نشریه مدیریت سلامت
پیاپی 50 (زمستان 1391)

Death information have critical role in adjustment of health plans and cause of death coding leads to organizing of this information. Purpose of this study is to review impact of errors in completion of Death certificate on underlying cause of death coding in Shahid Mohammadi hospital in Bandarabbas. this descriptive-cross sectional study performed in second half of 2011 by studying death certificates of all extinct. The first، certificates information was written on aside forms and residents determined sequences of death certificates. The next، researcher recoded certificates and compared his codes with original coders. The last، researcher referred to certificates their self for extracting information about documentation errors. Data entered in SPSS and was analyzed with descriptive statistics، chi 2 test and 95 percent confidence interval. accuracy rate of underlying cause of death coding was 51. 7percent. Between coding accuracy and major errors was meaningful relationship (P=. 001) but between coding accuracy and minors this not existed. Between majors ‘entry competing causes” has most affect (82. 1percent fault in coding). Between language of Death Certificate and occurrence of both major and minor errors there was a meaningful relation (0. 227and 0. 006). Also، this relation was found between number of lines and occurrence of both kinds of errors (0. 000). Impact of Majors on accuracy of underlying cause of death coding has proved. For resolving this problem، the physicians must be trained and the structure of Death Certificate must be edited.

Pre-hospital emergency medical services may have an effective role in the survival rate and prevention of serious injuries to patients and victims. On the other hand، increased length of stay can lead to an increase in hospital and patient costs while prolonging the recovery and rehabilitation time. This study aimed to investigate the relationship between pre-hospital care and hospital length stay in patients with acute myocardial infarction in Hazrate Rasool Hospital.

The population of this retrospective analytical cohort study constituted the patients diagnosed with Acute Myocardial Infarction hospitalized at Hazrate Rasool Hospital in Tehran in 2009. These patients were diagnosed during the first six month of 2009 and were ultimately discharged alive. The sample was the same as the study population. Data analysis was done by means of SPSS version 16، non-parametric Mann-Whitney، and Kruskal-Wallis tests.

The findings showed that 88% of the patients were transferred to the hospital with ambulance and had already received pre-hospital services. The average length of stay in the hospital was found to be 17. 6 days (SD = 4. 05). There were no significant differences in length of stay for the two groups of patients; those taken to hospital by ambulance and those who were not. However، a significant difference was observed between patients with various age groups. Moreover، the length of stay in patients with different insurance coverage was statistically significant. (P ≤0. 05)

According to the findings، although the means of transportation of the patients as well as pre-hospital services seem to have no impact on the length of stay in hospital، they may، however، affect other consequences such as improvement in overall health of the patient، reduction of injuries، pain، etc. which may not lead to a reduction in hospital stay. It seems that in studies examining factors affecting length of stay in hospitals، researchers should have systemic and holistic views on these factors in order to obtain a realistic contribution of each factor in increasing or decreasing the length of stay.

Inclusive، sufficient، precise and up to date information is necessary for planning in a health information system. Health Population Information Management System (HPIMS) is a system that collects، stores، retrieves، analyzes، interprets، and distributes health population information for prevention and treatment. The aim of this study was first; to compare Health Population Information Management System in health ministry، Iran statistics center، vital registry organization and United Nations، second، to propose a suitable model for Iran. This study was conducted to compare the features of Iran Health Population Information Management System with the United Nations standards. This was an applied cross-sectional study. The population included Iran Health Population Information Management Systems. The instruments of the study were a questionnaire and a check list. The data were collected through observation and an interview. The sources of information consisted of the staff، scientific documentation and the Internet. Criteria Rating Technique and descriptive statistics were used for data analysis. The findings showed an absence of timely، relevant، comprehensive and sufficient reporting in data registration system in Iran. Moreover، the organizations in charge of HPIMS had parallel functions which would lead to contradictory reports. Health Population Information، published by the Ministry of Health differed from that of Iran Statistics Center and other data registry organizations. Overall، HPIMS in the Ministry of Health was ranked as “very good” while the other organizations were ranked as “good”. The findings suggest that the information systems can only influence decisions if they are relevant، trustworthy and available for decision makers. However، information systems in Iran are inadequate to satisfy the needs of management. Therefore، it seems necessary to reform and design a suitable model representing accountability of organizations in regard to their duties and workflow. It is also suggested to decrease parallel functions and resources through a sharing system.

Every organization، including a hospital، bears its own climate which needs to be compatible with the needs of the personnel; otherwise، the efficiency of the organization will be diminished. This study was aimed at investigating the organizational climate of the hospitals of Tehran University of Medical Sciences (TUMS). This was a cross-sectional، descriptive، and analytical study including all general teaching hospitals of TUMS. The sample of the study consisted of 354 employees of clinical wards، supportive، and paraclinical departments. The instrument of the study was Sussman and Deep’s organizational climate questionnaire employed to assess their attitudes towards the organizational climate of the hospitals. Data entry was carried out by Excel software and data analysis was performed by SPSS software using T-test، Anova، and Duncan statistical methods. Less than half of the personnel believed that the organizational climate was favorable. Moreover، there was a significant relationship between organizational climate the three variables of age (p = 0. 01)، employment status (p = 0. 012)، and the job type (p = 0. 007). Most of the employees، having showed positive attitude only towards role clarity and organizational communication effectiveness، had negative attitude towards the organizational climate of the hospitals. The administrators of these hospitals، therefore، should take measures to change the climates through establishing efficient reward system، transparent organizational procedures، etc.

Considering the importance of websites in informing users and establishing communications، universities have started to design their own websites for organizing and making their information accessible. Evaluation of these websites through webometric methods will help recognize pitfall and strong points to reach a better quality and constant improvement. This study was aimed at ranking Pharmacy School Websites in Iran by Web Impact Factor (WIF). The webometric method was used in this study. The Data were collected via two search engines: Google and Yahoo. The population of the study consisted of 13 Pharmacy Schools in Iran. Excel and SPSS were used for statistical analysis. The results showed that website of Mashhad Pharmacy School with an WIF of 9. 66 in Yahoo and with 44. 96 in Google was at the highest rank. While Zanjan Pharmacy School with the WIF of 0. 05 in Yahoo and with 0. 067 in Google had the lowest rank. The results suggest that despite the low WIF، elements such as number of pages، mass of information and related links have an influence on WIF causing differences in ranking of Pharmacy Schools.

I ssues related to organizations and users are among factors influencing successful implementation of information systems. These factors should be taken into account by managers. The purpose of this study was to examine the influence of supervisors and workgroup on Hospital Information System (HIS) acceptance by users in medical hospitals of Tehran (former Iran) University of Medical Sciences.

After the literature review، a primary model including seven variables influencing HIS acceptance was proposed. A questionnaire including 121 questions based on the variables was developed، the validity and reliability of which were tested and confirmed by an expert panel and through Chronbach Alpha. The population of the study were 400 HIS users in hospitals selected by stratified random sampling method. To confirm the model and determine the relationship between variables، Structural Equation Modeling (SEM) method was used by applying LISREL Software.

The result of Normed Chi Square Index (χ 2 /df= 2. 49) showed that the model had fitness with the collected data. According to the model، supervisers and workgroup influenced Perceived Ease of Use، Perceived Usefulness، and Satisfaction which affected users Behavioral Intention to use Hospital Information System in these hospitals (P-value= 0. 0054).

Considering the goodnesss of fit indices، it is concluded that supervisors and workgroup factors have the potential to influence HIS acceptance. The application of the suggested model could increase the possibility of HIS acceptance in hospitals under the study.

The development and the adoption of electronic health records may face a number of barriers. These barriers can be classified as technical، organizational، individual، financial and ethico-legal. This study aimed at determining the importance of each of the mentioned barriers in the development and adoption of the electronic health records from the perspectives of the experts in the Ministry of Health. This was a descriptive applied research completed in 2011. The study population were constituted the faculty members working in of the departments of health information technology، health information management، and medical informatics، and as well as those who were in charge of the development and adoption of the electronic health records in the Ministry of Health and Medical Education. In this study، no No sampling method was used due to the limited number of the study population. Data were collected using a Likert scale questionnaire and were analysed by means of descriptive statistics. The content and face validity of the questionnaire were established and the reliability was calculated using Cronbach’s alpha. In total، 32 participants (51. 6%) completed the questionnaire. The participants'' perspectives showed that the most important barriers in the development and adoption of electronic health records were the technical barriers (mean=71. 00). The financial barriers and the ethico-legal barriers with the mean values of 70. 05 and 68. 16 were in the second and third place، respectively. The individual and organisational barriers with the mean values of 64. 84 and 62. 67 were in the fourth and fifth places. It seems that employing a team of experts in different areas related to the development and adoption of EHR، training users، and addressing technical concerns along with allocating financial resources can help overcome barriers to the adoption of EHR.

Webometrics ranking shows the amount of scientific and educational activities of universities and organizations annually. This study was an attempt to rank medical universities in Iran via three search engines.

This applied- descriptive study used webometric methods to survey 43 websites of medical universities in Iran. The three indexes of size، visibility and rich files were taken into consideration by three search engines. Data were analyzed with SPSS 16.

The results showed that the indexed page size of Tehran University of Medical Sciences enjoyed the highest frequency in the three search engines. Moreover، the lowest ranks belonged to Dezfoul، Jiroft and Yasouj. Concerning foreign links، Tehran University of Medical Sciences gained the rank of 13 and Hormozgan with an average of 23. 11 was in the upper ranks، but it was reported to have the rank of 26 regarding indexed page size.

The findings showed that even the eight high-ranked medical universities did not appear to receive favourable number of links and visitors from other websites. This suggests the low effect of medical universities on the Web in spite of their relatively high page size.