فصلنامه پژوهش های سلامت محور
سال پنجم شماره 1 (پیاپی 16، بهار 1398)

Recently, Activity-based Costing method has been used instead of traditional method of cost calculation, especially in the health sector. In spite of its advantages, this method has some limitations such as cost driver selection, which, in the case of being selected incorrectly, it leads to errors in results. The purpose of this study was to select the most appropriate cost drivers in hospitals.

This descriptive and qualitative study was done in one of the Educational hospitals affiliated to Iran University of Medical Sciences, Tehran, Iran. The allocated costs of IT, nutrition and cleaning units to the delivery, surgery, burn, dialysis, cardiovascular and eye wards were calculated based on the hospital financial data of 2016. Based on the searched data, cost drivers were identified and eventually, a panel of experts determined the most appropriate cost drivers.

The cost allocated by hospital the support units to the different wards varied based on different cost drivers. The appropriate cost drivers of nutrition, housing, and information technology units were the number of food portions, the square area and the number of active computers, respectively.

Due to the impact of cost drivers on the correct estimation of the cost of services in the healthcare sector, selection of appropriate cost drivers for each sector should be made on the agenda of Health policymakers.

Nurses as the most important human resource in health care organizations, play an important role in providing health care and the quality of health services. Since nurses’ job quit can directly and directly affect health organizations, this study aimed at identifying nurses’ point of view about effective factors on job quit.

This qualitative phenomenological study was conducted in 2018. Data were collected through semi-structured interviews with 18 nurses of one of the private hospitals in Tehran who had left their work environment. Data were analyzed using content analysis and MAXQDA-18.1 software.

Factors affecting job quit were identified in 4 main codes and 13 sub codes. Main codes included: organizational factors, financial and economic factors, individual and family factors and factors related to the workplace.

Implementing productivity law in the private sector, long-term contracts with staff, improving financial regulations of private hospitals and effectively overseeing their implementation, paying more attention to providing job benefits and motivating can lead to greater mental and occupational safety, decrease of occupational burnout, feeling good in the workplace, and ultimately, it can reduce job quit of nurses at private sector.

Medical tourism as a growing industry contributes to GDP growth and employment, and improves infrastructure in the country. Hospitals compliance with global criteria would undoubtedly increase the quality of therapeutic services for medical tourists. Hence, this study was conducted to evaluate the compliance of hospitals of Shiraz hosting medical tourists with global criteria.

This descriptive-analytical cross-sectional study was conducted in six hospitals with medical tourism units in Shiraz in 2018. Data were collected through a researcher-made checklist containing 48 questions with 6 dimensions. Data were analyzed using Spearman's correlation coefficient by SPSS version 22.

The examined hospitals were compliant with global criteria in terms of infrastructure facilities, quality of health services, and human resources management. In terms of accreditation and welfare dimensions, 3 hospitals matched with global criteria. However, none of the hospitals matched with global criteria of medical tourism services dimension. There was a significant correlation between the number of active beds and welfare services (P=0.00).

According to the relative compliance of Shiraz hospitals with global criteria for admission of medical tourists, it is necessary to pay attention to welfare and medical tourism services in order to develop medical tourism in Shiraz.

Human resources are the most important asset of any organization and the life and survival of any health system depends on its manpower. Therefore, the pathology of human resources in health care system is necessary. The purpose of this study was to determine the pathology of human resources in Shahreza Health and Treatment Network using the three- dimensional model.

This descriptive-analytical cross-sectional study was performed on 245 health care workers of Shahreza city in 2018 selected through stratified random sampling. Data collection tool was the standard questionnaire of human resource three-dimentional Pathology Model with three dimensions of behavior, structure and context. Data analysis was done using t-test and Friedman test and through SPSS version 22 software.

Mean scores of the structural factors and the behavioral factors were respectively 2.86 and 2.77 which indicated poor status of the employees in these factors. Mean score of the contextual factors was 3.23 and indicated good status of subjects in this item. Also, the components of payment system, motivation and job satisfaction, contractors and consultants were the most important causes of human resources trauma in terms of structural factors, behavioral factors and contextual factors, respectively. 

Along considering human resources pathology, the organization management system should pay attention to improving the organizational structure and work processes, fair distribution of rewards, paying attention to workers’ competencies, and creating a motivational organizational environment for staff growth and development.

Health Village is a residential/healthcare place for natural remedies combined with other medical treatments. Health village can be set in different sizes, depending on the amount of investments and the investors’ strategic objectives. In fact, a complete health village can cover all aspects of health and meet all the health needs of a community.

In this  review study, Persian and English articles  indexed in valid databases such as Google Scholar, SID, Pubmed, Irandoc Science direct and Scopus were searched using the MESH terms of “ Health village” and “Health resort” without time limitation.

Providing health services in natural areas and away from urban pollution can restore the health and well-being and also can cause psychological and physical relaxation not only in patients but also in those who are interested in living in places with services such as water therapy, herbal therapy, gravel treatments, mud therapy, and other services. 

The effort to create environments such as the health village, due to the potential of such centers in providing high levels of physical and psychological comfort for audiences, can be considered as a beneficial local business. Therefore, the health village is an environment that can contribute to the social and economic development while serving the health of the community.

Screening and timely treatment of neonatal phenylketonuria can prevent the irreversible complications of the disease. Therefore, the screening is essential during the early days of birth. The aim of the current study was to evaluate the indices of the phenylketonuria screening in Kerman district during 2013-2017.

This descriptive cross-sectional study was carried out on 92168 newborns referred to the reference sampling center in Kerman district from March 2013 to March 2018 and selected through census sampling. Data included the number of screened newborns, the time of the first sampling, the time of announcement of the suspected results, the level of phenylalanine, the number of re-screening by cause and the frequency of confirmed phenylketonuria. Mean, standard deviation, and frequency (percent) were calculated using Excel 2013 software.

The frequency of timely screening in Iranian and non-Iranian infants was 84.78 and 65.69%, respectively. Most newborns (99.75%) had normal levels of phenylalanine. The incidence of neonatal phenylketonuria in the study period was 0.16 per 1,000 live births.

The incidence of neonatal phenylketonuria in Kerman was approximately the same as the overall incidence in the country and the frequency of timely screening increased during the study period. Since evaluating any health-related program requires a rigorous data collection system, more attention must be taken to record the data needed to evaluate the program.

In slum areas, due to the economic, cultural and social reasons and how health services are delivered, the health status of people needs serious attention. Implementation of health reform plan in Iran led to increased attention to the health of slum area population. The present study was conducted to assess the outcomes of implementation of primary health care services reform in comprehensive health service centers at slum areas in Isfahan.

This qualitative research with phenomenology approach was conducted in 2018. Study samples consisted of 21 experts of health deputy and health providers of comprehensive health services centers in Isfahan University of Medical Sciences selected using purposive and snowball sampling methods. Data gathering was done by semi-structure interview. Data analysis was done using content analysis and through the 10th version of MAXQD software.

The outcomes of health Reform Plan implementation in primary health care services provision, at Isfahan's slum area Health Services Centers were organized and classified in 6 main themes and 51 sub-themes. Main themes were promotion of health care availability, private sector participation, management, improvement of staff education and providing resources based on the needs and establishing electronic health records with 51 sub-themes.

Feasibility of using public-private partnership models in building, operating, transferring, needs assessing, system evaluation and monitoring of the Comprehensive Health Service Center and compiling the required human resources chart can improve the outcomes of this plan.

Clinical Governance (CG) is an organizational strategy for maintaining and improving the quality and safety of patient care and increasing employees’ and managers’ responsiveness and accountability through developing an appropriate organizational structure and culture as well as developing, implementing and monitoring clinical guidelines, pathways and standards. This study aimed to examine the success of CG implementation in university hospitals, in Tehran, Iran.

In this descriptive analytic study, a researcher-made questionnaire was filled out by managers and CG executive managers of 39 university hospitals in Tehran/ Iran. Data analysis was done through SPSS software and using Pearson, Spearman and logistic regression.

Clinical Governance was moderately successful in Tehran university hospitals (58%). The most success was achieved in patient involvement and risk management dimensions and the least success was observed in clinical effectiveness and clinical audit dimensions. Management and leadership and clinical audit had the most effect on CG success. The involvement and commitment of managers and employees in implementing CG were moderate and physicians’ involvement and commitment was poor. The length of CG implementation time had significant relationship with managers’ and employees’ commitment and CG success.

Clinical governance was not successful in Tehran university hospitals. Active involvement and commitment of top managers, staff empowering, patient centeredness, evidence-based practice, and clinical audit are necessary for successful CG implementation.