trying to improve and correct it in some areas, and continuing of evaluation process seems necessary. Keywords: Indicators; Evaluation; Health Information Technology
Original Article
Ali Sanayei; Javad Khazaei Pool; Sajad Jafari; Hadi Balouei Jamkhaneh
Volume 10, Issue 4 , November 2013, Pages 571-580
Abstract
Introduction: Prerequisite for implementing telemedicine for providing medical services and health is its acceptance. The overall objective of this study was investigating the factors that influence the adoption of it with using ICT. Methods: method of this study was Analysing and data collection instrument ...
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Introduction: Prerequisite for implementing telemedicine for providing medical services and health is its acceptance. The overall objective of this study was investigating the factors that influence the adoption of it with using ICT. Methods: method of this study was Analysing and data collection instrument was combination of Theory of Planned Behavior and the Technology Acceptance model questionnaires. The present population of the study was physicians in Isfahan hospitals and 125 of them were selected as sample with classification random sampling. The validity of the model was performed by structural equation modeling method. For data analysis used software was SPSS19 and AMOS20. Results: Results show that perceived usefulness (β= 0.54) and perceived ease (β= 0.43) was effective on attitude toward telemedicine usage. The findings also shown a positive effect of perceived usefulness (β=0.61) and perceived behavioral control (β=0.39) on people's tendency toward this type of technology While the effect of subjective norm (β=0.18) on behavioral intention had not confirmed. Conclusion: The results suggest that the technology acceptance model and theory of planned behavior can predict people intention in application of telemedicine. Keywords: Telemedicine; Technology; Health Care; Hospitals
Original Article
Masoud Taghvaie; Elaheh Zakeri
Volume 10, Issue 4 , November 2013, Pages 581-591
Abstract
Introduction: In most cities, the proportional allocation of space, the optimal switching elements and services Physical and city services, especially health services (hospitals and clinics) and factors affecting the location of these centers, increasing urban problems for citizens. Our aim in this paper ...
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Introduction: In most cities, the proportional allocation of space, the optimal switching elements and services Physical and city services, especially health services (hospitals and clinics) and factors affecting the location of these centers, increasing urban problems for citizens. Our aim in this paper was to determine the allocation of health care services in deprived areas is the priority. Methods: Analytical methodology was used and the population of research was the health services centers (hospitals and clinics) at Isfahan in 2011. Field method is used for data collection. The possibilities of using geographic information system (GIS) and the radius of the function a land spatial distribution of hospitals, clinics and analysis-analyzing data and using the overlap index was attempted in this city. And finally to rank areas of the tactics used Tapsis Results: The differences between the three regions of Isfahan in hospital services and clinics there. Conclusion: Results showed that the services in Isfahan are adequate, but there is not good spatial distribution. . Keywords: Geographic Information Systems; Health Services; Hospitals
Original Article
maryam yaghoubi; Zahra Agha Rahimi; Marzieh Javadi
Abstract
Introduction: Importance of productivity and optimal use of limited resource in hospitals is considered as the most important mission of health care centers. This study was done to determine effective factors about productivity index in Noor and Ali Asghar hospital in Esfahan base on hierarchical analysis ...
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Introduction: Importance of productivity and optimal use of limited resource in hospitals is considered as the most important mission of health care centers. This study was done to determine effective factors about productivity index in Noor and Ali Asghar hospital in Esfahan base on hierarchical analysis technique. Methods: This is a descriptive -cross sectional study in 2010, in the hierarchical analysis process technique. The study population was Manager, Administrator, Supervisor, nursing managers, management of productivity in Noor and Ali Asghar hospital. Data collection tool was the paired comparisons questionnaire which formulated with the experts and scholars in this field (validity). Data analysis was done by Expert Choice software. Results: In relation to length of stay, patient discharge in weekend (0.566) had the most weight. In bed occupancy ratio index, timely professionals visit had the highest effect (0.169). Related to bed performance index, timely professionals visit (0.210) with the most Geometric mean had the highest effect. And finally in bed- days cost index, consumer and investment cost had the highest weight (0.159). Conclusion: According to effective factor on productivity indicator in hospital, Develop continuing education programs for health professionals, the appropriate triage in the emergency department, hospital equipment maintenance management and hospital cost effective implementation strategies is proposed. Keywords: Productivity; Hospitals; Hierarchical Analysis Process Techniques (AHP)
Original Article
Ahmad Reza Raeisi; Mohammad Hossein Yarmohammadian; Roghayeh MohammadiBakhsh; Hamid Gangi
Volume 10, Issue 4 , November 2013, Pages 601-610
Abstract
Introduction: The application of balanced scorecard is growing in public health and nonprofit organization. This model is a conceptual framework for formulating a set of performance indicators in line with strategic objectives. One of the key principles of the balanced scorecard process is to identify ...
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Introduction: The application of balanced scorecard is growing in public health and nonprofit organization. This model is a conceptual framework for formulating a set of performance indicators in line with strategic objectives. One of the key principles of the balanced scorecard process is to identify those indicators that accurately measure the strategies to achieve. The purpose of this study was to determining the performance indicators of Al-Zahra Hospital of Isfahan University of Medical Sciences based on Iranian BSC model. Methods: This is a qualitative research study that was conducted in Al-Zahra academic medical center at Isfahan University of medical sciences in 2011. The research populations are hospital managers at different levels. Sampling method is purposive sampling in which the key informed personnel participated in determining the performance indicators of hospital selected as the BSC team members at focused discussion groups. By the focused group discussion meetings, hospital performance indicators were developed and finalized and then these indicators were classified and placed in balanced scorecard perspectives. Research tool for information gathering was a checklist that designed based on research indicators and proposed indicators by Al-Zahra hospital which The construct and content validity of the checklist were confirmed several times by reviews and by the help of research supervisors, consultant and senior hospital administrators. Data analyzing was conducted using quality content analysis method. Results: Balanced scorecard of this center was determined in four perspectives: patients and community (customer), internal processes, learning and growth and financial perspectives, and then indicators were defined for each perspective. Total number of balanced scorecards indicators was 30 cases that most indicators respectively finalized in internal processes and learning and growth perspectives. Conclusion: Balanced scorecard offers a tool to translate organizations mission into tangible and measureable goals, activities and performance indicators. Success of balanced scorecard is due to careful selection of indicators that contain main essence of the organizations strategy. Categorizing indicators in four perspectives are very useful in improving hospital performance level. Therefore continuous monitoring and evaluation of these indicators are required in line with achieving hospital goals and strategies. Keywords: Balanced Scorecard; Performance Evaluation; Hospitals
Original Article
Masuod Ferdosi; Ali Nemati; Payman Farjadfar; Yousef Masuodian
Volume 10, Issue 4 , November 2013, Pages 611-618
Abstract
Introduction: Out of pocket payments (OOP) as a kind of financial resources in health systems has regressive effects on health status, equity and both qualitative and quantitative health system performance indicators. Higher health expenditures and higher OOP may lead to more people fall in poverty or ...
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Introduction: Out of pocket payments (OOP) as a kind of financial resources in health systems has regressive effects on health status, equity and both qualitative and quantitative health system performance indicators. Higher health expenditures and higher OOP may lead to more people fall in poverty or decrease their accessibility to health services. Unfortunately this could be found more among poor people whom need more protection. This study aimed to reveal if social security organization (SSO) wants to protect their insured people from higher amounts of OOP (bills more than 100 million Rials) how it would affect cost coverage of other people assuming fixed total cost of all bills for SSO. Methods: That was a cross sectional study on Isfahan hospital bills for inpatients of SSO during 2008. Sampling method was cluster sampling. We studied 2430 hospital bills and copayment paid directly by patient. The data were collected by Finance information form. The form was a standard so it is the reliable and valid. Data analyzed with Excel software and descriptive statistics. Results: Now SSO covers around 90% of hospital bills for its insured patients regardless of bill amount. Our calculations according to before mentioned show that SSO should pay less to low cost bills through one of these scenarios: First: for all bills fewer than 10 million Rials, covering 43% of costs. Second: for all bills fewer than 20 million Rials, covering 77% of costs. Third: for all bills fewer than 100 million Rials, covering 86% of costs. Conclusion: Findings show that social security organization by using Variable Copayment in different manners could protect individuals with high health expenditures and protect households against catastrophic costs.Key words: Hospitals; Social Security; Costs
Original Article
Saeed Rajaeepour; Susan Bahrami; Azam Kamali DolatAbadi; Ahmad Shabani
Volume 10, Issue 4 , November 2013, Pages 619-626
Abstract
Introduction: Universities are the main institutions that create knowledge capital in the employees and can support the knowledge-based economy. The aim of the present study was to investigate the correlation between the degree of knowledge management constituents’ application and educational performance ...
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Introduction: Universities are the main institutions that create knowledge capital in the employees and can support the knowledge-based economy. The aim of the present study was to investigate the correlation between the degree of knowledge management constituents’ application and educational performance in faculty members at Isfahan University of Medical Sciences. Methods: The type of research is descriptive, correlative. Statistical society includes all faculty members (643) and students (7,006) in the 2011-12. A sample size of faculty members (240) and students (1120) were selected through stratified random sampling. The measurement instrument included the research questionnaires of knowledge management and educational performance. The questionnaires' face & content validity were confirmed and their reliability calculated using Cronbach's alpha (r1=0.87, r2=0.92). Data analyzed in two descriptive and inferential levels. Results: The results of the study indicate that there was a significant multiple correlations between knowledge management and educational performance. Beta coefficients among strategic knowledge management and educational performance were significant and no autocorrelation existed and regression model were significant. Members' comments on relationship between knowledge management according to demographic characterizations were not the same but between educational performances there were significant difference. Conclusions: Knowledge management as a key tool for managing in the new century is systematic strategy and processes of define, access, transfer and application of knowledge by training organizations is that lead to innovation, competitiveness and productivity. Beside of problem solving, the decision making, strategic planning, and active learning deterioration prevent of intellectual assets and enhance the knowledge of educational organizations and increase their flexibility. Keywords: Knowledge Management; Performance Assessment; Faculty Members; Universities
مقاله مروری نظام مند
Maryam Okhovati; Reza Akbarnejad; Kambiz Bahaadinbeigy
Volume 10, Issue 4 , November 2013, Pages 627-644
Abstract
The aim of each information retrieval is to present relevant information to the right user at the right time. Images as a kind of information can convey a large volume of information. In medicine, the most common use of images is in education, research and medical diagnosis. This wide variety of usage ...
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The aim of each information retrieval is to present relevant information to the right user at the right time. Images as a kind of information can convey a large volume of information. In medicine, the most common use of images is in education, research and medical diagnosis. This wide variety of usage refers to the uprising importance of imaging through various fields of medicine. Therefore, current advances in medical imaging techniques and frequent use for example, in decision making systems and evidence-based medicine depicts the high necessity of medical images retrieval. This paper introduced text-based and content-based image retrieval systems, the application of the image systems especially in medicine. Some existing systems are described. Finally it was suggested although images have some features different from texts but some techniques in text retrieval such as artificial intelligence and relevance feedback can be used to improve the image retrieval systems. Keywords: Medical Information Storage and Retrieval; Medical Illustration; Information Retrieval Systems
