Journal of

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Background: Given the importance of quality in health care and meeting the needs of patients, it seems important to measure the quality of services and identify the weaknesses from the patients' perspective. The purpose of this study is to assess the service quality (SQ) of care as perceived by people with Type 2 Diabetes (T2D). Materials & Methods: A cross-sectional study was conducted among 180 people with Type 2 diabetes in diabetes clinic using convenience sampling method in Tabriz, Iran in 2012. Service quality was calculated using: SQ=10 – (Importance ×Performance) based on importance and performance of non-health aspects from the patients' perspective. Validity and reliability of questionnaire was reviewed and confirmed. Independent sample T-test and ANOVA were used to investigate relationship between service quality and categorical variables. Data analyzed bySPSS13 software. Results: The average service quality score was 8.17 of 10. From the participants' perspective, of 12 aspects of service quality, communication and prevention had the highest score for importance. Dignity had the highest score for performance. However, the highest service quality values were for continuity of care, dignity and confidentiality. Conclusion: overall service quality achieved inadequate quality and there is an opportunity to improve quality of care.

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Background: Medication administration is an important part of care process. Correct medication administration and its accordance with standards are essential concerning the significant effects on patients’ health. Hence, this study was designed and carried out to determine Medication administration process using “clinical audit”.

Materials and Methods: This study was a cross-sectional one which carried out with “clinical audit” in a hospital of Tabriz city in 2014. This audit conducted in six steps as followed: 1) selecting topic of clinical audit, 2) determining the criteria and standards, 3) assessment of current status, 4) comparing current situation with standards( Standards of Ministry of Health, Medication safety handbook, medication administration curriculum and NHS guideline in medication management), 5) designing and implementing intervention and 6) re-audit. In order to organize process evaluation, a valid instrument used via observation and checklist.

Results: Results of this audit study revealed that 11 out of 25 assessed steps had very low accordance with standards (less than 15%) and the average accordance of total process was 47 percent before intervention. However, the average of standard adherence rate increased to 78 percent after intervention implementation.

Conclusions: The results indicated the effectiveness of educational intervention programs in using kardex instead of medication card on improving medication administration process generally. In spite of the occurred improvement, it is necessary to have an ongoing assessment and intervention in order to quality improvement. 

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Background: Lack of financial resources or their poor organization is one of the service delivery challenges and Fraction of dedicated revenues is significant problem in health centers in financial resources management. Hence, this study conducted to investigate causes of dedicated revenue's fraction and strategies to reduce them.

Materials and Methods: This qualitative study was carried out based on phenomenology approach in East Azerbaijan Province in 2014. Data collection methods were Focus Group Discussion (FGD) and semi-structure interview guide based which continued to saturation. their participants were selected using purposeful sampling method. Data were analyzed using content analysis method.

Results: Based on participants' experiences, six themes were extracted for causes of fraction and strategies to reduce them. These themes included causes and strategies related to fractions per capita, insurance fractions, fractions related to sending documents, registration fractions, clients' deductions and fractions related to incomplete deposit of cash incomes. In general, eighteen causes and twenty three strategies were identified in dedicated revenues fractions.  

                                                                                                                    

Conclusion: The causes of fractions were related to all stages of changing service process to revenue and insurance obligations in health care centers and strategies and identified interventions emphasize on mentioned fields. 

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Background: The hospitals' reliance on insurer organizations' resources is increasing due to the growing number of insured persons. However, a relatively large share of these revenues cannot be collected for various reasons and is considered as hospital deductions from revenue. Hence, this study aimed to investigate the causes of hospital deductions from revenue and strategies to reduce them in hospitals affiliated to Iran University of Medical Sciences.
Materials and Methods: This qualitative study was conducted based on the phenomenological approach in 2017. Data was collected through semi-structured interviews consisting 17 finance experts in hospitals. Data analysis was performed using MAXQDA version10 and analytical framework of Gale et al. (2013).
Results: Based on the framework analysis, two themes were identified as the underlying causes of hospital revenue deduction including direct causes and root causes of revenue deduction. Also, in order to reduce revenue deduction strategies, eight themes were recognized including interaction with insurance organizations;  analysis, assessment, and feedback on revenue deficit; coordination and empowerment of employees; proper organization of human resources; strengthening regulatory system, motivational strategies; good planning  and creating an organizational structure.
Conclusion: The revenue deductions occur in all stages of converting services into income and the most important factor is lack of staff awareness and incentive to control deductions. Contributions of all process owners in the hospital and insurers and in particular the commitment of hospital’s senior managers are necessary to control the deductions.