مجله تحقیقات نظام سلامت حکیم
سال بیستم شماره 4 (پیاپی 79، زمستان 1396)

The importance of considering patients’ satisfaction with the health system development plan has an effective role in management planning. The purpose of this study was to determine the satisfaction rate of hospitalized patients in Tehran’s public hospitals as a reduction in the rate of payment for patients in the health system reform plan.
This was a descriptive cross-sectional study conducted in the first half of 1394. The research community is the patients of the Tehran State hospital. A multi-stage sampling (500 patients) was performed. The data gathering tool was a researcher made questionnaire whose validity and reliability were confirmed. Data analysis was done by SPSS software version 22 using correlation, factor analysis, and Friedman test.
Based on the findings of the research, it can be concluded that reducing the amount of hospitalized patients to make vitality, reducing illness due to the insignificant costs of treatment, and enhancing equity in health is a positive consequence of the program. As a result, the health system development plan plays an important role in patient satisfaction and has reduced the health concerns of people.

The archive of journals is a valuable and frequently used source. Protection and making them accessible are necessary to meet the users needs. This study aimed to determine the status of the archive of journals approved by the commission for accreditation and improvement of Iranian Medical Journals.
This study was a descriptive survey. A total of 318 scientific-research journals that were approved by the commission for accreditation and improvement of Iranian medical journals in 2015 year were studied. Data gathered via a checklist and questionnaire where its validity and reliability were confirmed. Data were analyzed by SPSS V.22 software.
A total of 69/5% of journals completed their archives and were presented through the journals website. Of the journals, 84% English and 53% in Farsi were successful in Archiving. A total of 30% of journals that published by the universities of medical science has defects in their archives. More than 50% of medical field journals have been recently published, however, electronic archives were not completed.
The Ministry of Health journals archive are in relatively good condition, however, there are long distance to achieve to a complete archival collection. Digitizing and accessibility of these resources can play a significant role in helping researchers. It has been considered as a proceed to preserve the field of medical science history.

This study aims to identify the appropriateness of CT Scan prescriptions for Lumbar Spine using the RAND Appropriateness Method in Shiraz University of Medical Sciences (SUMS).
A total of 281 patients referred to the hospitals affiliated with Shiraz University of Medical Sciences were selected as sample of the study in 2016. The scenarios derived through the RAND Appropriateness Method were compared with medical records of these patients by educated physicians.
Out of 281 cases of lumbar spine MRI prescriptions, 57.7% were appropriate, 32.7 % were uncertain, and 9.6 % were considered to be appropriate. In addition, some related factors to appropriateness of prescriptions were identified.
Clinical guidelines developed using RAND Appropriateness Method can be an appropriate instrument for policy makers, health care providers, and health insurance companies in order to reduce inappropriate cares and quality improvement, especially in developing countries. It is recommended that appropriateness of prescriptions will be considered as the criteria for payment and reimbursement to prescribers. In this way, inappropriate cares may be reduced.

The purpose of this paper was to analyze the relationship between economic variables (gross domestic product (GDP), the budget deficit, and health R and D spending, in the health sector) and noneconomic (carbon dioxide and the population over 65 years) on Iran’s health expenditures using 2 groups of macro economy and household budget for the period 1993 - 2013 and year- ahead forecasting.
For this purpose, ordinary least squares (OLS) method and Johanson cointegration test with Eviews 9 software and for forecasting, dynamic system model and Vensim 6.0 software has been used. The references of data, statistical center of Iran, central bank of Iran, world development indicators (WDI), and
world health organization (WHO) has until 2015.
The results of the macro model reveal no presence of a short run causal relationship between variables and government expenditure on health, while in the long run, GDP, Carbon dioxide, and budget deficit was found to be significantly causally related to health expenditure. The results of the second model in which data used household, meaningful relationship between carbon dioxide, and total household spending on household health expenditure in the short term is confirmed.
Despite the continuous increase spending on government expenditure on health during the period examined, for various structural reasons, short-term effects on the health sector had not been enough to reduce applicants’ (households) health care expenses; however, it also increased the paid out of patient’s pocket. It is expected in the years ahead for the share of government health expenditure to be higher than the share of the private sector.

Due to high prevalence of spontaneous abortion in the Markazi province compared to other neighboring provinces and inappropriate establishment of industries and air pollution in the city of Arak, this study was conducted with the aim of assessing the role of industrial air pollution on spontaneous abortion over the 5 preceding years.
The city of Arak, with polluted air, was considered as the case and Tafresh with clean air was considered as control. The prevalence of having spontaneous abortion over the past 5 years among 400 women aged 15 - 49 years attended to prenatal care clinics was compared between Arak and Tafresh over the first half of the year 1394 (2015) and the role of exposure to air pollution (residing in Arak versus Tafresh) in abortion was assessed after the control of other factors.
The prevalence of spontaneous abortion over the last 5 years was 23.5% in the whole sample. This rate was significantly greater in Arak than the corresponding rate among women who resided in Tafresh (35% vs. 12%, P These results are indicative of the importance of environmental pollutants and their changes including air pollution with population, fertility trends, which require special attention, and appropriate interventions.