Journal of

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Background: Medical tourism is an increasing industry that patients travel to abroad for receiving health care services. The countries which are successful in this industry have global accrediting quality. This research is aimed to access capabilities of selected hospitals in Iran University of Medical Sciences in attracting medical tourists according to JCI patient-oriented standards. 

Materials & Methods: This research is a descriptive, cross-sectional study that carried out in Hasheminejad, Rajaie and Motahhari hospitals. To collect data patient-oriented checklist of JCI standard used. Data analyzed by using descriptive statistic techniques.

Results: The results showed the high rates of consideration is related to medication  manage­­ment and standards used (84/5%), and anesthesia and surgical care standards (80%) that both of them are related to Hashemi­­nejad hospital and also patient and family rights standards (47/5%) are low rates of considerations that are related to Motahhari hospital. Generally, the mean rates of consideration in Hasheminejad (71/8%) are more than Rajaie hospital (67%) and these hospitals are more than Motahhari hospital (62/3%).

Conclusion: Generally, the selected hospitals had rather readiness and possible and appropriate capabilities in attracting medical tourists. Some standards (access to care and continuity of care, patient and family education, assessment of patients, anesthesia and surgical care) were appropriate and some of them were insufficient (patient and family rights, care of patients and patient and family education). According to identify strengths and weaknesses of the hospitals in medical tourism, they could use SWOT analytical model to increase their capabilities.

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Background: The Pabon Lasso graphical Model is a method to determine hospital efficacy as one of the most important part of health system in developing countries. This study aimed  at assessing the efficacy analysis using Pabon Lasso Model and comparing with national standards of educational hospitals affiliate to Qom University of Medical Sciences.

Materials and Methods: This descriptive study conducted in educational hospitals of Qom University of Medical  Sciences in 2011 - 2013. Data collected by approved forms of Health Ministry and three indicators including bed occupancy percentage, bed turnover rate, and average length of Stay were calculated for each hospital using Pabon Lasso model. One sample t-test conducted to data analysis.

Results: The mean of bed occupancy and bed turnover was 76.9±9.8 and 100.6±35.4 respectively which were significantly higher than national standards. In addition, the average length of Stay was 3±1.1 days that were similar to standard. The Highest efficacy calculated for IZ hospital and lowest efficacy observed in KA and NE hospitals. Moreover, ZA Hospital can achieve excellent efficacy in 2013.

Conclusion: The mean of bed occupancy and bed turnover assessed  very desirable  and higher than national standards. Moreover, only IZ and ZA hospitals had excellent efficacy based on Pabon Lasso model. 

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Background: Decision to stop or continue the treatment after awareness about complications and risks is patients' rights. On the other hand, patient`s discharge against medical advice could threaten patients' health. This study aimed to determine the causes of patient`s discharge against medical advice to prevent negative effects on patients and health costs.

Materials and Methods: In this study, 342 patients who left hospitals regarding discharge against medical advice were enrolled. Up to 48 hours of leaving hospital, the patients were received telephone contact, and if consented, were asked about the potential causes and whether or not the explanation of nurses or physician about the risks and side effects of discharge against medical advice. Furthermore, causes of discharge against medical advice were categorized as patient, hospital condition and combined causes.

Results: Study findings revealed that 48.5% of patients with personal reasons, 26% because of dissatisfaction with the service and 25.5% due to a combination of causes left the hospital. Most of the patients were in emergency department (p<0.001). There was relationship between type of disease (p= 0.037) and referred shift of patients (p=0.002) with type of discharge.

Conclusion: Given to the study results, it seems that planning for providing and maintaining human resources, training staff especially new entrance, monitoring medical team performance and organizing the triage system are essential in patient`s discharge against medical advice.

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Background and Aim: The aim of this study was to investigate the income changes resulting from the implementation of this book in the hospitals of the University of Medical Sciences.
Materials & Methods: This cross-sectional study was conducted based on retrospective information related to the first half of 1398 of Shahid Beheshti University of Medical Sciences. Data related to this study were collected from patients' records using hospital information system and hospital intelligent management system of Shahid Beheshti University of Medical Sciences. In order to analyze the data, the average of Rials per service was used for each hospital and type of admission.
Results: The results showed that with the implementation of the book of relative value 2018, the total income of the studied hospitals will increase by 10.67%. In total, the share of total book codes included in the study is 41% of the total, of which 20% is the professional component, 19% is the technical component and 2.4% is anesthesia. After book codes, hoteling with 26% and consumer goods with 14% and medicine with 11% make up the rest.
Conclusion: The approach of the 2018 book is more towards temporary inpatient services and encourages providers not to admit patients to receive services. Also in this book, the proper growth of the technical component of services will occur, which in other words indicates the approach and encouragement of investment in the hospital sector.