Journal of

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Background: The scarcity of resources and growing demand for health care, as well as moral, socioeconomic and political imperatives for efficient use of resources, make cost information and adoption of an accurate methodology an integral part of the modern management.
Materials & Methods: At first, a research protocol including literature review strategies, inclusion and exclusion criteria and data gathering methods, was designed. Afterwards, using an electronic search of several databases, some relevant studies were identified.
Results: In the costing literature the economic and accounting approaches are distinguishable. Two methods of marginal and average unit cost analyses are attributable to these approaches. Considering the type of the problem to be decided about and cost targets, costing methods can be different. Factors such as types of cost analyses and economic evaluation, timing overview, analysis approach and advantage or disadvantage of economy of scale have a significant role in determining the costs.
Conclusion: Having no consensus of opinion on the most appropriate principles to use in costing process is one of the main challenges of the time. There is a trade-off between the accuracy and cost of achieving cost information... Therefore, standardization of costing methodologies and adoption of comprehensive approaches for the main issues will predispose an economical international and organizational comparability.

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Background: Today using contrast media in order to diagnose different tissues in radiology section has found a vast range of applications. Thus application of safe procedures and protocols in usage of contrast media to prevent dangerous reactions seems to be of great necessity. That is why in this study we aimed to evaluate the safety of intravenous administration of contrast media in the radiology sections of medical-educational Centers of Urmia. Materials & Methods: This is a descriptive and cross sectional study. Data were gathered using questionnaires derived from articles and international standard guidelines such as (ESURE, RCR) in three areas including: drugs, protocols and facilities. Results: Results indicated that the level of compliance with safety protocols, facilities and drugs were 91.3% and 69.4% and 100% respectively. The average safety observance was 80.9% totally. The results showed that there were some deficiencies in some equipment such as pulse Oximeter and ECG. Moreover, it was found that a unique protocol is not used in all surveyed sections. Conclusion: Regarding the importance of this issue it is necessary to publish and implement a unique protocol for contrast media administrating and to provide all required equipment for improving patient safety process. Meanwhile a wide supervision should have been done by related authorities in or out of the organization.

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Background: Hospital as core of health and care system requires an effective leadership style and suitable strategy for organizational differences and conflict’ solving. Main goal of this study is to survey of relationship between leadership style and strategy of conflict management among chief executive officers of Urmia hospitals. Materials and Methods: This analytical-descriptive cross-sectional study was implemented in Urmia hospitals in 2013. Study population of the research includes thirty top managers in ten hospitals of Urmia. Data gathered through three questionnaires (personal and job characteristic leadership style with method of Fiedler LPC and conflict management). Data analyzed through SPSS software, mainly by Chi 2, Kruskal–Wallis and Spearman's Rho tests. Results: Results showed that Leadership style had significant statistical relationship with average of managers work experience (p=0.040). Also age and strategy of control had significant statistical relationship (p=0.01). Leadership styles and strategies of conflict management weren’t significantly with other descriptive variables such as (position, level of education, marriage situation, work experience, managerial studies and second job). Leadership styles and strategy of conflict management weren’t significant relationship, finally. Conclusion: Since that the determination of leadership style and methods of dealing with conflict management in hospitals is important, it is recommended that ever done comprehensive research on the effects of other factors such as organizational culture, social culture, character on leadership style and conflict management.

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Background: Informal payments are paid to individuals /health care providing organizations offering as cash or non-cash and are formed out of formal payment channels. This study aim at identifying the types of informal payments, causes, effects and policies to deal with them.

 Materials and Methods: This study was a review  one and relative  published articles identified by searching valid database ( Medlib, SID, Pub Med, Science Direct and Google Scholar)using keywords with their equal in Persian (informal payment and unofficial payment) and 128 articles were extracted. The articles refined step by step. In conclusion, 20 articles were selected according to study aims.

Results: The study findings consist of five main sections including the definition and form of informal payments, the existent causes of informal payments, effects of informal payments, statistics of informal payments in Iran and the world and policies to dealing with this important issue.

Conclusion: Due to the high prevalence of informal payments and severe negative effects on justice and respectable governance, policy-makers should focus on this issue and reduce its effects. Although, strategies to control informal payments are limited but strategies including regulation payment and medical tariffs, regulating power abuse, providing incentives and increasing responsibility of healthcare professionals, and changes in public perception are proposed.

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Background: The emergency department is as heart of hospital and is one of the first points of contact for patients with health care system are facing a variety of challenges. This study aimed to explore the challenges of emergency departments in teaching hospitals of Mashhad University of Medical Sciences.

Materials and Methods: This study was carried out through a qualitative approach and phenomenology method in 2013 in Mashhad, Iran. Twenty nurses and two emergency medicine specialists were recruited from four teaching hospitals in Mashhad Iran using purposive sampling. Data were collected through semi-structured in-depth interviews. Interviews were transcribed verbatim and analyzed using conventional content analysis approach according to colaizzi  with MAXQDA 3 software. 

Results: The results of this study indicated that challenges of emergency department lay in

Three main aspects including: "challenges in Human resources"(personal characteristics,  professional characteristics and human resource limitations), "nurses' dissatisfaction"(less quality hospital hoteling and services for staff, disproportion between the workload and salaries, Lack of support from nurses) and " challenges in human resources management "(Structural challenges, the performance challenges and challenges in human resource management). Each theme included several category and subcategory that explain various aspects of the challenges in emergency department.

Conclusion: Human resource limitations, nurses' dissatisfaction and poor management were the most important challenges. Providing adequate human resources, support of nurses and determination guidelines and process for nursing care can reduce these challenges in hospital emergency departments.