فهرست مطالب

طب و تزکیه - سال بیست و دوم شماره 2 (تابستان 1392)
  • سال بیست و دوم شماره 2 (تابستان 1392)
  • تاریخ انتشار: 1392/06/15
  • تعداد عناوین: 8
|
|
  • Karami Matin B., Rezaei S., Alinia S., Shaahmadi F., Kazemi Karyani A.* Pages 9-18
    Introduction and
    Objective
    The present study has investigated the trend of aging changes in Iran and health costs related to the aging.
    Method
    This is a review study about aging in Iran. Published articles and texts about the subject were gathered by valid websites and databases such as Web of Science, Science Direct, Google Scholar, Springer, and Google with key words: elderly population, the costs of aging, the challenges of aging and their solutions. After receiving the relevant articles and reading them, useful articles and papers have been selected and used in this paper.
    Results
    Iran and the world are increasing in older population, and projected that nearly 25 to 30 percent of Iran’s population will be old in 1410s. In all studies, it has been proved that with aging, treatment costs in various forms and sections will be increased. The causes of this increase compared with other age groups are: the continuous and frequent use of high volume of health services, the longer period of service (such as: increased length of stay and admission to hospitals and health accommodation) higher drug and medical’s expenses compared with other age groups because of the type of disease and response rate to treatment.
    Conclusion
    Elderly population is vulnerable to higher chronic diseases, and it could impose a heavy financial costs. The appropriate insurance coverage for the elderly, the provision of long term cares, the suitable aging facilities and equipment in the hospital and planning to train specialists in this field, increasing the retirement age and training of health staff and personnel about long term care, and other similar cases can be very effective in reducing the problems of aging.
    Keywords: population, Aging, costs, Iran
  • Ahmad Barati Marnani, Hasan Abolghasem Gorgi, Mohamad Mehrtak*, Aziz Rezapour, Seyed Esmaeel Afian, Amirkhosro Modhirshahla Pages 19-26
    Background And Objective
    Assessing the hospitals` performance is considered as a focal point because of their vital role in healthcare systems.. The performance of all hospitals of East Azarbaijan province was assessed using this model in this study.
    Methods
    This descriptive, cross-sectional and retrospective study was conducted in 20. All hospitals in the province were selected to study. Data were analyzed using Excel software.
    Results
    Of the total 39 hospitals, 14 were in zone 1(with low bed turnover and bed occupancy and lack of efficiency), 5 in zone 2(with good bed turnover), 15 in zone 3(high bed turnover and bed occupancy), and 5 were in zone 4(with high bed occupancy, long average length of stay and low productivity) of the graph.
    Conclusion
    Pabon Lasso is one of the most important tools used to assess hospital efficiency. Using this model produces information that can be used by policy makers in their attempt to make the health care system more productive. Considering that 61.6% of studied hospitals were in inefficient area, therefore, strengthening hospital management and paying enough attention to development besides improving health services quality are of those crucial solutions in the short-term.
    Keywords: Performance assessment, Hospital, Pabon Lasso graph
  • Mohammad Hadi, Haniye Sadat Sajadi*, Reza Goudarzi, Mohammadreza Ghasemi, Mohammad Hadian Pages 27-38
    Objectives
    Although measuring the Human Development Index can help policymakers to evaluate developments and priority policies, if we could be able to calculate the efficiency to achievement of this index, it would have be more applicable. The study aimed to measure the efficiency to access to HDI using Stochastic Frontier Analysis.
    Methods
    The present descriptive-analytic study was carried out through a cross-sectional method in 2010. The study population consisted of all cities of Isfahan province (n=21). All population was studied and sampling was not used. Data were gathered and estimated by studying all respecting reports and documents found in Isfahan University of Medical Sciences and Statistics and Information Office of Isfahan Governor during 2004-08. HDI was calculated according special formula. 4.1Frontierwas used to measure efficiency of selected cities and figure out the optimum production function.
    Findings
    The HDI for Isfahan was calculated according to the year-oriented succession: 0.627(2004), 0.643 (2005), 0.660 (2006), 0.669 (2007), 0.603 (2008). The mean of Technical efficiency of achieving the HDI index in mentioned province during the years of 2004 to 2008 was estimated around 0.95 regarding all seven modular inputs and around 0.94 regarding just five numbers of them.
    Results
    All put together, to achieve the main goal of increasing the efficiency of achieving the HDI index, some fundamental issues should be considered including the fulfillment rate of income index, enrichment of private sector potentials, attention focused on planning & development of Human Resources, investment rate on infrastructure, identifying investment opportunities by the purpose of utilizing the strengths and providing such a condition working as stimuli to encourage public sector participation.
  • Seyed Alireza Javadinia, Morteza Erfanian, Mohammadreza Abedini, Majid Askari, Ali Abbasi, Bita Bijari* Pages 39-44
    Background
    Nowadays, social networking sites (SNSs) are one of the most importing means to communicate in societies and worldwide. Iranian students have shown an increasing interest for using the networks recently. Whether and how precisely Iranian students use these social networking sites is unclear. Therefore in the present study, we have studied and determined the rate of using the social networking sites among the students in Birjand University of Medical Sciences during 2011-2012.
    Methods
    In this descriptive analytic study, 400 students of Birjand University of Medical Sciences were randomly participated. The content validity and reliability of questionnaire was confirmed. The information was analyzed using SPSS software Number 11.0, for Windows (SPSS Inc. Chicago, IL, USA).
    Results
    401 questioners were included. The mean age of participants was 20.71 ±1.87 years and two third of them (66.6%) were female. While more than half of the participants (57.5%) were knowledgeable about SNS, the participants who had a membership at least in one of the sites accounts for 37.8% (153 out of 401). Moreover, 147 of the members (36.6%) were indicated that they regularly check their accounts with an average usage of 49.0 ± 27.1 minutes per day. Most use of the virtual social networks was interact with old friends.
    Conclusion
    The present study demonstrated that a considerable percentage of the participants were the member of social networking sites. In this context, it is highly recommended to enhance the educational and cultural quality of these sites in order to appropriate and optimal application.
    Keywords: Students, social networking sites, university
  • Ranjbar Ezatabadi M., Bahrami Ma*, Arab M., Nasiri S., Hadizadeh F., Ahmadi Gh Pages 45-52
    Introduction
    The quality of service is a key ingredient in the success of health care organizations. Therefore several tools have been developed to measurement of service quality but the Parasuraman 22 item SERVQUAL instrument has been created based on the gap model remains the most widely used in a variety of industries. This study attempts to replicate the SERVQUAL measurement of Parasuraman et al in determining the existence of service gap in Shahid Rahnemoon hospital.
    Materials And Methods
    this descriptive - applied study was carried out through cross section of method in 2010. The research population comprised of patients admitted to Shahid Rahnemoon hospital words. 61 patients were calculated by sample size formula for unlimited population and obtained randomly. The data was collected by 22-item SERVQUAL questionnaire that was designed according to gap model. Data analysis was carried out through SPSS and LISREL -software. And Kolmosrof - Smirnoff and paired sample t -test.
    Results
    the results demonstrated that there was a quality gap in Shahid Rahnemoon hospital. In the other hand, the results showed that there were significant differences between expectations and perceptions of patients in SERVQUAL dimensions. Also, the study identified some critical and problematic items that have main role in constructing observed quality gap.
    Conclusion
    the existing quality gap means patients expectations exceed their. Perceptions. thus, improvement are needed across SERVQUAL dimensions.
    Keywords: Hospital, SERVQUAL, Service quality gap
  • Ali Mohammadi, Amir Abbas Azizi, Ramin Cheraghbaigi, Rouhallah Mohammadi, Javad Zaree, Rahman Setoodeh, Farshad Faghisolouk* Pages 53-60
    Introduction
    the main source of hospital income is by selling health care services provided to the insured. Thus, the quality of services and facilities to the insured population and other individuals can be improved by controlling these resources to make correct and efficient use of them and to avoid the wasting. So the aim of research was survey the amount deduction rate by medical services and social security insurance organizations with accounts to be sent to Teaching Hospitals University.
    Methods
    The study was cross-sectional, descriptive and type of it was applied study Research documents included all bills sent by Khorramabad Teaching Hospitals to Medical Services and Social Security organizations. The instrument for data collection was check list. Data by descriptive statistic and SPSS software were analyzed.
    Results
    The Mean of hospitalization and outpatient deductions accounts sent with Medical Services insurance was 4.22%, the highest and the lowest deductions accounts, respectively, were related to Shohadaye Ashaeer with 5.46 % and psychiatric hospital with 0.18 %. And so, the anesthesia cost have a highest percentage of bills deductions (18.46%). the average of hospitalization and outpatient deductions accounts sent with Social Security insurance was 4.22%. Shohadaye Ashaeer hospital with 6.24 % of most deduction and psychiatric hospital with 0.19 % had the lowest deduction.
    Conclusion
    although deduction was applied to a small percentage of accounts, a significant financial burden was imposes to the hospitals. The major causes of deduction, documentation incomplete records, lack of familiarity with hospital information systems, incomplete and incorrect registration insurance code; up coding, incorrect calculations, lack of adequate training and other factors as is. It is recommended to universities for reduce the amount of deductions to adopt appropriate policy.
    Keywords: medical services insurance, social security insurance, deductions, billing, hospital
  • Alireza Rahimnia*, Farshid Monajemi, Mahboobeh Shams Pages 61-70
    Background And Objective
    In order to alignment with developments in information and communications technology and enjoying the benefits of computer systems, “integrated system of continuing medical education” in the form of a information comprehensive system with the management information systems structure in 1389 designed and has been operation since 1390. According to the latest guidelines of the Head Office of Continuing Medical Education, all participants are required to provide certificate of education only through this system, this study was conducted to survey of the participants about the system.
    Methods
    This descriptive study was conducted in the second half of 1391, in the Head Office of Continuing Medical Education. The study population were included all participants in this system and with Random Sampling, sample size was calculated384 peoples. A valid and reliable researcher made questionnaire data were collected and finally, 343 respondents were. For data analysis Excel 2007 & Spss16.0 Softwars were used.
    Results
    Generally, 12.5% of the participants were assessed this system Excellent, 33.5% Desirable, 31.5% Acceptable, 18.7% Weak and 3.8% Undisirable. Among the eleven functional areas the highest mean scores were reports of continuing education CV (2.61±1.00) and detailed information about the programs was lowest(2.16±1.03).
    Conclusion
    Since the purpose of establishing this system in participants level, was intended to improve services to them, provide personal and educational data and facilitate the administrative and financial activities, with the commissioning of this system is effective steps have been taken to improve the educational system.
    Keywords: Continuing Medical Education, management information system, integrated advanced information management system
  • Dr. Mohammadreza Talebi Ardakani, Dr. Aidin Sooratgar, Dr. Yasin Asadi*, Dr. Behzad Hooshmand, Dr. Mehdi Shadnoosh, Dr. Zahra Alizadeh Tabari Pages 71-76
    Introduction
    Gingivitis is the most common form of periodontal diseases. Dental plaque is known as an essential cause of gingivitis. Because of the inability of many people to maintainadequate levels of plaque control through mechanical methods, Use of antimicrobial mouth rinses has been recommended as an adjunct to usual oral hygiene. Aim of present study was to determine the clinical anti plaque and anti gingivitis effects of Irsha and Listerine antiseptic mouth rinses. Method and material: This clinical study was a double-blinde, randomized, 21day trial which included 30 patients ranging in age from 18-24, with mild to moderate gingivitis. Exclusion criteria included previous scaling and polishing, effective systemic disease on our study process and history of smoking, etc. Plaque index(silness & loe 1964), modified gingival index(lobene 1986), papillary bleeding index(saxer & muhelmann 1975) were scored at baseline. Participants were assigned by a random code to one of three groups: Irsha antiseptic, Listerine antiseptic, normal saline (control group). All solutions were kept in the same bottles. At baseline, participants were refrain from all oral hygiene procedures for a period 72 hours during which they rinsed twice daily for 30 seconds with 15 ml of one of the mouthwashes. At day 3, all volunteers were recalled and we record mention indexes. Subjects of control group received scaling and dental prophylaxis and excluded from study. Subjects in Irsha and Listerine antiseptic groups follow their usual oral hygiene habits in addition to mouth rinsing. Subjects return to clinic after weeks for final assessment of indices. Then they received scaling and dental prophylaxis.Resuls: Both Irsha and Listerine antiseptic reduced papillay bleeding index. In both groups plaque index was reduced when mouth rinses were used at supplements to mechanical oral hygiene methods. Only Listerine antiseptic was effective in improving modified gingival index when it was used as an adjunct to usual oral hygiene methods.
    Conclusion
    Both Irsha antiseptic and Listerine antiseptic were effective in reducting plaque and gingivitis. But Listerine antiseptic was more effective in improving gingival inflammation.
    Keywords: mouth rinses, Irsha antiseptic, Listerine antiseptic, gingivitis, dental plaque