فهرست مطالب

Evidence Based Health Policy, Management and Economics - Volume:3 Issue: 4, 2019
  • Volume:3 Issue: 4, 2019
  • تاریخ انتشار: 1398/09/10
  • تعداد عناوین: 8
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  • Sima Rafiei, Rafat Mohebbifar, Amir Mohammad Kazemifar, Mahshad Shakuna* Pages 231-243
    Background

    The provision of manpower is one of the effective factors on the improvement in the coverage of health services and the realization of the highest community health level and a considerable part of the health budget is devoted to the production and update on human resources. Therefore, the current study aimed to estimate the number of nurses required in the Emergency Department (ED) of Imam Ali hospital based on the proposed method of the World Health Organization, in which the manpower is calculated based on the workload Workload Indicators of Staffing Need (WISN).

    Methods

    This was a cross-sectional descriptive study. The study population was all the nurses working in the emergency department of Imam Ali hospital affiliated by Alborz University of Medical Sciences and their duties in the hospital which was performed using the proposed method of the World Health Organization i.e. WISN in 2018. Determination of their duties and the time and number of times for performing them were carried out during the group discussion session through Delphi method.

    Results

    Based on the research findings, 40 standard nurses were calculated. The studied hospital had 4 nursing staff shortages. The working pressure ratio is 0.91in this study.

    Conclusion

    In the current study, the nursing staff shortage is observed and this shortage caused a high working pressure on the nurses working in the study area. Considering the vital role of nurses in the emergency department, it is recommended to employ and distribute the manpower based on the requirement and workload in the department.

    Keywords: Nurse, Workload, Emergency Department
  • Seyed Jamalaldin Tabibi, Mohammad Reza Maleki, Jamil Sadeghifar, Reyhaneh Sharifi* Pages 244-249
    Background

    Patient preparation process for surgery is one of the strategic control points in hospitals, which can improve the patient satisfaction and increase the quality of provided services. This study aimed to determine the impact of pre-surgery consultation unit startup on waiting time before surgery and cancellation of surgery.

    Methods

    This cross-sectional and analytical study was conducted in an Eye Hospital in Tehran. The study population included patients hospitalized for cataract surgery at Farabi Hospital in Tehran City, Iran. Data were collected using a researcher-made questionnaire containing information about the participants' gender, age, waiting time, cancellation of surgery, and length of stay. Data were analyzed by SPSS18 using Mann-Whitney and Chi-Square tests.

    Results

    Pre-surgery consultation unit startup was able to significantly reduce the patient waiting time before surgery (P-value < 0.001). No significant change was observed in cancellation rate and length of stay after the pre-surgery consultation unit startup (P-value > 0.05).

    Conclusion

    Considering the reduction of patients' waiting time as one of the key indicators in eye surgery, preoperative consultation process and other effective processes should be improved to maximize benefits of establishing a preoperative consultation unit at Farabi Hospital.

    Keywords: Preoperative counseling, Quality, Waiting time, Cancellation of surgery, Patient
  • Ali Ghorbani, Masoomeh Vaziri Seta, Roya Rajaee, Zahra Jamaly, Morteza Najafi, Marziye Najafi* Pages 250-258
    Background

    The provision of manpower is one of the effective factors on the improvement in the coverage of health services and the realization of the highest community health level and a considerable part of the health budget is devoted to the production and update on human resources. Therefore, the current study aimed to estimate the number of nurses required in the Emergency Department (ED) of Imam Ali hospital based on the proposed method of the World Health Organization, in which the manpower is calculated based on the workload Workload Indicators of Staffing Need (WISN).

    Methods

    This was a cross-sectional descriptive study. The study population was all the nurses working in the emergency department of Imam Ali hospital affiliated by Alborz University of Medical Sciences and their duties in the hospital which was performed using the proposed method of the World Health Organization i.e. WISN in 2018. Determination of their duties and the time and number of times for performing them were carried out during the group discussion session.

    Results

    Based on the research findings, 40 standard nurses were calculated. The studied hospital had 4 nursing staff shortages. The working pressure ratio is 0.91in this study.

    Conclusion

    In the current study, the nursing staff shortage is observed and this shortage caused a high working pressure on the nurses working in the study area. Considering the vital role of nurses in the emergency department, it is recommended to employ and distribute the manpower based on the requirement and workload in the department.

    Keywords: Nurse, Workload, Emergency Department
  • Amin Adel, Akbar Javan Biparva, Hosein Ebrahimipour, Shapour Badiee Aval, Elaheh Askarzadeh* Pages 259-265
    Background

    Providing financial resources for health services is the responsibility of the government, insurers and direct payments of individuals. Considering that health services are one of the most essential people's needsand impose a high cost on individuals, and may create catastrophic health costs for poor people. Therefore, the present study was conducted with the aim of analyzing the effect of health system evolution (HSE) program on out-of-pocket (OOP) payment in hospitals affiliated to Mashhad University of Medical Sciences.

    Methods

    This descriptive-analytic study was conducted in 24 hospitals of Mashhad University of Medical Sciences from 2013 to 2017 in order to survey the effect of HSE Program. The sample of this study included all patients with basic insurance referring to hospitals. Data were collected based on a researcher-made checklist for urban and rural patients. The statistical analysis software SPSS19 was used to analyze the data.

    Results

    According to the research findings, the total OOP payment percentage fell from about 20 % to 8 % at the end of the year. The percentage of the patient's spending on consumer use declined from 60 % to 6 %, for drugs from 30 % to 5.5 %, for services from 12 % to 4 %.

    Conclusion

    Increasing people's financial access to health care will improve the health of the community, which is expected to improve community health indicators by lowering their OOP payments. The continuation of OOP payments reduces the need for macroeconomic policies and sustainable budgets.

    Keywords: Health Services, Out-of-Pocket payment, Health Care Costs
  • Shekoofeh Sadat Momahhed, Mohammad Amin Bahrami*, Omid Barati, Maryam Moeini Pages 266-275
    Background

    Internal marketing is defined as "the process of attracting, developing, motivating, and retaining the qualified employees through
    job-products that satisfy their needs". Internal marketing practices in hospital make a positive work environment, which in turn, leads to the provision of higher care quality. This study was aimed to investigate the internal marketing practices in two educational hospitals of Yazd City, Iran

    Methods

    In this quantitative cross-sectional study, we used a valid questionnaire of internal marketing (Sarah May Lubbe, 2013) in two educational hospitals of Yazd, Iran. A total of 156 clinical and non-clinical employees selected from the studied hospitals participated in the study. Stratified random sampling method was applied and data analysis was done using SPSS19. We used descriptive statistics in data analyses.

    Results

    The mean score of internal marketing was 2.78 ± 0.60. Furthermore, employee satisfaction and benchmarking obtained the
    highest and lowest scores among the internal marketing dimensions with
    3.22 ± 0.64 and 2.27 ± 0.86 scores, respectively.

    Conclusion

    Our results showed the weakness of internal marketing practices in educational hospitals, which should be improved. For this, the results of our study should be prioritized to improve the activities.

    Keywords: Marketing, Internal marketing, Hospital
  • Alireza Hajizadeh, Edris Kakemam, Milad Khodavandi, Rahim Khodayari Zarnaq* Pages 276-283
    Background

    Sufficient length of consultations is of utmost importance for improving the quality of care and establishing a good physician-patient relationship. Multiple factors affecting outpatient consultation length were investigated among Sheikh Al-Raisi specialists. Sheikh Al-Raisi is a general medical institute in Tabriz, in 2018.

    Methods

    This study was a cross-sectional and performed at a specialty clinic in Tabriz. In order to select the samples, random sampling was used. The consultations of 400 patients with 18 specialists were analyzed. Length of Consultation and demographics of patients and physicians were collected in the year 2018. Checklists were used to collect the data and a multiple regression analysis was applied to investigate the association of the variables with consultation length.

    Results

    The mean and standard deviation consultation time was 6.9 and 2.6 min. In the multivariate model, the consultation time was longer for female patients. Lengthy consultation time was recorded in patients with bachelor's degrees or higher levels of education. The consultation time was longer in patients with gynecology problems (mean = 9.1) compared to those with other problems. In addition, older and female physicians provided longer consultation.

    Conclusion

    Clinical consultation time in specialists’ practice is estimated as short and is associated with the characteristics of the patients and the doctors and the types of their specialty. The results can be applied to make specialty consultation more effective, which can ultimately result in the delivery of the most optimum consultation period for each and every patient.

    Keywords: Consultation length, Physicians, Outpatient, Iran
  • Fatemeh Azadian, Mohammad Javad Moradian, Abdulrasool Hemmati, Mohammad Reza Karimi, Hassan Karami, Maryam Shirvani Shiri* Pages 284-292
    Background

    Diabetes is currently one of the most prominent causes of mortality and among the intensifying concerns of public health in the world. Education and enhancement of people’s knowledge about this disease can play an effective role in diabetes prevention and control. The present study was aimed at assessment of the effects of the Health week’s programs about diabetes on the citizens of Fars Province.

    Methods

    In this descriptive-analytical research, carried out interventionally, 501 people participated in the study both before and after the Health week. To define the sample’s volume, we used multi-stage cluster sampling. The study was conducted by using a made questionnaire which consisted of two parts, one part for demographic information and the other part for information about the people’s knowledge level of the Health Week and diabetes. The obtained data was analyzed by using descriptive statistics and Mc Nemar test, Paired t test, and independent sample t test in SPSS19.

    Results

    The results indicated that holding up the Health Week had significant effect on enhancement of the participants’ knowledge about the disease and the ways of its diagnosis as well as the prevention methods (P-value < .001). In addition, there was a significant change in the frequency of health informational resources in mass media such as TV, radio, social media and internet, pamphlets and poster (P-value < .001), while no significant difference was observed through billboards, Healthcare centers’ staff, etc. before and after the week.

    Conclusion

    Informing people about the Health week and its programs through mass media can play an effective role in enhancement of people’s health knowledge and lead to prevention of  the disease and proper behavior to fight it.

    Keywords: Assessment_Health_Awareness_Type 2 Diabetes
  • Amirsobhan Rostami, Fatemeh Keshmiri, Roohollah Askari, Sara Jambarsang, Milad Shafiei* Pages 293-302
    Background

    Reflection has been extensively used in different areas for better thinking about previous experiences and reaching to new behaviors, which leads to an improvement in personal skills and knowledge. Reflection ability is one of the most essential competencies for healthcare professionals and medical students, which is emphasized in several medical courses and references. This ability is improved with practice and repetition. Therefore, reflection in medical education is very important. Thus the aim of the present study was evaluation of reliability and validity of the tool for assessing this skill and determination of reflection ability level of health care management students.

    Methods

    The present descriptive and cross-sectional research, performed in two phases. The study population were 30 students of health care management. In the first phase, after the translation of the questionnaire, the reliability and validity of the questionnaire was determined. In the second phase and for evaluation of reflection ability level in health care management students, the Groningen Reflection Ability Scale questionnaire was completed by students and data analyzed with independent t-test and Pearson correlation statistical tests.

    Results

    The reliability and validity of the questionnaire were confirmed (Cronbach's alpha = 0.73). The reflection ability score of students was 82.13 ± 4.24. After a statistical analysis of data among genders, although the reflection scores of males (83.58 ± 4.37) were higher than females (81.17 ± 3.97), but this difference was not statistically significant (P-value ≥ 0.05). Also, the difference between demographic variables and reflection ability scores was not statistically significant (P-value ≥ 0.05).

    Conclusion

    This study showed that the GRAS questionnaire is a useful tool for assessing the reflection ability and students have medium scores of reflection ability so educational managers should pay serious attention in planning related fields.

    Keywords: Validity, Reliability, Reflection, Reflection ability