نشریه مدیریت سلامت
پیاپی 99 (بهار 1404)

Health information technologies, digital health and artificial intelligence significantly improve patient safety; however, these technologies sometimes compromise patient safety, leading to serious harm and even death. Many studies highlighted a variety of patient safety risks attributed to these technologies. Software malfunctions, incorrect data input, inadequate alerts generated by these technologies, delays in order entry systems, poor user interfaces, system misalignment with clinical workflows, algorithmic flaws, and gender, racial, and geographical biases are some flaws may result in patient safety incidents. Researchers in Iran mainly focus on positive aspects and outcomes of these technologies. Researchers are recommended to pay more attention to harmful impacts and patient safety risks of digital health and AI.

Glass ceiling beliefs, namely denial, resilience, acceptance, and resignation, can influence women’s career success, career path choices, and persistence behaviors in organizations. This study aimed to determine the relationship between these beliefs and career success among women graduated in healthcare management at university medical centers in Tehran.

This descriptive cross-sectional study involved 149 women with degrees in healthcare management in 2023. Participants were selected based on predefined criteria using a convenience sampling method. Data were collected using questionnaires on demographic characteristics, Smith's glass ceiling beliefs, and career success developed by Gattiker and Larwood.  The data were analyzed using SPSS version 27, applying descriptive and inferential statistics at a significance level of 0.05.

The mean score for glass ceiling beliefs among participants was 4.78±0.54. The scores for dimensions were as follows: resilience (5.81±0.70), resignation (4.67±1.18), acceptance (4.41±1), and denial (3.92±0.86). The mean score for career success was 3.15±0.65. The scores for subscales were as follow: interpersonal success (3.98±0.61), occupational success (3.26±0.73), hierarchical success (2.57±1), and financial success (2.49±0.97). Beliefs of denial (p<0.001) and resilience (p<0.001) showed a positive statistical correlation with career success, while no statistical correlation between was found between acceptance (p=0.899) and resignation (p=0.358) beliefs and career success.

Healthcare managers can enhance the likelihood of career success among female employees by fostering optimistic glass ceiling thoughts (denial and resilience). This can foster positive attitudes toward promotion and minimize pessimistic thoughts (resignation and acceptance) to overcome glass ceiling barriers and achieve career success.

Glass ceiling beliefs, namely denial, resilience, acceptance, and resignation, can influence women’s career success, career path choices, and persistence behaviors in organizations. This study aimed to determine the relationship between these beliefs and career success among women graduated in healthcare management at university medical centers in Tehran.

This descriptive cross-sectional study involved 149 women with degrees in healthcare management in 2023. Participants were selected based on predefined criteria using a convenience sampling method. Data were collected using questionnaires on demographic characteristics, Smith's glass ceiling beliefs, and career success developed by Gattiker and Larwood.  The data were analyzed using SPSS version 27, applying descriptive and inferential statistics at a significance level of 0.05.

The mean score for glass ceiling beliefs among participants was 4.78±0.54. The scores for dimensions were as follows: resilience (5.81±0.70), resignation (4.67±1.18), acceptance (4.41±1), and denial (3.92±0.86). The mean score for career success was 3.15±0.65. The scores for subscales were as follow: interpersonal success (3.98±0.61), occupational success (3.26±0.73), hierarchical success (2.57±1), and financial success (2.49±0.97). Beliefs of denial (p<0.001) and resilience (p<0.001) showed a positive statistical correlation with career success, while no statistical correlation between was found between acceptance (p=0.899) and resignation (p=0.358) beliefs and career success.

Healthcare managers can enhance the likelihood of career success among female employees by fostering optimistic glass ceiling thoughts (denial and resilience). This can foster positive attitudes toward promotion and minimize pessimistic thoughts (resignation and acceptance) to overcome glass ceiling barriers and achieve career success.

Artificial intelligence (AI) has the potential to transform healthcare. However, evidence demonstrates that the current medical education system is not preparing future physicians for the AI ​​revolution in healthcare. This study aimed to investigate medical students’ attitudes towards AI and assess their educational needs.

This cross-sectional study was conducted on 251 medical students at Mashhad University of Medical Sciences in 2024. The data were collected using a structured questionnaire, the validity and reliability of which were confirmed. The data were analyzed using descriptive statistics, independent t-tests and analysis of variance at a significance level of P<0.05 using SPSS-26 software.

Most students (76%) had not received any training in artificial intelligence; however, their attitudes towards it were positive, with 94.4% believing that artificial intelligence would facilitate physicians' access to information, and 88.8% stating that it helps them make more accurate decisions. On the other hand, concerns such as questioning the credibility of the medical profession by 73.7% and not being competent enough to inform patients about the risks of artificial intelligence were reported by 53.8% of students. Knowledge and skills related to AI applications, AI in scientific research, and AI applications to reduce medical errors were the educational needs of 91.2%, 89.2%, and 88.8% of students, respectively.

Considering the low awareness of medical students in the field of artificial intelligence and inadequate training provided to them on the one hand, and their positive attitude toward artificial intelligence on the other, it is suggested that, based on students' educational needs, artificial intelligence topics should be integrated into both the medical curriculum and extracurricular programs.

Administrative corruption is defined as the abuse of delegated organizational authority for personal gain. In Iran, the Administrative Health Promotion Act were formulated to strengthen governance ligimacy, improve efficiency, achieve organizational goals, and increase public satisfaction. This study aims to analyze administrative health policies within Iranian healthcare organizations.

This qualitative study was conducted using semi-structured interviews and document analysis. A total of 35 key informants involved in the formulation, implementation, or evaluation of administrative health policies were selected through purposive and snowball sampling and interviewed. Additionally, 13 relevant policy documents related to administrative health were identified and analyzed. The Mosaddeghrad Policy Analysis Model, consisting of four stages and ten steps, was applied. Data were analyzed using Braun and Clarke’s thematic analysis approach.

Despite the significance of administrative health at the national governance level, the unclear definition of corruption, structural deficiencies, insufficient financial resources, inadequate stakeholder involvement, weak network governance, frequent managerial changes, absence of detailed implementation plans, and resistance from some mid-level managers have hindered the effective implementation of administrative health promotion policies. Strengthening stakeholder engagement, ensuring sustainable resources, enhancing intersectoral coordination, increasing transparency and public invovement, and reinforcing political will are essential for improving administrative health and combating corruption.

Enhancing administrative health in healthcare organizations requires addressing key barriers and ensuring stakeholder engagement, coordination, and political will, alongside with clarity, transparency, and sustainable implementation to effectively combat corruption.

The healthcare system, like other sectors of public policy, is vulnerable to conflicts of interest (COI). Considering direct impact of COI on societal health, the emergence COI in the healthcare system carries potential risks to public well-being. This study aimed to determine the origin, challenges, and solutions for managing COI within the governance framework of the Iranian healthcare system.

This cross-sectional, empirical qualitative study employed a snowball sampling technique. We identified 50 health experts and conducted semi-structured interviews. We applied inductive approach for data analysis, facilitated by the Atlas Ti9 software.

Three primary themes emerged: "Origins of COI", "Challenges in managing COI situations", and "Solutions for managing COI situations". Altogether, we identified 57 codes for these three themes.

Cultural, political, managerial, executive, supervisory, and legal contexts contribute to the emergence of COI situations. Nevertheless, challenges- particularly structural, managerial, executive, and policy-related nature in conflict management, may delay COI management. Consequently, effective management of these situations requires addressing structural, institutional, and individual factors, refining policy management, strengthening laws and regulatory mechanisms, and enhancing the role of civil institutions.

To increase the efficiency and effectiveness of financial information systems, track financial status over time, and compare current performance with optimal state, organizations require to determine the key performance indicators (KPIs). This is of greater importance for hospitals as healthcare service providers, which in our country often face financial challenges. This study was conducted to formulate profiles for the KPIs of financial information system.

This applied research was carried out using a qualitative method in four phases: reviewing the literature, conducting semi-structured interviews with financial experts, forming a panel of financial experts, and developing KPI profiles for the financial information system, including the definition, calculation formula, and indictor norms).

Following the research phases, 36 indicators were identified, which were classified into three areas, costs, income, and productivity. The highest number of indicators were related to the cost, while productivity had the fewest indicators.

The developed profile for each indicator makes it possible to achieve a shared understanding of their concepts and provide a standardized calculation process, facilitating communication between experts and non-experts.

Health tourism is currently one of the most important sectors of the tourism industry and offers significant economic and social benefits. It refers to the travel of patients to other countries to acess more affordable healthcare services than those available in their home countries. The present study analytically investigates the impact of the convergence between Iran and selected middle eastern countries on Iran’s health tourism.

This study employs a descriptive-analytical design combined with a modeling approach, using an extended gravity model to examine the impact of convergence between Iran and middle eastern countries on health tourism in Iran during the period of 1995-2020. For data analysis, the panel data method was applied using Eviews 13 software.

The findings indicate that certain variables have a positive and significant impact on health tourism in Iran. A one-unit increase in the gross domestic product (GDP) of Iran and selected countries leads to growth of 1.5% and 0.04%, respectively, while increases in the population of Iran and other thesecountries results in 5.4% and 0.5% growth, respectively. Additionally, health expenditures in selected countries contribute to a 0.04% increase, and fluctuations in exchange rate in selected countries significantly increases health tourism. These findings indicate that strengthening economic conditions and population growth can drive the advancement of health tourism. In contrast, health expenditures in Iran and the geographical distance between Iran and selected countries have a significant negative impact on health tourism.

The study highlights the significant influence of diverse economic and social factors on health tourism. It is evident that improvements in GDP, population, healthcare expenses, exchange rates, and geographical distance can contribute to the growth of health tourism in Iran and the select countries. Therefore, to attract more health tourists, it is imperative to focus on improving both economic and healthcare conditions while minimizing geographical constraints. These insights provide valuable guidance for policymakers, planners, and investors in formulating effective strategies to advance this industry.