Showing 9 results for Health System
Alireza Milanifar, Mohammad Mehdi Akhondi, Parvaneh Paykarzadeh, Bagher Larijani,
Volume 5, Issue 1 (12-2011)
Abstract
Conflict of interest is a real situation in which a person as a decision maker simultaneously has two positions, one in private and the other in the public. In public role he or she has to pay attention to the society`s best interests and follows his or her best ones as private role. Conflict of interest is a common challenge of health system among both real and legal persons in all courses such as education, treatment, and researches.
The most causes of conflict of interest are named as deferent goals, lack of resources, authorities malfunction, health marketing and etc.
We aimed at discussing conflict of interest and its relation to law, its management, conflict of interest in pharmacy and pharmaceutical companies and also Iranian legal system viewpoint. In conclusion it seems that conflict of interest should be included in the law and the provisions to achieve the least conflict of interests in health system should be revised.
Hossein Jabbari Beirami, Fariba Bakhshiyan, Gholamreza Bateni, Mohammad Ali Mohjal Shojaae, Faridoon Abbasnejad, Majid Khalili,
Volume 5, Issue 2 (4-2012)
Abstract
In the middle age (500–1500), while European countries were struggling with frightening epidemics such as plague, smallpox, tuberculoses, leprosy, and their medical treatments were based on superstitions and fanaticism, scientists such as Avicenna and Rhazes laid the foundation of the golden period in medicine.
In the late periods of golden centuries, during the Mogul invasion of Iran, Rashidaddin Fazlollah Hamadani devoted a great deal of effort to preserve the knowledge by foundation of the knowledge city of Rabé Rashidi and
Daralshafa (Medical and Health Service College) in Tabriz.
Rashidaddin established a successful health management system which was accordance with the current modern health management systems. The objective of this review is to present a clear perspective of a successful Iranian Islamic model of health delivery system 700 years ago.
The review was conducted in the form of descriptive bases of original documents with a systemic approach.
Findings show a successful management experience in health system in terms of stewardship, resource allocation, provision of health services and financing which appears to be in accordance with the World Health Organization (WHO) declaration in 2000.
Promotion of team working, employment of fulltime and part-time physicians, implementation of a fair and functional economic structure, health economic, sustainable financial mechanisms, public insurance, home care provision, and isolation of communicable diseases in hospitals can be considered as examples of a successful Iranian Islamic health management system.
It can be concluded that as Iranian health management system is faced with many different challenges, gleaning lessons from successful national historical experiences can play a key role in the establishment of a competent system based on our Islamic and national values and in accordance with modern scientific achievements.
Mohammadreza Amiresmaili, Mahmood Nekoeimoghadam, Atefeh Esfandiari, Fatemeh Ramezani, Hedayat Salari,
Volume 6, Issue 3 (8-2013)
Abstract
In recent years, the financial relationship between the physician and the patient and some issues such as informal payments for health care have arisen as an unethical but common problem in many countries, including the Islamic Republic of Iran. Such issues are a threat to the professional reputation of physicians, and can have their own causes in different parts of the world. This study attempts to assess the causes of informal payments and the manners in which they are done in the hospitals of the Kerman Province in Iran in 2012.
This study was carried out using qualitative research methods, and semi-structured interviews. Structured interviews were conducted on a purposeful sample of 45 participants including patients, providers and policy makers in the Kerman province in Iran in 2012. This study was authorized by the ethics committee of Kerman University of Medical Sciences, and the consent form was completed by all participants. In this study the participants were asked questions regarding reasons for informal payments, and data were analyzed using content analysis.
There are several reasons for making informal payments, which include cultural, legal and quality factors. A number of reasons for asking informal payments by providers were discovered, including those related to tariffs, structural factors and ethical factors as well as to demonstrate the skill and competence of service providers.
Most of the reasons discovered for informal payments in Iran are similar to other countries in the world. They showed that inadequate funding of the health systems and inadequate formal payments to providers are the most important supply-side factors leading to informal payments. Given that qualitative studies usually cover potential reasons only, further studies are needed to investigate the matter more extensively.
Mahmoud Motavassel Arani, Mohammad Hassan Alamolhoda, Nikzad Easazade, Gholamreza Noormohammadi,
Volume 10, Issue 0 (3-2017)
Abstract
Modern medical ethics, in particular the principle of Non-Maleficent, advises the medical staff to avoid any harm to the patient. Islamic jurists, using religious texts and sources, have introduced rules that are applicable in many areas of life. Among these rules, is the rule Non-Harm, that in this article to review this rule and its applications in medicine. In addition to discussions of the documents, a better understanding of the words "Darar" and "Dirar" and deny or forbid the word "La" at the beginning of the base document, is one of the major issues and disputes. Organ transplants, family planning and birth control, responsibility to protect the health, need to see a doctor for treatment, civil responsibility for doctors in the treatment, responsibility for custodians of society for the control of AIDS, are the problems affecting today's health systems that the rule of No Harm is flowing in them.
Arghavan Haj-Sheykholeslami, Fatemeh Mollarahimi-Maleki, Marzieh Nojomi,
Volume 14, Issue 0 (3-2021)
Abstract
The purpose of this study was to perform a narrative review and documentary research in the history of community medicine specialty formation and the needs for its existence in health systems. We searched and reviewed related literature and documents in English and or Farsi (printed or online). Data was extracted and findings were categorized, summarized, and reported. About a century ago community medicine specialty was formed to respond to major health challenges of that time such as neglecting the effects of social determinants on populations’ health and total separation between clinical care and public health. Community medicine professionals are able to address many of the current health problems such as inequalities in health, fair financing problems, increasing demands and costs and disease-based health system approaches. They can be the leading advocates to emphasize the importance of social determinants in health of populations. They can promote communications with influencing institutions outside the health system to improve the health of the communities. This discipline can pave the way for the health systems to tackle the most important contemporary health challenges. Lack of attention to this discipline may hinder the achievement of sustainable development goals and health promotion of the communities. More support from officials and utilizing the skills of community medicine specialists can help health systems not only to better respond to the health needs of the society but also to facilitate the achievement of their main goals.
Mohammad Hossein Eftekhari, Alireza Parsapour, Ayat Ahmadi, Bagher Larijani, Neda Yavari, Ehsan Shamsi Gooshki,
Volume 16, Issue 0 (11-2023)
Abstract
Defensive medicine is performing actions that have no medical indication and benefit for the patient (positive defensive medicine) or refraining from performing risky actions that have a medical indication and benefit for the patient (negative defensive medicine). These actions are carried out by the physicians with the sole motive of protecting themselves against complaints or tensions such as the protest of the patient or colleagues and usually cause physical, psychological, or economic harm to the patient or the institution that pays the treatment fee, such as insurance organizations. It can have consequences in terms of the quality of care and the efficient use of limited health resources. Factors such as the physician’s concerns about lawsuits and proceedings may lead to defensive behaviors. This study presented suggestions for the management and prevention of such behaviors, including three main categories related to the strategies for the reformation of the patient complaint handling system, social strategies for the management and prevention of defensive medicine, and managerial-organizational strategies. These strategies are based on the findings of a mixed-methods research including an unsystematic review of resources and a qualitative study conducted using semi-structured interviews. The results have been discussed by the Medical Ethics Committee of the Academy of Medical Sciences of Iran.
Kourosh Delpasand,
Volume 17, Issue 0 (12-2024)
Abstract
All health systems face the dual challenge of resource shortages, which prevent them from providing all the services needed by society, while also striving to enhance justice in access to health services and care. The prioritization and allocation of resources are critical issues in the health sector, and ensuring fairness in these processes requires consideration of various criteria. This study aims to examine the methods of allocating human resources in the health sector and explain the challenges associated with allocating skilled human resources in the country. This qualitative study involved faculty members and individuals with a history of responsibility in the university. Data collection was conducted through interviews, which were arranged based on mutual agreement with participants. Interviews continued until saturation was reached, meaning they concluded when participants had no further information to provide and the interviewer had no additional questions aligned with the research objectives. The findings were categorized as follows:
- Prioritization Issues: The prioritization of resources is often directed towards newly established departments and hospitals, and personnel are allocated to new branches to launch new fields. The definition of processes important to the Ministry of Health is based on specific provincial conditions, which may not be included in standard lists. Prioritization should, therefore, be determined based on relevant indicators and the performance of personnel.
- Organizational Challenges: Organizational charts are outdated, and organizational structures are often unresponsive. Recruitment is based on obsolete charts, and there are discrepancies between created positions and the personnel recruited to fill them. Political influences, such as deception and hypocrisy, also complicate the allocation process.
Population Considerations: The floating population of each province must be considered in resource allocation. The periodic involvement of some individuals as companions and contract personnel in advisory roles alongside university presidents poses challenges. A gradual approach with well-defined management and realistic goals should be implemented over a five-year period.
- Management and Decision-Making: Human resource managers in universities lack decision-making authority. A national team of managers, specialists, and experts should be formed to address human resources needs. Human resources should be identified based on the estimated needs of existing fields. It is also essential to establish efficiency measurement frameworks grounded in relationships, but the Ministry of Health lacks specific notifications regarding these matters. Efficiency should be measured based on personnel performance and appropriately defined indicators.
- Emerging Challenges: The migration of specialists in various fields, combined with reluctance among doctors to pursue specialist-level studies in areas such as emergency medicine and pediatrics, further exacerbates human resource allocation challenges. Adding specialist experts and evaluating personnel before hiring are essential measures to address this issue. Additionally, consideration should be given to restructuring the Ministry of Health by dividing it into separate sub-units with distinct financial and management mechanisms.
This study identifies and extracts the criteria used for prioritizing and allocating resources within the health system. According to experts and policymakers in health and medical organizations, additional criteria should be considered beyond traditional metrics when prioritizing and allocating human resources.
Mehran Seif-Farshad,
Volume 17, Issue 0 (12-2024)
Abstract
Health care services, in addition to being recognized as fundamental rights in various global human rights declarations, play a crucial role in advancing the development of human societies. The four principles of biomedical ethics introduced by Beauchamp and Childress—autonomy, non-maleficence, beneficence, and justice—are pivotal for ethical analysis and decision-making. However, certain other dimensions, which may not be explicitly addressed within these principles, are essential for policymaking at both macro and micro levels in health care. Two such important principles are social solidarity and sustainability, both of which hold a prominent position in health systems planning. The principle of social solidarity refers to the ways in which unity, cohesion, and collaboration are fostered within a community. A socially cohesive society embraces cultural diversity, respects human rights and the rule of law, and demonstrates a shared commitment to social order and collective responsibility. Social solidarity can significantly reduce health risks by creating a strong societal framework where cooperative efforts foster conditions for well-being, minimizing disability and disease. On the other hand, a health care system is fundamentally responsible for establishing and maintaining a sustainable and high-quality care environment. Sustainability in health services is achieved when ethical obligations—such as maximizing possible benefits, balancing risks against benefits, ensuring fairness (including for future generations), and respecting public rights—are prioritized. Continuity of health care ensures better coordination and improved delivery of services. Disruptions in health policies or intermittent provision of health services can severely undermine public trust. A conceptual understanding of sustainability and continuity in public health ethics is crucial, as these principles ensure that health policies, programs, and services enable access to the highest attainable standard of health, free from economic, social, or political instability. However, sustainability should not imply stagnation; services must remain responsive to the evolving needs of populations and societies. Ignoring these two principles in health policymaking and program design can seriously erode public trust and ultimately harm individual and Health system planning, should be changed to Health care programs.
Alireza Heidari, Seyed Hamed Atashi, Farideh Kouchak, Zahra Khatirnamani,
Volume 18, Issue 1 (3-2025)
Abstract
Addressing patients’ non-medical needs reflects the desires of patients and their families to engage more actively in decision-making and treatment processes. The present study aimed to assess the level of responsiveness to the non-medical needs of hospitalized patients. This was a cross-sectional study conducted using a descriptive-analytical approach. A total of 392 patients hospitalized in Shahid Sayad Shirazi and 5 Azar educational-therapeutic hospitals, affiliated with Golestan University of Medical Sciences in Gorgan, were included in the study. Participants were selected through systematic random sampling. Data were collected using the validated and reliable responsiveness questionnaire developed by the World Health Organization (WHO). The mean (±SD) age of participants was (45.17 ±16.92) years, with 55.1% being male. The mean (±SD) overall score for the importance of responsiveness was (33.37 ±4.45), which was above the average. The majority of patients (over 65%) rated all dimensions of responsiveness as very important or extremely important. The most important dimension from the patients' perspective was the quality of the surrounding environment (95.9%), while the least important was the confidentiality of personal information (34.7%). The mean (±SD) overall score for responsiveness performance was 54.54 (0.70 ± 8), which was above the average. The overall score of the responsiveness performance and importance in Sayad Shirazi and 5 Azar educational hospitals was above average. Dimensions deemed important by patients but with weaker performance should be prioritized, and educational and therapeutic centers should pay more attention to patients’ non-clinical expectations.
