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Masoomeh Abdi Talarposhti, Ghahraman Mahmoudi Alemi, Mohammad Ali Jahani,
Volume 15, Issue 4 (10-2021)
Volume 15, Issue 4 (10-2021)
Abstract
Background and Aim: One of the reasons that caused healths clients are feeling dissatisfaction with health organizations is expectations that they are creating and not able to meet according to their expectations. Therefore, the present study was conducted with the aim of production a branding model for health services with the of clients’ expectations approach.
Materials and Methods: This compound study was performed in 2021. The statistical population of this study in qualitative phase included 20 academic and institutional experts using snowball sampling and the Delphi technique. For the quantitative phase, 830 people referred to health centers were selected as service recipients. The validity of the questionnaire was confirmed by face, content, and structural validity, and its reliability was confirmed by Cronbach’s alpha of 0.96 Quantitative data were presented by EQS software version 6.1 with confirmatory factor analysis and using structural equations.
Results: The results of factor structure in healthcare branding based on six main themes of competitive position, brand equity, brand accessibility, brand consolidation in the minds of clients and the market, branding strategies, and consumer-brand relationship with 19 sub-themes based on the perspective of health services clients (CFI=0/9, TLI=0/9, SRMR=0/049, RMSEA=0/09) had a good fit and the internal consistency of the items had significant levels (P<0/05).
Conclusion: The results of this study show that 19 sub-main themes confirm the six-factor structure of health services branding and were one of the effective themes in branding from the perspective of clients. Since the branding of health services improves the quantity and quality of services provided in the health system, therefore, it is suggested that by creating innovation in the quantity and quality of services provided, access to health services, creating a competitive advantage and empowering employees and improving communication skills, an effective step can be taken in health services branding planning.
Materials and Methods: This compound study was performed in 2021. The statistical population of this study in qualitative phase included 20 academic and institutional experts using snowball sampling and the Delphi technique. For the quantitative phase, 830 people referred to health centers were selected as service recipients. The validity of the questionnaire was confirmed by face, content, and structural validity, and its reliability was confirmed by Cronbach’s alpha of 0.96 Quantitative data were presented by EQS software version 6.1 with confirmatory factor analysis and using structural equations.
Results: The results of factor structure in healthcare branding based on six main themes of competitive position, brand equity, brand accessibility, brand consolidation in the minds of clients and the market, branding strategies, and consumer-brand relationship with 19 sub-themes based on the perspective of health services clients (CFI=0/9, TLI=0/9, SRMR=0/049, RMSEA=0/09) had a good fit and the internal consistency of the items had significant levels (P<0/05).
Conclusion: The results of this study show that 19 sub-main themes confirm the six-factor structure of health services branding and were one of the effective themes in branding from the perspective of clients. Since the branding of health services improves the quantity and quality of services provided in the health system, therefore, it is suggested that by creating innovation in the quantity and quality of services provided, access to health services, creating a competitive advantage and empowering employees and improving communication skills, an effective step can be taken in health services branding planning.
Emel Hoveyzi, Jila Najafpoor, Mehrdad Sharifi, Mansour Zahiri,
Volume 15, Issue 5 (1-2022)
Volume 15, Issue 5 (1-2022)
Abstract
Background and Aim: The growing health care needs of students actuated world Health Organization to develop School-based health projects in the last decades. The most important plan that has received worldwide attention and in Iran for nearly one decade is Health Promoting School (HPS) program which being implemented with collaboration of Ministries of Health and Education. Present qualitative study was conducted to evaluate this program implementation in Ahvaz education organization (District 1).
Materials and Methods: In this qualitative study data was collected by semi-structured interview. The study population consisted of school health experts affiliated with Ahvaz West Health Center and health deputy, health experts affiliated with education organization (District 1 and school headmasters and expert staffs in HPS (22 persons). The sampling was purposeful and the interviews continued until saturation of data. Content analysis was used for analysis of the data.
Results: Data analysis showed that most components of the HPS program in schools belong to education organization were not implemented properly. The major barriers were categorized into 5 and 47 main and subsidiary themes respectively. Poor stewardship and authority, policymaking and legislation, weaknesses in motivation, attitude and awareness of managers and experts, inadequacy in resources and infrastructure, ineptitude in program implementation and finally inappropriate evaluation system was specified as the main themes. According to results, some of the most important reasons for failure in HPS program consisted of, lack of functions definiteness between health deputy in ministry of health and education organization, job dissatisfaction in school health experts, not being a priority behalf education organization, insufficient delegation of authorized budget, lack of interpectoral cooperation between trustee organizations and indifference about program evaluation.
Conclusion: The most important challenge in the HPS program is the implementation barriers that make the establishment and implementation of this program almost ineffective. The serious and committed interaction between the ministry of Health and Education and between their respective provincial and county districts can provide the foundation for the implementation of this valuable program. A review of the organizational structure and executive framework of the program is also necessary.
Materials and Methods: In this qualitative study data was collected by semi-structured interview. The study population consisted of school health experts affiliated with Ahvaz West Health Center and health deputy, health experts affiliated with education organization (District 1 and school headmasters and expert staffs in HPS (22 persons). The sampling was purposeful and the interviews continued until saturation of data. Content analysis was used for analysis of the data.
Results: Data analysis showed that most components of the HPS program in schools belong to education organization were not implemented properly. The major barriers were categorized into 5 and 47 main and subsidiary themes respectively. Poor stewardship and authority, policymaking and legislation, weaknesses in motivation, attitude and awareness of managers and experts, inadequacy in resources and infrastructure, ineptitude in program implementation and finally inappropriate evaluation system was specified as the main themes. According to results, some of the most important reasons for failure in HPS program consisted of, lack of functions definiteness between health deputy in ministry of health and education organization, job dissatisfaction in school health experts, not being a priority behalf education organization, insufficient delegation of authorized budget, lack of interpectoral cooperation between trustee organizations and indifference about program evaluation.
Conclusion: The most important challenge in the HPS program is the implementation barriers that make the establishment and implementation of this program almost ineffective. The serious and committed interaction between the ministry of Health and Education and between their respective provincial and county districts can provide the foundation for the implementation of this valuable program. A review of the organizational structure and executive framework of the program is also necessary.
Marjan Ghazi Saeedi, Mozhgan Tanhapour,
Volume 15, Issue 5 (1-2022)
Volume 15, Issue 5 (1-2022)
Abstract
Background and Aim: Telemedicine provides medical services remotely. There are some problems with implementing telemedicine projects. The purpose of this study was to investigate the most common telemedicine services in Iran and other developed countries as well as examine the legal, financial and privacy challenges of telemedicine services in these countries, especially in the era of the COVID-19 epidemic.
Material and Methods: In this study, the status of telemedicine in Iran and developed countries was reviewed. Thus, related papers and grey literature were retrieved from PubMed, Scopus, SID and Magiran scientific databases. Also, related websites including the Ministry of Health and Medical Education of the Islamic Republic of Iran were examined. According to the study’s purposes, the relevant resources were selected and summarized by researchers.
Results: Radiology, psychiatry and cardiology are the most widely used telemedicine services for interaction with patients as well as emergency, pathology and radiology for healthcare professional communication. Teleconsulting is the most widely used telemedicine service in Iran. There are some laws such as article 74 from section 14 in the Iran development plan to support the provision of e-health and telemedicine services. Also, there are some limited laws for patients’ privacy. In Europe, there is a set of guidelines for health websites, mobile health and cross-border exchange of health information, etc. although there are no uniform laws about telemedicine. HIPAA in the United States and GDPR in Europe are some privacy laws in developed countries. There are some restrictions on telemedicine reimbursement in the United States including the fee-for-service payment model; however, the costs of telemedicine in the United States are usually less than face-to-face treatment.
Conclusion: In the present era using telemedicine services become a requirement due to the outbreaks of epidemics such as COVID-19. Concerning the experience of developed countries, telemedicine services development in Iran requires some considerations in terms of legal, financial and privacy aspects including the creation of explicit laws on patients and healthcare provider’s rights, providing the telemedicine guidelines in different clinical fields such as structured formats for teleconsultation as well as the explicit laws for preserving the patient’s privacy.
Material and Methods: In this study, the status of telemedicine in Iran and developed countries was reviewed. Thus, related papers and grey literature were retrieved from PubMed, Scopus, SID and Magiran scientific databases. Also, related websites including the Ministry of Health and Medical Education of the Islamic Republic of Iran were examined. According to the study’s purposes, the relevant resources were selected and summarized by researchers.
Results: Radiology, psychiatry and cardiology are the most widely used telemedicine services for interaction with patients as well as emergency, pathology and radiology for healthcare professional communication. Teleconsulting is the most widely used telemedicine service in Iran. There are some laws such as article 74 from section 14 in the Iran development plan to support the provision of e-health and telemedicine services. Also, there are some limited laws for patients’ privacy. In Europe, there is a set of guidelines for health websites, mobile health and cross-border exchange of health information, etc. although there are no uniform laws about telemedicine. HIPAA in the United States and GDPR in Europe are some privacy laws in developed countries. There are some restrictions on telemedicine reimbursement in the United States including the fee-for-service payment model; however, the costs of telemedicine in the United States are usually less than face-to-face treatment.
Conclusion: In the present era using telemedicine services become a requirement due to the outbreaks of epidemics such as COVID-19. Concerning the experience of developed countries, telemedicine services development in Iran requires some considerations in terms of legal, financial and privacy aspects including the creation of explicit laws on patients and healthcare provider’s rights, providing the telemedicine guidelines in different clinical fields such as structured formats for teleconsultation as well as the explicit laws for preserving the patient’s privacy.
Leila Nemati-Anaraki, Fatemeh Khazaee, Hasan Ashrafi-Rizi,
Volume 15, Issue 5 (1-2022)
Volume 15, Issue 5 (1-2022)
Abstract
Background and Aim: One of the most important needs of the elderly is information. Public libraries are among the centers that can play an effective role in providing information services year after year. The purpose of this study was to investigate the situation of public libraries affiliated with the Cultural and Artistic Organization of Tehran Municipality in the Health Information Report for 2020 in Tehran province.
Materials and Methods: The present study was descriptive-analytical in nature and with applied results. In this study, due to the comprehensiveness of the work, sampling was not done and in other words, the research sample was with the research community. The research community of Tehran Province Public Librarians was affiliated with the Cultural and Artistic Organization of Tehran Municipality (87 people). The validity of this questionnaire was confirmed based on the opinions of seven experts in the field of library and medical information. And its reliability was calculated 0.9 through Cronbach’s alpha. The research tool was a researcher-made questionnaire. Data were analyzed by SPSS software using descriptive statistics and one-sample t-test.
Results: The situation of resources, tools and technology as well as the services of public libraries affiliated to the Cultural and Artistic Organization of Tehran Municipality in providing health information to the elderly are unfavorable and below average (P>0.05). Findings show that services can be provided Health services in public libraries affiliated to the Cultural and Artistic Organization of Tehran Municipality for the elderly, respectively, insufficient budget and lack of facilities and equipment for the elderly and lack of up-to-date, lack or reporting of information sources.
Conclusion: According to the results, the situation of public libraries affiliated to the Cultural and Artistic Organization of Tehran Municipality in providing health information to the elderly in Tehran province was unfavorable. Due to demographic changes in the coming years, it is necessary for the public libraries of their country to prepare to provide appropriate services to the previous years.
Materials and Methods: The present study was descriptive-analytical in nature and with applied results. In this study, due to the comprehensiveness of the work, sampling was not done and in other words, the research sample was with the research community. The research community of Tehran Province Public Librarians was affiliated with the Cultural and Artistic Organization of Tehran Municipality (87 people). The validity of this questionnaire was confirmed based on the opinions of seven experts in the field of library and medical information. And its reliability was calculated 0.9 through Cronbach’s alpha. The research tool was a researcher-made questionnaire. Data were analyzed by SPSS software using descriptive statistics and one-sample t-test.
Results: The situation of resources, tools and technology as well as the services of public libraries affiliated to the Cultural and Artistic Organization of Tehran Municipality in providing health information to the elderly are unfavorable and below average (P>0.05). Findings show that services can be provided Health services in public libraries affiliated to the Cultural and Artistic Organization of Tehran Municipality for the elderly, respectively, insufficient budget and lack of facilities and equipment for the elderly and lack of up-to-date, lack or reporting of information sources.
Conclusion: According to the results, the situation of public libraries affiliated to the Cultural and Artistic Organization of Tehran Municipality in providing health information to the elderly in Tehran province was unfavorable. Due to demographic changes in the coming years, it is necessary for the public libraries of their country to prepare to provide appropriate services to the previous years.
Hamzeh Amin-Tahmasbi, Hossein Nasirzadeh,
Volume 15, Issue 6 (3-2022)
Volume 15, Issue 6 (3-2022)
Abstract
Background and Aim: Inattention of hospital waste management has caused many problems. As a consequence, it has put the environment and human health at serious risk. Medical centers are one of the important health institutions which in recent years, population growth, increasing clients and service populations has led to significant growth in waste production in them. The quality and quantity of medical centers waste is becoming more and more problematic and is considered as a dangerous toxic substance. The purpose of this article is to evaluate, prioritize and explain the management plan for treatment and disposal of medical centers waste.
Materials and Methods: Important criteria in choosing the method of waste disposal of medical centers were extracted from previous studies. Then, the importance of these criteria was determined using the Fuzzy Analytic Hierarchy Process (Fuzzy AHP) and at the end, the best disposal method was selected using the Fuzzy Weighted Aggregated Sum Product Assessment (Fuzzy WASPAS).
Results: Among the main criteria, environmental issues was the first priority with 0.517 weight and the criteria of cost and volume of waste with the points of 0.317 and 0.166 were ranked second and third, respectively. Also, between the sub-criteria, the air pollution was ranked first with 0.256 weight. Finally, among the disposal methods, the sanitary landfill method with 0.317 weight was ranked first and the microwave methods, waste incineration and autoclave with the points of 0.265, 0.253, and 0.173 scored second to fourth respectively.
Conclusion: Considering the obtained results and prioritizing, it is possible to achieve more risk reduction, reduction of environmental pollution and reduction of costs by disposing of waste in health centers. Accordingly, the most appropriate method for disposing of waste in medical centers in the country is the “sanitary landfill” method. Of course, sanitary landfilling of waste should be done in an appropriate and standard way to prevent groundwater pollution and damage to the environment. Solving the problems caused by hospital waste is a complex and multidimensional issue that requires the cooperation and assistance and integration of community facilities (government, private and public institutions).
Materials and Methods: Important criteria in choosing the method of waste disposal of medical centers were extracted from previous studies. Then, the importance of these criteria was determined using the Fuzzy Analytic Hierarchy Process (Fuzzy AHP) and at the end, the best disposal method was selected using the Fuzzy Weighted Aggregated Sum Product Assessment (Fuzzy WASPAS).
Results: Among the main criteria, environmental issues was the first priority with 0.517 weight and the criteria of cost and volume of waste with the points of 0.317 and 0.166 were ranked second and third, respectively. Also, between the sub-criteria, the air pollution was ranked first with 0.256 weight. Finally, among the disposal methods, the sanitary landfill method with 0.317 weight was ranked first and the microwave methods, waste incineration and autoclave with the points of 0.265, 0.253, and 0.173 scored second to fourth respectively.
Conclusion: Considering the obtained results and prioritizing, it is possible to achieve more risk reduction, reduction of environmental pollution and reduction of costs by disposing of waste in health centers. Accordingly, the most appropriate method for disposing of waste in medical centers in the country is the “sanitary landfill” method. Of course, sanitary landfilling of waste should be done in an appropriate and standard way to prevent groundwater pollution and damage to the environment. Solving the problems caused by hospital waste is a complex and multidimensional issue that requires the cooperation and assistance and integration of community facilities (government, private and public institutions).
Tahereh Abolghasem, Maryam Nakhoda, Dr Sepideh Fahimifar, Dr Mohammad Khandan,
Volume 15, Issue 6 (3-2022)
Volume 15, Issue 6 (3-2022)
Abstract
Background and Aim: Knowledge management and employee engagement are the key factors for organizations to achieve competitive advantage, increase productivity and improve performance. The purpose of this study was to identify the relation of effective factors on employee engagement and healthcare knowledge management in the organization.
Materials and Methods: This research was applied in terms of systematic review and was done by meta-analysis-quantitative method. The statistical population included external research. Data collection tools are researcher-made checklist and EBL critical appraisal checklist (Glynn). For this purpose, comprehensive meta-analysis software version 2.0 was used.
Results: Findings showed that at 95% confidence level, employee engagement has a significant relation on healthcare knowledge management and was able to explain 37% of knowledge management. Leadership (0.349), Reward (0.616), Organizational Culture (0.655), Job Satisfaction (0.674), Innovation (0.493), productivity (0.411), organizational performance (0.775) and organizational learning (0.548) are factors that was affecting employee engagement and healthcare knowledge management. The results of heterogeneity tests showed that the studies were heterogeneous and therefore the random effect size was used. The funnel diagram shows high standard error and high bias. In other words, the distribution of research was not normal and random.
Conclusion: Managers can increase the level of engagement and management of organizational knowledge by focusing on the identified factors and its implementation in the organization and increase the level of desire and participation of employees in knowledge management processes.
Materials and Methods: This research was applied in terms of systematic review and was done by meta-analysis-quantitative method. The statistical population included external research. Data collection tools are researcher-made checklist and EBL critical appraisal checklist (Glynn). For this purpose, comprehensive meta-analysis software version 2.0 was used.
Results: Findings showed that at 95% confidence level, employee engagement has a significant relation on healthcare knowledge management and was able to explain 37% of knowledge management. Leadership (0.349), Reward (0.616), Organizational Culture (0.655), Job Satisfaction (0.674), Innovation (0.493), productivity (0.411), organizational performance (0.775) and organizational learning (0.548) are factors that was affecting employee engagement and healthcare knowledge management. The results of heterogeneity tests showed that the studies were heterogeneous and therefore the random effect size was used. The funnel diagram shows high standard error and high bias. In other words, the distribution of research was not normal and random.
Conclusion: Managers can increase the level of engagement and management of organizational knowledge by focusing on the identified factors and its implementation in the organization and increase the level of desire and participation of employees in knowledge management processes.
Mohammad Reza Shahraki, Motahare Fallah,
Volume 16, Issue 1 (3-2022)
Volume 16, Issue 1 (3-2022)
Abstract
Background and Aim: The healthcare sector plays an important role in the development of communities by ensuring the health of individuals in each community and can have many social and economic effects on the lives of individuals in the community. The purpose of this study was to determine the development of the country’s provinces based on health facilities and the level of access to these facilities, to find solutions to reduce differences between different parts of the country.
Materials and Methods: This study was an applied study with a descriptive-analytical approach. In this study, 31 provinces of the country have been studied in terms of 10 indicators. Data and information of this study were extracted from the national statistical yearbook and ranked using Center-weighted index method by using Excel software. Then, using taxonomy method, the degree of development of the provinces has been determined.
Results: The results of the study show that South Khorasan province with a centrality index of 45,692 is in the first place, Yazd province with a centrality index of 43,933 is in the second place and Ilam province with a centrality index of 40,668 is in the third place. East Azerbaijan province with a centrality index of 27,375 is ranked 29th, Qom province with a centrality index of 25,417 is ranked 30th and Hormozgan province with a centrality index of 24,286 is ranked 31st. The degree of development of the provinces is between 0.507 to 0.98, which in terms of development of Yazd province is in the first rank and Hormozgan province is in the last rank.
Conclusion: The results show that there is a deep gap between the provinces in terms of development and access to health indicators; Therefore, it needs more attention and adopt the necessary policies and plans to reduce this gap.
Materials and Methods: This study was an applied study with a descriptive-analytical approach. In this study, 31 provinces of the country have been studied in terms of 10 indicators. Data and information of this study were extracted from the national statistical yearbook and ranked using Center-weighted index method by using Excel software. Then, using taxonomy method, the degree of development of the provinces has been determined.
Results: The results of the study show that South Khorasan province with a centrality index of 45,692 is in the first place, Yazd province with a centrality index of 43,933 is in the second place and Ilam province with a centrality index of 40,668 is in the third place. East Azerbaijan province with a centrality index of 27,375 is ranked 29th, Qom province with a centrality index of 25,417 is ranked 30th and Hormozgan province with a centrality index of 24,286 is ranked 31st. The degree of development of the provinces is between 0.507 to 0.98, which in terms of development of Yazd province is in the first rank and Hormozgan province is in the last rank.
Conclusion: The results show that there is a deep gap between the provinces in terms of development and access to health indicators; Therefore, it needs more attention and adopt the necessary policies and plans to reduce this gap.
Zahra Otroj, Firoozeh Zare-Farashbandi, Fatemeh Rastegari,
Volume 16, Issue 2 (5-2022)
Volume 16, Issue 2 (5-2022)
Abstract
Background and Aim: Health information seeking behavior can be influenced by several factors and variables such as personality traits, beliefs, values, tendencies, contextual factors and personal emotions. Health information has a direct relationship with the quality of life of people in society, it can be influential in decisions related to personal and social health and improve people’s performance in this field. This study aimed to determine the relationship between personality types of graduate students of Isfahan University of medical Sciences (IUMS) and their health information seeking behavior based on the Miller model.
Materials and Methods: This was an applied survey study. The study population was all graduate students of IUMS. The sample size was determined using the Morgan table of 297 people. Data collection tools are Neo Five Personality Factor Questionnaire and Miller Information Behavior Questionnaire. Data were analyzed by SPSS software.
Results: The results showed that there is an inverse relationship between personality type “Psychotic” and the component of “active search for health information”. Also there is a direct relationship between persons who are “Eager for new experiences” and “conscientiousness” with the component of “active search for health information”. But there is no significant relationship between personality types “extroversion” and “agreeability” with the components of health informing behavior. The studied students are not responsible and conscientious in terms of personality type, they often prefer solitude and are introverted and conservative. But more than half of them are balanced in the dimension of “agreeability”.
Conclusion: This study showed that people who are eager for new experiences and conscientious, search health information actively, but Psychotic persons are not willing to be active in seeking health information This means that the more responsible and conscientious people are, or the more eager they are for new experiences, the more actively they search for health information. Therefore, it is better for health policy makers to plan in such a way that the necessary health information is provided to them interactively based on the personality of the people.
Materials and Methods: This was an applied survey study. The study population was all graduate students of IUMS. The sample size was determined using the Morgan table of 297 people. Data collection tools are Neo Five Personality Factor Questionnaire and Miller Information Behavior Questionnaire. Data were analyzed by SPSS software.
Results: The results showed that there is an inverse relationship between personality type “Psychotic” and the component of “active search for health information”. Also there is a direct relationship between persons who are “Eager for new experiences” and “conscientiousness” with the component of “active search for health information”. But there is no significant relationship between personality types “extroversion” and “agreeability” with the components of health informing behavior. The studied students are not responsible and conscientious in terms of personality type, they often prefer solitude and are introverted and conservative. But more than half of them are balanced in the dimension of “agreeability”.
Conclusion: This study showed that people who are eager for new experiences and conscientious, search health information actively, but Psychotic persons are not willing to be active in seeking health information This means that the more responsible and conscientious people are, or the more eager they are for new experiences, the more actively they search for health information. Therefore, it is better for health policy makers to plan in such a way that the necessary health information is provided to them interactively based on the personality of the people.
Reza Abbasi, Fatemeh Rangraz Jeddi, Shima Anvari, Reza Khajouei,
Volume 16, Issue 3 (8-2022)
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.
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)
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.
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.
Ehsan Zarei, Kheyrollah Chavosh Sani, Mohammad Saadati, Soheila Khodakarim,
Volume 16, Issue 4 (10-2022)
Volume 16, Issue 4 (10-2022)
Abstract
Background and Aim: In recent years, public trust in health system has been considered one of the performance evaluation indicators of health systems. However, most of the research on public trust in health system is related to developed countries, and research in this regard is limited in Iran. A better understanding of trust in health system and some influential factors helps to develop targeted interventions to increase trust. The present study was conducted to investigate the level of public trust in health system in Rasht County.
Materials and Methods: In this cross-sectional study, 680 households (510 urban and 170 rural) were included. The data collection tool was a questionnaire to measure public trust in health system with 30 items and six dimensions, whose validity and reliability were confirmed. Mann-Whitney and Kruskal-Wallis tests were used to compare and analyze the difference in public trust in health system between groups.
Results: The overall score of trust in health system was 66.7 out of 112. The highest score for the quality-of-care dimension was 16.38 out of 28, and the lowest for the cooperation quality of providers dimension was 7.47 out of 12. Among service providers, the highest trust was in nurses and specialist doctors, and the least was in traditional medicine service providers. Women, government employees, people without health insurance, people with excellent and good health status, those who had used hospital services, and those who were satisfied with the last service received had a high level of trust in the health system (P<0.05).
Conclusion: The results showed that despite people’s trust in the expertise and knowledge of physicians and other providers, public trust in health system was relatively moderate, indicating deficiencies in the health system’s performance. Focusing on physician-patient communication and improving communication skills, establishing electronic records and sharing patient information between health service providers, and respecting patient rights can build greater trust in the health system.
Materials and Methods: In this cross-sectional study, 680 households (510 urban and 170 rural) were included. The data collection tool was a questionnaire to measure public trust in health system with 30 items and six dimensions, whose validity and reliability were confirmed. Mann-Whitney and Kruskal-Wallis tests were used to compare and analyze the difference in public trust in health system between groups.
Results: The overall score of trust in health system was 66.7 out of 112. The highest score for the quality-of-care dimension was 16.38 out of 28, and the lowest for the cooperation quality of providers dimension was 7.47 out of 12. Among service providers, the highest trust was in nurses and specialist doctors, and the least was in traditional medicine service providers. Women, government employees, people without health insurance, people with excellent and good health status, those who had used hospital services, and those who were satisfied with the last service received had a high level of trust in the health system (P<0.05).
Conclusion: The results showed that despite people’s trust in the expertise and knowledge of physicians and other providers, public trust in health system was relatively moderate, indicating deficiencies in the health system’s performance. Focusing on physician-patient communication and improving communication skills, establishing electronic records and sharing patient information between health service providers, and respecting patient rights can build greater trust in the health system.
Rajabali Daroudi, Mahmoud Zamandi,
Volume 16, Issue 6 (1-2023)
Volume 16, Issue 6 (1-2023)
Abstract
Background and Aim: The role of accurate information in decision-making and programs implementation has highlighted the need to design an appropriate costing system. The present study aimed to estimate the cost of student Training in the Department of Health Management and Economics at the School of Public Health, Tehran University of Medical Sciences using activity-based costing.
Materials and Methods: This research was an applied, descriptive, and cross-sectional study. In this study, all information was collected through interviews with seven officials, financial and administrative staff, and also by using available documents in the faculty. To analyze the costs, the administrative and educational sections were classified into three levels including overhead, middle, and final activity centers, and, using appropriate bases and Microsoft Excel 2013 software, costs of overhead, middle, and final activity centers, and finally, the total cost of each student was calculated.
Results: In this study, the total cost of education for each Ph.D. and master’s student in the department of health management and economics was estimated as 1.95 billion and 376 million IR Rials, respectively. So that the cost of each year of Ph.D. and master’s student education was 433 and 150 million IR Rials, respectively. Out of the total costs of the Department of Health Management and Economics, only 22% of the costs were related to overhead and middle activity centers, and 78% of the costs were exclusive to the final activity center, and the majority of these costs (97%) were related to the personnel, especially the faculty members.
Conclusion: The cost of training Ph.D. students due to the high coefficient of the degree and thus increasing the importance (cost share) of the field, receiving a scholarship from the Ministry of Health and a longer period of study, was estimated to be about 5 times that of a master’s degree. The Ministry of Health and universities can design and implement targeted research programs with the help of faculty members and graduate students, especially Ph.D. students, to solve problems and improve the health of the community, thus improving resource efficiency and productivity.
Materials and Methods: This research was an applied, descriptive, and cross-sectional study. In this study, all information was collected through interviews with seven officials, financial and administrative staff, and also by using available documents in the faculty. To analyze the costs, the administrative and educational sections were classified into three levels including overhead, middle, and final activity centers, and, using appropriate bases and Microsoft Excel 2013 software, costs of overhead, middle, and final activity centers, and finally, the total cost of each student was calculated.
Results: In this study, the total cost of education for each Ph.D. and master’s student in the department of health management and economics was estimated as 1.95 billion and 376 million IR Rials, respectively. So that the cost of each year of Ph.D. and master’s student education was 433 and 150 million IR Rials, respectively. Out of the total costs of the Department of Health Management and Economics, only 22% of the costs were related to overhead and middle activity centers, and 78% of the costs were exclusive to the final activity center, and the majority of these costs (97%) were related to the personnel, especially the faculty members.
Conclusion: The cost of training Ph.D. students due to the high coefficient of the degree and thus increasing the importance (cost share) of the field, receiving a scholarship from the Ministry of Health and a longer period of study, was estimated to be about 5 times that of a master’s degree. The Ministry of Health and universities can design and implement targeted research programs with the help of faculty members and graduate students, especially Ph.D. students, to solve problems and improve the health of the community, thus improving resource efficiency and productivity.
Mohammad Javad Kabir, Alireza Heidari, Nahid Jafari, Honarvar Mohammad Reza, Sajad Moeini, Zahra Khatirnamani,
Volume 16, Issue 6 (1-2023)
Volume 16, Issue 6 (1-2023)
Abstract
Background and Aim: Many health policies are not implemented or incompletely implemented after approval. This issue significantly reduces the popularity and responsiveness of the top managers of the health system and leads to service disruption in the target community. Therefore, this study was conducted to explain the existing challenges in the implementation of health policies.
Materials and Methods: A qualitative study was conducted in 2021. The participants in the study were 20 scientific and executive experts. The data was collected using an interview guide and the in-depth individual interview method and was analyzed using the content analysis method using thematic analysis with Graneheim and Lundman's approach.
Results: The challenges include the policies formulation (lack of evidence-informed decision-making, lack of attention to the details of the implementation, the change of the initial text of the policy, conflict of interests, unclarity the executives, the lack of proper integration between the political and technical components of the policies, the weak participation of the main stakeholders, the lack of the same understanding of policies concept between policy makers and executives and lack of budget forecasting), challenges of policies implementation (uncertainty about roles of executive organizations, lack of executive attachment, conflict of interest, lack of project management, change of formulated policies with change of executives, little belief among executives, lack of executive guarantee, lack of operational plan) and challenges of policies evaluation (Inadequate supervision and the absence of an informational and supervisory dashboard).
Conclusion: Using effective solutions to solve the challenges extracted in the stages of formulation, implementation and evaluation of health policies can lead to achieving the goals of the formulated policies and improving the health of the society.
Materials and Methods: A qualitative study was conducted in 2021. The participants in the study were 20 scientific and executive experts. The data was collected using an interview guide and the in-depth individual interview method and was analyzed using the content analysis method using thematic analysis with Graneheim and Lundman's approach.
Results: The challenges include the policies formulation (lack of evidence-informed decision-making, lack of attention to the details of the implementation, the change of the initial text of the policy, conflict of interests, unclarity the executives, the lack of proper integration between the political and technical components of the policies, the weak participation of the main stakeholders, the lack of the same understanding of policies concept between policy makers and executives and lack of budget forecasting), challenges of policies implementation (uncertainty about roles of executive organizations, lack of executive attachment, conflict of interest, lack of project management, change of formulated policies with change of executives, little belief among executives, lack of executive guarantee, lack of operational plan) and challenges of policies evaluation (Inadequate supervision and the absence of an informational and supervisory dashboard).
Conclusion: Using effective solutions to solve the challenges extracted in the stages of formulation, implementation and evaluation of health policies can lead to achieving the goals of the formulated policies and improving the health of the society.
Mahdi Hadi, Ali Jahan, Lila Najafi, Mohamad Ali Shariat,
Volume 17, Issue 1 (3-2023)
Volume 17, Issue 1 (3-2023)
Abstract
Background and Aim: Parallel to the progress of services, organizational complexity levels in health care centers (HCCs) have increased. The influential factors in this regard include the variety of services, the non-uniformity of the centers’ management conditions, and the rising expectations from the health system. Therefore, considering many factors influenced and effective, improvement of health services requires development of a systematic approach to evaluate their efficiency and management system. The aim of this study was to develop a balanced scorecard (BSC) model suitable for HCCs using a hybrid approach that combines the Fuzzy Delphi and DNAP techniques.
Materials and Methods: This research was a combined qualitative-quantitative study that was conducted with the aim of developing a BSC model suitable for HCCs. The statistical population consisted of 15 experts in health and medicine, who were selected based on the targeted snowball sampling. A researcher-made questionnaire and a 20×20 matrix questionnaire were used to collect the data. The questionnaire validity was calculated based on the experts’ opinions and the reliability was calculated using Cronbach’s alpha and consistency rate. The data was analyzed using Excel and MATLAB, and DNAP technique was used to determine the cause-and-effect relationship and the influence levels of the objectives.
Results: According to the results of the Fuzzy Delphi technique in the panel of experts, 5 viewpoints with 20 objectives of the BSC suitable for HCCs were identified and replaced the traditional viewpoints of the BSC. In addition, these results showed that the views of growth and development, intra-organizational processes, and social responsibility are considered as the influential factors due to the positive D-R values, while the views of patients and society, financial status, and performance are considered as the factors that are effective due to the negative D-R values.
Conclusion: The results of this study indicated that those points of view that are consistent with the goals of the HCCs should be used in the BSC in order to evaluate their performance. Also, prioritizing and determining the cause-and-effect relationship and considering the contribution of each point of view for achieving the goals of the HCCs can increase the performance.
Materials and Methods: This research was a combined qualitative-quantitative study that was conducted with the aim of developing a BSC model suitable for HCCs. The statistical population consisted of 15 experts in health and medicine, who were selected based on the targeted snowball sampling. A researcher-made questionnaire and a 20×20 matrix questionnaire were used to collect the data. The questionnaire validity was calculated based on the experts’ opinions and the reliability was calculated using Cronbach’s alpha and consistency rate. The data was analyzed using Excel and MATLAB, and DNAP technique was used to determine the cause-and-effect relationship and the influence levels of the objectives.
Results: According to the results of the Fuzzy Delphi technique in the panel of experts, 5 viewpoints with 20 objectives of the BSC suitable for HCCs were identified and replaced the traditional viewpoints of the BSC. In addition, these results showed that the views of growth and development, intra-organizational processes, and social responsibility are considered as the influential factors due to the positive D-R values, while the views of patients and society, financial status, and performance are considered as the factors that are effective due to the negative D-R values.
Conclusion: The results of this study indicated that those points of view that are consistent with the goals of the HCCs should be used in the BSC in order to evaluate their performance. Also, prioritizing and determining the cause-and-effect relationship and considering the contribution of each point of view for achieving the goals of the HCCs can increase the performance.
Negin Saldar, Rahim Shahbazi,
Volume 17, Issue 2 (5-2023)
Volume 17, Issue 2 (5-2023)
Abstract
Background and Aim: Health literacy plays a role in “reducing human casualties and financial costs” in a society. Emotional intelligence and media literacy also contribute to people’s success in life. Therefore, the aim of this study was to investigate the mediating role of media literacy in the relationship between emotional intelligence and health literacy among graduate students of Azarbaijan Shahid Madani University.
Materials and Methods: This research is based on the nature and general characteristics, quantitative; Based on the purpose, it is applied and based on the research method and data collection method, is a descriptive correlation based on structural equation model. The statistical population was graduate students of Azarbaijan Shahid Madani University in 2020 (2218 students). The statistical sample of the research is 327 people who were selected by stratified random sampling method. To collect data, Emotional Intelligence Questionnaire (1998), Montazeri et al. Health Literacy Questionnaire (2014) and media literacy questionnaire were used. The reliability of the questionnaires was obtained using Cronbach’s alpha coefficient of 0.91, 0.84 and 0.79, respectively. The collected data were analyzed using descriptive statistics and inferential statistics (structural equation model) using SPSS and LISREL software.
Results: The findings showed the mean of emotional intelligence, health literacy and media literacy of graduate students of Azarbaijan Shahid Madani University is 3.10, 3.47 and 3.58, respectively. Also, the results showed a significant relationship between emotional intelligence and students’ health literacy. According to the findings, there is a significant relationship between emotional intelligence with media literacy, and media literacy with health literacy. Also, the media literacy variable plays a mediating role in the relationship between emotional intelligence and health literacy (coefficient) of 0.58 units. The results of the structural equation model test also showed that the proposed conceptual model fits the relationship between emotional intelligence, health literacy and students’ media literacy.
Conclusion: Media literacy can not only directly affect students’ health literacy, but also has a mediating role between emotional intelligence and health literacy. Due to the effect of emotional intelligence on students’ health and media literacy, it is recommended that the necessary planning to be done in graduate education and to strengthen emotional intelligence.
Materials and Methods: This research is based on the nature and general characteristics, quantitative; Based on the purpose, it is applied and based on the research method and data collection method, is a descriptive correlation based on structural equation model. The statistical population was graduate students of Azarbaijan Shahid Madani University in 2020 (2218 students). The statistical sample of the research is 327 people who were selected by stratified random sampling method. To collect data, Emotional Intelligence Questionnaire (1998), Montazeri et al. Health Literacy Questionnaire (2014) and media literacy questionnaire were used. The reliability of the questionnaires was obtained using Cronbach’s alpha coefficient of 0.91, 0.84 and 0.79, respectively. The collected data were analyzed using descriptive statistics and inferential statistics (structural equation model) using SPSS and LISREL software.
Results: The findings showed the mean of emotional intelligence, health literacy and media literacy of graduate students of Azarbaijan Shahid Madani University is 3.10, 3.47 and 3.58, respectively. Also, the results showed a significant relationship between emotional intelligence and students’ health literacy. According to the findings, there is a significant relationship between emotional intelligence with media literacy, and media literacy with health literacy. Also, the media literacy variable plays a mediating role in the relationship between emotional intelligence and health literacy (coefficient) of 0.58 units. The results of the structural equation model test also showed that the proposed conceptual model fits the relationship between emotional intelligence, health literacy and students’ media literacy.
Conclusion: Media literacy can not only directly affect students’ health literacy, but also has a mediating role between emotional intelligence and health literacy. Due to the effect of emotional intelligence on students’ health and media literacy, it is recommended that the necessary planning to be done in graduate education and to strengthen emotional intelligence.
Ali Mohammad Mosadeghrad, Parvaneh Isfahani,
Volume 17, Issue 3 (8-2023)
Volume 17, Issue 3 (8-2023)
Abstract
Background and Aim: Induced demand is the provision of healthcare services to patients by the influence of healthcare providers. Induced demand causes excessive use of health services, increases the waiting time for receiving health services, increases the price of health services, increases the costs and reduces the efficiency of the health system. Policymakers and health managers should take measures to reduce induced demand. Hence, they should understand the reasons for induced demand in the health system. Therefore, this research aimed to identify the reasons for induced demand in the health system.
Materials and Methods: This research was carried out using the scoping review method. All published articles and documents about the reasons for induced demand in the health system until June 21, 2023 were searched in nine databases and Google Scholar search engine. Finally, 38 articles were selected and reviewed. The data were analyzed by thematic analysis method and using MAXQDA10 software.
Results: Thirty-eight studies about the reasons of induced demand in the health system were published between 1974 and 2021. The number of researches in this area has been growing since 2011. Overall, 32 reasons for induced demand in the health system were identified and grouped into three categories: macro (health system), meso (health care organization) and micro (provider and receiver of health services). The most frequent reasons for healthcare induced demand in the literature include inappropriate policies, insufficient monitoring, inappropriate payment system, large number of physicians, lack of attention to clinical guidelines, financial motivation of healthcare providers, patient insurance coverage, unreasonable patients’ expectations, inappropriate price of health services, the complexity of the health service and patients’ inadequate medical knowledge.
Conclusion: Induced demand has negative effects on the health system and will lead to an increase in health costs, waste of health resources, a decrease in the efficiency of the health system, and finally, a decrease in people’s access to essential health services. Several factors at different levels of the health system lead to induced demand for health services. Therefore, interventions should be systematically applied at three levels of the health system, healthcare organizations, and providers and recipients of health services to prevent and reduce healthcare induced demand.
Materials and Methods: This research was carried out using the scoping review method. All published articles and documents about the reasons for induced demand in the health system until June 21, 2023 were searched in nine databases and Google Scholar search engine. Finally, 38 articles were selected and reviewed. The data were analyzed by thematic analysis method and using MAXQDA10 software.
Results: Thirty-eight studies about the reasons of induced demand in the health system were published between 1974 and 2021. The number of researches in this area has been growing since 2011. Overall, 32 reasons for induced demand in the health system were identified and grouped into three categories: macro (health system), meso (health care organization) and micro (provider and receiver of health services). The most frequent reasons for healthcare induced demand in the literature include inappropriate policies, insufficient monitoring, inappropriate payment system, large number of physicians, lack of attention to clinical guidelines, financial motivation of healthcare providers, patient insurance coverage, unreasonable patients’ expectations, inappropriate price of health services, the complexity of the health service and patients’ inadequate medical knowledge.
Conclusion: Induced demand has negative effects on the health system and will lead to an increase in health costs, waste of health resources, a decrease in the efficiency of the health system, and finally, a decrease in people’s access to essential health services. Several factors at different levels of the health system lead to induced demand for health services. Therefore, interventions should be systematically applied at three levels of the health system, healthcare organizations, and providers and recipients of health services to prevent and reduce healthcare induced demand.
Roya Balaghiinaloo, Alireza Noruzi, Mohammadreza Esmaeili Givi,
Volume 17, Issue 3 (8-2023)
Volume 17, Issue 3 (8-2023)
Abstract
Background and Aim: It is not possible to provide health information services in health crises without a comprehensive understanding of these services and how to provide them due to the health crisis. Based on this, the aim of the current research was to obtain comprehensive information about the components of providing health information services in health crises.
Materials and Methods: The current research was conducted with a qualitative approach and a meta-combined method, using the seven-step method of Sandelowski and Barroso. The statistical population consisted of articles and theses published in persian and international databases between 1991 to 2022 AD and 1370 to 1400 solar. Out of a total of 8363 resources identified based on the critical skills assessment program, 40 resources were approved. Extracted information was coded and coding reliability was measured and confirmed using Kappa coefficient.
Results: From the results of the research, 74 codes were extracted in 21 concepts and 6 categories in the field of providing health information services to patients. which categories and codes include health information needs assessment (disease, health, health information sources, patients); accessibility and dissemination of health information (health information, access ways); Awareness and notification of health information (information, tools); Education (patients, managers and staff of hospital libraries, methods); Planning (health crisis, resources, budget, infrastructure, patients, librarians and Medical Information Specialists) and obstacles and limitations (expert force, budget, facilities and infrastructure and resources) were categorized.
Conclusion: Dealing with the issue and components of providing health information services to patients in health Disasters in hospital libraries can cause policymakers in this field to know more about the dimensions, concepts, and consequences of providing these services in order to provide access to health information for everyone, especially patients. According to the identified components, efforts can be made to prepare the necessary infrastructure in order to plan to strengthen the strengths and eliminate the existing weaknesses and make appropriate policies in order to play the role of health counseling and launch the health information service department in hospital libraries.
Mohamad Jebraeily, Shima Touraj, Farid Khorrami,
Volume 17, Issue 3 (8-2023)
Volume 17, Issue 3 (8-2023)
Abstract
Background and Aim: In the health system, reimbursement methods are an important criterion for the allocation of resources and the performance of service providers. The use of diagnosis-related groups (DRG) system reduces the length of stay and additional costs of the patient, prevents unnecessary treatment, increases resource efficiency and transparency of health care services. The development of the DRG system focuses on the accurate documentation of medical records and the correct coding of diagnoses and procedures. The purpose of this research is to evaluate the documentation and coding requirements of medical records in the implementation of a payment system based on diagnosis-related groups in Iran.
Materials and Methods: This research was descriptive-cross-sectional and was conducted in 2022. The data collection tool was a researcher-made checklist, the validity of which was confirmed based on the opinion of experts (health information management health economics) and its reliability was obtained by calculating Cronbach’s alpha (0.83). The research population consisted of 418 medical records in five medical training centers affiliated to Urmia University of Medical Sciences, which were selected through stratified-proportional sampling. Data were analyzed using SPSS software.
Results: The results of the evaluation of the documentation and coding requirements of medical records for the implementation of the DRG system showed that the demographic/administrative variables including age, sex, type of admission, length of stay, health insurance, and doctor’s expertise were completely recorded. Evaluation of clinical variables also showed that the main diagnosis, main procedure, secondary diagnosis and other procedures were documented in medical records in 98%, 97%, 88% and 75% respectively. Regarding the coding of the main diagnosis and the main procedure, 100%, secondary diagnosis 68% and other procedures 80% have been done.
Conclusion: Considering that some essential clinical variables for the implementation of DRG, especially co-morbidities, complications and other procedures are not recorded separately and completely, therefore it is necessary to define separate information elements in medical records and HIS for accurate recording of these variables and proper interaction between coders and doctors is established to increase the possibility of correct coding. It is also suggested that the DRG system be implemented in our country in a phased and gradual approach so that necessary changes are made in the documentation process and hospital information systems.
Leila Erfannia, Azita Yazdani,
Volume 17, Issue 3 (8-2023)
Volume 17, Issue 3 (8-2023)
Abstract
Background and Aim: With the spread of the Corona pandemic, the statistics of the number of mobile health applications have grown significantly. This research was conducted with the aim of evaluating the content of Persian language applications in the management of Covid-19.
Material and Methods: In this review research, a systematic search for Persian language programs in the field of Covid-19 management was conducted in four mobile application markets including Myket, Bazzar, Google Play and App Store. The content of the programs was evaluated based on a researcher-made checklist, which was verified according 3 specialist comments, in the five axes of ease of use, education, monitoring, privacy and data sharing. Programs that received more than 50% of the evaluation score were introduced as selected programs. By removing duplicate programs, 119 programs were extracted, of which 21 programs entered the final stage of quality evaluation based on the inclusion and exclusion criteria and after a complete review of the content and capabilities.
Results: Based on the total points of the program, Safiran Salamat received the most score (31), Ac19 and mask were ranked next with 27 and 22 points, respectively. These three programs along with Corona Amar Tashkhis as fourth program received more than 50% of the content review and 17 other programs received less than 50% of the total score. Government has a great role in programs development (three program were government and one was non- government base). All 4 programs, had acceptable score in ease of use but none of them develop for user tracking. Pearson’s correlation test was used to test the relationship between the quality (total scores of apps) and the popularity (amount of downloads), and no significant correlation was observed.
Conclusion: The results of the present study showed that Iranian mobile applications have an acceptable performance in the fields of education and information sharing, but their low popularity makes the achievement of these goals far from expected. Marketing strategies can be effective as one of the useful policy in increasing the use of mobile health programs. Also, the inclusion of capabilities such as contact tracing and online consultations can be fruitful in the pursuit of goals.
Omid Ali Gholami, Jamil Sadeghifar, Bahareh Kabiri, Shabnam Ghasemyani, Sadegh Sarhadi, Reza Jorvand,
Volume 17, Issue 4 (10-2023)
Volume 17, Issue 4 (10-2023)
Abstract
Background and Aim: Health literacy is recognized as a key determinant of health and is a central focus of public health policy strategies. The present study aimed to assess the health literacy level and identify the factors influencing it among the clients of comprehensive health service centers in Ilam city.
Materials and Methods: In 2022, a descriptive-analytical study was conducted to examine 429 clients aged 18-65 years who visited comprehensive selected health service centers in Ilam city. For adults the data collection tool used was the Helia health literacy questionnaire. Sampling was conducted in nine clusters, with each cluster consisting of 50 samples. The data was analyzed using SPSS software, which included descriptive statistical tests, Pearson’s correlation coefficient, and one-way analysis of variance, with a significance level set at 0.05.
Results: Based on the results, the average health literacy score was 80.16 ± 16.50. In terms of health literacy, 18.97% of people had inadequate or not very adequate health literacy, while 44.39% of the participants had excellent health literacy. The average health literacy scores across different dimensions are as follows: access to health information 65.74, comprehension of information 81/81, reading information skills 12.74, evaluation of information 05.75, and decision making and behavior based on information 61.92. A significant relationship was observed between job, education, and income variables and various dimensions of average health literacy (p-value≤0.001). However, there was no significant relationship between general health literacy and age, gender, and place of residence (P≤0.05).
Conclusion: The results of the present study demonstrate that vulnerable groups have significantly lower literacy levels. Furthermore, given the impact of education on enhancing people’s health literacy, it is advisable to leverage mass media, social networks, and educational centers to enhance literacy levels as a potential factor in community health.
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