فهرست مطالب

Evidence Based Health Policy, Management and Economics - Volume:2 Issue: 4, 2018
  • Volume:2 Issue: 4, 2018
  • تاریخ انتشار: 1397/09/03
  • تعداد عناوین: 8
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  • Raziyeh Montazeralfaraj , Mohsen Pakdaman , Hossein Fallahzad , Masoudeh Mojahed , Mahdi Ghadiri Atabak * Pages 226-238
    Background
    We can achieve a clear picture of the demands for services and the ways to respond to them by examining the status of health care services in patients with hepatitis B. In this way, we can minimize the gap between the promotion and improvement of the performance of service providers. Therefore, the aim of this study was to evaluate the utilization of healthcare services in patients with hepatitis B.
    Methods
    This cross-sectional study was conducted among 464 patients with hepatitis B who were selected by simple random sampling using a researcher-made questionnaire containing 20 items, according to the study variables. We entered the data into the Excel software and analyzed them by STATA 13 software using descriptive statistical tests and linear regression.
    Results
    There was a significance association between the utilization of education and counseling services, specialist visits, clinical services, and the place of provision of services. In addition, the utilization of education and counseling services had a significant association with the supplemental insurance and the incidence of hepatitis B in the family. A significance relationship was also observed between the number of visits to the specialist and the type of occupation, educational level, and duration of diagnosis. Utilization of inpatient cares had a significant relationship with the place of residence and the basic insurance status.
    Conclusion
    Generally, the rate of visits to access the healthcare services is low among patients with hepatitis B. Considering the fact that this disease is special, we suggest the authorities to provide health care services in three preventive levels free of charge (by providing a health insurance card for the patients. Furthermore, the government needs to implement the national health insurance (NHI) and therefore does not receive the franchise. Patients should refer to specialist according to the general practitioner's opinion. They also should have access to the services during the evening.
    Keywords: Utilization of health services, Hepatitis B, Specific Patients
  • Arash Rashidian , Maryam Radinmanesh *, Mahnaz Afshari , Mohammad Arab , Zahra Shahinfar Pages 239-248
    Background
    Global surgeries include ninety operations in the common surgical procedures, with the annual fixed fees; which the insurance companies pay hospitals accordingly. The aim of this study was to compare the global fees to these surgeries’ real costs and to investigate the affecting factors in two teaching hospitals affiliated to Tehran University of Medical Sciences.
    Methods
    This longitudinal retrospective descriptive-analytic study was conducted on all hospital records with global surgeries in three months in 2012 to 2013 in two educational hospitals affiliated to Tehran University of Medical Sciences.Data were collected using the researcher’s –made checklist and extracted from the HIS (Hospital Information System). SPSS20, EXCEL, and STATA software were used to analyze the data and to obtain the difference between the recorded costs and global fees.
    Results
    The global fees were less than the recorded costs in both hospitals. The recorded costs in hospital B were much less than hospital A for the same surgeries. In hospital B, costs have been reduced for some surgeries in 2013comparedto 2012 by reducing the patients’ length of stay and time management.
    Conclusion
    Fees in the referral hospitals of Tehran University, which usually involve complicated patients, should be determined more accurately. However, this study suggested that hospitals can greatly reduce the cost of global surgeries throughclinical and cost management.
    Keywords: Global surgery, Hospital, Fee
  • Tayebeh Baniasadi , Farid Khorrami *, Mohammad Jebraeily , Fahime Khamzade , Fateme Ghovvati Kisomi Pages 249-257
    Background
    Hospitals need a system for evaluating and monitoring performance for promotion the efficiency and effectiveness of their services and outcomes. Pabon Lasso model is a graphical chart that can be used to identify the current status and performance level of hospitals by combining hospital indicators, simultaneously. Therefore, this study aimed to evaluate the performance of Hormozgan University of Medical Sciences (HUMS) hospitals during a six-year period using this model.
    Methods
    This descriptive study includes all teaching and non-teaching hospitals affiliated with the HUMS. After gathering the required information related to three indices: Bed Occupancy Rate, Bed Turnover Rate and Average Length of Stay for the years 2009 to 2014 from the statistical systems and yearbooks, the situation of hospitals in terms of indices by drawing Pabon Lasso graphical charts using SPSS version 16, were analyzed.
    Results
    The results showed that during a six-year period, on average, 26 percent of hospitals were placed in zone I, that is the inefficient area, 28 percent in zone II, 30 percent in zone III which is an efficient area of the model and 16% in zone IV of the Pabon Lasso model.
    Conclusion
    The findings indicated that the utilization of hospitals beds is relatively desirable. Periodic monitoring of province centers and determining their status in the model, and also, performance assessment from another dimension is suggested in order to achieve more comprehensive and more accurate results.
    Keywords: Hospital Performance, Productivity Evaluation, Indicators Monitoring, Pabon Lasso Model
  • Hasan Jafari , Abbass YazdanPanah , Abdolreza Akbari * Pages 258-267
    Background
    One of the ways through which the quality of the hospital services can be improved is the accreditation, and most of the countries have launched their own accreditation system as a strategy to improve services. The aim of this research was to investigate the way of implementing the accreditation programs at Shahid Motahhari educational center in Marvdasht city.
    Methods
    The current study was qualitative with conventional content analysis which was conducted by using the semi-structured interviews with eight officials and employees of Marvdasht Shahid Motahhari Medical Education Center in 2017. Purposeful sampling was done in this study and the next stage; the snowball sampling method was used to select the desired samples. Data were gathered to reach the data saturation point, and conventional content analysis was done to analyze the research data.
    Results
    Two main themes and nineteen sub-themes were obtained through the nine categories. Self-confidence in the team, sense of superiority and achievement, all units’ coordination, accurate and scientific coherent supervision and management, and considering the book of standards as a guiding factor are among the strengths of this research.Poor management of programs, lack of proper context while running the program, lack of proper training, lack of financial and human resources, lack of commitment and interest in implementing the program among different groups were main identified barriers of the program.
    Conclusion
    The effective factors on the implementation of the accreditation standards in the healthcarecenters should be identified. Besides, planning effective education, continued monitoring and assessing, creating suitable contexts of financial and human resources,consolidating the strengths and using the available potentials can be effective factors in line with the implemetation of accreditation standards.
    Keywords: Accreditation, Hospital, Qualitative study, Evaluation
  • Fatemeh Najafipour Moghadam*, Irvan Masoudi Asl , Somayeh Hessam , Mahmoud Mahmoudi Majdabadi Farahani Pages 268-274
    Background
    Medical tourism represents the travel of individuals to receive health care and treatment to another country. One of the important factors in the marketing of medical tourism is promotion. The purpose of this study is to investigate the importance of promoting factor in the proposed marketing pattern of medical tourism services.
    Methods
    This study is a Descriptive-Correlational research method and an applied research in terms of purpose conducted in2017. The statistical population of the study consisted of all staff of medical centers and active units in the medical tourism area of the medical Science Universities in Iran and 630 of them were selected as a statistical sample by using simple sampling method. The data collection tool was a questionnaire with 63 questions related to tourism marketing components with scoring based on Likert scale. The validity of the questionnaire was evaluated by experts' judgment and reliability was measured by using Cronbach's alpha coefficient (0.82) and Test re Test (0.92) in SPSS22.
    Results
    According to the standard estimates of path coefficients, the promotion factor with score of 0.98 consisted of 8 components ranked first among others was determined.
    Conclusion
    Considering the importance of the promotion component, Policy makers in the field of medical tourism services should pay special attention to promotion and related issues in order to properly identify the Capacities and capabilities of active centers globally.
    Keywords: Medical Tourism, Marketing, Pattern
  • Sima Rafiei , Rafat Mohebibar , Bahman Ahadi Nejad , Nadia Nisari * Pages 275-280
    Background
    Social capital has an important role in empowering entrepreneurship activities and performance improvement inhuman resources. This study aimed to examine the relationship between social capital and entrepreneurship behavior of academic members of Qazvin University of Medical Sciences in 2018.
    Methods
    The present study is a descriptive cross-sectional method conducted among all faculty members working in Qazvin University of Medical Sciences in 2018. In order to collect study data, two standard questionnaires including social capital scale (Nahapiet & Goshal 1998) and entrepreneurial behavior (Leon Daes Zamptakis and Vasiliss Mustakis 2007) were used. Data were analyzed using descriptive and analytical statistical methods in SPSS 20.
    Results
    The results of the study showed that social capital and entrepreneurial behavior had a desirable condition. Furthermore, these two variables were statistically correlated (P-value < 0.05).
    Conclusion
    Promoting the level of social capital in academic environments has significant benefits and a positive impact on entrepreneurial behaviors of academic members of the university. Therefore, managers should strengthen this key element in their organizations to upgrade their professional job performance.
    Keywords: Social Capital, Entrepreneurial Behavior, Faculty Member of the University
  • Roohollah Askari , Mohammad Ranjbar , Mehran Nakhaeizadeh , Shiva Sheikholeslami *, Sara Sepehrifar , Morteza Adhami , Zeinab Shabooni Pages 281-289
    Background
    Leukemia is the fifth most common cancer among both genders. The prevalence of this type of cancer has been increasing in Iran. According to the Iranian Cancer Registry System, leukemia is among the first four cancer cases in terms of causing mortality. Considering the importance of survival rate of patients with acute cancers in Iran, this study aimed to study survival of patients with acute adult leukemia in Iran systematically.
    Methods
    In this study, all articles on the survival rate of patients with acute leukemia were searched throughout the Google scholar, web of science, PubMed, Scopus, Cochrane of science, Cochrane, Magiran, Irandoc, IranMedex and SID websites. Our search included the articles published up toJune 2017. Using the keywords of Iran, ، Leukemia, ، Survival rate, blood cancer, life expectancy and their compositions. The search process was completed by two researchers independently. Then, all the reviewed articles and theses that met our inclusion criteria were examined. The data were analyzed using a comprehensive meta-analysis software and by running the Cochran test.
    Results
    We investigated eight studies with a sample of 1219 people in our meta-analysis. The findings showed that the 1-year survival rate for adults with acute leukemia was 61 % and the 5-year survival rate was 48 %.
    Conclusion
    According to the research findings, the survival rate of patients with acute leukemia in Iran is the same as other countries.
    Keywords: Iran, Leukemia, Survival rate, meta-analysis, Systematic study
  • Behrooz Pouragha , Najmeh Baghian , Marziye Najafi * Pages 290-296
    Background
    Future is being continuously created at any moment and never stops. By reviewing the future, it can be discovered, evaluated and assessed to create desirable future. The health sector is daily faced with a variety of threats at different environmental, social, cultural, economic and political scales. To deal efficiently with these threats, it is necessary to use the future as an opportunity to promote people's health by investigating, anticipating and building it, and managing it properly. Therefore, this review was conducted with the aim of determining the domains and methods of future studies in the health sector.
    Methods
    In this review article, searching was performed by terms futures study or forecasting or fore sighting and health sector in four databases consisting of Two Persian databases Magiran and the Scientific Information Database and Two English ones Google Scholar and PubMed. In the first search, 531 articles were selected and retrieved. After the titles and abstracts were read and duplicate articles were excluded, and then the full texts of the remaining articles were reviewed, seven articles were included in the final analysis.
    Results
    The results of studies in the health sector show that future studies is an important tool and evidence for policy makers in almost all areas of the health system's functions, such as determining the amount and types of services needed, training specialists and other health sector’s staff, allocating funds, the number of beds and other facilities, developing and constructing of hospital wards, etc.
    Conclusion
    The results of studies in the health sector indicate that futures study provide important tools and evidence for policymakers in almost all areas of the health system's functions, such as determining the amount and types of services needed, allocating funds, number of beds, expansion of hospital departments, technology requirements, the impact of policies and programs.
    Keywords: Futures Study, Foresight, forecasting, Health