مجله مدیریت بهداشت و درمان
سال نهم شماره 4 (پیاپی 30، زمستان 1397)

Transnational higher education is a good tool to prepare students for future roles in the global economy. Educating a global citizen through an international curriculum, improving the learning environment, encouraging students and employees, developing global thinking, and promoting development and understanding among nations. The importance of internationalization is that universities should educate students who are ready to acquire international qualifications, understand global conditions and expand international relations. The main objective of this research is to identify the components of internationalization of the medical education industry in Iran. This research is a descriptive method in terms of applied purpose and collecting data. According to research tool, this research is considered as a qualitative research group. The research community includes experts in the field of higher education and medical education and medical industry. The MAXQDA12 Software has been used to analyze the data. The results of the research showed that the most important components of the medical education, including faculty level (with sub-components of relationship with other countries and international interactions), macro level (with sub-components of student, political situation, economic status, cultural situation, environmental factors and macro laws) industry level (With the following components of laws and regulations, decision-makers, market and customers) and university level (with sub-components of the infrastructure and capabilities of professors). The most important factors at the university level are the faculty empowerment, at the industry level, the component of the institutionalization of international culture is at the macro level of the standardization component and at the level of the components of the component is the relationship with other countries.

one of the main causes of the efficiency and effectiveness of any organization, is Staff training. This study aimed to determine the effect of training on productivity in physicians in health centers of Isfahan University of Medical Sciences. The semi experimental design was conducted. The population was consisting of 86 staff who were selected randomly. The population of this study was physicians that working in Health centers of Isfahan University of Medical Sciences. Data was collected through "Productivity Questionnaire of Hersi & Goldsmith". This questionnaire was completed before and after the study by physicians. The intervention group received in-service training for 51 hours. Before and after the intervention physicians completed questionnaires of productivity. Data were analyzed using SPSS software version 16. Paired t-test was used to compare the data in both groups before and after the intervention. The results showed that there is a positive and significant relationship between the mean score of physicians' productivity before and after of in-service training. (P<0.05). The subscales include motivation and performance evaluation also increased after intervention. (P<0.05). The in-service trainingin physicians can improved a number of components of productivity. Therefore, it is recommended to improve the factors affecting productivity by enriching the training.

Economic growth in rich countries tends to slow down naturally, so the growth process will ultimately lead to convergence. The aim of this study is to investigate the convergence of per capita health expenditures and health outcomes in countries of the Economic Cooperation Organization. This is a descriptive-analytical Study that was done with the economic data of the countries of the Economic Cooperation Organization in 1995 -2014 and using EViews software version 10. Stochastic convergence using Panel Unit-Root test, and also the standard deviation of log per capita health expenditures and health outcomes have been used to evaluate sigma convergence, and beta convergence with estimating the panel data convergence model. Absolute and conditional stochastic convergence in per capita health expenditures were not approved in ECO countries. The coefficient of the absolute beta convergence of per capita health expenditure in ECO countries was 0.29. The conditional beta convergence coefficient was 0.30 in countries with high human development and that was 0.01 in countries with medium human development. The life expectancy Beta convergence coefficient was 0.28 in ECO-countries and 1.16 for the under-five mortality rate. There is no sigma convergence. Based on the results, the non - convergence of per capita health expenditure and health outcomes divergence show an increase in disparity and revealthat poorer countries have improved their health at a much slower rate than their wealthier member in ECO. Therefore, it is necessary that ECO policies be planned and implemented with the aim of reducing regional differences.

The ultimate ambition of organizations in today's fast-changing world is to properly manage and direct challenges and successfully deal with the continuous, dynamic, and unpredictable environmental changes. Agility is an attribute of organizations that enjoy such a management. The present study aimed to rank agility factors, examine their conditions, and identify strategies for enhancing agility in hospitals in the Iranian city of Birjand. This was an applied study using a descriptive-analytical method, and the A.T. Kearney model was used to assess organizational agility. The data was collected through a questionnaire that was distributed among 75 employees in three hospitals, namely A Hospital, B Hospital, and C Hospital. SPSS and Excel were used for statistical testing and ranking, using the TOPSIS method. Considering the mean test results (t-tests) for the three hospitals and the significance level obtained for each criteria, it was found that A Hospital is an agile organization for the three criteria of culture and values, customer service, and organizational change. Considering that the performance management enjoyed a significance level below 0.05 for B Hospital, it is an agile organization in this regard. Meanwhile, C Hospital proved to be an agile organization in terms of culture and organizational change. Ranking results for agility of hospitals through TOPSIS showed that C Hospital with a relative immediacy index of 0.555 held the first place, A and B hospitals with relative immediacy indexes of 0.523 and 0.440 held the second and third place respectively. The statistical test results showed that out of the six organizational agility criteria, A Hospital enjoyed a desirable condition for the three criteria of culture and values, customer service, and organizational change, B Hospital for one criterion, namely performance management, and C Hospital for two criteria of culture and values and organizational change.

prediction the per capita health expenditures can be useful and effective in determining the best policies for financing and managing of health expenditures. Accordingly, the main objective of this study was to predict the per capita health expenditures trend in Iran. In this paper, we specified a health expenditure model relying on theoretical basics in order to obtain desirable forecasts. On the basis of three forms of linear, exponential and quadratic equations and using theoretical foundations in the field of per capita health expenditure function, we used genetic algorithm (GA) and particle swarm optimization (PSO) algorithm to simulate Iranians per capita health expenditure during 1979-2015. Then we selected the superior model in terms of prediction power criteria and forecast per capita health expenditure until 2041. Also, the statistical analyzes were performed using the MATLAB software version R2016b. The predicted results indicate that per capita health expenditures in Iran will increase with a positive slope by 2041. The amount of this expenditure will be from $ 1081 (based on 2011 constant prices) in 2015 to $ 2628 in 2041 (about 2.5 times). With regard to the projected amount of per capita health expenditures up to 2041 horizon, policy makers in the health sector should take the necessary measures to finance the expenditures of this sector.

 According to Importance of state of health care service providing, system performance, and its major impact on public satisfaction, the main question is about the public satisfaction evaluation as a consequence of the quality of health care services? The aim of the proposed model in this study is to develop a comprehensive model incorporates various criteria to assess the satisfaction of performance health care services providing. The descriptive-analytical approach is adopted for this study with an applied purpose, among 384 patients referred to the Shahrood hospitals in 2018. At first, key dimensions of satisfaction assessment of health services have been identified based on the literature and the experts’ opinions via using a researcher-made questionnaire. The statistical relationships between proposed model dimensions are analyzed by structural equation modeling technique. Key findings of this study indicate that general satisfaction of health care services has a significant relationship as well as path coefficient with the others assessed dimensions such as quality of health services (0.87), staff skills (0.77), access to services (0.66), and cost of services in order of priority (0.54). Considering the dimensions of satisfaction has a significant role in achieving appropriate service providing, desirable performance, and enhancing the efficiency of health care services. Finally, this consideration can lead to applied efforts to significantly increase patients’ satisfaction. In addition, using the obtained results of this study can provide an efficient finding for customers classification based on the level of satisfaction and their specifications.

Social Security Organization as a health service provider provides some parts of healthcare services in indirect sector through contracting with private and public centers. The purpose of this paper was to performance assessment and ranking provincial units of this organization in indirect treatment sector. In this cross-sectional descriptive study, the performance of this organization's indirect treatment across the country was assessed using the TOPSIS method by considering six important attributes. For this purpose, each province was considered as an alternative also the required data from the 2017 statistical yearbook was obtained. Calculations and ranking of provinces were done using Excel 2010 software. The ratio of the total number of contracted healthcare centers to the population covered by the treatment of each province and proportion of the total number of doctors contracted to the population covered by the treatment of each province attributes with the highest weight were identified. The highest and lowest performance scores were calculated 1 and 6×10-4 respectively. Although the social security organization has used indirect treatment in all provinces of the country as a strategy to increase the access of insured persons to medical resources, it did not have the same performance in all provinces. Therefore, it is recommended to increase the purchase contracts of health services with hospitals, clinics, polyclinics, day clinics, healthcare centers, general practitioners, specialists and dentists of public sector, private, military, etc., especially in provinces with poor performance.

Research shows that more than 50% of patients do not receive clear information about their own healthcare services and consequently their treatment is not performed with their own participation. The present study was conducted aiming at investigating and recognizing patient-centered care in hospitals for its increasing significance in the health system.

The research is a review study conducted through a search of reputable scientific databases such as Springer, Elsevier, Pubmed as well as Persian databases such as Magiran and SID between 2010 and 2018. Key terms such as “Patient-Centered Care” and “Patient Centredness” were used to search the English databases, and to search in Persian databases, key terms such as "Patient-focused care "and" Relationship between doctor and patient "were employed. 

The patient-centeredness has different definitions, leading the focus of treatment from illness to patients. Therefore, providing health services is based on a traditional physician-centered model, in which the physician knows best, is changing to a patient-centered healthcare approach. The main goal of the patient-oriented approach is the participation of patients and their families in providing services.

In a patient-centered health system, instead of focusing on the physicians’ decisions and priorities, the focus is on the patients’ needs and concerns, and in this regard, the healthcare centers should implement programs to increase the patients’ participation in the therapeutic process so that in addition to increasing patient satisfaction, better therapeutic results can be achieved.