Hospital
بیمارستان
jhosp
Medical Sciences
http://jhosp.tums.ac.ir
211
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2008-1928
2228-7450
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jalali
1397
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gregorian
2019
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fulltext
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بررسی مقایسه ای چارچوب های ارزیابی عملکرد نظام سلامت در جهان
A Comparative Study of the Health Systems Performance Assessment Frameworks in the World
سیاست گذاری ، برنامه ریزی و رهبری و مدیریت در بیمارستان
سیاست گذاری ، برنامه ریزی و رهبری و مدیریت در بیمارستان
مقاله مروری
Review Article
<strong><span style="font-family:b roya;"><span style="font-size:12.0pt;">زمینه و هدف</span></span></strong> <span style="font-family:b roya;"><span style="font-size:11.5pt;">: با توجه به ضرورت ارزیابی عملکرد نظام های سلامت، الگوها</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">و</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">چارچوب­های</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">مختلفی توسط گروه ها و سازمان های مختلف برای پرداختن به این مهم ارایه شده است. این پژوهش،</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">به</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">بررسی تطبیقی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">چارچوب</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">های</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">ارزیابی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">عملکرد</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">نظام</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">سلامت</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">در</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">جهان</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">پرداخته</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">است.</span></span><br>
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<strong><span style="font-family:b roya;"><span style="font-size:11.5pt;">مواد و روش</span></span></strong> <strong><span style="font-family:b roya;"><span style="font-size:11.5pt;">ها:</span></span></strong> <span style="font-family:b roya;"><span style="font-size:11.5pt;">پژوهش</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">حاضر</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">از</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">نوع</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">مطالعات</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">تطبیقی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">توصیفی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">می</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">باشد</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">که</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">به</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">روش</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">توصیفی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">تشریحی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">مبتنی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">بر تحلیل</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">مقایسه ای</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">در سطح</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">جامع</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">انجام</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">گرفته است. حوزه</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">پژوهش</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">شامل</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">چارچوپ</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">های</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">نظام</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">سلامت</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">می باشد و نتایج در</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">جداول</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">تطبیقی بر</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">اساس</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">عوامل</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">تعیین</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">شده</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">مورد</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">مقایسه</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">و</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">تفسیر</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">قرار</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">گرفته اند</span></span><span dir="LTR">.</span><strong><span style="color:#0D0D0D;"><span style="font-family:b roya;"><span style="font-size:11.5pt;"></span></span></span></strong><br>
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<strong><span style="font-family:b roya;"><span style="font-size:11.5pt;">نتایج</span></span></strong><strong><span dir="LTR"><span style="font-family:b mitra,bold;">:</span></span></strong> <span style="font-family:b roya;"><span style="font-size:11.5pt;">در</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">مجموع از 16 چارچوب بدست آمده، 11چارچوب</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">وارد مطالعه شده و </span></span><span style="font-family:b roya;"><span style="font-size:11.5pt;">و</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">مورد</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">مقایسه، توصیف</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">و</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">تشریح</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">قرار</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">گرفت</span></span><span dir="LTR">.</span><span style="font-family:b roya;"><span style="font-size:11.5pt;"> برخی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">از</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">چارچوب</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">های ارایه شده علاوه بر تمرکز بر عملکرد خود نظام سلامت به عنوان چارچوبی برای</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">ارزیابی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">عملکرد</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">نظام</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">سلامت</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">نیز بکار می روند.</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">هر</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">یک</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">از</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">چارچوب</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">ها</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">دارای</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">هدف</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">خاصی بوده</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">که به</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">اهمیت</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">ارزیابی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">در</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">نظام</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">سلامت</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">تاکید</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">می کنند. </span></span><br>
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<strong><span style="font-family:b roya;"><span style="font-size:11.5pt;">نتیجه</span></span></strong> <strong><span style="font-family:b roya;"><span style="font-size:11.5pt;">گیری</span></span></strong>: <span style="font-family:b roya;"><span style="font-size:11.5pt;">چارچوب­های</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">نظام</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">سلامت</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">در</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">طول</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">زمان</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">تغییرات قابل ملاحظه­ای یافته اند.</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">چارچوبهای</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">ارایه</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">شده</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">در</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">سال</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">های</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">اخیر</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">نسبت</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">به</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">چارچوبهای</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">اولیه</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">، بر ابعاد بیشتری تاکید دارند. بهره</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">گیری</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">از</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">این</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">ابزارها</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">در</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">جهت</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">شناخت</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">اهداف</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">بهتر</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">نظام</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">سلامت،</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">ارزیابی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">بر</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">اساس</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">محدوده پاسخگویی</span></span><span dir="LTR">)</span><span style="font-family:b roya;"><span style="font-size:11.5pt;">فعالیت</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">سازمانی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">و</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">یا</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">مرزهای</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">خارج</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">از</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">سازمان</span></span><span dir="LTR">(</span><span style="font-family:b roya;"><span style="font-size:11.5pt;">و</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">راه</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">های</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">رسیدن</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">به</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">آن</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">ها</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">موثر</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">می</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">باشد</span></span><span dir="LTR">.</span><span style="font-family:b mitra;"><span style="font-size:12.0pt;"> با </span></span><span style="font-family:b roya;"><span style="font-size:11.5pt;">بهره</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">گیری</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">از</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">چارچوب های ارایه شده با</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">توجه</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">به</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">ابعاد</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">و</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">اهداف</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">هر</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">یک،</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">می</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">توان</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">عملکرد</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">نظام</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">های</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">سلامت</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">را</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">مورد</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">مداقه</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">و ارزیابی</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">قرار</span></span> <span style="font-family:b roya;"><span style="font-size:11.5pt;">داد</span></span><span dir="LTR">.</span><span style="font-family:b mitra;"><span style="font-size:12.0pt;"></span></span><br>
<strong>Background</strong>: Need to assess the health system performance, various models and frameworks have been developed by different groups and organizations. This study explores health system performance assessment frameworks using the comparative-analytical study.<br>
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<strong>Materials and Methods:</strong> This is a comparative-descriptive study conducted using descriptive-prescriptive method based on comprehensive comparative analysis. The scope of research includes health system frameworks. The study results compared and interpreted based on identified factors in comparative tables.<br>
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<strong>Results</strong>: Overall, 11 frameworks out of 16 ones described, analyzed and compared to each other. Some of the frameworks in addition to providing insight about the health system have focus on assessment of health system performance. Each framework follows especial goals which focus on importance the health systems assessment.<br>
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<strong>Conclusion</strong>: During the time, health system frameworks have changed and developed according to the health systems changes. Developed Frameworks in recent years are more comprehensive than others which have been presented at first. Utilizing these frameworks in order to identify health system goals, assess based on responsibility (organizational actions or outside the organizations) and ways to reach them can be effective. Using the developed frameworks based on their domains and objectives can be considered in health system performance.<br>
نظام سلامت, چارچوب ارزیابی, عملکرد نظام سلامت, مطالعه تطبیقی
Health system, Frameworks, Health system performance, Comparative study.
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http://jhosp.tums.ac.ir/browse.php?a_code=A-10-980-2&slc_lang=fa&sid=1
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heydari
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