مجله مدیریت بهداشت و درمان
سال سیزدهم شماره 3 (پیاپی 45، پاییز 1401)

Different countries have used methods and tools for promotion of health care to date. One of these methods is clinical governance. In this study, effective dimensions on clinical governance were evaluated in the point of view of health managers.

In this qualitative study, a comprehensive model of effective agents on clinical governance was presented by Delphi Fuzzy method. Using literature review and opinion of 30 experts and health managers of Golestan University of Medical Sciences, Goragn, and Phalsaphi privet hospital, impaired items on eight dimensions of clinical governance in Phalsaphi hospital were selected, designed as a model and assessed by Fuzzy analysis.

According to suggested model, effective dimensions and variables were in three groups including stimuluses, enablers and challenges. The significance level was 8.31 based on the mean of significance level column. According to it, the internal marketing dimension with the highest significance level (10.88) and after that dimensions including education (research and development) and empowering employees with the significance level 10.54 and 10.48, respectively, had the highest effect on clinical governance implementation. The lowest effect on successful implementation of clinical governance was belong to the education dimension with the significance level 2.95. 

The findings suggest that establishment of clinical governance in studied hospital specially needs strengthen internal marketing, education (research and development) and empowering employees and clinical governance can be used to improve the performance of the treatment centers.

The pharmaceutical product market is one of the largest and highest -paid markets in the world in which the upper figures are exchanged every year. A market where any inaccurate decision on it quickly boosts the black market and makes the drug dealers stronger. The purpose of this study was to investigate the factors affecting the market for specialized drugs in Iran.

The results of the study have been examined in a quantitative method. The method used in this study is based on fundamental studies. The present study is based on the data collection method. In this study, targeted sampling methods used to select experts and simple random methods in 385.

The results showed that the two modulations of the proprietary profit reduction on the relationship between processing and ease of consumption on the drug market prediction of 4.414 with a significant level of 0.0001, which is less than alpha = 0.05, As the most important factor and adjustment of proprietary profit reduction on the relationship between the office and the physician on the anticipation of the drug use market with a coefficient of 2.355 and the significant level of 0.0001 to two important factors in impact on the anticipation of the drug use market Specialized in Iran are identifiable.

Finally, the drug market is very attractive in many ways. Drug manufacturers must persuade physicians to sell the drug to the final consumer who are patients, in other words, the final decision maker here. Therefore, given the high impact of the drug characteristics and the patient's characteristics on the drug selection, it is better to marketing their time and energy on the marketing of more desirable drug profiles (for physicians).

Oral clefts are common congenital malformations and their incidence varies among racial or ethnic groups. Despite the importance of congenital abnormalities, accurate statistical information about this disease is not available, so by using registry systems, enough information can be provided to decision makers to control this disease.

The current study is a cross-sectional descriptive study of registry system data; that the data of 1461 patients with cleft palate have been analyzed in a period of 15 years. The collected data includes various variables along with geographical distribution.

The findings of the present study indicate that the gender ratio of boys to girls is 1.3 to 1. In 4.79% of the mothers of babies with cleft palate, there was a history of underlying disease, of which hypothyroidism was the highest with 0.9%. In 54% of cases, parents were related. 58.31% of babies with cleft palate had other abnormalities in addition to this problem.

The incidence rate of cleft palate is different in different parts of the world and in our country this variation may be affected by social and racial factors in different regions.

The current article was written with the aim of investigating the trends of mortality in the last three decades. The total number of researches and articles reviewed was 79 articles, researches, dissertations and theses, which were analyzed using Cm2 and Maxq software. data was analyzed, and the results of the research showed that the developments related to the reduction of mortality in the reference countries were quite slow and gradual, the process of which took nearly two hundred to two hundred and fifty years, but the process was not uniform in all countries, but the major Western countries have gone through these stages that lead to the formation of population theorists. At the end of this period, due to the transfer of experiences and scientific knowledge in the field of health from reference countries to other countries such as Iran, a much shorter period of time has passed. For example, in our country, Iran, since the beginning of the developments of prevention, treatment and doing things related to mortality control, a period of 60 to 65 years has happened. The findings of the research showed that in Iran, the process of changes from underlying and contagious diseases has alternately aligned with lifestyle changes, and today the most important causes of death are related to diseases, but cardiovascular diseases have the most The percentage that is directly related to the lifestyle and further confirming this analysis, after accidents and accidents is ranked second, and the share of men's deaths in all cases, which causes the difference between the life expectancy of women and men between two Three years have changed in favor of women

Organizational transparency is one of the tools that helps organizations in achieving goals, especially health-related goals. Due to the increasing role of organizational transparency and organizational health in achieving organizational goals, especially the impact of these two dimensions in healthcare organizations such as universities of medical sciences whose goal is to improve society's health, this study aims to identify the dimensions and components of organizational transparency with a health promotion approach It was organized in the University of Medical Sciences.

This study was applied in terms of purpose, which was carried out using the Delphi method. The research community was experts who were familiar with the research subject, and according to the principle of theoretical saturation, 25 of them were selected by purposeful and snowball sampling methods. The data of the current research were collected with tools including review of library resources and interviews with experts and analyzed after three rounds of Delphi.

The results showed that the dimensions and components affecting organizational transparency include dimensions: organizational transparency with eight components, information management, organizational accountability and human resource management with seven components each, trust and monitor ability and administrative automation with six components each. Religious and spiritual education, organizational control, participation, and responsibility were each with four components, lack of secrecy, information technology, culture building, and organizational whistle-blowing were each with three components. Also, the dimensions and components affecting organizational health included: effectiveness with seven components, cohesion with six components, optimal distribution of power with five components, morale, innovation, autonomy, adequacy of communication, and goal focus with three components each.

According to the results of this study, health professionals can design and implement programs to improve organizational transparency with the approach of promoting organizational health, and the University of Medical Sciences can identify the above components for organizational health and organizational transparency.

The spread of infectious illnesses has been one of the elements that endangers society's health. Although many of these hazards have been greatly decreased as a result of medical science advancements, we have seen that diseases like the COVID-19, nevertheless constitute a severe threat to the health of all societies. This study aims to analyze the prevalence of widespread illnesses in order to evaluate the analysis of the aforementioned situation, taking into account the evolution of social and legal systems in societies.

This study was conducted using a descriptive-analytical approach.

In light of various interpretations of its contents, the domain of innocuous and harmless regulations has many distinct meanings, which makes its application highly challenging. After establishing a particular criterion, it is suggested that harmlessness is the absence of injury and the prohibition of producing harm as a result of the abuse of rights, with the criterion of abuse of rights being seen as a breach of accepted conduct.

As long as there is a broad illness outbreak, the disease's transmission is seen as damage, and because of the rule of harmlessness, the disease's transmission and facilitation are forbidden. Even though an act that falls under the purview of an individual's rights in a typical circumstance is thought to be the source of disease transmission and harm, in the event of a disease outbreak, it is regarded as unusual behavior and is limited or prohibited due to the second part of the rule that it is harmless. The conflict between losses does not provide a problem since, in the circumstances described, the individual loss is contrasted to society's loss, and society's loss is significant.

The development of the social sector is one of the key goals of the government of any country, especially less developed or developing countries. The importance of health as one of the key aspects of development and economic well-being of individuals and nations is increasingly recognized in the world. This can be seen from a series of reforms carried out by countries to increase investment in health in order to achieve the health Millennium Development Goals. The lack of investment in health and measures to address environmental and social determinants of health is a serious limitation to improve health outcomes in these countries. Considering that the convergence of governments in per capita health costs leads to a decrease in inequality or an increase in equality across regions, which will be a major development goal of a nation or governments, this research examines the process of convergence in terms of health costs. It evaluates per capita.

In this research, the convergence of health expenditures per capita in the provinces of Iran is studied using the dynamic panel method. Therefore, for this purpose, the data related to 30 provinces of the country during the years 2007 to 2019 have been used. Due to the separation of Alborz province since 2010, the data related to this province has been calculated with Tehran province. In order to analyze the convergence process of per capita health costs of the provinces, the beta and sigma convergence method and the dynamic panel generalized moment model (Panel GMM) will be used.

The results showed that there is absolute and conditional beta convergence in health expenditure per capita in the provinces of Iran. The speed of convergence in government per capita expenditures on health is higher than private per capita expenditures, and this has been effective in the general convergence process of per capita health expenditures in each province. Also, the examination of the distribution of per capita health costs in each province indicates the existence of sigma convergence in the provinces of Iran.

Although there is a path for convergence, this analysis has revealed the need to invest more resources in the field of healthcare. In fact, the current levels of investments that have been made in the health of the country are not enough to expand the huge project of the health sector. As the convergence of sigma in relation to private and public spending on each person's health showed, the dispersion of the mentioned components has decreased. This means that the variable that has a lower standard deviation (state health expenditures per capita) has created uniform and homogeneous expenditures in the health sector. Government expenses alone are not responsible for healthcare expenses, and the private sector needs to invest in this matter. In general, the health sector requires more expenses than public revenues. As a result, a problem is observed in the healthcare systems of most countries, and that is the pressure on government revenues. As a result, in terms of recommendations for health policies, diversification of financial resources for this level of health, treatment and health is one of the strategies that should be considered.