Payavard Salamat

Forecasting of Physicians Supply and Demand in Medical Sciences Universities of Iran

Mahdi Shahraki

Background & Aim: Physicians as human capital and resources are one of the main components of health production. The imbalance of physician supply and demand affects the health and economics. Therefore, this study aimed to estimate and forecast the supply and demand of physician working in Iranian medical universities.
Materials and Methods: This a descriptive-analytical and applied study was conducted at national level for Iran during 1991-2017. The statistical population was physicians working in Iranian medical universities. ARIMA method was used to estimate and forecast physician supply and Vector Error Correction Models was used for physician demand. The data is annual time series that was extracted from the statistical yearbooks of the Statistical Center of Iran and the World Bank database. Eviews 10 software was used to estimate the models.
Results: The results showed that physician demand in Iran was affected by Gross Domestic Product, age structure and hospital beds, and according to the forecast of supply and demand of physicians, we will be faced to the physician shortage in the years 2018-2030.
Conclusion: In the coming years, Iran is facing with physician shortage. Therefore, it is recommended to adopt policies to increase physician capacity in medical universities and to increase strong incentives to retain physicians and prevent their migration.

A Model of Satisfaction Promotion for International Students in Universities of Medical Sciences in Tehran

Mohammad Ali Hosseini

Background and Aim: International student satisfaction is a vital element in international universities and one of the promotion methods in the global ranking, and is considered as a competitive factor.
Materials and Methods: The research method is mixed (quantitative-qualitative) of exploratory-confirmatory type. The statistical population includes experts, international department managers and foreign students(1352 people) in three universities of medical sciences in Tehran, Shahid Beheshti and Iran. The sampling method is qualitative, purposeful and the sample size is 21 professors. In a small part of the multi-stage cluster method, 450 international students were selected. The research tool was a semi-structured interview in the qualitative part of the interview and a researcher-made questionnaire in the quantitative part.
Results: According to the research results, the most influential factor in the foreign students' satisfaction model includes virtual services(0.84), loyalty(0.81), university reputation and rank (0.78), admission process(0.75), Research services(0.72), Staff and management services(0.71), International services(0.70), Educational services(0.68), Health services(0.67), Welfare services(0.65), Financial facilities(0.64), university infrastructure(0.63) and cultural services(0.61).
Conclusion: In order to attract financial resources, international competition, improve regional and global ranking, universities should consider and plan the priorities of the proposed satisfaction model to improve the level of satisfaction of foreign students.

Iran hospital accreditation governance: Challenges and solutions

Fatemeh Ghazanfari

Background and Aim: Hospital accreditation is “an external evaluation of a hospital’s structures, processes, outputs and outcomes by an independent professional accreditation body using pre-established optimum standards”. Accreditation is a strategy for ensuring the quality and, safety of hospital services. An accreditation program’s efficacy depends on the validity of its governance, methods, standards, and surveyors. The Iranian hospital accreditation program faces some challenges. This study aimed to identify the governance challenges of the Iranian hospital accreditation program and its solutions.
Materials and Methods: This qualitative study was performed using semi-structured interviews in 2019. Using a pluralistic evaluation approach, 151 policy makers, accreditation surveyors, hospital managers and staffs, and academics from the ministry of health, medical universities, hospitals and health insurance companies were purposively recuited and interviewed. Thematic analysis was used fordata analysis.
Results: Overall, 23 governance challenges were identified and were grouped into seven categories, i.e., organizational structure, organizational communication, policy making, planning, financing, stewardship and evalutation. Lack of independence, inappropriate organizational structure, resource shortage, senior managers’ mobility and turnover, weak internal and external communication, a compulsory accreditation program, insufficient knowledge of hospital accreditation, and lack of evaluation of the hospital accreditation were the main challenges. Establishing an accreditation council with four idependent scientific, accreditation, appeal and performance evaluation committes, piloting the accreditation program, proper planning, cascade education and training, allocating a specific budet for hospital accreditation, getting the ISQua accreditation certificate and public announcement of hospitals’ accreditation results were proposed as solutions to these challenges.
Conclusion: The governance of Iran's hospital accreditation program faces serious challenges. Improving the governance of the accreditation program leads to achieving the desired results.

Determining and Ranking the Lean Criteria for Hospital Using Fuzzy Interpretive Structural Modeling (FISM)

Hamzeh Amin-Tahmasbi

Background and Aim: The growing healthcare expenses, technological advancements and increasing competition in healthcare services, brings up new challenges for healthcare industry in providing appropriate services to customers. The Lean methodology, which is a managerial approach, provides tools necessary to eliminate waste and increase customer satisfaction through increasing quality of the services and decreasing the wait times and costs. The Scope of this paper is to determine and rank the lean criteria for hospitals.
Materials and Methods: 22 base criteria for a lean organization was selected and reconciled to hospitals from literature review. Then they were evaluated by experts in the field using Likert scale, leading to 18 criteria. The correlation of these criteria was found using ISM methodology, followed by ranking of these criteria. Lastly, the criteria were categorized utilizing MICMAC analysis.
Results: utilizing MICMAC analysis, the "defining the flow of processes & continuous improvement", "utilizing visual surveillance to understand the situation & exploit the problems" were identified as the most important variables.
Conclusion: In order to increase quality of services and customer satisfaction and to reduce operating costs, hospitals are advised to utilize lean methodology. In which case the management should pay more attention to the two more important criteria derived by MICMAC analysis, "Defining the processes in order to find problems" and "Continuous improvement and utilizing visual surveillance in order to find problems".

The Study of Medical Equipment Purchase Management in Hospitals of Tehran University of Medical Sciences

Sareh Daneshgar

Background and Aim: The use of purchasing mechanisms in the field of Medical Equipment and with government law and regulation can serve as a way to move towards smart purchase and increase access to vulnerable groups in order to receive services promote justice. This study conducted to Review of purchase management of Medical Equipment in Hospitals of Tehran University of Medical Sciences.
Materials and Methods: In this applied study conducted in 2018, the study population consisted of 623 individuals and research sample of 431 individuals for each domain that were selected by stratified random sampling. Data were collected using researcher-made questionnaire whose variables were extracted from comparative studies and its validity was measured by content validity Ratio, content validity index and Cronbach's alpha coefficient were obtained. SPSS18 and AMOS software were used to analyze the data by statistical methods of exploratory and confirmatory factor analysis.
Results: According to the results, effective dimensions in purchase management of Medical Equipment in Hospitals of Tehran University of Medical Sciences included Technical, Organizational, Political and Economic dimension with path coefficient of 1.244 1. 151, 0.973 0.845. Values indicate that all study paths are meaningful; in the other words, path coefficients are applicable.
Conclusion: Based on this study, Effective dimensions in purchase management of Medical Equipment consist of four dimensions (Technical, Organizational, Political and Economic) which is a comprehensive and multidimensional concept. Therefore, consideration of all its dimensions and components can best guide the buyer agencies in moving towards efficient purchase.

Drawing Co-Citation Networks of Corona Virus Studies

Samira Daniali

Background and Aim: The purpose of the present study is to map the coronavirus domain citation network to better understand this domain based on all other citation networks.
Materials and Methods: The present study is applied in terms of purpose, and is descriptive scientometrics in terms of type, which has been done with the all-citation method. In this study, all scientific publications on coronavirus(6980 documents) in the period 1985-2019 AD were studied on April 10, 2020 in the Web of Science database. For analysis and drawing all citation maps, VOSviewer and Excel software were used.
Results: In the field of coronavirus, 6815 documents, 10246 journals, and 40298 authors were identified. Ksiazek(2003) with the acute respiratory syndrome(SARS) topic received 875 citations and won the first place. The most cited documents in the field of coronavirus have 5 clusters; and the first cluster with 201 documents and with the topic of studying the structure of coronavirus is the largest one. Journal of Virology -- with the thematic range of genome structure and replication, virus identification, etc. -- ranked first with 35,383 citations. The most cited journals in the field of coronavirus are 5 thematic clusters, and the first one is the largest cluster with 121 journals and with the thematic domains of health policy, coronavirus, etc. Also, Woo won PCY first place with his specialization in identifying new microbes and emerging infectious diseases, and receiving 1491 citations. The most cited authors in the field of corona virus are in 6 thematic clusters; the first cluster with 195 authors in specialized field of virology and coronavirus is the largest cluster.
Conclusion: By identifying the highly cited scientific products in the field of coronavirus, efforts have been made to provide a comprehensive view of top documents, top journals, and top authors so that it can be a decision-making tool in the shortest possible time.

An Overview of the Features and Content of Dermatology Mobile Applications

Horieh Masourian

Background and Aim: Mobile-based programs have been developed as tools to help both patients and physicians in various fields especially in dermatology. Therefore, the main objective of this study was to review the features and contents of dermatology applications.
Materials and Methods: The methodology was comparative and descriptive. Applications in the field of dermatology were evaluated and compared through this research. Inclusion criteria included applications that have been downloaded more than 100 times in Google Play and App Store and applications designed in diagnosis in various fields of dermatology such as treatment, management, remote consulting, and self-care areas. Exclusion criteria included those developed before 2010 and those related to the non-dermatology areas. Besides, different features were considered for comparison based on literature review and expert consultation. Next, the recognized applications were reviewed and compared based on determined categories.
Results: Based on criteria, a total of 33 applications were identified through searching. Of these, 33.3% of Apps were in the field of education, and 24.2% were in self-care. Regarding disease, applications were categorized into nine different domains. Of these, 61% of applications were covering different types of skin diseases. Also, in examining the frequency of the features of the evaluated programs, providing recommendations and suggestions with 57.57% and educational contents and the possibility of uploading images with 51.51%, respectively, had the highest frequency among the features of the programs.
Conclusion: Analysis showed that education and self-care domains have a high rank among others. It indicates that developing such applications could facilitate patient education and self-management by himself or caregivers. However, this area needs more attention and the using health information technology capabilities to make applications smarter in this area.

Medicine and Health in Ancient Iran; Persian Language and Literature and the Divan of Mashreqi Shirazi

Gholamreza Mastali Parsa

Background and Aim: Medical concepts can be studied in language and literature. The purpose of this study is to investigate the term"pezeshk" and"medical terminology” in ancient Iran, in Persian language and literature, and in Mashreqi Shirazi poems.
Materials and Methods: This research has been done by reviewing and studying three articles, three databases, and about fifteen books. Since the subject of study is “medicine in Iran” and “Persian language and literature”, non-Iranian physicians and Iranians whose works are in Arabic have been excluded from this study.
Results: The history of medicine in Iran is as old as the history of Iran itself; and its influence can be clearly seen in Persian language and literature. The root of the term“pezeshk” is Avestan(Baesha-za), which has changed to Baesha-zak in the Middle Persian and in Bejeshk and Pezeshk in Parsian, which is still used today. The names of many Iranian ancient therapists are associated today with widely used medical terms: Trita is one of the first Aryan therapists, and his name is the same as“treat”. The names of some ancient Iranians are considered as the first ones in the world of medicine, e.g., Mehrdad II Ashkani, the first immunologist. Besides, in this study, the influence of medicine on literature was proved in the poetry of Mashreqi Shirazi(970-1038 AH), a shiite poet.
Conclusion: Medicine is not an imported science to Iran and the history of medical science in this country is, as evidenced by history, as old as the history of Iran. This longevity can be seen in the Persian word “pezeshk” itself, and in the names of the first Aryan and Iranian physicians and the medical schools of ancient Iran. The global name of Medicine is taken from the first historical dynasty of Iran, Maad(Medi in Greek), and one of the first Maad healers, Cina(Cine) Moghani. In literature, it is apparent that Hakim Mashreqi was aware of medicine. Such awareness included the constituent elements of the body, name of some diseases, treatment and the name of some drugs.