فصلنامه پژوهش های سلامت محور
سال چهارم شماره 4 (پیاپی 15، زمستان 1397)

Intensive Care Unit (ICU) is the most important units in hospitals, which imposes high costs to patients. This unit is considered as one of the high-cost unit for providing End-of-Life Services. The cost analysis of the ICUs can help managers decide on how to provide the services of this unit.

In this descriptive study, the total cost of Internal and Neurosurgery ICUs in a selected teaching hospital affiliated to Iran University of Medical Sciences in 2017, was evaluated using top-down approach. The financial records of the units and data on the cost drivers were collected from accounting and related units, respectively.

About 7% of the total hospital costs was related to the ICUs. The direct costs allocated to the internal and neurosurgery units were about $2261000 and $928000, respectively. Payments, medicines, and hospital consumables had the highest share of costs, respectively. By considering the total costs, the units as well as services studied were loss-making. 

Given that the hospital is a teaching one, teaching students about saving resources reduces the costs. Also, by providing home health care services for patients at the end-of-life stage hospitalized in the ICUs can also help the hospital achieve its financial goals.

Medication error is a preventable event that can lead to patient harm. The Pharmacy Information Systems (PISs) promise to reduce medication errors. Considering the importance of these systems, the aim of this study was to evaluate the performance of pharmacy information systems in Shiraz hospitals.

This descriptive-analytic cross-sectional study was conducted on 31 pharmacies in Shiraz hospitals in 2018. Data were analyzed using standard checklist for the evaluation of hospital information system (HIS). After analyzing the data normalization by Shapiro-Wilk test, ANOVA test was used. Data were entered into SPSS version 24 software.

Public, private, and non-public hospitals had respectively the highest average scores in the pharmacies information systems. In terms of the performance of pharmacies information systems, most public (61.1%) and private (60%) hospitals and all non-public hospitals (100%) were at moderate level. In addition, there was no significant relationship between different dimensions of performance of the pharmacy information systems and hospital ownership type. 

It is necessary that the designers and analysts of the pharmacies information systems, while cooperating and consulting with users of these systems, pay more attention to design and modify the pharmacy information systems.

Pregnancy is a natural process in every woman's life, which its natural consequence is the birth of a child. But some pregnancies may end in maternal death. Therefore, in-depth study of effective factors in reducing maternal mortality due to pregnancy and complications of delivery can be significantly contributed to the promotion of pregnant women's care programs. The aim of this study was to determine the present status and effective factors of maternal death in Kerman University of Medical Sciences.

This descriptive study was conducted on the medical records of 30 pregnant women who were died due to pregnancy and delivery complications in 2002 to 2016. Data were collected from health centers in Baft, Bardsir, Zarand, Sirjan, and Kerman, which are under coverage of Kerman University of Medical Sciences.

The average age of pregnant women who were died was 31.5 years. Bleeding was the main direct cause and heart diseases were the main indirect cause of their death. Kerman had the highest maternal mortality rate and Baft city had the lowest maternal mortality rate. 

In order to effectively reduce the ratio of maternal deaths due to pregnancy and delivery complications, it is necessary to pay attention to the quality of care before, during, and after delivery, and necessary sensitization with regard to targeted training.

Patients’ length of stay in emergency departments is one of the key criterion which has been focused by hospital managers recently. This study aimed to assess the influencing factors on patients’ length of stay in an emergency department of a training hospital affiliated by Alborz Medical University of Medical Sciences.

This was a descriptive-analytical study with a cross-sectional design in 2017. Study population consisted of all inpatients in a six month time period from the beginning of the study year. Through the use of Cochrane sample size calculation formula 555 numbers of samples were selected which their related data were obtained from the review of patients’ medical records. To test study hypotheses data were entered to a SPSS version 20 and analyzed through descriptive statistical analysis method, Pearson correlation test, t-test, and ANOVA.

Mean of patients’ length of stay was 11.31 hours. Evidence showed that this mean time was correlated with some of the factors including internal or external medical counseling, the necessity to have a medical laboratory test, a medical imaging test or the time interval between triage and the first physician’s visit.

Modifying hospital processes and performance procedures in an emergency department with an aim to improve service quality and effective interactions among different hospital units can play a helpful role in solving existing problems.

Operational research as an evaluation strategy can be effectively used in the evaluation of health information technology. This study was conducted to evaluate the application of operational research technique in the assessment of health information technology.

This is a review article. In order to collect data, English-language studies on the use of operational research in the assessment of health information technology, which were published in Scopus, MEDLINE, and ScienceDirect databases between 2000 and 2018, were investigated. Of 251 retrieved studies, 14 studies met the inclusion criteria.

It was revealed that different techniques of operational research such as simulation, analytical hierarchy process, linear programming, and data envelopment analysis, were used in the health information technology assessment, among which simulation was the most widely used technique.

Operational research techniques prevent the trial and error in the selection process by providing detailed scientific approaches to decision-makers in different sections of health care, and provide proper situations for reducing the costs.

Regarding the effect of chronic kidney disease on the physical, social, and mental health of patients, evaluation of the quality of life in hemodialysis patients is of great importance. This study aimed to evaluate the quality of life in patients with chronic renal failure (CRF) treated with hemodialysis.

This cross-sectional descriptive-analytic study was performed on 85 patients who referred to Dialysis Center of Selected Educational Hospital in Shiraz Selected teaching hospital, and selected by census sampling. Data were collected using SF36 questionnaire with 8 dimensions of physical function, performing physical role, physical pain, general health, vitality, social function, performing emotional role, and mental health. Data were analyzed using t-test and ANOVA. Data were entered into SPSS 21 software.

It was revealed that 61.2% of the patients were male, 42.4% aged 45-64 years, and 37.6% had social insurance. The highest mean score for the dimensions of emotional health, mental limitation, and vitality was obtained to be 66.4, 63.3, and 61.5, respectively. There was a significant relationship between age, marital status, physical activity, place of residence, educational level, and health-related quality of life in hemodialysis patients. 

In order to promote patients' health, policymakers should provide access to healthcare services, welfare, education, and sport facilities for dialysis patients.

Population aging is one of the factors that increase the need and consequently the demand for health care. The purpose of this study was to evaluate the demand function for health services in different age groups.

This study was a panel data type that estimated the demand function of outpatient health services using the population age pyramid of the country during the period of 2006-2011. In order to estimate this model, age groups were considered as the explanatory variable and the number of outpatient visits to health centers was considered as the dependent variable. Information on these variables for all provinces of the country was collected from the Iranian Statistics Center. Data analysis was performed using Eviews software version 7 and Stata version 11 software.

There was a significant relationship between demand for health services and age groups of 59-40 years (P= 0.05) and over 60 years (P= 0.04). In the age group of 40-59 years, there was an increase of almost 5% in the number of visits to medical centers, while in the age group of over 60 years the increase in demand was 0.19%.

As population aging is a foreseen and unavoidable phenomenon of the future of our country, identifying the health needs of the elderly and providing therapeutic methods that meet the needs of this population, while considering the limited resources are necessary.

Accreditation, as a known method for evaluation of health care centers, is used with the aim of enhancing healthcare quality in the health systems of different countries and its success has a direct relation to the effective performance of its surveyors. So, the purpose of this study was to provide a conceptual framework for evaluating the accreditation surveyors of Iran hospitals.

This qualitative study with a phenomenological approach was conducted in 2018 through eliciting the views of 30 expert and experienced interviewees in the field of hospital accreditation at the Ministry of Health, medical universities, hospitals, as well as accreditation surveyors selected purposefully with maximum diversity. Data were collected through semi-structured interviews and analyzed using content analysis.

A total of 4 main codes and 28 sub-codes were identified. Main codes included necessity and importance, principles and requirements, structure and methods of surveyors’ evaluation.

The results of this study can provide an effective framework for health system administrators in evaluation of accreditation surveyors of Iranian hospitals. In other words, continuous evaluation of accreditation surveyors’ performance using different methods based on the principles and requirements found in this study can lead to the performance improvement of accreditation surveyors and finally the achievement of the accreditation goals.