نشریه مدیریت سلامت
پیاپی 88 (تابستان 1401)

Today, in dynamic environments, there are many disruptions in supply chains that negatively affect the performance and productivity of organizations; therefore, identifying the critical success factors for managing disruptions is essential. This is also true in the health tourism supply chain.The primary purpose of this study was to determine the critical success factors and design its model in the health tourism supply chain to improve resilience.

In the first phase, the critical success factors were identified and categorized through interviews with experts in the health tourism supply chain of Ayatollah Yathribi Hospital in Kashan. In the second phase, a panel of experts was formed, and the model of critical success factors was designed through an ISM.

After the interviews with experts, 70 critical success factors were obtained, which were classified into 12 general categories. Finally, through the panel of experts, the model of critical success factors was identified where the environmental management factor had the most impact. Factors of flexibility in the supply chain, supplier management, coordination and cooperation in supply chain, and inventory management were the dependent variables.

Examining the critical success factors of the health tourism supply chain is very important for countries that are interested in improving resilience of this industry. It is also btter for managers, policymakers, and health tourism planners not to overlook the benefits of identifying and analyzing critical success factors at the supply chain level.

One of the important economic issues that arise due to limited resources and increasing costs in the health care system is the analysis of hospital costs. The aim of the present study was to investigate and compare the cost structure of the selected hospitals affiliated with Isfahan University of Medical Sciences from 2011 to 2020.

The present applied research is a descriptive type. A researcher-made checklist was used to collect the data. The cost data were obtained from accounting and financial department of each hospital. Then, the data verification process was carried out in cooperation with financial and accounting department of Isfahan University of Medical Sciences. The data were analyzed by using Microsoft Excel 2016.

The results showed an increasing trend in the total cost of hospitals. The cumulative cost structure of the selected hospitals during the years under Study showed that personnel costs accounted for 55.95% of the total cost (ranging from 46.40 to 70.93%). The costs of medicine and medical consumables, which had the highest share after the personnel costs, accounted for 19.76% of the total cost (ranging from 12.98 to 33.30%).

Identifying the cost structure provides a correct and evidence-based insight for planning, cost management and evaluation of hospital efficiency and paves the way for hospital officials to reduce hospital costs and improve the quality of health services. Consequently, this can form the basis for informed decision-making. Considering that in the hospitals under study, a significant share of the total cost was allocated to personnel costs and medicine and medical consumables, hospital officials can pay more attention to the management of these costs and prioritize them in their planning.

The pharmaceutical industry of each country shows the capability of that country in providing health for the society. Medication has always been one of the most important pillars of health due to its effects on health. As a result, production, distribution, and pricing are a special priority of governments. Therefore, the medication subsidized currency allocation policy was formulated and implemented in order to guarantee patients' access to drugs in the conditions of currency shortage and international sanctions against Iran. The objectives of the present study were to analyze the policy of subsidized currency allocation to medication and to present political alternatives in Iran.

The present study is a retrospective health policy analysis using a qualitative research method. Data were collected by using semi-structured interviews with key informants through analyzing policy and legal documents. We also analyzed the data by using framework analysis. To categorize and analyze the findings, we used MAXQDA 11 software.

Results showed that contextual factors, including situational, structural, cultural, and international factors had an impact on all policy-making  processes of  currency allocation for medication. Four political alternatives for the allocation of subsidized currency for medication, we proposed: 1) removing the policy of subsidized currency and paying the exchange rate difference to insurance companies; 2) announcing a new rate for the subsidized currency; 3) paying the total exchange rate difference (selling half of the currency to pharmaceutical industries and the rate difference to consumers); 4) releasing a part of medication currency.

Challenges and negative consequences of subsidized currency have gradually emerged. Before modifying the policy of subsidized currency, the requirements should be reviewed. Developing a detailed and step-by-step road map  via  the participation of influential and interested institutions is  necessary to modify this policy.

Fourth-generation libraries can no longer be satisfied with web software facilities and must use technologies, including digital realities to increase the level of service and attract clients. Therefore, this review aimed to identify the roles and effects of these technologies in libraries.

In this systematic review, PubMed, Web of Science, Scopus, and Google Scholar advanced search were used to extract and compile documents. Retrieved articles were entered into Endnote software. Two researchers independently explored the content of the articles against the inclusion and exclusion criteria and removed the irrelevant ones. Differences were resolved by consensus with a third researcher.

Fifty-two articles were selected for final analysis. The findings showed that in all kinds of libraries, the use of digital reality technologies can provide and receive new services, strengthen the process of training users, enhance their information literacy, improve the professional activity of librarians, save money, and finally manage and enrich library resources and knowledge sharing in research networks.

Modern libraries face many challenges, such as lack of funds to run communication infrastructure, lack of staff involvement in operational activities, and the need to train skilled personnel to provide services; however, they can present an attractive image of their services through knowledge sharing in the research networks, strengthening education, increasing information literacy, and effective resource management.

The e-prescribing system is one of the basic technologies in the health system structure which was developed with the aim of properly managing healthcare resources and services, preventing common manual prescribing errors, and increasing patient safety. Given that the user interface of e-prescribing system is considered as the main factor of user acceptance, the purpose of the present study was to evaluate the user interface usability of the e-prescribing systems of  Iran Health Insurance Organization (IHIO) and Social Security Organization (SSO) in Iran.

This descriptive-cross-sectional  study  was conducted in 2022. The research sample consisted of 150 physicians working in educational-therapeutic centers of Urmia University of Medical Sciences who were selected through stratified sampling with proportional allocation. The data collection tool was a researcher-made questionnaire The validity and reliability o f which were verified. The data were analyzed by means of descriptive statistics and independent t-test using SPSS software.

No statistically significant difference was found between the user interface SSO and IHIO in general (terms, letters, icons and navigation) and specific (alert display, personalization, entering and displaying information, guidance and interactions) areas. However, there was a statistically significant difference in "color" (P=0.047) and "visibility" (P=0.049).

The user interface of two e-prescribing systems in Iran has an average status in terms of usability. Therefore, it seems necessary for system developers to use aesthetic elements, interaction in the user's language, presentation of useful information in a simple and clear format in the design of the user interface according to the principles of human-computer interaction.

The pharmacy information system plays an effective role in managing patients' medication information through informing physicians about unsafe medication prescriptions, prescribed overdoses, and possible drug interactions. The present study was conducted with the aim of evaluating the pharmacy information system using the HOT-fit (Human, Organization And Technology-Fit) model in selected teaching hospitals at Mashhad University of Medical Sciences.

We conducted this cross-sectional study in 2019 in two stages. First, we presented the extracted criteria and confirmed them in the panel of experts. In the second stage, the pharmacy information system was evaluated from the point of view of 118 users of the system, namely the secretary or nurse who register medication requests in the clinical and specialist departments of HIS. The evaluation results were analyzed using linear regression test via SPSS, version 21.

In the specialized panel, 24 criteria were confirmed; then, we designed a questionnaire according to the HOT-fit model which was provided to the users. According to the result, 55.37% of the users rated the system's performance as favorable. Results showed that according to the analysis of 17 hypotheses of the HOT-fit model, there is a significant relationship between aspects of technical, human, and organizational factors, as well as net benefits. Also, there was not a statistically significant relationship between the aspect of information quality in the technical factor and the aspect of  the system use in the human factor.

System use and information quality criteria increase the satisfaction of information system users. In this regard, in the design of the hospital information system, attention should be paid to the compatibility of the system with the tasks of the user and the usefulness of the expected output. Also, we believe that more studies should be conducted on the information quality and system use criteria that lead to user satisfaction.

Information therapy is a simple solution to facilitate patients' access to health information, which can contribute to patient self-care. Considering the importance  of treatment and health information, and  engagement of people with different specialties in the process of information therapy, this research was conducted    to identify the opportunities and challenges of establishing an information therapy center.

The present study was an applied-qualitative research. The study  population included patients,  medical librarians, physicians, health care providers, and psychologists with experience in information therapy and health information prescription. A purposive sampling  along with  snowball sampling were perfomed. The data were collected via  a semi-structured interview.  The data were then analyzed by using MAQDA20 software.

By analysing the interviews, we were able to identify  a main class entitled "Benefits of Information Therapy" including 4 subclasses of “patients and families”, “medical staff”, “health system”, and “medical librarians” under the main themes of "Opportunities". Under the and"Challenges", four subclasses of “barriers to information therapy”, “financial issues”, “implementation”, and “execution” were also identified.

Despite the benefits of establishing an information therapy center for patients and their families, treatment staff, psychologists and medical librarians, there are some obstacles posed by these groups and the healthcare system, which require further consideration. Careful investigation and finding solutions to  remove the obstacles as well as  creating  an approprite platform to  adopt the center in the society and health sector. In order to establish this center, it is necessary to consider inter-group and inter-organizational cooperation with  detailed planning, as well.

Accurate delineation of myocardial fibrosis in Late Gadolinium Enhancement Cardiac Magnetic Resonance (LGE-CMR) has a crucial role in the assessment and risk stratification of HCM patients. As this is time-consuming and requires expertise, automation can be essential in accelerating this process. This study aims to use Unet-based deep learning methods to automate the mentioned process.

This study used three consecutive Unet-based networks for Region of Interest (ROI) detection, myocardial segmentation, and fibrosis delineation. The study was conducted on LGE images of 41 images diagnosed with HCM, which were contoured by two experts.

This model reported a Dice similarity coefficient and accuracy of 89.74 and 98.22 in myocardial segmentation and 88.42 and 94.66 in fibrosis delineation, respectively, and could outperform the previous methods

The results confirm that using deep learning methods for delineating myocardial fibrosis not only can automate the process, but also helps improve the results and decrease the required time.