مجله مدیریت بهداشت و درمان
سال سیزدهم شماره 4 (پیاپی 46، زمستان 1401)

Nowadays, responding appropriately to the stakeholders’ expectations is one of the most important factors for organizations effectiveness, especially in the health system, as the responsible of generation, propagation and promotion of health in societies. Analyzing the stakeholders’ evaluation components, this research aims to provide practical information about stakeholders’ management for the head of hospitals in Guilan University of medical science (GUMC).

This research is applied in terms of purpose and descriptive-survey in terms of implementation method. Statistical population includes heads of hospitals in GUMS and academic experts where 19 of them are participated in the research. For screening the components extracted from the literature, fuzzy Delphi method was used, while for analyzing and structuring the components, interpretive structural modeling (ISM) was used. In addition, for data gathering, snowball sampling method and questionnaire tool were used.

Conducting the fuzzy Delphi method, among the 30 components extracted from the literature, 10 factors; stakeholders’ participation, information, relationships, level of need, benefits of cooperation, motivation, planning ability, consistency with the organization goals, possibility of monitoring stakeholders and the importance of the stakeholders’ position were determined as main factors and were structured by the ISM method at three levels.

According to the MICMAC analysis, the indicators of stakeholder’ participation, stakeholder relationships and the importance of the stakeholder's position were recognized as the most important components in stakeholder’s evaluation, which indicates the necessity of managers attention to these factors in the evaluation of stakeholders and using them for achieving to hospital goals.

Nowadays, at the international level, it is necessary to use evidence in decision-making in the field of policy and planning of the health and medicine sector, the present study was conducted with the aim of investigating the status of management based on economic evaluation evidence in the field of medicine in the health system of Iran and selected countries.

This research is a comparative study that was conducted in 1401. The sampling was purposeful and the countries of Australia, England, Germany and Canada were compared in terms of the components of using evidence in the economic evaluation of the drug field. To collect data, reliable databases and other related sources were used in the field of the research topic. The findings were compared in the form of a comparative table.

The findings showed that producing and extracting evidence is mandatory in Canada, England and Australia and optional in Iran and Germany. Also, except for Australia and Canada, in other countries, evidence is not used to add drugs to the drug list. Also, there are standards and frameworks for producing evidence in all countries except Iran.

The results showed, designing an integrated model to reduce work parallelism, developing communication with research centers, determining principles and regulations for the production and application of evidence, strengthening the leadership, management and supervision of the health system in accordance with the state of the country and other countries with similar conditions are proposed.

When the organizational ideology of an organization becomes very strong, it can affect the entire structure; and finally, there is a structure that is called the missionary (mission-oriented) structure. Therefore, the current research was carried out with the aim of identifying the components of missionary organizations.

In order to achieve this goal, In the qualitative phase, while reviewing the subject literature through Thematic Analysis approach, and semi-in-depth interviews of 15 experts who were professors and managers of Tehran University of Medical Sciences were selected by non-random sampling method; To measure the validity of the themes and validation, through data angle and to calculate the reliability of the Holsty method, which were confirmed with a coefficient of 0.98. And with the use of MAXQDA No. 12 software, effective criteria on missionary organizations were identified.

Qualitative data analysis led to the formation of fifty-one basic themes and eleven organizing themes and three overarching themes including configuration components, content components and structural components.

The results showed that the criterion of organizational ideology is one of the basic criteria and key players, which is necessary and should be taken into account in the organization of the missionary organizations.

Providing safe care in accidents and crises by pre-hospital emergency aid units plays an effective role in reducing the burden of injuries and damages. This study was conducted with the aim of investigating the factors affecting the provision of safe care by pre-hospital emergency units in Mazandaran province.

This research was descriptive-analytical (cross-sectional). The statistical population of the research was operational personnel of emergency units of selected pre-hospital emergency bases in Mazandaran province (N=165) and sampling was done by census method. The data collection tool was a researcher-made questionnaire, which was used to check the quantitative content validity using the content validity index and the content validity ratio. Then the reliability of the questionnaire was estimated by Cronbach's alpha method of 0.82. Data analysis was done using SPSS 20 software. The ranking and prioritization of factors affecting the provision of safe care in pre-hospital emergency units was done with Friedman's test.

From the point of view of operational personnel of pre-hospital emergency aid units of Mazandaran province, 5 factors were effective in providing safe care in pre-hospital emergency aid units, which is the motivation factor in the first place (with an average rating of 3.49) as the most effective factor and medical equipment in the fifth place (with an average rating of 5.49), was the least effective factor.

Policy-making in the field of improving the motivation of the personnel of relief units and their training, providing the necessary manpower, managing relief units and improving medical equipment will improve the provision of safe care in pre-hospital emergency relief units.

To identify the effective dimensions and components in the establishment of the information therapy approach for immune system deficiency diseases in the children's medical center using the meta-combination method.

In this research, which was an applied study in terms of its purpose, the qualitative research method and meta-composite technique were used to collect data, and CASP was used as a tool to control the quality of selected articles and combine qualitative findings.

By analyzing the articles and experts' opinions, two main dimensions: a) informing (health literacy) including 6 sub-dimensions: acquiring information, identifying information, sharing information, increasing awareness, meeting information needs, increasing health knowledge; and b) treatment (health services) including 6 sub-dimensions: patient satisfaction, caring behavior, reducing the cost of inpatient treatment, use of health information, health maintenance training, and disease prevention (including 12 effective sub-dimensions in total) were obtained.

Paying attention to the effective factors in the establishment of the information therapy approach (separated by dimensions, including information and treatment), as an inevitable pillar in the health system, which is the basis for facilitating access to information and its timely dissemination for both groups, doctors and patients. It not only focuses on the prevention of diseases, but it is also able to help reduce the country's medical expenses by playing a complementary role in the treatment process, as well as improving the level of health literacy of the community.

Today, the style of managers in the management of the organizational complex plays an important role in motivating and exploiting factors and resources. So that the most successful managers are those who choose the best management style according to organizational conditions.

The purpose of this dissertation is to review and evaluate management strategies in the management style in Shohada Hospital and to provide an optimal strategy to improve the management style and method in the hospital. In this regard, in this study, the statistical population includes all experts and staff of Shohada Hospital that a sample of 20 people was selected. Data collection was done by field method. In order to collect data, researcher-made questionnaires were used, the validity of which was confirmed by experts.

Participatory management style according to the calculation table of relative proximity to ideals had the highest value with CI equal to 0.982. Also, among the evaluation indices of management styles, motivation, organizational commitment and organization goals, communication, productivity and cohesion coordination, the coefficient of importance was 27.5, 15.25, 15.25, 14.25, 13.75 and 13.5 respectively.

The results indicate that the best management style in Shohada Hospital in Kermanshah is a participatory style and the management of authority, among other styles, is the last priority and among the evaluation criteria of management styles, the index Motivation comes first.

The impact of positive and negative shocks or the asymmetric impact of public health expenditures during periods of recession and boom (business cycles) on health status is of particular importance in terms of making appropriate decisions in the field of controlling the vulnerability of the lower classes of society in these periods. Based on this, the main purpose of this study is to estimate the asymmetric effect of public health expenditures on the health status in Iran during periods of recession and boom.

The present descriptive-analytical and applied study using the time series data during the period of 1979-2020, investigated the long-term effects of positive and negative public health expenditures shocks during business cycles, per capita income and physician per capita on the death rate of children under 5 years and life expectancy. Filtering approach and three filters HP, BK and CF have been used to identify business cycles. Also, the models were estimated in the form of a regression model using the Non-linear Auto-Regressive Distributed Lags (NARDL) method in Eviews 12.0 software.

The results show that the public health expenditure had a pro-cyclical behavior during the period under review. In the long-term, the effect of negative public health expenditure shocks during business cycles on weakening health indicators is greater than the effect of its positive shocks on strengthening health indicators (confirmation of asymmetric effect). Also, the impact of positive and negative shocks on public health expenditures during periods of economic recession is greater than during periods of economic boom. With a 1% decrease in public health expenditures during periods of economic recession, the death rate of children under 5 years increases by 0.17% and the life expectancy decreases by 0.13%.

Based on the results of this research, it is recommended to increase public health expenditures during periods of economic recession in order to reduce the vulnerability of the lower classes of society. But, considering the pro-cyclical behavior of public health expenditures, it is necessary to adopt policies and solutions to reduce the intensity of this behavior.