مجله پایش
سال بیست و یکم شماره 6 (پیاپی 106، آذر و دی 1401)

Accreditation is the evaluation of structures, processes, and performance results of hospitals in order to continuously improve the quality of services in order to assure quality, safety, and effectiveness of services of accredited hospitals. The aim of this study was to identify the consequences of the new generation of hospital accreditation using the Three-Branch Model.

This was an exploratory mixed-method study that used the purposeful sampling method of 20 semi-structured interviews with content analysis. A Delphi technique was used to design the initial model, which was then modified and confirmed by experts. The model was then tested by distributing a stratified quota sample of 384 hospital employees, and a questionnaire was made by the researchers using Morgan's table. We used SmartPLS3 to analyze the data through confirmatory factor analysis.

Data were categorized using 18 codes, 9 concepts, and three main categories after analysis. The main codes included: social consequences; creating public trust, improving the level of community health, organizational consequences; improving hospital performance, organizational communication, and behavioral outcomes; employee satisfaction, employee job performance improvement, organizational learning, patient satisfaction, and patient safety.

Based on the findings, the most significant outcomes of accreditation were improvements in hospital performance, patient satisfaction, and community health. Indeed, with the correct implementation of the accreditation process, one could witness the improvement of the organization's performance, increasing patient satisfaction, and improving population’s health.

Man needs a space that protects him from the effects of the environment. This space includes physical, social and psychological aspects, and the proper design of the physical environment inpatients should be inspiring and spirit-giving to greatly affect the reduction of patients' depression. The purpose of this research was to provide a model for designing inpatient spaces based on reducing patients' depression.

This was a mixed methods study (quantitative-qualitative) which was completed in June 2021. The extraction of factors in reducing depression derived from the following sources. 1. The literature review, 2. Experts’ opinion, and 3. A user survey and distribution of a questionnaire among 205 hospitalized patients. Then a path analysis was performed to suggest a model using AMOS software, and the relationships between factors, fit indices and were determined.

Seven main factors on reducing depression in the design of inpatient spaces were found and included: visual perception, naturalism, functionalism, physical safety, logical process, psychological safety, and diversity from the highest to the lowest. As such visual perception showed the highest direct and indirect effects.

The findings suggest that considering the factors indicated by this study might lead to the reduction of patients’ depression in inpatient spaces.

Since cardiovascular diseases have been the dominant cause of death in Iran in recent decades, on this basis, this study amid to determine the role of changes in the epidemiological pattern of this cause of death in increasing the life expectancy of Iranians in both sexes from 2006 to 2019.

Information on the cause of death by age and sex for the years 2006 and 2019 was obtained from the death registration system of the Ministry of Health and Medical Education. Using the standard life table technique, life expectancies at birth were calculated for the years 2006 and 2019. Then the role of decrease in deaths due to cardiovascular diseases in improving life expectancy was analyzed by sex.

From 2006 to 2019, about 3.8 years have been added to the life expectancy of females and 4.5 years to the life expectancy of Iranian males. The decrease in the death rate due to heart attack has led to the improvement of the life expectancy of women and men, by 1.5 years and 1.4 years, respectively. Also, 0.8 years and 0.6 years of increase in life expectancy of women and men in Iran were due to changes in deaths from stroke. In addition, the impact of various types of cardiovascular diseases on increasing life expectancy has been caused by changes in the pattern of death in old age.

The increase in life expectancy in Iran has been achieved mainly through changes in old-age mortality, especially due to cardiovascular diseases. Due to age structure transitions, this trend is expected to continue in the future, which has important implications for health care planning and future prevention strategies.

Objective (s):

 Financial development is an important factor in economic growth and health. It not only directly but also indirectly affects the health status through the quality of the environment; Therefore, this study aimed to determine the impact of financial development and environmental quality on health status in MENA member countries.

A descriptive study was performed at international level for the MENA member countries. The panel data for the years 1990-2019 was extracted from the World Bank databases. Im, Pesaran and Shin (IPS) and Levin, Lin, and Chu (LLC) tests for stationary; Pedroni and Kao tests for co-integration and Fully Modified Ordinary Least Squares (FMOLS) and Dynamic Least Squares (DOLS) estimators were used to analyze the data using the Eviews 10 software.

The mean (SD) life expectancy was 71.5 (5.05) years and the mean (SD) financial development index and carbon dioxide were 39.82 (25.09) and 81.91 (21.47) in the sample countries, respectively. The logarithm of financial development coefficient on logarithm of life expectancy in FMOLS and DOLS methods was equal to 0.02 and 0.03, respectively, and the logarithm of carbon dioxide coefficient in FMOLS and DOLS methods was -0.03 and -0.002, respectively. The logarithm of globalization in both methods had an effect coefficient of 0.30 on logarithm of life expectancy.

The expansion of financial development, globalization and GDP per capita had a positive effect and the increasing of carbon dioxide had a negative impact on health status. Therefore, policies to reduce environmental pollution and expand financial development and globalization seem necessary. In this regard, limiting the use of fossil fuels, replacing renewable energy, the use of air quality measuring instruments are proposed. It is also proposed to expand financial development in infrastructure, industries and technological services in the health sector and appropriate incentives for private sector investment.

Objectiv (s):

 One of the ways to reduce costs in hospitals is to establish a day surgery ward.  This study aimed to analyze the cost of surgeries before and after the establishment of the day care department in a teaching hospital affiliated to Iran University of Medical Sciences in Tehran, Iran.

This descriptive study was conducted in 2020 using the data of the hospital's accounting system and the patients' clinical records during 2015-2019. To analyze the data and compare the costs the records of patients with selected surgeries such as  removal of deep screw or pin, closed metacarpal fracture treatment, treatment of nasal fracture, placement of external fixation device, removal of plaque or rod inside the canal, adjustment of external fixation system, maxillofacial fixation, treatment of open mandibular complex fracture were included (251 people for the inpatient wards and 243 people for the daily surgery ward).

The greatest economic savings per surgery were related to the treatment of complex mandibular fractures. The least economical savings were made for each operation of removing the plate or rod inside the canal, installing an external fixator. In total, the cost of eight selected surgeries in the day care department showed an average cost reduction of 26% compared to the men's general surgery department.

The establishment of the day care department seems cost effective. The day care unit reduces hospital costs, frees up hospital beds, and reduces the patient's physical and psychological complications.

Several factors lead to the migration of patients to other cities with large and higher quality medical centers in order to receive diagnostic and treatment services. This study aimed to find out reasons for patient migration from Sistan and Baluchestan Province to Mashhad.

This was a descriptive study that carried out in 2020. The total number of patients was 2063 and the sample size for interview using Cochran's formula was 350. Using a standard questionnaire with 37 questions, data related to patient migration were collected in five dimensions (hospital characteristics, staff, services provided, facilities and personal characteristics). Data were analyzed using SPSS23 software and t-test, One Way ANOVA.

The most common disease among immigrants was pediatric diseases with 35%. The most important migration factors from the patients' view were related to quality of services provided with an average of 4.7 (SD = 0.29), followed by the factor related to staff 4.2 (SD = 0.45).

The most important factors in migration were the quality of services and hospital staff. Paying attention to improving the quality of medical services and creating motivation and commitment in hospital staff and the spirit of respect for patients can prevent unnecessary migration to other areas.

Objective (s): 

Induced abortions are mostly unsafe, so they are considered as a threat to mothers' health. Unintended pregnancy is one of the most important variables affecting induced abortion. The aim of the present study was to determine the relationship between unintended pregnancy and induced abortion.

This was a quantitative study. A self-designed questionnaire was used to collect data. The statistical population included married women aged 15 to 49 living in Sadra city of Fars province, Iran. The data was collected from April to May 2022. For data analysis, SPSS software version 20 was used.

A total of 379 people were studied. The results showed that among the demographic variables, only religion had a significant effect on the odds ratio of experiencing an induced abortion. The experience of an unintended pregnancy also significantly increased the risk of induced abortion.

The findings suggest that training women of reproductive age might be helpful to reduce unintended pregnancies and, subsequently, reduce intentional abortions.

Scientific evidence is provided using different resources and during a regulated cycle. Various variables could influence the cycle. Of these the role of peer reviewer is very important. They could be influential in the growth and development of biomedical journals and pave the way for investigators and authors of scientific papers. It is recommended that specialized training be held to improve the review skills. A detailed understanding of the motivation of reviewers also is recommended.

There is minimal data on the effects of COVID-19 on male fertility, so it has become an important topic for investigation. The coronavirus (SARS-CoV-2) can damage the testicles as well as the male reproductive system through various mechanisms and cause infertility in men. In a study ‘in situ hybridization’ did not detect the viral genome in testicular tissue samples. This suggests that the testicular damage was probably due to the inflammatory and immune response and not due to direct damage by the virus. Therefore, there is a possibility of testicular damage and subsequent infertility following a COVID-19 infection. Testicular damage can be caused either by direct viral invasion by binding the SARS-COV2 virus to ACE2 receptors or by an immune and inflammatory response. Follow-up studies of the reproductive function of recovered male patients are needed to investigate this possibility.