لیلا ریاحی

In this study, the antagonistic effects of 14 Plant Growth-Promoting Rhizobacteria strains (PGPRs) against the phyto-pathogenic species Alternaria terricola Woudenb. & Crous were investigated, both in vitro and in vivo. The obtained results revealed significant inhibition effects of the 14 PGPR strains against A. terricola in both direct contact and indirect bioassays with significant variation. The dual in vitro culture tests revealed substantial inhibition rates in the growth of A. terricola strain, ranging from 25±5.41% (Pseudomonas koreensis O3RR25) to 71.87±3.12% (Bacillus megaterium FR1.11). Moreover, the indirect antagonism test showed that the volatile organic compounds produced by the 14 tested PGPR strains significantly inhibited the growth of A. terricola mycelium, with variations ranging from 36.61±0.94% (P. brassicacearum O3RR24) to 67.75±0.94% (B. megaterium FR1.11). Microscopic examination of A. terricola following exposure to the volatile compounds revealed significant structural damage, including inhibition of conidial germination, deformations, thin or fissured structures, irregular lengths, and the formation of empty segments. The in vivo application of B. megaterium FR1.11 resulted in the reduction of fungal development on detached leaves and tomato seedlings. This treatment engendered a significant increase in the levels of chlorophyll a, b and total, carotenoids, polyphenols, and proline in infected tomato seedlings compared to the control. Applying this PGPR strain to infected tomato plants allowed maintaining comparable level of malondialdehyde as the control. B. megaterium FR1.11 showed considerable in vitro and in vivo antifungal activity and could serve as a promising candidate for biological control strategies targeting phytopathogenic species of the genus Alternaria.

Telemedicine has the greatest role in the expansion of health care in deprived areas and villages by providing facilities for doctors or other health workers to examine patients through video conference, internet and etc., to a consultant specialist in a telemedicine center. The current research was conducted with the aim of designing and evaluating a telemedicine model and improving access to health services.

In this research, a mixed method was used, which is a combination of qualitative and quantitative methods. The information needed for this research was firstly extracted through semi-structured interviews with 10 university experts, managers and experts of the Ministry of Health using snowball sampling method, and during three stages using thematic analysis method (open coding, axial coding, and selective coding) was analyzed with MAXQDA software and finally, according to the interviews, dimensions, components and indicators were extracted and a researcher-made questionnaire was designed. Based on the interview process, coding and tests, the final model of the research was presented. Then, in the quantitative part, the questionnaire was distributed among 384 people and the relationship between the dimensions was determined from structural equation modeling and Smart PLS software.

The results showed that there is a positive and significant relationship between the dimensions of planning, coordination, organization, control, financing and telemedicine services in Iran.

Considering that the provision of telemedicine services is a new trend that has received more attention in recent years due to special health conditions and the spread of the corona virus, and therefore it seems necessary to plan for the establishment of a model telemedicine services in Iran for everyone, especially remote areas. It is also recommended to create an economic plan to make money from the telemedicine program.

Background & Medical errors, which refer to mistakes made by healthcare professionals in delivering medical services, can have serious negative impacts on patient health and safety. Due to the potential risks to patient well-being, this issue has garnered significant attention from researchers in the health system. This study aims to examine the relationships between preventive and corrective systems and medical error management in hospitals affiliated with the University of Medical Sciences in Alborz Province.
Materials & This research is descriptive-correlational and applied in nature, conducted cross-sectionally during the winter of 2023. The study population consisted of nurses with at least one year of experience, selected through simple random sampling, totaling 313 participants based on Cochran's formula. To evaluate the hypotheses, after assessing the content and face validity of the researcher-developed medical error management questionnaire, data were analyzed using descriptive statistics (mean and standard deviation) and Spearman’s correlation test in SPSS version 26.
The results indicated a significant and positive relationship between corrective systems and medical error management (P=0.000). Furthermore, the relationship between medical error management and corrective systems was significant in most cases (P=0.000).
The study’s findings highlight that medical error management is significantly dependent on preventive, supervisory, and control policies, as well as educational and training aspects. The Iranian health system currently faces challenges with insufficient supervisory and transparency measures. Therefore, improving infrastructure and using electronic registration platforms, such as medical error detection software and electronic prescriptions, can lead to reducing medical errors and improving the quality of medical services.

The emergence of COVID-19 has precipitated a global health crisis, profoundly affecting various dimensions of human life, including social, academic, cultural, economic, and political spheres. This study aims to compare the management strategies employed by South Korea, Japan, and Iran in response to the pandemic, highlighting the effectiveness of their approaches and the resultant outcomes.

This research employs a comprehensive literature review of articles from scientific databases, including Scopus, Elsevier, Science Direct, PubMed, and ISI. It analyzes the strategies each country implemented to curb the spread of COVID-19, highlighting both successes and challenges encountered during the pandemic.

The findings indicate that countries with prior experience in managing epidemics, such as South Korea and Japan, were better equipped to handle the COVID-19 crisis. South Korea’s rapid response included widespread testing, contact tracing, and the use of technology to monitor the virus's spread. Japan, leveraging its geographical proximity to China and existing health infrastructure, also implemented effective measures, including travel restrictions and public health campaigns. In contrast, Iran faced significant challenges in managing the pandemic. The rapid spread of COVID-19 overwhelmed its healthcare system, exacerbated by pre-existing economic sanctions and health infrastructure deficiencies. Despite various strategies implemented by the Iranian government and the Ministry of Health, including public awareness campaigns and temporary lockdowns, the outcomes were less favorable compared to South Korea and Japan. Inadequate responses to the health crisis resulted in serious social and psychological consequences, worsening the situation.

Countries that effectively managed the new coronavirus pandemic had prior experience with epidemics. Their swift actions and recognition of the critical situation contributed to minimizing human and financial losses.

The purpose of this study is to compare the policies and strategies of the Social Security Organization as the second provider of social insurance and treatment in Iran with 5 other countries.

Methodos: 

This research is a comparative study with a qualitative approach that was conducted in 1401, the sampling was purposeful and the five countries of Japan, Costa Rica, Egypt, Greece and Mexico in the components of policies and strategies, including treatment management and administration, social components, provision Financial and insurance, legal, policy making and strategic plan were compared with Iran. In this study, an authentic database was used and the data were analyzed using the comparative education model in the four stages of description, interpretation, juxtaposition and comparison, and compared in the form of a comparative table.

The results indicate the impact of the components of health and treatment management, financing and insurance, social, legal, policy making and strategic plan on the policies and strategies of the treatment deputy of the Social Security Organization; The social component with an average of 92.8% had the highest frequency observed among the accepted documents and the strategic plan component had the lowest frequency observed among the accepted documents with an average of 65.5%.

Paying attention to the growing elderly population, paying attention to the financial stability of the social security organization, the correct implementation of the insurance and medical policies and the correct and scientific formulation of the strategic plan can lead to an improvement in the provision of medical services and an improvement in the management of expenses and resources of the organization. ; Therefore, it is necessary to review and modify the policies and strategies of the deputy of social security treatment.

Due to the significant effect of doctors' behavior on the improvement of health care and its consequences on patients, it is necessary to adopt cost-effective and cost-effective measures for beneficial treatments in order to make appropriate decisions and better acceptance of treatment by patients.

This is a descriptive-analytical applied study. The research community included specialists, managers and employees of medical centers in both public and private sectors. The effective factors on patient preferences were extracted and the initial questionnaire was designed, and then the effective factors were determined and prioritized using exploratory and confirmatory factor analysis in Imus software.  The standardized IUS questionnaire was used regarding the factors affecting the patient's tolerance of uncertainty. Finally, the questionnaire was distributed and collected among 550 people by stratified method.

The results of these studies show that 6 factors are effective on patient preferences in the public and private sector, the highest score in the public sector with a factor loading of 0.53 belongs to the patient's insistence and the type of insurance, and in the private sector it belongs to the comparison of treatment options. Regarding the factors affecting the measurement of uncertainty tolerance, respectively, in the sub-factors of the emotional dimension, interest in decision-making and courage in decision-making, and in the sub-factors of the behavioral dimension, the factors of attention in uncertain decisions and searching in uncertain conditions and sub-factors of the dimension Cognitive certainty of recovery and doctor's trust were placed in both public and private sectors, respectively.

Communication with the patient and better understanding is effective in increasing satisfaction and quality in providing health services. Therefore, it is necessary to pay attention to the patient's preferences and tolerance of uncertainty and determine the affecting factors it in order to improve the patient as quickly as possible.

Health tourism is a relatively new concept with rapidly growing application. Therefore, the aim of the present study is to determine the factors affecting health entrepreneurship in the field of health tourism.

The present study is a practical study that was conducted as a systematic review (scoping review). To collecteing data, PubMed, Scopus, Web of Science, Proquest, and Google Scholar databases were searched in August 2022 to obtain all scientific documents in this field without time limits and with the related keywords. EndNote 20 software was used to manage and screen articles. Duplicate cases, screen titles and abstracts, study characteristics, and the most important results were recorded in the data collection form. Due to the fact that our data analysis was qualitative data, it was done in the form of meta-synthesis, which is why the content analysis method was used for data analysis using MaxQda 2018 software.

Out of 2942 identified articles, 27 articles were included in the study. Most of these studies were conducted in Iran, China, and Russia. The most important factors affecting health tourism entrepreneurship include strategic planning, provision of support services such as accommodation and insurance, access to high-quality medical centers, providing high-quality services, appropriate marketing and advertising, and the use of new information and communication technologies in accessing services. .

It is necessary for health managers and policymakers to pay attention to the establishment of laws and standards of health tourism, cooperation between government and private institutions, and providing solutions for the institutionalization of health tourism, especially in areas with tourism potential. This work requires providing sufficient financial and human resources and strengthening entrepreneurial skills and thinking in those interested in this field and marketing.

Among the challenges of the healthcare system are the shortage of specialists, the lack of quality knowledge, and the unequal distribution of skills among healthcare workers, which are of concern to the World Health Organization until 2030. Therefore, the purpose of the present study was to localize the second goal of the global human resources for health strategy, which including assessing the current and future needs of the population for human resources, while taking into account the dynamics of the labor market in Iran.

This study was conducted in 2023 using a mixed method approach through a review of related articles and semi-structured interviews with 18 experts in the field of human resources nationwide using MAXQDA2020 software. Then, in a quantitative phase, with the opinions were gathered from243 managers and human resources experts from medical universities, statistical analysis and confirmatory factor analysis (CFA) were employed, and finally, the localized model of the second goal of the global health human resources strategy in Iran was developed.

In the qualitative interview phase, 21 variables were identified and after quantitative phase, they were reduced to 14 variables. This variables were categorized as current and future needs assessment of the population for human resources (3 variables) and dynamics of the health labor market (11 variables). The standard deviation for the second objective was reported to be 0.891. The values related to these criteria, namely Cronbach's alpha and the composite reliability of the research factors, were greater than 0.7 in all factors, indicating the appropriate reliability of the model.

Strategic investment in human resources is essential to improve health services and achieve long-term sustainability of health care systems, especially in developing countries. The study also calls for increased collaboration and knowledge sharing between countries, improved working conditions, and targeted training programs to effectively address workforce challenges.

People with disabilities constitute a large population of society. Providing optimal rehabilitation services to people with disabilities has always been a primary concern of the health system in any country. One of the most essential duties of governments is to maintain and improve the health of all members of society. Considering the many factors affecting the realization of this goal, besides the serious will of the governments, we need the interdisciplinary work and cooperation of all the institutions of society and using all resources of various social, medical, and educational institutions. Another crucial factor lies in the adoption and application of laws supporting people with disabilities and planning to motivate them to find jobs, which is one of the priorities of governments. This study was conducted to compare the empowerment services for people with disabilities in different countries.

The present comparative study reviewed relevant qualitative studies on this topic in 2021. We used the library method to collect data, encompassing all articles related to the study subject. To conduct the study, the required data were collected by reviewing the relevant texts found in the library, websites of related organizations of selected countries in line with research questions, and a systematic search in reliable and specialized databases in English and Persian between 1995 and 2022. The extracted articles were evaluated and compared in a comparative table. Of 121 research articles and annual reports from the considered countries, we removed duplicate and unrelated articles and then applied the inclusion criteria. Finally, 49 articles and reports on managing empowerment services in 8 countries were selected and reviewed in full text.

The results revealed that in all studied countries, people with disabilities participate in planning empowerment services based on their nationality and citizenship. Regarding the hiring of human resources, all studied countries were working on training specialized human resources through their academic system. Unfortunately, Iran and India lacked comprehensive national data on this topic. In the meantime, the conditions were provided for planning and policymaking in America, Germany, China, South Africa, and Turkey. Funding for the services was primarily provided by the insurance system in Germany, America, China, and Turkey and taxes in England. However, the budget was provided through subsidies from public revenues and taxes in Iran. Investigations in the control area show that appraising the performance of the personnel providing empowerment services and monitoring by related institutions have been considered more by the relevant institutions. They use service quotas to control the empowerment services in Iran, Turkey, India, and China. Employment services for people with disabilities in Iran, Germany, England, Turkey, and India include a mandatory employment quota, and educational measures and income support are appropriate in all countries.

The empowerment system in Iran lacks the necessary integrity. In Iran, the university system trains human resources similarly to other countries. However, Iran has no access to comprehensive national data. Like most countries, the public budget and taxes provide financial resources in Iran. The dominant approach in most countries is the insurance system, but in Iran, the insurance system cannot cover the costs, and most of the expenses are paid by people with disabilities.

Due to increasing costs of the health sector and the inefficiency of the public sector, granting autonomy to hospitals was implemented in the independent hospital program.The aim of this study was to investigate the effect of establishing an independent hospital program on the performance indicators of pilot hospital in Qazvin.

The status of eight functional indicators of the pilot hospital was collected in the period of 2017-2020 before and after the establishment of the independent hospital program. Data were analyzed using paired t-test and Wilcoxon and interrupted time series at a significant level (p<0/05) and analyzed by SPSS24 STATA15 software.

The result of paired t-test and Wilcoxon-Neschein test shows that the establishment of an independent hospital program has had effect on the average active bed, active day bed and discharge number. Based on the analysis of the interrupted time series model, the average active bed with 55.96 units, active day bed with 1576.51 units, occupied day with 3357.14 units, percentage of bed occupancy with 40.63 unit and the number of surgeries with 736.60 units had an increasing average and the number of discharges with 47.92 units and average stay with 1.42 units, shows a decreasing average.

The present study does not show a significant change in performance indicators. It is suggested that managers and policy makers of the health system, if they wish to expand the plan, conduct comprehensive and detailed studies in this field.

Background & objectives: 

According to the recommendation of the World Health Organization, health insurance is an effective tool to achieve the global goal of universal health care coverage. The present study was conducted to design and determine a valid and reliable questionnaire to measure universal health insurance coverage in Iran.

 This descriptive-applied study was conducted in 2022. Based on the data obtained from the review and comparative study, an initial questionnaire was prepared based on the balanced scorecard model. Content validity was measured using a panel of 15 experts and content validity ratio (CVR) and content validity index (CVI) for each question. The test-retest method was used in a sample of 30 people to determine the reliability. Data were analyzed using Excel and SPSS 20 software. 

 Validity assessment was done in two stages. The final questionnaire was approved with a total content validity index score of 0.85 and a content validity ratio of 0.67. The results of Spearman's correlation coefficients for the four dimensions of the questionnaire showed the acceptable reliability of the questionnaire components. 

 Considering that the designed questionnaire was approved in terms of validity and reliability, it can be a suitable tool for determining the requirements for achieving universal health insurance coverage in Iran.

Blood consumption is of great importance in the world and Iranian medicine and is effective in saving the lives of many patients. The high cost of preparing blood and blood products indicates the considerable importance of managing the use of blood bags.

This study was descriptive and cross-sectional. The study tool was a researcher-made questionnaire with five options based on the Likert scale; its validity and reliability were confirmed by experts. The sample included 201 anesthesiologists, surgeons, and operating room staff of Nemazee Hospital to complete the questionnaire. Data were analyzed in SPSS 23 software.

In evaluating the current situation of optimal blood consumption management in the operating rooms from the participants' point of view, the most common items included:  "Development of educational programs to manage blood consumption through meetings and lectures, and retraining and training workshops" and "Registration and reporting of reasons for obsolescence of blood products (e.g. poor performance in over-ordering)" (79.1% and 78.1%, respectively). In terms of feasibility, the most common factors improving the current situation consisted of: "Use of safe blood transport equipment in the hospital" and "Prioritize the use of older blood bags instead of newer blood bags (in accordance with FIFO law (First In / First Out) by blood banks)".

This study showed that blood reservation is done too much. In this regard, there is a need for more control in terms of quality and quantity in the operating room of hospitals.

Accreditation means the systematic evaluation of health care centers with specific standards. The overall purpose of this study was to investigate the effect of accreditation interventions on patient safety measurement in operating rooms of one of the social security hospitals in Tehran.

The present study is cross-sectional in terms of result, application and implementation method, analytical and time. The statistical population is information sources related to the patient safety measure and its sampling is in the period 1391-1399. The sampling method is numerical and includes all the information related to this time period. Data collection tools are receipts that have been extracted by library method from data sources and data centers in coordination with the Quality Improvement Office and the hospital statistics unit. Data analysis was performed using SPSS software and intermittent time series analysis method.

Findings of time series analysis, research has been reported in three forms of incremental effect, decreasing effect and ineffectiveness of the accreditation scheme of the scales. In the patient's safety measure, the results of the fragmentary regression table showed that at the beginning of the study period, the average patient's safety measure was 76.34%. Monthly changes in patient's safety measure were not significant before the intervention (P = 0.43). After the intervention, the mean level of the patient's safety measure did not change suddenly and significantly (P = 0.42). Also, the difference in the trend (slope) of the patient's safety measure before and after the intervention did not change significantly (P = 0.31). But the results showed that after the first intervention, the trend (slope) of the patient's average safety measurement changed significantly (P = 0.000); So that the patient's safety measure after the first intervention has increased seasonally by 1.06%. In general, the results of the study have shown that, as a result of the implementation of the accreditation scheme, the patient's safety measure has increased.

The results show that the implementation of accreditation measures has an effect on patient safety measures. The number of significant measures from 2016 to 2016 shows that the third and fourth editions of the national accreditation standards of Iranian hospitals have been effective. Based on the analyzes performed, it is recommended that the patient's safety measure be increased after the first intervention. Therefore, the implementation of accreditation in hospitals is recommended to managers.

As health and financial resources become more complex and limited in health care organizations, outsourcing and proper management become more important. This article aimed to determine the effective factors and design a model for outsourcing management of non-clinical services in public hospitals.

In the results, this research is one of the applied studies. A 28-item questionnaire was used to collect data which the variables were extracted from comparative studies of selected countries. The validity of the structure was evaluated by experts and the Cronbach's alpha coefficient was determined to be 0.85. The study population included health system policymakers, outsourcing experts, and managers of public hospitals. For sampling, the stratified method is used and data analysis is performed using IBM SPSS and LISREL software.

According to the final model, 6 main and effective factors on outsourcing management were identified, which included planning, decision making, performance management, contract, communication and knowledge management, in orderly. Planning factors with coefficients of 0.94 had the most impact and knowledge management had the least impact with a coefficient of 0.34 on the outsourcing management of non-clinical services in Iranian hospitals.

Based on the resulting model, there are various factors in effective management that dimensions related to planning and decision making are of special importance and need to be more considered when outsourcing non-clinical services in public hospitals

The growth of the elderly population is one of the most important and prominent issues in today’s societies. One of the consequences of an aging population is the effects it has on health spending, which in some countries accounts for a significant portion of government spending. The purpose of this study is to compare the elderly services management system in the selected countries of this study with Iran in terms of policy, planning, financing and organizational structure in providing elderly services.

The present study was a review-comparative study on qualitative studies in 1399. Library method was used to collect data. The study population is all articles related to the research topic. In order to conduct information research by reading texts from the library, the websites of related organizations in selected countries in line with research questions and systematic search based on keywords based on aging, aging services management, aging management strategies and financing from reputable databases and Specializations in English and Persian languages were collected between 1998 and 2019 and were evaluated and compared in a comparative table of areas. Systematic search based on related keywords Scopus, Science Direct, PupMed and Google scholar along with national databases including SID, IRANDOC, ISC. Out of 128 identified sources, the researcher reviewed and evaluated their content according to the research strategy, and finally, after removing 81 of them for reasons such as duplication, irrelevance, etc., 47 articles remained for final analysis.

Aging system policy in all selected countries (US, UK, Japan, Korea and Italy) has been centralized in a way that using regional, provincial or state-based planning using public tax financing systems, funds Insurance, the national medicine system, by defining the target population and specific service packages, plays an effective role in providing quality and accessible services to the elderly. The provision of services in these countries is integrated (health, medical and social welfare) and Providing care services for them is free.

It is suggested to use the experiences of successful countries in the field of aging management, by creating an integrated and centralized policy system in the dimensions of health and social welfare; Relying on sustainable financing from public taxes, labeled taxes and old-age insurance premiums and reforming planning structures in providing and receiving services, the level of effectiveness and efficiency of old-age management can be improved.

Falls are the main cause of injuries and death among the elderly and lead to using medical services. This study aimed to assess the effect of falls on medical costs among elderly inpatients.

This retrospective cross-sectional study was done in a public hospital (heart center) in Qazvin, Iran. In this study, 79 medical records of the elderly who had experienced in-hospital falls and 79 medical records in control group with similar characteristics who had not experienced in- hospital falls during 2016-2019. The data, including the elderly age, sex, fall characteristics, and all hospital costs related to falls were gathered from hospital accident forms, medical records, nursing reports, and official data banks. The overall costs of services provided for fallen elderly were compared with the control group. The data were analyzed by SPSS software, version 22, using Chi-square and paired sample t-test. P<0.05 was considered statistically significant.

Total cost of all services provided for the elderly during their hospitalization was 106.596$ (base year: 2019, $1=42500 IRR), of this amount 8.600$ (8.06%) was related to the services due to in-hospital falls. The highest costs were related to treatment services (40%), diagnostic services (33%), visits (21%) and consultation (6%). The difference between the case and control groups was 7.310$. The elderly falls significantly increased medical costs by 8.06% (P≤0.01).

Even falls that do not lead to serious injuries waste medical services and increase hospital costs by making changes in treatment methods and increasing the length of hospital stay.

Patient safety is a global concern in the field of health services and an essential component of the quality requirements of health care, so the present study aimed to assess the level of patient safety substructures in three selected Mashhad’s teaching hospitals in 2017.

This Descriptive-Analytical and cross-sectional study was performed using WHO patient safety assessment protocol as a research tool. The study population consisted of senior and middle managers, staff, physicians, and patients of hospitals that a total of 54 sample people were selected by purposeful sampling method. Questionnaire data were collected by observation, review of documents, completion of checklists and structured interviews, and then analyzed through descriptive and analytical tests using version 21 of SPSS software.

In this study, a total of 20 critical patient safety standards were evaluated, the overall average level to achieve the standards was calculated to be 75.8%. Among the four domains studied, the domain of governance and leadership with a ratio (83.3%) had the best and the domains of a safe environment and patient and community participation with a ratio (50%) had the weakest status. There was no statistically significant difference between the three hospitals in terms of the level of compliance with the standards (p <0.05).

In general, the overall situation of patient safety substructure hospitals was evaluated at a relatively good level. The commitment of senior managers to the priority of patient safety, improving staff training, and increasing the informed participation of patients and companions to eliminate weaknesses and improve the current situation, can qualify for the title of patient safety friendly hospital for these hospitals that have a special place in the field of health tourism in the region and country

 Providing desirable rehabilitation services to people with disabilities has always been one of the most critical concerns of the health system in all countries. Today, it is crucial for policymakers and health care providers to recognize the different systems for providing rehabilitation services to people with disabilities. In this regard, it is beneficial to conduct comparative studies and use successful countries’ experiences in this subject. This comparison-analytical study aimed to compare the systems for providing rehabilitation services to people with disabilities.

This comparative study was conducted in nine countries in 2020. To determine the comparison framework in this research, four dimensions of health systems’ functions were used based on the 2000 report of the World Health Organization. The countries were compared in dimensions of stewardship, resource production, financing, and service provision. Findings obtained from each country were presented separately in the comparative tables. The model used in this comparative study was based on the Beredy Model that contains four stages of description, interpretation, proximity, and comparison. In the present study, the purposive sampling method was used. The statistical population included rehabilitation systems globally, and the research examples were Iran, China, Turkey, India, the USA, Mexico, Germany, England, and South Africa. Criteria for entering the research according to the functional model of the World Health Organization were the availability of data and selecting at least one country from each continent of America, Europe, Asia, and Africa.

 The findings showed that in Iran, the Welfare Organization was responsible for providing rehabilitation services for people with disabilities, while in other countries, it was the Ministry of Health. Also, to compare resource production, two staff training indicators and access to comprehensive national data were used. In all countries studied, the training of specialized human resources is done through the university system. Iran, India, and Mexico did not have full access to comprehensive national data, but the United States, Germany, China, South Africa, and Turkey provided the platform for planning and policy-making. Moreover, funding in Germany, the United States, China, and Turkey is mainly provided through the insurance system. In the United Kingdom, it is mainly provided through tax, but in Iran, it is provided through subsidies from the public revenues and taxes. Finally, besides the private sector, rehabilitation services in Iran’s public sector were provided incoherently by various organizations. Some of these organizations are the Ministry of Health and Medical Education, the Exceptional Education Organization, the Red Crescent, the State Welfare Organization, and the Martyrs and Veterans Affairs Foundation, while in other countries, these services are often provided through hospitals and the private sectors.

 Despite the numerous strengths in the system of providing rehabilitation services to the disabled in Iran, the integration of the rehabilitation sectors of various organizations within the Ministry of Health not only increases the inter-sectoral and intra-sectoral coordination, the coherence of management, and unified policy, but also leads to reduced costs, proper allocation of resources and increased financial resources in this sector. Besides, it leads to a reduction in overlapping tasks and responsibilities and prevention of duplication of work, training of specialized personnel based on the needs, and finally providing more desirable services. Therefore, policymakers and planners must review and reform the laws and processes to form a system for providing rehabilitation services to the disabled in Iran.

Medical tourism is one of the important sub-branches of the tourism industry. One of the factors influencing the choice of hospital by the tourist is the way of providing hotel services in hospitals.

The research was a descriptive correlational study conducted in 2009 in selected private hospitals in Tehran. A researcher-made questionnaire was used to collect information about the components of hoteling and a Shahroudi questionnaire was used to examine the observance of the components affecting the attraction of health tourists. The samples included 78 employees of the international department of two private hospitals in Tehran. To measure normality, Kolmogorov-Smirnov tests and multivariate regression and Pearson correlation coefficient were used to measure and determine the relationship between variables by SPSS 21.

This study showed that there is a significant relationship between the six pillars of hospital hotels with the attraction of medical tourists. Pillars of "buildings and installations" (p <0.05), (r = 0.231), "equipment and facilities" (p <0.05), (r = 0.263), "welfare services" (P <0.05), (r = 0.357), "cleaning and hygiene services" (p <0.05) and (r = 0.234), "nutrition" (p <0.01), (r = 0.393), and "administrative affairs and workflow" (p <0.01), (r = 0.332), are directly correlated with the attraction of medical tourists. It was also found that "human resources" is not correlated with the attraction of medical tourists.

In order to attract more medical tourists, it’s necessary that hospital managers and health policy makers pay more attention to the hoteling pillars, especially "nutrition" and "administrative affairs and workflow", which have the most correlation with attracting medical tourists.

From the point of view of health economics, medical equipment has a special place and a large part of the capital of medical centers and medical institutions is spent on maintenance and modernization of this equipment he purpose of this study is the relationship between employing a medical equipment expert and the cost of purchasing medical equipment in the units covered by Marand Health Center.

The present study is an analytical research in terms of implementation method. And from the perspective of the result, it is practical. Data collection method in this study was done with the library method and data collection tool was filing. Statistics and financial documents related to the costs of purchasing medical equipment of the units covered by Marand Health Center and comparing this cost in the years when the medical equipment expert was present (1996-97) with the years when the medical equipment expert was not present in the center (1994) -95) was done. All collected data were taken based on the base discount rate of 1997. For descriptive analysis of data, cumulative percentage and frequency percentage statistics, and for inferential analysis proportional to the levels of measurement of variables, statistics such as paired correlated t have been used.

The results of statistical tests show that there is a significant difference between the costs of purchasing medical equipment in employing a medical equipment expert and not employing a medical equipment expert with PValu.

Considering that there was a relationship between employing a medical equipment expert and the costs of purchasing medical equipment in the units covered by the city health center, it is recommended to health managers to prevent equipment disruptions and impose purchasing costs without a medical equipment program at the health center level. Maintenance of medical equipment As well as the management of medical equipment in the treatment department, use the presence of independent experts and technical staff of medical equipment in the health centers of the cities.

Organizations to develop and succeed need the knowledge, capabilities, and experience of human resources in a highly competitive global market. In knowledge organizations such as health organizations, is essential existence of performance evaluation system to maintain and grow tacit knowledge. The purpose of this study is to identify the most important dimensions and appropriate indicators for evaluation the performance of knowledge workers.

This study was a narrative review articles and reports on the knowledge workers health system between 2010 and 2020. In order to access related scientific documents, electronic search in both Persian and English using the keywords performance evaluation, performance evaluation system of knowledge workers, Scientific (SID), Iran Medical Sciences Articles Database (Magiran), Iran Medex article database (Iran Medex), PubMed, Science Direct, Inter Science, Ovid, Pro Quest.

The search results in different sites, including 7 articles in Persian in the field of evaluating the performance of knowledge workers, have been paid a survey variable such as independence, creativity and self-control by considering the results-based management and educational and research activities.

In the health system as a knowledge-based organization, managers must plan to implementation an optimal knowledge performance evaluation system. Thus fit model should be design to evaluation performance of knowledge workers, so that in addition an effective management of service delivery processes better health care quality outcomes.can be achieved.

Empowerment of managers and employees can be considered as one of the most important factors for making employees and organizations more efficient. Therefore, this study aimed to investigate the effect of managerial factors and identifying its components and variables in empowering health networks managers.

This applied, exploratory and cross-sectional study conducted among 430 managers of health networks of East Azerbaijan, West Azerbaijan and Ardabil provinces that were chosen by stratified random sampling method in 2018-2019. Data collected using a researcher-made questionnaire which its validity confirmed by experts and its reliability calculated using Cronbach's alpha coefficient of 0.96 Data analyzed by using descriptive statistics and exploratory and confirmatory factor analysis.

Based on the standard coefficients of confirmatory factor analysis, the "guidance and participatory management" with a factor loading of 0.96 and "manager’s feeling of belonging to a group" with 0.87 factor loading were the two effective management components on empowering health network managers and the indicators of both managerial components were significant at p<0.001 level. The variables of "consulting", "information sharing", "ability development" and "participatory management" with factor loadings of 0.85, 0.76, 0.75 and 0.71, respectively, had the highest importance.

The approved model of empowerment managerial factors in this study can be used as a practical guide for health system policy-makers and managers to play an effective role in empowering their managers by improving the managerial factor in health networks and organizations and through the participatory management, information sharing, guidance and support, delegating authority and responsibility.

On the page 52 in engelish abstract and 53, in abstract section, line 5 and 55 column first paragraph, the method section of article the method of conducting is quantitative-qualitativeand in terms of time it is cross-sectional. The reliability of the questionnaires was determined through re-testing and Cronbach's alpha coefficient, which was .872% for the whole questionnaire and 85% correlation coefficient. In the present study, a researcher-made questionnaire based on a comparative study was used and 41 questions were asked. In the following, in order to enter the stage of exploratory factor analysis, the adequacy of the data was first measured, for which the KMO Bartlett's test, which was 0.952, was used. 10% of the articles were coded by 3 people with a doctorate degree and work experience or research in the field of aging in the introductory stage, and the coefficient of agreement was 85%, and in the next stage, the whole sample was examined by one of them. Also, in page 56 the title of Table 2 is "Results of Comparative Studies of Active Aging Management for Iran".

The speed of service delivery in medical centers, especially emergencies, is of particular importance in reducing mortality and disability. Time management in providing vital and short-term health care services can endanger patients' lives. One of the most important indicators used in the evaluation of emergency centers is the waiting time for patients to receive diagnostic and treatment services. This study was conducted in 1397 in order to study the timing indicators and design of the management dashboard in a specialized heart center in Tehran.

This type of research is a section in which the emergency time indicators of the Ministry of Health were examined. All the relevant data in the emergency department was collected in a hospital in Tehran in 1397. Then, the design and creation of the dashboard was loaded based on the data of the indicators specified in the emergency department using QuickView software and the performance of this section was presented.

In the present study, six emergency timing indicators were examined. Then, according to the information obtained, the relevant dashboard was designed.

Reducing the length of stay in the emergency department leads to increased patient satisfaction and potentially cost savings. The main mission of the emergency is to providing high quality services in the shortest possible time. Prolonged emergency stops reduced the possibility of providing services to other patients in need of emergency medical care, which can lead to patient dissatisfaction and increased casualties.

The health system is one of the most important pillars needed by human societies and participation in the health system is considered as a suitable tool to encourage people to develop and improve health activities in their lives. The present study aims to determine the framework and dimensions of public participation in the health system and examines the experiences of selected countries.

The present study is a comparative study that was conducted in 2009-2010. The comparative study collected data from 5 countries: England, Mexico, Norway, Singapore and Iran and was examined in eight components. To analyze the data, comparison tables were used, which include a comparison of dimensions obtained from the study of the pattern of public participation in the health system of selected countries.

The findings of the study showed that in the studied countries, in order to promote public participation in the health system, strategies such as the development of new information technologies, reducing government ownership and social inequality, reforming the health system and Benefit from creating appropriate structures for grassroots participation, developing non-governmental organizations, and emphasizing and promoting moral and cultural values.

The concept of public participation needs more information transparency and the impact of factors such as economic factors, the creation of appropriate organizational structures and information technology on it should be further discussed and localized according to the conditions of the country.