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Developing a Probabilistic Two-Stage Model for Hierarchical Healthcare Facility Location by Considering the Service Rate (A Case Study of Tehran Heart Center)
Zohreh Kaheh, Dr Ali Husseinzadeh Kashan,
Volume 15, Issue 4 (1-2017)
Abstract

Background: medical centers location is one of the most important problems, which should be considered in different dimensions to improve the services. In this paper, we consider the hierarchical maximum covering problem for bi-level healthcare systems including Clinics and hospitals, by taking the service rates into account. In this problem, the initial objective is minimizing the uncovered demand nodes, and secondary objective is the minimizing the lost demand rate as a measure of potentially patients’ retention in coverage radius.

Methods: In this paper, the serving system in the Tehran heart center hospital is considered for queue analyses. The proposed method is a mathematical optimization model called probabilistic two-stage programming model. To evaluate this model, a number of numerical problems are solved through GAMS software.

Results: according to the results, we have found that the best condition for locating the medical centers is that the clinic are located adjacent to a hospital. Decision making about the location problem by considering the service rate in each healthcare centers, increases the reliability to the result of the optimization model.

Conclusion: The proposed model is able to help the decision makers to attain an optimized decision for locating the medical centers in deprived areas, inspired by the medical centers in areas with similar population. Therefore, if the clinics and hospitals are located by considering the hierarchical mode and their service rates, the patients’ welfare will be enhanced.


Exploring the Context, Intervention, and Consequences of Health Marketing in Iran; Strategies for Enhancing and Improving Health Services
Behrooz Rahimi, Seyed Mahdi Jalali, Hamed Nazarpour Kashani,
Volume 22, Issue 2 (9-2023)
Abstract
Introduction: Equitable geographical distribution of healthcare system initiatives, aimed at increasing quality and economic efficiency, is a crucial aspect of ensuring access to healthcare services. This study seeks to elucidate the contextual, procedural, and outcome factors of health marketing in Iran, with a focus on enhancing and improving health services.
Methods: This research was conducted using a qualitative approach. The sampling method employed was purposive, resulting in the participation of 51 experts. The study data were analyzed using content analysis.
Findings: The findings of this study have been categorized into conceptual subgroups, including causal conditions, foundational components, strategies, contextual factors, intervening factors, and consequences of implementation.
Conclusion: Adopting an effective health marketing model can create opportunities for service providers to generate sufficient income, thereby motivating them to deliver high-quality services. Attracting ample income, in addition to ensuring service quality for recipients, will also lead to their satisfaction with the healthcare system and contribute to the continuous provision of desirable services.
 

Challenges Facing Pre-Hospital Emergency Medical Services in Iran: A Meta-Synthesis Study
Alireza Rahimi,
Volume 24, Issue 2 (9-2025)
Abstract
Background and purpose: Pre-hospital Emergency Medical Services (EMS) play a pivotal role in managing life-threatening conditions. However, evidence suggests that the Iranian EMS system faces multifaceted challenges across human, managerial, and infrastructural dimensions. This study aimed to conduct a comprehensive meta-synthesis to identify and analyze the challenges characterizing pre-hospital EMS in Iran, based on research evidence published between 2014 and 2025.
Methods: This study employed a meta-synthesis approach utilizing the seven-step framework by Sandelowski and Barroso (2006). A systematic search of major domestic and international databases using relevant keywords yielded 414 initial records. Following a rigorous screening process based on inclusion/exclusion criteria and quality appraisal, 25 articles were selected for the final analysis. Data were synthesized and categorized using thematic analysis.
Results: The findings revealed that the challenges facing the Iranian pre-hospital EMS can be categorized into six main themes: human resources, logistics and infrastructure, organizational and managerial barriers, socio-cultural issues, and educational deficits. A deeper analysis highlighted the multifaceted and intertwined nature of these obstacles. The results indicate that these challenges do not exist in isolation but are interconnected within a complex network of cause-and-effect relationships.
Conclusion: The findings confirm that the challenges within Iran's emergency system mirror global trends and overlap significantly with issues reported in other low- and middle-income countries (LMICs). Addressing these problems requires a holistic and systemic approach that simultaneously targets human, logistical, organizational, and socio-cultural dimensions, while ensuring system preparedness for potential accidents and disasters.
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