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S.h Rahimi, M Masoumpour, E Kharazmi, Z Kavousi,
Volume 12, Issue 3 (12-2013)
Abstract
Abstract
Background: Hospital Emergency ward plays a pivotal role in hospital and health care system regarding necessity of immediate,qualicative and effective performance due to numerous and complicated processes happens in the emergency ward. QFD is one of the most effective methods used for designing and improving the quality in order to fulfill customers' expectations and improve their satisfaction from provided service.
Materials & Methods: This study is aimed to investigate following subjects : 1)identifying the customers' expectations (n=80) and service`s components (n=15) through interviews, 2) defining the relationship between patients' expectations and the service`s components, and also relationship between the service`s component themselves 3) designing the service quality model based on the house of quality diagram”
Results: After identifying 13 components of customers' expectations and 20 components of service, 9 components of service were prioritized as parts of service quality model in 3 levels: 1) Physician's office physical environment
2) Improving Nursing performance`s and hospital hotel`s service facilities ,equipping inpatient` room, physician`s room and triage space 3) Improving guide systems, providing adequate welfare for the patients' families, and facilitating the waiting room.
Conclusion: The current quality model designed in this study can be a general guide to improve the quality of services provided by the emergency ward. However, using this model has its limitations such as being complex and time-consuming.
Key words: QFD, House of Quality, Services of Emergency Ward
R Ravangard, V Keshtkaran, Sh Niknam, A R Yusefi, A R Heidari,
Volume 12, Issue 3 (12-2013)
Abstract
Abstract
Background: Hospital managers' decision-making styles indicate the usual pattern managers use to make their decisions. This paper is aimed to determine the variety of managers' decision-making styles` in public and private hospitals in Shiraz.
Materials & Methods: In this cross-sectional study, 106 administrative, financial, internal and nursing managers were selected from 28 public and private hospitals through census sampling technique to participate in this study. The data were collected by a 22-item questionnaire (α = 0.86) and analyzed using T-Test and ANOVA in significance level of 0.05.
Results: Studied managers used rational decision-making style more often than avoidance of decision-making style. Older and official managers and private hospital managers used the intuitive decision-making style more often.Managers who had not attended management training courses used the intuitive and dependent decision-making styles more often. Managers who were teaching in the fields of nursing and midwifery used rational decision-making patterns more often.
Conclusion: It seems necessary to provide sufficient ground for scientific and evidence-based decision making for all hospital managers. Therefore identifying present obstacles and providing an environment in which managers could improve their decision-making skills is recommended.
F Azadi, M R Maleki, M Azmal,
Volume 12, Issue 3 (12-2013)
Abstract
Abstract
Background: Medical tourism industry as one of the tourism dimensions results in a sustainable development and dynamic economy in countries. This study was conducted to examine performance of Tehran’s selected public and private hospitals in attracting medical tourists from foreign costumers’ points of view.
Materials & Methods: This cross - sectional study was conducted in Tehran’s selected public and private hospitals in 2011. The study population included 79 foreign patients who referred to four hospitals in Tehran as medical tourists. Data were collected using a self-made questionnaire which consisted of 23 questions which evaluated eight hospital performance components in attracting medical tourists. Descriptive and analytic statistics was used for data analysis.
Results: Overall, the hospitals` performances were evaluated to be in an appropriate level. Through Patients` viewpoint, three components including staff number, staff performance quality and staff`s up to date knowledge and skills were in a proper level. Moreover, Staff’s acquaintance with foreign languages and giving proper notifications were reported to be in a very poor level. There was a significant relationship between all of the performance components in attracting medical tourists and hospital ownership excluding staff’s acquaintance with foreign languages and their familiarity with the facilities.
Conclusion: Teaching international languages to key staffs and empowering their communication skills can be effective in attracting medical tourists. Considering this, both public and private hospitals must have a serious plan to achieve this goal.
A A Nasiripour, P Raeissi, N Yazdani,
Volume 12, Issue 3 (12-2013)
Abstract
Abstract
Background: Several factors have an impact on hospitals` crisis preparedness including the status of “internal factor ”. This study is aimed to investigate the relationship between the status of hospitals `internal factors and their level of preparedness in crisis.
Materials and Methods: This correlative, applied, and cross-sectional study was conducted in 12 hospitals of Kurdistan University of Medical Science in 2008. The data were collected using the standard Weisbord questionnaire and hospital preparedness checklist to measure the status of internal factors and the hospitals` level of crisis preparedness ,respectively. The data were analyzed using descriptive and analytical statistical methods.
Results: Changing internal factors would result in 74% of the changes in level of hospital preparedness in crisis in all studied hospitals . The preparedness level and the organizational structure of the hospital had strongest relationship and preparedness level and personnel’s attitude to changes had the weakest respectively .
Conclusions: Hospitals should analyze their internal factors status in order to improve their preparedness level in crisis. Concentrating on different aspects of internal factors, reviewing objectives, improving increasing teamwork, involving personnel in decision-making, using performance-based rewards, forming communication committee, improving leadership styles, training organization `s managers and leaders, and facilitating internal and external coordination could be effective .
H Jabbari Beirami, A Jannati, Y Mousazadeh,
Volume 12, Issue 3 (12-2013)
Abstract
Abstract
Background: Hospitals are the most important health organization and consume major part of health system`s budgets. Downsizing is one of the strategies used for providing suitable services in hospitals. This study was conducted to do a systematic search for hospital downsizing methods and theirs consequences in order to choose suitable method for Iran.
Materials & Methods: Related Articles were identified by systematic search on databases such as Medlib, SID, Pub Med, Science Direct and Google Scholar meta search engine using keywords like Downsizing, Hospital Downsizing, Hospital Rightsizing, Hospital Restructuring, Staff Downsizing, Hospital Merger, Hospital Reorganization and Persian equivalents. 379 articles were extracted and refined step by step. Finally, 25 articles were selected according to study`s goals.
Results: The identified downsizing methods included reducing the number of employees and hospital beds, outsourcing, merging hospital wards and combination of fore mentioned methods. The most important consequences of using these methods were: cost, revenue, outpatient visits and surgery, length of stay and hospital admission rates, mortality rate, stakeholder satisfaction, workload of employees mental health and absenteeism .
Conclusion: study results indicated that different methods of downsizing are used for providing suitable services and decreasing costs in hospitals. Using Merger and outsourcing are suggested among different methods in hospital wards according to current situation of our country.
J.s Tabrizi , K Gholipour , R Alipour , M Farahbakhsh , M Asghari-Jafarabadi, M Haghaei ,
Volume 12, Issue 4 (3-2014)
Abstract
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.
E Zeraatkar , H Rahmani , M Ghazi Asgar , J Saeid Pour , S Azami , A Aryankhesal , M Pakdaman ,
Volume 12, Issue 4 (3-2014)
Abstract
Background: Hospital waste is one of the environmental problems .Ignoring the proper management of these wastes can lead to outbreak of diseases and epidemics which threat the public health and rise high costs as a result. This study is aimed to assess the level of staff awareness and hospital performance concerning waste management in selected hospitals of Tehran University of Medical Sciences in 2010.
Materials & Methods: This is a descriptive-analytical study. The data were collected by distributing a multipartite Likert scale questionnaire among 351 individuals which had been used to measure hospital awareness and performance. The collected data were analyzed by SPSS software. Among Descriptive tests Chi-Square test was used to determine the correlation of qualitative variables and Pearson correlation coefficient was used for quantitative variables. The significance level was considered at 0.05.
Results: Significant differences had been seen among different professions` level of awareness .There were no significant difference among different hospitals ` average awareness level although there were significant statistical differences among each hospital`s performance level (p ≤ 0.001).
Conclusion: Due to relatively poor status of hospital`s waste management and hospital staff `s performance , better planning for proper management and wastes `excretion is needed to achieve sustainable development, public health protection and the environmental preservation. Staff Training and their performance monitoring and improving is one of the most important factors of hospital waste management plan success.
M Mehrolhasani , V Yazdi Feyzabadi , T Barfeh Shahrbabak ,
Volume 12, Issue 4 (3-2014)
Abstract
Background: A method of performance assessment is required to improve Productivity and reduce hospital costs . Pabon Lasso diagram is known as a tool for performance assessment. The current study is aimed to assess and compare Kerman province`s hospitals performance by using Pabon Lasso diagram.
Materials & Methods: This descriptive and cross-sectional study was conducted retrospectively between 2008 and 2010. All hospitals of Kerman province in three groups of public, social security and private were selected by census method (N=23). The data were gathered from statistics unit and entered into SPSS 18.0. Three indicators include bed occupancy rate, bed turnover and average of length of stay were calculated and then hospitals` performance were analyzed by Pabon Lasso diagram.
Results: In first two years, seven and eight hospitals out of twenty-three and in third year nine hospitals out of twenty-two located in third zone of the model (desired productivity) respectively. Among all hospitals, regarding number and ownership type, social security hospitals had better performance in 2008. Additionally Public hospitals had better performance than others in 2009 and 2010,.
Conclusion: Public hospitals had better performance.Although studied hospitals` performance experienced growing trend, only one third of the them had desired performance. It can be caused by changing the provided services type from inpatient to outpatient services.It seems that Considering type of ownership and assessing past trend of 3 studied indicators concurrently is necessary for Planning for development of a broader range of inpatient services and diversified medical services based on province`s need.
L Vali , M ,amini Zade, T Sharifi , N Oroomiei , S Mirzaee , R Ghorbani Nia ,
Volume 13, Issue 2 (8-2014)
Abstract
Abstract
Background: EMS technicians are faced with numerous stressful situations during a working day. These mental tensions may significantly effect on delivered services quality actually. This situation can be considered as a threaten risk for people who use the EMS. This study aimed to determine the most common stressful factors influencing the EMS technicians in Kerman.
Materials Methods: In this cross-sectional study 140 EMS technicians participated. Sampling method was census and data collection was done by using a valid and reliable nursing tension factors questionnaire. Data analyzing was performed by SPSS software version 19 using Pearson correlation coefficient, Spearman and regression tests.
Results: The most and least common stressful factors were patient care (Mean=3.24) and environmental tension (Mean=2.64) respectively. Regression analysis revealed significant relation between age and environment tension factors (β = -0.155, p=0.034,) and managerial stressful factors had significant relation with gender (β= -2.955, p= 0.047) and educational level of EMS technicians (β= -0.23,p=0.05).
Conclusion: Patient care and personal factors cause stressful situations among EMS technicians. Therefore, it is recommended emergency managers to provide strategies toward decreasing job stress in order to improve the quality of working life and organizational commitment to help EMS technicians.
A Outofi , E Kharazmi , A Yousefi , A Heidari ,
Volume 13, Issue 2 (8-2014)
Abstract
Background: Managers can provide manpower motivations activity contexts and real efficiency through identifying and anticipating according to organizational goals. Since, today’s working motivations have not been realized in hospitals, this study aimed at determining and comparing the importance of hygiene-motivational factors in both Kosar and Faghihi hospitals in Shiraz.
Materials and Methods: In this cross-sectional survey, study populations included all staffs of Kosar and Faghihi hospitals in Shiraz. One hundred fifty selected by stratified randomly sampling participated in the study.The study questionnaire was designed based on Herzberg theory. Questionnaire validity proved by available experts and Cronbach alpha calculated 0.95. Statistical analysis was done using SPSS software and independent t-test.
Results:The most important hygiene factors were "job security" and "supervision" and the most significant motivational factors were "success" and "appreciation". Hygiene factors are more important than motivational ones in both hospitals. Hygiene and motivational factors had more mean score in Kosar hospital compare to Faghihi hospital.
Conclusion: In the Kosar charity hospital hygiene-motivational factors were significant more than faghihi governmental hospital from the staff viewpoints. Hence, the directors of the hospitals should organize appropriate incentive actions owing to differences in terms of ownership toward quality improvement and efficiency of hospitals.
Sakineh Alizadeh, Mohammad Reza Maleki, Rahim Khodayari Zarnaq , Sajad * . Darzi Ramandi , Ahmad Sadeqi,
Volume 13, Issue 3 (12-2014)
Abstract
Background: Strategy is one of the important factors affecting the organizational structure. Taking the relationship between these two mentioned factors into consideration is essential. This study surveys the relationship between organizational structure and strategies of public and private hospitals in Tehran.
Materials & Methods: This study is a descriptive and analytical study of 20 selected public and private hospitals conducted in Tehran in the year 2012. The statistical population included supreme hospitals managers .We did a complete count because the sample size was small(60 managers). Research instrument was Miles and Snow strategy and Robbins's organizational structure questionnaire. A panel of experts were used for validity of questionnaires while the estimation of their reliability was calculated by Cronbach`s Alpha which was 0.75. The data analysis was conducted with descriptive statistics and Spearman correlation test.
Results: Among the structural dimensions, “centralization” was between was 85% and 75%, “formality” was 92% and 88% and “complexity” was 81% and 100% public and private hospitals respectively. Dominant strategy for both groups of hospitals was analytic. Correlation coefficient between strategy and organizational structure in public hospitals was -0.2 and in private hospitals was +0.3 which showed that relationship was not significant.
Conclusion: There was not a significant relationship between dimensions of organizational structure and the dominant strategy (analytical strategy) in public and private hospitals. If these hospitals tend to follow analytical strategies, they should reduce their complexity. Moreover, centralization could be towards analytical strategies if there is a strict control on current activities and little on new ones.
Faramarz Pourasghar, Jafarsadegh Tabrizi, Nesa Kavakebi, Ahad Banagozar Mohammadi,
Volume 14, Issue 3 (9-2015)
Abstract
Background: Patient transfer requires the wide variety of functions such as collaboration, appropriate communication and coordination between hospitals and the Center for Treatment Guidance and Information (CTGI). This study aimed at determining the influencing factors in the coordination of patient transfer and also explaining the situation of the CTGI in patient transfer process coordination.
Materials and Methods: This study was a qualitative study (phenomenology) conducted using three Focus Group Discussions (FGD) and thirty interviews with participants who were involved in the process of patient transfer in a referring hospital, six patient receiver hospitals and CTGI in Tabriz. Purposive sampling was used to select study participants. Data was analyzed using content analysis.
Results: The effective factors of the patient transfer coordination were categorized in four main themes including weakness in the exchange of clinical information, data constraints, legal protections weakness and guidelines implementation and lack of clinical empowerment in managing patient. Eighteen sub-themes were identified which include legal protections weakness and guidelines implementation in center for treatment guidance as sector problems.
Conclusion: There are some problems in coordination of patient transfer process which is relate to non adherence a specific procedure for admission , ineffective interactions and information exchange. In order to achieve uninterrupted medical treatment, the patient transfer coordination should be improved. The center for treatment guidance and information should be obtained its position as a supervising authority.
, , , , , ,
Volume 14, Issue 4 (1-2016)
Abstract
Background: Emergency response of hospitals to deal with disasters is essential to success in providing qualified emergency services. The aim of current study was to evaluate emergency response of hospitals in Karaj against disasters.
Materials and Methods: This study was a cross sectional one which performed among 13 Karaj hospitals in 2013. To collect data, emergency response Checklist WHO (2011) was utilized with 90 questions prepared in 9 domains (Command and control, Communication, Safety and security, Triage, Surge capacity, Continuity of essential services, Human resources, Logistics and supply management and Post-disaster recovery). Data analysis carried out using SPSS version 20 with descriptive tests.
Results: mean score of emergency response was 44.17%. The most and the worst dimensions were hospital triage 70.30% and accident reconstruction after the emergency 24.84% respectively.
Conclusions: Based on WHO checklist, only 44.17% of studied hospitals were able to respond disaster events. Planning and providing a systematic framework to deal with disasters is a necessity, and the major role of hospitals should not be ignored in providing services considering its priority in plans and budgets in disasters conditions.
Leila Doshmangir, Fereshteh Torabi, Hamid Ravaghi, Ali Akbari Sari, Hakimeh Mostafavi,
Volume 15, Issue 1 (6-2016)
Abstract
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.
Jafar Sadegh Tabrizi, Saeedeh Alidoost, Golshan Asghari,
Volume 15, Issue 1 (6-2016)
Abstract
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.
Maryam Zarghani, Nematollah Shomoosi, Nilofar Mohaghegh, Maryam Haseli, Fatemeh Jahanjooabd, Eman Tahmtan,
Volume 15, Issue 1 (6-2016)
Abstract
Background: Nowadays, it is essential to employ medical and clinical librarians to provide the required information for healthcare professionals and enhance accessibility to evidence based information in hospital libraries. Thus, this study aimed at assessing the medical librarians' employment status in hospital libraries in Tehran city in 2013.
Materials and Methods: This was a descriptive and cross-sectional study. Study population considered from all 152 hospitals in Tehran city. Data collected using a questionnaire and analyzed by SPSS version 18 using descriptive statistics.
Results: only thirteen participants had medical librarianship and information science degree. While 28 persons graduated in librarianship and information science from universities affiliated to Ministry of Science, Research and Technology and others had degree in non relevant fields. The majority of participants (51.3 %) with non-related degree were educated empirically and others had learned librarianship skills with other methods. Most of participants were employed based on hiring official process and friends and relatives recommendation.
Conclusions: There is a real lack of medical librarians in the hospital libraries in Tehran city. Thus, these libraries are not able to perform their professional duties such preparing information and omitting healthcare professionals' needs in hospitals. It is necessary that hospitals’ managers attempt to hire medical librarians' and overcome employment barriers.
Zahra Maebood Mojdehi, Amir Ashkan Nasirirour, Pouran Raeissi,
Volume 15, Issue 2 (6-2016)
Abstract
Background: Medical centers and hospitals need to expand internet, Application Service Providing (ASP) to convert it to a long-lasting choice to compete. Hence, the present study carried out with the aim of determining the relationship between quality of service providing software systems and customer satisfaction in selected hospitals of Tehran University of Medical Sciences with similar hospital information systems.
Materials and Methods: This study was a descriptive-analytical and correlation one. The study population consisted of revenue and clearance employees' unit in selected hospitals. Study method was census using Kim et al questionnaire. Descriptive statistics such as frequency, percentage and average; and inferential statistics like Kolmogorov-Smirnove Test and Pearson correlation coefficient utilized in order to data analysis.
Results: There was a significant positive correlation between quality of Application System Provider variables and users satisfaction in order of severity in system quality (r = 0.734, P = 0.01), service quality(r=0.721, P = 0.01) and information quality(r=0.521, P = 0.01). As, system quality had the most impact on users' satisfaction.
Conclusion: There was a significant relationship between the quality of Application Service Providing (ASP) with the users' satisfaction in selected hospitals of Tehran University of medical sciences. Although, all variables had positive and significant relationship with user satisfaction, their average was less than moderate limit. So, the health managers are advised to consider these issues in management methods.
Hossien Dargahi, Alia Akbar Razghandi, Zeynab , Rajab Nezhad,
Volume 15, Issue 2 (6-2016)
Abstract
Background: Concerning to the importance of team learning and process change, the clinical laboratories employees should be familiar with organizational learning. This study aimed at assessing and determining organizational learning capability among clinical laboratories employees of Tehran University of Medical Sciences hospitals.
Materials and Methods: This study was a descriptive-analytical and cross-sectional one which conducted among 85 employees of clinical laboratories using Cochran formula at five general teaching hospitals of Tehran University of Medical Sciences. The research instrument was Gomez et al. questionnaire consisted of four dimensions such management commitment, systematic approach, open climate and knowledge transfer in 17 questions. Five point Likert scale was used to rank questions. SPSS software 19 version was utilized to data analysis using t- test, Pearson Correlation Coefficient and Welch method.
Results: The average score of organizational learning among employees of studied clinical laboratories was 3.11 which showed relative desirable situation. Also, management commitment as an element of organizational learning had significant difference among the clinical laboratories (p=0.002). There was a significant relationship between employees education level with knowledge transfer and integration capability (p=0.04).
Conclusion: The process of organizational learning capability of the studied clinical laboratories was not desirable. Therefore, in order to complete establishment of organizational learning in clinical laboratories, should pay attention to some elements such establishment of patient safety system, initiation of error registration system and encouraging employees to report the errors
Fereshteh Alizadeh, Seyyed Jamaledin Tabibi, Mohamadreza Maleki, Amirashkan Nasiripour, Abbas Toloie Eshlaghi,
Volume 15, Issue 3 (8-2016)
Abstract
Background: Demographic prediction indicates that Iran population move towards an aged society until 2025, Hence, the need for medical care will be increased. The study aimed at predicting geriatric specialists based on dynamic system approach for the Iranian elderly.
Materials and Methods: After an exploratory study, data gathering and building similar structured in order to determine geriatrics number prediction by considering the important factors. Causal loop diagram to show relationship between variables, stock-flow diagrams for quantitative analysis of system dynamic behavior was conducted and model equations in Vensim software version 5 used.
Results: After simulation, intake students' simulated model revealed increased trend then a sharp decline and finally the pattern had fixed trend from 2009 to 2012. Pattern of physician who was still in study and also graduated physician was in growing trend. Employed physician had growing trend and then it fixed, and retired physician had fixed trend at first and then had an incremental trend. Finally, the various behavior of workforce assessed in three level.
Conclusion: According to increasing growth of the elderly population until 2025, we will encounter with shortage more than 2500 geriatrics which can be compensate by 50% graduated admissions of the major annually.
Jafarsadegh Tabrizi , Saeideh Alidoost, Ahmad Mardi, Mostafa Farshi-Khorsand , Mohammadali Rahmat ,
Volume 15, Issue 3 (8-2016)
Abstract
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.
