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Showing 93 results for Health

Seyed Mostafa Kohestani, Dr Hojjat Rahmani, Dr Sheyda Nourbakhsh, Dr Farhad Habibi, Ghasem Rajabi Vasoukolaei,
Volume 18, Issue 3 (10-2019)
Abstract

Background: Nosocomial Infections (Nis) Are Regarded As The Most Common Complications Of Health Cares. These Infections Affect Patient’s Safety in Developing and Developed Countries. The Aim Of This Study Was To Epidemiology and Determine the Causes of Nosocomial Infectioin Teaching Hospital of Tehran In A Teaching Hospital In Tehran.
Materials and Methods: This Cross-Sectional, Descriptive And Analytical Study Was Designed In 2019 At A Teaching Hospital Affiliated With Iran University Of Medical Sciences. The Nosocomial Infection Registry Data between 2017 and 2018 Was Used. The SPSS24.0 Software Package Was Used To Analyze Data Into Descriptive (Frequency, Percentage, Mean and Standard Deviation( And Analytical) ANOVA) Statistics.
Result: The Most Frequent Type of Infections Were Urinary Tract (39.76%), Ventilator Associated Events (20.92%), Bloodstream (20.71%), Respectively. Skin and Soft Tissue Infections (0.7%) Had The Lowest Prevalence. The Highest Incidence Of Nosocomial Infection Was In The ICU With 200 Patients And The Lowest Incidence Was In The ENT With 23.1 Patients And The Overall Incidence Of Nosocomial Infections Was 84.9 Patients Per 10,000 Patient-Days.
Conclusion: Designing The Related Interventions To Control Nosocomial Infections, Making Hospital Managers And Staff To Sensitive In Nis Control, Holding Specialized Training Programs, Considering Basic Design Of The Physical Structure Of Hospital Wards, Considering Attitudinal And Motivational Are The Most Effective Ways To Combat Nosocomial Infections.

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.


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.
 
Simin Shams Javi, Pouran Raeissi, Amir Ashkan Nasiripour,
Volume 19, Issue 2 (8-2020)
Abstract

Background: One of the fundamental changes in the health system of Iran in recent years is the "health system reform plan", that the effects of which should be examined from various dimensions. The purpose of this study is to determining the effect of health system reform plan on health indicators in population covered by Ahvaz University of Medical Sciences.
 
Materials & Methods: In this descriptive-analytical study, the data of the selected health indicators of Ahvaz University of Medical Sciences in the period before and after the health care system reform plan (from 2012 to 2018) was collected, described and analyzed with SPSS.
 
Results: The highest rate of change in mortality indices was between 2013 and 2015, orderly in U5MR, IMR & NMR, With the mean difference 13.282, 10.825 & 7.955 (P=0.001, P=0.002 & P=0.004). The highest rate of change in Care Coverage for Children Under-five, is between 2014 and 2015 with mean difference of 11.335 and about the Antenatal Care Coverage, between 2014 and 2017, with mean difference 10.050 (orderly p=0.002 & p>0.001). MMR was not significant.
 
Conclusion: The time trend analysis on health indicators confirms that the changes in the early years of the reform plan have been a lot, then it has slow down. Most of the change in health indicators is related to years of 2015 and 2016. The findings indicate that the latest health reform plan in Iran has improved the mortality indices (Reduce in NMR, IMR & U5MR), Care Coverage for Children Under-five and Antenatal Care Coverage (6+). Health reform plan has not affected on MMR.
Maryam Zahedi, Seyed Mohsen Banihashemi, Sedigheh Mohammadesmaeil, Mansour Sharifi,
Volume 19, Issue 2 (8-2020)
Abstract

Technological progress and changes have affected the field of medicine and health. Also, the electronic health record is used for convenience of treatment, prevention and diagnosis, but it has advantages and disadvantages that we have studied them in this research.
Method: Qualitative research methods and Grounded theory  were used for the sociological study of electronic health record, and in order to achieve a comprehensive theory in this field by using the theoretical saturation method, twenty experts in the fields of medicine, policy, sociology and informatics that They were familiar with electronic health records, were selected from the community of experts as the statistical population and by using the three stages of open, axial and selective coding, important concepts and categories were extracted in each stage.
Results: The most important result of the research is multidimensional effects of electronic health record. Electronic health record by reducing emotional interaction and prioritizing registered data reduces the intimacy in the patient- physician relationship, and recording data in the specific political and economic environment of the country bring a fear of social stigma and disclosure, especially when system security, investing, and training employees face some problems, and the constant changes of managers reduce their risk-taking and positive effects.
Conclusion: In order to have a proper system and comprehensive and pervasive use of electronic health record, cultural, managerial and technological changes are necessary. Cultural contextualization in the society and among individuals, risky and efficient management and the use of integrated information systems along with system security can increase efficiency. Moreover, this efficiency will lead to research, development and progress.
Hossein Alaie, Niloufar Amiri Ghale Rashidi, Mojtaba Amiri,
Volume 19, Issue 3 (11-2020)
Abstract

Background: The Family Physician Program, one of the most important efforts of the Iran health system to establish a referral system, was developed and implemented in several provinces, but it faced challenges due to several reasons that prevented the program's progress. So This study was conducted to analyze the family physician program to identify the causes and challenges of the program failure.
Materials & Methods: This retrospective study of policy analysis is a qualitative study with Purposive sampling. Semi-open interviews and document analysis were used for data collection. Data analysis was performed through thematic analysis in the policy triangle framework using MAXQDA software.
Results: According to the study framework, the challenges of the Family Physician Program in the context are conflict of interest, dependency of plans to oneself, instability in management and plans, insufficient attention to culture, resources, and infrastructure. In terms of content include disproportionate executive approach, Lack of localization, selection of inappropriate tools, insufficient transparency, and ambiguity in goals, tasks, and responsibilities; The challenges of the process were examined based on the policy cycle.
Conclusion: The implementation of the family physician program is influenced by cultural, social, political, managerial, and economic factors. As the Ministry of Health officials has re-introduced this crucial program, reviewing the content and methods of program implementation seems necessary.
Leila Hosseini Ghavam Abad, Abbas Vosoogh Moghadam, Rouhollah Zaboli, Mohsen Aarabi,
Volume 19, Issue 4 (12-2020)
Abstract

Background and Aim: Clinical governance is one of the important frameworks for continuous quality improvement and safety in health care systems. Identifying the axes of this approach according to local conditions is one of the important priorities of the health system. The aim of this study was to identify the views of stakeholders on the axes of clinical governance in primary health care based on family physicians in Mazandaran province.
Methods: The present qualitative study was conducted using the conceptual framework analysis method in 2018-2019. The study population were key policy makers of Ministry of Health, Health deputy of the University, the county health network, family physicians association, family physicians, and the parliament research center. Participants were selected using purposeful and snowball sampling methods. Data were collected through semi-structured interviews and were analyzed and coded using MAXQDA 11 software.
Findings: According to the interviewees' views, the research findings were classified into 4 main dimensions: dimensions of clinical governance, requirements and structures, decision-makers and dimensions of quality and safety assessment. 17 sub-themes including community participation, clinical audit, clinical effectiveness, personnel management, training, information use, risk management, guidelines and procedures, promotion of health indicators, equipment and facilities, referral system, financing, policy makers, effectiveness, efficiency, human aspects of services and justice were identified and extracted.
Conclusion: According to the research findings, to facilitate the implementation of clinical governance, solutions such as the existence of appropriate infrastructure, commitment of managers, supportive culture, sufficient knowledge, monitoring and evaluation, appropriate culture building, facilities and equipment and sufficient financial resources are suggested.
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.
Neda Vahedi Nezhad, Farzad Firouzi Jahantigh,
Volume 20, Issue 1 (5-2021)
Abstract

Introduction and purpose: Risk assessment is a necessity in high-risk work environments like hospitals. During epidemics, the need to maintain the health of healthcare staff increases as they are effective people in controlling the spread of the disease. The purpose of this study was to assess the occupational safety of healthcare staff against coronavirus using FMEA in infectious diseases ward of Bu-Ali Hospital in Zahedan.
Methodology: Failure modes were identified using brainstorming technique. After scoring them with S, O and D, they were prioritized by calculated RPN. To improve the traditional FMEA, failure modes were prioritized with weighted FMEA and MCDM techniques. After identifying the critical failure modes, the root causes of them were identified and categorized.  Finally, corrective solutions were provided to handle them.
Results: Three processes including emergency admission, patient visit, and sampling were identified as priority processes. 58 failure modes and their effects were identified in 6 categories. 13 critical failures modes (RPN above 100) equivalent to 22% were identified. Then 42 root causes of them were identified by brainstorming technique and their classifications were done by Eindhoven. Finally, 49 corrective strategies were presented to handle critical risks.
Conclusion: Identifying 58 risks and their effects, identifying and classifying root causes and providing corrective solutions indicate the capability of the FMEA to assess the risk of critical departments such as hospitals. As a result, the FMEA is able to detect risks, reduce their consequences and improve quality. Risk assessment techniques along with the commitment of managers and the renewal of organizational policies can ensure the effectiveness of these activities.

Kamran Irandoust, Jafar Yahyavi Dizaj, Hiwa Mirzaii, Faroogh Na'emani,
Volume 20, Issue 2 (9-2021)
Abstract

Background & Aims of study: Service delivery is known as the most tangible function of the health system and hospitals are the most obvious manifestation of this function. Also, one of the most important factors in creating catastrophic health expenditures is the use of hospital services; therefore, in the present study, an attempt was made to describe the share of hospital service costs from total household health expenditures.
Materials and Methods: The present descriptive study was performed retrospectively for the period of 2011 to 2015. The study was done using the Household Expenditure and Income Survey (HEIS) which is conducted annually by the Statistical Center of Iran (SCI). Based on the designed model, the share of hospital costs from household health expenditure was determined by year and type of services in urban and rural areas.
Results: On average, 18.5% of households used hospital services and about 28.7% of household health expenditure had been spent on receiving health services from hospitals. The average cost of household hospital medical services was 92.4% in urban areas and 91.4% in rural areas. On average, 51% of the cost of household medical services in hospitals was related to public hospitals, and the highest cost spent by households in public hospitals was allocated to surgery.
Conclusion:  The share of hospital services costs and the rate of use of these services among Iranian households are significant, which may lead to poverty and catastrophic health expenditures. Therefore, it is necessary for health decision makers to design and implement evidence-based policies to manage and control this part of health costs.

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.
Hamid Mohammadi, Shahram Tofighi, Mostafa Rajabi, Hamidreza Izadbakhsh, Bahar Hafezi,
Volume 20, Issue 2 (9-2021)
Abstract

Background: The outlook for hospital care is changing rapidly. Supply and demand stimuli in the health service system are changing dramatically. The health department of the Social Security Administration has also been challenged by the growing number of patients. This study was conducted to help this organization with the aim of designing a conceptual causal model of the interaction between supply and demand of health care.
Materials and Methods: This research is a qualitative study that was conducted in 2020. It presented a conceptual model in two steps in the first step, semi-structured interviews were used to extract important factors in the supply and demand of health services in hospitals. In the second step, the system simulation approach was used and the feedback relationships between the patient's routes to the hospital and the provision of medical services were presented.
Results: According to the study hypothesis, the prevalence of disease and budget allocation as an indicator of medical need and expected medical demand, positively affect the number of visits to hospitals of the Social Security Organization. Accordingly, four sub-models of patient flow, health care budget, treatment staff (physician, nurse) and hospital capacity were extracted.
Conclusion: Medical budgets allocated to hospitals to improve medical facilities and increase the number of staff, have created positive expectations among social security insured regarding the use of hospital services. Paying attention to providing sufficient manpower (doctor, nurse) and bed capacity with the budget which is spent for this service are the indicators of improving the quality of services.
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.
Yahya Salimi, Ali Kazemi-Karyani, Shahin Soltani, Farid Najafi, Zhila Azimi, Bahman Roshani, Sina Ahmadi, Satar Rezaei,
Volume 21, Issue 1 (5-2022)
Abstract

Background: The aim of this study was to evaluate the effect of health sector evolution plan (HSEP) on the prevalence of cesarean section and vaginal delivery in public hospitals in Kermanshah province.

Methods: In the present study, cesarean section (C-section) and vaginal delivery data were collected and evaluated in 17 public hospitals from 2009 to 2019. The main variables of this study included the prevalence of C-section and the prevalence of vaginal delivery for 121 months, both were obtained by dividing the number of deliveries by C-section and vaginal delivery by the total number. Interrupted time series analysis was used to examine the effect of HSEP on the prevalence of cesarean and vaginal delivery rates.

Results: The prevalence of C-section before and after the HSEP was 42.5% and 43.2%, respectively. Months before the intervention, the rate of C-section was increasing by 0.13%, which was statistically significant. In the first month after the intervention, the prevalence of     C-section decreased by 3.6% that was statistically significant. The share of C-section in the months after the implementation of the HSEP showed a monthly increase of 0.12% compared to before the intervention, which was statistically significant.

Conclusions: The results of the study showed that the HSEP has led to a significant reduction in C-section in short term, but in the months after the implementation of the plan, the prevalence of C-section has increased again.
Hamid Mohammadi, Shahram Tofighi, Mostafa Rajabi, Hamidreza Izadbakhsh, Bahar Hafezi,
Volume 21, Issue 1 (5-2022)
Abstract

Background: The use of simulation models can help elucidate the intuitive behavior of complex health care problems. Today, the complexity of problems goes far beyond our capacity to solve them manually. System simulation is considered as a wise option by approaching structural problems and understanding the complex interactions within the problems and their changes. The purpose of this study is to review the most advanced applications of system dynamics in healthcare.
Materials and methods: This study is a systematic selection of articles that explored the applications of system dynamics in health care in 11 databases between 1999 and 2019. The focus of this research was on articles with the keywords including system dynamics in health care, dynamic health care analysis, continuous health care simulation or dynamic health care simulation.
Results: 79 articles related to system dynamics applications in healthcare were identified in databases. Eighty-five percent of the articles focused on finance, politics, government, regulation, public health, and health care planning. Among the articles, the patient's treatment path, obesity and demand for healthcare workforce were examined.
Conclusion: The tendency to use continuous simulation in healthcare has increased. However, the power of hybrid simulation can take advantage of the inherent strength of the system dynamics overview perspective, and in a hybrid model it can utilize a holistic perspective for managing health care systems. Potential areas with the application of systems dynamics in future research include planning and policy-making in public health decision-making, purchasing quality management, care and risk.

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.
Mohammad Hossein Sadeghian, Morteza Abdolvand,
Volume 21, Issue 3 (12-2022)
Abstract

Background: Since the health and treatment staff are constantly exposed to critical and stressful situations during the outbreak of the Covid-19 pandemic, the present study aims to investigate the relationship between spiritual health and resilience in the personnel of hospitals accepting patients with the corona virus affiliated to Tehran University of medical Sciences.
Materials and Methods: The current study is a descriptive and analytical study that was conducted cross-sectionally in 2019. The study population included medical staff, including doctors, nurses, paramedics, and service personnel who participated in the fight against Covid-19. In order to measure resilience, Connor and Davidson's questionnaire was used, and Polotzin and Ellison's spiritual health questionnaire was used to measure spiritual health. 145 questionnaires were included in the study. Statistical tests of mean, standard deviation, Pearson correlation coefficient, analysis of variance and independent t were used to analyze the data.
Results: The average resilience score among the subjects was 64.3. The results showed that resilience in the field of spiritual effects with an average of 3.07 was the highest and in the field of tolerance of negative effects and strength against stress with an average of 2.33 had the lowest average. Spiritual health in 55.9% of the studied units was at a moderate level and none of them had a low level of spiritual health. Resilience and all its domains had a statistically significant positive correlation with spiritual health and its domains.
Conclusion: Managers' attention to the spiritual health of health center staff can reduce stress and pressures caused by work in critical situations and be an effective step towards greater productivity of human resources.
Ahad Norouzzadeh,
Volume 21, Issue 3 (12-2022)
Abstract

Background: Global statistics shows that health tourism grew significantly before the outbreak of Covid-19, but with the beginning of the pandemic and the closure of countries' borders to immigrants, this trend has declined significantly. The present study aimed to identify the bottlenecks of health medical tourism in the context of the outbreak of Covid-19 and to present scientific solutions for its development using two stages of content analysis and surveying.
Materials & Methods: This research is exploratory in terms of purpose and descriptive in terms of type, which was conducted by field method. Study population was selected in two stages; the first stage consisted of 20 physicians with more than 15 years of experience in Ardabil province who were chosen by snowball sampling method and the second stage consisted of 200 employees of the province's University of Medical Sciences who were randomly selected. In order to analyze the data in the first stage, the content analysis  was used in 6 stages and in the second stage, the first and second order confirmatory factor analysis test was used.
Results: The research findings showed that 9 main themes and 29 sub-themes were identified as barriers and bottlenecks in health medical tourism and 23 scientific solutions were presented to reduce barriers and bottlenecks in health medical tourism in the event of COVID-19 outbreak.
Conclusion: The adaptive fit indices are good and the RMSEA value is 0.047 which indicates that the model has a good fit.
Ebrahim Jafari Pouyan, Maryam Babaei Aghbolagh, Farnoosh Azizi, Aida Asghari,
Volume 21, Issue 3 (12-2022)
Abstract

Management is a key pillar in order to achieve the goals of health systems. An efficient structure for identifying, recruiting, training, promoting, monitoring and evaluating the performance of managers is highly likely to help the specialization of management, prevent non-specialized selection processes and possible deviations. Given the managerial level in which they play a role, health managers ought to have the required competencies and characteristics. The leading countries generally thrive to have structures where proper candidates are systematically placed in the position of management and promoted to the higher positions. Therefore, the experiences of these countries should be solicited in line with the local social, political, economic and cultural factors in order to achieve the health system goals.

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