نشریه مدیریت اطلاعات سلامت
سال پانزدهم شماره 3 (پیاپی 61، امرداد و شهریور 1397)

Integration in the health system has many benefits for patients, providers, and the system itself. This research was conducted to determine the functional and informational variables affecting the integration of Iranian health system in period of years 2017-18. The present exploratory study was conducted in two phases. In the first phase, factors affecting health system integration were extracted from the literature as well as from interviews with experts in healthcare administration. In the second phase, data from the first phase were integrated, and a model of health system integration was designed resulting in a researcher-made questionnaire. The model was validated through qualitative (i.e., expert opinion), and quantitative (i.e., exploratory and confirmatory factor analysis) approaches. The data were collected from 506 specialists in hospitals in 5 provinces of Iran. Exploratory and confirmatory factor analysis was used to analyze the data. According to the results of exploratory factor analysis in the functional-information dimension, "information management" was the most important item with 0.665 of factor load. Regarding the standard coefficient of confirmatory factor analysis, the effect of the functional-information factor on integration was 0.95. The existence of a referral system, the existence of a decision supporting system, and the management of financial resources, also had the greatest importance in the integration of the health system with 0.79 of factor load. The health system can provide the necessary support for health system integration through management of financial, human, and information resources, as well as the development of information systems and electronic health records, and performance monitoring. It can also integrate clinical, financial, and management information in order to improve the quality of care.

Hospital supply chain (HSC) competitiveness represents the ability of a hospital to provide its services in competition with other hospitals. The competitive HSC has the ability to compete with other hospitals in provide services to patients. The purpose of this research was to provide a competitive model for HSC. This was a mixed-method study. By reviewing the literature using meta-analysis method, and performing 12 exploratory interviews with the key informants of private hospitals, the components of competitive HSC were extracted. Then, the opinions of health professionals in focus group were gathered, the competitive model of HSC was designed, and the indicators of questionnaire were finalized. The statistical population of the study consisted of the directors and assistant directors of private hospitals in Tehran, Iran (73 hospitals), with a sample of 238 people. In order to increase the certainty, 272 questionnaires were sent to top managers of 34 private hospitals, and 244 questionnaires were collected. The content validity of the questionnaire was confirmed by the participation of 17 health professionals in the country. Cronbach's alpha coefficient and composite reliability were used to verify the reliability. Data was analyzed using structural equation modeling with partial least squares approach using SmartPLS 3 software. Triple constructs of competitiveness leading factors (including strategy, information technology, human resource, and integrity), competitiveness factors (including specialization, demand management, outsourcing, supplier’s relationship, standardization, information sharing, and health tourism), and competitive supply chain performance factors (including customer, financial, organizational processes, and learning and innovating) were identified as the main components of the HSC competitive model. Identified indicators provide a comprehensive framework for increasing the competitiveness of the HSC, which will improve the performance of HSC against competitors.

Due to the current role of medical tourism as an industry, better understanding of its market can be important. One way to understand the market and its targets is through clustering them, and understanding the characteristics of each cluster. The present study was conducted to determine and analyze the demographic, geographic, and behavioral variables within the clusters of medical tourism market. This was a descriptive-survey conducted using a questionnaire. 151 questionnaires were completed by foreigner patients in selected hospitals in Tehran City, Iran, who were selected using one-stage cluster sampling. The results of the questionnaires were examined using K-means and chi-square correlation coefficient via SPSS software. The findings identified four different clusters of medical tourists, namely first, second, third, and fourth clusters, with significant differences in terms of the studied variables. In other words, the examined demographic variables included gender, age, education and income, the country of origin of tourists was considered as a geographical variable, as well as behavioral variables including the number of trips, the length of stay in Iran, the type of medical service received, the main source of information for travel in Iran, the method of regulating treatment, doing side activity, and the type of side activity. All the variables had significant differences in different clusters. The differences in clusters should be considered by policymakers and activists in this area. It is important to provide a regular and systematic program for recognizing and planning of Iraqi medical tourists. Furthermore, medical tourism managers can provide an increasing number of side plans in cooperation with hospitals and agencies for this potential market.

The core of health care services is providing information for patients. The negative effects of cancer on the quality of patients’ life require them to receive comprehensive care, called "palliative care". The present study was conducted with the aim to evaluate the information behavior of patients with cancer in the field of palliative care. A descriptive cross-sectional study was performed on 100 patients with cancer. Sampling was selected in a non-randomized and convenience method. Data were collected by a researcher-made questionnaire, with approved validity and reliability (α = 0.89), distributed among the patients. Finally, mean and standard deviation were used to describe the data. The information needs in "mental health" care was more than other palliative care dimensions. The highest source of information used was "talk with the nurse", and the patient's most willingness to source information was "physician". The "shortage of physicians’ and nurses’ time" was mentioned as the highest barrier, and "free counseling by the poverty care team" as the highest priority in the selection of patient information services. The attention of the treatment team, especially the physician and nurse, to the patient's information needs, as well as the elimination of concerns, stress, and other needs of the patient was of the important points in this study. Moreover, alongside this team, information services include the use of virtual spaces, the organization of virtual groups, and the use of medical information counselors in health centers to meet the patient's needs, is from the issues considered in this study.

One of the indicators of research outputs of universities is assessment of the capability to of transferring knowledge to technology via assessment of citedness of scholarly outputs by patents. Current research aimed to investigate the status and factors associated with the citedness of scholarly outputs by patents in Scopus for the type 1 medical science universities of Iran during 2000-2015 period. Research population comprised of all scholarly output published by eight type 1 Iranian medical science universities (Tehran, Shahid Beheshti, Shiraz, Isfahan, Tabriz, Mashhad, Ahwaz, and Kerman) in Scopus database during 2000-2015 period. Data were collected from Elsevier’s SciVal. Moreover, data analysis was conducted using descriptive correlation statistics. Of 76111 studied publications, 998 scientific outputs were cited 3145 times from patents. Citedness rate of medical science universities’ scholarly output were found to be higher than the average rate of Iran (0.39%), but lower than the international average rate (1.1%). The highest and lowest shares of cited publications by patents were seen in the Tehran University of Medical Sciences (1.53%) and Tabriz University of Medical Sciences (0.58%), respectively. Results of running a series of multiple linear regression tests showed that four indicators, namely Source Normalized Impact per Paper (SNIP), SCImago Journal Rank (SJR), total number of publication’s authors, and total number of publication’s contributing institutions had statistically significant impacts on possibility of citedness of scholarly outputs by patents. In addition to the topic and practical nature of the scholarly output, results of the study showed that research collaboration, as well as publishing in high quality journals, has an impact on getting cited by patents.

As physicians have not sufficient time for updating their clinical information, medical librarians could play an important role to satisfy their needs. This study aimed to identify the obstacles towards the role-playing of medical librarians in facilitating the scientific communications among physicians and paramedical practitioners based on the viewpoint of medical professionals in Bushehr University of Medical Sciences, Bushehr, Iran. This qualitative study was conducted using semi-structured interviews. Interviews were continued until all relevant themes and domains saturated. Sampling was done purposefully. In this study, 10 physicians and paramedical practitioners were chosen to ask the questions. According to the interviews, five barriers were identified entitled attitude, individual, structural, technical, and organizational aspects towards the role-playing of medical librarians in facilitating the scientific communications among physicians and paramedical practitioners. The most important obstacle was a personal obstacle. Using the results of this research and the identified challenges, it is possible to use the structural and organizational reforms as well as changes in attitudinal and behavioral factors to facilitate the scientific communication between physicians and paramedical staff of the Shohada of Persian Gulf Hospital in Bushehr. The results of this study can be used to solve the organizational problems of libraries. Moreover, this research can be used to formulate a plan for personal training of medical librarians.

Creating an image of the conceptual structure of health literacy area, as well as the study of interdisciplinary and the relationship between its domains seems necessary. The present study examined the intellectual structure of health literacy area in Web of Science database using co-word analysis. This was a scientometrics research and bibliometric study, carried out using co-word analysis method. Social network analysis was used for this purpose. The research community compiled all the relevant scientific literature on the field of health literacy in Web of Science during the years 1993-2017. For data analysis, network integrity and centrality indices were used. Clustering co-efficient (7.17) and network density (0.58) were high in the resulted network. Moreover, the intellectual structure of this domain consisted of eight subject clusters. Health care, psychiatry and psychology, public health, social sciences, communications, health services, and medical education had the highest levels of centrality throughout the entire network. The results show that the intellectual structure of the health literacy domain in general has an integrate structure with a proper relationship between its concepts and subjects. This shows the essence of this area, which is able to establish a consistent and sustained relationship with the social sciences and humanities as a branch of medical science. Finally, the results of this study will help health literacy researchers to understand the research trend of this area in future studies based on the identified areas of influence.