Journal of

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Background: Current paper aims at investigating factors affecting physicians'knowledge-sharing intention in teaching hospitals affiliated to Tehran University-Medical Sciences in which one of the most authentic model of behavior prediction namely planned behavior has been used as the theoretical framework of study.
Materials and Methods: The method of current study is descriptive/survey correlational type and statistical society includes physicians employed in hospitals affiliated to Tehran University-Medical Sciences.Date was collected by questionnaires and analyzed using Lisrel&SPSS software.Confirmatory factor analysis was employed to evaluate consistency,Cronbach's alpha was used to assess reliability and structural equation modeling was used to fit the model and test hypotheses.
Results: Prediction power of model for knowledge-sharing intention of physicians is(R2=0.66)The results suggested that impact of attitude on the knowledge-sharing intention is positive and significant with factor loading of(=0.87)However,influence of subjective norms and perceived behavioral control on the knowledge-sharing intention was not confirmed.Influence of subjective norms on attitude were evaluated positive and significant with factor loading of(=0.55)As a result, subjective norms affect knowledge-sharing intention through indirect mediation of attitude.All tests were significant at the level of(P0.01).
Conclusion: According to findings of this research on improvement of knowledge-sharing behavior of physicians, health authorities need to take corrective measures to enhance the attitude and subjective norms of physician.

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Objective: This study was aimed to assess Service Quality (SQ) of maternity care from the perception of pregnant women. Methods and materials: A cross-sectional study was conducted using a sample of 185 pregnant women at the 9th month of pregnancy were selected randomly from 40 health posts and urban health centers in Tabriz, Iran. Service Quality was calculated using: SQ = 10 – (Importance × Performance) based on importance and performance of non-health aspects from the customer’ perspective. Data collection used a researcher-developed questionnaire whose validity and reliability was reviewed and confirmed. Data analyzed using SPSS-17 software. Independent sample T-test and ANOVA were used to investigate relationship between service quality dimensions and categorical variables. Results: From the customers’ perspective the average service quality score was 7.59 of 10. Service quality aspects of “confidentiality” achieved scores at the level of good quality (≥9) and “support group” (3.48) reached low service quality scores. Also, result indicate housewife assess SQ better than worker (p=0.047) and mother who's have planned pregnancy has had greater SQ score (p=0.022). Although, in the linear regression analysis, job status and planned pregnancy were significantly and independently related to SQ score. Conclusion: Findings revealed a significant room for quality improvement in most aspects of provided care, particularly support group and safety from the perception of people who received maternity care.

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Background: Activity-Based Costing Analyzes the Activities Performed in the Service Delivery Process and Accurately Identifies Costs to Improve The Performance and Efficiency of The Delivery Units and Calculates the Cost of Each Activity by Identifying Services and Activities. The Purpose of This Study Was to Calculate the Cost of Radiology Services Based on Activity Based Costing Method In Firooz Abadi Hospital.
 
Materials and Methods: This is a descriptive retrospective study conducted in 2018. Data were collected through interview with Hospital officials, direct observation and from existing documents in hospital. Data entry was done through Excel software and analyzed Based on activity-based costing system in eight steps.
 
Results: Based on the Findings of this Study, Four Types of Imaging Services Were Commonly Found In Firooz Abadi Hospital. From Total Radiology Costs, 79.3% Were Estimated to Be Related to Direct Costs and 20.7% to Indirect Costs. Finally, the Cost Per CT Scan Service Was 725,133 Rials, Mammography 608,054 Rials, Radiology 809,165 Rials and Ultrasound Service 512,692 Rials.
 
Conclusion: Results of the Study Indicated that Direct Costs accounted for most Costs in Radiology Unit, So Improving Performance and Policies in Health System, Particularly in Human Resource Management, Service Consumption Standardization and Staff Training Suggested to Cost Reduction.
 

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Background: Estimation of cost functions is an appropriate tool for optimal resource allocation in hospitals. The present study aimed at estimating cost function for hospitals affiliated to Shiraz University of Medical Sciences.
                                    
Materials & Methods: In the current cross-sectional study, inputs, costs and resources data for 28 hospitals were gathered from hospital statistics and information system. Required data were collected monthly for two years (2015-2016). Then, The Cobb-Douglas cost function was estimated using panel data analysis. STATA 14 was used for data analysis.
 
Results: Estimates showed that hospitals' cost elasticity concerning the inpatient and outpatient admission were 0.555 and 0.058 for large hospitals, and 0.769 and 0.099 for small hospitals (P<0.01). Among hospitals inputs, the cost of a physician with coefficient 0.175 in large hospitals and 0.481 in small hospitals (P<0.01) was most cost driver. In studied hospitals, average cost (36,406,480 Rial) was higher than marginal cost (26,548,020). Moreover, scale economies index were in small, large, and all hospitals were 0.868, 0.613 and 0.729, respectively. The number of active bed, length of stay and teaching activity had a positive effect on hospitals cost (P<0.01).
 
Conclusion: According to the findings, to control costs, the hospital should manage most cost drivers, such as physicians and pharmaceutical costs. Moreover, According to the average and final cost and scale economies index, hospitals should expand their service provisions with current inputs and resources in order to reach the optimum point of output.

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Background: The occurrence of all kinds of errors and mistakes imposes many costs on the hospital and society. Whistleblowing and error reporting plays an essential role in preventing and reducing errors, but the rate of error reporting in hospitals is low. This research was conducted in order to investigate the effect of selected individual factors on whistleblowing of hospital employees.

Materials: The research was conducted as a descriptive correlational study. 229 nursing and para clinic staff of a hospital in Tehran were selected by random sampling. A standard questionnaire with 69 items from valid questionnaires of selected factors, including organizational commitment, source of control, moral judgment, altruism, individual's attitude towards whistleblowing and intention to whistleblowing was collected and its validity and reliability were confirmed. The method of data analysis was confirmatory factor analysis and SPSS and Amos software were used as well.

Results: The variables of organizational commitment, altruism and individual's attitude towards whistleblowing have an effect on the intention of whistleblowing, and moral judgment and source of control have no effect on the intention of whistleblowing. Also, individual variables such as age, gender, and work experience did not have a significant effect on the intention to blow the whistle.

Conclusion: Strengthening organizational commitment, altruism of employees and the positive attitude of the individual toward whistle-blowing play an important role in improving error reporting. Hospital management methods can strengthen or weaken these factors. Participatory management style, job empowerment, supporting and creating a safe environment for reporting, promoting employees' ethical and professional principles,  and learning and sharing medical errors are effective measures in promoting whistle-blowing.