جستجوی مقالات مرتبط با کلیدواژه "خدمات سرپایی" در نشریات گروه "پزشکی"

We are witnessing a marked increase in demand for outpatient services. Patients experience health-related anxiety, which exerts destructive effects on the treatment. The control and management of this anxiety create confidence in health services. The present study aimed to determine the effect of nursing counseling on health anxiety and its relationship with trust in nursing services in the outpatient department.

In this quasi-experimental study conducted in 2021, 60 participants were randomly selected from the outpatient department of a clinic and assigned to two groups: intervention and control. Data collection tools were a demographic information questionnaire, Alkovskis and Warwick Health Anxiety, and Trust in Nurses Scale (TNS) (Radwin and Cabral, 2010). The participants answered demographic and health anxiety questionnaires. After the visit, the intervention group received nursing counseling, while the control group only received routine training. One week later, the participants answered the health anxiety questionnaire and trust in nurses scale again. Data were analyzed in SPSS software (version 18) using descriptive and inferential statistical tests.

The mean of health anxiety before the consulting was not significantly different between the two groups (P=0.20); nonetheless, after the consulting, the intervention group obtained a lower mean score compared to the control group (P>0.001). There was a significant difference between this mean before and after consulting in the intervention group (P>0.001). There was a significant positive relationship between receiving nursing counseling and confidence in nursing services (P>0.001) (C.V=-0.145).

As evidenced by the results of this study, the provision of nursing consultation reduces patients' health anxiety and increases confidence in nursing services. It is suggested to pay attention to this role of nurses in outpatient departments.

The payment system of specialist physicians has significant effects on the country's health costs and the provision of medical care at a fair, sufficient and high-quality level. This study was conducted to design the payment system's implementation guidelines for providing specialized services in the electronic referral system.

A qualitative study was conducted in 2021. The participants were hospital managers, top managers and experts in charge of health, treatment and development departments of Ministry of Health and Golestan University of Medical Sciences, Health Insurance Organization of Golestan province, specialist physicians and faculty members. Fourteen focus group discussion and six in-depth individual interviews were conducted. The content analysis method was used to analyze the data.

The requirements for the establishment of an efficient and effective payment system were classified into 6 main themes (legal, political, managerial, executive, economic, cultural and social) and 32 subcategories. The executive mechanism was classified into 3 main themes (executive structure, executive process and monitoring and evaluation method) and 16 subclasses.

The implementation of the designed instruction can lead to increasing the access and benefit of services, improving the quality of providing specialized services, cost management and finally increasing the satisfaction of service providers and receivers.

The current study aimed to evaluate outpatient service quality from the perspective of employees in hospitals affiliated with Iran University of Medical Sciences in 2020.

In this descriptive study, 100 clinical and non-clinical employees were selected through a simple random sampling method from four teaching hospitals. Data were collected by using a standard SERVQUAL questionnaire. Data were analyzed using independent t-test.

Approximately 77% of the employees participated in the study. The mean scores of the employees' expectations and perceptions of service quality were 4.72 and 3.96 out of 5, respectively. In comparing the mean scores of perceptions and expectations, the highest and lowest gaps were related to the dimensions of tangibility (gap=-1.22) and empathy (gap=-0.50), respectively.

There was a significant gap in all dimensions of expectations and perceptions. Therefore, in order to minimize the existing gap, managers and policy makers are suggested to pay more attention.

Health system services are not reliable without quality assessment. It is important to explore gaps between standard services and the existing situation to improve the quality of health system. This study aimed at studying the quality assessment of electronic referral system in one of the major provinces of Iran.

This study was a cross-sectional study, utilizing SERVQUAL model. The population comprised 3 groups totaling approximately 11,004 people. The sample size allocated to each city was determined in proportion to each city’s population. A sample of 384 patients who had used electronic referral service at level 2 and received outpatient services made up the population of the study. The data were collected through a two-part questionnaire. The validity of the questionnaire was confirmed by 10 experts, including senior and mid-level managers and medical science university faculty members. The questionnaire assessed demographic data and the patients' perceptions and expectations. The data were analyzed using descriptive statistics and analytical statistics such as nonparametric mean comparison tests, in view of the normality assumption, including Wilcoxon test, Mann-Whitney and Kruskal-Wallis. Spearman correlation test was used to determine the intensity of correlation between the study variables. The significance level of all tests was considered 0.05.

There were identified gaps throughout all dimensions of health services among the studied clinics (P <0.001). The biggest gap was observed in the empathy dimension (0.57) and the smallest one was observed in the tangible dimension (-0.38). The gap between the services provided to patients was different in terms of guarantee, gender (P = 0.005), empathy, level of education (P = 0.028) and reliability based on the particular city considered (P = 0.028).

In the hospitals implementing the electronic referral system in Golestan province, there is a gap in all dimensions and it indicates that the expectations of the recipients have not been fully met in virtually any of the dimensions.

 The public sector of the health care system provides justice and access for all people who need more specialized services through the referral system. If the challenges of the referral system are not identified and addressed promptly, the system will not be efficient and effective. The purpose of this study was to rank the reasons for non-referral of outpatient level 1 to level 2 in the electronic referral system of Golestan province in 2019.

 In this descriptive and cross-sectional study, 431 outpatients participated from the pilot hospitals of the e-referral system in Golestan province, who did not refer to the level 2 specialist despite that an appointment was set by the system. The participants were selected using a stratified random sampling method. Data were collected using a questionnaire and analyzed by descriptive statistics and Friedman test in SPSS 23 software.

 The most important reasons for patients who were not  referred from level 1 to level 2 in the electronic referral system included the presence of a trusted and familiar physician, inability to pay the visit of a specialist, and high cost of transportation from home to the designated specialist, respectively. The gender of the specialist physician and lack of guidance on referral to the specialist physician were indicated by the referral center. Patients ranked the reasons of not referring to the specialist differently (P < 0.001).

 The current status can be improved by increasing the public confidence in specialized physicians working in the electronic referral system and making the specialized services free for the poor patients. Furthermore, raising the patientchr('39')s awareness about using Level 2 specialized services through the mass media can help patients to benefit from these services.

Nowadays, measuring the quality of services in order to effectively allocate resources and ensure a higher level of patient satisfaction is on the agenda of healthcare managers. The aim of this study was to investigate the possible gap between the perception and expectation of service quality from patients and managers’ perspective in the selected outpatient clinics affiliated with hospitals of Iran University of Medical Sciences.

This descriptive-analytical cross-sectional study was conducted in 2019. The required data were collected based on a valid and reliable questionnaire (SERVQUAL). Chi-square and Mann-Whitney U tests were used to analyze the data. The data were analyzed using SPSS version 25.

The patientschr('39') expectation (4.76) was higher than managers’ expectation (4.58), while the patientschr('39') perception level of service quality (3.20) was lower than the managerschr('39') perception level (3.73). The gap between expectation and perception of patients in all dimensions was statistically significant; moreover, the highest gap was found in the responsiveness dimension. From the managerschr('39') viewpoint, a significant relationship was reported between the expectation and perception gap in all dimensions except the responsiveness one. Moreover, the highest mean score gap was related to the tangibility dimension (P-Value = -1.73).  

There was a negative gap between the expectations and perceptions from managers and patients’ perspectives in all the service quality dimensions. Hospital managers should attempt to reduce the gap between the expectation and perception by providing timely services and improving staff communication skills.

The aim of this study was to evaluate the outpatient visits of elderly people under the Social Security Organization (SSO) and to compare it with other age groups.

This was a cross-sectional descriptive study that used outpatient data of SSO in 2017. All data (14'418'911 cases) were analyzed after restoring and cleaning processes. SPSS software was used for data analysis.

Findings showed that 6.5% of all outpatient visits were by elderly. The elderly group had been referred to outpatient services at an average rate of 6.8 times per year. Elderly people over the age of 85 years referred to physicians 48.1% more than children under the age of 2 year and this was 78.3% for elderly aged 65 to 85 years..

A considerable portion of the economic burden and costs of the health system under social security organization belong to the elderly group, which will continue to increase in the future. In this regard, it seems necessary to manage services demanded by this age group using appropriate measures.

Abstract

This study aimed to investigate the effect of socioeconomic factors on outpatient services due to lack of access to outpatient services or failure to receive related services and to study the unmet needs of outpatient services in the country.

This study is an analytical-descriptive study. The data were collected from micro-health services data plan developed by the Health Research Institute in collaboration with the Statistical Center of Iran in 2014. The data were analyzed using econometric models, logistic regression analysis, and Stata version 13.

A significant statistical relationship was found between the socioeconomic indicators and the causes of unmet needs for outpatient services. Based on the logistic regression model, there was a statistically significant relationship between income level, type of activity, educational level, type of insurance, marital and residential status (urban/ rural) and failure to receive outpatient services. The most significant relationship was observed between the economic and social features and the reasons of not fulfilling the need for outpatient services.

The improvement of socioeconomic variables affect the use of outpatient services; therefore, the health system managers are required to pay greater attention to patients’ needs for health services.

One of the most important measures to ensure achieving Universal Health Coverage (UHC) is expanding health insurance coverage to all population. Accordingly, the present study was conducted with the aim of investigating the effect of having health insurance on the utilization of outpatient services provided by physicians using the data of the utilization of health services survey (2015).

This study is a secondary analysis of the utilization of health services survey data that was conducted in two groups of the insured and uninsured to examine the differences between these two groups in outpatient healthcare utilization provided by physicians. The variables were insurance status as an independent variable and the number of physician visit as a dependent variable. This analysis was disaggregated by place of residence and income.

The visit per capita for outpatient services was lower in all uninsured groups. The visit per capita in insured people was almost two times more than that of uninsured individuals, which was 4.25 and 2.61 among insured and uninsured individuals, respectively. Therefore, the lack of basic health insurance decreased the utilization of outpatient services by 50 percent. General physician visits per capita for insured people living in urban and rural areas were 11.2 and 0.35, respectively.

Based on the results of this study, the visit per capita is directly related to the insurance status of the individuals. Therefore, it is necessary to ensure the equity in utilization of outpatient services provided by the physicians among various groups of population.