نشریه مدیریت سلامت
پیاپی 82 (زمستان 1399)

Benchmarking is one of the superior methods and processes for performance and organizational improvement. This study was conducted to determine benchmarking rate of disaster management committee members in Iranian public hospitals in effective disaster response.

This cross-sectional study was conducted in 2018. The research community was Iranian public hospitals that were randomly selected based on spatial planning. The data were collected using a researcher-made questionnaire including two parts of individual variables, and amount and technique of benchmarking using 14 open-ended and closed-ended questions. The data were analyzed by SPSS-23 software.

Out of 410 members available from the hospital crisis and disaster management committee who were studied, 103 persons (25.1%) had from 1 to 8 benchmarking cases during the period of cooperation with this committee, and a total of 237 cases of benchmarking were recorded. Thus, the mean number of benchmarking cases was 0.58±1.2. Thus, the mean score of benchmarking was 0.58±1.2. There was a significant relationship among the number of benchmarking cases and the duration of cooperation in the Disaster Management Committee (P=0.001 & r=+0.177), the number of active beds in the hospital (P=0.024 & r=+0.117), educational level (P=0.029 & r=+0.109), and the city of hospital (28.4% in metropolitan areas and 15.9% in non-metropolitan areas) (P=0.010).

This study showed that benchmarking rate per capita among the studied members was in a lower level compared to other similar studies. Therefore, it is suggested that appropriate intervention programs be designed and implemented.

Medical tourism facilitator firms are the firms which act as intermediaries between suppliers of medical tourism and the patients. In order to have efficient and sufficient outcome, these firms need a well-organized infrastructure. In this research, we investigated the infrastructure management indicators of medical tourism facilitator firms in Iran.

This research was conducted by using a two-step quantitative

the Delphi technique and distribution of a structured questionnaire. Statistical population for the first data collection step consisted of the experts in medical tourism and e-business. The second statistical population was medical tourism facilitator firms. The data were analysed using the structural equation modelling (SEM).

The infrastructure management for a Medical tourism facilitator firm included the following five factors: activity configuration, network partner, capabilities, internal (mission, strategy and structure) and external (government, competitors and technology) factors. Activity configurations of a firm, included Collaboration platforms, Virtual communities and Value-chain integrators as main activities of an Medical tourism facilitator firm firm. By examining the network partner factor, it became prominent that insurance companies must be considered more although they face limitations due to sanctions. Capability include facilities in medical and tourism segment, access to database of hospitals and physicians. Considering the internal factors mission, structures and strategy of the firm in the context of planning, their target segment, the firm’s human resources and IT structure of the firm should be developed. The government affects Medical tourism facilitator firm firms by making rules and regulations in the context of visa issuance, having relationship with medical tourism target countries, investing and supporting medical tourism system. The internal and external competitors should be monitored wisely for activities, partners, services, prices and the type of provided services. Technology is towards e-health and health applications and platform to provide required data and information for patients of MTF firms as well.

To manage infrastructure of an MTF firm, it is necessary to consider activity configuration, network partner, capabilities, internal and external factors comprehensively, as mentioned in this paper. Designing a platform between facilitators and partners as well as facilitators and patients is recommended.

Considering the importance of creativity and in order to make the optimal use of medical universities to fulfill their missions, the present study was conducted to analyze the importance-performance drivers of staff creativity in medical universities.

This study was a quantitative-qualitative study in which the importance-performance approach was used. In the present study, 10 experts in the field of resource management, human development and psychology, as well as 83 human resource managers of medical universities in the country were present. Data were collected using a questionnaire which was initially prepared using library resources and previous models. Then, according to the opinion of the participating experts, common factors were eliminated and finally, 10 factors were obtained as drivers of creativity. After that, quantitative indicators were determined for the identified factors, and the final questionnaire with 28 questions was provided for the human resources managers of the universities. Also, the content validity and construct validity of the questionnaire were calculated and confirmed. Internal consistency of the questionnaire was also obtained using Cronbachchr('39')s alpha. Using confirmatory factor analysis, the importance of the factors was extracted, and in the end, the indicators were placed in the significance-performance matrix.

The mean age of managers participating in the study was 46.35 years, and the average age of their management in the field of human resources was 5.43 years. Among the drivers of creativity, leadership style, organizational structure, individual factors, paving the way for creativity in the individual, and support of senior management with loads of 0.70, 0.68, 0.68, 0.67 and 0.65 are the most important factors, respectively. The results of one-sample t-test also showed that apart from the two components of work complexity and organizational culture, the average of other drivers is significant compared to the hypothetical average, and for managers, the situation of these factors in the organization is somewhat favorable.

Leadership style, organizational structure, individual factors, paving the way for creativity in the individual, and supporting senior management are effective and very important components in promoting and developing creativity in the health sector. In addition, for the optimal use of the creativity matrix, the type of organization and the importance-performance of each creativity strategy must be identified.

Attracting and retaining physicians in rural and low-income areas are the most important challenges for health system policymakers, which affects the poor health status of the population living in these areas. The purpose of this study was to investigate the factors related to the willingness of the working physicians to stay in rural areas and evaluate them according to the recommendations of the World Health Organization.

This applied research was conducted using descriptive-analytical and cross-sectional method in 2019. The study population was 306 physicians working in rural health centers under the supervision of Mashhad University of Medical Sciences. They were chosen through the census method, and the data collection tool was a researcher-made questionnaire. Descriptive statistics, simple, and multiple ordinal regression models were used to analyze the data.

The results showed that the willingness of the working physicians to stay in rural areas of Mashhad was low (16 percent). Furthermore, there was a significant relationship among the importance of laws and regulations, the observance of educational dimension, laws and regulations, financial incentives and personal and professional supports with the willingness to stay in rural areas (p <0.05).

The use of adequate financial incentives commensurate with the expectations of employees and commensurate with the opportunity costs of living in rural areas, accompany with individual and job support for employees, can strengthen the effects of each dimension and ultimately the willingness to stay in rural areas.

One of the main concerns of health system managers has always been to control and reduce health care costs. Optimal use of health center resources to maintain and improve services requires cost analysis and application of the results obtained in the process of supply and consumption of required items. The purpose of this study was to extract a suitable model for managing the costs of medical supplies in health centers.

This is an applied research and the used descriptive research method was cross-sectional. The annual purchase cost of medical supplies of health centers of Hamadan University of Medical Sciences was extracted from the hospital information system and after processing, the results were analyzed using the experiences of researchers and the criteria for medical equipment of the country. The K-means algorithm in the Rapidminer software (version 9.6) environment was used for the data clustering.

The annual purchase costs of medical supplies were clustered into nine categories based on the unit and total purchase price using the K-means, and then based on the analysis of each category, cost management strategies such as price reduction through centralized purchasing, concluding contracts with authorized suppliers, careful monitoring and control of consumption, and concluding a memorandum of understanding with other medical centers for the exchange of surplus or required goods were presented.

Cost analysis of medical supplies based on price, purchase, and consumption in a given period of time using clustering algorithm provides valuable information for resources and expenditures management of the health system managers and leads to maintaining, continuing, and improving the level of services of health centers.

One of the approaches that influences the decision-making and management of universities is evidence-based management. Evidence-based management requires managerial and organizational decisions and informed actions using the best available evidence in which the best evidence is used as norms and standards. Therefore, in line with the importance of this issue, the present study aimed to determine the sources of evidence used in decision making of staff managers in Iran University of Medical Sciences.

The present descriptive-analytical study was conducted in 2019 among 71 managers of Iran University of Medical Sciences. The research tool was a standard evidence-based management questionnaire. In this study, the sampling was not carried out and all managers participated in it. Spearman test and SPSS-24 software were also used to analyze the data.

The findings of the study on the sources of evidence used by managers in organizational decisions and programs showed that the highest source of evidence was socio-political development program and the lowest was the use of sources of scientific research evidence.

Any decision that is made without evidence-based management cannot be considered evidence-based and can have negative outcomes in any decision-making organization. Therefore, it is necessary that the relevant officials and policy makers provide a suitable platform by formulating specialized policies and providing the necessary infrastructure to reduce the gap between the current situation and the evidence-based management model.

Qasedak, a performance-based plan payment, is a method that seeks rewarding quantitative dimensions of performance and encourages health care providers in order to achieve predetermined goals. The purpose of this study was to investigate employeeschr('39') satisfaction with the performance-based payment plan in 2019.

The present study was descriptive-analytical and cross-sectional. The population of the study was all the staff members across selected hospitals of Iran University of Medical Sciences. Data were collected by a questionnaire and analyzed using the independent-samples t-test, ANOVA, and Pearson correlation tests in SPSS software.

The average score of satisfaction among medical, nursing, support and paramedic staff from the performance-based payment was poor (2.33 out of 5). There was no significant relationship between the amount of satisfaction with the performance-based payment system and the work unit of the studied employees (p-value = 0.330). Also, there was no significant relationship between the age and work experience and level of satisfaction (p-value = 0.945 and 0.823, respectively). However, there was a significant relationship between employeeschr('39') satisfaction and their job category (p-value = 0.042). The highest and lowest levels of satisfaction were related to the physicians and financial-administration staff, respectively.

Employeeschr('39') level of satisfaction with the performance-based payment system, especially among non-clinical staff, is not acceptable and this can affect staff performance and quality of work adversely. Hence, authorities should pay more attention to this issue.

Some of the significant and irreparable financial losses in hospitals are Insurance deficits which for various reasons are not fully reimbursed by the insurance companies. Therefore, the present study was an attempt to determine the amount and causes of insurance deficits in selected Teaching  and non-Teaching hospitals affiliated to Iran University of Medical Sciences.

This cross-sectional descriptive study was performed in six selected hospitals of Iran University of Medical Sciences. The research population included patients’records during the first six months of 2020 for inpatient and outpatient wards. Reports of deficits for Health Care and Social Security Insurance were collected by referring to the revenue units of the hospitals. The data collection tool was a researcher-made form. The deficit amount of each hospital was collected separately for the type of file and teaching and non-teaching hospitals. Data were analyzed by descriptive statistics using Excel software.

The findings showed that the most deductions applied in inpatient records are related to surgery and hospitalization fees, respectively, and in outpatient documents are related to visits, laboratory services, diagnostic and counseling services.

According to the type and causes of deficits identified based on research findings, policy makers and planners in the field of healthcare system are advised to hold workshops for staff in the process of treating patients with insurance rules, using hospital information systems, using relevant graduates, and analyzing files before sending them to insurance companies in order to prevent insurance deficits.