جستجوی مقالات مرتبط با کلیدواژه « سیاستگذاری » در نشریات گروه « پزشکی »

The purpose of the current research is to identify the needs of the management structure of medical centers-hospitals in order to compensate for the damages caused by the fight against Covid-19.

This study is applied in terms of purpose and qualitative in terms of research method, and by using semi-structured interviews with 19 experts who were selected through purposive sampling, effective policies on the management structure of medical centers were identified and were categorized. The data of this section were categorized and analyzed using the three-step open, central and selective coding method. The validity of the categories and themes obtained using experts' confirmation and the reliability using the open test method were found to be 83%.

Experimentation and data analysis of the obtained data led to the formation of 179 subcategories, 43 categories and 8 main themes. During this research, 8 factors of social support of the organization, motivational measures, behavioral measures, financial and welfare measures, open communication, systems Management, organizational policies and human resource policies were selected as the main themes of the research.

Based on the results of qualitative data coding, the democratic style of management and the increase of welfare services were selected as the key categories of the management structure of medical centers due to frequent repetition among the codes received, and based on the number of repetitions of the received codes, the themes of welfare services with The coefficient of 0.172, human resources policies with the coefficient of 0.152 and motivational solutions with the coefficient of 0.148 took the first to third ranks, respectively.

Besides physical, mental and social health, the spiritual dimension of health has been under consideration for the last decade. Due to the importance of academic studies for policymaking, in this meta-analysis, Iranian studies on spiritual health have been scrutinized. 414 studies with the keyword “spiritual health” have been searched from Persian scientific databases and have been analyzed by their authors’ field of education. Findings were presented based on papers’ publishing year, journal ranking, methodology, target groups and research questions. Results showed that researching spiritual health in Iran requires applying more varied methods and studying more diverse target groups. In addition, they have to be more published in bilingual and higher-ranked journals; researchers have to avoid repetitious and non-applicable subjects. To conclude, 3 main political strategies have been suggested: according to contextual characteristics in Iran, integrated definition and indicators must be presented by a certain reference and applied by every researcher in the field, indispensably; based on the integrated definition and indicators, a specific research tool has to be introduced to every researcher; finally, future studies and policy research must be conducted.

Pharmaceutical costs account for a major part of health-related costs, and the induced demand for medicine imposes a large financial and economic burden on individuals and the whole society. Therefore, the aim of the present study is to identify the factors effective in creating induced demand for medicine in Iran.

This study is based on grounded theory approach and it was conducted in 2022. The interview questions were semi-structured and asked by experts. The initial selection of the samples was based on targeted sampling from among experts and scholars in the field of medicine and treatment from all over the country. The snowball method was used to increase the sample volume until it reached sufficiency. This research was completed by interviewing 20 experts.

The key factors effective in creating induced demand were identified in the form of 4 themes, 8 categories and 31 subcategories. The extracted themes included social, structural-organizational, economic and beneficiary-related factors. Social factors included the categories of society's culture and pharmaceutical literacy, structural-organizational factors included the categories of regulatory mechanisms and educational and political factors, economic factors included the categories of payment and insurance systems, and finally the beneficiary-related factors included the categories of suppliers and demanders.

Based on the results of this study, several factors play a role in the creation of induced demand for medicine, and following these factors can help policymakers formulate appropriate strategies to reduce unnecessary medicine prescription.

Many health policies are not implemented or incompletely implemented after approval. This issue significantly reduces the popularity and responsiveness of the top managers of the health system and leads to service disruption in the target community. Therefore, this study was conducted to explain the existing challenges in the implementation of health policies.

A qualitative study was conducted in 2021. The participants in the study were 20 scientific and executive experts. The data was collected using an interview guide and the in-depth individual interview method and was analyzed using the content analysis method using thematic analysis with Graneheim and Lundman's approach.

The challenges include the policies formulation (lack of evidence-informed decision-making, lack of attention to the details of the implementation, the change of the initial text of the policy, conflict of interests, unclarity the executives, the lack of proper integration between the political and technical components of the policies, the weak participation of the main stakeholders, the lack of the same understanding of policies concept between policy makers and executives and lack of budget forecasting), challenges of policies implementation (uncertainty about roles of executive organizations, lack of executive attachment, conflict of interest,  lack of project management, change of formulated policies with change of executives, little belief among executives, lack of executive guarantee, lack of operational plan) and challenges of policies evaluation (Inadequate supervision and the absence of an informational and supervisory dashboard).

Using effective solutions to solve the challenges extracted in the stages of formulation, implementation and evaluation of health policies can lead to achieving the goals of the formulated policies and improving the health of the society.

Today, health insurance has an important role in promoting community health and well-being. In our country, health insurance has shortcomings that are mainly related to policy issues. Therefore, the purpose of this study is to design a model for improving health insurance development policies in Iran.

Methods and Materials:

 The present study is developmental-applied in terms of purpose and is in the group of exploratory mixed research. In the qualitative stage of this research, the theme analysis method was used and in the quantitative stage, structural equation modeling was used. In the qualitative stage, in order to design a research model, 26 academically and executive experts in the field of health insurance who were purposefully selected were interviewed. Also, in a quantitative phase, 186 managers and specialists in the field of health insurance who were randomly selected, were polled with a questionnaire.

Based on the findings, 5 strategies were identified, including promoting macro-management in health insurance, improving insurance services, promoting insurance justice, resource management and using a sustainability approach. Also, the designed model includes variables related to drivers, contextual factors, strategies and consequences. Findings of data analysis by structural equation modeling showed that the components of the research model are approved and all estimated path coefficients are significant.

Finally, the results showed that by providing the interests of stakeholders and also considering all the variables affecting policy-making, it is possible to improve the health insurance policy-making process.

Paying attention to efficient policies in the field of nursing education and checking their quality will lead to the institutionalization of an efficient educational system in the field of nursing. For this purpose, a comparative study was conducted in this field with other countries in order to find out the existing strengths and gaps. This study was conducted with the aim of comparative comparison of nursing education policies in Iran, Canada, America, and Nepal.

The present article was carried out with a descriptive-analytical and comparative method in 2022. Searching texts without  a time limit with Farsi and English keywords: "Comparative comparison", "policy making", and "nursing education" in sites and databases related to nursing education policy.Google and Google Scholar search engines were used. 25 studies in Farsi or English were included in the study with full access to the text of the article. To make a comparative comparison, Bereday's Brady model was used in 4 stages description, interpretation, contiguity, and comparison.

The comparison of the policies of four countries showed that policymaking in Canada on nursing education was responsive according to the needs of the society and in the United States educational policies were based on law and activities. In Nepal, despite the evolution of educational policies, there are still deficiencies in this field. In Iran, the transformation and innovation program in medical science education has been developed with an eye on the future.

Based on the results, in order to promote and improve policymaking in the field of nursing education, the development of human resources and the support of the clinical, teaching, and student staff, as well as their participation in the formulation of policies, will increase its effectiveness and implementation capability. Periodic review and identification of required policies based on the needs of society and transfer of knowledge to the hospital by establishing a strong relationship between the nursing schools and hospitals will help the professionalization of the nursing force.

Mental health is considered one of the most important health indicators of societies, which is specifically followed by psychiatrists, psychologists, and other behavioral and social scientists. Women comprise half of the world's population and have a direct role in nurturing the other half. Women are always at risk of mental problems due to their multi-dimensional role in society. Although women live longer than men, they are more vulnerable to mental disorders including depression, anxiety, and Alzheimer. This policy brief is achieved through evaluating presentations at the 8th International Conference on Women's Health with a special focus on women's Mental Health held on Nov 4&5, 2019 in Tehran, Iran. The topics of the conference included measures taken to promote women's mental health, the role of policy-making in women's mental health promotion, analysis of Iranian women's mental health status, family consolidation, vulnerable women, and tlerance. Based on the findings from presentations and expert panels, women's mental health status in Iran is not desirable. So, it implies the importance of preventive interventions and improving mental health services. Other strategies could be following recommendations provided to promote women's mental health in Iran including improving primary health care by mental health services, assigning a specified authority to enhance the intra-sectoral governance and inter-sectoral leadership.

Good governance in the last two decades attracted the attention of scientific and international circles around the world. It is a type of governance that is committed to supporting and promoting human health. In order to achieve good governance, components have been identified that knowledge of the weight and importance of each component is undoubtedly necessary to achieve the desired results in the policy-making of the Iranian health system.

This research is descriptive-survey in terms of goal setting and methodology. The multi-stage stratification and availability method was used for sampling and the theoretical saturation rule was used to determine the sample size. In order to define and explain the concept of components of good governance and health policy-making, the library method and review of reference sources were used. 100 survey managers and experts in the Ministry of Health and Golestan, Mazandaran and Neishabour Universities of Medical Sciences were interviewed using a survey method and using a checklist tool (researcher-made (pairwise comparisons)). To analyze the data, Changchr('39')s improved fuzzy AHP method and Expert choice software were used.

Among the components of good governance (for the policy-making process of the Iranian health system), the rule of law included the most important component. After the rule of law, consensus and agreement, transparency, accountability, justice and fairness, effectiveness and efficiency and ethics were in the next ranks.

Good governance is a new narrative of concepts such as democracy, human rights and justice to pursue people-centered human development goals. The rankings obtained from the analyses of this research indicate the need to pay more attention to the rule of law in the health policy-making cycle. It is suggested that in designing the health sector of the seventh economic, social and cultural development plan, executive strategies are paid attention to strengthening the components of good governance, respectively.

Hospital accreditation is “an external evaluation of a hospital’s structures, processes, outputs and outcomes by an independent professional accreditation body using pre-established optimum standards”. Accreditation is a strategy for ensuring the quality and, safety of hospital services. An accreditation program’s efficacy depends on the validity of its governance, methods, standards, and surveyors. The Iranian hospital accreditation program faces some challenges. This study aimed to identify the governance challenges of the Iranian hospital accreditation program and its solutions.

This qualitative study was performed using semi-structured interviews in 2019. Using a pluralistic evaluation approach, 151 policy makers, accreditation surveyors, hospital managers and staffs, and academics from the ministry of health, medical universities, hospitals and health insurance companies were purposively recuited and interviewed. Thematic analysis was used fordata analysis.

Overall, 23 governance challenges were identified and were grouped into seven categories, i.e., organizational structure, organizational communication, policy making, planning, financing, stewardship and evalutation. Lack of independence, inappropriate organizational structure, resource shortage, senior managers’ mobility and turnover, weak internal and external communication, a compulsory accreditation program, insufficient knowledge of hospital accreditation, and lack of evaluation of the hospital accreditation were the main challenges. Establishing an accreditation council with four idependent scientific, accreditation, appeal and performance evaluation committes, piloting the accreditation program, proper planning, cascade education and training, allocating a specific budet for hospital accreditation, getting the ISQua accreditation certificate and public announcement of hospitals’ accreditation results were proposed as solutions to these challenges.

The governance of Iranchr('39')s hospital accreditation program faces serious challenges. Improving the governance of the accreditation program leads to achieving the desired results.

The revenue of world's medical tourism industry has recently increased by 20% annually. Hence, investing in this sector is not only seen as a means of increasing revenue but also it is accompanied by some positive consequences including the improved services, the creation of a more favorable trade balance and increased tourism. The aim of this study was to codify and evaluate the policy indexes and medical tourism rules in Iran in moving towards expanding the health villages.

In this study, the combination of qualitative and quantitative methods was used. In the first stage, the content analysis was selected as a research strategy and MAXQDA 18 software was used for data analysis. Collected through questionnaire and interview, the obtained data were submitted to the expert’s panel to be analyzed. In this way, the indicators were finalized. In the second stage, the quantitative evaluation of indexes was done by using multi-criteria decision-making techniques.

The results of this study indicated that as far as the development of medical tourism based on health village expansion approach is concerned, the indicators relating to health insurance rules, the medical errors rules, advertising policies, the required and new rules and regulations and supportive policies are the most important indicators in the field of laws and policy-making in terms of priority. Ethical Considerations: In this study, ethical considerations such as Knowledge competence and expertise of the Statistics Community have been considered.

This research revealed that it is a necessity for the respective authorities to pay particular attention to the development, design and implementation of long-term and short-term strategies proportionate to the proposed indicators in an integrated manner with special emphasis on prioritization realized for the health system in moving towards medical tourism promotion.

The overall purpose of the present study was to investigate the impact of managers' policy making and decision -making techniques on the promotion of specialized skills of the staff of the Mazandaran Province Tax Affairs Office to present the model.

This research was a purposeful, applied and descriptive method of survey. The statistical population was formed by the staff of the Mazandaran Province Tax Affairs Office of 1075, and according to Cochran formula, 283 people were selected by the random-sampling method. To collect data, a policy -making researcher -made questionnaire with 40 questions, decision -making technology researcher questionnaires with 50 questions and staff specialized skills questionnaires were used with 22 questions.

Structural equation tests were used to analyze the data. The formal and content validity of the tools was approved by the specialists and their reliability was calculated using Cronbach's alpha coefficient for a policy questionnaire of 0.89, 0.91 decision -making techniques and specialized staff skills of 0.93.

The results showed; The impact of policymaking and decision -making techniques on the specialized skills of employees in the General Directorate of Tax Affairs of Mazandaran Province is positive and significant and the model provided is suitable.

Elite and efficient human resources play a vital role in the various national arenas and, therefore, their good management is crucial. Elite migration or brain drain among developing countries is of great importance, as these countries lose more capital in the process of international human capital flows, and their development is usually slowed by this phenomenon. The main purpose of the current study is to investigate the extent and mechanism of the impact of elite migration on the development of home countries as well as presenting opportunities and challenges for policymaking in this field.

The study was systematically reviewed using the PRISMA protocol in international (PubMed, Scopus, Google Scholar) and national databases (SID, Magiran, ISC). According to PICOS strategy, published papers until July 2019 in both English and Persian language using a variety of combinations of keywords; brain drain, challenges, developed country, development, migration, elite, policy, developing country and their Persian equivalent was searched. After searching and selecting articles, the text of the final articles was evaluated with the help of PRISMA checklist. Finally, the relationship between elite migration and development and related policies was presented as narrative synthesis.

With a detailed review of the final analyzed papers; can identify factors and variables affecting the three main issues that are central to migration and development: a) brain drain and development; b) the financial flows in result of elite migration; c) the the role of immigrant elite communities in development. By systematically reviewing the papers, we find that the potential impacts of elite migration on development is complex and multidimensional which require multidimensional response from policymakers. The impacts of elite migration can be positive or negative depending on the country, economic and social trends of the country and create opportunities or constraints for economic, social and human development.

In general, immigrant elite societies can play an important role in the economic, social and political development of their home countries. Immigrant elite communities can be the source of ideas, knowledge and skills, and social capital. Communications and networks of elite immigrant communities with their home country can serve as an important channel for enhancing the positive impacts of immigration on the country of origin. However, many developing countries, including Iran, still suffer from elite immigration or brain drain. Therefore, in order to realize the positive effects of elite migration, there is a need for rigorous and comprehensive policymaking that will undoubtedly include challenges such as the need for significant international dialogue and cooperation.

Upper documents of Iran are categorized in one of four levels of philosophy, doctrine, principles and policies, according to the level of policy making system. The “Second Step of the Revolution” Statement was issued by Iran’s Supreme Leader. This article, reviewing the status of this statement in the Upper documents of Iran and provides a model for its implementation in Iran’s medical education system.

first phase: the expert panel was formed and the list of upper policy documents of Iran was prepared. Second phase: the content of the statement was analyzed and its imperative propositions in the higher education system were extracted. Third phase: adaptation of the packages of reform and innovation of medical education with the main categories of “second Step of the revolution” statement took place.

107 propositions were extracted from the statement and 14 propositions related to the higher education system were extracted. Finally, three categories related to education, including the achievement of scientific hegemony and the promotion of national dignity, advantageous and community-based science and justice in access to services and eliminating poverty were extracted from the contents of the statement and the packages of reform and innovation matched with these categories.

According to the results this statement should be classified as the country's policy principles. Given the direction that this statement has been made to the country, it is clear that the current and new policies and laws of the country should be drafted and reviewed in accordance with this statement.

One of the main issues in the development is the extent to which the competencies and talents of the society’s human workforce is properly employed. The women’s participation in various economic, social and other areas is one of the country’s production indices. However, the women and their activities have been always confronted with many challenges in the course of history and there is also currently a large gap in regard of the women’s participation in political areas, as well, between the positions of the women in the Iranian society and the international community. One of the most important strategies is empowering women with an emphasis on the idea that the women’s participation is not solely conceptualized as their enjoyment of the advantages and results of the development plans rather they should actively take part in the implementation of the developmental plans and programs. It seems due to the objectiveness of the political structure and the volume of the political power accumulation that the political structure should be seminally somehow required to welcome the demands for equality. Subsequently, timely decisions can be made for establishing the legal rules that, drawing on the equality of rights and freedoms, can form the basis of the participation-demanding deeds. Considering the existent weaknesses in the participation of the women and the limitations induced on women in the country’s culture and policy-making, the present study aimed at investigating the various aspects of women’s roles, potentials, participation rates and participation-hindering factors disregarding the gender as well as the undertaken and suggestable measures for enhancing the women’s participation through the country’s general policy-making.

Science and technology policy making has recently been considered, due to the complexity of the decision-making environments in the world. Medical higher education is one of the subsets of science and technology systems in which future-oriented policy making is particularly important because of the changing environment of health systems and the need to respond to this changes.
Since the formation of the ministry of health and medical education in Iran, some efforts have been made for medical education policy making, which has often been reactive and has not been properly implemented. The program for the reform and innovation in medical education as the first future-oriented policy making experience in the field of medical higher education in Iran began in 2015 And is being implemented using the spatial planning program and a multilevel system. This paper examines the dimensions and patterns of higher education and policy-making experiences of higher education in Iran.

Tackling inequity in health is one of the main objectives of health systems. The aim of this study was to assess the achievements and challenges, as well as solutions, in reaching the equity in health in Iran. This study was conducted using a qualitative approach. Data were gathered by reviewing documents and conducting focused group discussions with the stakeholders. The analyzed data were categorized into three groups including achievements, challenges, and solutions. The Iranian health system has achieved many successes in the past 10 years including expanding the primary healthcare networks to city outskirts, implementing the family physician program (urban and rural), implementing the Health Transformation Plan (HTP) and subsequent decrease in catastrophic and impoverishing health expenditures, and increasing the public access to health information and subsequent responsiveness of policymakers. However, some factors hindered further achievements, including the absent or incomplete implementation of laws and practical policies, insufficient attention to the social determinants of health, and poor designing and implementation of the health annex for the policies. It seems that there are little problems in legislation and policymaking in the country and the laws are almost compatible with the recommendations of the World Health Organization, aiming at the inequity reduction in health. However, there is a gap between the policymaking/legislation and the practice. In other words, legislation is poorly practicable and the principles of good governance, including attracting the participation and cooperation of stakeholders, are not fully respected.

Health labor training is the main mission of medical education system in order to improve accountability of education in community. Accordingly, the program on the development and innovation of medical education as strategic guidelines for health education in the Islamic Republic of Iran has been developed in the form of 11 operational packages. one of the things that actually ensures the correct implementation of the organizational policies is the regular and proportionate evaluation of the programs, the Plan for Monitoring and Evaluating these programs has been developed in the phase of development of Packages for Reform and Innovation in Medical Education and the evaluation of Packages, simultaneously with its implementation, is underway.
Methods and Materials: The Plan of Monitoring and Evaluation of Packages for Reform and was designed and implemented concurrent with the launch of these Packages. The steps include Formation of Evaluation Committees, Development of Indicators for Monitoring and Evaluation, Designing ATNA; a Platform for Collecting Indicators, Process Evaluation and Output Evaluation.
Results and Monitoring and evaluation of Packages for Reform and Innovation in Medical Education has been carried out in different stages and in evaluating these Packages, a combination of scientific patterns has been used.
Since February 2016 two evaluation phases were implemented in the field of medical education.

Accreditation is an appropriate strategy for improving the quality, safety and effectiveness of hospital services. Iran national hospital accreditation was initiated as a government and mandatory program in 2012. This study aimed to identify the prerequisites of hospital accreditation implementation in Tehran province hospitals.
This qualitative study was performed using semi-structured interviews with 72 managers in different level from 15 university, private, military, social security and charity hospitals in 2016. Hospitals were selected purposefully through Tehran province hospitals. Content analysis was used in order to data analysis.
Pilot testing of standards before announcing to hospitals for implementation, education and training of hospital managers and employees on accreditation standards, providing required resources, allocating enough time for implementing the standards and providing incentives for implementing standards are the main hospital accreditation prerequisites. Absence of these prerequisites in accreditation implementation resulted in huge challenges for hospital managers and employees.
Providing the accreditation prerequisites for hospitals facilitates implementation of hospital accreditation in hospitals which in turn results in quality improvement, safety and hospital services effectiveness.