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Background: Today, one of the effective ways of providing services is contracting with outside of organization and outsourcing. Objective: The current study aimed to investigate effect of outsourcing on performance of nutrition unit in studied hospitals. Methods: The current descriptive – analytical study performed in 2013, in two non-military hospitals and two military hospitals. 602 patients and 930 personnel were selected by simple randomized sampling. Data gathering performed by Patient and personnel satisfaction questionnaire, check list of kitchen's hygiene condition and check list of assessing the time spent by hospital manager for nutrition unit. Data on personnel cost were collected through accounting department. Data analysis performed by spss19 software. Findings: Patient and personnel satisfaction with food services of non-military specialized hospital (4.03±0.45) were more than military specialized hospital (p= 0/03 for patients & p= 0/021 for personnel) and in non-military general hospital were more military general hospital (p= 0/039 for patients & p= 0/028 for personnel). Hygiene condition of non-military hospitals kitchen was better than military hospitals, the time spent by hospital manager for nutrition affairs in military specialized hospital was 1.5 times more than non-military specialized hospital and in military general hospital it was 6.5 times more than non-military general hospital. Personnel cost in nutrition unit of military hospitals were 1.5 times more than non-military hospitals. Conclusion: Regarding the positive impact of outsourcing on performance of nutrition unit in hospitals, it is recommended that this strategy be applied in nutrition unit of military hospitals.

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Background: Depression is a common disorder with incremental trend among patients with hemodialysis. This study conducted in order to determine correlation between social support and depression among patients undergoing hemodialysis of Kerman city.

Materials and Methods:  This study was a cross-sectional one. 182 hemodialysis patients referred to health centers of Kerman were selected by census sampling method. data was collected Using questionnaires  including demographic information, Beck's Depression Questionnaire (BDI) and Social Support Questionnaire (ESSI: Enriched Social Support Instrument) and analyzed  by SPSS  software version 17 utilizing descriptive statistics (mean and standard deviation) and Pearson Correlation Coefficient test.

Results: 68.1% of the subjects had some degree of depression. Also, 83% of participants reported good social support. Furthermore, Assessing the relation between depression and social support revealed an inverse relationship between depression and social support (P =0.005), increasing social support occurred decreasing depression as well. 

Conclusion: Study results indicated high prevalence of depression among the patients. It seems special attention in should be paid to psychological issues in hemodialysis wards. Nurses can prevent depression incidence by recognizing high risk individuals in term of perceiving social support among these patients. 

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Background: Physiotherapy information system is one of health information systems which used to increase the efficiency and effectiveness of physiotherapy department. Studies have revealed due to usability problems, users' interaction with some information systems is complicated. This study aimed at evaluating users' interaction problems with physiotherapy information system.

Materials and Methods: This study was a cross-sectional and descriptive one which performed using heuristic evaluation method; the users' interaction problems of a physiotherapy system among 105 hospitals were identified, classified and rated based on their severities by three evaluators. Data were gathered using a data collection form designed in Excel software.

Results: In this study, 82 unique interactive problems identified which majority of them 28% (n=23) were related to unconformity of system design with real world conventions with major mean severity of the problems. The lowest numbers were related to the problems including lack of guidance, system documentation and error prevention with major and minor severity respectively.

Conclusion: A number of systems, which are used in many health care centers such as assessed system in this study suffer from several problems which endanger user interaction about the systems can lead to error and patients' harm. To identify and eliminate this type of problems, it is recommend that usability evaluation of these systems to be carried out regularly to enhance users' satisfaction, workflow improvement and patient safety. 

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Background: Todays, hospitals are facing with shortage of resources and increasing costs challenges, So, cost information and cost calculation of hospital delivered services can be effective in efficient resources allocation and tariff rates reforming and budget. This study aimed at calculating the cost of services and  physiotherapy department's income of Sina hospital and comparing with approved tariffs in 2013-2014.

Materials and Methods: This study was a cross sectional and retrospective one. The cost price of 13 physiotherapy services calculated using Activity Based Costing method for physiotherapy unit of Sina hospital of Tehran in 2013-2014. Data collection tool included some forms related to services costs of physiotherapy and related activity centers. Also, in order to estimate cost proportion of other wards in physiotherapy unit, the proportional allocation bases was determined, then direct allocation method was utilized.

Results: The most costs of 13 provided services were less than tariffs in 2013. Generally, the costs pertain of physiotherapy services computed 794286777 Rials which workforce costs (48.4 percent) was the most proportion and then energy buildings depreciation and equipment costs. This issue is due to equipment dependency in physiotherapy unit services.

Conclusions: study results revealed there was difference between real cost of services and approved tariffs, therefore, in order to more accurate pricing, exact calculation methods such as Activity Based Costing recommended. Considering high personnel and capital costs pay special attention to these resources, appropriate use, identifying and omitting wasted costs can be effective in increasing efficiency and saving costs.

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  Abstract

  Background and Aim: Especially in the case of Hospital services, quality assesment is an complicated and vague issue. For achieving this goal Multiple Criteria Decision Making methods help us. These studies aims to knowledge and prioritize quality indicators and rank selected inpatient wards in an elected hospital of Tehran university of medical science by using Analytical Hierarchy Process and TOPSIS methods.

  Materials and Methods: This is a descriptive-analytical and cross-sectional research. At the first, with an overview of the research literature and expert opinion, indicators of quality assessment were selected. Then we did prioritization of these indicators with using of expert opinion and AHP method. In the final stage, selected inpatient wards the Hospital were ranked in terms of quality of service using TOPSIS by a sample consist of 300 of inpatients.

  Results: Eight main domains (Responsiveness, Safety and risk management, Tangibles, attention to patient, Health communications, Competency and professionalism, accessibility, Credit and assurance) were selected for quality assessment. Among these indicators, competency had the highest priority and attention to patient had the lowest priority. Also the department of Heart had the highest quality of service and the department of Neurology had the lowest quality.

  Conclusion: According to crucial role of the service quality on patients’ satisfaction, the use of appropriate indicators for quality of services, prioritizing them and also proper assessment of the quality of hospital services can play a major role in health policies.

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Background: Hospital accreditation is assumed as an effective control mechanism for health systems to improve quality and efficiency. Current study thus, seeks to look into the relationship between hospitals’ accreditation and efficiency
Materials and Methods: In order to measure efficiency, hospital inputs and outputs included the ratio of physician and nurse to bed, mortality and nosocomial infection rate and quality of inpatientservices were used. A sample of 554 hospitalized patients selected using stratified random sampling
method. Data gathering instruments were researcher-developed questionnaire and checklists. DEAP and SPSS software deployed to assess correlation between accreditation rank and technical efficiency
Results: Average hospitals’ technical efficiency score was 0.94 indicating an improvement capacityof %5.1 for hospitals efficiency. The mean quality score was 4.13 out of 5( in the range of 3.9-4.3)There was no correlation between hospitals accreditation rank and their technical efficiency
Conclusion: According to the results, it seems efficiency should be also considered in accreditationmetrics. In addition, for measuring efficiency, performance based inputs and specifically outputs tohave reliable results should be chosen

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Background: Job burnout is a result of long-term job stress, which can reduce the quality ofeducation and provision of services. This study aimed to investigate the relationship between jobburnout and its dimensions with occupational stress in Isfahan University of Medical Sciences in 2018.
Materials and Methods: The present study was a descriptive-analytic one. The sample of studyconsisted of 137 staff in faculties of Management and Medical Information, Advanced Technologies inMedicine, Rehabilitation and Nursing and Midwifery in Isfahan University of Medical Sciences using
convenience sampling method in 2018.The study tools were demographic s , Maslach and OSIPOWquestionnaires. Data was analyzed using SPSS version 23 software by descriptive statistics andinferential statistics such as ANOVA, T-test and Pearson correlation coefficient.
Results: Emotional exhaustion calculated in low level (45.2%), depersonalization in high level (45.2%), personal accomplishment in high level (75.3%) and the most participants had normal stress(54.8%). Similarly, based on Pearson Correlation Coefficient, there was a positive significantrelationship between job stress and job burnout and its dimensions, but there was no significantrelationship between personal accomplishment and job stress.
Conclusion: Study results revealed that the higher job stress among employees, the higher jobburnout among employees. As a result, implementing the interventions to reduce occupational stressand strengthen some resources can be helpful to reduce the burnout of employees.

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Background:  Development of the tourism sector and health tourism specifically can improve the Non-Oil GDP. In this regard, in accordance with the policies of the Ministry of Health and Medical Education, international patient department establishment has been facilitatated health tourism development in the affiliated hospitals. This study aimed to evaluate the performance of international patient department  and its effect on the attraction of medical tourists among hospitals affiliated to Medical Sciences Universities in Tehran City.
Matrials and Methods: This analytical cross-sectional study was designed and conducted in 2017. Study population consisted of all hospitals affilliated to  Tehran University of Medical Sciences (TUMS), Iran University of Medical Sciences (IUMS) and Shahid Beheshti University of Medical Sciences (SBMU). In this study,  hospital entrance criteria was certified by the Health Tourism Department of MOHME. Data was collected using the health tourism assessment checklist which approved by the MOHME. SPSS version 24 utilized to data analysis using descriptive and Inferential statistics.
Results: The study results revealed that  the overall performance of international patient department was evaluated at a desirable level (87.5 score) in hospitals of Tehran city.  Hospitals had the highest rank of hoteling indices (95/100), in compliance with the regulations and functional indicators gained 87.03 and 82.2 score, respectively.  Also, data analysis highlighted that there was no significant difference between hospitals of TUMS, IUMS and SBMU. The establishment of international patient department had no effect on health tourists attraction.
Conclusion: Considering the purpose and mission of international patient department to facilitate the provision of quality and satisfactory services in health tourists, management and oversight mechanisms for the standards implementation such as patient admission, follow up in the origin country and development of hospital marketing policies in order to attract international patients and increase hospital incomes are recommended.

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Background: with increasing demand for treatment, patients are monitored with help of Internet of Things(IOT). Patient's monitoring devices and technologies include heart rate measurement, blood pressure measurement, blood glucose and other vital signs. The purpose of study is to provide a model of clustering patient physical monitoring gadgets and apps in Healthcare Internet of Things (HIOT) environment using data mining techniques, so based on the needs and characteristics of the user, the more appropriate results of choosing technologies acquired.

Materials and methods: This study is a review and functional since its result. The data includes 6 unique features of 60 selected technologies including function, price, connectivity route, power supply, location and type of use that has been extracted from R&D and advertising sites of technologies and also relevant articles. data analysis method is clustering technique and K-medoids algorithm. to identify the most effective features, random forest algorithm has been used.

Results: the proposed clustering model takes into account 6 as inputs and clusters gadgets and apps in accordance with selected characteristics as the model outputs. clustering problem data is clustered in 4 categories.  Silhouette index is 0.45, which indicates the validity of the model. The type of application and then the price had the greatest impact on clustering.

Conclusion: By this model, patients or users can find the most appropriate technology based on the type of disease and other effective features, such as price. So with accurate physical and momentary monitoring, disease progression decrease and prevention of disease will improve.