نشریه مدیریت سلامت
پیاپی 16 (تابستان 1383)

Health information managers classify the information of health care and treatment on the bases of classifications system of medical procedures, and also they analyze the statistical reports on the bases of this arranged information. Today without an efficient and complete medical classification system, it would seem almost impossible to render health care with acceptable quality. By this system the results of care process are documented using standard codes. These codes become the basis for data analysis for medical team, researchers, policy makers and planners. Taking into account, the absence of classification system of procedures in iran. The necessary to create an appropriate model to satisfy coders'needs in urgently felt.

This cross sectional comparative study wasconducted in the year 2003-4 to present a compatible model for national medical classification system. The means for collecting data were texts, periodicals, internet and electronic mails. In this research the the trend of development, structure, responsible organization, advantages and limitations and also the standards have been used in designing English classification system were studied in order to recommend a national classification system of procedures. Using Delphi system, the recommended model was put into practice in two phases. Eventually after the analyses of test results, a workable model for national classification of medical procedure was presented.

The results obtained from comparison of English cassification of medical procedures with each other and with our own systems are presented. Also the final model has been completely described in five major axes, multiaxially, expandability without changing main structure of system, more expansion, Persian guideline for coding, necessary modifiers, standardization ability and organizing the chapters on the bases of the type of procedures or interventions are some of the advantages of the recommended model compared with the available medical classification systems.

It seems that the recommended model for national classification system of medical procedures as compared with the national classification systems in English speaking countries has some similarities to the system of Nordic countries rather than other English systems. Since the national cassification system of medical procedures is in i5s infancy in iran and also due to occurrence of negligence in some procedures, some codes are advised in case of unpredicted medical procedures.

Breast cancer is the most common malignancy among women - and second Leading cause of cancer mortality in most world wide countries. many studies indicate that Breast self examination ( BSE ), clinical breast examination ( eBE ) and mammography reduce mortality of breast cancer. This study assess effect of education of prevention on breast cancer on knowledge and belief of university. students (B.S) residing in fatemieh dormitory's of Tehran university by application heath belief model .

This study was quasi - experimental ( before -after) carried out on 99 university students. Sampling was a cluster multi stage random method. Selffadministered Questionnaire was prepared to collect the data. Paired T test, ANOVA, X2 test were used to analyze the data. The educational method applied was giving lectureecompanying Pamphlets and film and slide presentation. In this study Participants were between 20 - 25, 17.2 % of them had a positive family history of breast cancer, 12% of them were medical history of breast disease. 

While the mean number of the group in the pre test was 5.68(from total 22), it became 16.96 in posttest. paired T test indicated Mean of knowledge's and health belief score had a statistically significant difference between pretest and Posttest ( p < 0/0001 ) . conclusion Education about prevention of breast cancer can promote knowledge and Attitude about screening measurement of breast cancer.

Overcoming the existing crisis in the hospitals without considering the patients needs and their satisfaction is impossible. The level of hospitalized patients satisfaction with different units is one of the important criterions for evaluation of the quality of hospital services. 

The present study was carried out by a cross-sectional method during the spring of 2002 for evaluation of hospitalized patients satisfaction with provided services in different units of hospitals (Shafa, Bahonar and Kerman Darman) affiliated to Kerman University of Medical Sciences. The statistical population of this research includes patients over fifteen who have been hospitalized in the internal and surgery wards of the above hospitals for a minimum period of 48 hours. According to the pilot study, the minimum required sample size were 564 patients and for more confidence, 600 patients were interviewed in the releasing time. Study tools were prepared on the basis of the standard questionnaires of the Ministry of Health and Medical Education and Isfahan and Shahid Beheshti Universities of Medical Sciences. The collected data were analyzed by SPSS program and using Chi square and T tests.

About 59% of patients were satisfied with the hospital services. Among the different units, the highest level of dissatisfaction was shown for the patients' nutrition and hygienic conditions of their rooms and the highest level of satisfaction was shown for the clinics and nursing units. The results indicate no relationship between satisfaction with different hospital units and the patients' age, level of education, duration of hospitalization and marital status. 

Solving the problems resulting in patients dissatisfaction requires the administrators commitment and effort. Hospital administrators should consider the patients' needs and expectations to acquire their satisfaction and encourage them to cooperate in their own treatment and care process and help the hospital to achieve its objectives.

In every organization ,man power is the most important element. of excellence and progress and is the essential factor in the realization of its goals. Since job satisfaction plays a significant role in achieving organizational goals as well as individual and social health, thus the influencing factors must be examined by the public sector so they cold correct the weaknesses and reinforce the strengths through careful recognition of opportunities and threats . the present study was conducted toward the above-mentioned objective. 

The study is a descriptive - analytical research conducted on 324 randomly selected personnel of Birjand University of Medical Sciences. The data collection tool was job description index. The data were analyzed by Analysis of variance (ANOV A) and k2 by means ofSPSS software.

The findings indicate that there is a significant relationship between gender and job satisfaction regarding promotion system and salary (P < ',' 0). There was also a significant relationship between the personnel with different educational backgrounds in five job types. Personnel vlith degrees higher than bachelor were more satisfied with their jobs and salaries. Theses People, however, showed less satisfaction with their supervisors, colleagues, and promotion system. A significant relationship was also observed between service rank and job satisfaction. The Most amount of dissatisfaction concerning payment was related to clinical and "health" care Personnel. 

In order to increase job satisfaction, modifications must be done in areas like the present evaluative methods, payment systems, personnel's attitudes toward their jobs, and manager - personnel relationships. Taking personnel's needs into account, and planning precise long-term schedules can also be effective in this regard.

long-term hemodialysis and kidney transplantation are the most common treatment for kidney failure. Regarding the increasing demand of these patients to receive therapeutic services, cost-effectiveness of these methods are compared.

This Cross - Sectional research was done to compare cost - effectiveness of long - term hemodialysis and kidney transplantation using Delphi index and patients' medical records. Research population are Kidney patients referring to Shahid Hasherminejad Hospital in 1378.

In this survey expenses of 1378 were tallied. Findings show that kidney transplantation expenses were 38% and 18.5% of long-term hemodialysis for male and female patients, respectively. In Delphi Scale, effectiveness of kidney hausplautation was 7 times more than long-term hemodialysis. In summation, cost-effectiveness of kidney Hausplantation is 8 times more than hemodialysis.

Long-term dialysis average expenses are four times more than kidney transplantation index of effectiveness in kidney transplantation method was more than long-term dialysis up-to the age 54 in the research population.Cost-effectiveaess of kidney transplantation method in different age groups is 3-14 times more than long-term dialysis.

The Significance of research in the Promotion and development of Scientific Capabilities of a country in evident, provided that these research studies are done by analyzing and reviewing the information resources in such a way that avoids duplication of the work already done. Among The information resources, internet is to be the most complete and efficient source of information providing an easy access to a large volume of information in a short period of time.

Data collection was done by a library and internet research.

Playing an important role, internet, through a worldwide network, provides the background information required for review of literature, through subject index, online accent to libraries, articles and valid journals of the world, theses, dissertations of post-graduate studies, exploration based on subject content, address, title and connection with researchers, experts, specialists of different careers and professors in different stages of a research including the range and significance of the problem, review at the literature, prerequisite studies atc.

Providing a world wide information network, along with diverse capabilities, internet plays a determining and prolific role in every stage of a research, and removes the limitations of the traditional system of getting access to the information. Thus, considering the effectiveness of this system it is recommended To promote researchers' Knowledge and skills for acknowledging and utilizing the system to help them conduct valuable research studies.

Training, in each organistion, may be offered III different forms including in-service education. In-Service education in hospitals is increasing important because of the dynamic of medical Sciences.

This research was done as a quais i-experimental study, to evaluate a retraining program offered to promote the knowledge of medical record practitioners of a social security hospital in Estahan in fall 1382. There were 30 subjects whose knowledge level was measured by a questionnaire before and after the retraining program. Face validity of the questionnaire was confirmed and its reliability was measured by a pretest and a post - test. The first part of the questionnaire included personal details and the second part consisted of 30 questions related to the subject content offered in the program. Data analysis was done by parametric and non parametric tests with the aid of SPSS soft ware.

The Percentages of correct mowers, given by the subjects in the pretest and posttest, were 50% and 78%, respectively. The personnel's with an educational background, related to medical education, showed higher scores both on the pretest and the post test. The scores of medical practitioners of Shariati hospital, on both tests, were lower than those of the other two hospitals, Qarazi and Fatemehalzahra.

Considering the significant effect of this retraining program on promoting the knowledge level of the practitioners, it seems essential to offer such a program for all medical record practitioners.

Nowadays, tatal quality management is welcomed as the common language and enlightening means of all organizations trying to modify their prior approaches by implementing this management system. However, the in formation systems with all their faults have caused some problems in implementing this high quality system consequently, favourable or considerable results are achieved. 

This paper was done as a library and internet research lay the review of literature. It was attempted to show the role, importance and mechanism of providing a eorrect information system if different stages of total quality management from the beginnig up to the end. Furthermore, the significance and provision of correct information system in all 9 stages of FOCUS-PDCA were discussed.

Review of literature:

The related studies mostly reveal that the main reason for unfavourable outcome of total quality management in the failure either in data collection or in the presenttion of the results. Thus, the real nature and efficiency of this management system is not totally revealed.

FOCUS-PDCA is a suitalle strategy under the topic of total quality management which encourages. Personnel to Think systematically. Morover, considering the prinaples of TQM, the real promotion of procedures is facilitated by the provision of information. Hence, along with the implementation of total Qulality Management, the modificalion of information systems should be considered simultaneously. The modification of the information systems is required during the procen of promotion at the end. Of it. Modification is the only assisting means to demonstrate TQM and its output in a precise system. When the output, folloswing the procen, is explained by statistical and reliable data, one can discuss whether the procen of promotion is effective and in compliance with the needs of the clients.