Showing 251 results for Hospital
Dr Siamand Anvari, Dr Esmaeil Asadi, Gilda Rajabi Damavandi, Dr Mashala Vali Khani, Dr Behrang Shadloo, Sepideh Masoud Sinaki,
Volume 18, Issue 4 (1-2020)
Abstract
Background: The purpose of this study was to investigate the quality of life of employees working in a psychiatric hospital.
Materials & Methods: The present study is a descriptive cross-sectional study conducted in Roozbeh Hospital in 2018. The sample size was calculated using Cochran's formula and 112 questionnaires were analyzed. Quality of life was assessed using the 36-item Short Form questionnaire (SF-36). Data analysis was conducted using SPSS software, descriptive statistics, Kruskal-Wallis, Chi-Square and Cramer's post-test.
Results: The findings revealed that the overall score of quality of life was 68.8. The highest mean of quality of life score was related to Physical functioning function (84.2) and energy fatigue had the least score (58.7). Also, the results of the study showed that there was a significant relationship between education groups and quality of life in terms of physical functioning (P-value=0.007); work experience and quality of life in social functioning dimensions (P-value<0.02); between having hospital patient communication and caregivers' communication with the quality of life in energy fatigue and pain dimensions (0.005, 0.05> P-Value); in Roozbeh Psychiatric Hospital staff.
Conclusion: According to the research findings, the quality of life of Roozbeh Psychiatric Hospital staff is moderate and educational and therapeutic interventions are recommended to improve the quality of life of the staff.
Dr Masoud Etemadian, Dr Hossein Shahrokh, Dr Aidin Aryankhesal,
Volume 18, Issue 4 (1-2020)
Abstract
Background: This study aimed to explore the process of establishing a non-governmental and nonprofit hospital, as a corporate infantry, and a model for the establishment of autonomous and corporate hospitals.
Materials and Methods: This was a qualitative case study. The data were collected by interviewing the founders of Moheb Mehr Hospital, staff and some university officials and charity organizations. The data analysis was conducted based on grounded theory principles and data were coded in three stages of open, axial and selective coding.
Results: The primary factors behind the establishment of Moheb Hospital were the low level of physicians' fees and the physicians’ dual practice in the public and private sectors. The existence of unused spaces at Hashemi-Nejad Hospital and the possibility of contracting supplementary insurance were the secondary factors. The reaction included welcoming from hospital physicians and opposition from the government and the Ministry of Health. A good patient access was created due to the lower charges, in comparison to the private sector, and having contract with the supplementary insurance. The negative comments from the government and the Ministry were gradually adjusted.
Conclusion: The decentralization initiatives of the public sector in hospitals should be considered as a bottom-up process. Instead of turning government hospitals into independent or corporate, it is better to re-establish them in an autonomous or corporate form. Also, before any decentralization action, financial and managerial stability must be created in the organizations. Morevoer, employee benefits must be preserved. Instead of receiving government funding, it is better to use the capacity of the endowment and receive bank loans.
Jafar Yahyavi Dizaj, Dr Sara Emamgholipuor Dashti, Faroogh Na'emani, Reza Reza Hashempuor,
Volume 18, Issue 4 (1-2020)
Abstract
Background & Aims of study: Hospital care and paramedical services has become one of the most important and problematic issues in the field of health and critical concern of health planners and policymakers. In current study, contribution of various paramedical services costs were extracted from the total household health expenditure.
Materials and Methods: The current study is a descriptive study that was conducted in a 5-year study period from 2011 to 2015. The annual income-based survey data of the household provided by Statistics Center during 2011-2015 was used to achieve the study aims. Excel_2013 software was used. Contribution of household and paramedical services cost were calculated from household health expenditures per year in urban and rural areas.
Results: Regarding the results of the current study, on average, 20 % of total household health expenditure is allocated to paramedical services in urban and rural areas. The cost of radiology, sonography, radiotherapy, scan, echo cardiac stress test, endoscopy, electrocardiogram (ECG) etc, accounts for the largest contribution of hospital and non-hospital paramedical services costs, which include an averagely about 50 %t of paramedical services costs.
Conclusion: Understanding paramedical services costs can guide policymakers and decision-makers in the field of paramedical services to decide better. Moreover it helps them to reduce direct payments from the pocket of household health expenditures. Therefore, considering the laboratory sector and radiology, sonography, radiotherapy sectors and so on are very important to reduce paramedical services costs.
Dr Mohammadali Zohal, Dr Sima Rafiei, Neda Esmaeelzadeha, Sanaz Jamshidi, Nafiseh Rastgoo,
Volume 18, Issue 4 (1-2020)
Abstract
Background & Aim: Regarding the chronic course of obstructive pulmonary disease and multiple problems which it brings to individuals and the community in terms of physical, mental, and economic aspects; this study aimed to investigate the role of life-style factors in disease exacerbation and hospitalization among COPD patients.
Methods & Materials: This is a descriptive, prospective study of outpatients with COPD in a tertiary care clinic. To collect data, a demographic questionnaire (including age, gender, marital status, occupation, and educational level), an international physical activity questionnaire (IPAQ), and a mini-nutritional assessment (MNA) tool were used. Disease severity was also determined by Initiative for Chronic Obstructive Lung Disease (GOLD) index.
Results: A total of 128 patients (78.1% male) were recruited with a mean age of 65.3+11.9 years. Findings revealed significant correlations among physical activity level of patients and their nutrition, smoking behavior, BMI, and disease exacerbation. In fact patients with older age, lower BMI, smoking habit for a long time, and limited physical activity were more probable to face with disease exacerbation and hospitalization.
Conclusion: Evidence suggests that adoption of health promotion strategies and emphasis on health based approaches can be helpful in reducing hospitalization among COPD patients. Due to their effectiveness and low cost, such policies are regarded as cost effective strategies in dealing with chronic diseases.
Somayeh Fadaei, Mostafa Kazemi, Fateme Nezhad Shokoohi,
Volume 19, Issue 1 (4-2020)
Abstract
Background: Assessing and improving the quality of services in hospitals because deal with the health of humans is very important. The purpose of this study is to identify and weigh quality criteria and ranking of four hospitals in Mashhad.
Materials & Methods: The present study is of type Applied Studies that is a cross-sectional study conducted in the winter of 1396. In this study, by literature review, dimensions of service quality in the hospital was identified. Then, a paired comparison questionnaire (including 8 people) was used to conduct the survey. Then coefficients of importance of each dimension were calculated through the process of hierarchical analysis in a fuzzy environment. Decision-making matrix questionnaire was completed by a 400-person sample of patient companions in four hospitals.Then, hospitals were ranked using GRA-TOPSIS method. The validity of questionnaires were confirmed by the expert group.
Results:Using FAHP, knowledge and skills of medicine obtained the most important coefficient. Also, using GRA-TOPSIS, third hospital received the fourth place in the provision of services. Also in the third hospital the quality of access requires the greatest improvement.
Conclusion: In addition to ranking hospitals based on quality of service criteria, the GRA-TOPSIS method is able to identify each hospital's weaknesses in each criterion. As a result, the priorities for improving the quality of service in each hospital were identified, and the hospital manager could work to improve performance on the criteria that he or she achieved with lower performance than other hospitals.
Ziba Khalili, Mohammad Panahi Tosanloo, Bahman Khosravi, Naser Iravanimanesh, Rezvan Kazemi Dastjerdeei, Loghman Azmoudeh, Ramin Ahmadzadeh, Abolghasem Pourreza,
Volume 19, Issue 1 (4-2020)
Abstract
Background and Aim: Conflict between health workers is an important problem in health care units around the world. The aim of this study was to identify the causes of conflict between nursing staff and other occupational groups in the hospital.
Materials and Methods: This descriptive-analytical study was conducted in 2018. A researcher-made questionnaire was used to collect data. The questionnaire was designed in two parts: demographic variables and causes of conflict between nursing and other occupational groups with a Likert scale of 5 points. 120 nursing staff of Ardabil University of Medical Sciences randomly selected were surveyed. Data were analyzed by SPSS software15 using descriptive and inferential statistical methods.
Results: The highest rate of conflict reported by nurses was related to the conflict with the group of managers (4.17±0.94) and the lowest rate was with administrative, financial and support staff (3.55±1.13). The most important reasons for conflict between nursing staff and different groups were: imposing non-specialist roles (such as completing doctors' documentation); perceived inequality in workload distribution; insufficient understanding of nursing work conditions; unreasonable differences in salaries and other benefits, and unfair distribution of manpower. There was also a statistically significant correlation between the level of conflict with marital status, work experience, age group (p <0.05).
Conclusion: The results of the present study showed the role of some factors causing conflict between nursing staff and other occupational groups. These findings could be a practical guide for hospital managers in making practical decisions and strategies for managing workplace conflicts.
Ali Mohammad Mosadeghrad, Fatemeh Khalaj,
Volume 19, Issue 1 (4-2020)
Abstract
Background and purpose: Electrocautery is a very important tool in surgery. Electrocautery burn is a common side effect of operation surgeries. Quality management is a useful strategy for improving the quality and safety of hospital services. The objective of this study was to examine the impact of quality management on reducing electrocautery burns.
Materials and methods: A participatory action research was conducted in the operating theatre of a hospital in Tehran, Iran, in 2013 and 2014. A quality improvement team was established in the hospital operating theatre. The quality improvement team using an 8-step quality management model, standardized working processes, identified quality goals for the processes and improved them until achieved the quality goals. Data on electrocautery burns was collected before and after the intervention and compared.
Results: Electrocautery burn rate was 0.40% in 2012. A wet patient due to sweating or washing during the surgery, in-appropriate patient position, faulty earth well, faulty anti-static mattress and long usage of electrocautery devices were the main reasons of electrocautery burn injuries. Accordingly an action plan was developed and implemented for preventing and reducing electrocautery burns. Consequently, electrocautery burn rate was reduced to 0.21% and 0.02% in 2013 and 2014. Electrocautery burn was significantly reduced by 95% in two years.
Conclusion: Electrocautery burns can be easily prevented using the quality management strategy. Implementing an appropriate quality management model appropriately in a supportive environment enhances the safety of hospital services.
Masoud Etemadian, Ali Mohammad Mosadeghrad, Mahmoud Reza Mohaghegh Dolatabadi, Hamed Dehnavi,
Volume 19, Issue 1 (4-2020)
Abstract
Background: Public-private partnership (PPP) in constructing and operating hospitals is a good strategy to provide high quality services to people at lower cost for the government. However, PPP is facing several challenges. The objective of this research was to identify and explore the PPP challenges in building Moheb Yas hospital in Tehran, Iran.
Materials and Methods: A qualitative approach was used for this case study in 2018. In-depth semi-structured interviews were conducted with 24 key stakeholders, managers and employees who were involved in PPP initiative implementation using purposive and snowball sampling methods. Thematic analysis approach was used for data analysis.
Results: Moheb Yas hospital was built in the yard of a public hospital (Co-location PPP) by the private entity. Then, the public hospital was moved into the private hospital. The new hospital was transferred to the government after one year owing to some challenges. These challenges include an inappropriate PPP model, low government capacity and competency in PPP, low trust in private partner, difficulty in funding the project, demolishing the old building, applying for hospital licences, merging two public and private hospitals, and difficulties in equipping the new hospital with human and physical resources.
Conclusion: The PPP was not successful in this case. Although PPP initiatives have benefits for the health system, but, it comes with numerous challenges especially in developing countries owing to disparate goals, incentives, and management practices of public and private sectors. The research findings provide useful insights for policy makers and senior managers in health systems in similar countries about the main barriers of PPP initiatives in the health sectors.
Ali Akbarisari, Farhad Habibi, Bahman Khosravi, Pejman Hamouzadeh, Mani Yousefvand,
Volume 19, Issue 1 (4-2020)
Abstract
Background: Performance appraisal and quality evaluation of the services provided will achieve the organizational goals and improve the level of staff capability. In order to evaluate accurately and efficiently, we need to use standard indices, to compare the quality and quantity of work with standards, to know the current conditions and to solve its problems
Methods: This study is an applied study. This was done through a combined method of reviewing the texts and consensus of experts. Initially, the literature review and emergency evaluation indices were extracted, then the duplicate indices were removed and similar indices were merged, then weighted experts and questionnaires were compiled with the indices. Content validity, Cronbach's alpha coefficient and test-retest were used to assess the validity, internal consistency and reproducibility of the questionnaire, respectively. Data were analyzed using Excel and SPSS 20 software.
Finding: Final questionnaire with 105 questions in 8 areas including management and leadership (15); human resources (22); physical space and facilities (18); medicine and medical equipment (6); guidelines and policies (17); patient-centered (10); documentation of patient records (5); quality and time indices in the emergency department (12). The results showed that the final questionnaire was reliable (0.89) and repeatable (ICC = 0.98).
Conclusion: The Hospital Emergency Performance Assessment Questionnaire is a valid and reliable instrument and can be used to evaluate the performance of hospital emergency services.
Farhad Lotfi, Erfan Kharazmi, Mohsen Bayati, Hajar Alipour, Saeid Lohivash, Ali Jajarmizadeh,
Volume 19, Issue 2 (8-2020)
Abstract
Background: Estimation of cost functions is an appropriate tool for optimal resource allocation in hospitals. The present study aimed at estimating cost function for hospitals affiliated to Shiraz University of Medical Sciences.
Materials & Methods: In the current cross-sectional study, inputs, costs and resources data for 28 hospitals were gathered from hospital statistics and information system. Required data were collected monthly for two years (2015-2016). Then, The Cobb-Douglas cost function was estimated using panel data analysis. STATA 14 was used for data analysis.
Results: Estimates showed that hospitals' cost elasticity concerning the inpatient and outpatient admission were 0.555 and 0.058 for large hospitals, and 0.769 and 0.099 for small hospitals (P<0.01). Among hospitals inputs, the cost of a physician with coefficient 0.175 in large hospitals and 0.481 in small hospitals (P<0.01) was most cost driver. In studied hospitals, average cost (36,406,480 Rial) was higher than marginal cost (26,548,020). Moreover, scale economies index were in small, large, and all hospitals were 0.868, 0.613 and 0.729, respectively. The number of active bed, length of stay and teaching activity had a positive effect on hospitals cost (P<0.01).
Conclusion: According to the findings, to control costs, the hospital should manage most cost drivers, such as physicians and pharmaceutical costs. Moreover, According to the average and final cost and scale economies index, hospitals should expand their service provisions with current inputs and resources in order to reach the optimum point of output.
Mohammadhossein Ronaghi,
Volume 19, Issue 2 (8-2020)
Abstract
Background: The fourth industrial revolution consists of combining network devices with cloud computing methods and analyzing large data and artificial intelligence, which makes it possible to call such an infrastructure smart. In a Smart Hospital, all things and devices are designed to be connected and integrated, thus achieving better patient care, increasing efficiency and reducing time waste. Therefore, the aim of this paper was to recognize the components of smart hospital based on disruptive technologies of industry 4.0.
Materials and Methods: This applied research has been done in two phases using qualitative approach in winter 2019. In the first step, the components of smart hospital were recognized from previous studies. In the second step, research experts evaluate conceptual model by Delphi method. The expert panel consists of 15 individuals active in information technology in healthcare according to targeted sampling.
Results: According to research results the main components of smart hospital are eight technologies: Internet of things technology, robotic, blockchain technology, cloud computing, big data, augmented and virtual reality technology, additive manufacturing and artificial intelligence.
Conclusion: According to components of smart hospital, Hospitals managers should equip their organization and adopt process and equipment by disruptive technologies. Due to sanctions, investment in Iranian knowledge-based companies active in new technologies field and Joint venture with them can be a suitable solution for healthcare policymakers.
Elham Ramezan Pour, Hojjat Rahmani, Mehdi Raadabadi, Ghasem Rajabi Vasokolaei, Neda Rashidi,
Volume 19, Issue 2 (8-2020)
Abstract
Introduction: The operating room is one of the most sophisticated workplaces, consisting of a vast array of electrical, gas and radiation equipment that are more susceptible to accident than other hospital departments. Therefore it is important to observe safety tips in this section. The purpose of this study was to evaluate the standard of safety in operating rooms of hospitals affiliated to Mazandaran University of Medical Sciences in 2019.
Method: This study was a descriptive cross-sectional study. The statistical population consisted of all operating rooms of hospitals affiliated to Mazandaran University of Medical Sciences. The tool used was a checklist that was completed by researchers by observation and interviewing on-site. Safety standards have been evaluated in terms of the physical space of the operating room, fire safety, personnel safety, patient safety, infection control. Data were analyzed by SPSS version 21.
Results: The operating rooms of university-affiliated hospitals were 80.10% secure in overall safety. The patient's safety area, with 83.34%, had the shortest distance from the standards and the infection control safety area, with 74.24%, had the highest distance from the standards. The highest and lowest scores were related to the safety standard related to the operating room of hospitals (2) and (1).
Conclusion: According to the findings, the operating rooms of the studied hospitals are generally in desirable compliance with safety standards. However, it is essential to pay attention to problem areas to increase the safety factor for staff and patients in the operating room, so appropriate remedial measures should be taken to ensure complete safety of the operating room for all components.
Mahmoud Mirakbari, Maryam Ooshaksaraie, Maryam Daneshmand Mehr, Hossein Amouzad Khalili, Seyed Ali Majidi,
Volume 19, Issue 2 (8-2020)
Abstract
Introduction : A large number of hospitals and medical healthcare centers catch fire every year. Nowadays, one of the most significant challenges that hospital designers and health providers faced with is fire safety. This study conducted to determine a comprehensive model for fire safety in hospitals by reviewing related studies.
Method: This study was conducted using a comprehensive review to find a research paper published on fire in hospitals. Electronic databases such as PubMed Scopus google were searched using the proper search strategy.
Results: Overall, 14 studies were obtained. The findings were analyzed qualitatively through thematic synthesis and divided into some main themes: essential sections and divisions of hospitals in the field of fire, emergency exit patterns, materials and construction status, Flammable consumables materials in hospitals, and appropriate firefighting equipment.
Conclusion: The dangers of medical equipment and flammable material, the types of firefighting equipment in the hospital building, architectural safety issues regarding the degree of fire resistance of structures, roofs, doors, walls, and emergency exit stairs are crucial points To protect staff and patients in hospitals that should consider simultaneously.
Afsaneh Khademi Jolgehnejad, Reza Ahmadi Kahnali, Ali Heyrani,
Volume 19, Issue 3 (11-2020)
Abstract
Background: Scenario planning is one of the most crucial future study methods in uncertain and complex situations. Hospital supply chain resilience also requires an understanding of future events due to the complexity of relationships and exposure to unexpected circumstances. The purpose of this study is to formulate scenarios for the future development of hospital supply chain resilience.
Materials & Methods: This research is the second stage of research with a mixed approach, and it is in the category of normative scenarios based on intuitive logic. Participants in this study were purposefully selected from the experts of two hospitals. In the first phase, the impact-uncertainty questionnaire and the effect-uncertainty diagram were used to determine the critical uncertainties. After forming the scenario team, based on the impact diagram and the scenario matrix, The cause and effect relationships of the variables were determined in the second phase.
Results: Drivers of Hospital supply chain resilience were clustered into 14 main categories, and the results of the impact-uncertainty diagram showed that "people's culture" and "accident nature" play a more significant role in scenario development as critical uncertainties. Four scenarios were developed based on the opinion of experts for these two drivers.
Conclusion: four scenarios, "compatible," "turbulent," "broken," and "combative," were developed based on the critical drivers in supply chain hospital resilience. Use the inspirational feature of these scenarios can help managers in health and crisis management be more prepared to face the crisis. Scenarios based on intuitive logic can be used for futures studies in other areas of the health system.
Iravan Masoudi Asl, Masoud Aboulhallaje, Meghdad Rahati,
Volume 19, Issue 3 (11-2020)
Abstract
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.
Sara Karami Parsa, Leila Nazarimanesh, Mahmood Mahmoodi Majd Abadi Farahani,
Volume 19, Issue 3 (11-2020)
Abstract
Background and Purpose: The importance of hospital quality services in order to best utiliz available resources are not unknown to managers. This is especially important in the maternity sector due to the high density of referrals. Implementation of LDR (Labor, Delivery, Recovery) is one of the new approaches to improve delivery services in the country. The purpose of this study was to evaluate the effectiveness of LDR system on quality of delivery services in two selected hospitals of Qom.
Methods and Materials: This is a descriptive-survey study. Data were collected with a cross-sectional approach to compare the quality of service indicators of a hospital with LDR system as a case and a hospital without LDR system as a control group. Data were collected using a standard questionnaire by Poisson sampling and analyzed by SPSS software.
Results: There was no significant difference between the two hospitals except for LDR implementation. There was no significant association between LDR implementation in delivery sector with overall quality of service indicators (3 vs. 2.5) , input, process and output quality indices. However, LDR implementation had a significant effect on some items of these indices (level of significance = 0.05).
Conclusion: According to the research findings, implementation of LDR did not have a significant effect on overall quality of services, but it did affect the subscales of these indices. Therefore, it seems clear that there is a need for proper management policy to control the costs involved in implementing this system.
Ebrahim Jaafari Pooyan, Hojjat Rahmani, Mohammadamin Mirshekari,
Volume 19, Issue 4 (12-2020)
Abstract
Introduction: Identifying the challenges of Quality Improvement Offices (QIOs) not only helps in planning the quality of hospital services and in trying to provide a suitable solution to solve the problems of these offices but also plays an important role in strengthening the offices and increasing the quality of clinical and non-clinical services of hospitals. This study aimed to investigate the challenges of quality improvement offices in hospitals and provide appropriate solutions.
Methods: The present qualitative research was conducted using semi-structured interviews with 40 managers and hospital boards, matrons, quality improvement experts of hospitals and accreditation offices experts of medical universities in Tehran. Content analysis method was used to analyze the data obtained from the interviews. Then, the collected data were analyzed and classified by MAXQDA10 software.
Results: By analyzing the interviews in the field of challenges and solutions, the extracted codes were classified into four areas of management, standards, evaluation and staff. The most codes were related to management with 5 themes and 21 sub-themes. In addition, most of the solutions were related to the field of management.
Conclusion: The findings of the study showed that most of the challenges and solutions were in the field of management. Focusing on this field could be helpful in improving the quality of offices performance.
Fateme Vahdati, Mohammadreza Mohammadkhani, Omid Khosravizadeh, Rana Soheylirad, Sogol Sarikhani, Bahman Ahadinezhad,
Volume 19, Issue 4 (12-2020)
Abstract
Background: In addition to providing effective and equitable services to low-income groups, teaching hospitals must obtain a significant share of the demand of high-income groups in order to have a balanced and positive operational performance. The aim of this study was to investigate the market orientation of teaching and medical hospitals in Qazvin.
Materials & Methods: This descriptive-analytical study was conducted at teaching and medical hospitals of Qazvin University of Medical Sciences in a cross-sectional manner in 2020. Data were collected in a one-month period through a questionnaire survey. The study population was the total staff working in 6 hospitals of this university who were selected using quota-random sampling method. The required data were obtained by collecting 411 market orientation questionnaires (Ahmad and Eqbal 2013) and were analyzed in SPSS 16 software. One-way analysis of variance with 95% confidence interval was used to compare the means.
Results: The market orientation of all studied hospitals was 2.88 out of 5. Also, customer orientation had the highest average (3.32 out of 5) and paying attention to competitors had the lowest average (2.80 out of 5). The mean for dimension of coordination between tasks was 2.86 out of 5. Apart from paying attention to competitors, there was a statistically significant difference in terms of market orientation, customer orientation and coordination between tasks(P <0.05).
Conclusion: The status of the studied hospitals were in medium, high and below the average in terms of market orientation, customer orientation and attention to the competitor, respectively. To achieve a profitable service market, hospitals must implement a strategic plan against competitors and direct staff duties to strengthen market orientation.
Sajjad Moshki, Shaghayegh Vahdat, Somayeh Hesam,
Volume 19, Issue 4 (12-2020)
Abstract
Background: The present study aimed to determine the causes of patients' readmission in hospitals affiliated to Bam University of Medical Sciences in 2019.
Materials & Methods: The current study was a descriptive-analytic study and the study population included patients readmitted in Pasteur Hospital in Bam, Javad Al-Aimeh Hospital in Narmashir, and Ayatollah Hashemi Rafsanjani Hospital in Regan in 2019. The samples consisted of 312 patient records which were chosen randomly. Data were collected by a checklist and were analyzed using SPSS software version 23 and descriptive and analytical tests (Chi-square and one-way analysis of variance).
Results: The results showed that the internal medicine department received 34% of readmissions. The average readmission cost was 17,265,353 Rials. The most common reasons for readmissions were having a new disease (46.2 percent) and recurrence of the former disease (39.8 percent). Findings of inferential statistics revealed no significant relationship between the causes of readmissions and gender (P = 0.566), age (P = 0.065), or costs (P = 0.625), but there was a significant relationship between the causes of readmissions and marital status (P = 0.049) and married people had more readmissions than single people.
Conclusion: It is necessary to pay more attention to readmissions caused by disease recurrence. It is also possible to prevent such readmissions and improve the quality of medical services by standardizing hospital processes and tools, standardizing staff training, and employing new diagnostic and treatment methods.
Hiwa Mirzaii, Hojjat Rahmani, Mohammad Arab, Jalal Saeidpour,
Volume 20, Issue 1 (5-2021)
Abstract
Background: Medical tourism has been considered in our country for many years. The arrival of international patients in the country will boost the medical tourism sector; however, the necessary infrastructure must be created for this. The guidelines for the establishment of the International Hospital Unit are one of the legal infrastructures for standardization in this field. Therefore, this study was conducted with the aim of strategic analysis of the establishment of an international patient unit in hospitals of Tehran University of Medical Sciences.
Materials & Methods: This combined study was performed in 2019 in three hospitals of Tehran University of Medical Sciences that had a license to operate this unit. In-depth interviews were conducted in each hospital with experts in this field. The data were then categorized into four categories of strengths, weaknesses, opportunities and threats, and according to the results of the SWOT technique, the necessary strategies were presented.
Results: There are opportunities including low cost of medical services in Iran, low value of Iranian Rial and political and religious ties with countries in the region. Significant threats also included the existence of professional competitors, the widespread activity of brokers, and the large number of trustees for the industry within the country. Finally, appropriate strategies were presented for each hospital.
Conclusion: This market in our country faces many threats and needs policies appropriate to the current situation with an immediate action. The results also showed that two hospitals are in a competitive state and one hospital is in a defensive state.
