asefzadeh s

Increasing pressure to follow a vision on complete health care organizations، better quality and excellence selection systems has become one of the main concerns for organizations and their managers.. The aim of this study is to determine the relationship between the level of ISO 9001-2008 quality management system and altering indictors of quality effectiveness in Rasht Hospitals. This is a descriptive and correlational study which was performed in three ISO-certified hospitals. The degree of ISO implementation measured using the requirements of ISO 9001 standards through questionnaires. Data of quality effectiveness indictors were compared using dependent T-test before and after the implementation when determining the mean and coefficient of variation. There was a significant relationship between some indicators of quality effectiveness such as patient satisfaction، number of inspected complaints and improved procedure within implementations of ISO quality system (p<0. 05). On the other hand there was no significant difference between the mean alteration of the average length of patient's hospitalization before and after the placement. Create a systemic visualization of the powerful tool such as ISO quality management system and imperative practical performance system in one organization discriminent addition to correcting systems and improving staff performance، will improve some indicators of hospital.

The assessment of the elderly’s health condition can help to designinterventional studies to promote their satisfaction and quality of delivered medicalservices. We intended to evaluate health priorities of the aged population ofMinoodasht district. The data were collected from 119 people aged 60 or over through door-to-door structured interviews containing 25 stems with in the locationduring March 2009. The data were analyzed using statistical methods. A total of 119 people 57% men and 43% women with average age of 65.7 years old, were interviewed.The most prevalent disease within the target population were musculoskeletal(22.6%), cardiovascular (15.5%), digestive and endocrine (15.5%), infectious(14.3%), respiratory (11%) and CNS (5.9%) disorders.The average rate of hospitalization of the people was 40% per year.The causes of hospitalization were cardiovascular diseases (25%), surgeries(20.5%), infectious diseases (13.6%), eye diseases (9.1%), gynecology (4.5%), andcasualties (4.5%) of the total. The average expenditure per prescription was 60330Rials (Iranian currency). The study revealed that preventive interventions within the pilotproposals should be implemented to improve the health status of the people of thearea. A health consultancy unit is also being initiated for this purpose.

One of the most important challenges of our time is the need to have a system of disaster management to confront the natural and man made disasters. In order to set in place such a system in a country, there is an essential necessity to design a special organizational structure in the areas of disaster management. The main objective of this study was to design a structural model for disaster management in Iran. This is a comparative study with an applied proposed model. In planning this structure of disaster management, the study is based on institutional structures of United Stats of America, Japan, Australia, India, Turkey and Indonesia in comparison with Iran. The information used in this study has been researched both from first hand scientific and bibliographical sources; mainly from foreign sources like books, scientific magazines, official reports which have been obtained directly from databases in the related countries and domestic printed and official published documents. In planning the structural research model, the original model was based on comparative studies and situational analysis of related countries. This model was conceived using Delphi scientific technique and put for scrutiny by 30 of scientific scholars and professionals in the field of disaster management and then the final model was proposed. The results of studies in selected countries showed that: developed countries have an organizational structure for disaster management that is able to respond to natural and man made disasters in one centralized command structure with a structural pattern that enjoys a high degree of centralized complexity and formal structure. Meantime the results in most countries studied showed that the structure of disaster management is in the form of exclusive independent organization under the countries highest executive's authorities. Most countries attention to the whole system of organizing disaster management is focused on process of mitigation, forecasting, preparedness, response and recovery. The pattern designed in this study was also prepared based on the findings of this study's conclusion, like considering basic plan; a centralized unique organization for natural and man made disasters; a high level council in macro level and other levels with a need to categorize the delivery services in accordance with the conditions of Iran was proposed. Paying attention to Iran's vastness; variety of disasters and its degree of strength; necessity of existence of a prevailing plan, a need for a new organizational structure is felt as one of the countrie's essential needs in the field of disaster management. Use of a suitable and deserving structural model will lead to increase economic advantage, reduction of beurocratic barriers and speeding up disaster management related activities.

This study wanted to assess the demand for curative cares among Takistan households to provide health planning information.In this survey a random cluster sampling of 457 households was performed. Data were collected through interviews using a structured questionnaire.The family size was 4.2. The causes for the participants visiting their doctors were infectious respiratory and musculoske diseases tale The average frequency of visits per individual each year was 2.4 to general physician, 1.2 to specialist, 0.1 to dentist, 1.7 to diagnostic center and 3.4 to pharmacy. The rate of hospitalization per 100 persons per year was 0.07 with the average of 4.3 days. The most important cause of hospitalization was emergencies (20.3%). Only 46% of the rural populations were satisfied with rural health insurance.According to the findings revision of the insurance system planning for better curative cares is recommended.

The present study was designed to assess the influence of mode of delivery on fetal pituitary-thyroid axis. The endocrine profile (umbilical venous plasma) of three groups of term infants was compared immediately after delivery. Samples were taken after 30 vaginal deliveries, 30 emergency cesarean sections during labor and 30 elective cesarean sections before labor. The study was performed in the Kowsar Hospital in Qazvin. The samples were matched based on maternal age, parity and gestational age and none of them had previous history of medical complications. Measurements of TSH and thyroid hormone levels were performed using immunoenzymometric and radioimmuno assays, respectively. Mean cord plasma TSH level of vaginal and emergency cesarean section was significantly lower than that of the elective cesarean section (p<0.0001; 3.3±1.8, 9.0±3.2 and 12.1±6.4 μU/mL, respectively). Mean concentrations of T4 and T3 were significantly higher in the elective cesarean section as compared with the emergencycesarean section and vaginal deliveries (p<0.05; 8.5±1.3, 7.4±2.4 and 7.4±1.3 μg/dL for T4 and 76±12, 62±20 and 51±16 ng/dL for T3, respectively). These results suggest that labor may reduce plasma thyrotropin and thyroid hormone concentrations at birth.