مجله مدیریت بهداشت و درمان
سال چهاردهم شماره 2 (پیاپی 48، تابستان 1402)

  The importance of advertising as a tool to change people's attitude and behavior, along with the high costs of advertising, the issue of the advertising effectiveness, especially in the field of health, has attracted the attention of many country’s managers and decision makers as well as researchers; Therefore, the purpose of this research is to identify and cognitively map the variables affecting the advertising effectiveness of organizations active in the healthcare system in order to develop suitable scenarios in this field.

The present qualitative-quantitative mixed research in the first step identified variables affecting the advertising effectiveness by analyzing the content of articles published at the national and international level in the field of health and in the second step through a questionnaire related to fuzzy cognitive mapping of relationships between eleven variables obtained from the first step has been analyzed and the scenario has been compiled by Fcmapper and Pajek software.

Data analysis resulted in eleven frequent variables in the selected articles that have an effect on the advertising effectiveness in the field of health, along with their impact and scenarios for achieving the goals of the health and treatment system in the field of advertising.

The effectiveness of advertising is the extent to which an advertisement ends in a desirable effect, considering the high amount of government investment on health advertisements and also the undeniable importance of health, the present research invite the managers and decision makers of organizations active in the health and treatment system to increase the awareness of the audience through useful advertising that invites appropriate information on the features of health-related products and services; Effective advertisements that use the brand value in this area along with the social influence of healthcare specialists to reduce the mental risk of the target audience and pave the way to the realization of the goals of the countries in the field of prevention, treatment and promotion of people's awareness in the field of health.

The extensive advantages of the 4th generation of industry led to the entry of these technologies into the healthcare sector. Many countries have been able to create many competitive advantages by successfully implementing Healthcare 4.0. In Iran, the fourth generation of health care has not yet been properly investigated and implemented. Identifying implementation barriers and relationships between them can help decision makers in making appropriate decisions to facilitate Healthcare 4.0 implementing. This research was done with the aim of identifying these barriers and analyzing and relationship between them.

This research was done in 2 stages. In the first stage, using semi-structured interviews with experts and the use of thematic analysis, barriers were identified, and in the second stage, using a researcher-made questionnaire and the method of fuzzy total interpretative structural modeling, a causal model of relationships between barriers was designed to identify the most fundamental barriers. The method of sampling in both stages was judgment and snowball and the sample size in them is 16 and 10 people, respectively.

The results of interviews with experts led to the identification of 44 main barriers, which are divided into 7 categories: " barriers due to sanctions", "Financial and economic barriers", "Hardware and software barriers", "Cooperation barriers", "competitive barriers", "management barriers" and "human resource barriers" were categorized. The modeling results showed that "barriers caused by sanctions", "competitive barriers" and "human resource barriers" are respectively the most important barriers and should be given special attention in policy making.

The results of the research presented a new perspective on the barriers to healthcare 4.0. This perspective is about barriers related to sanctions and competitive issues. As a result, it is recommended to facilitate international communication, train decision-making and problem-solving skills, and develop knowledge-based activities to remove sanctions barriers. Also, facilitating public-private partnership and facilitating the presence of international companies in the field of healthcare can help increase competition.

Cost management and reduction in healthcare resource utilization while maintaining the quality of laboratory services and making sure of the continued provision of servicesare one of the basic challenges facing hospital managers under COVID-19 pandemic conditions. Hospital managers have to control laboratory performance, identify the bottlenecks, and finally decide which program is necessary for reducing inappropriate utilization of laboratory resources and increasing hospital revenue. Accordingly, study of the workload in clinical laboratories provides them with valuable information to develop and implement policies that improve laboratory performance.

This applied cross-sectional research followed a descriptive-analytical method for analyzing the workload of the clinical laboratory of Amirul Mominin Ali Zabol Hospital in Sistan region in order to investigate the volume of referrals in two years before and after the start of the epidemic. Covid-19 and determining the causes of possible changes has been done.

The research findings indicated that the number of inpatients referring to the hospital laboratory has decreased by 18.7% and outpatients by 49.7%, 2 years into the Covid–19 pandemic in comparison with the same period before it, and the number of tests has decreased by 0.025% in the inpatient ward and by 55.13% in the outpatient ward compared to the pre-epidemic period, on the other hand, the average number of test for each person has increased by 21.09% in the inpatient ward and has decreased by 8.9% in the outpatient ward.

Based on research results, the Covid–19 pandemic affects the workload of clinical laboratories. Cancellation of elective hospitalization cases, decrease of patients' visits to the hospital, closure of non-COVID wards and clinics, reduction in accidents, increases in economic problems, and uncertainty on the quality of services were among the mentioned factors that decreased the number of patients visiting the hospital.

The purpose of this research was to investigate the factors influencing the attraction of medical tourism in selected educational and therapeutic hospitals of Shahid Beheshti University in 1401.

This research was an applied research. 200 managers and employees of these hospitals were included in the study, and 127 of them were selected as samples based on Morgan's table. In this research, the researcher made a questionnaire with 24 questions taken from the background of the research and by confirming the validity and reliability to the amount of 0/711 and 0/802 Used. Exploratory factor analysis test, sample t-test and confirmatory factor analysis with SPSS and PLS software were used.

In total, all factors with eigenvalues higher than one were able to explain 91.371 of the variance of 24 items related to the questionnaire. Considering that all values are higher than 0.7, therefore Cornbrash’s alpha of the research variables is confirmed. According to the AVE table, all structures are greater than 5. And as a result, the convergent validity of the model and the appropriateness of the fit of the measurement models are confirmed.

The investigations showed that the physical space of the hospital, the supporting infrastructure for foreign patients, the strengthening of the transportation system, the strengthening of marketing, the role of experienced medical staff, the quality of providing medical services, and the respect for the opinions of tourists are important in attracting tourists. Medical tourism has an impact.

Accreditation is one of the evaluation tools of health care systems, especially hospitals, which is one of the priorities of the Ministry of Health in Iran. Human resources have been seen as the most important resource of the organization in the accreditation of hospitals as a common axis with professional health. The purpose of the current research is to determine the parameters and present the model of the national accreditation program for hospitals with emphasis on the axis of human resource management from the point of view of experts in this field at the country level.

This study was conducted using the qualitative method of content analysis and through the review of related articles and semi-structured interviews with a number of experts and accreditation evaluators at the country level, and 12 scientific and executive experts based on data saturation in a purposeful judgment manner were interviewed.

Accreditation measures of human resources management in five axes: employing employees with six sub-axes, empowering and growing with six sub-axes, supporting employees with six sub-axes, leadership and management with eight sub-axes, and monitoring and control with seven sub-axes.

In accreditation standards with emphasis on human resource management axis, the metrics related to monitoring and control were emphasized more with an average score of 7.39 out of 9. More attention of the compilers of accreditation standards to the metrics related to this axis can lead to more accurate accreditation of the human resources of the country's hospitals.

Considering the importance of examining somatic symptoms in patients with epilepsy, the present study was conducted with the aim of investigating the structural model of somatic symptoms based on perceived social support and childhood trauma with the mediating of depression, anxiety and stress in patients with epilepsy.

This study in terms of purpose was applied and in terms of implementation method was descriptive from type of correlation. The research population was the patients with epilepsy of Iran in the 2021 year, which number of 260 people of them were selected as a sample by simple random sampling method. The research tools were included somatic symptoms questionnaire (Kroenke et al., 2002), perceived social support scale (Zimet et al., 1988), childhood trauma questionnaire (Bernstein et al., 2003) and depression, anxiety and stress scale (Lovibond and Lovibond, 1995). Data were analyzed by structural equation modeling in SPSS-24 and AMOS-26 software.

The findings showed that the model of somatic symptoms based on perceived social support and childhood trauma with the mediating of depression, anxiety and stress in patients with epilepsy had a good fit. Also, social support had a significant negative effect on depression, anxiety and stress and somatic symptoms, childhood trauma had a significant positive effect on depression, anxiety and stress, and depression, anxiety and stress had a significant positive effect on somatic symptoms (P<0.05), but trauma childhood had no significant effect on somatic symptoms (P>0.05). In addition, social support with the mediating of depression, anxiety and stress had a significant negative effect on somatic symptoms and childhood trauma with the mediation of depression, anxiety and stress had a significant positive effect on somatic symptoms (P<0.05).

According to the results of this study, it is necessary to plan to reduce somatic symptoms in patients with epilepsy by increasing social support and reducing depression, anxiety and stress.