Showing 103 results for Pour
Farshid Nasrolah Beigi, Pouran Raeissi, Farbod Ebadifard Azar,
Volume 20, Issue 2 (9-2021)
Abstract
Background and Aim: Burnout is one of the most important factors that reduces the productivity of personnel. Therefore, this study aimed to determine the relationship between human resources management functions and job burnout from the perspective of managers and staff of deputy of Health in Iran University of Medical Sciences.
Materials and Methods: Subjects of this cross-sectional study consisted of 657 managers and staff members of deputy of Health in Iran University of Medical Sciences that 242 individuals were selected according to Morgan's table as the study population. Research data were collected using two questionnaires of burnout and human resources management functions.
Results: 174 (70.7%) participants in the study were women, with mean age and work experience of 41.3 and 15.8 respectively and a standard deviation of 7.35 years. 78.9% of married people and 69.1% of the participants were dissatisfied with the status of their salaries. The dimensions of consequential evaluation, transparent job description and comprehensive training with averages of 4.17, 4.12 and 4.03 out of 7 had the highest score among the various dimensions of human resources functions. Different dimensions of burnout showed that the highest mean was related to feelings of personal inadequacy and depersonalization (4.72). The results of the Pearson correlation test showed that there was a statistically significant relationship between human resources management functions and burnout with a correlation coefficient of -0.439 (P <0.05).
Conclusion: Job burnout can be significantly reduced with the improvement of human resources management functions.
Ali Rezapour, Forough Roodgarnejad, Nima Ranji Jifroudi,
Volume 20, Issue 3 (12-2021)
Abstract
Introduction: Health tourism is one of the most lucrative and competitive industries in the world and is a new field of tourism. The purpose of this study is to present a conceptual model of health tourism development on community welfare.
Materials and Methods: This research is qualitatively exploratory. The study population included university professors and health tourism managers. Fifteen people participated in the study through purposive non-probabilistic sampling and through semi-structured and in-depth interviews. Data analysis was performed with MAXQDA10 software and a grounded theory approach based on three stages of open, axial and selective coding. To check the validity, two methods of participatory feedback and receiving the opinions of colleagues, and to ensure the reliability of the interviews, two methods of retesting and two coders were performed.
Results: The data analysis was based on 100 keywords (open source). By identifying the relationship between the codes, 18 common concepts were categorized. The main concepts were categorized according to the axial coding method. Because traces of medical and health facilities, health tourism infrastructure, and relationship development policies were seen in most of the interviewees' quotes, they were selected as the central sub-categories of health tourism and these three items were placed at the center of the model. And other categories were associated with it.
Conclusion: The development of health tourism is a tool for the development of society and increases investment in the political, social, cultural and economic sectors of society, creates employment, increases income and people's satisfaction and vitality, and promotes the development of welfare, the improvement of the quality of life and wellbeing.
Beheshteh Jebelli, Mohammad Varahram, Mehdi Kazempour-Dizaji, Shirin Esmaeili, Habib Emami, Elham Ghazanchaei,
Volume 20, Issue 4 (12-2021)
Abstract
Introduction: After the increase in the incidence and global spread of Covid-19 virus, medical centers faced a number of problems and challenges following this crisis. In order to increase the quality and safety of medical services and their optimal management, both in critical and non-critical situations, health care providers in different countries of the world have used various methods that increase the organizational commitment to improve quality.
Method: This study is a cross-sectional analytical research. Data were collected through a researcher-made questionnaire based on 903 accreditation standards notified by the Ministry of Health by available sampling method from 326 employees of Masih Daneshvari Center in 2021. Data were analyzed using SPSS software version 22.
Results: The results showed that out of an average of 8 areas related to accreditation standards, participants in the areas of professional ethics and compliance with the recipient of services, infection control, environmental health and waste management mentioned the most compliance in the emergency situation caused by Covid-19 and areas of clinical management and patient safety were ranked next.
Discussion and conclusion: According to the participants, observing the areas of environmental health and waste, service recipients and infection control has been more practical during Corona pandemic. The principles of accreditation seem to be accepted as quality improvement standards and can be an effective guide in preparing medical centers for emergency conditions.
Fatemeh Mohammadkhani Ghiasvand, Masoumeh Abbasabadi Arab, Habibollah Taherpour Kalantari, Hossein Alipour,
Volume 21, Issue 2 (9-2022)
Abstract
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.
Seyed Ahmad Ahmadi, Seyed Mohammad Mahdi Paknejad Rizi, Pouran Raeissi,
Volume 21, Issue 2 (9-2022)
Abstract
Introduction: Health tourism is a new form of tourism industry that aims to maintain recovery and regain physical and mental health and has grown in recent years. Therefore, the present study was conducted to investigate the factors affecting the marketing of health tourism in hospitals affiliated to Iran University of Medical Sciences.
Methods: The present study is descriptive-analytical and was conducted on 270 individuals at some point in 2021. The study population consisted of all heads, managers, matrons, quality managers and heads of international patients of public and private hospitals affiliated to Iran University of Medical Sciences. The data collection tool was a researcher-made questionnaire. Data were analyzed by using SPSS software version 23.
Results: The results of study showed a significant difference between the components of price, place, promotion and people in the two types of hospitals (P-value <0.05). While no significant difference was observed between other components (product, physical evidence and process) (P-value <0.05).
Conclusion: Providing the needs of medical tourists will increase their satisfaction. Therefore, paying attention to the effective factors in marketing and trying to solve the shortcomings of this field can be very effective in attracting health tourists and turning Iran into a medical tourist destination.
Azadeh Sobhkhiz Koozehkanan, Zahra Haji Anzahaei, Farideh Ashrafganjooie, Mohammad Hossein Pourgharib Shahi,
Volume 21, Issue 2 (9-2022)
Abstract
Background and purpose: Today, hospital care, relying on the health record system, has received more attention than before. Considering the diversity of data in these systems, the design of standard conceptual and logical models by service providers will play an important role in their success. Therefore, this research was conducted with the aim of designing a logical data model of the hospital information management system for athletes based on international standards.
Materials and methods: The design of the logical model of the hospital information system for athletes in Iran based on the main entities and components of the system was done after comparing the selected countries, the initial review of the needs of the beneficiaries, the dataset validated by the experts and the validation of the conceptual model, and the diagrams were painted. The meeting was held with the presence of experts to validate the proposed logical model. The proposed amendments were discussed and carried out in the meeting, the collective agreement on the presented logical model and the validity of the model were confirmed.
Results: login activities, password change, examination appointment booking, athlete information registration, examination registration, test results registration, vaccination information registration activity, health reminder registration, and health information registration were determined as the main diagrams of this system.
Conclusion: Based on the findings, it seems that access to sports medicine information is the key point, and a person can see and receive health needs related to him in a patient-centered treatment.
Sorayya Adelpourdehnavi, ُseyedeh Samaneh Miresmaeeli, Aidin Aryankhesal,
Volume 21, Issue 2 (9-2022)
Abstract
Background
Satisfaction with the salary and other payments and the way they are distributed are of the most important and effective dimensions of human resources management. The purpose of this study was to determine the level of employee satisfaction with the performance-based payment plan in 2021 across hospitals.
Materials & Methods
This was a cross-sectional study conducted in 2021 on 280 employees of teaching hospitals affiliated to Iran University of Medical Sciences. Data were collected by a questionnaire and analyzed by non-parametric tests and Spearman correlation in SPSS.
Results
The mean of total satisfaction in the staff was 2.95 ± 0.55 (out of 5). Among the various categories in the field of satisfaction, the highest mean of satisfaction was related to the physical conditions of the workplace with 3.3 ± 0.64 (out of 5) and the least was related to the payment system with 2.56 ± 0/86. The mean performance of all employees was 63.72 ± 8.82. (out of 100). In this regard, the mean score of staff attendance was 74.22 ± 6.97, job type was 30.97 ± 15.78 and the average quality coefficient of performance was 85.98 ± 11.12. According to the Spearman correlation test, there was a significant correlation between mean total satisfaction and attendance score (r = 0.19), job type score (r = 0.32) and performance quality coefficient (r = 0.21) (p-value <0.05).
Conclusion
The mean of employee satisfaction with the performance-based payment scheme was estimated to be moderate. It seems that health policy makers need to work and plan to improve payment and increase the motivation of healthcare staff.
Mehdi Raadabadi, Mohammad Sadeghi, Masoud Saffari, Mohadeseh Karimizadeh, Ezat Dehghan Manshadi, Mehdi Jabinpour, Elham Haji Maghsoudi,
Volume 21, Issue 2 (9-2022)
Abstract
Introduction& Purpose: One of the challenges that organizations face today is the issue of retaining employees in the organization. Meanwhile, addressing the causes of early retirement among health workers is doubly important. The aim of this study was to investigate the causes of early retirement in retirees of Yazd University of Medical Sciences.
Methods: The present descriptive research was conducted to find the causes of early retirement among retirees of staff of Yazd Medical Sciences between 2016 and 2018. Collecting dada was done by examining the personnel file, retirement system and through interviewing people. Data description was done using descriptive statistics and SPSS.21 software.
Results: The average number of years of service lost was 3.7 years. In total, there were more than 528 years of service lost. Regarding job characteristics, the majority of retirees were employed in service and nursing positions (4701%), in hospital (45%) and health centers (42.9%). The study of the causes of early retirement showed that the most common causes of retirement were related to boring work environment (55.7%), physical problems and underlying diseases (40.7%) and lack of support from officials (24.3%).
Conclusion: According to the findings, multilateral support in the organization, promotion of rewards and economic benefits, creating morale in the organization, observing the principles of mental health, reducing anxiety and creating hope and increasing participation of employees in the decision-making process can be effective in reducing early retirement.
Marziyeh Najafi, Morteza Nazari, Hojjat Rahmani, Ghasem Rajabi Vasokolaei, Behrooz Pouragha, Sima Feizolahzadeh, Roya Rajaee,
Volume 21, Issue 4 (1-2023)
Abstract
Background and purpose: One of the main challenges of human resource management in hospitals is the proper distribution of nurses, which is necessary to improve the efficiency and quality of health services. In this review, this rate is compared in selected countries and Iran in order to provide the necessary evidence for managers and policymakers in human resource management
Materials and Methods: This study was conducted as a field review in 2019 with the aim of comparing the standards of nurse distribution to beds/wards in selected studies. The search was conducted with related keywords in "Scopus", "Web of Science", "PubMed" databases without a time limit.
Results: The distribution of nursing per bed was reported in Australia, England, Northern Ireland, Wales, Israel, America, California, Pennsylvania and New Jersey. In Iran, the rate of nurses to intensive beds was slightly higher than the average and the ratio of nurses to ordinary and emergency beds was lower than the average of selected countries average.
Conclusion: Nurses' distribution was generally lower than the average of other countries, and this ratio was lower in some sectors and higher than the average in some sectors. Recruitment and redistribution of the appropriate nurse in different sectors by benchmarking successful countries are suggested.
Moslem Sharifi, Jalal Saeidpour, Mohammad Javad Kabir, Abdollah Poursamad, Mehdi Ebrahimi, Bahman Khosravi,
Volume 22, Issue 1 (5-2023)
Abstract
Background and purpose: With the establishment of a comprehensive health information system (SIB system) in the health department of Iran's health system, one of the important programs of this country to improve health care through the integration of health information was keyed. This study analyzed the performance of this program from the point of view of the end users of the system in the health centers of Boyar Ahmad city.
Materials and Methods: This study was a qualitative research that was conducted using semi-structured interviews and focus group meetings with 25 system users, support officials and staff experts at different levels, reviewing relevant documents and also observing users' performance. The snowball sampling method was carried out in a targeted and networked manner. Qualitative content analysis was used to analyze the data. MAXQDA10 software was used to record, organize and manage study data after collection.
Results: The findings of this study showed that the deployment of this system from the users' point of view contains many positive and negative points, which can be categorized in five general axes, data management system, caregivers' performance, care management, quality of care and infrastructure. The most important challenges of the system included technical inefficiencies, operational inefficiencies, the challenge of statistics and reporting, and technical and social infrastructure, and the most important benefits were improving the quality of care, tracking and reporting, facilitating the care process, and improving the performance of caregivers.
Conclusion: From the point of view of users, the Sib system can be considered as a positive experience in improving the quality of health care, but due to the existence of many challenges, it is far from its final goals
Atefeh Tasht Zar, Malike Beheshtifar, Reza Zare, Amin Nik Pour,
Volume 22, Issue 2 (9-2023)
Abstract
Background and Purpose: The purpose of this study is to validate the model of organizational evolution in hospitals affiliated with the Bushehr University of Medical Sciences.
Materials and Methods: This study was applied in terms of its purpose and quantitative in terms of its implementation method, employing a structural modeling approach. The statistical population in this part of the research included all managers, deputies, and experts in the field of the subject studied in Bushehr hospitals, totaling 130 individuals. A sample size of 100 was determined using Morgan's table and was selected via simple stratified random sampling. The research tool was a researcher-developed questionnaire. The questions and items of the questionnaire were compiled using research literature, theoretical foundations, and the results of a qualitative study. The face and content validity was confirmed by experts, and its reliability was obtained with a Cronbach's alpha method result of 0.976. Data were analyzed using the structural equation modeling method in SMART PLS software. Results: The findings of this research demonstrated that the structural model of organizational evolution has 43 sub-components across six components: causal conditions, background, mediating, central phenomenon, strategies, and outcomes. All variables obtained can be considered in the design of the final model. In conclusion, the effectiveness of each variable was discussed and analyzed from an existential perspective. The results indicated that the causal conditions, background conditions, intervening factors, and outcomes in the model of organizational evolution in hospitals affiliated with Bushehr University of Medical Sciences were significant.
Conclusion: The results showed that the model of organizational evolution in hospitals affiliated with Bushehr University of Medical Sciences is valid.
Behrooz Rahimi, Seyed Mahdi Jalali, Hamed Nazarpour Kashani,
Volume 22, Issue 2 (9-2023)
Abstract
Introduction: Equitable geographical distribution of healthcare system initiatives, aimed at increasing quality and economic efficiency, is a crucial aspect of ensuring access to healthcare services. This study seeks to elucidate the contextual, procedural, and outcome factors of health marketing in Iran, with a focus on enhancing and improving health services.
Methods: This research was conducted using a qualitative approach. The sampling method employed was purposive, resulting in the participation of 51 experts. The study data were analyzed using content analysis.
Findings: The findings of this study have been categorized into conceptual subgroups, including causal conditions, foundational components, strategies, contextual factors, intervening factors, and consequences of implementation.
Conclusion: Adopting an effective health marketing model can create opportunities for service providers to generate sufficient income, thereby motivating them to deliver high-quality services. Attracting ample income, in addition to ensuring service quality for recipients, will also lead to their satisfaction with the healthcare system and contribute to the continuous provision of desirable services.
Javad Pourgholam Sarivi, Fatemeh Rahmaty, Maryam Yaghoubi,
Volume 22, Issue 2 (9-2023)
Abstract
Introduction : The Internet of Things (IoT) enables the connectivity of all devices in our daily lives, and it has had a positive impact on healthcare, specifically in disease diagnosis and prevention, especially during times of crisis. The objective of this research is to identify the factors that influence the use of IoT in combating COVID-19 in hospitals.
Materials and Methods: This qualitative study was conducted in 2023, using semi-structured face-to-face and telephone interviews with ten experts in health information technology and the Internet of Things. Data analysis was conducted using directed content analysis with MAXQDA software, version 2018.
Results: The data analysis resulted in 124 codes, which were then divided into 32 subcategories. These subcategories were further classified into six categories according to the model of the International Telecommunication Union. The categories include Network (five subcategories), Application (ten subcategories), Equipment (four subcategories), Support (three subcategories), Management (six subcategories), and Security (four subcategories). The Application category had the highest frequency, while the Support category had the lowest.
Conclusion: Infrastructure and legal aspects are among the most significant factors in the implementation of the Internet of Things in healthcare, particularly in the fight against COVID-19.
Ebrahim Hasanzadeh, Hasan Aboulghasem Gorji, Aziz Rezapour, Mani Yousef Vand,
Volume 22, Issue 2 (9-2023)
Abstract
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
Mehran Lak, Farnaz Vosough, Kianoush Saberi, Shahnaz Sharifi, Hadi Pashapour,
Volume 22, Issue 4 (1-2024)
Abstract
Background and Purpose: Infections related to inadequate healthcare practices can have adverse effects on healthcare systems. This study aims to identify the gap between the current handwashing practices and standard levels by determining the frequency of handwashing among staff at Shahid Modares Hospital in Tehran.
Methods: This descriptive cross-sectional study was conducted in the wards of Shahid Modares Hospital between 2018 and 2019. The tool comprised two parts: job information and hand hygiene practices at different times and specific actions. Observers directly monitored all staff in each shift using a headcount method. Each column represented the hand hygiene compliance score of a specific professional group, allowing simultaneous performance evaluation.
Results: Out of 640 observed instances, 202 involved the use of disinfectants, 255 involved handwashing, 111 involved glove use, and in 71 instances, hand hygiene was not observed. The highest compliance occurred when staff intended to contact the patient's body, while the lowest compliance was observed after performing surgery on the patient.
Conclusion: Given the significant role of nurses in therapeutic interventions, multifaceted training interventions, the drafting of hand hygiene policies, and increasing awareness among department officials should prioritize this group of employees. These measures aim to bring practices closer to desired standards and prevent unwanted consequences.
Asgar Aghaei Hashjin, Ali Nemati, Seyed Mohammad Tabatabaee Jabali, Pouria Farrokhi,
Volume 22, Issue 4 (1-2024)
Abstract
Background and purpose: Iran is ranked among the top ten nations in the world for hosting a large number of migrants and refugees. During the COVID-19 outbreak, refugees and migrants were among the most vulnerable groups. This study aimed to investigate the extent of healthcare service utilization by refugees and migrants during the COVID-19 pandemic in healthcare centers affiliated with Iran University of Medical Sciences
Methods: This quasi-experimental study was conducted in 2021 in Tehran. The research environment included all healthcare networks and general and specialized hospitals. Data were collected through document review and registered information in the Sina system. All provided services were categorized into four groups: primary care, outpatient, emergency, and inpatient services. Data analysis was performed using the Chow test and Interrupted Time Series model with the Wats and Sctest software packages in R version 4.3.0.
Results: The decrease in utilization of outpatient, emergency, and inpatient services by refugees and migrants was significant (P-value < 0.001), whereas the decrease in primary care services was not significant. Additionally, after the onset of COVID-19, only the utilization of inpatient services showed a significant increasing trend (P-value < 0.013).
Conclusion: During the COVID-19 pandemic, the utilization of all healthcare services by refugees and migrants, including primary, outpatient, emergency, and inpatient care, decreased. It is recommended to provide complete insurance coverage for refugees, offer free treatment for impoverished refugees, increase awareness among refugees to encourage greater use of health services, reduce existing social and economic barriers, and facilitate interaction between healthcare providers and refugees.
Mehrak Pourmotahari, Soad Mahfoozpour, Shahram Tofighi, Shaghayegh Vahdat, Irvan Masoudi Asl,
Volume 22, Issue 4 (1-2024)
Abstract
Background and purpose: As health resources face increasing constraints, the use of medical imaging services has risen significantly. On average, diagnostic services account for approximately 10% of total healthcare expenditures, and this figure is steadily increasing. This study aims to identify the causes of irrational utilization of medical imaging services and propose corrective measures.
Methods: This descriptive-survey research was conducted in two phases. In the first phase, a comprehensive literature review was performed using both international and national databases, covering the period from 1990 to November 2021. Relevant studies were identified using specific keywords. In the second phase, a semi-structured questionnaire was developed, and a series of in-depth interviews with experts and professionals were conducted. Data were analyzed using the six-step thematic approach by Braun and Clarke, utilizing MAXQDA software.
Results: A total of 605 studies were initially identified, of which seven met the inclusion criteria after rigorous screening. In the second phase, 12 in-depth interviews were conducted, yielding 65 codes, which were organized into 12 themes. The identified themes included legal issues, conflict of interest, monitoring challenges, poor governance and stewardship, inappropriate policymaking and planning, financial incentives, inadequate service provision infrastructure, health culture, education and continuous training systems, financing and purchasing services, political factors, and inadequate insurance systems. Various strategies for controlling the inappropriate use of diagnostic and therapeutic services were proposed, including policy interventions, monitoring and evaluation, and training.
Conclusion: The irrational use of healthcare services is a significant challenge in many countries. Key contributing factors include incomplete insurance coverage, out-of-pocket payments by patients, defensive medical practices, and gaps in knowledge. Addressing these issues requires targeted interventions and reforms.
Seyed Rahim Safavi Mirmahalleh, Mohammad Rahim Ramazanian, Mahmoud Moradi, Mostafa Ebrahimpour Azbari,
Volume 22, Issue 4 (1-2024)
Abstract
Background and Purpose: Health status is undeniably one of the most critical indicators of social development and progress. Providing healthcare poses a significant challenge for human life, and managing the healthcare supply chain is of strategic importance. The aim of this research is to analyze and compare the results of meta-synthesis with thematic analysis in identifying the risks of the pharmaceutical industry's supply chain.
Methods: This research follows a qualitative approach, utilizing both meta-synthesis and thematic analysis to identify supply chain risks in the pharmaceutical industry. In the first step, a meta-synthesis and systematic review of related studies over the past twenty-three years were conducted, identifying one hundred articles, which were refined to twenty-six key articles for the research. In the next step, risks specific to Iran's pharmaceutical supply chain were identified through thematic analysis and semi-structured interviews with experts, using targeted sampling. Finally, the results from these two approaches were compared and analyzed.
Results: The meta-synthesis approach identified ten general supply chain risks in the global pharmaceutical industry. Similarly, the thematic analysis approach identified ten specific supply chain risks in Iran's pharmaceutical industry. Six risks were common to both approaches: low quality of raw materials, complexity and incompatibility of information systems, supply of foreign currency and financial payments, transportation and insurance issues, increase in the price of raw materials, and unavailability of medicines. These common risks are critical for both the global and Iranian pharmaceutical supply chains.
Conclusion: Stakeholders in Iran's pharmaceutical supply chain (including hospitals) should prioritize managing these six common risks to improve supply chain performance. Additionally, they should focus on the four unique risks identified through thematic analysis specific to Iran's pharmaceutical supply chain, applying appropriate control measures and activities.
Leila Vali, Hojat Farehmandnia, Ahmadreza Mohammadpour,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose:
As people age, physical dysfunction often increases, leading to various challenges and a heightened need for urgent medical services. Elderly individuals are among the primary users of healthcare and pre-hospital emergency services. Their subjective experiences during emergencies are influenced by their need for timely and relevant information regarding emergency procedures and their clinical condition—a need that is also shared by their caregivers. This study aims to elucidate the experiences of elderly individuals who have used pre-hospital emergency services in Shiraz.
Methods:
This qualitative study was conducted in two phases. In Phase 1, semi-structured interviews were conducted with 21 elderly participants using purposeful and snowball sampling until data saturation was achieved. The interview transcripts were analyzed using Colaizzi’s method to extract key themes. In Phase 2, a panel of experts was convened to further discuss the findings and provide recommendations.
Results:
Analysis of the interviews revealed several themes related to the elderly’s experiences with pre-hospital emergency services. These themes were categorized into sub-themes including ambulance condition, performance of technicians, timeliness of emergency response, and issues related to emergency rules and regulations. In Phase 2, the expert panel offered practical solutions to address the identified challenges.
Conclusion:
The findings indicate that elderly patients face significant challenges when accessing pre-hospital emergency services, such as poor ambulance conditions, suboptimal technician performance, delayed emergency response times, and restrictive emergency protocols. The recommendations provided by the expert panel could inform policy development and lead to improvements in the quality of pre-hospital care for the elderly.
Amirhossein Abdolalipour, Masoumeh Mikailiy, Khadijeh Alizadeh,
Volume 23, Issue 4 (2-2025)
Abstract
Background and purpose: This study proposes an integrated model to explore the mediating role of financial performance in the relationship between quality indicators, learning and growth, and the overall performance of hospital facility management services.
Methods: The statistical population included hospital managers across West Azerbaijan Province, Iran. Based on Cochran’s formula, 147 participants were selected using a simple random sampling method. Data were analyzed using Structural Equation Modeling (SEM) via SmartPLS software. Standardized factor loadings were used to assess model fit, and the Z-test was applied to evaluate the statistical significance of the relationships. Predictive power was assessed using the adjusted R² and Stone-Geisser Q² criteria.
Results: The indirect effects of quality indicators (t = 2.41), learning and growth indicators (t = 2.20), and internal process indicators (t = 2.39) on hospital service performance—mediated by financial performance—were all statistically significant (t > 1.96). Standardized path coefficients of 0.201, 0.344, 0.359, and 0.805 further confirmed the model's empirical robustness and goodness of fit.
Conclusion :The findings suggest that improvements in internal processes, service quality, and organizational learning and growth significantly enhance financial performance, which in turn improves the effectiveness of hospital facility management services. These enhancements contribute to increased patient satisfaction, strengthened hospital reputation, reduced operational costs, and ultimately improved revenue and financial efficiency.
