مجله بیمارستان
سال یازدهم شماره 4 (زمستان 1391)

The environmental hygiene standards are one of the factors that compliance with them can help hospitals achieve their goals. Therefore having enough information about the environmental hygiene status of the hospital is of great importance. This study evaluates the environmental hygiene indexes status in hospitals. A cross sectional – descriptive study was conducted in 2011. Using the census method, all of Karaj's hospitals formed the statistical population of this study (n=8). Data was collected from the checklist of National Program of Public Hospitals Accreditation (the hygiene and cleanliness segment) which included 68 questions with the overall score of 800 and evaluated the hygienic status of the hospital from 6 different aspects.. These checklists were filled, making interviews and observation of the status of each hospital. Data were analyzed using Excel and SPSS software (version 16). The results showed that among the different aspects of hygienic and cleanness situation of hospitals, water and wastewater hygiene and professional hygiene of the hospital had respectively the largest and lowest difference percentage with their highest standard levels. Overall, the average score of compliance with hygienic standards was about 742 ±1.9 in the entire centers. This average score was respectively, 716.5± 18, 760± 11.5 and 768 in university-related hospitals, private hospitals and hospitals related with the social security organization. To improve the environment hygiene status of the hospitals,more effort through developing practical strategies, making appropriate decisions and allocating enough resources are recommended.

The purpose of this study is to survey the Working Life Quality of specialists working in affiliated hospitals of Tehran University of Medical Sciences. The statistical population of this study includes 400 specialists and a crosssectional Descriptive & analytical method has been used to gain credible results.. Van lar working life quality questionnaire was used to gather the data needed.. The data were analyzed with the SPSS software through T-test and Anova statistical tests. In addition, the simultaneous effect of independent variables in the model was evaluated using the Backward Regression Model. The average total working life quality of specialists working in affiliated hospitals of Tehran university of medical sciences is estimated to be 48.75 percent. Total working life quality of male specialists is higher than the females and the index is higher in specialists resident in Tehran compared to the other ones but these differences are not significant statistically.. Working life quality of specialists which are satisfied with the facilities in their working places are higher compared to the others and these differences are significant statistically. In addition working life quality has decreased with the increase in the experience. Working life quality of the Specialists studied is not in a satisfying level, thus more attention and effective plans are needed from responsible authorities in the ministry of health and the managers of the hospitals studied in order to improve specialist`s working life quality.

aging is a very sensitive period of life and paying attention to the problems and requirements of this period seems to be a social necessity. Improving medication for old patients is challenging and sometimes medication`s benefits are less than its disadvantages for the patient. Because of the numerous evidences of problems caused by medication in the elderly in the recent decade, many specialists and physicians have introduced tools and techniques for identifying these problems which are caused by medication and prescription of risky medicines. Several methods, tools and criteria for assessment of quality of medication and medicine prescription in elderly have emerged since 1990.. We found out two categories of criteria reviewing the literature which are generally named as distinct criteria (criterion based) and implicit criteria (judgement based).The distinct category including Beers, Zhan, McLeod, Laroch and STOP/START criteria are all developed by a panel of experts and consensus in several stages. The second category of criteria concentrates on evaluation of clinical information. All the tools and methods described in this study are used in Europe and in the USA which have limited market similarities with our country thereforedevelopment of tools for assessing prescription quality for the elderly in Iran is absolutely necessary.

Current paper aims at investigating factors affecting physiciansknowledge ring intention in teaching hospitals affiliated to Tehran University-Medical Sciences in which one of the most authentic model of behavior prediction namely planned behavior has been used as the theoretical framework of study.

The method of current study is descriptive/survey correlational type and statistical society includes physicians employed in hospitals affiliated to Tehran University-Medical Sciences.Date was collected by questionnaires and analyzed using Lisrel&SPSS software.Confirmatory factor analysis was employed to evaluate consistency,Cronbach's alpha was used to assess reliability and structural equation modeling was used to fit the model and test hypotheses.

 Prediction power of model for knowledge-sharing intention of physicians is(R =0.66)The results suggested that impact of attitude on the knowledge-sharing intention is positive and significant with factor loading of(=0.87)However,influence of subjective norms and perceived behavioral control on the knowledge-sharing intention was not confirmed.Influence of subjective norms on attitude were evaluated positive and significant with factor loading of(=0.55)As a result, subjective norms affect knowledge-sharing intention through indirect mediation of attitude.All tests were significant at the level of(P0.01).

According to findings of this research on improvement of knowledge sharing behavior of physicians, health authorities need to take corrective measures to enhance the attitude and subjective norms of physician.

The different effective factors on out of pocket payment (OOP)have been introduced as follows: low salary of the employee’s, low governmental tariff, chronic disease, gifts to personnel, physician and other cadre’s requests, fear of bad or no services. In addition OOP has negative effects on the accessibility of services. This article studies the distribution of effective factors on OOP (formal and informal) through cardiac patients and its side effects.

This is a descriptive-exploratory study. The data were collected by interviews and questionnaires reliability of which was approved by specialists and their validity were approved by simulation-in Shahid Madani hospital in Tabriz in the winter of 2010.

all the persons studied had an experience of OOP. Formal payments included the free cost of the services with no insurance cover and the margin between the tariff and the rate that the physician or the hospital declares (83% of OOP). In addition 10% of persons encountered informal payments 80% of which was due to the physician’s request and 20%as a gift. The results describes the OOP`s side effects so that 52% of patients faced a postpone in getting services because of the OOP and 72% pointed that OOP has had an enormous effect on providing the necessary needs of the families.

The high rate of OOP and the weak performance of insurance system will result in injustice and intensifies the unfavorable effects of OOP on the health system and society.

In order to achieve the goals of health system, trying to evaluate and improve of health system performance via policy and decision makers is necessary.

This is a descriptive and practical study. Information gathered through sheets through World Health Organization statistical reports. data analyzed by using DEAP softwar (version of 2) and Data Envelopment Analysis (DEA).

Based on study technical efficiency in various scenarios were different. The results showed that health systems are high sensitive to human resources, and health sector's usually share the national expenditure difference scenarios during the period of study which show the managing efficiency and scale improvement s in Iranian health system.

This study showed the countries with the highest and lowest performance and efficient states (reference) for the inefficient countries among a few countries which increased their health resources to improve performance. However, with high efficient resource allocations in the most countries to achieve into these results are very significant to economic savings.

Organizational commitment among nurses as care providers provided the quality of patient care by their conservation. Therefore, nurses are committed to the investment and the competitive advantage of clinics and hospitals which have a significant impact on increasing the quality of services. In this study, the effect of psychological contracts and organizational trust studied as an organizational commitment of Ghaem hospital nurses in Mashhad province. Strategy survey - analysis of data obtained for the study of 193 Ghaem hospital nurses in the city of Mashhad through distributed questionnaires by the structural equations and partial the least squares method to seek the help of software were analyzed. The results indicated that the first, model of the material used has a strong theoretical model that is to predict nurse's organizational commitment. Secondly, all direct and indirect relationships between variables in the model were significant. But the relationship between organizational trust and nurses’ continuous commitment was not confirmed. This study indicates not only depends on nurse's organizational commitment to creating positive psychological space, but also they are in the reliability of this space gives rise to the obligation. On the other hand, the quality of the organizational commitment for nurses could be effective and efficient in use of available resources. Therefore, hospital administrators need to be more attention to an effective component of organizational commitment as supply facilities, participate in decision making, good communication, and job enrichment.

The scarcity of resources and growing demand for health care, as well as moral, socioeconomic and political imperatives for efficient use of resources, make cost information and adoption of an accurate methodology an integral part of the modern management.

At first, a research protocol including literature review strategies, inclusion and exclusion criteria and data gathering methods, was designed. Afterwards, using an electronic search of several databases, some relevant studies were identified.

In the costing literature the economic and accounting approaches are distinguishable. Two methods of marginal and average unit cost analyses are attributable to these approaches. Considering the type of the problem to be decided about and cost targets, costing methods can be different. Factors such as types of cost analyses and economic evaluation, timing overview, analysis approach and advantage or disadvantage of economy of scale have a significant role in determining the costs.

Having no consensus of opinion on the most appropriate principles to use in costing process is one of the main challenges of the time. There is a trade-off between the accuracy and cost of achieving cost information... Therefore, standardization of costing methodologies and adoption of comprehensive approaches for the main issues will predispose an economical international and organizational comparability.