نشریه مدیریت سلامت
پیاپی 76 (تابستان 1398)

Abstract

The International Statistical Classification of Diseases and Related Health Problems has been created for various purposes by the World Health Organization which annually modifies it for a better classification of diseases and achievement of intended objectives. Therefore, this study aimed to determine the knowledge of coders in educational hospitals about the changes made in the10th version of the classification system.

This descriptive-analytic study was conducted in 2018. The research population included coders in educational hospitals situated in south east of Iran. The population of the study consisted of 83 people selected through convenience sampling method and Morgan table. Data were gathered through an electronic questionnaire the link of which was sent to the participants. The data were analyzed in SPSS22 software using Pearson and ANOVA tests.

The participants had a very low knowledge of the changes in ICD-10 (27.36 ± 15). There was a significant relationship between the  knowledge of the participants and their education, and working experience as coders (P = .001)

The findiongs indicated the coders’ low awareness of the changes in ICD-10; therefore, it is necessary to hold essential training workshops and create Persian sites to help them get familiar with the changes.

Hospitals are considered as critical health service providers. Taking the advantage of knowledge sharing and establishing trust between suppliers and hospitals, supply chain performance can achieve IT and supplier integration and pave the way for effective competition in the modern world, especially in health care services. Therefore, the current study aimed to analyze factors affecting knowledge sharing through supplier integration in hospitals in Mashhad.

This applied research was conducted from 2018 to 2019. The population consisted of all hospital managers and employees among whom 273 people were selected through multistage sampling carried out in private, charity and public hospitals. Data were collected using a standard questionnaire addressing five variables: trust, supplier integration, IT integration, knowledge sharing and supply chain performance. The construct validity of the questionnaire was assessed and confirmed through confirmatory factor analysis, and the reliability was calculated as 0.871 using Cronbach's alpha. The data were then analyzed by the SPSS, and Liserl software. Moreover, regression tests were run.

According to the findings, the impacts of trust and IT integration on knowledge sharing were 0.33 and 0.48, respectively. The impacts of trust and IT integration on supplier integration were 0.33 and 0.35, and the impacts of knowledge sharing and supplier integration on supply chain performance were 0.36 and 0.71, in that order. The results also confirmed the mediating effects of trust, knowledge sharing, and supplier integration on supply chain performance.

Supply chain performance requires the establishment of trust between hospitals and suppliers, leading to enhanced knowledge sharing, IT and supplier integration, reduced costs, increased speed, and improved quality.

Inaccurate and delayed entry of information are one of the sources of failure in the communication of information between hospital information systems and electronic health record in Iran. The purpose of this study was to investigate the accuracy and timeliness rate of patients’ information in hospital information system whose information was not successfully sent to electronic health record system.

In this descriptive study, conducted in 2016, 882 records which had failed to be sent from hospital information systems to electronic health record system were reviewed. A checklist was used to collect data which were then analyzed by SPSS.22 to calculate the frequency of accurate and timely data entry in hospital information systems.

A total of 18758 demographic and clinical information were examined. Overall, the accurate and timely data entry in hospital information systems were 97% and 99.87%, respectively. The highest rate of inaccurate information was related to patients’ identification numbers, national codes, full addresses and places of residence, and the highest rate of delayed data entry was related to final diagnosis and causes of patient death.

The results demonstrated a high rate of accurate and timely data entry in hospital information systems. The results also identified some sources of inaccurate and delayed data entry which could be attributed to the negligence of the users. Therefore, it is recommended to hold orientation sessions to enhance users’ knowledge about accurate and timely data entry, and also design systems capable of producing feedback in order to improve the accuracy and timeliness of data entry.

Health insurance is one of the most important components of health care financing to reduce inequality in out-of-pocket payments. Therefore, considering the importance of insurance, increased out-of-pocket payment, and the demand for private insurance, and also the multiplicity of insurance funds, this study aimed to investigate the effects of health insurance on out-of-pocket payments among urban households in Iran.

In this applied, descriptive-analytic study, conducted in 2016, a sample of 17809 urban households in different provinces were recruited from the Center of Statistics of Iran. A household cost-income questionnaire, prepared and completed by the Center of Statistics of Iran, was used to collect data which were then analyzed by using the Stata 14 and double sample selection method.

The results showed that the household head's literacy and marital status, the family size, the number of children and elderly, wealth, per capita income and expenditures on education and tobacco had a direct effect on the probability of buying health insurance. Furthermore, households with one type of health insurance had to tolerate more out-of-pocket payments than the other households and finally, households with health insurance, social security insurance and other insurances experienced the highest out-of-pocket payments.

The significant difference between the out-of-pocket payments to different insurance types necessitates the establishment of an integrated insurance system which provides the same level of goods and services to all people in the community. On the other hand, the harmonization of health tariffs can reduce the inequality in out-of-pocket payments among the households. Moreover, it is recommended to have a system for monitoring the quality of care.

Knowledge management and intellectual capital are key factors for organizations to achieve competitive advantage. The purpose of this study was to determine the relationship between knowledge management and intellectual capital in faculties affiliated with Iran University of Medical Sciences.

The participants of this applied study, conducted in 2018  consisted of 283 non-faculty instructors teaching at Iran University of Medical Sciences. Two standard questionnaires, Lawson’s Knowledge Management and Bontis’s Intellectual Capital questionnaires were used to collect data which were then analyzed by using SPSS software version 22. Moreover, Pearson correlation coefficient was used to measure the relationship between knowledge management and intellectual capital.

According to the findings, the knowledge management status in the faculties of Iran University of Medical Sciences was 2.92 which was lower than the average. While the intellectual capital status in was 3.05 which was higher than the average. Also a positive and significant relationship was found between knowledge management and intellectual capital (r = 0.697, P = 0.001).

Considering the existence of a positive and significant relationship between intellectual capital and knowledge management, the officials are recommended to focus on strengthening the components of knowledge management and intellectual capital dimensions to enhance the intellectual capital, make the optimal use of human capital and implement knowledge management and expand it within the organization.

Considering the growth of cancer in the world and also in Iran, the oncology ward is considered as one of the most significant wards in hospitals. Information quality plays a key role in improving the performance of this ward. Dashboards can track the key indicators and improve the performance of oncology wards through transferring information to managers.Therefore, the current study aimed to identify the performance indicators for oncology wards, based on the the needs of decision makers, and then design and evaluate an appropriate dashboard.

In the first stage, the key performance indicators were determined using a questionnaire which was completed by all 30 oncology administrators in private hospitals as well as hospitals affiliated with Medical Universities in Tehran. In the second stage, QLIKVIEW software was used to design a dashboard which was evaluated by hospital directors, and directors of the oncology wards in Shohada Haftom Tir and Firouzgar Hospitals.

Seven key performance indicators, including the number of patients, days off, hours of training, personnel, complaints, as well as income and expense were identified. The satisfaction mean scores of hospital directors, the technical staff and the internal director of the oncology ward were 7.5±0.32, 7.4±0.39, and 7.3±0.37, respectively.

Dashboards can collect data scattered between various depatments, summarize them, and provide key performance indicators. The information available in dashboards in oncology wards can provide a basis for informed decision making to improve the performance of the ward.

The importance of management's role in any organization is obvious. Selection and appointment of competent managers in healthcare organizations -given the importance of their services- will also have a significant impact on health systems and communities. Therefore, it is necessary to identify and validate key management skills and competencies to design educational programs and identify and employ the best managers.

This descriptive study consisted of two phases. First, a literature review was performed to identify the required competencies and skills for healthcare management and leadership based on which a five point likert-scale qestionnaire was developed. In the second phase, a Delphi technique was used to collect 20 experts' opinions about the extracted criteria in the questionnaire.

Based on the experts' opinions, eight key criteria including: personality traits, values, basic management knowledge, hospital management knowledge, planning skills, organizing skill and resource allocation, leadership skills, monitoring and supervision skills, and 46 sub-criteria were approved.

Management knowledge is one of most important skills for managers; therefore, it is necessary to revise approaches for selecting managers and change the attitude of hospital managers form autocratic management to leadership and Intra-organizational collaboration and coordination.

The necessity of changes in universities moving from the second to the third generation, requires scientific and applied studies in this field. The present study aimed to provide a model for the organizational structure of third generation of Medical Universities.

This qualitative study was conducted in Medical Universities in Tehran and Fars provinces. The population consisted of 288 assistants and senior experts 18 of whom were selected as statistical sample by using the theoretical saturation method. An open-ended interview was used to collect data which were then analyzed using MAXQDA12 software and three phases of open, axial and selective coding to develop a grounded theory and a model.
Reisuls: The final model represented 6 main categories of internal and external requirements, university structure, consolidation of organizational structure and the existing barriers, internal factors, and entrepreneurship all of which can be considered as the innovation of this study.

The internal and external needs of universities affect the structures of the third generation universities; therefore, some strategies are needed to consolidate the organizational structures. These strategies are also affected by internal factors and barriers, and would ultimately lead to entrepreneurship and its advantages.