نشریه مدیریت سلامت
پیاپی 102 (زمستان 1404)

Scrutiny of the activities of a scholarly journal can help its managers and other policy makers to learn about the status quo, science production process, publication trends, and research impact of the journal. This study sought to analyze the bibliometric characteristics of Journal of Health Administration (JHA).
The research population of this descriptive–applied study included all articles published in the journal between 1997 and 2024. Bibliographic data were extracted from the journal website and the Magiran database, and RIS files of the articles were collected. Citation information was obtained from Google Scholar, Scopus, and the Publish or Perish software. Data analysis was performed using Excel and VOSviewer.
Over a 27-year period, the journal published 733 articles, 89% of which were original research papers. Since 2019, when the journal was indexed in Scopus, no significant change has occurred in the previous fluctuating pattern of citations. Most collaborations were with domestic authors. Keyword cloud analysis revealed frequent use of terms hospital management, Iran, and COVID-19.
To increase citations, JHA could devote a larger share of its published content to review articles. To attract contributions from foreign authors, measures can be sought from the Office of International Affairs. Suitable strategies for achieving greater balance in the thematic distribution of articles may include parallel promotion among target groups in related disciplines, providing more article thematic diversity at the time of article acceptance, and focusing on frontier topics of knowledge.

Dental care represents a major component of high-cost healthcare services globally. Therefore, this study aimed to assess Iranian households’ exposure to catastrophic health expenditure arising from out-of-pocket payments for dental care services.

This descriptive–analytical study used data from 20,764 insured households participating in the 2019 Household Income and Expenditure Survey of Iran. Catastrophic health expenditure was estimated using the World Health Organization methodology, and data were analyzed using descriptive statistics in Stata.

The study indicated that utilization of dental services was significantly associated with an increased likelihood of households’ exposure to catastrophic health expenditure, with the incidence rising from 4.8% to 6.3%.

Given the high level of out-of-pocket payments for dental services, expanding insurance coverage for these services through both basic and supplementary insurance benefit packages is essential.

 Health tourism has emerged as an important strategy for economic diversification and attracting foreign investment, drawing global attention. Although regions such as Azerbaijan in Iran, particularly Maragheh, hold considerable untapped potential, systematic efforts to utilize these capacities remain limited. This study aimed to identify main potentials and barriers for developing health tourism in Maragheh.
 This qualitative study was conducted in 2024 using semi-structured, in-depth interviews. Experts and key stakeholders in health tourism and related organizations in Maragheh County were recruited through purposive and snowball sampling until theoretical saturation. Data collection and analysis were occurred simultaneously. Thematic content analysis was applied, including transcription, initial coding, and theme development through rigorous review and consensus.
 The development of health tourism in Maragheh is influenced by three main domains. The county has significant potential, such as therapeutic natural resources (mineral springs), a favorable geographical location, and specialized health services. However, major obstacles, such as inadequate infrastructure for accommodation and treatment, weak marketing, lack of intersectoral collaboration, and a limited tourist-friendly culture, restrict capacity utilization. Furthermore, hospital-specific operational barriers exist, such as staff shortages, weak communication skills, financial constraints, and lack of integrated planning, clearly reflected in long waiting times due to high non-local patient admissions.
 Despite its potential, Maragheh faces challenges in developing health tourism. Improving tourism and health infrastructure, clarifying treatment costs, fostering intersectoral collaboration, expanding marketing, attracting investors, reducing bureaucratic barriers, and enhancing security are essentials for the growth of this industry.

Moral injury is a form of psychological trauma experienced by healthcare workers, leading to guilt, shame, emotional distress, and reduced morale. This study evaluated the psychometric properties of the Persian version of the Moral Injury Symptoms Scale-Health Professional (P-MISS-HP) among Iranian nurses.
A cross-sectional study was conducted in 2025 in Urmia, Iran. The scale was translated using a forward–backward translation approach. Face, content, and construct validity were assessed in a sample of 220 nurses randomly divided into two groups. Exploratory factor analysis (EFA) using maximum likelihood and Oblimin rotation was conducted in one group; and confirmatory factor analysis (CFA) was performed in the other. Reliability was assessed using Cronbach’s alpha and McDonald’s omega coefficients. Convergent and discriminant validity were evaluated using average variance extracted (AVE), composite reliability (CR), maximum shared variance (MSV), and the Heterotrait-Monotrait (HTMT) ratio.
EFA identified two factors, shame/guilt/condemnation and spiritual troubles, explaining 63.2% of the variance; one item was removed. CFA confirmed this two-factor model with strong fit indices (CMIN/DF = 1.424, CFI = 0.988, RMSEA = 0.062). Internal consistency was high (α = 0.901, ω = 0.904). Convergent validity (AVE > 0.50, CR > 0.90), and discriminant validity (MSV < AVE, HTMT = 0.621) were also confirmed
The Persian version of the Moral Injury Symptoms Scale-Health Professional demonstrated strong psychometric qualities and is a reliable instrument for assessing moral injury among Iranian nurses.

Implementing an electronic prescribing (e-prescribing) system can address numerous issues associated with paper-based prescriptions, including reducing the costs of care, minimizing prescribing errors, decreasing adverse drug reactions, and enhancing patient safety. Despite the known benefits of e-prescribing, its implementation faces numerous challenges; therefore, identifying these challenges can be a positive step towards its effective implementation. In this regard, the present study aimed to identify the challenges of e-prescribing in private pharmacies in Bandar Abbas, Iran.
This qualitative study was conducted in 2025 in Bandar Abbas. A purposive sample of 25 participants, including pharmacists, pharmacy technicians, pharmacy managers, and pharmacy staff, was recruited until data saturation was achieved. Data were collected through semi-structured interviews. Qualitative content analysis was performed using MAXQDA version 2020 software.
Five main challenges were identified: stakeholder-related challenges, legal challenges, technological challenges, security challenges, and financial challenges. In total, 34 subcategories of challenges were introduced.
Despite the advantages of e-prescribing in improving the speed of medication dispensing and enhancing the quality of healthcare services, its implementation faces several barriers. These barriers include insufficient technological development, financial constraints, legal and regulatory challenges, and security-related concerns. It is recommended that policymakers first facilitate the implementation of e-prescribing by revising and updating existing regulations, and guidelines. Subsequently, adequate financial resources and incentives should be allocated to support its effective implementation. Furthermore, the provision of essential infrastructures such as secure high-speed internet access and upgrading health information systems should be prioritized.

Despite infrastructural limitations, telemedicine plays a crucial role in improving access to healthcare services in underserved areas of Iran. The city of Saveh faces similar challenges; therefore, this study aimed to evaluate the feasibility of implementing telemedicine across multiple dimensions in the healthcare centers of this city.
This quantitative, cross-sectional study was conducted in selected healthcare centers in Saveh in 2023. The study population consisted of 70 physicians, 13 information technology staff, and 19 managers and heads of healthcare centers, selected through a convenience sampling method. Data were collected using a researcher-made questionnaire based on the Mehraeen and Kiberu instruments, assessing three dimensions of readiness: human–professional, technical–communication, and organizational–managerial aspects. Face and content validity were confirmed by five experts, and reliability was assessed using the test–retest method (r= 0.71). Data analysis was performed using descriptive statistics and one-way analysis of variance (ANOVA).
The mean attitude scores toward telemedicine among IT staff, managers, and physicians were 3.8, 3.7, and 3.1 (out of 5), respectively, with a statistically significant difference (p < 0.05). More than 84% of participants identified the lack of dedicated and adequate funding, along with insurance and reimbursement issues, as the main barriers to telemedicine implementation.
Despite positive attitudes and adequate awareness of telemedicine, inadequate technical and communication infrastructure, insurance-related challenges, and insufficient training remain the primary obstacles to its implementation in Saveh. Strengthening infrastructure, providing continuous training, and revising insurance policies are essential for the successful deployment of telemedicine.

The professional landscape of Medical Library and Information Science (MLIS) has undergone significant transformation, extending beyond traditional libraries to encompass information management, research support, clinical practice, technological innovation, and virtual environments. Revising the MLIS curriculum, particularly the internship program, is essential to meet contemporary professional and societal demands. This study aimed to revise the MLIS internship curriculum based on current field requirements.
This mixed-method study included two phases. In the quantitative phase, a researcher-developed questionnaire was administered through a nationwide 360-degree survey to MLIS students, graduates, faculty members, and internship supervisors (December 2023–February 2024). Data were analyzed using descriptive statistics in SPSS version 28. In the qualitative phase, three focus group discussions were held with 16 educational policymakers, guided by the Krueger and Casey framework. Thematic analysis was performed to identify key domains and formulate a comprehensive internship model.
Participants strongly agreed that internship bridges academic education and professional practice. High agreement supported developing clinical-medical librarianship and evidence-based practice for Master’s students (mean: 4.59±0.67) and executive, managerial, and policymaking roles for Ph.D. students (mean: 4.59±0.74). Students endorsed expanding internship sites (mean: 4.33±0.78) and implementing multi-site internship experiences (mean: 4.40±0.73). Qualitative findings supported a three-phase internship across four domains: clinical-medical, technology and communication, research, and traditional libraries/information centers.
A persistent gap exists between practical training and real-world professional needs. Addressing this gap requires fundamental revision of internship curriculum, including detailed guidelines, diverse practical opportunities, and supportive environments to effectively prepare students for academic progression and professional success.

The trend of citations received by 198 Scopus-indexed articles from the Journal of Health Administration between 2019 and 2024 shows that the number of citations has increased from zero in 2019 to 97 and 84 in 2024 and 2025, respectively. A total of 183 citations (51%) were in Iranian journals, while the remaining 174 citations (49%) were in non-Iranian journals. The annual trend demonstrates a growing share of citations from non-Iranian journals and international authors, suggesting an expanding global visibility of the journal following its inclusion in Scopus. Iranian authors are usually less inclined to publish their high-quality articles in Persian journals or to cite articles published in Persian. Research policies such as lower research scores for Persian articles, higher evaluation scores for universities and research centers based on articles published in English ISI-indexed journals with better quartiles, allocating research grants to authors with more articles indexed in ISI journals with better quartiles and higher impact factors, and requiring doctoral students to publish their research in journals covered by PubMed and ISI are among the factors that make Iranian authors reluctant to publish in Persian journals. Therefore, Persian journals, including the Journal of Health Administration, are deprived of both high-quality articles and citations.