جستجوی مقالات مرتبط با کلیدواژه "health service" در نشریات گروه "پزشکی"

A comprehensive understanding of the current state of geriatric care in Iran is necessary in order to strengthen and align it for responding to the current and future needs of the elderly in the country. The purpose of this study was to identify the challenges and barriers in the elderly care system in Iran.

This was a qualitative study. Forty semi-structured interviews were carried out with various participants involved in providing care to the elderly across the country in 2019. Participants were selected using maximum variation sampling. Using MAXQDA10 software, data were analyzed by the qualitative content analysis method based on six building blocks of health systems developed by the world health organization.

Challenges and barriers in the elderly care system were categorized into six groups: service delivery, health workforce, health information system, access to essential medicine, financing, and governance/leadership. Also, some of the most important challenges of the elderly care system included: absence of a single organization with sufficient power as the steward for providing the elderly services, lack of integration of services for the elderly from primary care to specialized care; shortage or inadequate distribution of skilled manpower; lack of insurance coverage for home care services for the elderly; lack of registry system or database for the elderly; lack of or weakness in elderly-friendly activities in the service centers.

The current elderly care system in Iran faces many challenges in all six building blocks of the World Health Organization. Reforming and redesigning the elderly care system based on the findings of this study is necessary and urgent in order to meet the needs of the elderly in the country.

Transparency is a set of organizational practices that promotes good governance and democratic processes in the organization. If it is implemented in the organization, it improves the decision-making process and makes the process of organizational decisions constructive and effective. Therefore, this study aimed to explain the effective factors of transparency in the strategic decision-making of health system managers.

This exploratory (qualitative-quantitative) study was conducted based on an applied research method. In the qualitative part, the statistical population includes managers and faculty members at Ilam University of Medical Sciences. The snowball method was used for sampling. Moreover, semi-structured interviews were used to collect information in this part. Based on the rule of theoretical saturation, 17 interviews were conducted. Furthermore, Grounded Theory was employed to analyze the data in the qualitative part. In the quantitative part, the purpose was the model testing designed in the qualitative part. Accordingly, a researcher-made questionnaire based on the qualitative model was used to collect the information in this part. The statistical population of the quantitative part of the research included 250 managers and faculty members of Ilam University of Medical Sciences. Structural equations and PLS (volume 2) software were used to investigate the relationships and effects of the components in the model.

According to the findings of the qualitative part, 27 concepts and 4 final components or indicators, (managers' responsibility, employee participation, moral values, as well as information and communication management) were identified during three stages of open, central, and selective coding. The findings of the quantitative part revealed that managers' responsibility (with a coefficient of 0.546 and t-value of 3.058), employee participation (with a coefficient of 0.548 and a t-value of 3.789), moral values (with a coefficient of 0.618 and a t-value of 3.019), as well as information and communication management (with a coefficient of 0.764 and a t-value of 3.76)  have a positive and significant relationship with organizational transparency.

According to the research findings, it can be stated that the most effective factors in increasing organizational transparency in the strategic decision-making of health system managers of Ilam University of Medical Sciences are attention to information and communication management, institutionalization of moral values, employee participation, and managers' responsibility.

During the Covid-19 pandemic, quality of services provided by medical centers are importance. The present study aims to investigate the quality of diagnostic services provided by medical centers in Zanjan, Iran during the Covid-19 pandemic using Parasuraman’s quality model.

This is a descriptive correlational survey. The study population consists of all patients referred to medical centers in Zanjan province in 2020. Of these, 370 were selected using a convenience sampling method. The sample size was determined using Cochran’s formula. The data collection tool was a standard service quality questionnaire whose validity was assessed by experts, and a Cronbach’s reliability coefficient >0.7 showed its acceptable reliability. Its convergent validity was confirmed using the partial least squares (PLS) model with Average variance extracted > 0.5). Data analysis was performed in PLS and SPSS v. 21 Software. Hypotheses and model fitting were evaluated by structural equation modeling, PLS method, and importance-performance map analysis (IPMA).

There was a high gap between the perceived and expected status of the quality in terms of empathy. Regarding the dimension of tangibility, the services had good quality compared to other dimensions, since there was a small gap between the perceived and expected status. Based on the results of IPMA, the highest coefficient belonged to the assurance dimension, while the lowest coefficient belonged to the reliability dimension.

There is a gap between the current status and desired status in all dimensions of health service quality in Zanjan, Iran. People’ expectations are more than their perceptions; they expect to receive better quality health services during the Covid-19 pandemic.

The Islamic Republic of Iran's health system is divided into three levels: the first level is the Primary Health Care (PHC) system, the second level includes specialized polyclinics/clinics, general and specialized hospitals, and the third level is the sub-specialized hospitals. Based on the available evidence, Iran's HS has evolved and progressed since 1984, becoming a comprehensive, public-centered, responsive, and cost-effective system, (Figure 1) (1,2).  
During the COVID-19 pandemic, countries reacted differently based on their HS infrastructure and structure, available primary resources (financial and human resources), and the severity of the disease spread. Evidence reveals that most countries relied on their hospitals and health systems to combat the COVID-19 epidemic. However, the health system’s response was slightly different in the Islamic Republic of Iran. Since the early days of identifying cases and preparing hospitals for admission and treatment of COVID-19 patients, the PHC system initiated a comprehensive reaction to combat the COVID-19 pandemic as the first line and the first point of the HS's contact with the community. In this regard, the PHC system determined the principal policies for combating COVID-19 as follows (3):- General vaccination based on the priorities in the national document Provision of active and essential healthcare and services (in-person/remotely)
- Early identification of COVID-19 cases and tracing their close contacts (family/workplace)
- Protection and isolation of vulnerable populations (reverse quarantine
- Ensuring compliance with isolation and quarantine rules (hotel quarantine and house quarantine)
- Development and improvement of outpatient COVID-19 treatment
Different solutions and strategies have been devised to implement and fulfill the determined policies, which can be divided into three general categories:a) Modifying the structure of service delivery
b) Modifying the programs and procedures
c) Improving the methods of service provision
Strategy 1: The first strategy is to make structural changes in the PHC system (Figure 2), which occurred in the first week of the outbreak in the Iran’s PHC system. Through alterations in structure, human resources, duties, and function, 1200 comprehensive urban (1099) and rural (111) health centers were designated as COVID -19 centers for suspected COVID-19 outpatients from rural health houses, urban health posts, rural/urban comprehensive health service centers, and other private centers.

Home quarantine to prevent the spread of Covid 19 has a number of psychological consequences, including feelings of loneliness that can have long-term negative consequences. The purpose of this study was to review studies on loneliness caused by Covid-19.

This study was a systematic review study. Articles published in 2020 (until August 10) using the keywords of Corona virus, loneliness, social isolation, mental health, Covid-19 and quarantine and by searching on reputable sites Pabmed, Science Direct, Google Scholar, Sage, Proquest Performed in the presentation of coronavirus, Covid-19 and alone. After screening, finally 33 original studies were obtained which were examined in terms of research quality and methodology. Finally, 14 articles were included in the research and analyzed.

At the time of the outbreak of Covid-19, 29.2% of the subjects showed signs of psychiatric disorders and 35.86% of the subjects experienced feelings of loneliness. Longitudinal findings as a safer way to explore feelings of loneliness over time showed that the elderly (over 65), the chronically ill, and those who lived alone before Covid-19 were at higher risk of loneliness. . Risk factors for feeling lonely include low economic status, female gender, younger people, having at least once Covid-19, weaker and older self-perception, low social support, and protective factors including employment, living with a spouse, Self-compassion, spiritual well-being, was a sense of social belonging.

Feeling lonely in quarantine is not a prevalent feeling, and health policymakers need to plan based on the individual characteristics of those at risk. These programs are better designed for the elderly (over 65), young people (under 30) and women to save them from the risk of health problems caused by loneliness.

Health services management is one of the important fields in health system. Assessing the abilities of graduates in this field will help to identify educational needs. Therefore, the purpose of this study was to evaluate the competency of bachelor graduateswho have employed in the health system units.

This cross-sectional study was conducted on 51 graduates, 41 junior employee and 28 senior employees of health-related organizations in East Azerbaijan Province and from the perspective of all three groups. The 360-degree method was employed using a researcher-made validity and reliability questionnaire with a 5-point Likert scale. Data analysis was performed using descriptive statistics and paired t-test.

Graduates in the field of ethics from a superior perspective (4.01 ±0.76), Customer orientation from the perspective of graduates (4.13 ± 0.76), Problem solving from the perspective of a colleague (3.94 ± 0.89), Service delivery management (3.93 ± 0.91) and change management from the perspective of a graduate (3.90 ± 0.85) And in the field of financial management (3.32 ± 1.14), human resource management (3.74 ± 0.81) and knowledge management from a superior perspective (3.46 ± 1.01) had less ability. The largest gap was identified in the field of financial management from the perspective of all three groups, but from the perspective of the graduates themselves, there was a greater gap in the field of information and communication management (3.89. 0.84).

This study showed that graduates in financial management and information and communication management need to be promoted. Therefore, reviewing the educational curriculum, using new teaching methods and holding supplementary training courses in these fields can help to improve graduates' abilities.

Elderly satisfaction is considered as a tool to measure the productivity and effectiveness of hospital services. Any decision and planning in relation to the elderly, requires accurate knowledge and based on objective and scientific observations of their problems. The aim of this study was to determine the status of geriatric services in two NAJA selected hospitals.

This was an applied study, in terms of purpose, and a mixed exploratory study, in terms of data, using unstructured in-depth interviews (qualitative part) and a questionnaire with five-point Likert scale (after evaluating validity and reliability (quantitative part)). To determine the level of satisfaction and problems, from 300 elderly clients of two NAJA hospitals in Tehran city, were performed between February 21, 2019 and November 22, 2019.

The results showed that the level of satisfaction was with physicians (90%), emergency (75.6%), para clinic (83%). Also, the most mentioned problems of the clients regarding the costs (10.7%), such as the free cost of some drugs (5.7%), the problem of absentee appointments (10.2%), the high volume of clients (6.4%), the problems of parking space (6%). The solutions provided by clients were insurance expansion and supplementary insurance (17.5%), work conscience (13.4%) and disease prevention services (12.4%), and dental expansion (8.2%). Quantitative analysis showed the favorable condition in terms of employee satisfaction and the need for measures to control costs, expand insurance services, NAJA and hospital services.

Different parts of hospital according to the percentage and analysis, have acceptable situation but there are defects about equipment, electronic services, staff encounter and the aging services community system in NAJA hospitals, despite of being at the suitable therapeutic level, need to serious practical actions to increase the level of satisfaction.

Awareness of patient satisfaction from service quality is vital to advance performance improvement strategies. The main goals to evaluate the quality of services in the health and treatment system are service performance, service identification, service performance improvement evaluation and finally providing favorable service to customers.

In this research, seven key aspects were identified to assess the quality of health care system. Then, they weighted by the best-worst fuzzy developed method. In the following by using a researcher-made questionnaire, the openions of referrals to selected departments of the treatment center have been reviewed as a statistical sample of service quality. Finally, the complex of treatment centers, hospital departments, and quality dimensions were analyzed and ranked by Fuzzy Vikor Method, Friedman statistical tests and Analysis of variance.

Development of comprehensive satisfaction assessment model could include desirable range of criteria affecting the satisfaction of the referrers to health centers. In addition, using developed multi-criteria fuzzy hybrid decision making has been able to consider the uncertainty of the assessment process for the qualitative criteria considered by the evaluators. Key findings of the research suggest that the final weights in order of priority are: pivotal patient (0.198), time (0.188), effectiveness (0.178), responsiveness (0.123), warranty (0.112), financial (0.108), and health communication (0.9).

Health centers by focusing on priority-based performance improvement programs can offer a better level of service quality and can achieve higher customer satisfaction. Therefore, they will be able to achieve a sustainable competitive advantage.

The elderly people consume much of the home health care. Therefore how to organize home care services and identify the services needed is important in order to manage and control resources. The purpose of this study was to describe home health services status in Tehran, Iran.

A sample of elderly people receiving home health care during April 2017 to September 2017 was studied. The data was collected using a checklist. Data was entered into SPSS V.19 and analyzed by descriptive statistics.

In all 278 elderly people were studied. Of these 59.4% were female and 65.2% were married and their mean age was 81 ± 2.5 years. The results showed that the most frequent services that needed were nursing service (55.4%), physician visit (17.0%) physiotherapy (15.0%). Medical services had a significant statistical relationship with the age and marital status of the elderly but non-medical services (physiotherapy, nursing and laboratory) had a significant relationship with gender, age, marital status and education (p≤0.05).

The findings showed that elderly people needed a variety of services. Also there were differences in the use of home health care among the elderly by age, gender, and other demographic factors. Overall, it is necessary for health care providers to understand the growth of the elderly population in the country and their needs in the coming years in order to plan appropriate programs and actions.

The health care system should provide qualified health care services to people with disabilities equal to other members of population. The attitude of health professionals in providing standard services to people with disabilities has a significant impact on the quality of health care services. This study aimed to translate the “Scale of Attitudes toward Disabled Persons” (SADP) to Persian, and evaluate its content validity and reliability. Initially, based on the International Quality of Life Assessment project the process of translating to Persian was done by 6 translators. Content validity ratio (CVR) and content validity index (CVI) were assessed by 8 occupational therapists. Relative content validity coefficient was investigated in order to verify the reliability of the questionnaire. The questionnaires were completed twice within 10 days by 52 health professionals who participated in this study. Internal consistency and the reliability of the test-retest were determined by calculating the Cronbach’s alpha coefficient and the intra-class correlation coefficient (ICC), respectively. From 24 items, the presence of 22 items in the questionnaire was confirmed by calculating the CVR and CVI. The Cronbach's alpha for two subscales of optimism/human right and pessimism/behavior was 0.70 and 0.65, respectively. Intra-class correlation coefficient for the two scales was 0.71 and 0.69, respectively. The Persian version of SAPD has good content validity and internal consistency for evaluation the attitude toward people with disabilities. Test-retest reliability is average due to the nature of attitude evaluation. SADP, along with other tools, can be an appropriate tool for evaluation attitude of health professionals toward persons with disability.