مجله مدیریت بهداشت و درمان
سال دهم شماره 1 (پیاپی 31، بهار 1398)

Outsourcing in the hospital is considered as a solution to a variety of problems. Outsourcing in a hospital is a transfer of part of the activities that lead to hospital productivity.The purpose of this study was to design a model for evaluating the outsourced service performance of Shahid Dr. Labafinejad Hospital using a balanced scorecard. The method of this study was descriptive-survey and applied to the target. The statistical sample was used to determine the criteria of the outsourced service performance evaluation model of all managers (25 people), supervisors of different departments of the hospital (55 people) and experts in quality improvement and procurement services (30 people) in Shahid Dr. Labafinejad Hospital and To determine the weight and importance of the outsourced performance evaluation model, 10 hospital managers.The research tool was a researcher-made questionnaire. Data were analyzed using Factor Verification and Fuzzy AHP Approach. According to findings from Factor Verification Assessment for the Oversea Exercise Evaluation Model of Shahid Dr Labafinejad Hospital, using BSC, thirteen criteria were determined. Also, according to Fuzzy AHP analysis, in the model for evaluating the outsourcing service of Shahid Dr. Labafinejad Hospital, dimensional priority is dimensional internal business processes (0.370), financial dimension (0.293), dimensional customer (0.229), and dimensional growth and learning (0.108). The proposed model for the Shahid Dr. Labafinejad Hospital and other educational hospitals in the country can be implemented and provides an opportunity to evaluate the outsourced service performance using the BSC model.

Today, the pharmaceutical industry is considered one of the world's most important and largest industries, and the possession of such industry is one of the most important criteria for the development of countries. Internationalization of technology has a defined process, which is the transfer of knowledge and technology from an individual or group to a person or group in order to use it in a system, process, product or method of doing business. The purpose of this research is to identify the factors influencing the internationalization of pharmaceutical technology companies with an institutional approach. In this research, institutional factors influencing the internationalization of pharmaceutical companies using qualitative method and through interview with pharmaceutical industry experts were identified and analyzed using the Grounded theory method. This research is applied in terms of purpose and is descriptive in terms of collecting data. As a result of data analysis, the most important institutional factors considered by the experts, including 33 factors from all interviews, were extracted and identified, and these factors were classified into four regulative, normative, cognitive, and conducive dimensions. The results of the research showed that in the regulative dimension, the factor facilitating the export laws and reforming the drug pricing system, in the normative dimension, management stability and company programs, in the cognitive dimension, familiarity with international marketing and the importance of research and development, and In the conducive dimension, obtaining credible international certificates is one of the most important institutional factors affecting the internationalization of pharmaceutical technology companies.

Child mortality is one of the most important cultural, economic and health indicators in evaluating the health status of the community. This study aimed to analyze the relationship between health centers with the child mortality based on the Gini coefficient and Lorenz curve. This ecological descriptive study was conducted in 2016 to examine the equality or inequality in the distribution of health facilities in the cities of Mazandaran province based on demographic indicators. The research population consisted of health centers, health personnel, emergency centers and the number of employees in these centers. After collecting data from the Ministry of Health of Mazandaran and babol University of Medical Sciences, the obtained data was analyzed using Dasp2.1, STATA and SPSS19 software. Gini coefficient for the distribution of rural health centers was 0.28 and 0.32 for urban health centers, based on population. The Gini coefficient for distribution of health centers and health personnel was higher than 0.3. There was a significant relationship between the ratio of rural health centers to the population and child mortality (r = -0.853, p-value = 0.03) of children under five years old (r = -0.901, p-value = 0.01), and between the ratio of health centers to population and child mortality (r = -0.367; p-value = 0.03) of children under five years old (r = 0.489, p-value = 0.03). Since a significant level of inequality was found in the distribution of some health centers, considering the relationship between health centers and child mortality.

The important role of risk and its challenges in organizations is one of the reasons for the importance of examining the risks of production. Considering the classification of the pharmaceutical industry as one of the most important industries, the investment risks in this industry have been analyzed using the Failure mode and effects analysis (FMEA) method. This method is one of the risk management techniques to identify, analyze, and ranking risk factors in order to increase the efficiency of the industry. This descriptive study suggests FMEA as a quantitative method for identifying production risks and, by computing risk priority numbers (RPNs), represents the probability of their risks and effects in the pharmaceutical industry. In this research, after identifying the risks of drug production through literature review and interviewing experts, a questionnaire was designed that out of 66 identified risks, 19 risks were identified and ranked by experts as important risks. Good manufacturing practices (GMP), exchange rate fluctuation, no marketing strategy and lack of proper estimation of market trends, inventories of raw materials and inventory of supplies was identified as the most important risks of drug production.

The jobs that employees have the role of care are naturally susceptible to various types of physical and mental illnesses. Psychological well-being is one of the variables that can act as deterrent and moderating against such issues and problems. This study aims to investigate the role of psychological empowerment in the prediction of psychological well - being in health care workers. This research is descriptive – correlative study. The statistical population of this study was 720 people of the health care workers of the city of Qayen, among which, using cluster random sampling method, and 250 people were selected as sample. Data were gathered using psychological empowerment questionnaire of Spritzer and Mishra (1995) and psychological well-being of Riff (1995). The results were analyzed using SPSS software whit Pearson correlation coefficient and regression test. The results showed a positive and significant relationship between three dimensions of psychological empowerment (autonomy, meaningfulness, and trust) with psychological well-being, but there was not relationship between two other dimensions of psychological empowerment (competence and effectiveness) with psychological well-being.The results of the regression analysis showed that, among the dimensions of psychological empowerment, two dimensions (trust and self – determination) have the power to predict psychological well - being. Therefore, human resource needs and priorities must always be considered and as far as possible, the empowerment programs in the organization must be carried out.

Organizational ideology has been developed at all times through the dissemination of customs and traditions and myths and sagas. Therefore, the present study with the aim of analyzing the relationship between organizational medical myths and organizational ideology with the role of mediating organizational saga in the mission-oriented organization of the University of Medical Sciences. This research is a descriptive-correlation study. The statistical society of this study consist of consist of Hamadan University of Medical Sciences with 3250 Employee to using Morgan table and G*power, finally 344 numbers with use of category sampling method were selected as samples. The measurement tools in this study consisted of three researcher-made questionnaires; their validity and reliability were reviewed and confirmed. Structural equation modeling was used to analyze the data based on covariance and software of LISREL. The results of structural equation modeling showed that the organizational medical myths have a positive and significant relationship with organizational saga. Also, the relationship between organizational medical myths and organizational ideology is mediated through organizational saga. According to the research results, with an increasing focus on organizational medical myths, and the Mythology and Legendary of the new series that will create organizational saga, a step will be to strengthen and develop a strong organizational ideology.

Introduction Growth of health expenditures, financial limitations, low efficiency and quality of service provision in public hospitals and ever-increasing expectations have obligated healthcare systems to utilize private sector’s capabilities. According to other countries’ experiences, public-private partnership (PPP) is a solution that not only reduces defects of every sectors, but also integrates both sectors’ advantages. This study was aimed to review PPP models in hospital management and propose suggestions for best model selecting in different situations. In this study, after organizing questions as well as determining search strategies, opted articles were assessed deeply; definitions as well as different PPP models’ pros and cons in hospitals management were analyzed; and finally, these models were compared according to quality-effectiveness, access, financial efficiency, and risk sharing indicators. By reviewing 32 peer-reviewed articles, PPP models were categorized in service providing, financing as well as developing infrastructures, and compound levels. Based on the results, “clinical outsourcing” and “management contract” have attained high level in access and quality-effectiveness indicators and “BOO”, “DBFO”, and “clinical outsourcing” models have achieved high level in financial efficiency. Furthermore, “operating contract” and “privatization” are placed in two ends of risk sharing spectrum. Finally, “outsourcing”, “management”, and “lease” contracts are advised to improve productivity of public hospitals; and “BOO”, “BOT”, as well as “DBFO” models are advised to develop infrastructures and increase the number of hospitals beds. Considering hospital management challenges and health economics specifications, utilizing public-private partnership models is a vital issue to fulfill the aims of healthcare system.

The psychological characteristics of managers as an important issue in the success of organizations and considered as the main element in empowering the human resources of the organization as well as increasing their productivity. Positive psychological characteristics of managers can lead to mental feeling of employees and they Self-esteem and the higher the level of mental health of managers is, it can create good features for management in managers. The current research aimed to identify psychological traits of Middle managers in Hospitals of the University of Medical Sciences in the city of Urmia Which has been studied by the combined method (quantitative - qualitative). In the qualitative section, postmodern paradigm, phenomenological strategy, and latent content analysis technique by semi structured (in-depth) interview (to the theoretical saturation level) with 13 cases of Middle managers. In the quantitative section, using the structural equation modeling by partial least squares method, the reliability and validity of the obtained tool was confirmed. The interviews were analyzed through open coding and axial coding using MAX QDA12 and the Smart Pls2software has been used to confirm the tool. The psychological characteristics of the middle managers in the community were identified in the four dimensions of Self- Reliance, Self-Efficiency, Building Trust, and Legal Attitude , and a structural model based on these components was presented and the reliability and fit of the newly developed model were measured, so that the average of collective sustainability for all categories (AVE = 0.87), and the combined reliability (CR = 0.86) and equation fitting (Gof = 0.452) were obtained that the model had a relatively strong fit and can be generalized to the entire statistical society. Managers can, by identifying and properly using their psychological characteristics, can rely on themselves and enhance and enhance the sense of doing business, increase motivation and commitment in the staff, as well as increase productivity and success and increase the performance of employees, which leads to The success and survival of its organization.