نشریه مدیریت سلامت
پیاپی 77 (پاییز 1398)

Considering the fact that the health reform plan has been implemented for five years, it is necessary to re-evaluate the plan and adapt it to the needs and macro policies of our society. Therefore, the current study aimed to use health-related scientific evidences together with the experiences, opinion, and expertise of field professionals to achieve priorities for health reform plan and adapt them to future needs of the country.
 

This qualitative study was conducted in 2018. At first, scientific evidences were gathered through review of literature, and then a semi-structured interview was developed to collect data from 15 health professsionals and experts chosen through a snowball sampling method. Data were analyzed using content analysis method.

The results demonstrated the existence of 12 policies which were then prioritized by using Interpretive- Structural Modelling.
Conclusion. Evidence-based policymaking should be used as the main approach in health system, and careful attention should be paid to policies for the old, for preventing diseases and promoting mental health, for accident and incident, for modifying internal processes, such as electronic health records, and for developing health guidelines, referral system and family doctors.

The picture archiving and communication system is a digital device designed for processing, archiving and communicating medical images with different parts of hospitals, physicians and radiologists. Therefore, the current study aimed to determine the impact of the system on users’ satisfaction with imaging services before and after its implementation.

This cross-sectional, descriptive-analytical study was conducted in two phases, before and after the implementation of the picture archiving and communication system, and on all physicians and radiologists (N= 51) working in Nohome Dey Hospital in Torbat Heidaryeh. At first, the overall satisfaction of the users from the system was evaluated, and then the result was compared with their satisfaction before and after the implementation of the system. A questionnaire was used to collect data which were then analyzed by SPSS using descriptive statistics and Wilcoxon test.

The overall user satisfaction was 55.5 (maximum score 65). However, there was a statistically significant difference (P < 0.0001) between the mean scores before and after the implementation of the system (23.74 and 32.05, respectively). 

The level of users’ satisfaction (physicians and radiologists) increased after the implementation of the picture archiving and communication system; as a result, the system can improve the satisfaction of physicians and radiologists.

One of the most important goals of healthcare organizations is cost management in order to save money, provide quality services and achieve customer satisfaction, however, it poses serious challenges for managers. The current study aimed to identify the main components of cost management in hospitals based on a process-orientation approach.

This qualitative research was conducted using Grounded Theory in Tohid Hospital in Bushehr Province. The population consisted of all knowledgeable authorities and experts in cost and financial management 16 of whom were selected through a purposeful sampling. Data were gathered through a semi-structured interview lasting for 40-50 minutes. Considering the theoretical data saturation, the number of contributors was 16, but in order to ensure the data collection 20 people were interviewed. The data were analyzed using the Corbin and Strauss method, and the credibility was confirmed through plausibility, transformability, reliability and verifiability.

According to the findings, 78 initial codes, 20 primary classes and 7 classes of Hospital Cost Management Strategies were extracted, such as identifying cost centers, setting internal rules and regulations, monitoring and controlling, establishing a costing system, work-group formation and operational planning.

To manage the hospital costs, it is necessary to identify the components of the costs. The components identified in this research are formed in a coherent and organized model to become a useful tool for hospital cost management.

Hospitals, major components of health system, have a high contribution to healthcare resources. Therefore, considering the importance of hospital holding in effective and efficient hospital management, the current study aimed to identify and explain the role and importance of factors affecting hospital holding administration in Iran Social Security Organization.

This was an applied-descriptive study. First, the variables and key factors affecting hospital holding administration were extracted through a literature review and an interview with 15 content experts. Based on the results a questionnaire was developed and distributed among 405 staff and line managers and experts working in the Social Security Organizations in Iran. Data were analyzed by SPSS23 and AMOS24 using exploratory and confirmatory factor analyses Structural Equations Modeling.  

Five factors affecting hospital holding administration were identified including strategic planning, financing, decision rights, monitoring and evaluation, and accountability. Financing and decision rights, with factor loadings of 0.83 and 0.44, had the most and least significant effects on Social Security Organization hospital holding administration, respectively.

All five factors are required for effective and efficient hospital holdings administration; however, it is recommended to pay more attention to financing and monitoring and evaluation.

The Emergency Department has significant role in reducing mortality and accelerating the delivery of emergency services. Emergency performance indicators play an important role in evaluating the performance of emergency department. Therefore, this study focuses on investigating the emergency performance indicators in Trauma Centers of Mashhad University of Medical Sciences.

This was a mixed-method study conducted in 2018. At first, emergency performance indicators were collected in three selected trauma centers during 2014-2017. Second, the reasons for the changes in indicators were reviewed qualitatively during the focus group meetings.

According to the result, keeping a medical record for patients without vital signs; calculating the cardiopulmonary resuscitation rate for all traumatic and non-traumatic patients increase the rate of unsuccessful cardiopulmonary resuscitation. Some factors were found to increase triage time, such as the increased number of patients and mass accidents, lack of timely recording at the point of care or connection between the triage system and the Hospital Information System.

To improve the quality of emergency department performance, an emergency medical practitioners should be present at the emergency department, and adequate equipment, a triage committee and real-time triage records should be available. Therefore, the managers should follow the required guidelines and procedures to improve the quality of the emergency function and review the indicators.

Informal, under-the-table, payments are paid to individuals/ health care organizations as cash or non-cash through informal channels. This study aims to identify the amount of informal payments in Shiraz University of Medical Sciences.

This descriptive study was conducted in winter 2014 and winter 2016 (before and after the Health Reform Plan). A questionnaire and telephone interviews were used to collect data which were then analyzed by using SPSS and Excel software.

The average informal payment to physicians, nurses, service staff, security guards, and other employees were 11.1%, 22.2%, 22.2%, 0%, 0%, respectively.

According to the results, the Health Reform Plan, in general, has significantly reduced informal payments (P <0.01) in Shiraz University of Medical Sciences.

The analysis of the sale and use of drugs plays an important role in meeting the country’s drug demands in different therapeutic groups. In the meantime, the most important challenge is the conventional and empirical methods of predicting drug demand in the pharmaceutical industry. The current study aimed to examine the efficiency of the two proposed methods of Artificial Neural Network and Curve Fitting in comparison with the current conventional method, i.e., the Compound Annual Growth Rate model.

Pharmaceutical sales data (from March 20, 2000 to March 19, 2017)     were aggregated and necessary treatments were applied. In the next step, the three aforementioned forecasting methods were used, and their efficiencies were compared by using the root mean square error.

About 200 generic drugs were studied and 17 major therapeutic groups were identified. The sale prices for two years (from March 21, 2018 to March 19, 2020) were predicted. The calculated annual sales error for the artificial neural network and curve fitting from March 20, 2000 to March 19, 2017 was reported to be less than 7 percent for 11 years (of 13 years computed with Neural Network method) and 15 years (of 17 years computed with Curve Fitting method), respectively.

The Neural Network and Curve Fitting methods outperform the conventional Compound Annual Growth Rate model and in the case of low experimental data for drug sales, the Curve Fitting model acts more efficiently but with more input data, the Neural Network method acts more efficiently than the other two methods.

 Clinical specialists need to develop necessary information skills to meet their research requirements. The current study focused on the effect of educational interventions by clinical informationists on medical students’ information behavior.

 This was a semi-experimental study in which a two group  pretest–posttest design was used. The population consisted of 60 medical students (30 in the experimental and 30 in the control group at Isfahan University of Medical Sciences) who were selected through the convenience time based sequential sampling method. A researcher-made questionnaire including 19 items based on a 5-point Likert scale (very little to very high) was used to collect data which were then analyzed by SPSS using the descriptive and inferential statistics.

 The trainings offered by the clinical informationists motivated the experimental group to focus on seeking information about clinical issues. Following the intervention, the experimental group achieved significantly higher need to search for information, during and after clinical rounds, than the control group. Moreover, the use of electronic information resources and clinical databases in the experimental group was significantly higher than the control group.

Considering the importance of electronic information resources, universities of medical sciences are required to teach the use of databases, specifically as part of the medical students' curriculums and medical education programs.