Journal of

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Background: Patients are the raison d'etre of the hospitals therefore satisfying their needs and expectations is one of the most important duties of the hospitals. Consequently in recent decades patient satisfaction has been considered as a reliable measure for studying the quality of care and treatment. Hence in the present study, documents related to patient satisfaction in Iran was surveyed and the overall level of satisfaction was estimated using meta-analysis.
Materials and Methods: Articles on patient satisfaction were identified by searching different data bases using appropriate key words. Twenty six studies were extracted after applying inclusion criteria measures. The results were analyzed using Meta-analysis commands in STATA11 software.
Results: 14058 cases were surveyed in this 26 studies by meta- analysis. Based on the random-effect model the patient overall satisfaction percentage was estimated at 70.5 (CI:63.3-77.6) though based on fixed effect model.
Conclusion: The scale of patient satisfaction in Iran is in a proper level compared to other countries. Additionally, there has been an increasing trend in patient satisfaction in recent years, which might be attributable to measures such as using different methods of quality improvement, customer orientation and customer reverence.

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Abstract Background: Hospitals are the most important health organization and consume major part of health system`s budgets. Downsizing is one of the strategies used for providing suitable services in hospitals. This study was conducted to do a systematic search for hospital downsizing methods and theirs consequences in order to choose suitable method for Iran. Materials & Methods: Related Articles were identified by systematic search on databases such as Medlib, SID, Pub Med, Science Direct and Google Scholar meta search engine using keywords like Downsizing, Hospital Downsizing, Hospital Rightsizing, Hospital Restructuring, Staff Downsizing, Hospital Merger, Hospital Reorganization and Persian equivalents. 379 articles were extracted and refined step by step. Finally, 25 articles were selected according to study`s goals. Results: The identified downsizing methods included reducing the number of employees and hospital beds, outsourcing, merging hospital wards and combination of fore mentioned methods. The most important consequences of using these methods were: cost, revenue, outpatient visits and surgery, length of stay and hospital admission rates, mortality rate, stakeholder satisfaction, workload of employees mental health and absenteeism . Conclusion: study results indicated that different methods of downsizing are used for providing suitable services and decreasing costs in hospitals. Using Merger and outsourcing are suggested among different methods in hospital wards according to current situation of our country.

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Background: Data Envelopment Analysis (DEA) is a mathematical model that evaluates the relative efficiency of Decision Making Units (DMUs) with multiple input and output. The purpose of this paper was systematic study of applying this technique in Iranian hospitals.

Materials and Methods: In this systematic review which was conducted in September 2015 and February2016, attempted to search the research which conducted in Iranian hospitals regardless of the time of publication using searching keywords in six scientific databases and with the help of Google search engine. A total of 6,613 researches found. Then, 6,566 researches removed from the study because of the irrelevant, repetitive and Inaccessibility to the full text. Then,  attempted to statistical analysis of 47 remaining researches via Excel 2010 software.

Results: 93.6 percent of the researches were published in 2009 onwards. The most research and least research have been conducted in three and eleven provinces respectively. The diversity of output indexes have been more than diversity of input indexes. In 81 percent of researches; input oriented model was used and in 74.5 percent of researches variable returns to scale is assumed. In most studies, referred to Iran's inefficient hospitals because of existence of excess resources.

Conclusions: In last seven years, the interest of Iranian researchers has increased about DEA application in hospitals especially in Tehran, Yazd and Khoozestan provinces. Scientific and rational use of resources is a proposal to the relevant authorities.

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Background and purpose: Supplementary health insurance plays a pivotal role in the health economy and individual payments, enhancing access to health services and improving individual quality of life. This study aims to explore the challenges and strategies for developing supplementary health insurance.
Methods: This systematic review examined research related to the challenges and strategies for the development of supplementary health insurance in various countries, focusing on articles published in the last five years in both domestic and international databases. For each article, a data extraction form was completed, and the data were subsequently classified, summarized, and analyzed.
Results: Seventeen articles met the study's inclusion and exclusion criteria and were analyzed. The main challenges and strategies for developing supplementary health insurance were identified across seven primary themes: premium and financing, electronic infrastructure, quality improvement, moral hazards and adverse selection, cost-effectiveness and efficiency, evidence-based decision-making, and effective awareness and advertising.
Conclusion: Considering the numerous identified challenges and barriers in the development of supplementary health insurance, it is recommended to focus on creating electronic infrastructures and necessary platforms to enhance and develop policies in supplementary health insurance, particularly in the dimensions of service packages, cost-effectiveness, and efficiency