جستجوی مقالات مرتبط با کلیدواژه "آنالیز سری زمانی منقطع" در نشریات گروه "پزشکی"

Due to increasing costs of the health sector and the inefficiency of the public sector, granting autonomy to hospitals was implemented in the independent hospital program.The aim of this study was to investigate the effect of establishing an independent hospital program on the performance indicators of pilot hospital in Qazvin.

The status of eight functional indicators of the pilot hospital was collected in the period of 2017-2020 before and after the establishment of the independent hospital program. Data were analyzed using paired t-test and Wilcoxon and interrupted time series at a significant level (p<0/05) and analyzed by SPSS24 STATA15 software.

The result of paired t-test and Wilcoxon-Neschein test shows that the establishment of an independent hospital program has had effect on the average active bed, active day bed and discharge number. Based on the analysis of the interrupted time series model, the average active bed with 55.96 units, active day bed with 1576.51 units, occupied day with 3357.14 units, percentage of bed occupancy with 40.63 unit and the number of surgeries with 736.60 units had an increasing average and the number of discharges with 47.92 units and average stay with 1.42 units, shows a decreasing average.

The present study does not show a significant change in performance indicators. It is suggested that managers and policy makers of the health system, if they wish to expand the plan, conduct comprehensive and detailed studies in this field.

The performance of the emergency department as one of the most dangerous treatment areas has a great impact on the performance of other hospital departments. This study investigated the effect of specialist residency program in the health system reform plan on the performance indicators of the emergency departments in hospitals affiliated to Tehran University of Medical Sciences.

The present study was a descriptive-analytical cross-sectional one that was performed in 2019 in the emergency departments of all hospitals affiliated to Tehran University of Medical Sciences. Six emergency performance indicators were collected on an average monthly basis in two time periods, 26 months before and 46 months after the implementation of the program, by referring to the hospital units. The data were analyzed using interrupted time series model with Eviews 10 and SPSS 24.

The implementation of the program did not have a significant effect on the level and trend of the percentage of some indicators including patients decided upon within 6 hours, patients discharged from the emergency department within 12 hours, unsuccessful cardiopulmonary resuscitation, and mean triage time (level 2). However, it had a significant effect on the level and trend of the percentage of discharge against medical advice. Implementation of the program did not have a significant effect on the trend of the mean triage time (level one), but had a significant effect on the level of the said indicator.

Although some of the performance indicators of the emergency departments improved after the implementation of the program, still certain infrastructure such as human resources supply and holding well-organized and efficient training courses are needed for the proper implementation of this program.

The health sector evolution (HSE) plan has been implemented since 2014 and includes seven programs. Since one of the goals of this plan was to improve the condition of emergency departments, in this study we evaluated the effect of HSE plan on performance indices of emergency department in hospitals affiliated with Tehran and Iran Universities of Medical Sciences, Tehran, Iran. The present cross-sectional study was conducted in all Hospitals affiliated with Tehran and Iran Universities of Medical Sciences. Six performance indices of emergency department were collected monthly in two 12-month periods before and after implementation of the HSE plan by referring to the hospitals’ statistics unit. Data were analyzed via SPSS 22 using paired T-test and Interrupted Time Series (ITS) model. The results of ITS showed that implementation of HSE plan had no significant effect on the rate and trend of indices such as percentage of patients who left the emergency department within 12 hours and percentage of patients discharged against medical advice (p > 0.05). On the other hand, HSE plan implementation affected the rate and trend of indices such as percentage of patients who were decided upon within 6 hours and the average turnaround time for emergency tests significantly (p Implementation of HSE plan has resulted in improved percentage of patients who were decided upon within 6 hours and increased average turnaround time for emergency tests. In addition, although it has significantly increased the trend of successful CPR percentage, it has decreased the rate of successful CPR.