نشریه مدیریت سلامت
پیاپی 15 (بهار 1383)

In the new millennium people face many serious challenges in health care including an upward trend in non contagious disease. Cardiovascular diseases, cancer, and diabetes have had a bigger share respectively. Since cancer mostly develops (come on) in later life considering the young population of our country and an increase in life expectancy, there is an anticipation that the development of this disease would be on the rise with great momentum.

Despite promising trend in improving many aspects of health care and treatment in the last decade in our country, little attention has been paid to the subject of registering cancer on an international standard. Effective practical research specially in etymology, materialization of prevention objectives, screening programs in the country's healthcare and treatment policy and the evaluation of the efficiency of their strategies would materialize when the national cancer registration policy is established and it's data are collected and compleied on time.

This purpose of this comparative cross sectional research was to study the national cancer registration system of England, Denmark, Malaysia and Iran and propose a suitable model for Iran in the year 2003-4.

Method of the study: With the help of library resources, internet, consultation with foreign and domestic specialists, national cancer registration system of England, Denmark and Malaysia were evaluated, to suggest a model for the country which would take into consideration the economical, cultural and geographical condition of the country. This method in three phases was put in to trial with the help of DeIfy approach. For the first and second phase a questioner was prepared and the third stage of this trial was carried out in session with the participation of specialists to evaluate. The third model and after analytical work, the final model was presented.

Cancer registration and reducing the costs Findings reveal that in order to optimize the infrastructure of cancer registration including data elements, registration criteria, information gathering process, classification and control mechanism of the current national cancer registration should be reevaluated, the results of comparison of cancer registration systems of selected countries are shown in twelve tables and the proposed model is shown in two diagrams.

Challenges relating to expense and quality, has induced an atmosphere in a way that decision makers at all levels are investigating for objective data to evaluate healthcare organizations.

Since medical records documents the care of patients, and are considered to be the first yard stick to evaluate the care rendered to the patients, this essential that they follow certain rules and regulations, so that the quality of services offered by this department be compatible and durable according to evaluative standards.

Research method:

In a descriptive comparative study and with the assistance of fax, internet, and email standards of medical records in the United States, Australia, and Canada were gathered and compared with the Iranian standards.

Research findings show that the Iranian ministry of health science, and medical education has taken in to consideration the minimum standards relating to medical records policies and procedures. All countries under study except Iran had standards for education and professional development.

Iran is the only country that the use of computer, and other technological gadgets were used without definiting its objective for use.

Discussion and

With a glimpse at the importance of the role that standards play in facing the expense and quality challenge in today's health care system, it is essential that medical Records as part of the system, abide by a standard and efficient system. But due to the constraints available standards prescribed by the ministry, the need to implement a standard system by the experts see use eminent.

Occupational injuries and their related mortality are seen more in the middle-aged people. In the cycle of production Human being has an important role but cannot be considered as like other consumable products a commodity. The attempt to decrease occupational injuries has been an everlasting effort of man kind. The aim of this research is to study the costs of insured population who are deceased due to occupational injuries in Tehran.

This Study was done in 1382. Data of Years 1378-80 were used. The study populations were all insured people died due to occupational injuries in Tehran province. Required data were gathered through a check - list from different department of Social Security Organization. The Data were analyzed by Excel and a Specially designed software packages.

During the research period, 19.8% of occupational injuries occurred among people under social security insurance plan in Tehran province. 3.1 %of these injuries resulted in death. Occupational injuries have destroyed more than 7552 years of lost life span. And 3656 years of economical contribution in Tehran. The human costs were more than 777 billion rials. Yearly human cost for each death is estimated at 3.3 Billion rials. Data analysis showed that this amount equals 0.03% of total GNP.

Decision makers and responsible authorities have to detect factors decreasing occupational injuries and increasing safety coefficients in working environments.

The present Study entitled " Assessment of effective factors for job motivation of line personnel in hospitals affiliated with Shiraz University of Medical Sciences" was carried out in year 2001. Regarding To importance of manpower in heath care systems and that manpower is the most valuable source of hospitals, motivating this source for more efficiency and effectiveness is very important.

this research was a Cross- Sectional study and specific objectives were appointment of motivation factors priority from personnel' sidea and comparison among these factors with a view to job and demographic variations. Data was collected by questionnaire. Sampling was systematic random form and sampling ratio was about 10 percent.

After collection of data, among nine motivating factors, three factors all gained more than 80 percent of motivating score and selected as the most important factors. These. factors were "Good Communication and work Relations" "Suitable Salary and Benefits" and "Organizational Security and Justice" .Significant relations between motivating factors and some demographic factors acquired.

According to psychological and organizational behavior principles and regarding to result, The first three factors hadn't been met and personnel had too need for them.

Information documented in the medical records includes demographic Factors, history, examinations and treatment. Information documented in the health record file has impressive Effect on the quality of care and treatment of patients. The pieces of information concerning patients who need operation are completed in special operation sheet that should be exact, on time and complete. 

The present study was carried out by a cross-sectional method during the spring of 2003 to compare the completion of special operation sheets among two medical teaching hospitals (Imam Khomeini and Motahari) affiliated to Uromia University of Medical Sciences. In this study special operation sheets of 200 files in every hospital (total 400 files) were reviewed. The collected data were analyzed by SPSS program and using Chi square and T tests. 

the proportion of items completed on the pre- operation care sheet, anesthesia sheet, operation report sheet and recovery room sheet subsequently %66, %42, %79 and %65 in the hospitals. Overall special operation sheets in Imam Khomeini hospital were more complete than Motahari Hospital (%69 versus %59).

Discussion and conclusion:

low proportion of sheet completion in the hospitals studied necessitates the use of electronic record systems, medical record university graduates, motivating efficient person. and conducting workshops to upgrade the completeness and accuracy of documentations of information in files.

for developing the efficiency and effectiveness of the health 0services, the paper files, because of their numerous limitations, have to be displaced with the electronic records which have many advantages. This research was done for introducing the efficiency and effectiveness of the most advanced electronic records available in the industrial health during the years 1381-1382.

Collecting the information was done with the library study and using the Internet and E-mail. Review of the studies: the interpretation Connected with the computer. Use for the clinical data, begun in 1950.

In this article the EHR, EPR, EMR systems will be presented which are the most important and available electronic records. The inspections have shown that with the electronic records besides the diminution of mortality and the expenses related to diagnosis and cure, have saved % 15 in the consumption of the paper and producing the papery- forms. 51 % in the medical copying expenses and 65% in the archives expenses and refunding the information of the medical records.

To invent one propitious electronic record system in our Country, we advise to search very intensively the electronical systems, available in the whole world, and from now on with training all health Personnel, we can prepare a propitious condition to use these systems.

for developing the efficiency and effectiveness of the health 0services, the paper files, because of their numerous limitations, have to be displaced with the electronic records which have many advantages. This research was done for introducing the efficiency and effectiveness of the most advanced electronic records available in the industrial health during the years 1381-1382.

Collecting the information was done with the library study and using the Internet and E-mail. Review of the studies: the interpretation Connected with the computer. Use for the clinical data, begun in 1950.

In this article the EHR, EPR, EMR systems will be presented which are the most important and available electronic records. The inspections have shown that with the electronic records besides the diminution of mortality and the expenses related to diagnosis and cure, have saved % 15 in the consumption of the paper and producing the papery- forms. 51 % in the medical copying expenses and 65% in the archives expenses and refunding the information of the medical records.

To invent one propitious electronic record system in our Country, we advise to search very intensively the electronical systems, available in the whole world, and from now on with training all health Personnel, we can prepare a propitious condition to use these systems.

The core requirement of successful and first- in- class organizations is doing right things and doing things right. Recent organizations should be able to have excellent performance from strategic and operational point of view so that they can face the current and future world challenges. Performance measurement is one of the ways for directing organization to the right targets and avoiding diversity in practices. The effective perfOlmance measurement will result in accountability and responsiveness and make it possible to maximize the utilization of limited and available resources. In this paper some of the dimensions and frameworks for performance measurement are presented and reviewed then a conceptual framework has recommended for determining performance dimensions and indicators.

This article has writed based on literature review method.

Literature review: In this paper after presenting scant history of performance measurement and characteristics of traditional models of performance measurement, following models have been introduced Balanced Scorecard in Trusts Hospitals in National Health System and The Ontario Hospitals Association, The resultants and determinants framework (RDF), Danish model, Montreal university, The experience of the "Quality Indicator Project" (QIP, USA), The NHS Performance Assessment Framework (PAF), WHO framework. 

Reviewing models and frameworks based on suggested principles indicate that every one have strengths and weakness, but in hospital PM should be considered all performance areas. So that, when performance is reviewed, theoretical and organizational features of hospital should be understood. In the end of this paper the conceptual framework is proposed that, in addition of focus on customer/patient oriented goal and strategies, measures performance of input, structural and managerial systems, output and organizational outcome and present a comprehensive and balanced picture of hospital.