Naser Seifollahi, Seyed Ali Naghavi,
Volume 21, Issue 4 (1-2023)
Abstract
Background: Nowadays, the medical tourism market is one of the most profitable and competitive industries in the world, and it is one of the new developed fields of tourism. Advertising is one of the methods of increasing tourist attraction and influencing tourists' decision-making to choose a destination. The present research aimed to simulate the effect of advertising on the attraction of medical tourists in the hospitals of Yazd city.
Materials and methods: The present research is applied in terms of research objective, and in terms of methodology, it is in descriptive-analytical research. The statistical community was formed by university professors and experts in the field of medical tourism, and managers of hospitals and medical centers in Yazd. The snowball method was used for sampling. Information was collected through text reviews, questionnaires and semi-structured interviews with experts. The integrated and innovative approach of factor-based modeling and Taguchi method was used for data analysis, and the software used was AnyLogic and MiniTab.
Results: The results of the scenario execution revealed that among the advertising tools, internet advertising is more effective, and television ads, specialized tourism magazines, and seminars and conferences are in the next ranks. As the final output of the research, the investigation of the main effects related to each advertising tool led to identification of the suitable level of each tools and the presentation of the most favorable scenario based on the advertising program of Yazd hospitals.
Conclusion: Based on the fact that among the advertising tools, internet advertising has the greatest effect on attracting medical tourists, hospital management should pay special attention to internet advertising to attract more tourists in the field of medicine. In this way, more information will be provided to tourists and the demand for medical tourism will increase.
Hassan Niroomand Sadabad, Ali Vafaee Najar, Elahe Houshmand, Jamshid Jamali, Zahra Keyvanloo, Mahdi Dehnavi,
Volume 21, Issue 4 (1-2023)
Abstract
Background and purpose: Considering the important role of doctors in the implementation of accreditation standards and the necessity of their involvement in this process, this study was conducted in order to identify the views of doctors regarding the challenges of participating in accreditation programs in social security hospitals in Mashhad.
Materials and methods: This study is a cross-sectional descriptive-analytical research that was conducted in two hospitals of the Social Security Organization of Mashhad, Iran. in 2022. The participants were 56 full-time working doctors with at least one year of work experience in the hospital. Data analysis was done using SPSS version 26 software.
Findings: Among the challenges of doctors' participation in accreditation programs , the dimensions of the motivational mechanism (3.96±0.63) , provision of suitable resources for the implementation of accreditation (3.83±0.78), physician empowerment programs (3.78±0.73) and the role of the quality improvement office in attracting doctors' participation (3.75±0.74) were more important from the doctors' point of view, and patients' demands (2.90±0.75) and role ambiguity 2.77±0.96), were less important in their opinion.
Conclusion: Managers should consider that employee motivation and resource allocation are necessary for the effective implementation of the accreditation standard. Empowering doctors in the implementation of accreditation standards as well as the participation of quality improvement offices to interact with doctors and attract their participation are very important factors.
Rohollh Hosseini, Anis Javanmard,
Volume 22, Issue 1 (5-2023)
Abstract
Background: Achieving goals and developing hospital services depends on competence and optimal management. There will be competent managers who can be successful in performing managerial roles. Playing the roles supports the management in the direction of efficiency, administration and optimal management of the hospital. The purpose of this study is to evaluate and prioritize the roles of management in the hospital from the experts' point of view.
Materials and Methods: This research has a practical purpose and a descriptive and analytical approach. The statistical sample of the research included 65 experts from Imam Khomeini (RA) Al-Shatar Hospital, who were identified based on the snowball and selective sampling method. In this study, a self-made matrix questionnaire whose validity has been confirmed by experts was used to collect data. TOPSIS technique was used to analyze the data. In this study, five criteria and three main roles, which include 10 secondary roles, were identified
Results: The data analysis showed that the promotion of organizational commitment with the percentage of importance (23.2%) with the most important criterion, followed by organizational improvement criteria (20.9%), coordination and coherence (19.4%), promotion of employees' job motivation (7%) 18.00) and improvement of performance efficiency (18.4%) are ranked as effective indicators respectively. Also, the sub-role of analyst supervisor (0.926) was introduced as the most important role among the sub-roles of management in the hospital.
Conclusion: Considering that the role of decision-making was introduced as the most important role, as well as the consequences of decisions on the present and future of the hospital, it is necessary for the hospital management to pay more attention and importance to the role of decision-making in order to make optimal decisions.
Hossein Rahimi Klour, Seyed Ali Naghavi,
Volume 22, Issue 1 (5-2023)
Abstract
Background and objective: As a critical factor for hospital effectiveness, agility uncovers the way such organizations react to internal and external changes. From this perspective, the present study was to design an agent-based model to simulate organizational agility development in the hospitals of Ardabil Province, Iran, in view of the effective factors.
Materials & Methods: Utilizing an exploratory, mixed-methods research design, this study was performed in accordance with inductive-deductive reasoning. For this purpose, the samples included 10 theoretical and experimental experts, selected by purposive sampling of the non-probability type. As well, the data collection tools were interviews and questionnaires. During the qualitative phase, the main factors affecting organizational agility were initially isolated using thematic analysis. Afterward, the given factors were prioritized with the fuzzy Delphi method in the quantitative phase. Ultimately, the model for organizational agility development was simulated through the agent-based approach.
Results: With reference to the study results, 50 primary codes, 15 sub-themes, and 5 main themes were identified, and then “influence in management” was acknowledged as the most significant one shaping organizational agility. Besides, the simulation outputs demonstrated that the proposed model could provide the right estimate of the future of organizational agility development in the hospitals of Ardabil Province, Iran.
Conclusion: Along with the study results, hospital managers are suggested to reflect on the effective factors identified here to better fulfill organizational agility development.
Eesa Niazi, Fatemeh Chourlie,
Volume 22, Issue 2 (9-2023)
Abstract
Background and purpose: In response to evolving external environments, organizations must renew their valuable resources to sustain competitive advantage. Dynamic capabilities empower organizations to effectively navigate these continual changes. Essentially, dynamic capabilities foster a stable behavioral orientation within organizations, facilitating integration, reformulation, renewal, and reconstruction of resources and capabilities, particularly enhancing and revitalizing core capabilities in response to dynamic environments to achieve sustainable competitive advantage. This study explores the influence of dynamic capabilities on constructive collaboration and supply chain performance within healthcare centers. Dynamic capabilities are categorized into four perspectives: sensitivity, learning, coordination, and integration. Constructive collaboration serves as a mediating variable, while technological orientation acts as a moderating variable in the model.
Methods: This study adopts an applied purpose and descriptive-survey method. The statistical population comprises employees at Ayatollah Taleghani Gonbadkavus Hospital. Using a questionnaire adapted from Mandal's (2022) study, the research establishes relationships between variables, categorized as descriptive-analytical. The questionnaire's validity was assessed using convergence and divergence methods, and reliability was confirmed using Cronbach's alpha and composite reliability. Data analysis employed structural equation modeling and Smart-PLS software.
Results: Data analysis reveals a significant relationship between the learning, coordination, and integration perspectives of the hospital and constructive collaboration. However, no significant relationship is observed between the sensitivity perspective and constructive collaboration, nor between constructive collaboration and the performance of the healthcare system's supply chain. A significant relationship exists, and technological orientation does not moderate the relationship between the sensitivity perspective and learning with constructive collaboration, but it moderates the relationship between the coordination and integration perspective with constructive collaboration.
Conclusion: Improvements in collaborative efforts across various hospital departments, decreased risks of medical errors, enhanced service quality, and elevated professional status of staff are among the outcomes of assessing the performance of hospitals' sustainable supply chains.
Reza Pirayesh, Hamed Rastegarnia, Fatemeh Alilou,
Volume 22, Issue 2 (9-2023)
Abstract
Background and Objective: Employee creativity is a key element for
achieving sustainable competitive advantage in both private and public
organizations. This study aims to explore the influence of leadership styles
and feedback behavior on employee creativity growth, considering the
mediating role of the communication mechanism among employees of
public clinics in Zanjan.
Materials and Methods: This applied study follows a descriptive-survey
approach. Data were collected through field observations, questionnaire
distribution, and library research related to the study variables. The
statistical population included all employees of public clinics in Zanjan. From
209 people, 135 were randomly selected as the sample based on Cochran's
formula. The questionnaires were distributed and completed by these
individuals. Data collected via questionnaires were analyzed using structural
equation modeling with PLS and SPSS software.
Results: Feedback behavior (coefficient = 0.256), leadership styles
(coefficient = 0.543), and the communication mechanism (coefficient =
0.126) significantly influenced employee creativity. Additionally, feedback
behavior (coefficient = 0.267) and leadership styles (coefficient = 0.348)
significantly impacted the communication mechanism. The results also
indicated that the communication mechanism effectively mediated the
relationship between leadership styles (coefficient = 0.044) and feedback
behavior (coefficient = 0.034) on employee creativity growth.
Conclusion: The findings suggest that leadership styles and feedback
behavior significantly influence employee creativity growth through the
mediating role of the communication mechanism. Organizational managers
should leverage these factors to enhance their employees' creativity
Amir Fazel, Behnam Karamshahi, Azin Harandi,
Volume 22, Issue 3 (12-2023)
Abstract
Background and Purpose: Today, the use of strategic management accounting techniques within organizations is expanding rapidly. However, the implementation of these techniques and the examination of variables affecting them in hospitals remain largely unexplored. The aim of this research is to investigate the impact of accountants' networking on the use of strategic management accounting techniques, considering the moderating roles of hospital information systems and organizational culture.
Methods: This descriptive-correlational study utilized a 43-question questionnaire, whose validity and reliability were confirmed. The statistical population consisted of all employees and accountants in the finance and accounting departments of hospitals in Kerman, totaling 141 individuals. The census method was used to complete the questionnaire, with 139 questionnaires returned. Structural equation modeling and Smart PLS 3 software were used to test the research model.
Results: Statistical indices confirmed the model's appropriate fit (GOF=0.738). Networking of accountants, hospital information systems, and results-oriented culture positively influence the use of strategic management accounting techniques, whereas innovative culture has no effect. Additionally, hospital information systems and results-oriented culture positively moderate the relationship between accountants' networking and the implementation of strategic management accounting techniques, while innovative culture does not have any moderating effect.
Conclusion: This research contributes to the expansion of strategic management accounting techniques in hospitals and highlights the importance of influencing factors. Hospitals should apply these techniques while giving due consideration to the factors that affect them.
Saeede Afshari, Shaghayegh Vahdat, Iravan Masoudi Asl, Somayeh Hesam,
Volume 22, Issue 4 (1-2024)
Abstract
Background and purpose: In today’s competitive organizational landscape, the significance of recruiting and developing competent human resources has become paramount. Organizations not only aim to select and attract capable and efficient personnel but also seek to enhance and expand their capabilities. Consequently, the concept of meritocracy has become a key concern for modern organizations. This study aims to investigate the factors influencing succession planning in the leadership of healthcare organizations in Iran.
Methods: This qualitative study was conducted using content analysis in 2020. The statistical population comprised key decision-makers and policymakers in successful and prominent Iranian organizations known for effective succession planning, such as the Islamic Revolutionary Guard Corps (IRGC) and the public banking system. A total of 15 experts were selected through purposive and snowball sampling, with data collection continuing until theoretical saturation was achieved. Data were gathered through structured interviews, and the analysis and coding were performed using MAXQDA 11 software.
Results: The study identified five main themes: alignment of strategic goals and needs analysis, strategic communication and organizational structure, talent identification and empowerment, development and excellence of qualified individuals, and monitoring of succession planning programs. These were further divided into 13 sub-themes.
Conclusion: Organizations and managers should provide comprehensive support and demonstrate commitment to the effective implementation of succession planning programs. This will lead to improved organizational decisions and policies, ensuring that competent and qualified individuals are placed in key positions. Additionally, this approach will enhance work quality, boost employee motivation, reduce resource wastage, and improve career advancement opportunities for staff.
Seyed Masoud Mousavi, Sajjad Bahariniya, Aisa Mardani, Najmeh Baghian,
Volume 22, Issue 4 (1-2024)
Abstract
Background and Purpose: Organizational commitment among nurses, a critical aspect of hospital workforce management, is influenced by various factors, including job attachment. This attachment fosters motivation and commitment, which ultimately enhances the quality of healthcare services. This study investigates the relationship between organizational commitment and job attachment among nurses working in selected teaching hospitals affiliated with Shahid Sadoughi University of Medical Sciences in Yazd in 2022.
Methods: This descriptive-analytical study involved all nurses at Shahid Sadoughi Hospital in Yazd. A sample size of 298 nurses was determined using Cochran's formula. Data collection was conducted using the Job Descriptive Index (JDI) by Edwards and Kilpatrick (1984) and the Organizational Commitment Questionnaire (OCQ) by Allen and Meyer (1990). The data were analyzed using the Chi-square test with SPSS version 21 software and structural equation modeling via LISREL software.
Results: Among the nurses surveyed, 43.17% reported being satisfied with their jobs, while 40.17% exhibited organizational commitment. The findings revealed a significant relationship between job attachment and organizational commitment (P<0.001). The average scores were 3.75 ± 0.76 for the affective dimension, 3.97 ± 0.26 for the continuance dimension, 3.65 ± 0.36 for the normative dimension, and 3.74 ± 0.93 for overall job attachment.
Conclusion: The significant direct relationship between job satisfaction and organizational commitment highlights the importance of managerial focus on enhancing job satisfaction to increase employee responsibility and commitment. Managers should prioritize factors that improve job satisfaction as a means to strengthen organizational commitment.
Asgar Aghaei Hashjin, Ali Nemati, Seyed Mohammad Tabatabaee Jabali, Pouria Farrokhi,
Volume 22, Issue 4 (1-2024)
Abstract
Background and purpose: Iran is ranked among the top ten nations in the world for hosting a large number of migrants and refugees. During the COVID-19 outbreak, refugees and migrants were among the most vulnerable groups. This study aimed to investigate the extent of healthcare service utilization by refugees and migrants during the COVID-19 pandemic in healthcare centers affiliated with Iran University of Medical Sciences
Methods: This quasi-experimental study was conducted in 2021 in Tehran. The research environment included all healthcare networks and general and specialized hospitals. Data were collected through document review and registered information in the Sina system. All provided services were categorized into four groups: primary care, outpatient, emergency, and inpatient services. Data analysis was performed using the Chow test and Interrupted Time Series model with the Wats and Sctest software packages in R version 4.3.0.
Results: The decrease in utilization of outpatient, emergency, and inpatient services by refugees and migrants was significant (P-value < 0.001), whereas the decrease in primary care services was not significant. Additionally, after the onset of COVID-19, only the utilization of inpatient services showed a significant increasing trend (P-value < 0.013).
Conclusion: During the COVID-19 pandemic, the utilization of all healthcare services by refugees and migrants, including primary, outpatient, emergency, and inpatient care, decreased. It is recommended to provide complete insurance coverage for refugees, offer free treatment for impoverished refugees, increase awareness among refugees to encourage greater use of health services, reduce existing social and economic barriers, and facilitate interaction between healthcare providers and refugees.
Mehrak Pourmotahari, Soad Mahfoozpour, Shahram Tofighi, Shaghayegh Vahdat, Irvan Masoudi Asl,
Volume 22, Issue 4 (1-2024)
Abstract
Background and purpose: As health resources face increasing constraints, the use of medical imaging services has risen significantly. On average, diagnostic services account for approximately 10% of total healthcare expenditures, and this figure is steadily increasing. This study aims to identify the causes of irrational utilization of medical imaging services and propose corrective measures.
Methods: This descriptive-survey research was conducted in two phases. In the first phase, a comprehensive literature review was performed using both international and national databases, covering the period from 1990 to November 2021. Relevant studies were identified using specific keywords. In the second phase, a semi-structured questionnaire was developed, and a series of in-depth interviews with experts and professionals were conducted. Data were analyzed using the six-step thematic approach by Braun and Clarke, utilizing MAXQDA software.
Results: A total of 605 studies were initially identified, of which seven met the inclusion criteria after rigorous screening. In the second phase, 12 in-depth interviews were conducted, yielding 65 codes, which were organized into 12 themes. The identified themes included legal issues, conflict of interest, monitoring challenges, poor governance and stewardship, inappropriate policymaking and planning, financial incentives, inadequate service provision infrastructure, health culture, education and continuous training systems, financing and purchasing services, political factors, and inadequate insurance systems. Various strategies for controlling the inappropriate use of diagnostic and therapeutic services were proposed, including policy interventions, monitoring and evaluation, and training.
Conclusion: The irrational use of healthcare services is a significant challenge in many countries. Key contributing factors include incomplete insurance coverage, out-of-pocket payments by patients, defensive medical practices, and gaps in knowledge. Addressing these issues requires targeted interventions and reforms.
Mohammad Amin Zar Foroush, Zeinab Partovi Shayan, Ghasem Rajabi Vasakolaei,
Volume 23, Issue 1 (5-2024)
Abstract
Background and purpose: The laundry unit is one of the most critical support services in a hospital. Optimizing processes and implementing effective management strategies in this unit can significantly impact cost management. This study aims to examine various aspects of hospital laundry units.
Methods: This research was conducted across the teaching hospitals affiliated with Tehran University of Medical Sciences. The study employed a multi-step approach. First, the most crucial performance criteria for laundry units were identified through a fuzzy Delphi technique, consulting 20 experts in the field. These criteria were then weighted using the Step-wise Weight Assessment Ratio Analysis (SWARA) method. Finally, hospitals were ranked using the VIseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) method.
Results: The analysis of main criteria in the laundry unit revealed the following significance levels: "performance criteria" (56%), "equipment and facilities" (28%), and "cost management" (16%). Among the sub-criteria, "process" emerged as the top priority with a weight of 0.285, followed by "general laundry section regulations" (0.155), "safety and health" (0.139), and "general" (0.081).
Conclusion: The findings highlight the paramount importance of the "process" sub-criterion in hospital laundries. Consequently, we recommend updating guidelines for linen collection, washing, maintenance, and distribution. Furthermore, given that "general laundry section regulations" ranked as the second priority, we suggest implementing clear separation of dirty and clean pathways within the laundry unit and establishing a system for continuous recording and weighing of received garments. These measures can significantly enhance overall process management and cost efficiency.
Saied Moradi, Mohammadreza Rabiee Mandejin, Mohammad Mohammadi,
Volume 23, Issue 1 (5-2024)
Abstract
Background and purpose: The implementation of key components in the selection of meritorious candidates, ensuring they possess the necessary capabilities for key and sensitive positions, and adhering to the principle of meritocracy in the distribution of power and division of duties and responsibilities among society’s elites, not only contributes to the stability, growth, and development of the country but is also one of the secrets to the success and longevity of leaders. Therefore, this article aims to explain the factors influencing the competence development of public hospital managers, guided by the general policies of the health system.
Methods: The research was developmental in purpose and qualitative in method, utilizing thematic analysis. The statistical population included books, articles, documents, and knowledgeable human resources, comprising government management experts, hospital managers with a master's degree or higher, and at least ten years of experience in hospital management. The study employed a purposive approach with semi-structured interviews, continuing until theoretical saturation was reached (16 interviews)
Results: A total of 18 competence development factors were identified, categorized into 75 components and 671 dimensions. The implementation of the Strauss-Corbin model revealed that causal conditions included leadership, doctors, and staff. Intervening conditions encompassed the economy, research technology, and education. In addition to goals and missions, organizational platform, creativity, services, and structure were considered contextual conditions. Human resource management, public relations, and religion were identified as strategies, while the resulting consequences were classified into expertise, a knowledge-based economy, and internationalization.
Conclusion: According to the research findings, it appears that to advance, upgrade, and excel in hospitals that play a critical role in the health of society, these identified factors can be utilized to enhance the competence of public hospital managers.
Roohollah Askari, Hassan Jafari, Arefeh Dehghani Tafti, Neda Futuhi Tafti,
Volume 23, Issue 1 (5-2024)
Abstract
Background and purpose: Nurses, as the closest healthcare providers to patients, hold significant popularity and trust. Strengthening their competence in spiritual care is critical in ensuring holistic healthcare delivery. This study aimed to evaluate the spiritual care competence of nurses working in selected teaching hospitals of Shahid Sadoughi University of Medical Sciences in Yazd in 2023.
Methods: This cross-sectional study was conducted on 262 nurses employed in three selected teaching hospitals (Shahid Sadoughi, Shahid Rahnamoun, and Afshar hospitals). Data were collected using the Standard Spiritual Care Competence Questionnaire (SCCS) and analyzed through ANOVA, Mann-Whitney, Kruskal-Wallis tests, and Spearman's correlation coefficient using SPSS version 21 software.
Results: The overall mean score and standard deviation of spiritual care competence among nurses were 83.9±18.2, indicating an optimal level of competence. Among the dimensions of spiritual care competence, the "personal support and consultation with the patient" dimension scored the highest (18.8±5.2), while the "communication" dimension scored the lowest (7.3±1.6). The highest overall competence score was observed at Shahid Rahnamoun Hospital (88.5±17.7)
Conclusion: While the overall competence in spiritual care among the nurses studied was favorable, the low score in the communication dimension highlights the need for workshops focused on effective nurse-patient communication. Developing these skills can significantly enhance nurses' roles in improving patient health outcomes.
Mahshid Zare, Zahra Kavosi, Sedighe Sadat Tabatabaei Far,
Volume 23, Issue 1 (5-2024)
Abstract
Background and purpose: The COVID-19 pandemic has brought a significant shock to healthcare systems worldwide, including Iran. The mental health of nurses, who have been at the forefront of the fight against the virus, has been profoundly impacted. This study aims to examine the mental health status of Iranian nurses during the pandemic.
Methods: This rapid review was conducted by searching keywords such as "Mental Health," "Nurse," and "COVID-19" in databases including Google Scholar, PubMed, ScienceDirect, ProQuest, Mag Iran, and Civilica. Articles were selected based on their titles, abstracts, and full texts in alignment with the study’s research objectives.
Results: The reviewed studies revealed a range of mental health disorders among nurses working in COVID-19 wards, with stress, anxiety, and depression being the most common. Several factors, such as demographic variables and the specific departments where nurses served, were identified as influencing their mental health. Given that the mental health of nurses affects the quality of care, resilience, and job satisfaction, various strategies have been proposed to improve their mental health.
Conclusion: The findings suggest that the mental health status of nurses is not at an optimal level, and neglecting this issue could lead to long-term harm to the healthcare system and its economic stability. It is recommended that healthcare managers and policymakers implement appropriate measures to address this critical concern.
Seyed Mohammad Mahdi Heydari Baghdadabad, Alireza Maetoofi, Ali Farhadi Mahalli , Mojtaba Tabari,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose: Hospitals play a critical role in promoting public health and well-being in social contexts. This necessitates codified standards aimed at maintaining treatment quality and enhancing social satisfaction. Hospital accreditation policy evaluation is considered a systematic process that can have significant social and functional implications for hospitals. This study aims to present an evaluation model of hospital accreditation policy based on the process of paradigmatic phenomenology.
Methods: Using Husserl's (1970) phenomenological approach, this study developed a paradigmatic evaluation model in five analytical steps. First, through interviews with experts and open coding, propositional themes related to the phenomenon under study were identified. A focus group was then formed to discuss and analyze these propositions. Each proposition was scored using the Q-method checklist, with scores ranging from +6 to -6, to identify paradigmatic clusters.
Results: During the qualitative analysis, 16 interviews resulted in 138 open codes. After eliminating redundancies and overlapping codes, 50 propositional themes were finalized. These themes were organized into conceptual clusters within the framework of paradigmatic phenomenology, following Husserl's methodological steps.
Conclusion: The study's findings underscore the formation of a hospital accreditation policy evaluation model structured around causal, intervening, contextual conditions, strategies, and outcomes. This model has the potential to enhance the effectiveness of healthcare service delivery and improve the overall quality of treatment in society.
Shadi Khalilolahi, Nasrin Kazemi, Saeid Besharati, Atefe Abedini, Mohammad Varharam,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: The globalization of medical tourism has intensified competition among destinations, making it crucial to identify key success factors. While research emphasizes the role of host communities in tourism development, non-medical aspects of medical tourism remain underexplored. This study examines healthcare staff perspectives to identify the drivers and barriers affecting medical tourism in public hospitals.
Methods: This qualitative study employed structured interviews with 16 healthcare staff at Masih Daneshvari Hospital, selected through purposive sampling. Interviews were conducted in person during the summer of 2024 until data saturation was reached. Data analysis followed an inductive content analysis approach using MAXQDA software for coding, grouping, and categorization of themes into drivers and barriers.
Results: Key drivers of medical tourism development include skilled human resources, strong medical potential, affordable healthcare and associated costs, and the presence of complementary attractions. Conversely, major barriers include inadequate welfare services for medical tourists, managerial and institutional inefficiencies, hospital infrastructure deficiencies, and political and cultural challenges.
Conclusion: Developing a successful medical tourism sector requires a holistic approach. Identifying, prioritizing, and implementing strategic plans to strengthen facilitators and address obstacles are essential steps toward sustainable growth in this field.
Milad Mehri, Mohammad Efatpanah, Ebrahim Jaafaripooyan, Mohammad Arab,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: Abuse within health insurance systems represents a significant challenge for health systems globally, leading to substantial negative repercussions. This study investigates instances of abuse in the Iranian Health Insurance Organization and proposes strategies to mitigate such abuses within its primary insurance processes.
Methods: This applied study employs a qualitative methodology, with data collected via semi-structured interviews. Experts from the Iranian Health Insurance Organization were interviewed to gather their insights. Data analysis was performed using conventional content analysis, and MAXQDA 20 software was used for coding and categorizing the findings.
Results: Instances of abuse within Iran’s health insurance system were classified into two main categories: "providers" and "service recipients," which were further divided into 18 subcategories. The underlying causes of these abuses were analyzed on two levels: macro-level factors (economic, cultural-social, legal, and technological) and micro-level factors (implementation processes, oversight, and service delivery). Based on these findings, strategies for reducing abuse were proposed in three primary areas: "planning," "execution," and "control." These strategies included revising and amending relevant laws and regulations, enhancing technological infrastructure, and improving information systems in the planning phase; verifying the identities of service recipients and providers during service delivery; and strengthening oversight personnel, alongside continuous inspections, in the control phase.
Conclusion: This study indicates that revising laws and regulations within the insurance sector, upgrading technological infrastructures, providing continuous training for claims assessors, enhancing inter-organizational communication, and strengthening oversight of service providers are essential strategies for preventing abuse in the Iranian Health Insurance Organization.
Morteza Ghaderi Azarkhavarani, Mohammadreza Khajeh Aminian, Milad Ahmadi Marzaleh, Mohammad Hosein Yarmohammadian, Seyed Masood Mousavi, Hassan Nouri Sari,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: The Emergency Operations Center (EOC) is a centralized facility designed to coordinate disaster management activities across all phases of the disaster management cycle. EOCs play a vital role in facilitating efficient and effective responses by coordinating information and resources. This study aims to highlight the importance of establishing a standardized framework for EOCs in Iranian universities of medical sciences and to examine its key dimensions.
Methods: This study is a commentary article that compiles information from published literature on the framework of emergency operations centers. It focuses on two prominent global frameworks: the World Health Organization’s Public Health Emergency Operations Center Framework and the U.S. Federal Emergency Management Agency’s Emergency Operations Center Guidelines. The study emphasizes the necessity of creating a standardized framework for emergency operations centers in Iranian universities of medical sciences.
Results: EOCs across different countries vary in terms of their missions, authorities, and resources. Consequently, the frameworks used in these centers are not uniform, and are largely shaped by the governance and regulatory requirements specific to each country.
Conclusion: A standardized framework, tailored to the specific needs and conditions of Iran, is essential for EOCs at universities of medical sciences. Such a framework could enhance the operational capabilities of these centers during incidents and disasters, improving their responsiveness and effectiveness.
Shahrzad Rasekhi, Sedighe Sadat Tabatabaei Far, Abdosaleh Jafari,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: This study aimed to review the average waiting time of patients referred to emergency departments in Iran and to identify the key factors influencing it.
Methods: A systematic search was conducted in scientific databases including PubMed, ScienceDirect, ProQuest, Scopus, Web of Science, Magiran, and Civilica using keywords such as "waiting time", "duration", "emergency", and related terms. After applying the inclusion criteria, 26 relevant studies were selected for analysis.
Results: Findings from this rapid review showed wide variations in reported waiting times. The average time from patient arrival to the first physician visit ranged from approximately 2 to 32 minutes. The time to the first medical intervention ranged from 3.7 to 262 minutes. The time from diagnostic test request to receiving results ranged from 20.17 to 629.2 minutes for laboratory tests, 5.85 to 1080 minutes for radiology, and 3.7 to 32.3 minutes for electrocardiograms. The most significant factors affecting patient waiting times included patient-related characteristics, reasons for referral, hospital and emergency department-related factors, and human resource availability and performance.
Conclusion: Patient waiting times in emergency departments are influenced by a range of interrelated factors. To reduce delays, it is recommended to improve triage systems, enhance human resource management, implement smart technologies, upgrade infrastructure, and increase public awareness through patient education.
