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Background: The aim of this study is to explore the safety and diagnostic performance of dual-source CT scan in comparison with single source CT scan and conventional angiography in patients with coronary heart diseases.
Materials and methods: A systematic review was performed using CRD standard methods. The Cochrane Library, MEDLINE, EMBASE، Google Scholar and TRIP were searched up to April 2009. The references of the marked studies and gray literature were also searched.

Results: 17 articles were included. 9 articles reported the safety and 12 articles reported the diagnostic performance of DSCT.  Generally DSCT was a non-invasive and safe procedure.  Using DSCT the exposure of patient to X-ray was less than 64-slice single source CT (SSCT) and more than conventional angiography. For the DSCT the mean sensitivity was 90.4%, mean specificity was 82%, mean PPV was 83% and mean NPV was 96%. For the SSCT the mean sensitivity was 90.4%, mean specificity was 82%, mean PPV was 83% and mean NPV was 96%. The mean sensitivity, specificity, PPV and NPV of DSCT were slightly higher than SSCT.

Conclusion: DSCT is a noninvasive and relatively safe technology. The diagnostic performance of DSCT is higher than SSCT, but its performance is not so much high to be able to substitute the conventional invasive angiography which is still the gold standard test.

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Background: The purpose of this study is to survey the Working Life Quality of specialists working in affiliated hospitals of Tehran University of Medical Sciences.

Materials & Methods: The statistical population of this study includes 400 specialists and a crosssectional Descriptive & analytical method has been used to gain credible results.. Van lar working life quality questionnaire was used to gather the data needed.. The data were analyzed with the SPSS software through T-test and Anova statistical tests. In addition, the simultaneous effect of independent variables in the model was evaluated using the Backward Regression Model.

Results: The average total working life quality of specialists working in affiliated hospitals of Tehran university of medical sciences is estimated to be 48.75 percent. Total working life quality of male specialists is higher than the females and the index is higher in specialists resident in Tehran compared to the other ones but these differences are not significant statistically.. Working life quality of specialists which are satisfied with the facilities in their working places are higher compared to the others and these differences are significant statistically. In addition working life quality has decreased with the increase in the experience.

Conclusion: Working life quality of the Specialists studied is not in a satisfying level, thus more attention and effective plans are needed from responsible authorities in the ministry of health and the managers of the hospitals studied in order to improve specialist`s working life quality.

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Abstract Background: Organizational commitment is an important occupational attitude which demonstrates personnel staffs liability for their organization. This study aimed at assessing the level of nurses’ organizational commitment in selected hospitals of Tehran University of Medical Sciences in 2011. Materials and Methods: In this cross - sectional study, 363 nurses with BS and MS degree who employed in selected hospitals of TUMS were chosen using random sampling method. Data were collected using a 2-section questionnaire including demographic variables and organizational commitment. With the intention of data analysis, descriptive statistics, independent t -test, chi square, Kruskal-Wallis, Mann-Whitney tests were conducted. Significant level assumed at 0.05. Results: Study results confirmed that organizational commitment and its all dimensions (affective, continuous and normative) were in moderate level (65.87± 15.32). The Level of organizational commitment had significant relation to job position (P<0.001), ward type (P<0.001), years of experience (P=0.03), and the hospitals (P=0.004). There was no significant relationship between demographic variables and organizational commitment (P>0.05). Conclusion: Since, None of the demographic variables revealed significant association with organizational commitment and occupational and organizational factors had significant relation with organizational commitment, it seems that personal factors should not be considered as the main criteria of recruiting committed nurses

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Background: One of the key duties of family physician is to form health records and provided recording services. This study conducted to form health records and aevaluate health records in family physician program in Northern Province of Iran.

Materials and Methods: This cross-sectional study was carried out in second half  2011. 139 of centers implementing family physician program in three provinces of Golestan, Mazandaran and Gilan were selected using systematic random sampling, and assessed performance recording of all family physicians. A self- designed questionnaire was used which the validity and reliability of were confirmed. Data were analyzed by SPSS₁₈ at the significant level of p<0.05.

Results: Out of the 189 assessed family physicians, the profile of patients referred to the second level and its results were recorded in referral record forms by 43 physicians. Out of 1890 studied families, 1559 families had health record which had filled 892(57%) health record completely. Out of 5869 assessed family members, 4229 patients were examined periodically by their family physician at least once and 1919(46%) results filled entirely. during 559 were reported with health records, among which 892 were filled out completely. There was a significant difference between referral record rates to registered specialist between the Northern Province of Iran (P=0.001).

Conclusion: The quantity and quality of health record formation was not in the expectation level as well and appropriate interventions are needed. 

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Background: Medical errors and adverse events are the main reasons of many avoidable deaths and imposed expenditures in worldwide health systems. Hence, this study aimed to recognize some challenges, medical errors and adverse events, and to address the appropriate solutions in order to solve them in the Iranian health system.

Materials and Methods: This qualitative study had three main data resources including key informants, national documents and expert panel. Key informants (30 persons) and experts (12 persons) were selected purposefully from macro, meso and micro levels of health system and some other health related organizations. Data were interpreted and analyzed through a mixed (inductive/deductive) thematic framework.

Results: Although, most reasons of medical errors were in relation with weak patient security system and low level security culture in hospitals, other factors like manpower, physical and external agents of hospital environment induced these errors as well. The most considerable solutions to decrease the medical errors comprised identification of medical error reasons in different levels of heath system, errors documentation and generation a consolidated system for recognition and following the errors and their main causes.

Conclusion: Relieveing the reasons of medical errors and adverse events can be a great step to prevent them. In order to eliminate the medical errors and its challenges, it is necessary to develop the consonant programs in national level via conclusive will of organizations, groups and related individuals.

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Background: Administrative violations of employees at their workplace create a conflict between individual and organizational goals. Due to the long process of handling these violations, this study aimed to identify and present some suitable solutions in order to reduce delay in the health sector.
 
Materials and Methods: This study was carried out at three steps. At the first step, causes of delay in handling of administrative violations were extracted along with the proposed solutions using interviews. In second step, Delphi method was applied in order to find out the agreement of experts on the suggested solutions. In third step, practical solutions were prioritized using the analytic hierarchy process.
 
Results: Overall, 23 out of 39 solutions were certified  after consultation with experts running the first round of Delphi using the interview. These solutions were presented to 15 experts using a self-constructed questionnaire and 18 solutions were approved by the experts finally.Solutions were divided into six groups of motivational, organizational, administrative, process, and research group solutions.
 
Conclusion: Training as the main key to prevent the delay can work effectively at all levels and processes of service delivery. Hiring well-informed and conscious managers at various organizational levels as well as having experienced and mindful research group on administrative violations can speed up the process of handling these violations.

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Background: Administrative violations are a person-centered behavior that violates the accepted organizational norms, and thus, can threaten the organization health. Therefore, the present study aimed to identify the causes of prolonging the time of taken to deal with administrative violations were at the staff of Ministry of Health and Medical Education.
 
Materials and Methods: This study was a qualitative content analysis one. For sampling, convenience, purposeful and snowball sampling methods were used. The sample size continued to saturate the interview data with each group of people. Data collection was performed with open questions and interviews using semi-structured interviews. Finally, all interviews were analyzed using MAXQDA software.
 
Results: After implementing and data analysis, the causes for prolonging the time spent on administrative violations in primary and recruiting boards were divided into five main categories including "member characteristics"; "actual proceedings"; "Inevitable factors"; " legal factors "and" organizational factors".
 
Conclusion: According to the findings and experts’ opinions, the most problems in the process of handling administrative violations are related to the time lag in the notification process, investigation and expertise. Membership training, teamwork, and the use of members with different expertise can prevent employees from handling administrative offenses.
 

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Background: Organizational culture is one of the important predictor of organizational effectiveness, and a key factor success of the organization as a competitive advantage. Todays, a continuous assessment of organizational culture status is considered essential; therefore, this study aimed to identify and measure organizational culture of the Ministry of Health and Medical Education.
Materials and Methods: This descriptive-analytical study was conducted on the headquarters of the Ministry of Health and Medical Education in 2018. The study population consisted of all employees of the Ministry of Health and Medical Education (N=2200), 327 personals were selected through Cochran formula and stratified sampling method. The data collection instrument was a researcher-made questionnaire whose validity and reliability were confirmed (Cronbach's alpha =86.5%). In order to data analysis SPSS₂₄ using descriptive and inferential statistics tests were utilized.
Results: The mean score of total organizational culture was 3.30 ± 0.70 from 5 which was higher than the theoretical average. Also, there was also a significant difference in partnership dimension in terms of employment type and in participation dimensions, accountability to the upstream institutions as well as total organizational culture score in terms of deputy. There was a direct statistical association between dimensions of organizational culture.
Conclusion: According to study results, strong organizational culture will lead to improved performance in the organization and alignment of individuals and activities. Given the importance of specific role of culture in each organization, plans success and change strategies, human resources managers should take appropriate actions to improve internal and external communication and increase teamwork and accountability. 
 

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Background: equality in access of health care services is one of the most important goals of Health system .In this study, we provided a description of the distribution of Otorhinolaryngology Head & neck surgery specialists in the Provinces of Iran in 2017.
Materials & Methods: This descriptive-analytical study was conducted in 2017 to describe the distribution of Otorhinolaryngology Head & neck surgery specialists in the Provinces of Iran in 2017. Data were gathered through Ministry of Health and Statistical Center of Iran. Gini Coefficient, Concentration Curve ,Multiple Regression and Geographic Maps used by Microsoft R Version 3-6-0 for data analysis.
Results: The highest and lowest ratio of Otorhinolaryngology Head & neck surgery specialists per population in the year 2017 was reported in Tehran (2.31 per 100,000 populations) and Hormozgan (0.39 per 100,000 populations).
Conclusion: There was a considerable disparity between different regions of the country in terms of access to Otorhinolaryngology specialists.

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Background: Hospital, as the largest and most important health system unit, has the highest costs. Governments cannot finance all of the costs of this sector, so reforms are inevitable. In this regard, researchers have explained the underlying factors in financing policy and its commanding.
Materials & Methods: This study is a descriptive study done by qualitatively and quantitatively method in 2019. The statistical population included experts from the health sector, the capital market, and the Social Security Organization. A purposive sampling method was used. Data collection tools were receipts and a semi-structured questionnaire for interviews. MAXQDA 11 software was used to analyze the interviews, and the Delphi technique was used for validation. Walt Gilson and Kingdon models were used for policy analysis and commanding.
 Results: Underlying factors in policy-making and commanding the financing of hospitals from the capital market are macro-factors (governance and legal, political, social, and economic factors) and micro-factors (stewardship, financing, and technical factors). The financing problem stream of hospitals, the policy flow that includes public-private partnership models, and the political flow that began with sanctions open a window of opportunity to finance hospitals through the capital market.
 Conclusion: Upstream documents and development plans allow the privatization of governmental organizations; therefore, in addition to government budgets and dedicated revenues, hospitals can use private-sector financing strategies. In the meantime, easy and inexpensive financing, transparency, and accountability are the capital market characteristics that introduce it as an appropriate strategy. 

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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.

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Background and purpose: Supplementary health insurance plays a pivotal role in the health economy and individual payments, enhancing access to health services and improving individual quality of life. This study aims to explore the challenges and strategies for developing supplementary health insurance.
Methods: This systematic review examined research related to the challenges and strategies for the development of supplementary health insurance in various countries, focusing on articles published in the last five years in both domestic and international databases. For each article, a data extraction form was completed, and the data were subsequently classified, summarized, and analyzed.
Results: Seventeen articles met the study's inclusion and exclusion criteria and were analyzed. The main challenges and strategies for developing supplementary health insurance were identified across seven primary themes: premium and financing, electronic infrastructure, quality improvement, moral hazards and adverse selection, cost-effectiveness and efficiency, evidence-based decision-making, and effective awareness and advertising.
Conclusion: Considering the numerous identified challenges and barriers in the development of supplementary health insurance, it is recommended to focus on creating electronic infrastructures and necessary platforms to enhance and develop policies in supplementary health insurance, particularly in the dimensions of service packages, cost-effectiveness, and efficiency

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Background and purpose: The Emergency Operations Center (EOC) is a centralized facility designed to coordinate disaster management activities across all phases of the disaster management cycle. EOCs play a vital role in facilitating efficient and effective responses by coordinating information and resources. This study aims to highlight the importance of establishing a standardized framework for EOCs in Iranian universities of medical sciences and to examine its key dimensions.
Methods: This study is a commentary article that compiles information from published literature on the framework of emergency operations centers. It focuses on two prominent global frameworks: the World Health Organization’s Public Health Emergency Operations Center Framework and the U.S. Federal Emergency Management Agency’s Emergency Operations Center Guidelines. The study emphasizes the necessity of creating a standardized framework for emergency operations centers in Iranian universities of medical sciences.
Results: EOCs across different countries vary in terms of their missions, authorities, and resources. Consequently, the frameworks used in these centers are not uniform, and are largely shaped by the governance and regulatory requirements specific to each country.
Conclusion: A standardized framework, tailored to the specific needs and conditions of Iran, is essential for EOCs at universities of medical sciences. Such a framework could enhance the operational capabilities of these centers during incidents and disasters, improving their responsiveness and effectiveness.

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Background and purpose: The healthcare sector is undergoing a profound transformation driven by rapid scientific, economic, and social advancements. The World Health Organization (WHO) emphasizes the necessity of medical equipment and supplies for reducing health disparities and achieving strategic health system objectives. However, there is a notable gap in the literature regarding this cost component within the Iranian health system. This study, therefore, aims to quantify the share of pharmaceutical and medical consumable costs in Iran's total health system expenditure.
Methods: This retrospective, cross-sectional study analyzed outpatient and inpatient medical records from 2018 to 2020. Data on the costs of pharmaceuticals and medical consumables were extracted from Iran's National Health Accounts (NHA) and the SPAS dashboard. The collected data were statistically analyzed to determine the proportional costs of these items relative to total national health expenditure.
Results: Between 2018 and 2020, inpatient pharmaceutical and medical consumable costs constituted 12% of the total health expenditure, demonstrating an annual decrease of 1.8%. In contrast, outpatient costs accounted for 19.5% of the total, with an annual increase of 0.7%. Basic health insurance allocated approximately 10.3% of its budget to cover these items, which corresponds to 31.5% of the nation's total healthcare spending.
Conclusion: The findings highlight the critical need for strategic interventions within Iran's health system. Key implications include the necessity for effective supply chain management, strategic planning to reduce import dependency, and robust mechanisms for monitoring prices. Mitigating the adverse effects of inflation and sanctions is paramount. Furthermore, increasing the healthcare budget's share of the Gross Domestic Product (GDP) and expanding insurance coverage are essential for ensuring financial protection for the population and advancing towards Universal Health Coverage (UHC).

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Background and purpose: The Student Welfare Fund of Iran's Ministry of Health is a public institution tasked with providing financial aid to medical students. Amid growing demand for these services and constrained government resources, a comprehensive analysis of the full cost of loan disbursement is crucial for ensuring operational efficiency and financial sustainability.
Methods: This applied, descriptive study conducted a retrospective cost analysis from the perspective of the Student Welfare Fund. The study population comprised all student loan records processed during the 2024 fiscal year. A hybrid top-down and bottom-up costing methodology was employed to determine the full cost of the loan disbursement process. Data were extracted from the Fund's internal financial records, annual reports, and publicly available price lists for equipment and consumables, and subsequently analyzed using Microsoft Excel.
Results: The full cost per loan processed was lowest for single-student academic and essential-needs loans, at IRR 33,538,137, and highest for housing deposit loans, at IRR 56,743,475. The total cost for all student loans disbursed during the 2024 fiscal year amounted to IRR 124,222,283,295.
Conclusion: Processing times were shortest for academic loans and longest for housing deposit loans. Human resources constituted the largest cost component in the disbursement process. Despite the significant personnel costs, a comparison between the full costs and the service fees collected suggests that the Fund's operational processes and staff performance are acceptably efficient.