نشریه مدیریت سلامت
پیاپی 29 (پاییز 1386)

Abstract Hospital is known as an important and the most costly performing unit of health care systems, therefore, economic analysis of this unit is very important This study designed to estimate hospital production function in Orumieh Medical Sciences University hospitals. for this study 16 hospitals were studied. We used panel data for estimation of mentioned function, data were gathered from 2000 to 2006. A double- logged form of the Cobb-Douglas production function has been estimated. The dependent variable is inpatient admissions, the explanatory variables that are included are the umber of doctors, nurses, beds, other staffs and average length of stay (ALOS). As a result of study the elasticity of doctors is EY. P =1.08, the elasticity of nurses is EY. N =3.4, the elasticity of beds is EY. B =1.4, and the elasticity of other staffs is EY. P P =2.8. There was not significant correlation between ALOS and the number of admission. The marginal production of inputs are MPP =391, MPN=244, MPB=103, MPP P =273, and, there is an increasing return to scale. Also, we have investigated MRTS1 between production factors. Results of this study show that, the maximum elasticity is attributable to the number of nurses and then respectively to, other staffs, beds and doctors. The marginal production of inputs shows an important role of doctors in production. The decision makers, in critical circumstances can substitute inputs with considering MRTS between inputs. There is an increasing economic of scale and in long-term there will be a monopolistic competition market, therefore, for achievement to equity issue, the intervention of government in this hospitals market is necessary.

Abstract patient's satisfaction indicates the accurate care providing, and is considered as an important indicators of health care quality. Patient's satisfaction with admission services is quite important. This study aimed at determining the level of consumer's satisfaction with admission services and its related determinants in teaching hospitals affiliated to Kashan University of Medical Sciences. In this descriptive-analytic study, 384 patients or their relatives were interviewed using a questionnaire. Data analysis was done through descriptive and analytic statistics such as: percent, means, SD, t-test, X2 and ANOVA test. Totally 46.2% the consumer's perceived services of admission unit good. They were completely satisfied with the waiting time (8.03ｱ1.43 points of 10), and with the staff behavior (15.78ｱ2.9 points of 20). They were also satisfied with the staff's responses to their questions (14.6ｱ2.7 points of 20), and with equity in admission turn (4.41ｱ1.6 points of 10). Satisfaction was significantly related to patient's job, length of stay and sex. Also patient's satisfaction with staff's responses was significantly less than from that of their relatives (p<0.05). Generally, patients or their relatives were satisfied with admission services. Of course, the admission staffs could response better to satisfying their questions, especially on consent forms, pay more attention to females, and old patients as all theses will lead to more the patient's satisfaction.

Abstract It is very important to use fundamental of total quality management in medical record department as a part of hospitals which their action has a tremendous affect on performance, evaluation, and upgrading the quality and quantity of health care activities in hospitals. The research were done with the idea of measurement of the rate of applying fundamental of total quality management in medical record departments of Iran University of Medical Science's teaching hospitals to report suggestions for upgrading the department performance. This is a descriptive cross- sectional study were done in 2004. The study population is all personnel of medical record departments of Iran University of Medical Science's teaching hospitals and data were collected by a questionnaire and were analyzed by SPSS. Our findings showed that in medical record departments of Iran University of Medical Science's teaching hospitals only the concept of" raise and reward "was worst between the nine sections of total quality management. According to the out coming results, it is clear that some activities must been arranged to improve group and personal participation, training workshops periodically, collection, analyzed, and evaluation of customer's point of view and redesign different medical record department.

Abstract One of the most effective factors on increasing effectiveness, efficacy and ultimately productivity, is the organizational manager styles. Due to every organization has unique condition it needed and its own management skills, manager's knowledge of the patterns and management theories, makes their job much easier and causes their organizations successes. Main objective of this study is finding different methods of the management in teaching and non teaching administrators in Kerman University of Medical sciences in different levels and their duties (planning, organizing, controlling). This is an applied study carried out as cross-sectional analytic method. The research population is all the high level and intermediate administrators. Tools of collecting data were two questionnaires: questionnaire Achecked the Fiddler methods and questionnaire B checked manager's performances. After evaluating validity and reliability those two questioners; they were distributed among University's administrators. Data analysis was done as descriptive(frequencies, means, and standard deviations);and analytic(one way analysis of variances, regressions, Toki HSD test, Duncan, and Pearson's correlation and Spearman tests) using SPSS software. About almost 49% of administrators in planning, and 48% of them in organizing, judged in upper level, and 40% in the medium level. Other finding showed that between their styles (duties oriented and relation oriented) and planning, organizing, and control there was significant correlations. Also between the mean of administrators control in different age groups and different years of services and levels of the their experiences there were meaning differences. According to our findings the duty oriented and relation oriented administrators both have good performances in planning and determining organizational goals. Also our findings showed that with a suitable organizational managing style in, duties could be arranged to improve organization's performances. That means, the more manager's style are coordinated with the facts and needs of subordinate people, the more accomplish such as planning, organizing, and controlling, would achieved by administrators. Because management is a relation between control and influence, both duties oriented and relation oriented administrators are assure to achieve their goals.

Abstract To cope with natural and unnatural critical events such as air crashes, car accidents, chemicals; and earthquakes or floods needs powerful resource management. Some of these critical events are tiny; and by using local and available resources management could be resolved, but some cover extended geographical areas and so need a massive, vast resources and high level management; for example intense earthquakes which were occurred in Iran. Distributed information systems; including web based DMS and DSS, that has been just developed in some countries, have gained much importance. One typical case was implemented by World Red Crescent in Turkey's earthquake which tolerated many damages six years ago.This system is a distributed system and a type of decision support system that can be used in vast critical by disaster managers. This system is compounded of operational research (for example mathematical based-optimization and simulation) and artificial intelligent (for example knowledge based-systems and pattern recognition) and information management systems (network and. Net based system) methods. Designing and implementing of this system is very important according to span discussion and available facilities in our country. Literature review: This is a librarian and internet based-research. Architecture of disaster information management system based available information in various articles and web sites in internet are reviewed and then it has been naturalized based on conditions and facilities of our country. In this research proposed architecture has benefits of similar systems as well as It has been naturalized based on conditions and available facilities and it can been operated in various organizations, and can reduce damages due to natural hazards. Applying this architecture is first step in triggering of natural disaster information management systems to reduce damages. Damages due to natural disasters should be reduced by using this system and integrating of available information of various resources in different organizations.

Abstract Health centers are more contaminated and pathogenic- and in briefly more dangerous- than other offices and work places for the employees. The goal for the following research was review of the occupational injuries occurrence and prevalence; and some affective factors among Hashtrood health network employees. This cross sectioned study was conducted by questionnaire distributed to 270 Hashtrood health center employees. Data were analyzed by SPSS through X2, t-test and logistic regression. The incidence and prevalence rates of occupational injuries were 43.8%and 61% respectively. Needles and sharp objects injuries had the highest ratio (Incidence rate 22.4% and 19% respectively, and prevalence rate 34.3% and 25.1% respectively). Only 32.6% of the employees reported their injuries. In 49.5% of cases they havent got the proper trains. The rate of occupational injuries among hospital and laboratory employees (70% and 66.7% respectively) is more than other centers (P<0.05). There was an significant correlation between the employees education level and their occupational injuries, that means the most occupational injuries have been happened for the one who has diploma or less education (P<0.05). Given to the vast occupational injuries, preventing measures must be considered. To reduce the occupational injuries, we suggest providing the needed training for the new comers and periodically for the employees; and also a proper reporting system by employees especially in hospitals and labs.