Journal of Evidence Based Health Policy, Management and Economics
Volume:6 Issue: 2, Jun 2022

The use of advanced and expensive technologies requires financial, human and capital resources. Brain Magnetic Resonance Imaging (MRI) has high contrast sensitivity for visualizing differences among the tissues. Unnecessary diagnostic imaging imposes excessive cost on health systems. This study aimed to determine the appropriateness of brain MRI prescriptions in 2021.

This cross-sectional study recruited 274 patients who referred to Bushehr teaching hospital. They had been prescribed MRI of the brain due to headache and dizziness. We used the data collection form developed in the previous study. The appropriateness of the brain MRI prescription was determined based on the appropriate indications during 2021.

About 61 % of the referrals were due to headache and 39 % were because of dizziness. Overall, MRI was evaluated as inappropriate for about 38 % of the patients. The appropriateness of prescriptions had a significant relationship with age, gender, education, job status, complaint, prescribing physician, and MRI applicant with P-value > 0.050.

Findings revealed more than one-third of brain MRI services were not clinically appropriate. Due to the high cost of MRI, it is necessary to make prescriptions in accordance with indications to prevent unnecessary diagnostic procedures and to prevent induced demand. Health system policymakers and healthcare providers should develop clinical guidelines and implement them to reduce the costs of health systems.

Medical tourism provides Effective economic, political and social profits to the countries active in the field, which should be taken into account in a competitive market. This study aimed to evaluate the relationship between foreign patients' satisfaction and other aspects of health tourism in educational and medical centers of the Iran University of Medical Sciences (IUMS).

This was a descriptive correlational study with a researcher-made questionnaire. The first part of the questionnaire contained the demographic characteristics of the participants, and the second part included 30 questions about the components that affect receiving medical services by foreign nations. The reliability coefficient of the questionnaire was determined by using Cronbach's alpha (0.980). Expert judgment was used to assess the validity of the questionnaire. Out of 70 hospitals affiliated with the University of Iran in 2019, 10 hospitals from 35 licensed centers in the field of international health were randomly selected, and 300 questionnaires were delivered to foreign patients who were willing to complete the questionnaire. The received information was from Random sampling recorded in SPSS25 software. Descriptive Statistics was used to determine the effective factors.  

The largest numbers of foreign patients in this study were from Iraq (64 %) and Kuwait (24 %), respectively. In correlation review, there was a significant relationship between satisfaction of foreign patients and financial dimension (0.785), quality of treatment dimension (0.914), medical facilities dimension (0.799) and tourism facilities dimension (0.918) in hospitals.

This study demonstrates that there is a significant relationship between satisfaction of foreign patients and other aspects of health tourism (such as financial dimension, treatment quality, treatment and tourism facilities) in hospitals, Which needs to be given special attention by health tourism managers for short-term and long-term planning for its development.

The importance of paying attention to improving productivity in different health system departments  has become increasingly evident. This is due to increased costs of health care goods and services, limited resources and production facilities. This study aims to measure the productivity of hospitals' Medical Records Departments (MRD) affiliated with Urmia University of Medical Sciences to provide a comprehensive analysis of their performance.

In this study, total productivity and total factor productivity changes of medical record departments in hospitals affiliated with Urmia University of Medical Sciences were calculated. This was conducted through Kendrick-Creamer and Malmquist indexes in 2016-2020, and has examined the trend of each one of them. Input variables included the number of personnel and equipment. Output variables encompassed the number of outpatient and inpatient medical records prepared for patients, responses to letters, and patients referred to the studied MRD. After estimating the production function, the elasticity of production factors and the return to the scale of medical record departments were calculated.Total productivity changes and production function were estimated via Deap2,1 and Frontier4,1 softwares by applying input minimization and variable returns to scale assumptions.

The results of the Malmquist index indicated that the average total productivity changes of medical records departments of hospitals during the study period were equal to 1,096. This is greater than one; therefore, it can be concluded that productivity has decreased by about 9.600 % during the study period. Changes in technological efficiency have had the greatest impact on reducing productivity, to other factors. In addition, the results of Kendrick-Creamer index during the years under review demonstrated that the average total productivity of production factors obtained, was equal to 18725.530 services.

There is decreased productivity due to technological changes in the studied departments. This is because of the lack of sufficient knowledge of the medical records department staff in the use of technology and equipment for providing efficient services . Holding training courses for the appropriate use of technology by personnel can be useful in this regard.

Today, the success of organizations depends on creativity, innovation and entrepreneurship. One of the appropriate tools for the growth of organizational entrepreneurship is an appropriate leadership style tailored to the concepts of entrepreneurship in the organization. This study aimed to examine the relationship between leadership style and organizational entrepreneurship in the staff managers of Ahvaz University of Medical Sciences in 2019.

This was a descriptive-analytic cross-sectional study conducted in 2019. All the staff managers (n= 85) of Ahvaz University of Medical Sciences were approached to participate in the study. Sampling was conducted using the census method. Sixty participants completed the questionnaire. Data were collected using two questionnaires: 1) the leadership style questionnaire, Clark and 2) the organizational entrepreneurship questionnaire. Data were analyzed using SPSS16 descriptive statistics (e.g. frequency, percent, mean ± Standard Deviation (SD)), and statistical tests including t-test, ANOVA and Pearson Correlation Coefficient.

The mean ± SD of organizational entrepreneurship in staff managers was estimated at 3.18 ± 0.66. The highest type of leadership among managers was related to participative leadership with 3.90 ± 0.51. There was a direction and significant association between autocratic leadership style and organizational entrepreneurship (r = 0.30, P-value = 0.01). In contrast, no significant association was found between participative leadership and organizational entrepreneurship (P-value = 0.05) and between laissez-faire leadership style and organizational entrepreneurship (P-value = 0.62).

Having a leadership style tailored to the business environment makes the organization an entrepreneurial organization. In order to have an entrepreneurial organization, some measures must be taken so that managers can adopt appropriate leadership styles to provide the necessary environment for creating a successful organization and the presence of creative and entrepreneurial people in the organization.

The most well-known classification of the cost of diseases is direct medical cost. The aim of this study is to investigate and analyze direct treatment costs of patients with Covid-19 by hospitals affiliated with Ilam University of Medical Sciences.

This was a descriptive-analytical, cross-sectional study performed retrospectively. The hospital expenditure information in Ilam province from March to October 2020 was used. Cost information related to all patients was collected and classified and reviewed using Excel 2016 software. The average direct treatment costs of hospitalized patients were also determined.

The direct costs of treatment in hospitalized patients in Ilam were estimated at $ 2349272.094 (98669427959 billion Rials). The per capita direct medical costs were calculated to be $ 1228.056 (51578373 million Rials(. The largest share of the cost related to pharmaceutical services and the share of basic insurance was equal to $ 934.570 (39,252,109 million Rials).

Results of the study indicated that the treatment costs of patients entering Ilam province are high, and the highest cost concerns pharmaceutical services. Taking necessary measures to prevent and control the spread of coronary artery, using the most cost-effective drug interventions and reducing unnecessary hospital stays of patients can increase the efficiency of financial resources and reduce direct medical costs in Ilam province.

Hospital management style can affect various aspects of hospital performance. One of these aspects is the level of market orientation of the hospital. Therefore, the present study attempts to answer whether management style makes a difference in the degree market orientation of hospitals or not.

This research is a descriptive-analytical and cross-sectional study conducted in 2020. About 420 people were selected by stratified sampling out of the six medical centers' staff in Qazvin, Iran. A total of 411 people (97.86 %) completed the questionnaires. The collected data were analyzed using STATA15 and SPSS16 software. Robust regression analysis was used to estimate the role of management style in the level of market orientation of hospitals. Mean variables were analyzed using one-way analysis of variance and post hoc test.

The score range of the variables was from 1 to 5. Autocratic and delegating styles obtained the highest average (3.22 ± 0.54) and the lowest average (2.87 ± 0.70), respectively. Among the dimensions of market orientation, customer orientation had the highest average (3.32 ± 0.84), while competitor orientation obtained the lowest average (2.80 ± 0.86). The average score of market orientation was 2.88 ± 0.65. A statistically significant difference between hospitals was observed in terms of participative and delegating styles (P-value < 0.05). In addition to market orientation, there was a statistically significant difference between hospitals (P-value < 0.05). The regression coefficient between the level of the hospital market orientation and the participative and delegating styles was 0.10 and 0.09 respectively (P-value < 0.05). In contrast, the regression coefficient between autocratic style and level of market orientation was estimated to be -0.76.

It can be concluded that managers should use more participatory and delegating styles to increase the market orientation of the studied hospitals.

Depression is one of the most common and serious disorders which threatens the mental and physical health of the nurses. This article investigated prevalence of depression among the nurses of Iran using meta-analysis.

This meta-analysis study was done in 2021 using a random-effects model. Data were collected from January 2000 to June 21, 2021, from PubMed, Web of Science, Scopus, Magiran, SID databases and Google Scholar search engine. The data were analyzed using CMA software (Version 2.2.064, the US, Biostate Company).

18 articles were retrieved. The total prevalence rate of depression in Iranian nurses was 12 % [95 % CI= 8.03-17.10]. The highest prevalence rate of depression among nurses was 40.90 % [95 % CI= 32.60-49.70] in Razavi Khorasan, in 2020, and the lowest prevalence rate was 1.70 % [95 % CI= 0.06-4.40] in Lorestan, in 2017. A significant statistical correlation was observed between the prevalence of depression, the sample size, and the work experience (P-value< 0.05). Moreover, we found that the highest rate of depression was based on BDI (Beck's Depression Inventory) questionnaire, and the eastern region of Iran.

According to the results, depression has prevailed among one tenth of the Iranian nurses. The finding of this study can help improve the decision- making process for treating depression in Iranian nurses.