Journal of

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Background: New manegerial approachfor hospital administration as one of the health system reforms with several goals including increased staff motivation were enforced. However, motivation and job satisfaction are two very important factors for survival of organisation. The purpose of this study was to investigate the relation between paying the fee for service, motivation and job satisfaction using the expectancy theory of Victor Vroom. Method: The descriptive-analytic research conducted in a public hospital of Tehran city in 2013. The sample size was estimated 209 caseswhich selected by using Stratified sampling method.Information Through a three-part questionnaire containing personal informationwith 6 questions, expectations standard questionnaire with 25 questionsand job satisfaction standard questionnaire with 13 questions were collected. SPSS18 software was used for data analysis. ResultsIn all occupational groups other than physicians, direct significant relationship was observed between the Fee for service and job motivation. In all occupational groups except paraclinic, directly significant relationship between motivation and job satisfaction was observed. Among all occupational groups only in the Administration– Finance Group Direct significant relationship was observed between the Fee for service and job satisfaction. Conclusion: In this study, hospital staff had Above-average job satisfaction and job motivation lower than average. improving skills through training opportunities, Codification of appropriate Politics and Policies of reward–function and situating favorable bonus from view of the employee (According to motivational differences) are Examples of strategies to improve motivation

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Background: In year 1995, new system administration plan of hospitals (fee for service) was notified. This scheme was implemented in hospitals for 20 years. In the early September 2104, new guidelines of performance-based fee for service plan with the aim of deficiencies in the previous plan was reviewed and implemented in hospitals in Isfahan. This study aimed at investigating reform strategies to improve monitoring performance and infrastructure implementation development of the new scheme of fee guidelines in 2014.

Materials and Methods: This study was a qualitative one based of phenomenology. Depth interviews were used to collect data. Eleven individuals assessed including top and middle managers and professors of Isfahan University of Medical Sciences using content analysis method.

Results: In this study, eight main themes and ten sub-themes extracted including appropriate policy making, health management reform in health system, cultural building in monitoring, proper planning, physicians' motivation, infrastructure improvement, improving training, informatics and constructive interactions between senior managers and hospitals' directors.

Conclusion: With the aim of rationalizing the health system, new instructions and fee for service plan should be considered well to tackle weak points. It seems that coping with these weak spots in new fee for service plan, has feasibility to provide more satisfaction among physicians and staff. To achieve main goal of the project which defined as patients and staff satisfaction, using new reform strategies to facilitate plan implementation, continuing observation and stronger mentoring recommended.