Somayeh Nouri, Dr Leila Riahi, Dr Kamran Hajinabi, Dr Katayuon Jahangiri ,
Volume 16, Issue 4 (2-2018)
Abstract
Background: Priority setting and resource allocation are assumed to be the most important issues of health-sector and fairness thereof requires considering various criteria. This study was performed to identify the criteria used for priority setting and resource allocation in the world health systems through comprehensive review.
Materials and Methods: Cochrane, PubMed and SCOPUS database were searched systematically from Jan.1,2005 to Oct.10,2016. The English articles with codified and specified qualitative and quantitative criteria in the resource allocation context in health sector were included in the study. The obtained data were synthetized thematically.
Results: Overall, 9162 papers were extracted. At the beginning of review of the included articles, 9089 papers were removed due to duplication and also based on the title. The abstracts of the remained papers were reviewed and 17 papers were removed. Full text of 59 remained papers were reviewed and based on matching with the inclusion criteria, 34 other papers were removed, too, and ultimately 25 papers were included in the final phase of the study. Extracted criteria were categorized into four dimentions based on economic, management, structural and contextual, out of which the most frequent ones were related to cost, health system goals, local capacity and disease status, respectively.
Conclusion: In this study, the most important criteria used by policy makers and decision makers of health system in the world were extracted for priority setting and resource allocation. The results indicated that in the world, priority setting and resource allocation in the health system is made mainly based on criteria such as cost-effectiveness, disease status, equity/equality and the need.
Dr Nader Tavakoli, Milad Amini, Dr Mahsa Mahmodinejad, Mohammad Veisi, Dr Hasan Amiri, Yousef Sadat, Ali Tahmasebi,
Volume 17, Issue 1 (5-2018)
Abstract
Background: Assessment of appropriate and inappropriate services offered at the hospital is a very important topic to improve resource allocation. Thus, this study performed to assess inappropriate admission and length of stay to modify extra costs and effective resource management.
Materials and Methods: This study was a descriptive-analytic one which conducted as a cross sectional study in the first half of 2017. The Appropriateness Evaluation Protocol(AEP) was used to collect data. A total of 420 patients hospitalized in Haft Tir and Firoozgar Hospitals were selected using stratified sampling method. collecting data was analyzed using descriptive and analytical statistics by SPSS18.
Result: 391 individuals were admitted appropriately and 29 were classified as inappropriate admission. The rate of inappropriate admission estimated about 7% in the hospitals. female Sex, type of admission, the length of admission and place of patient residence had effect on prediction of inappropriate admission rate (p ≤ 0.05).
Conclusion: Considering the high percentage of inappropriate admission and stay length of patients as well as high costs of health services in these hospitals, the problems can be greatly reduced using proper planning, admissions management between the hospital units.
Dr Bakhtiar Ostadi, Reza Mokhtarian Daloie, Dr Mohamad Mahdi Sepehri,
Volume 17, Issue 4 (2-2019)
Abstract
Background: Today, hospitals have faced many requests for quality services, while their costs are increasingly growing as well. These facts; Therefore, necessitate much more attention from hospital mangers in order to reduce healthcare costs. Moreover, the urgent need for a precise costing approach is more evident. Activity-based costing provides useful information on the activities required to achieve services with desirable quality. However, given that the basic information for ABC system is provided under conditions of certainty, the possibility of using this approach in terms of uncertainty would be greatly decreased. This study aims to propose a new framework called FL-ABC.
Materials and Methods: Since, costing processes environment happen under conditions of uncertainty in the hospital, fuzzy logic in the ABC model was used in order to make more accurate estimates of hospital costs and increase the reliability of the results.
Results: This proposed model was used in a hospital lab unit and the results were compared with the standard ABC system. The results showed that the maximum difference in the prescribed costs was 77708951.89 and 67508112.57 IRR in serology and parasitology tests, respectively, mostly due to uncertainty in the assigned costs to each activity.
Conclusion: The FL-ABC system, in terms of taking into account the uncertainty in the parameters of cost, provides more accurate estimates of the cost of activities under conditions of uncertainty which estimates the costs of health care services more accurately.
Dr Aboulghasem Pourreza, Dr Batoul Ahmadi, Dr Jamil Sadeghifar, Mohsen Mohammadi, Mohammad Veysi,
Volume 17, Issue 4 (2-2019)
Abstract
Background: Femoral fracture surgery is one of the most common and expensive surgical procedures and forearm fracture surgery is common performed by Ilam Imam Khomeini Therapeutic Center. This study conducted to analyze the difference in actual cost and global surgery tariffs in this hospital.Also, the related factors acutal cost of mentioned surgery were identified.
Materials and Methods: This cross-sectional and descriptive study was conducted on factors related to the actual costs of femoral and forearm fractures. The Activity-Based Costing approach identifies the related cost associated with these surgeries in through six steps. Data analysis was performed using Excel 2016 software.
Results: The avarage actual cost of the femur fracturs , the code 2 forearm and the code 1 forearm were 953 thousand and 700 tomans, 444 thousand and 400 tomans and 337 thousand and 800 tomans , respectively. The actual cost of surgery for femoral fracture per unit surgery was 406,000 and 400 tomans lower than the Ministry of Health's tariff. But ,the real cost of the code 2 forearm was 33 thousand tomans higher, as well as the code 1 forearm 20 thousand tomans higher than the global tariff.
Conclusion: Overall, there are significant differences between hospital costs and the Ministry of Health's global tariff. That can be corrected by improving the hospital's performance, as well as carefully examining the cost of global surgical procedures for amending the system of tariff regulation and make the actual amount closer to the tariff level.
Saeide Alidoost, Dr Aziz Rezapour, Rahim Sohrabi, Roghayeh Mohammadibakhsh, Dr Ali Sarabi-Asiabar, Narges Rafiei,
Volume 18, Issue 1 (5-2019)
Abstract
Background: The hospitals' reliance on insurer organizations' resources is increasing due to the growing number of insured persons. However, a relatively large share of these revenues cannot be collected for various reasons and is considered as hospital deductions from revenue. Hence, this study aimed to investigate the causes of hospital deductions from revenue and strategies to reduce them in hospitals affiliated to Iran University of Medical Sciences.
Materials and Methods: This qualitative study was conducted based on the phenomenological approach in 2017. Data was collected through semi-structured interviews consisting 17 finance experts in hospitals. Data analysis was performed using MAXQDA version10 and analytical framework of Gale et al. (2013).
Results: Based on the framework analysis, two themes were identified as the underlying causes of hospital revenue deduction including direct causes and root causes of revenue deduction. Also, in order to reduce revenue deduction strategies, eight themes were recognized including interaction with insurance organizations; analysis, assessment, and feedback on revenue deficit; coordination and empowerment of employees; proper organization of human resources; strengthening regulatory system, motivational strategies; good planning and creating an organizational structure.
Conclusion: The revenue deductions occur in all stages of converting services into income and the most important factor is lack of staff awareness and incentive to control deductions. Contributions of all process owners in the hospital and insurers and in particular the commitment of hospital’s senior managers are necessary to control the deductions.
Dr Nasrin Shaarbafchi Zade, Dr Alireza Jabbari, Mehri Hashemian,
Volume 18, Issue 2 (8-2019)
Abstract
Background: Calculating the cost of services enables the existing resources to be used in the most efficient and effective way possible. Time- Driven Activity Based Costing is a method that, in addition to costing, also calculates the efficiency and unused capacity of resources. The purpose of this study was to use this method to calculate the costs of radiology and CT scans services in two hospitals.
Materials & Methods: The present cross-sectional and retrospective research was done in a descriptive-analytic manner in two hospitals affiliated to Isfahan University of Medical Sciences in 2018. Data were collected in designed Excel forms, and costs of services were calculated using Time- Driven Activity-Based Costing (TDABC) method.
Results: The cost of most radiology services and total CT scan services in the government sector was more than that of the private sector. The unused capacity of resources in the public sector was more than private sector. The time spent for providing the services in the two hospitals was the same except for the technician's career. The average cost of radiology services was 223324 in hospital (A), and 194094 Rials in hospital (B). The average cost of the CT scan services was 600522 in hospital (A), and 485230 Rials in hospital (B).
Conclusion: According to the findings of the study, the need for human resources management to reduce unused capacity and increase efficiency, as well as improving service delivery processes in order to reduce the time required to provide services seems necessary. Replacing low-cost resources is another solution that is effective in reducing costs. The standards of the most efficient centers of health services are often worth the benchmarking.
Vahid Alipour, Aziz Rezapour, Ebrahim Hasanzadeh, Saeid Bagheri, Mohammadreza Sheykhi Chaman, Yaghoub Yousefi,
Volume 18, Issue 3 (10-2019)
Abstract
Background: Activity-Based Costing Analyzes the Activities Performed in the Service Delivery Process and Accurately Identifies Costs to Improve The Performance and Efficiency of The Delivery Units and Calculates the Cost of Each Activity by Identifying Services and Activities. The Purpose of This Study Was to Calculate the Cost of Radiology Services Based on Activity Based Costing Method In Firooz Abadi Hospital.
Materials and Methods: This is a descriptive retrospective study conducted in 2018. Data were collected through interview with Hospital officials, direct observation and from existing documents in hospital. Data entry was done through Excel software and analyzed Based on activity-based costing system in eight steps.
Results: Based on the Findings of this Study, Four Types of Imaging Services Were Commonly Found In Firooz Abadi Hospital. From Total Radiology Costs, 79.3% Were Estimated to Be Related to Direct Costs and 20.7% to Indirect Costs. Finally, the Cost Per CT Scan Service Was 725,133 Rials, Mammography 608,054 Rials, Radiology 809,165 Rials and Ultrasound Service 512,692 Rials.
Conclusion: Results of the Study Indicated that Direct Costs accounted for most Costs in Radiology Unit, So Improving Performance and Policies in Health System, Particularly in Human Resource Management, Service Consumption Standardization and Staff Training Suggested to Cost Reduction.
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.
Arash Mofarahzat, Ali Akbar Fazaeli, Yadollah Hamidi,
Volume 19, Issue 1 (4-2020)
Abstract
Background and Objective: Tuberculosis is an infectious disease and is the leading cause of death from single-agent infectious diseases. The purpose of this study was to estimate the economic costs of this disease and its effective factors in Hamadan province.
Methods: This descriptive-analytical study was conducted on a cross-sectional (two-year time scale) study in 2014 and 2015. The population of this study is tuberculosis patients in Hamadan province. Data extraction was performed by examining the file of patients with tuberculosis in urban and rural health centers and patients of hospital in Hamadan. Also, using a logistic model and Stata 15, social factors and households that are more likely to be exposed to this disease were studied.
Results: A total of 173 tuberculosis patients were identified, with an estimated cost of treatment of 8307 million IRR. Also, the results of the Logit model showed that people living in the city over 65, low educated, and people with HIV The order of 22, 14, 18, and 6 percent would be greater than the likelihood of exposure to tuberculosis.
Conclusion: The cost of tuberculosis, in addition to allocating a significant amount of health resources in the province, also imposes a high burden on households. The social and economic consequences of these costs lead to many abnormalities such as the exclusion of women with a family or the abandonment of the children of affected people.
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.
Hojjat Rahmani, Ghasem Rajabi Vasoukola, Rajabali Daroudi, Mani Yousefvand, Zeinab Fakoorfard,
Volume 19, Issue 4 (12-2020)
Abstract
Background: Considering the importance and position of the health sector in socio-economic development programs, it is necessary to be aware of the current situation and to recognize its issues and problems. Determining costs and the amount of profit or even loss in the health sector helps in managing costs. The purpose of this study was to evaluate the cost of common laboratory services and compare them with the tariffs approved by the Ministry of Health and Medical Education in the selected hospital of Tehran University of Medical Sciences.
Materials and Methods: The present study was a cross-sectional and retrospective study. In this study, activity-based costing technique was used. The study population was the laboratory of the selected hospital of Tehran University of Medical Sciences. Data collection tools were information forms, software, interviews and direct observation. The analysis was performed using Excel 2016 software and finally, the cost price was compared with the approved tariff.
Results: The findings indicated that the highest and lowest costs were related to the cost of manpower and energy carriers, respectively. The highest cost was related to the urine analysis test and the lowest was related to the sodium and potassium tests.
Conclusion: The results of this study showed that the cost of conventional laboratory services in the selected hospital of Tehran University of Medical Sciences and the tariffs approved by the Ministry of Health and Medical Education in 2019 were different.
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.
Hossein Dehghanzadeh, Mohammad Meskarpou_amiri, Sayyed_morteza Hossein_shokouh, Mohammadkarim Bahadori, Javad Khoshmanzar,
Volume 20, Issue 1 (5-2021)
Abstract
Background: Due to the legal necessity of changing the approach of universities from traditional budgeting into the operational budgeting system, it should be noted that this method of budgeting is associated with challenges. The aim of this study was to evaluate the feasibility and prioritization of operational budgeting dimensions in a military medical university.
Materials & Methods: This descriptive-analytical and cross-sectional study was conducted in 2020 in two stages. In the first stage, 68 managers, staff and experts of the deputy for Planning and Finance of a Military Medical Sciences university were enrolled by census method. In the second stage, 10 experts were purposefully included in the study. Data collection tool was two valid and reliable questionnaires. Data were analyzed using t-test and SPSS software in the first stage and using AHP approach and Expert Choice software in the second stage.
Results: The average overall score and the score for each of the dimensions of ability, authority and acceptance of operational budgeting was 2.3, 2.39, 2.38 and 2.31, respectively which was at an undesirable level (P< 0.05). Also, dimensions of the ability with a weight of 0.547, acceptance with a weight of 0.244 and authority with a weight of 0.209 had the highest weight and importance in the implementation of the operational budgeting system, respectively.
Conclusion: Based on the results, it is necessary to pay attention to the three main dimensions of ability, authority and acceptance in implementing operational budgeting in the study population.
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.
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.
Elahe Eyshi, Omid Khosravizadeh, Aisa Maleki, Bahman Ahadinezhad,
Volume 21, Issue 2 (9-2022)
Abstract
Aim & Background: Cost management is the most important factor affecting the economic performance of the hospital. Good management of costs in the short term stabilizes and balances the operating balance of the hospital and secures the hospital in terms of liquidity. Also, good management of costs in the long term makes the hospital financially stable. According to the mentioned cases and increasing hospital costs, the present study was conducted with the aim of identifying and investigating the factors, drivers and obstacles to improve cost management.
Methods & Materials: This systematic review was conducted in 2020. Data was collected through searching keywords in Google scholar, PubMed, Scopus, Web of Science, Science direct, Magiran, SID and Irandoc databases from 2007 to 2020. The classification of the results of the studies was done by the researchers.
Results: All the components identified and extracted from the articles were divided into four dimensions (increasing factors, prerequisites, obstacles and solutions) to improve hospital cost management.
Conclusion: Reviewing the results of each study showed the importance of each component in managing, improving and controlling hospital costs. In this regard, policy makers at decision-making level and managers at executive level should pay attention to the components and dimensions affecting the control and improvement of hospital costs according to the structure, process and expected consequences, and then decide on their implementation.
Sorayya Adelpourdehnavi, ُseyedeh Samaneh Miresmaeeli, Aidin Aryankhesal,
Volume 21, Issue 2 (9-2022)
Abstract
Background
Satisfaction with the salary and other payments and the way they are distributed are of the most important and effective dimensions of human resources management. The purpose of this study was to determine the level of employee satisfaction with the performance-based payment plan in 2021 across hospitals.
Materials & Methods
This was a cross-sectional study conducted in 2021 on 280 employees of teaching hospitals affiliated to Iran University of Medical Sciences. Data were collected by a questionnaire and analyzed by non-parametric tests and Spearman correlation in SPSS.
Results
The mean of total satisfaction in the staff was 2.95 ± 0.55 (out of 5). Among the various categories in the field of satisfaction, the highest mean of satisfaction was related to the physical conditions of the workplace with 3.3 ± 0.64 (out of 5) and the least was related to the payment system with 2.56 ± 0/86. The mean performance of all employees was 63.72 ± 8.82. (out of 100). In this regard, the mean score of staff attendance was 74.22 ± 6.97, job type was 30.97 ± 15.78 and the average quality coefficient of performance was 85.98 ± 11.12. According to the Spearman correlation test, there was a significant correlation between mean total satisfaction and attendance score (r = 0.19), job type score (r = 0.32) and performance quality coefficient (r = 0.21) (p-value <0.05).
Conclusion
The mean of employee satisfaction with the performance-based payment scheme was estimated to be moderate. It seems that health policy makers need to work and plan to improve payment and increase the motivation of healthcare staff.
Sanaz Zargar Balaye Jame, Nader Markazi Moghaddam, Hesam Sharifnia, Mehrdad Khoshian,
Volume 22, Issue 3 (12-2023)
Abstract
Background and Purpose: Medical imaging is one of the most expensive sections of a hospital due to the use of superior technology, specialized personnel, and adherence to special protective regulations, all of which have a direct impact on the diagnosis and treatment of diseases. Time-driven activity-based costing (TDABC) provides an overview of hospital activities, enabling the identification and management of costs and resources with greater accuracy and ease. The purpose of this study is to examine the total costs of services and the unused capacity of resources to provide financial management solutions for hospital administrators.
Materials and Methods: This descriptive and retrospective study was conducted on the statistics and accounting data of a general hospital in Tehran in 2018. The study falls under the category of applied research due to the potential use of the results in financial management and resource consumption. The data collection method included the review of documents and financial statements, timing of all activities in the imaging department, and calculations based on the time-driven activity-based costing method, using Excel software, with the elimination of the cost of unused resources.
Results: The study found that the total cost was mostly below the approved tariffs, with the main cost components being 34% manpower, 23% overhead, 22% equipment, and 15% consumables. The findings indicated that only 58% of resource provisioning expenses played a role in determining the total cost of services.
Conclusion: The findings of this research suggest that reducing the unused capacity of resources and organizational reforms can decrease the total cost of services, increase profitability, and optimize resource usage to enhance the quality of hospital services.
Masoud Ali Karami, Hadi Hayati,
Volume 22, Issue 3 (12-2023)
Abstract
Background: The rise in healthcare expenditures, particularly drug costs, has posed a significant challenge to the healthcare system. This issue is particularly critical for chronic diseases such as diabetes, as various factors influence patients' access to these medications and their financial ability to pay for them. Thus, this study aimed to investigate the access and purchasing power for anti-diabetic drugs in pharmacies and hospitals in Khorramabad city in 2022.
Materials and Methods: This descriptive-analytical study included patients and visitors to private pharmacies and hospitals in Khorramabad. The required information was collected through patient prescriptions, pharmacy records, interviews, and checklists based on the World Health Organization protocol. Data analysis was performed using t-test, chi-square, ANOVA, and logistic regression, utilizing SPSS version 21 software.
Results: The findings revealed that among the socio-economic factors affecting the financial ability to pay for diabetes medications, income level is identified as a significant factor, particularly in patients with underlying conditions, where their income is adversely impacted. Additionally, the results indicated that, unlike the free market, in the healthcare and pharmaceutical market, no socio-economic factor from the demand side (i.e., patients) influences pharmacies as drug suppliers in terms of the accessibility index.
Conclusion: Despite the good availability of medications in pharmacies, the financial constraints faced by patients in covering medication costs suggest that government intervention through measures such as enhanced insurance coverage and medication subsidies could support economically disadvantaged groups.
Roholah Hosseini, Mohammad Reza Zaman Parvar Barkosrai ,
Volume 22, Issue 3 (12-2023)
Abstract
Background and purpose : Managers, as the most important organizational decision-makers, have a significant and decisive role in the success and development of hospitals. Competency models help hospital managers to apply the knowledge, skills, and experiences needed to fulfill their responsibilities and mission. It helps them to do their jobs more successfully. The purpose of this study is to design a management competency model in order to optimize management systems in Karaj hospitals.
Methods: The current research is based on a quantitative approach, and in terms of its purpose, it is an applied research type, and in terms of data collection, it is a survey type. The statistical population of his research was all employees and medical staff in the hospitals of Karaj city. The sample size is 384 people and stratified random sampling method was used.The data was collected using a researcher-made questionnaire whose validity was confirmed by experts. The software used in this research is SPSS22 and AMOS.
Results: According to the findings The impact of the six main dimensions of the management competency model included Knowledge competence (1.02), personal competence (0.98), interactive competences (0.38), executive competences (0.51), value and moral competences (0.42) and in The maximum job qualifications (0.41) were determined.
Conclusion: Based on the findings The impact of knowledge and personal competence on management competence in hospitals is higher than other dimensions. In other words, management competence in the hospital is highly dependent on the knowledge and personal competence of managers. Also, based on the goodness of fit index, the hospital management competency model was modified and evaluated within the standard. It is suggested to provide the basis and preparations for the implementation of the model for appointing competent managers and improving the competence of the hospital management system.
