Journal of

Background and Aim: Urban health is one of the challenges of the 21st century. Rapid growth and expanding urbanization have implications for health. In this regard, information technology can remove a large number of modern cities' problems. Therefore, the present article aims to study modern information technologies in the development of urban health.

Materials and Methods: This is a review article based on library research and Internet searches on valid websites such as Science Direct, Magiran, Springer and advanced searches in Google. Some 164 domestic and foreign texts were studied on such topics as the application of ICT tools including cell phones and wireless tools, GIS, and RFID in the field of urban health in 2011. Finally, 30 sources were used.

Conclusion: Information and communication technologies play an important role in improving people's health and enhancing the quality of their lives. Effective utilization of information and communication technologies requires the identification of opportunities and constraints, and the formulation of appropriate planning principles with regard to social and economic factors together with preparing the technological, communication and telecommunications, legal and administrative infrastructure

Background and Aim: Learning may be the only sustainable competitive advantage for all organizations. A learning organization is an organisation where people continually expand their capacity to create results they truly desire new and expansive patterns of thinking are nurtured collective aspirations are set free people are continually learning from what others have learned. The aim of this research is to study whether a learning organization and its subsystems are established in Shahrekord University of Medical Sciences (SKUMS).

Materials and Methods: This descriptive-survey study was conducted in 2012. Marquardt's standard questionnaire was used to measure learning organization based on Likert's scale with a Cronbach's Alpha coefficient of 0.946. The research sample consisted of 177 staff members (bachelor's degree holders and bove) in seven vice-chancellorships of SKUMS, selected through simple random sampling.

Results: The findings of the study are twofold. (1) According to the results of one-sample t-test with a 95% confidence interval, the mean scores in learning organization and sub-systems of learning dynamics, people empowerment, knowledge management and technology application subsysems were higher than the assumed mean of 3 however, the figure turned out to be equal to the assumed mean for the organization transformation subsystem, and (2) Based on Freidman Test, there was a significant difference between the means of at least 2 learning organization subsystems.

Conclusion: According to the research findings, more attention should be paid to the subsystems of learning organization establishment and balanced development of these subsystems.

Background and Aim: Focus on organizational health could ensure the future success of any organization. Considering the fast changing conditions of hospitals and the necessity of effectiveness, employees are required who can show voluntary behavior towards the organization and customers. Therefore, this study mainly aims to survey the relationship between organizational health and organizational citizenship behavior in selected hospitals of Tehran University of Medical Sciences(TUMS).

Materials and Methods: This cross-sectional, descriptive-analytic study was conducted in 2010. The population of the study comprised the entire staff of TUMS selected hospitals. In total, 312 employees were selected. The researchers gathered their data using questionnaires of organizational health and organizational citizenship behavior. For data analysis, both descriptive statistics(percentage, mean, standard deviation and variance) and inferential statistics(Pearson correlation and regression) were applied. The data were analyzed using SPSS18 software.

Results: The correlation between the organizational health and five dimensions of organizational citizenship behavior(Conscientiousness, Altruism, Helping Behavior, Civil Virtue, Sportsmanship, and Courtesy) was significant(p = 0/0001).

Conclusion: Given this significant correlation between organizational health and organizational citizenship behavior, organizations can make improvements in employees' behavior. This can be achieved by creating harmony among members and through continuous improvement and growth.

Background and Aim: Financial reforms in the healthcare system go back to 1384. This study aims to analyze and summarize the most important strengths of implementing the first phase of the reform in units affiliated with the Ministry of Health and Medical Education from the experts' point of view at middle and operational levels.

Materials and Methods: In this qualitative research study, 15 coaches of the new financial health management reform along with 8 financial managers of Medical Universities were selected purposefully to participate in expert panels to be interviewed. Data were saturated following the interviews. The data analysis process was conducted applying Kruger method with one of the researchers having no conflicts of interest with the topic.

Results: Human resources enabling, effective trainings, integrated information system, dynamic culture, structural appropriateness, efficiency and effectiveness, and perfect facilities were the seven themes extracted from the content analysis of the interviews each theme was further divided into some sub-themes.

Conclusion: Recognition of the strengths of the first phase of health system's financial management reform may help bring about the possibility of more correct and exact planning to direct these changes and maintain the achievements as well as designing a long-term horizon and determining an ideal vision for the next phases of the reform.

 Background and Aim: Today, many families either have pets or work in animal husbandry units. It is very important to investigate the mental outcomes of animal care and also to study their keepers’ personality traits. This study aims to perform a comparative examination of owners’ mental health and character specifications or those of animal husbandry units’ personnel.

 Materials and Methods: In this descriptive study, about 500 people were selected through available sampling technique. They had contact with animals or worked in a husbandry unit in the suburbs of Tehran. After referring to the veterinary clinic of Tehran University, they were studied using a general health questionnaire and an international personality question bank. The collected data were analyzed using SPSS software as well as multivariate and follow-up tests.

Results: The results of the present study show that all general mental health sub-scales except for anxiety are different in these groups. However, no difference was observed regarding responsibility and extroversion. Meanwhile, the adaptability of dog owners was lower than that of sheep owners moreover, cattlemen were more irritable than sheep owners.

Conclusion : In sum, the mental health of pet owners of the present study is at a lower level compared to that of those in other countries. It seems that the difference is due to religious and cultural differences existing between the two.

 Background and Aim: One of the effective factors on staffs’ job satisfaction is their general health and personality types. This study is aimed to study the relationship between general health and personality types with the staffs’ job satisfaction .

 Materials and Methods: Seventy One women and men employee, aged 21 to 56 years working at Yazd health center were examined with full enumeration and by using General Health Questionnaire(GHQ), Job Descriptive Index(JDI) and the five-factor personality inventory(NEO). Research method was descriptive-correlation type and data were analyzed by using statistical tests like Pearson correlation, independent t test, ANOVA and stepwise regression.

 Results: The results showed that the relationship of the staffs’ general health with their neuroticism was direct (r=0/542) and with extraversion and agreeableness was reverse(r=-0/38, -0/34). But, it was not correlated with flexibility and responsibility . General health is inversely related to the three job satisfaction components(nature of work, job promotion, salary & job satisfaction total score) and it was irrelevant with the satisfaction of coworkers and supervisors. Lower general health was associated with neuroticism and good general health was associated with extraversion and agreeableness. Lower general health was also associated with lower job satisfaction and vice versa. Also there was a correlation between nature of work satisfaction and extraversion(p=0/01).

 Conclusion : We conclude that by decreased or increased general health of staffs and effect of their personality traits, job satisfaction would decrease or increase. Many cause decreased or increased of job satisfaction

Background and Aim: Decision support systems(DSSs) refer to one of the types of information technology applications that can help clinicians to make right and timely decisions about patients. The aim of this study is to learn more about DSSs and their applications and effects on health care.

Materials and Methods: In this systematic review, articles which were published between 2000 and 2012, which were available as full texts through databases and search engines -- such as PubMED, EBSCO host research, Google scholar and Yahoo -- and which were also of clinical-trial type were examined besides, certain books in this area were used as primary sources.

Conclusion : The findings show that DSSs were applied in five areas in health care, which had a significant effect on improving the process of care and the performance of providers. These areas are as follows: disease progress management(15.15%), care and treatment(27.27%), medication(27.27%), evaluation(27.27%), and preventation(12.12%). In general, improvement can be seen in three areas: quality of care and patient safety, cost effectiveness, and provider’s level of knowledge.

 Background and Aim: Investigating the effect of intellectual capital on an organization’s ongoing processes is a way of determining its weaknesses as well as appropriate strategies which help managers to make decisions. The main purpose of this study was to confirm intellectual capitals through improving organizational culture among staff managers of IKRF—deputy for support and health.

 Materials and Methods: This is a cross-sectional descriptive study that was conducted in 1389. The respondents were selected among staff managers of IKRF—deputy for support and health(N=50). Data collection was a questionnaire which consisted of three parts developed by the researcher. Data analysis was performed with SPSS version 16 with the help of descriptive statistics and Pearson correlation test.

 Results: Most of the top and middle managers enjoyed an average organizational culture(top managers=58/3% middle managers=78/3%). The intellectual capital of most managers of this study was below average(mean=2.23). Finally, with respect to the entire managers—both top and middle—, there was a significant relation between organizational culture and intellectual capital( P<0/001).

 Conclusion: Taking into account the significant relation between OC and IC and also the point that organizations try to apply appropriate human resources it becomes further important to improve managing intellectual capitals. In this respect, organizational culture is the most basic substructure.

Background and Aim: Stewardship and delivery of health services are considered as the most important areas in the healthcare system of the Islamic Republic of Iran in 1404. This study was conducted to investigate the main challenges in medical education stewardship because of its importance in the management and leadership of education from the viewpoint of education process providers.

Materials and Methods: This qualitative research was conducted using thematic and framework analyses to obtain the collective view of faculty members of Medical Sciences Universities in Iran. The data were collected applying deep semi-structured interviews. To increase the acceptability of the study, four criteria of Lincoln and Gupta were used. Codes, categories and themes were extracted by expert researchers of qualitative studies who had no conflict of interests with the topic.

Results: Of the 24 faculty members interviewed, 7 were females and 17 were males. They comprised 5 full professors, 8 associate professors, 9 assistant professors and 2 lecturers. The findings of the interviews were categorized in three main lines of stewardship in health system in the form of main and sub themes so that there were 2, 2 and 5 main themes in each line, respectively.

Conclusion : Since many of the challenges extracted from the present interviews are considered as essential interventions for achieving the stewardship functions of health system -- and, as a result, medical education -- , it is important to pay more attention to these challenges and at the same time conduct more complete studies to get more practicable solutions to these problems.

Background and Aim: Today, healthcare system is exposed to inappropriate human resources distribution challenges in all over the world. So far there is not an appropriate policy for human resources distribution in Iran. This deficiency may cause several problems for providing healthcare services. This research was aimed to determine the situation of human resources distribution among Tehran University Of Medical Sciences (TUMS) Hospitals.

Materials and Methods: This is a cross-sectional definitive study induced in four general and special TUMS hospitals. The research tool was a checklist that determine the number of nurses, paraclinic and supportive employees and finally the decrease and increased of the human resources among the departments of the hospitals regarding Iranian Ministry of Health (MOH) issues. The data was collected and analyzed by SPSS software and determined the differences between current situation in accordance to MOH issues.

Results: We observed the deficiency of human resources among all studied hospitals. Also the distribution of human resources among most of the hospitals departments was not coordinated with MOH issues.

Conclusion : It seems the distribution of human resources among Iranian healthcare system is not followed by a special model. Therefore, we suggest the model of health human resources planning should be determined and related by information, providers, services, education and policy as healthcare system factors and overlapping of these factors.

 Background and Aim: Aging is a natural experience which is usually accompanied by a variety of diseases. Hence, this research was conducted to study the elderly people’s disease rate and the number of times they refer to medical centers in Tehran.

 Materials and Methods: This descriptive analytical study was conducted on the old people referring to the Elderly Centers in Tehran in 2012. For data collection purposes, valid and reliable self-report demographic and disease questionnaires were used. The data were analyzed by SPSS software together with T-test and one-way ANOVA.

 Results: Four hundred old people participated in this study. Of the participants, 300 (75%) were female and 100 (25%) male with a mean age of 67.65 (±6.38) years. Besides, 160 (40%) people had heart diseases, 137 (34.3%) muscoskeletal diseases, and 83 (20.8%) endocrine diseases. Moreover, 381 (95.2%) participants had referred to doctors and therapeutic centers at least once during the last year. Furthermore, 177 subjects (44.2%) were hospitalized at least once last year.

 Conclusion: The prevalence of diseases in elderly people is more than expected. Most old people refer to doctors and therapeutic centers, which is indicative of the fact that they suffer from diseases and need varied health services.

 Background and Aim: One of the most important factors to present successful managers is general health. If managers have not highly general health, then they will encounter many problems. Therefore, this research is aimed to induce the general health among Tehran University of Medical Sciences hospitals’ administrators. 

 Materials and Methods: A cross-sectional, deceptive and analytical study was conducted among 25 Tehran University of Medical Sciences hospitals administrators in Tehran, Iran. The research tool was general health questionnaire developed by Goldberg and Hillier to assess the administrators general health and its demographic details. Data was analyzed by SPSS software and using analytic statistical methods.

 Results: The results of this study showed that the hospitals administrators had normal range of general health. Also, there was significant correlation between anxiety with physical dysfunctions, and depression with physical dysfunctions, and anxiety with social functions.

 Conclusion: The rate of general health among TUMS hospitals administrators is higher than the other mangers compared with similar studies in Iran and out of Iran. Therefore, we suggest periodic medical examination, general health training, and consultant services to develop or maintain the general health among healthcare managers.

 Background and Aim: The applicability of any technology to enter a certain field is determined by defining the advantages and disadvantages of the system in that field. The aim of this study is to show the advantages and limitations of using speech recognition systems in health care and providing practical solutions to improve the acceptability of the system in that field.

 Materials and Methods: This is a descriptive research with a review method that employs library resources and online databases such as Proquest, Pubmed, Science Direct, Ovid and Scientific Information databases using key words like speech recognition software, health care, benefits, barriers, and solutions.

 Results: Speech recognition system has many advantages like increased accuracy of medical documentation, and reduced documentation time. It is a tool for data entry into electronic health records. However, there are several limitations in applying the system in Iran, such as the lack of definition of database system and the high cost of hardware and software.

 Conclusion: Considering the study results in relation to the benefits and limitations of systems in healthcare area, solutions such as production of a national integrated database for the exchange of health information, improving database to increase the accuracy of word recognition, and training the users of the system can reduce the limitations of the system to some extent. Also, in the country’s movement towards the implementation of electronic health records and the users’ need to enter data into the computer, the software is a good alternative to keyboard and mouse input.

 Background and Aim: : Technical knowledge of managers of health care industry regarding budgeting have an essential function on increased efficiency of organizations working in this sector, since every single right decision, rely on appropriate knowledge and analysis. Therefore, the purpose of this study was assessment of technical knowledge of managers of health care system regarding budgeting.

 Materials and Methods: This was a descriptive  -analytic, cross- sectional study. From 80 managers of Tabriz Medical Sciences University 63 participated in the study and a questionnaire was employed to collect data. Data was analyzed by Spss 16 software, Pearson correlation test, T test and ANOVA.

 Results: Mean of total scores was 16.9±4.6 of 30. There was no significant difference between total scores in different courses (P=0.276) and positions (P=0.431). Mean of total scores between women and men (P=0.782) were the same.

 There weren't significant relation between technical knowledge of managers with age (p=0.392, r=0.1), job background (p=0.299, r=0.1) and management background (p=0.121, r=0.2).

 Conclusion: With respect to low level of manager's awareness about budgeting,improving of technical knowledge is essential. Lack of significant relation between technical knowledge of managers and their length of management practices, with unstable situation, may harm seriously organizational achievements. Reviewing and promotion of educational programs and continuous training of managers with respect to budgeting seems to be an essential need for improving manager's performance.

 Background and Aim: In order to better design an electronic health record system in the country, determining standardized data elements for creating an integrated information system is important. In this study, the minimum data set of radiology reporting system is determined.

 Materials and Methods: In this descriptive cross-sectional study, 13 radiologists, 3 anesthesiologists, 3 general practitioners and 3 insurance experts working in the Imaging Center of Imam Khomeini hospital in Tehran were chosen. The research tool was a questionnaire having 11 parts. Content validity and test-retest method were used to measure the validity and reliability of the questionnaire, respectively. Data analysis was performed using the SPSS software.

 Results: The highest means reported were radiologists' written explanations and suggestions (9.6), image interpretation (9.5), the name of contrast material (9.4), the name of imaging procedure (9.3) type and date of previous measures (9.1), and the final diagnosis (9) and the lowest averages belonged to referring physician's address (4.8), relationship between patients and the primary individual insured (4.3), and religion (2.2).

 Conclusion: In an electronic health record system, due to the importance of radiology reports for the diagnosis and future management of a patient's clinical problems, it is necessary to pay attention to the minimum set of data related to these reports such as administrative, insurance, patient identity, and clinical data, and the results of radiological examinations for exchanging with electronic health record system.

 Background and Aim: The quality of health record depends on the quality of its content and proper documentation. Minimum data set makes a standard method for collecting key data elements that make them easy to understand and enable comparison. The aim of this study was to determine the minimum data set for Iranian athletes’ health records.

 Materials and Methods: This study is an applied research of a descriptive - comparative type which was carried out in 2013. By using internal and external forms of documentation, a checklist was created that included data elements of athletes health record and was subjected to debate in Delphi method by experts in the field of sports medicine and health information management.

 Results: From 97 elements which were subjected to discussion, 85 elements by more than 75 percent of the participants (as the main elements) and 12 elements by 50 to 75 percent of the participants (as the proposed elements) were agreed upon. In about 97 elements of the case, there was no significant difference between responses of alumni groups of sport pathology and sports medicine specialists with medical record, medical informatics and information management professionals.

 Conclusion: Minimum data set of Iranian athletes’ health record with four information categories including demographic information, health history, assessment and treatment plan was presented. The proposed model is available for manual and electronic medical records.

 Background and Aim: The hypothesis of supplier induced demand has attracted a lot of attention over the past three decades. Most studies in this field agree that healthcare providers have the ability to influence the demand for their products. The purpose of this study is to evaluate the role of institutions in the phenomenon of induced demand. This study has been done using experts' experiences in Isfahan University of Medical Sciences.

 Materials and Methods: This is a qualitative study in which the semi-structured interview was used for data generation. The participants were those informed in this regard and considered as experts. For data saturation, purposive sampling was done. In this study, 17 people were interviewed, and criteria such as reliability and stability were considered. The anonymity of the interviewees was guaranteed. The data were transcribed and categorized, and then analyzed using thematic analysis.

 Results: In the present study, thematic analysis was conducted and 30 sub-themes and 2 main themes were extracted. The two main themes were healthcare insurance organizations and other health organizations. Each of the themes had its own sub-themes.

 Conclusion: The findings help health policy-makers have a better picture regarding the role of various institutions in the phenomenon of induced demand.

Background and Aim: The Household financial contribution is one of the most important issues in health system. This study aims to determine and present some indices of h ousehold financial contribution in health system in Iran.

Materials and Methods: In this cross sectional- descriptive study, the methods were introduced by World Health Organization. Fair Financing Contribution Index (FFCI), catastrophic health expenditure and impoverishment in Iran were calculated from a national representative data derived from Iranian Statistics Center, Household Budget Survey, and Consumption Expenditures, at 2011. The indicators have been calculated on the basis of the total cost analysis, health and capacity to pay Iranians households.

Results: Household financial contribution in the health system for households living in rural areas is more than urban areas. In this study, more than 3 percent of the households were facing catastrophic health expenditure . Also 1.5 percent of the households have been impoverished. Fair Financing Contribution Index in rural and urban areas was 59 and 65 percent respectively.

Conclusion: Calculation of the indicators related to households financial contribution in Iranian health system need to predict and implement appropriate plans, as well as monitoring and assessment of health system programs in order to increase the equity in the household financial contribution and effectiveness of Utilization of resources.