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Showing 128 results for Hospital

Alireza Ahmadnezhad, Mohamad Sadegh Sangari, Ali Bozorgi-Amiri ,
Volume 11, Issue 6 (3-2018)
Abstract

Background and Aim: Nowadays, e-procurement systems have provided many opportunities to improve supply and procurement activities in healthcare industry through Internet-based electronic communications for supplier-buyer interactions. Considering the fact that the implementation of these systems is not successful in many cases, extensive preparation in relevant areas is necessary before implementation. This paper aims to present a framework of key readiness factors of hospitals for the adoption of e-procurement system.
Materials and Methods: This study was an applied descriptive survey. The framework of readiness factors was developed based on an extensive review of literature and e-readiness models as well as opinions of experts in the field of information technology, procurement, and healthcare systems. The proposed framework was applied in a case study of a specialty hospital located in Tehran in 2016. The data were collected using a questionnaire, and Fuzzy Cognitive Map (FCM) method was used for modeling and analysis of the identified factors.
Results: In this research, a comprehensive framework of critical readiness factors of hospitals for e-procurement adoption was developed comprising five main components: management, technology, process, human resource, and environment. Environmental and managerial factors were identified as the most important readiness determinants of the case hospital, and among various factors, managers' expertise in IT, IT infrastructures of hospital, and continuous monitoring of system's performance are of higher priority.
Conclusion: This paper provides guidance for more accurate planning to improve readiness and successful adoption of e-procurement systems in hospitals by identifying the most important influential readiness factors.

Fereydoon Azadeh, Seyed Javad Ghazi Mirsaeid, Nadia Motamedi, Mohammad Zarei,
Volume 12, Issue 1 (5-2018)
Abstract

Background and Aim: Ranking of hospital libraries based on standard criteria and taking pattern of top libraries would improve the quality of library services. The purpose of this study was to rate hospital libraries based on LibQual criteria and Vikor model. 
Materials and Methods: This study was conducted in a survey method. The statistical population was 3850 actual users of the library of 8 governmental hospitals (with capacities up to 320 beds) in Tehran in 2016. To achieve the goals, The LibQual questionnaire and AHP technique were used. The validity of both questionnaires has been confirmed in various studies. Cronbach's alpha coefficient greater than 70 percent For LibQual questionnaire and inconsistency rates less than one percent for Vikor questionnaire confirm the reliabilities. Data analysis was performed using the expert choice software. Ranking were done using the Vikor technique.
Results: According to three main dimensions for LibQual, "library as a place" weighing 0.379 was the first preference, and "quiet space for individual activities" weighing 0.364 was the first in this dimension too. The dimension of "information control" weighs in 0.318 at the second, and "service impact" weighs 0.303 was in the third grade. In the ranking based on the Vikor criteria, the Library of Firoozgar hospital was in the first place.
Conclusion: The library of Firoozgar hospital in Iran university of medical sciences was the forefront and could be an exemplar for the other libraries.

Maryam Jafar Tajrishi, Seyed Jamaledin Tabibi, Kamran Hajinabi,
Volume 12, Issue 4 (11-2018)
Abstract

Background and Aim: In today’s competitive market conditions of hospital industry, in addition to the quality of clinical services, a hospital should also concentrate on Hotelling Services Quality designed for the patient and his entourage. The purpose of this study was to investigate the effect of hoteling quality on patient loyalty.
Materials and Methods: The research method of the study was descriptive-survey with an applied goal. The research instrument was a questionnaire whose validity and reliability were verified by face-to-face survey and Cronbach's alpha. The sample size according to Cochran formula for unknown population was 385 patients in two private hospitals of Tehran that were randomly selected. The data were analyzed by descriptive and inferential statistics such as multivariate linear regression test.
Results: According to the findings of the study at 95% confidence level, the quality of human resources (p<0.001), the quality of hospital welfare services (p<0.001) and the quality of administrative affairs and workflow (p=0.002), the quality of cleaning and sanitation services (p<0.001) and the quality of building and hospital facilities (p=0.033) have a positive effect on patient loyalty. Also, two other dimensions, that is, the quality of hospital equipment and facilities (p=0.317) and the quality of hospital nutrition services (p=0.123) did not have a meaningful effect on patient loyalty.
Conclusion: From patients' perspective, the hotelling quality in the studied hospitals has a direct impact on patient loyalty, and its improvement will increase patients’ loyalty in those hospitals. 
 

Ebrahim Jaafaripooyan , Ali Mohammad Mosadeghrad , Abbas Salarvand ,
Volume 13, Issue 2 (7-2019)
Abstract

Background and Aim: Hospital accreditation is an external evaluation strategy used to improve the quality and effectiveness of services. Accreditation surveyors are among the important factors affecting the validity of accreditation results. Since the effectiveness of an accreditation system depends on its surveyors, the aim of this study is to identify the evaluation criteria of hospital accreditation surveyors in Iran.
Materials and Methods: This qualitative study was conducted in 2017 based on stakeholders’ views about the hospital accreditation program. Data were collected through semi-structured interviews and analyzed by thematic analysis method. Then the framework was designed and finalized with expert opinion.
Results: Forty-four criteria identified for the evaluation of hospital accreditation surveyors in Iran were classified into six domains: personality, experience, knowledge, attitude, skills, and organizational citizenship behavior. Accreditation surveyors should have an acceptable combination of such criteria.

Conclusion: Evaluation of accreditation surveyors with these criteria will lead to their better performance and ultimately promote the validity of the accreditation results. These criteria also result in a native definition for “accreditation surveyor” that can be used by the directors of accreditation system of hospitals for the management of accreditation surveyors.

Jala Saeidpour, Niloufar Faridfar, Mahsa Ghaziasgar,
Volume 13, Issue 2 (7-2019)
Abstract

Background and Aim: Today, small businesses can be considered as a good strategy for different parts of hospitals in the country. Therefore, the use of any new mechanism in the health system needs to be examined and adapted to local conditions. This study aims to investigate factors affecting the implementation of outsourcing from the viewpoint of managers of Tehran University of Medical Sciences (TUMS) hospitals.
Materials and Methods: The present research is a descriptive-correlational and applied study. Due to the size of the population (TUMS managers of financial and hospital affairs), sampling was done by census method. The research tool was a researcher-made questionnaire with two sections -- demographic information and factors affecting outsourcing in hospitals -- and was distributed among the subjects. Then, to run descriptive statistics for data analysis, SPSS version 18 was used.
Results: Fifty-eight percent of the participants had a long service record and 80% had postgraduate degrees. For successful outsourcing in hospitals, the following should be considered: formation of a strategic outsourcing team, checking out the quality of outsourced services, and managers’ close monitoring and mastery over outsourced principles.
Conclusion: Since outsourcing of services can achieve positive results in terms of improving the quality of services, satisfying stakeholders, reducing costs, generating income, and so on, using the perspectives of queue managers who have a long service record can be effective in the implementation of successful decisions.

Fatemeh Sadat Zaribaf , Fatemeh Sheikhshoaei , Seyed Javad Ghazimirsaid Ghazimirsaeed,
Volume 13, Issue 3 (9-2019)
Abstract

Background and Aim: Considering the effect of organizational climate on work motivation, not using the librarians who have a satisfactory feeling about their job can cause irreversible damages to the library. Therefore, the aim of this study is to determine the effect of organizational climate of college and hospital libraries on the burnout of librarians working there.
Materials and Methods: This is an applied research and a descriptive-analytical survey. One hundred seventy-seven librarians from faculties and hospital libraries affiliated to Tehran, Iran and Shahid Beheshti Universities of Medical Sciences were surveyed by census method in 2019. Data collection instruments were Halpin and Croft's organizational climate and Maslach and Jackson job burnout questionnaires. The validity was confirmed by 3 experts and the reliability by Cronbach's alpha coefficient. For data analysis, SPSS software, and descriptive and analytical statistics were used.
Results: The findings showed that the mean of organizational climate was at a desirable level (3.4)  and the average of job burnout was 1.7; therefore, the job burnout status of librarians is desirable because it is a negative variable. Also, the components of organizational climate predict 41% of job burnout variable. Among demographic characteristics, job burnout variable varies only in terms of field of study, and organizational climate only in terms of the type of library.
Conclusion: In general, the organizational climate status and job burnout status of the studied libraries are desirable; also, organizational climate components affect job burnout.

Mohammad Yahyaei , Ali Akbar Ahmadi , Pirhossein Koulivand, Mojtaba Rajab Beygi,
Volume 13, Issue 5 (1-2020)
Abstract

Background and Aim: In today's complex work environment, organizations need a strong link between strategy and effective strategy execution. The purpose of this research is to integrate Balanced Scorecard model with Kaizen management to meet this need and increase innovation efficiency in organization and create sustainable competitive advantage.
Materials and Methods: This study was a descriptive study in terms of purpose and in terms of data collection, in three stages. Two researcher-made questionnaires(validity and reliability of 0.852)were used perform this applied research in Shahroud hospitals. The first is identify factors using the Delphi method by 16 experts and The second was to confirm the indices, which were completed randomly by 829 hospital beneficiaries and analyzed by confirmatory factor analysis. Structural-interpretive model was used to determine the effect of indicators on each other. In order to determine the cause and effect relationships between the goals and the two models Quality Function Deployment matrix was used by expert opinion.
Results: This study showed that in order to achieve the goals of learning development perspective in BSC model, one needs to use "mura" in Kaizen model. Also, to achieve internal process goals, the muri dimension must be used, to achieve the financial perspective objectives of the "deletion"(muda), and for the customer perspective goals, the "mura" dimension must be applied.
Conclusion: Integration of BSC and Kaizen models can provide a suitable framework for continuous improvement of performance, because it has been successfully Performance in Shahroud hospitals, this research has shown that it seeks continuous improvement and increased productivity in the hospital.

Masood Taheri Mirghaed, Batool Ahmadi, Abbas Rahimi Foroushani, Ghasem Rajabi Vasoukolaii, Mohammad Arab,
Volume 13, Issue 6 (2-2020)
Abstract

Background and Aim: Nowadays, medical tourism market is considered as one of the most profitable and competitive industries in the world and is one of the new areas of advanced tourism. The aim of this study was to investigate the marketing status of medical tourism in private and public hospitals affiliated to Tehran University of Medical Sciences (TUMS) in 2018.
Materials and Methods: This is a cross-sectional descriptive-analytic study that investigated the marketing status of medical tourism in 6 private and 14 public hospitals affiliated to TUMS in 2018. A valid checklist was used for data collection; besides, SPSS software, descriptive statistics, Mann-Whitney test and Kruskal-Wallis test were applied for data analysis.
Results: Product factor has a satisfactory status in state-owned hospitals and an average status in private hospitals. Place factor, people factor, process factor, and physician factor are satisfactory in public and private hospitals. Promotion factor in public hospitals is unacceptable and in private hospitals is average. Besides, price and place factors in public and private hospitals are average. Moreover, there is no significant relationship between any of the above factors and the type of hospitals (public, private).
Conclusion: Due to marketing mix, hospitals and medical institutions can increase the confidence of tourists by adopting international standards in addition to enhancing international reputation. Also, paying more attention to media advertising and providing more facilities can improve the condition of hospitals, thereby attracting more medical tourists and expanding the industry in Tehran.

Mahdi Isazadeh, Zahra Sadat Asadi, Mahdi Tahmasebi Gharajehmalek, Manijeh Soleimanifar,
Volume 14, Issue 1 (3-2020)
Abstract

Background and Aim: Currently, electronic health(e-health) tools are known as an effective means of communication and educational tool in the field of health to manage conditions in sensitive situations. The purpose of this study was to evaluate the level of electronic health literacy of patients referring to a selected military hospital.
Materials and Methods: The present descriptive-analytical study was performed on 204 patients who referred to a selected military hospital in Tehran in 2019. Data collection tools included a demographic information questionnaire and an e-health literacy questionnaire. SPSS software was used for data analysis, and the level of significance was set at 0.05.
Results: The mean score of electronic health literacy was 29.28±5.47. The level of e-health literacy of patients with different educational backgrounds was significantly different. Also, the electronic health literacy of patients using the Internet differed significantly. Patients' e-health literacy had a significant correlation with their educational level(p=0.02, r =0.169) and using the Internet(p<0.001, r=0.328).
Conclusion: Higher education is associated with higher levels of e-health literacy, and can be improved by creating internet training areas to access health information to improve e-health literacy.

Zahra Mohammadzadeh, Hamid Reza Saeidnia, Ali Ghorbi,
Volume 14, Issue 3 (7-2020)
Abstract

Background and Aim: A hospital website is an appropriate system for exchanging information and connecting patients, hospitals and medical staff. The purpose of this study was to identify and classify desirable web-based services in websites of Iran's hospitals based on Kano’s Customer Satisfaction Model.
Materials and Methods: This was a survey study. The statistical population of the study consisted of hospital website users, of whom 120 were randomly selected. The data collection tool was a questionnaire based on Kano model. The validity of the questionnaire was confirmed by the information science and health information technology (HIT) professors. Data were analyzed using Kano model evaluation table, Excel software, and descriptive statistics. Cronbach's alpha test was used to determine reliability (a=0.82).
Results: First, the desirable web-based services of the hospitals’ websites were identified. Then, 67 identified services were classified into mandatory criteria (29 services), one-dimensional criteria (15 services), attractive criteria (14 services) and indifferent criteria (9 services). Most services were mandatory, attractive, one-dimensional and indifferent in content components.
Conclusion: Most services identified in this study were on the websites of the world's leading hospitals; HIT designers and professionals and hospital managers are expected to use such services in designing hospital websites. Although the comments of site designers and experts were practical in some cases, they attracted a limited number of users due to their unfamiliarity with specialized website design topics.

Hamzeh Amin-Tahmasbi, Maede Ghasemi,
Volume 14, Issue 4 (10-2020)
Abstract

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".

Azam Lari , Nehzat Goudarzi , Sareh Daneshgar , Mahnaz Taheri Pour,
Volume 14, Issue 4 (10-2020)
Abstract

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.

Ali Mohammad Mosadeghrad, Fatemeh Ghazanfari,
Volume 14, Issue 4 (10-2020)
Abstract

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.

Mohammad Reza Mehregan, Shahrokh Yousefzadeh, Ali Reza Hatam Siahkal Mahalle,
Volume 15, Issue 2 (5-2021)
Abstract

Background and Aim: The overall goal of the medical department is to develop and manage an efficient and effective supply chain. Intrinsic instability and unpredictability of treatment needs to require a flexible supply chain. Agility reflects the hospital's response to environmental changes, and agile hospitals are able to provide appropriate services to the patients. Hospital supply chain management agility needs to find the main aspects affecting the relationship and communication between them and to analyze the dimensions together. The purpose of this study was interpretive-structural modeling and analysis of dimensions of agile hospital supply chain management.
Materials and Methods: The research design combined descriptive - survey exploratory approach to the future. The population study were doctors, nurses and staff at the University of Medical Sciences. The Delphi technique was used to determine the dimensions of agility and the interpretive-structural modeling approach was used for analysis and modeling. Mick Mac software was used to analyze the dimensions of agility.
Results: The final model of agile hospital supply chain management with 16 dimensions had 8 levels, which was at the highest level of cost reduction and at the lowest level of organizational leadership commitment. The results indicate that leadership commitment is the foundation of supply chain agility in the hospital. Knowledge management variable had low impact and effectiveness and was known as a secondary leverage variable. The results showed that most agile supply chain management aspects of the main causes of complex communication and interaction, and the importance of agility in the hospital of the show. 
Conclusion: The analysis and interpretation of functional from the aspect of Impact and Influence of agility dimensions in hospital environment Showed that, Dimensions of strategic planning, human resource development and staff skills training, human resource management and employee satisfaction, process management, process integration and organizational transformation, flexibility, organizational communication development and information management integration, service quality management and continuous improvement, acceptance of new technology and new ideas, speed of service, patient  understand and satisfaction, monitor, find best responds demand and market sensitivity in the strategic area are located and They cause model instability and With high impact and high influence, They play an important role in the agility of hospital supply chain management.


Zahra Aghasizadeh, Ali Reza Pouya, Nasser Motahari Farimani, Ali Vafeaa Najjar,
Volume 16, Issue 1 (3-2022)
Abstract

Background and Aim: Hospitals are the most important component of the health system and accurate evaluation of their performance is important. So far, much research has been done on the evaluation of hospitals using DEA models, but in these studies, organizations are considered as a black box and system processes and relationships between them are ignored. In this study, the efficiency of hospitals was evaluated using network envelopment analysis and its results were compared with simple envelopment analysis.
Materials and Methods: The method of the present research was ptactical and the nature of the survey was descriptive. The research population was all hospitals and educational centers affiliated to Mashhad University of Medical Sciences with a capacity of more than one hundred beds, which included twelve public hospitals and forty-eight sections. To collect information, methods of observing and studying documents, records and statistics of hospital activities have been used. For validation, by calculating Spearman correlation coefficient, it was found that the proposed model has a significant correlation with the Black Box DEA Model and the validity of the model was confirmed. SOLVER DEA and EXCEL software were used to implement the model.
Results: The results show that by considering the internal departments of the organization as well as the relations between the departments, a more accurate analysis of the efficiency of the hospitals would be done and we will have a better separation in the ranking between the organizations. Also, by using the network DEA model, the overall efficiency, the efficiency of each department and the rank of each department in comparison with similar departments in other hospitals are determined.
Conclusion: The framework presented in this study can be an appropriate criterion for measuring the efficiency of hospitals and their internal sections by determining the overall position of each hospital relative to other hospitals and by determining the efficiency of the section. By determining the efficiency of the internal departments of hospitals, a suitable priority is provided for allocating resources and investing in different departments in the direction of organizational improvement.

Reza Abbasi, Fatemeh Rangraz Jeddi, Shima Anvari, Reza Khajouei,
Volume 16, Issue 3 (8-2022)
Abstract

Background and Aim: Hospital managers are one of the key decision-makers in the implementation of health information systems. This study aimed to determine the implementation challenges of health information systems based on the hospital managers’ perspective.
Materials and Methods: This descriptive-analytical study was conducted in 2019 on the hospital managers of three provinces (Kerman, Yazd, Sistan and Baluchestan). Data were collected using a self-administrated questionnaire. The face validity of this questionnaire was approved by experts in health informatics and health information management and its reliability was confirmed by Cronbach’s alpha (α=96.7%). Data were analyzed using SPSS. To investigate the relationship between the mean of each challenge with demographic variables, Pearson, Independent T-test, and ANOVA tests were used.
Results: In this study, the factors related to ignoring the hospital manager’s needs in system selection (1.333 out of 2 points), hardware purchase cost, insufficient user training to using the system (1.238), inadequate manpower and health informatics specialists (1.19), software purchase cost, insufficient financial resources (1.142), high cost of system launching, the lack of integration and interoperability among information systems, lack of support from health care professionals (1.047), and lack of management experience in choosing the best system (one out of 2) had the highest scores (out of 2 points). Also, personnel training costs to work with the system (-0.092) and Lack of improvement in work processes (-0.047) obtained the lowest scores. Data analysis showed that managers with clinical backgrounds considered financial and human challenges more important than non-clinical managers (P<0.031).
Conclusion: The hospital managers believed that financial, human, technical, managerial, and organizational factors are the most important challenges in implementing health information systems in Iran’s hospitals respectively. The health policy-makers and planners at large and small levels can address many of the challenges before implementing systems by focusing on identified priorities.

Hamzeh Amin-Tahmasbi, Kimia Malekzadeh Shafaroudi,
Volume 16, Issue 4 (10-2022)
Abstract

Background and Aim: Today, treatment is one of the important goals of tourism. Tourism in health and healthcare is growing rapidly in the world. Despite the fact that Guilan province, as one of the most important and touristic provinces of the country, has an annual population of 500,000 foreign tourists and can be the center of health tourism in Iran. Unfortunately, this province has not been able to have a proper share of the revenues of this field and attract foreign patients in parallel with its treatment capacities.
Materials and Method: The aim of this study was to identify the factors affecting the development of health tourism. In this regard, first, literature review was used and opinions of experts in this field, who were employees in five hospitals in Rasht, including Velayat, PourSina, Aria, Pars and Qaem hospitals, were selected using the Snowball sampling method. Twenty-five effective factors were identified and using Delphi method, 14 factors were selected as the final factor. Then by used of the Best and Worst Method (BWM), the importance of each factor was determined. Finally, using DEMATEL method, the effect of this factor on each other was determined.
Results: After conducting two rounds of Delphi, 11 factors that had an average lower than the average of the total opinions of the experts and there was more disagreement about them were eliminated. Then, by implementing the best-worst method, the quality of medical services was determined as the most important factor, and the ease of booking an appointment in advance for admission and the status of the banking system were determined as the least important factors among the final factors. Also, based on the results of the DEMATEL method, the quality of medical services has the greatest effect and the ease of booking an appointment in advance for admission has the least effect on other factors. Finally, the quality of medical services is the most effective and appropriate advertising about health tourism in domestic and foreign chambers of commerce has the least effectiveness.
Conclusion: Health tourism in Iran despite the relative quality and cheap price, has not yet found its place in the market due to the lack of proper advertising is still taking the first steps. Considering the environmental conditions and the existence of tourism aspects of Rasht, carrying out measures such as improving the quality of medical services, appropriate marketing, and improving infrastructures will lead to the development and improvement of health tourism, and as a result, increasing satisfaction and attracting more customers.

Mohammad Jalali, Ehsan Zarei, Ali Maher, Soheila Khodakarim,
Volume 16, Issue 5 (12-2022)
Abstract

Background and Aim:  With the outbreak of the COVID-19 pandemic, the performance of hospitals were affected, and changes were made in the utilization of hospital services. Analyzing hospital performance data during the COVID-19 pandemic can provide insights into service utilization patterns and care outcomes for managers and policymakers. This study was conducted to investigate the impact of COVID-19 on selected outcome indicators in the hospitals of Shahid Beheshti University of Medical Sciences, Tehran.
Materials and Methods: This research was descriptive-analytical and of the time series analysis type. Six outcome indicators were considered: hospitalization rate, bed occupancy rate, the average length of stay, emergency visits, laboratory tests, and imaging requests. Related data from 12 affiliated hospitals from 2017-2019 (pre-COVID) and 2020 (post-COVID) were obtained from the hospital's intelligent management system. The data were analyzed using R software's interrupted time series analysis method.
Results: The hospitalization rate (P=0.015), bed occupancy rate (P=0.04), and the number of laboratory tests (P=0.003) significantly increased immediately after the outbreak of the pandemic. In contrast, emergency visits (P=0.034) have significantly decreased. The bed occupancy rate and the number of imaging requests showed no significant change. The decrease in emergency room visits within one year after the pandemic was significant, but the changes in other outcome indicators were non-significant (P>0.05).
Conclusion: Understanding the changes and impact of a major event on hospital outcome indicators is necessary for decision-makers to effectively plan for resource allocation and effective pandemic response. The outbreak of COVID-19 has caused a change in performance and hospital outcomes by affecting the supply and demand of services. In a year after the pandemic's beginning, except for emergency visits, the other indicators have not experienced significant changes. Preservation of essential services such as emergency room visits is recommended in the strategy of rapid response to an epidemic outbreak and public campaigns to encourage people to seek medical care if needed in future waves of the pandemic.

Saeed Nateghi, Ali Ganjali Khan Hakemi, Soheila Damiri, Samira Raoofi, Elham Haghshenas, Sara Akhavan Rezayat, Shamsi Ekhtiyar, , Maryam Radin Manesh,
Volume 16, Issue 5 (12-2022)
Abstract

Background and Aim: Effective monitoring and evaluation of human resources in countries require an agreed set of indicators and measurement tools. Due to the existence of different payment mechanisms, this study aimed to identify performance evaluation indicators in hospitals affiliated with the Tehran University of Medical Sciences.
Materials and Methods: A qualitative phenomenological study was conducted in 2022. Data were collected using semi-structured interviews, purposive sampling, and participation of 23 members of the Senior executives and financial team of hospitals affiliated to Tehran University of Medical Sciences and analyzed by content analysis method using MAXQDA-10 software.
Results: Twenty-three experts participated in this research, 78.2% were men and 21.7% were women, and a total of 526 final codes were identified and according to the balanced scorecard management tool in 4 main themes of finance, customers, internal processes, and growth and Development. Also 8 sub-themes of resource efficiency with 86%, medical tourism with 52%, professional ethics with 65%, satisfaction with 78%, accreditation with 48%, diagnosis and treatment with 78%, education with 56% and The research was categorized with 78%.
Conclusion: The provision of optimal medical services requires managers to be aware of the performance of subordinate personnel, which makes it possible to choose the appropriate criteria, develop performance evaluation systems and conduct correct evaluation, informing Doctors regarding the indicators considered for more accurate evaluation are among the suggestions that can be a solution to the existing problems. Another important point considering the limited available resources is the role of doctors in the field of health tourism to which attention will lead to an increase in financial resources.

- Zeinab Hashemzadeh, Farhad Habibi, Hossein Dargahi, Mohammad Arab,
Volume 17, Issue 1 (3-2023)
Abstract

Background and Aim: Home care is an alternative method of hospitalization, especially for chronic patients and is an innovative approach to improve care and reduce the costs of hospital readmissions. The present study was conducted with the aim of investigating the benefits and challenges of implementing the home care plan after being discharged from the hospital considering the perspective of health service recipients and providers at Tehran University of Medical Sciences in 2021.
Material and Methods: The present study is an applied research that was conducted qualitatively using structured and semi-structured interviews. The research sample was those responsible for the implementation of this project at the ministry and university level, the implementers of this project in 4 hospitals, 5 institutions providing home care services, and family of patients. Twenty-eight people from the research community were included in the study using the purposeful and snowball sampling method. Content analysis method was used to analyze the interview data. MAXQDA2020 software was used for data classification.
Results: The results were classified into two categories: benefits and challenges of the home care plan after discharge. A total of 61 open codes were extracted from the analysis of research interviews, so that 27 codes led to the identification of 5 themes (Including improving service delivery, reducing costs, achieving health goals, cultural and social benefits, providing the necessary infrastructure) in the benefits and 34 codes led to the identification of 7 themes (including policy-making, legal and ethical, economic, manpower, cultural-social-communication, service provision limitations and time and place limitations) in the challenges.
Conclusion: The result of this research showed that home care services after being discharged from the hospital play an important role in completing the provision of healthcare services. Home care services after being discharged from the hospital improves service delivery, reduces costs, and helps in achieving health goals. It also benefits patients, society and the government in various cultural and social fields. On the other hand, it seems that there are challenges in the political, legal, economic and cultural fields in the way of the optimal implementation of this plan. Therefore, planning to evaluate and solve the problems facing these services is essential.


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