فرید خرمی

This study aims to monitor the scientific productions of the faculty members at Hormozgan University of Medical Sciences (HUMS) during the COVID-19 pandemic indexed by Scopus using the citation and altmetrics indexes.

This is a descriptive-analytical study using a scientometric approach in 2023. The study population consists of the articles of the HUMS faculty members during the pandemic (2020-2022) indexed by Scopus. The search was conducted using the affiliation identifier form of the Scopus database with no restrictions on the type of study. The search yielded 956 articles (152 articles related to COVID-19). Altmetrics extension was used in Google Scholar search engine to check the status of works in social networks. Bibliographic information, citations and altmetrics index of the articles were entered in Excel software and then analyzed using descriptive and analytical methods in SPSS software, version 26.

The rate of attention paid to all articles and COVID-19-related articles was 90.27% and 46%, respectively. The attention was mostly paid by capture (68.89%), social media (8.8%) and view (8.4%), according to the altmetric indicators. There was a strong and positive correlation between the citation index and the altmetrics index of the COVID-19-related articles. These articles were mostly visible on Mendeley, followed by Twitter and Facebook.

Information about the visibility of articles in different social networks along with the number of citations can lead to efficient competition among faculty members in social networks.

In the health system, reimbursement methods are an important criterion for the allocation of resources and the performance of service providers. The use of diagnosis-related groups (DRG) system reduces the length of stay and additional costs of the patient, prevents unnecessary treatment, increases resource efficiency and transparency of health care services. The development of the DRG system focuses on the accurate documentation of medical records and the correct coding of diagnoses and procedures. The purpose of this research is to evaluate the documentation and coding requirements of medical records in the implementation of a payment system based on diagnosis-related groups in Iran.

This research was descriptive-cross-sectional and was conducted in 2022. The data collection tool was a researcher-made checklist, the validity of which was confirmed based on the opinion of experts (health information management health economics) and its reliability was obtained by calculating Cronbach’s alpha (0.83). The research population consisted of 418 medical records in five medical training centers affiliated to Urmia University of Medical Sciences, which were selected through stratified-proportional sampling. Data were analyzed using SPSS software.

The results of the evaluation of the documentation and coding requirements of medical records for the implementation of the DRG system showed that the demographic/administrative variables including age, sex, type of admission, length of stay, health insurance, and doctor’s expertise were completely recorded. Evaluation of clinical variables also showed that the main diagnosis, main procedure, secondary diagnosis and other procedures were documented in medical records in 98%, 97%, 88% and 75% respectively. Regarding the coding of the main diagnosis and the main procedure, 100%, secondary diagnosis 68% and other procedures 80% have been done.

Considering that some essential clinical variables for the implementation of DRG, especially co-morbidities, complications and other procedures are not recorded separately and completely, therefore it is necessary to define separate information elements in medical records and HIS for accurate recording of these variables and proper interaction between coders and doctors is established to increase the possibility of correct coding. It is also suggested that the DRG system be implemented in our country in a phased and gradual approach so that necessary changes are made in the documentation process and hospital information systems.

Clinical coding is a complex and error-prone process. Correct clinical coding requires high-quality documentation of medical records. This study aimed to identify the quality of medical records documentation and the accuracy of coding with ICD-10 compared to ICD-11.

This cross-sectional descriptive study was conducted in 2022. The samples were chosen from 11638 medical records of patients admitted at the Shahid Mohammadi teaching hospital with the diagnosis of injury, poisoning, and certain other consequences of external causes. Using Cochran's formula, 500 medical records were evaluated. The research was conducted in two stages to check the accuracy of coding and the defects in the documentation of medical records for coding. The research data collection tools were separate checklists for each stage. Data were analyzed using descriptive statistics in SPSS software.

The number of codes allocated to the studied medical records was 1673 and 1468 codes based on ICD-10 and ICD-11 classification systems, respectively. The majority of records (98%) had at least one type of major or minor error, 23% had only major errors, 46% had only minor errors, and 31% had both types of ICD-10 coding errors. Moreover, 81% and 26% of the medical records contained adequate information to fully or relatively fully describe the codes using ICD-10 and ICD-11 classification systems, respectively.

Compared to ICD-10, there were more defects in the documentation of medical records for coding with ICD-11. Development written documentation guidelines by ICD-11, using templates and reminders, and providing feedback to healthcare providers. Using automated coding support tools, coding audits, and continuous training of coders are essential for coding quality improvement.

 

The payment system based on diagnosis-related groups was created to control the costs of health care services, increase efficiency in inpatient care, and improve transparency in hospital activities. The success of this system depends on complete and accurate documentation of medical records and correct coding of diagnoses and procedures. This research aimed to determine the problems of documenting medical records to implement a payment system based on DRGs.

This research was a qualitative study that was conducted using the semi-structured interview method in 2022. The research population included experts in health information management and health economics at Urmia University of Medical Sciences, who were selected purposefully. Data analysis was done through content analysis using ATLAS.ti software.

From the point of view of the interviewees, the most important problems of documenting medical records in the implementation of DRGs, included the lack of clinical documentation guidelines, the lack of necessary information elements, the lack of accurate evaluation of the quality of documentation, and coding, the lack of continuous training courses, the incompleteness of documentation, and the lack of sufficient interaction between doctors and coders were in the hospital.

The results of this research showed that some essential variables for implementing the DRGs system are not defined separately and clearly in the medical records and the hospital information system, and the quality of the documentation and coding is not accurate and complete. Therefore, it seems necessary to consider separate information elements for the main diagnosis, the main action, and the comorbidity and complications in the standard medical record forms.

COVID-19 is a viral respiratory disease caused by SARS-COV-2, which affects the lower respiratory tract, and causes pneumonia in patients. The disease rapidly spread around the world after the outbreak in late 2019, and became one of the challenges of health care systems. Older adults and patients with underlying diseases such as cardiovascular diseases, hypertension, and diabetes are at a higher risk for COVID-19, and need more care. Due to its prevalence in older adults and normal population, diabetes is important in terms of putting a burden on intensive care systems during the COVID-19 pandemic. Diabetes is also one of the most common comorbidities in patients with COVID-19, which is considered a risk factor for these patients. In addition, the association between diabetes and respiratory distress syndrome is not yet fully understood. Some studies have suggested that diabetes is not associated with respiratory distress syndrome while some others suggest that pulmonary dysfunction follows diabetes. It is also unclear what factors are associated with disease prognosis and mortality in COVID-19 patients with diabetes. In the current study, we aimed to investigate the status of demographic factors, comorbidities, lifestyle and laboratory results in diabetic patients with COVID-19, and compare them with the non-diabetic population and determine the prognostic factors in diabetic patients with COVID-19.

This study is a cross-sectional study performed on 415 patients with COVID-19 in the COVID-19 ward of Shahid Mohammadi Hospital of Hormozgan University of Medical Sciences from February to September 2020. Based on their diabetes, these patients were divided into diabetic and non-diabetic groups. Then, data on demographic factors, smoking, opioids and alcohol consumption, comorbidities (chronic lung disease, asthma, obesity, chronic kidney disease, type 2 diabetes, dementia, malnutrition, chronic neurological disease, rheumatic disease, hypertension, hyperthyroidism, hypothyroidism, favism, hyperlipidemia, and malignant neoplasms), some personal lifestyle features were determined in diabetic patients and compared with non-diabetic populations. Also, the information on biochemical variables, including hemoglobin, white blood cells, lymphocyte, neutrophils, hematocrit, platelets, prothrombin time, alanine aminotransferase, bilirubin, aspartate transaminase, lactate dehydrogenase, blood urea nitrogen, creatinine, blood glucose, sodium, potassium, C reactive protein were measured patients of the two groups. Also, heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, temperature, and oxygen saturation were determined in diabetic and non-diabetic patients.Quantitative variables were described by number (n) and percentage (٪). Qualitative variables were described using mean and standard deviation (SD), median and interquartile range (IQR). The Shapiro-Wilk test was used to assess the normality of quantitative variables. Independent t-test or Man-Whitney U test, and Chi-square or Fisher's exact tests were used to compare variables. In all statistical analyses, a p-value less than 0.05 was considered statistically significant. Statistical analysis was performed by IBM SPSS version 22 (IBM Corporation, Armonk, NY, USA).

The findings of our study showed that in the diabetic patients’ group 82 patients (41.2%) and in the non-diabetic population 135 patients (55.32 %) were men. In the diabetic group, the mean age of recovered patients was 58.52 years and the mean age of those in the deceased was 57.73 years, which was not statistically significant. In the non-diabetic group, the mean age of patients recovered was 47.98 years and the mean age of those in the deceased was 62.58 years, which was statistically significant (p <0.001). In the diabetic population, 773 patients (42.69 %) and in the non-diabetic population, 132 patients (54.09 %) had positive PCR. In the diabetic population, 18 patients (10.59 %) and in the non-diabetic population, 10 patients (4.09 %) had chronic kidney disease. In the diabetic population, 11 patients (6.43 %) and in the non-diabetic population, 13 patients (5.32 %) smoked. In the population of diabetic patients, the mean level of hemoglobin (P = 0.002) and lymphocyte count (P = 0.043) in the living cases were significantly lower than those in the deceased. The mean levels of neutrophils (P = 0.012), aspartate transaminase (P = 0.020), lactate dehydrogenase (P = 0.041), blood urea nitrogen (P = 0.003), and creatinine (P = 0.011) in the diabetic population were significantly higher in the living cases than those in the deceased, but the comparison of these cases in the non-diabetic population did not show a significant difference.In diabetic patients, there was a significant difference between the number of survival and death in each group of positive and negative PCR (P = 0.011); While the difference in mortality and survival between PCR positive and negative groups in non-diabetic subjects was not significant. In diabetic patients, a significant difference was also reported between the number of survival and death in groups with CKD and without CKD; while in non-diabetic participants there was no significant difference between CKD and non-CKD groups in terms of survival and death. Corticosteroid treatment also significantly led to a difference in the number of survival and death cases among the diabetic population, but a comparison of these cases in the non-diabetic population did not show a significant difference.In the group of diabetic patients, respiration rate (number of breaths per minute) was significantly lower among the living cases compared to those in the deceased (P < 0.05), while our findings in this regard did not show a significant difference in non-diabetic individuals. Also, in diabetic patients, the amount of oxygen saturation was significantly higher among the living cases than those in the deceased (P < 0.05), in which case the same results were observed in non-diabetic patients (P < 0.05).

In this study, the mortality rate in diabetic patients was significantly associated with lymphopenia, elevated aspartate transaminase, lactate dehydrogenase, blood urea nitrogen, and creatinine compared to non-diabetic patients.  Our findings suggest that individuals with type 2 diabetes are more prone to complications of COVID-19 and its related mortality; therefore these patients need more medical attention in the COVID-19 pandemic. Also, considering that so far limited studies have focused on the possible differences in the complications of Covid-19 disease and its mortality in diabetic individuals compared to non-diabetic individuals, it is recommended that more studies with higher sample sizes in other populations be performed to confirm the results of the present study.

The preparation, sale, or use of controlled drugs (CDs) require close regulation, and misuse of these drugs can have irreversible side effects. Therefore, the present study aimed to design a web-based system entitled San-Tech for monitoring of CDs.

This is a practical development study carried out to design and establish a program to monitor controlled drugs. The study was performed in three stages. At first, the informational and functional elements of the program were identified through interviews and investigations. In the second stage, they were reviewed and approved by experts. Then, this system was designed using the C # programming language, the server with ASP.NET Core API technology, and the user with Angular technology.

The informational elements required for this system included 70 items in the classes of the patient, drug, prescription, physician, specialty, pharmacy. Nine functions are also considered for this system to apply more control over the use of CDs. The system was designed and available for pharmacies at https://pharmacy.hums.ac.ir.

This system can record some information, including patient and physician details, type and number of CDs, and the time of visit. According to this information, pharmacies, as well as Food and Drug Administrations, could monitor the sale and use of CDs

The aim of this study was to determine the status of ICD-10 codes assigned to cancer patients' medical records in terms of three attributes of accuracy, completeness, and timeliness.

in this cross-sectional descriptive study, 374 medical files with C00-D48 diagnosis codes were selected through stratified sampling. Data gathering tool was a researcher-made checklist consisted of clinical information summary, codes assigned by assistant professors and coders, the review and comparison of the codes, the results obtained from the control of codes by ICD-10 and the errors extracted from coders’ codes. The factors affecting the occurrence of coding errors at different levels and their impact on the accuracy and completeness of the codes were classified.

Totally, coding errors were observed in 79 cases (21.74%). differences in codes at the level of the chapter were due to not following the rules for choosing the main diagnosis (30 cases) and inadequate study of the records (38 cases). In terms of completeness, in 27 cases (7.43%), codes assigned by coders were defective compared to assistant professors’ codes. In relation to the timeliness, in accordance with the WHO standard, coding was done within 48 hours of the patient's discharge.

According to the results, coding quality is not only dependent on the coders, but also on other factors such as documentation defect. Therefore, continuous training for both coders and documenters is necessary to resolve defects, especially in the field of cancer. It is also recommended to use the results of this study for planning related workshops.

Most modern medical issues are inherently complicated and accurate decisions are not always likely to be made based on logical reasons. Furthermore, the huge volume of information relevant to a simple diagnostic area makes this decision making even more troublesome. Hence, with the advent of technology, there is an ever increasing need for the Clinical Decision Support System (CDSS) in hospitals. This study has been conducted in an Iranian hospital with the aim of identifying the most significant barriers for implementing CDSS and suggesting appropriate strategies to remove them.
This qualitative cross-sectional study was conducted in 2015. The sample population of the study included 180 physicians and nurses in Shahid Mohammadi hospital in Bandar Abbas whose performance was changed using CDSS. The participants were selected using stratified sampling from 23 different wards in the hospital. First, the barriers and strategies for implementation of CDSS in other countries were extracted from a review study which was used to make a preliminary model. Then, the results of a questionnaire and Delphi tests in three rounds were included in the final model.
The most significant barriers in implementing CDSS were categorized into 6 groups according to the participants. These include barriers from human resources and infrastructures as well as financial, technical, environmental and legal ones. The barriers for them were divided into 5 categories including structural, technical, financial, human and environmental ones.
Since the most significant obstacle in implementing CDSS in this hospital was from humans, the hospital can use the barriers provided in 5 categories and better benefit from the system. These barriers are training the human resources before they start working, engaging them in implementation process of the CDSS and using evidence-based scientific databases in CDSS while removing fundamental barriers to the system.

The hemodialysis patients face with multiple physical problems and psychosocial and social challenges. The proper interventions in the field of their education have a positive impact on the reduction of complications and improvement of the quality of their life. Despite the potential benefits of patient education, its success depends on various factors. The purpose of this study was determined present situation and factors affecting success of patient education in hemodialysis centers of Urmia University of Medical Sciences.
This is a cross-sectional descriptive study conducted in 2015. The study population included 420 patients in hemodialysis centers in Urmia University of Medical Sciences. Data were collected using a self-structured questionnaire which was estimated as both reliable and valid. The data were analyzed by SPSS 20 software descriptive statistics and analytical statistics.
The most common of patients education methods in hemodialysis centers under study included handout-pamphlet (37%), oral conversation (26%) and workshop (18%). The most factors affective in hemodialysis patients education were related to patient education based on learning needs (4.85), ease of learning educational content (4.77), Proper communication between providers and patients (4.61), Skills of educators (4.50) and patient participation in the planning and implementation of education (4.44) respectively).
The hemodialysis patients need education in order to adapt to their condition and perform self-care behavior. So, physicians and nurses should provide education based on learning needs of patient through effectively communicating with patients and applying various methods. It is necessary that continuing education for healthcare provider conducted and also the quality of patient education evaluated and motivation of health care providers increased.

Patient safety is a major concern for health care organizations. The first step to improve culture of patient safety is its assessment. Accordingly this study was performed with the aim of assessing culture of patient safety from nurses’ perspective in the hospitals affiliated to Hormozgan University of Medical Sciences. It was a descriptive cross-sectional study. The sample consisted of 190 nurses working in educational hospitals of Hormozgan province who were recruited by stratified random sampling in 2012. Data was collected by Hospital Survey on Patient Safety Culture questionnaire (HOSPIC) and analyzed by independent T. test, one-way ANOVA and Post hoc test of LSD using SPSS- PC (v. 16). Among the different dimensions of patient safety culture, the lowest score was related to the number of employees and its related issues (40.25%) and the highest score was related to team work in the unit (85.60%). In the past 12 months, 63 nurses (35.7%) did not report any errors and 53 nurses (30.1%) reported only 1 or 2 error. Significant differences was seen between the score of different dimensions of patient safety culture and nurses’ work experience, the type of employment, hospitals, and the amount of working hours (p <0.05). Regarding the findings, it is suggested that managers and policy makers identify the factors involved in patient safety culture and improve the working environment, and promote supportive organizational climate in hospitals. Farther research is needed to detect the causes of nurse's failure to report medical errors.

Numerous factors affect on quality of nursing documentation. Continuous evaluation and identifying factors affecting documentation have a significant role on improving the quality of documentation. This study aimed at Nurses’ organizational behavior and their quality of documentation in teaching hospitals of Hormozgan University of Medical Sciences. This is a descriptive cross-sectional study conducted in 2013. The study population were nurses in teaching hospitals of Hormozgan University of Medical Sciences. From a total of 552 nurses, 215 nurses were selected using random sampling. Three standard questionnaires and three Self-made check list were used for data collection. Validity of the tools was measured using comments of professors and experts and reliability of the questionnaire was measured using Cranach’s alpha. Collected data were analyzed using SPSS version 16. Pearson, ANOVA, and T-student were used to assess relationship between variables. Levels of nursing education and type of employment stipulated in the employment contract had significant effect on the score of documentation (P<0.01). In addition, hospitals and various departments had significant differences in the documentation scores. From the other side, job satisfaction, social capital and organizational citizenship behavior have significant positive correlation with the total score of nursing documentation (P<0.05). Nurses organizational behavior including job satisfaction, social capital, and organizational citizenship behavior, can have an impact on the quality of their documentation. Therefore, hospital managers and supervisors can ensure quality of nursing documentation following improving organizational behavior.

The reimbursement mechanism of the cost of treatment is an important factor which directly or indirectly affects the financial management and control of hospitals costs، hence different countries use different reimbursement systems. This study evaluated the prospective reimbursement system (global system); at one of the hospitals in Hormozgan University of Medical Sciences. This descriptive-analytical study evaluated 1286 Global inpatient records in Fekri hospital affiliated to Hormozgan University of Medical Sciences. First the actual cost of care and length of stay for each of the global records was extracted using the hospital information system. Then the average cost and patient''s stay for each of global procedures were compared with the cost and length of stay determined by Iran global system. Data analysis was performed using descriptive statistics and T-test was used to test the research hypothesis. One quarter of all inpatient records belonged to global payment system. 62% of global records belonged to OB/GY operations، 20% to general surgery and 18% to ophthalmic surgery. The analysis of the cost of 86% of surgery global records showed to be beneficial for the hospital، where 91% of these cost differences were found to be significant. For more than 99% of cases in global system، the average length of stay was less than average standard length of stay، and for 64% cases this difference was found to be statistically significant. Regarding the reduction of length of stay of patients in global payment system، the review and implementation of global payment system for other diagnoses and operations is highly recommended.

Organizational citizenship behavior (OCB) and social capital constitute Organizational behavior، which have important effect on performance and productivity. Therefore this study was conducted to analyze the relationship between social capital and (OCB) among employees at teaching hospitals in Hormozgan University of Medical Scinces. This cross-sectional study was performed in 2011. Standardized questionnaires of Podsakoff and Nahapeit were used to gather data on OCB and social capital، respectively. The validity of questionnaires was approved and its reliability was measured by calculating Cronbach''s alpha which was shown to be 0. 72، 0. 84، respectively. Sampling was done through classified random sampling method. Data analysis was performed using SPSS 19 software and to analyze the relationship between above mentioned variables ANOVA and Pearson tests were used. The mean value of organizational citizenship behavior and social capital were found to be 3. 1±0. 53 and 2. 7±0. 58، respectively. A statistically significant relationship between OCB and social capital was observed. In addition، There was significant relationship between demographic variables such as education، organizational position، shift work and gender with social capital and OCB (P<0. 01) Considering the importance of organizational citizenship behavior for Institutions، to improve efficiency it is suggested that administrators of hospitals and health care institutes adopt policies to enhance these two issues among staff.

Every project of information systems is to develop by four main stages of analysis; design، implementation and evaluation. This study was addressed to determine the current and desired status of benefits achieved in hospital information system and evaluate the success rate of hospital information system project in Shahid Mohammadi hospital، Bandar Abbas، Iran. This cross - sectional study was done in 2012. The target population of this research was all managers and experts involved in implementing hospital information system، in Shahid Mohammadi hospital. A questionnaire with confirmed validity and reliability was used to collect the data. Wilcox on test was used for statistical analysis، using SPSS software and the gap between current and desired situation was determined، using gap analysis model. The results show that use of hospital information system tends to realize the clinical benefits (55. 52%)، management benefits (56. 72%) and the financial benefits (60. 67%) in current status. The least gap of the expected status is related to financial (23. 79%)، clinical (26. 17%) and managerial (26. 91%) aspects. According to the results، in management m an administrative dashboard in hospital information system can be produced to reduce the gaps in management and have quick access to clinical and para-clinical data. To escalate financial benefits and resuce insurance payment problems، hospital balance reports is suggested

Coding underlying cause of death is associated with both written information on death certificate and interpretation of rules about coding cause of death by coder. This study aimed to review the cause of death coding accuracy in Hormozgan University of Medical Sciences (Hormozgan، Iran). This was a descriptive cross-sectional study which was performed in 2010-2011 for six months. The study population included the death certificates of all the deceased in Shahid Mohammadi Educational Hospital (n = 345) and Pediatrics Educational Hospital (n = 59). First، information of death certificates was written on new forms. Then، the residents of the clinical wards determined the sequences and then the researcher took action for recoding death certificates and comparing his codes by original coders. Data were analyzed by descriptive statistics and chi-square test. Coding accuracy rate in Shahid Mohammadi Hospital، Pediatrics Hospital and in total were 51. 7%، 54% and 52. 1%، respectively. Coding accuracy had a statistically significant association with International Classification of Diseases Tenth Edition (ICD-10) chapters، number of lines and languages used for completing death certificates. The best status of coding was in chapters of genitourinary system diseases (87. 5 percent) and neoplasms (69. 4%). The worst condition was in chapters of external causes (21. 4%) and endocrine، nutritional and metabolic diseases. The most application (36%) and the best coding status (65% accuracy) belonged to general rule. Rule 3 was the most erroneous (85%) and neoplasms coding rules had been observed at rate 65. 7%. Coding cause of death in these hospitals had not desirable status and education is essential for both physicians (regarding how to complete the death certificate) and coders (about rules of selecting and coding underlying cause of death).

Due to the low tariffs of diagnostic and treatment services in public hospitals and the high cost of health care facilities، the need to receive all revenues from insurance agencies is essential. This study was carried out by the main purpose of prioritizing insurance deductions according to objective intervention in Shahid Mohammadi hospital in Bandar Abbas. In this cross-sectional study the research population includs all 2300 inpatient records that were under insurance deductions during August to January of 2008. The data were collected by referring to the documents of insurance organizations and Shahid Mohammadi hospital records. The deduction factors of bills were weighted and ranked by Shannon Entropy method and the descriptive data was analyzed using SPSS16 software. The highest deductions were related to villagers health insurance fund (Khadamat Darmani-Rostaeian) (53%)، City hospitalization health insurance fund (khadamat Darmani-Bestari Shahri) and social insurance (Taamin Ejtemaei)، with 14 and 11 percent، respectively. The orthopedic ward (33%) and general surgery ward (17%) had the highest deductions among all of the hospital wards. After weighting and prioritizing deduction factors، surgeon commission، medicine، geographic full time of physicians and anesthesia were the main factors of the deductions. According to the results، most of the deduction factors were pertinent to the surgery wards that were due to the lack of the doctors and the personnel knowledge who were involved in the treatment process under the insurance laws. The health care team training، use of hospital information systems and providing deductions feedback to the employees can reduce deductions.

Death information have critical role in adjustment of health plans and cause of death coding leads to organizing and being used of this information. Purpose of this study is to review the impact of documentation errors on cause of death coding accuracy in Shahid Mohammadi hospital in Bandarabbas. This descriptive cross sectional study performed in second half of 2011 by a survey on all death certificates. At first, certificates information were written on forms separately and residents determined sequences of death certificates. Next, the researcher recorded certificates and compared his codes with primary coders. At last, the researcher referred to death certificates for extracting information about documentation errors. Data entered in SPSS and was analyzed with descriptive statistics and chi square test in 95% confidence interval. Accuracy rate of causes of death coding was 51. 7%. There was a meaningful relationship between coding accuracy and major errors (P=. 001); but, between coding accuracy and minors there was not. Among major errors, «cause of death with equal effects» has the most affect (82. 1% error in coding) and the most impact of this error was in endocrine chapter, (94. 4% error in coding). Number of death certificate lines and its language have meaningful relation with both errors. Cause of death coding is not acceptable in this hospital. Considering impact of major errors (9. 4%) on coding accuracy, physicians training in death certificate issue is required.

Given the ever-increasing importance and value of information, providing management with a reliable information system, which can facilitate decision making regarding planning, organization and control, is vitally important. This study aimed to analyze and evaluate information needs at statistics and medical records departments of Iranian medical universities. The findings of this study can be utilized in designing and selecting a comprehensive information management system. This descriptive applied cross-sectional research was carried out in 2008. The managers of statistics and medical records departments at 39 medical universities in Iran were included. Data was collected by a questionnaire. Since different methods can be used in designing information systems, the principles of BSP (business system planning) and CSF method (critical success factors) methods were considered. The collected data was analyzed by SPSS16. A total number of 137 needs were determined from which 63% were considered as basic by the managers. In addition, 12% of information needs were categorized as the critical success factors of managers. On the other hand, 17% of the identified information needs were not priorities and were thus excluded. Finally, 18% of information needs were obtained through forms, 9% through the database, 33% through both forms and database, and 3% through the website. However, 37% of the needs lacked a definite source. Since 37% of information needs of the managers did not have a particular source, developing an information system in such offices is necessary. Despite the important role of users in designing information systems (identifying 63% of information needs), other scientific methods are also needed to be utilized in designing information systems.

Given the ever-increasing importance and value of information, providing the management with a reliable information system, which can facilitate decision making regarding planning, organization and control, is vitally important. This study aimed to analyze and evaluate information needs of medical equipment offices. This descriptive applied cross-sectional study was carried out in 2008. The population of the study included the managers of statistic and medical records at the offices of vice-chancellor for treatment in 39 medical universities in Iran. Data were collected using structured questioners. With regard to different kinds of designing information systems, sampling was done by two methods, BSP (based on processes of job description) and CSF method (based on critical success factors). The data were analyzed by SPSS-16. Our study showed that 41% of information needs were found to be critical success factors of managers of office. The first priority of managers was "the number of bed and bed occupancy at hospitals". Of 29 identified information needs, 62% were initial information needs of managers (from the view points of managers). Of all, 4% of information needs were obtained through the form, 14% through both the form and database, 11% through the web site and 71% had no sources (forms, databases, web site). Since 71% of the information needs of statistic managers had no information sources, development of information system in these offices seems to be necessary. Despite the important role of users in designing information systems (identifying 62% of information needs), other scientific methods is also needed to be utilized in designing information systems.

Quality improvement is the main purpose of health care organizations in general and of hospitals in particular. Physicians are the main users of information systems. It is, therefore, necessary to study the impact of using medical information systems on health care quality and the factors affecting the physicians’ use of these systems. This is a descriptive-analytic study in which simple randomized sampling was used to select 74 physicians in teaching hospitals. The reliability of a researcher-made questionnaire – validated by experts – was confirmed by test-retest. The data were analyzed by SPSS using descriptive and inferential statistics. Laboratory information system, online vital sign system, and drug interaction inspection system (with mean values of 4.61, 4.28, and 4.08, respectively) showed the highest effects on health care quality. Moreover, the factors of data security concern, constant system upgrade, and lack of trust in the quality of the services of information technology workforce (with mean values of 4.05, 4.04, and 3.97, respectively) were found to have the highest impact on the physicians’ use of medical information systems. Physicians stated that information systems had an effective role in the quality improvement of health care. Data security concerns, lack of computer skills, lack of training for the optimal use of information systems, and slow transmission speed were the most effective factors in preventing physicians from using information systems. Thus, optimization of information systems especially in the aforementioned areas seems necessary for health care quality improvement.

Considering the importance of information, providing the management with a reliable information system, can facilitate decision making regarding planning, organizing and controlling. This study aimed to analyze and evaluate information needs of managers at vice - chancellorship for treatment in Iranian medical science universities. This cross-sectional study was carried out during 2009. The study population consisted all managers of vice-chancellor for treatment of 39 medical universities. Data collection was based on a predesigned questionnaire. In this study two methods of business system planning (BSP) and critical system factors (CSF). Data were analysed by SPSS software. Of 669 identified information needs, 45% were initial information needs of managers. 12% of the needs were not priorities and thus excluded. 14% of information needs were obtained through the forms, 4% through the database, 21% through both the form and database, 5% through the web site and 56% were without any sources. It was shown that 56% of information needs of managers were without sources, So, designing management information system based on critical success factors and other scientific methods is necessary.

Proving management with a reliable information system, can facilitate decision making regarding planning, organization and control. This study aims to evaluate information needs of Iranian Nursing Offices. This applied, cross-sectional research utilizes critical success factor (CSF) and business system planning (BSP) methods to assess information needs Iranian nursing offices. Of 78 identified information needs, 56% were initial information needs of managers. 18% of information needs were found to be critical success factors of managers of nursing office. The first priority of managers was "the number of manpower employed at hospitals separated by wards". 5% of the identified information needs were not priorities and thus excluded, 3% were through the web site and 70% were without sources. Despite the important role of users in designing information systems, other scientific methods also need to be utilized in designing information systems.