نشریه مدیریت سلامت
پیاپی 59 (بهار 1394)

Hospitals are the centers consuming most of the resources in the health sector. Determining the efficiency of hospitals is very beneficial when resources are limited. To determine efficiency of an organization، several indicators are used for comparison. Pabon Lasso Graph is one of the techniques that simultaneously compares these indicators. The main purpose of this study was to determine the efficiency of social security hospitals of Tehran based on Pabon Lasso Model in 2011. This descriptive cross-sectional study was carried out in seven hospitals under the direct supervision of social security in Tehran in 2011. In this study، the average bed occupancy rate، average length of stay and bed turnover rate in hospitals were 77/75%، 4/03 days، and 82/29 per year، respectively. The results showed two hospitals were in zone I، a hospital in zone II، a hospital in zone III and three hospitals were located in zone IV. And only one hospital was efficient. The findings showed that only one hospital (14/2%) from seven hospitals appeared to be efficient. Hospital manager should take into consideration the hospitals that were inefficient.

decentralization is known an improve process and Promotion of health system and Inevitable part of wide reforms to promote equity, efficiency, quality, Economic justification. Administrative assignment is a method for Decentralization of government. The aim of this study was Comparison of Efficiency and Effectiveness of Karaj Shahid Rajaie Hospital before and after decentralization.

This study was analytical and Comparison. Undertaken work cross - sectional. The data were collected via the questionnaire and Data collection form. After of data collection of before and after decentralization analysis was carried out with the SPSS 19 software and Statistical methods used are descriptive and analytical statistics (Mann-Whitney U).

after of decentralization inpatient beds 4.8 %, occupation beds 3.6 %, percent of occupation Bed 0.3 %, numbers of discharge of those 3.4 % rate of rotation of the hospital bed 1.3 % was increase. Numbers of inpatient in the after decentralization 3.3 % and numbers of outpatient 16.5 % increased. hospital costs with inflation 2012, 19 % decreased and hospital total revenues was increase overall of 6.5 %. hospital infection rates in the after decentralization, 0.06 % increased. employee satisfaction average before of decentralization was mean and after decentralization was high. There are significant differences (P <0.0001), inpatient satisfaction average before of decentralization was low and after decentralization was mean. There are significant differences (P<0.0001).

Efficiency and Effectiveness of karaj Shahid Rajaie Hospital after decentralization was Improvement, therefore Politicians and managers of health system should good infrastructure for the use of this mechanism in order to health system reform, especially public Hospitals.

Access to health care is one of the main goals in all societies. This study aimed to investigate the access level in provinces in Iran. This descriptive-applied and cross-sectional study was conducted in 2012. Statistical population consisted of all provinces in Iran. Data were collected through library and online research. The Ministry of Health and Medical Education and Statistics Center of Iran as authorities of Information, were referred to for collecting relevant data. Taxonomy techniques were used to assess the of development level of provinces, Shannon entropy techniques were used to determine the weights of indicators and TOPSIS techniques were employed to rank states in terms of access to health care. Based on Taxonomy technique from among 31 provinces, 12 provinces were considered to be developed, 9 semi-developed and 10 underdeveloped. Based on Shannon entropy, the ratio of the number of pharmacists to province population was the most important indicator. According to TOPSIS, in term of access to health services; Markazi and Ardabil provinces ranked the first and the last respectively. Due to the large differences among provinces, planners and officials are recommended to allocate the funds according to the development level.

Hospitals are considered as one of the main health delivery systems and the largest and most expensive operational units that have specific importance and sensitivity. This study was conducted to assess the performance of hospitals affiliated with Iran University of Medical Sciences applying economical techniques. This was a cross sectional with a data panel study conducted in 16 hospitals affiliated with Iran University of Medical Sciences in 2006-2012. Two forms according to research objectives were designed one for registering Pabon Lasso indexes and the other for DEA inputs and outputs. Excel software was used for analyzing the former data and Windeap 2.1 for estimating the efficiency and productivity indexes of the hospitals. Pabon Lasso Model shows that in the years 2007 and 2011 the number of hospitals in the third zone was at the maximum level. Furthermore, the mean of technical and managerial efficiency was at the maximum level (0.889±0.135, 0.909± 0.142) in 2011. Malmquist index shows that during the study period the mean of total productivity changes was 1.018 indicating a decrease in hospital productivity during the study period. It seems that system changes in Iran University of Medical Sciences has led to negative fluctuations in efficiency and productivity indexes of the hospitals. Applying managerial approaches along with reassessing the indexes after managerial status of the University is suggested.

Technological advances have made using scientific methods necessary in purchase decisions. The present study has investigated the prioritization factors affecting purchase of medical equipment at selected hospitals in Tehran.

The present study is a descriptive cross-sectional study conducted in 2014. About 645 members of Medical Equipment Committee and medical equipment users (including clinical and Para-clinical administrators) in a number of hospitals in Tehran were selected using census method. Data were gathered using a questionnaire the validity and reliability of which were maintained by experts and the inconsistency ratio of questionnaires being less than 0.1, respectively. The collected data were analyzed using AHP model and Expert Choice 11 software. Responsiveness rate was 87%.

Four determinants were found to influence the purchase of medical equipment including "quality", "after sale services", "brand", and finally, "price" with the geometric means of 0.414, 0.278, 0.160, and 0.148, respectively.

The results showed that health care organizations have paid great attention to the quality of medical equipment and consider it as part of the quality of their services. Health care providers are aware that a leading factor of their success is the correct diagnosis of health problems and that use of appropriate standard equipment plays a major role in it.

Information therapy is a process which informs patients and plays a complementary role in the process of therapy. It can enhance public health information literacy, thereby decreasing the health costs. This study evaluates the feasibility of information therapy services in educational hospitals of Shahid Beheshti University of Medical Science. This is a descriptive survey. The population of this study includes chiefs, and physicians of twelve educational hospitals in shahid Beheshti University of Medical Science. Stratified sampling was used to select the study sample from among the chiefs, executive managers and 239 physicians of selected hospitals. Two questionnaires were developed for data collection. The first questionnaire was for investigating the physician’s opinions about creating information therapy centers and the second questionnaire was for evaluating current conditions in educational hospitals. The data were analyzed by Excel 2007. The results of the study showed that all the physicians and chiefs of the hospitals believed in the adoption of information therapy services. Most of the physicians believed that patients’ willingness to receive information from their physicians (89/97%) as well as the variation in educational levels in patients (94/99%) will affect their use of information therapy services. The feasibility study showed that despite funding and staff deficiencies, delivery of information therapy services is possible in educational hospitals of Shahid Beheshti University of medical science.

Thalasemia Major is one of the most common anemia diseases that can be fatal if not promptly diagnosed. The survival analysis of these patients can be an appropriate strategy in determining risk factors for death in these patients. The purpose of this study was to choose the best model to determine the risk factors for death in patients with the thalasemia major using common methods in the survival analysis.

The data of this retrospective cohort study, with 296 patients with thalassemia major, was collected in 2004- 2013 in Zafar Clinic in Tehran. Akaicke information Criterion was used for comparison of the models and the choice 351of the best model. Data analysis was carried out with R3.0.2 software at the significant level of 0.1.

The values of the Akaicke information criterion (AIC) for the parametric weibull, frailty weibull, log-normal, log-logistic, Gompertz, gamma and the semiparametric Cox were computed and found to be 27.56, 29.56, 18.73, 23.39, 26.26, 68.10, 24.73, respectively. The mean survival time for men and women were 40.2 and 39.7 years, respectively. The Log-normal model showed that age, age at the first desferal injection, onset of blood injection, the patient's birthplace, mother's education variables were significantly correlated with patient survival.

According to the values of AIC, the parametric log-normal model was chosen and suggested as the best model.

Red Crescent Organization is as one of the most important NGOs that plays important roles in the field of crisis management. Effectiveness of this organization is depends on the role that assistance forces plays as human capital. In this regard, talent management is a complete collection of processes to identify, apply and manage people in order to successful implementation of business strategy. The main objective of this study is to evaluate the impact of different types of leadership on talent management and identify the most suitable species for the development and improvement of talent management.

This study is descriptive and functional, and was conducted with a single cross-sectional survey and fieldwork. Statistical population of this survey is Rescuers of the Red Crescent Yazd that was calculated based on a sample size, 246 persons were randomly selected and surveyed. In order to explain the relationship between variables, is used two questionnaire; the Multifactor Leadership Questionnaire (MLQ) Bass and Alive (1995) and Talent Management, that reliability has been checked through Cronbach's alpha and validity has been checked through the Content Validity. Data were analyzed through structural equation modeling with SMART-PLS software and t-test - Student was conducted in SPSS 18.

The results indicate the predominance of transformational leadership and then transactional leadership in this organization and reveal poor alignment, retention and talent development. On the other, based on the output of PLS method, transactional leadership has significantly and positively associated with all the components of the talent management process and transformational leadership has only a significant relationship with attracting process.

Due to the significant and direct impact of transactional leadership on the talent management and also current situation prevailing in the organization, movement toward replacement transactional leadership instead of transformational leadership should be a priority and with improve it in addition of the increase efficiency and effectiveness of the organization, situation of talent management will be improve significantly.