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Study of Burnout Syndrome among Faculty Members and Lecturers in one of the Schools of Tehran University of Medical Sciences
Hossein Dargahi, Farough Nomani , Kamran Irandoost,
Volume 12, Issue 6 (Feb & Mar 2019)
Abstract
Background and Aim: In educational systems, the burnout of faculty members and lecturers is a big problem that affects their interaction with students. Therefore, this research aims to determine the rate of burnout syndrome among the lecturers and faculty members in a school in Tehran University of Medical Sciences (TUMS).
Materials and Methods: This study was a descriptive-analytical and cross-sectional research performed by Maslach′s burnout questionnaire among 40 academic members and lecturers selected by census method. The data were analyzed by SPSS software version 20.
Results: The mean age of respondents was 48±18 years. Some (42.5%) of the subjects had 21-30 years of educational work experience. The emotional burnout of the participants was at a high level in this study. However, in the dimension of depersonalization disorder, it was moderate. Meanwhile, their job performance was below moderate. Also, there was a significant correlation between emotional burnout and gender (P=0.043) and between depersonalization disorder and executive work experience (P=0.043).
Conclusion: Due to the remarkable high frequency of job burnout among faculty members and lecturers, holding in-person meetings, the analysis and pathology of causes of burnout, and application of supportive mechanisms are recommended to improve their job performance.

Determination of Catastrophic Health Expenditures among Elderly People in Iran
Sara Emamgholipour, Vahid Saberzadeh, Hossein Dargahi,
Volume 14, Issue 1 (Apr & May 2020)
Abstract
Background and Aim: Given the rising trend of ageing and the vulnerability of the aged group to diseases and health costs, it is important to determine the exposure of elderly households to the burdensome costs of health.
Materials and Methods: The incidence and severity of elderly costs at provincial level and income quintiles were calculated; besides, chi-square test was used to determine the relationship between household socioeconomic variables and exposure levels. The sample included 9103 elderly people aged 65 and over, and the data of their own and their households were extracted from the statistical center in 2016. Data analysis was performed using SPSS16 software.
Results: The exposure rate of households with rural elderly people (9.74%) was higher than urban ones (6.2%), and the intensity of exposure was higher in rural areas than urban. In both groups, the highest exposure was in the second and the lowest in the fifth quintiles. The elderly households in Hormozgan province had the highest and in Kohgiluyeh and Boyer-Ahmad had the lowest exposure. Number of elderly people in family, place of residence, employment status, household dimension, costs of chemotherapy, addiction abandonment, orthopedics, special medications, household spending and out-of-pocket payment for health services were significantly correlated with exposure. However, elderly person's literacy, insurance, marital status and the presence of persons under 12 years in the family did not show a significant relationship with the amount of exposure.
Conclusion: The exposure rate and its intensity is higher among rural elderly people than urban ones, and the exposure of poorer elderly people is higher; these points indicate that the distribution of financial resources in the health system is not fair and requires  purposeful policymaking decisions for these groups.

Iran Health Tourism' Strategic Analysis in Corona Situation
Reza Dehghan, Hamideh Reshadatjoo, Kambeiz Talebi, Hossein Dargahi,
Volume 14, Issue 6 (Feb & Mar 2021)
Abstract
Background and Aim: Health tourism is one of the most important tourism types in Iran. Iran has many strengths in health tourism. Also, there are challenges such as communication and information inconsistency in the health tourism industry and the outbreak of COVID-19 disease. Due to the unknown issues about COVID-19, it is important to determine effective strategies to control the consequences and reduce the economic and social effects of the virus in all industries, especially the health tourism industry.
Materials and Methods: In this systematic review study, 500 published papers from 2018 to 2020 were evaluated. In the group interview section, we used the views of participated health tourism experts in the scientific events in Iran, Turkey, and Oman. Also, the SWOC Analysis model (strengths, weaknesses, opportunities, and challenges) and MAXQDA software were applied.
Results: The results showed that the selected strategies were defensive and competitive. This research showed that the strengths of the health tourism industry overcome the weaknesses and development opportunities outweigh the challenges. Also, the maintenance strategy is the best strategy to support health tourism in the current situation in Iran.
Conclusion: It is necessary to be following issues for the politicians of Iran's health tourism industry to design a comprehensive document of Iran Health Tourism Diplomacy, preparation of a strategic plan for the development of health tourism, establish an independent organization of Iran Health Tourism, develop electronic health in the health tourism industry, design a health tourism insurance system, and…, with the aim of entrance to the current markets and creating new foreign markets.

Assessing Senior Managers' Level of Awareness of Standards and Regulations Related to the Health System: A Case Study in Tehran University of Medical Sciences
Hossein Dargahi, Farugh Nomani, Mohammad Rahim Ghohestani,
Volume 15, Issue 2 (Jun & Jul 2021)
Abstract
Background and Aim: Managers’ sufficient awareness about rules and regulations and the legal issues of health system may lead to their optimal performance in organizations. Therefore, this study is conducted to determine senior managers’ level of knowledge about legal rules and regulations related to the health system in Tehran University of Medical Sciences (TUMS).
Materials and Methods: The present descriptive-analytical cross-sectional study was conducted in 2017. The sample consisted of 75 senior managers. The research tool was a researcher-made questionnaire whose face validity was confirmed using the opinions of 7 specialists and experts in the field of medical law, health care and medical services management; besides, regarding its reliability, Cronbach's alpha and test-retest reliability coefficients were 0.89 and 0.79, respectively. With SPSS software, data analysis was performed using descriptive statistics including absolute and relative frequency and inferential statistics including Pearson and Ka-square correlation tests.
Results: The level of knowledge of the studied managers was below average in most legal areas and legal standards related to the health system. There was a significant inverse relationship between the level of knowledge of organizational, financial and transactional areas, and administrative and employment of managers with passing relevant training courses (P=0.01 and P=0.04).
Conclusion: TUMS senior managers' level of knowledge in the three areas of organizational, financial, and rules and regulations is at medium and lower than medium levels. To raise the awareness of managers, necessary arrangements such as holding training courses with new methods such as simulation, screenwriting, case study and experimentation and using new technologies such as hybrid knowledge management and technology integration are suggested. Also, creating managers' strategic competency system at the levels of general and specific skills, along with continuous training and monitoring the accountability and feedback provided in management processes, will ensure future reforms.

Explanation of the Benefits and Challenges of Home Care Plan after Hospital Discharge: A Qualitative Study
- Zeinab Hashemzadeh, Farhad Habibi, Hossein Dargahi, Mohammad Arab,
Volume 17, Issue 1 (3-2023)
Abstract
Background and Aim: Home care is an alternative method of hospitalization, especially for chronic patients and is an innovative approach to improve care and reduce the costs of hospital readmissions. The present study was conducted with the aim of investigating the benefits and challenges of implementing the home care plan after being discharged from the hospital considering the perspective of health service recipients and providers at Tehran University of Medical Sciences in 2021.
Material and Methods: The present study is an applied research that was conducted qualitatively using structured and semi-structured interviews. The research sample was those responsible for the implementation of this project at the ministry and university level, the implementers of this project in 4 hospitals, 5 institutions providing home care services, and family of patients. Twenty-eight people from the research community were included in the study using the purposeful and snowball sampling method. Content analysis method was used to analyze the interview data. MAXQDA2020 software was used for data classification.
Results: The results were classified into two categories: benefits and challenges of the home care plan after discharge. A total of 61 open codes were extracted from the analysis of research interviews, so that 27 codes led to the identification of 5 themes (Including improving service delivery, reducing costs, achieving health goals, cultural and social benefits, providing the necessary infrastructure) in the benefits and 34 codes led to the identification of 7 themes (including policy-making, legal and ethical, economic, manpower, cultural-social-communication, service provision limitations and time and place limitations) in the challenges.
Conclusion: The result of this research showed that home care services after being discharged from the hospital play an important role in completing the provision of healthcare services. Home care services after being discharged from the hospital improves service delivery, reduces costs, and helps in achieving health goals. It also benefits patients, society and the government in various cultural and social fields. On the other hand, it seems that there are challenges in the political, legal, economic and cultural fields in the way of the optimal implementation of this plan. Therefore, planning to evaluate and solve the problems facing these services is essential.

Identification of Conflict-of-Interest Management Strategies in Iranian Healthcare System Comparing with Selected Countries: A Scoping Review
Hojjat Rahmani, Payam Bahadori, Hossein Dargahi, Mohammad Arab, Nasrin Abolhasanbeigi Gallehzan, Mohsen Mardali,
Volume 19, Issue 6 (3-2026)
Abstract
Background and Aim: The occurrence of conflict of interest in the Iranian health system has a negative impact on the provision of efficient and effective health care and services to patients, the training and education of students in medical sciences. Despite the efforts made in the country’s health system to manage conflict of interest, this phenomenon is currently observed through various factors, including the inefficiency of the financial structure, lack of transparency, and the lack of an integrated health information system in Iran.
Materials and Methods: The present scoping review study that aimed to identify and determine conflict of interest management strategies in the Iranian health system in comparison with selected countries and to select appropriate strategies in 2024-2025 using the Arksey and O’Malley guidelines. All relevant articles and resources from 2007 to 2024 were extracted from national and international databases by observing the entry and exit criteria and by selecting Persian and English keywords. After screening steps using Prisma flowchart, 23 studies in English and Persian language from international and national databases, were analyzed.
Results: Findings from 17 international studies—most of which were conducted in the United States—along with 6 domestic articles, showed main strategies of Iranian conflict of interest which included participation, transparency, legal oversight, processes reform, restructuring and reorganization. Although, using collective campaigns for correction of process behaviors and decisions, definition of ethical ethic codes, and standardization may help implementation of these strategies. Also, the most common cause of conflict of interest in the health system is individual rather than organizational, which requires regulation, the use of legislative levers, and the transparency of financial relations in the health system.
Conclusion: Accurate identification of potential examples of conflict of interests among the agents of health care system by implementing information clarification, and using modern procedures may decrease the challenges in formulating and implementing strategies of conflict of interests among Iranian health care system. Although benchmarking from successful countries will be helpful in these countries. The implementation of these recommendations may face challenges within Iranian society, including resistance from certain professional groups, a lack of financial and technical resources, and the complexity and specific conditions of the health system. Therefore, a step-by-step approach to implementing policy recommendations for managing conflicts of interest in the health system should be considered.

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