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Showing 131 results for Health
Mahmoud Moradi, Sara Bahrami Nia,
Volume 13, Issue 4 (11-2019)
Volume 13, Issue 4 (11-2019)
Abstract
Background and Aim: The aim of this study was to evaluate the health literacy of patients referring to specialist physicians' offices in the city of Kermanshah.
Materials and Methods: This is a descriptive analytical cross-sectional study. The population of the study (patients and their companions) included those referring to specialist physicians' offices. In 2017, 380 people were randomly selected and were studied during three months. The data collection tool was Health Literacy for Iranian Adults Assessment Questionnaire. Its validity was confirmed by specialists and its reliability turned out to be 0.89 by Cronbach's alpha. Data were analyzed by statistical tests (Spearman's correlation, Mann–Whitney U test and Kruskal-Wallis test) using SPSS software.
Results: The findings of the study showed that the health literacy of patients and their relatives, referring to physicians' offices in the city of Kermanshah, was relatively favorable, i.e., more than average. The three sources of "the Internet", "questions asked from doctors and medical staff" and "radio and television" are the priorities of information or health literacy. The results showed that people's health literacy was different in terms of age, sex, education, and occupation.
Conclusion: The results of this study revealed that often those people who have low and limited health literacy are among vulnerable community groups (having old ages, low educational levels, and low income). So, considering the health information needs and health literacy of vulnerable groups and designing simple and targeted education using the appropriate media are recommended.
Materials and Methods: This is a descriptive analytical cross-sectional study. The population of the study (patients and their companions) included those referring to specialist physicians' offices. In 2017, 380 people were randomly selected and were studied during three months. The data collection tool was Health Literacy for Iranian Adults Assessment Questionnaire. Its validity was confirmed by specialists and its reliability turned out to be 0.89 by Cronbach's alpha. Data were analyzed by statistical tests (Spearman's correlation, Mann–Whitney U test and Kruskal-Wallis test) using SPSS software.
Results: The findings of the study showed that the health literacy of patients and their relatives, referring to physicians' offices in the city of Kermanshah, was relatively favorable, i.e., more than average. The three sources of "the Internet", "questions asked from doctors and medical staff" and "radio and television" are the priorities of information or health literacy. The results showed that people's health literacy was different in terms of age, sex, education, and occupation.
Conclusion: The results of this study revealed that often those people who have low and limited health literacy are among vulnerable community groups (having old ages, low educational levels, and low income). So, considering the health information needs and health literacy of vulnerable groups and designing simple and targeted education using the appropriate media are recommended.
Hossein Samadi-Miarkolaei, Hamzeh Samadi-Miarkolaei,
Volume 13, Issue 5 (1-2020)
Volume 13, Issue 5 (1-2020)
Abstract
Background and Aim: Nowadays, the application of Information and Communication Technology is becoming increasingly prevalent in our daily lives, and especially in organizations. One of these phenomena is employees' use of the organization's Internet for personal purposes during work hours, which is referred to as cyberloafing. One of the important organizational variables that can strongly be influenced by this technology is the level of entrepreneurship in the organization. Therefore, this study seeks to investigate the relationship between cyberloafing and organizational entrepreneurship(OE) in Babolsar Healthcare and Treatment Network(HTN).
Materials and Methods: The present research is an applied study. The statistical population of the study includes all employees of Babolsar HTN. Using simple random sampling, 165 employees were selected as sample. In this study, standard questionnaires were used to measure cyberloafing and OE. Finally, the data were analyzed by using SPSS and LISREL softwares.
Results: The findings of this study showed that there was a significant and inverse relationship between OE and cyberloafing(P<0/001). There was also a significant inverse correlation between organizational entrepreneurship and cyberloafing in structural equation modeling test. On the other hand, the values of the fit indices were RMSEA=0.022, NFI=0.96, GFI=0.97 and χ2/df=1.07, that all indicate the suitability of the model.
Conclusion: The results of this study indicated that cyberloafing phenomenon in Babolsar HTN had an adverse effect on OE. Based on these results, it is suggested that HTN managers teach their employees how to use cyperloafing effectively.
Materials and Methods: The present research is an applied study. The statistical population of the study includes all employees of Babolsar HTN. Using simple random sampling, 165 employees were selected as sample. In this study, standard questionnaires were used to measure cyberloafing and OE. Finally, the data were analyzed by using SPSS and LISREL softwares.
Results: The findings of this study showed that there was a significant and inverse relationship between OE and cyberloafing(P<0/001). There was also a significant inverse correlation between organizational entrepreneurship and cyberloafing in structural equation modeling test. On the other hand, the values of the fit indices were RMSEA=0.022, NFI=0.96, GFI=0.97 and χ2/df=1.07, that all indicate the suitability of the model.
Conclusion: The results of this study indicated that cyberloafing phenomenon in Babolsar HTN had an adverse effect on OE. Based on these results, it is suggested that HTN managers teach their employees how to use cyperloafing effectively.
Mohammad Hossein Ronaghi, Foroughosadat Hosseini,
Volume 14, Issue 1 (3-2020)
Volume 14, Issue 1 (3-2020)
Abstract
Background and Aim: The Fog Computing is a highly virtualized platform that provides storage, computing and networking services between the Cloud data centers and end devices. Fog computing fits the characteristics of real-time health monitoring systems. In such systems, a large amount of data is acquired from a multitude of bio and environmental sensors. On the other hand, its distribution and open structure makes it vulnerable and weak to security threats. Therefore, the aim of this paper was to identify the security challenges in healthcare.
Materials and Methods: This applied research has been done in three phases using mixed-method approach in 2019. In the first phase, security codes from library resources by content analysis was identified. In the second phase interpretation of experts by Delphi method, Panel of IT experts consists of twelve members who work on healthcare sector was evaluated. Finally, we used Analytic Hierarchy Process method for ranking security codes.
Results: According to fuzzy AHP results attacks(0.31), secure communications(0.23), authentication and access control(0.19), trust(0.15) and privacy preservation(0.12) are the most important criteria in security challenges of fog computing.
Conclusion: According to the results of this study, secure communications and network attacks are the major challenges in fog computing, because fog nodes are usually deployed in some places with relatively weak protection. They may encounter various malicious attacks. As a result, policymakers should be aware of the role of secure communications and network attacks in fog computing implementation.
Materials and Methods: This applied research has been done in three phases using mixed-method approach in 2019. In the first phase, security codes from library resources by content analysis was identified. In the second phase interpretation of experts by Delphi method, Panel of IT experts consists of twelve members who work on healthcare sector was evaluated. Finally, we used Analytic Hierarchy Process method for ranking security codes.
Results: According to fuzzy AHP results attacks(0.31), secure communications(0.23), authentication and access control(0.19), trust(0.15) and privacy preservation(0.12) are the most important criteria in security challenges of fog computing.
Conclusion: According to the results of this study, secure communications and network attacks are the major challenges in fog computing, because fog nodes are usually deployed in some places with relatively weak protection. They may encounter various malicious attacks. As a result, policymakers should be aware of the role of secure communications and network attacks in fog computing implementation.
Sara Emamgholipour, Vahid Saberzadeh, Hossein Dargahi,
Volume 14, Issue 1 (3-2020)
Volume 14, Issue 1 (3-2020)
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.
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.
Reza Safdari, Majid Alikhani, Foziye Tahmasbi, Zohre Javanmard,
Volume 14, Issue 1 (3-2020)
Volume 14, Issue 1 (3-2020)
Abstract
Background and Aim: The incidence of osteoporotic fractures, which leads to morbidity and mortality in the elderly, is increasing worldwide. Mobile health application could empower patients to engage in managing their own health. This has a significant impact on improving health outcomes in chronic diseases. For this reason, this study was conducted to develop a mobile-based self-management application for patients with Osteoporotic fractures.
Materials and Methods: In this descriptive-developmental study, initially, the data required in this research were collected through searching in library resources, clinical guidelines and application review. Then, a questionnaire was applied by physician to validate and determine the significance of these elements and the rational design of application was provided with the obtained elements. Finally, the application was developed in Android Studio environment and then evaluated.
Results: The main application parts include: Disease prevention information, fracture risk assessment tool and information for self-management in osteoporotic fractures care which was divided into two parts: Hip fracture and other fractures. Moreover, provides functions like exercise program adjustments, reminders and patient records. The application functions were evaluated and was able to meet the expectations.
Conclusion: This is a mobile application with validated content and can be used to help patients with osteoporotic fractures to manage their disease and to obtain self-management skills.
Materials and Methods: In this descriptive-developmental study, initially, the data required in this research were collected through searching in library resources, clinical guidelines and application review. Then, a questionnaire was applied by physician to validate and determine the significance of these elements and the rational design of application was provided with the obtained elements. Finally, the application was developed in Android Studio environment and then evaluated.
Results: The main application parts include: Disease prevention information, fracture risk assessment tool and information for self-management in osteoporotic fractures care which was divided into two parts: Hip fracture and other fractures. Moreover, provides functions like exercise program adjustments, reminders and patient records. The application functions were evaluated and was able to meet the expectations.
Conclusion: This is a mobile application with validated content and can be used to help patients with osteoporotic fractures to manage their disease and to obtain self-management skills.
Mahdi Isazadeh, Zahra Sadat Asadi, Mahdi Tahmasebi Gharajehmalek, Manijeh Soleimanifar,
Volume 14, Issue 1 (3-2020)
Volume 14, Issue 1 (3-2020)
Abstract
Background and Aim: Currently, electronic health(e-health) tools are known as an effective means of communication and educational tool in the field of health to manage conditions in sensitive situations. The purpose of this study was to evaluate the level of electronic health literacy of patients referring to a selected military hospital.
Materials and Methods: The present descriptive-analytical study was performed on 204 patients who referred to a selected military hospital in Tehran in 2019. Data collection tools included a demographic information questionnaire and an e-health literacy questionnaire. SPSS software was used for data analysis, and the level of significance was set at 0.05.
Results: The mean score of electronic health literacy was 29.28±5.47. The level of e-health literacy of patients with different educational backgrounds was significantly different. Also, the electronic health literacy of patients using the Internet differed significantly. Patients' e-health literacy had a significant correlation with their educational level(p=0.02, r =0.169) and using the Internet(p<0.001, r=0.328).
Conclusion: Higher education is associated with higher levels of e-health literacy, and can be improved by creating internet training areas to access health information to improve e-health literacy.
Materials and Methods: The present descriptive-analytical study was performed on 204 patients who referred to a selected military hospital in Tehran in 2019. Data collection tools included a demographic information questionnaire and an e-health literacy questionnaire. SPSS software was used for data analysis, and the level of significance was set at 0.05.
Results: The mean score of electronic health literacy was 29.28±5.47. The level of e-health literacy of patients with different educational backgrounds was significantly different. Also, the electronic health literacy of patients using the Internet differed significantly. Patients' e-health literacy had a significant correlation with their educational level(p=0.02, r =0.169) and using the Internet(p<0.001, r=0.328).
Conclusion: Higher education is associated with higher levels of e-health literacy, and can be improved by creating internet training areas to access health information to improve e-health literacy.
Mohammad Reza Haji Ghasemi, Mehdieh Azhdari,
Volume 14, Issue 2 (5-2020)
Volume 14, Issue 2 (5-2020)
Abstract
Background and Aim: Neurological disorders occur under the conditions when there is perturbation in one part of the brain or the nervous system. The increasing outbreak of neurological disorders and its high expenses imposed on society have made the necessity to modify the policies of health care. This study calculated the cost of services for pediatric neurology patients to reduce costs.
Materials and Methods: This quantitative cross-sectional descriptive-analytic case study implemented a Fuzzy Time-Driven Activity-Based Costing(FTDABC) model in treating pediatric neurology patients in 2016. The Wilcoxon nonparametric test was used to test the hypothesis of the research and investigate the significant difference in the cost of services provided to patients in the FTDABC and the traditional costing model.
Results: The results confirmed a meaningful patient services costs in both methods; the cost of patient care using FTDABC model was estimated to be 5,736,843,432 Rials, 41.61% of which goes to overhead and 5.94% goes to idle capacity. Visiting and counseling activities, controlling vital signs, and patient displacement were identified as the most time-consuming activities in the treatment process, respectively.
Conclusion: According to the research findings, it seems necessary to reform human resource management and reduce idle capacity to increase the effectiveness of hospital resources and improve the therapeutic processes. If management can reduce patient displacement activity by 20%, it will result in 2.89% reduction of time and 1.86% of the cost of the treatment process.
Materials and Methods: This quantitative cross-sectional descriptive-analytic case study implemented a Fuzzy Time-Driven Activity-Based Costing(FTDABC) model in treating pediatric neurology patients in 2016. The Wilcoxon nonparametric test was used to test the hypothesis of the research and investigate the significant difference in the cost of services provided to patients in the FTDABC and the traditional costing model.
Results: The results confirmed a meaningful patient services costs in both methods; the cost of patient care using FTDABC model was estimated to be 5,736,843,432 Rials, 41.61% of which goes to overhead and 5.94% goes to idle capacity. Visiting and counseling activities, controlling vital signs, and patient displacement were identified as the most time-consuming activities in the treatment process, respectively.
Conclusion: According to the research findings, it seems necessary to reform human resource management and reduce idle capacity to increase the effectiveness of hospital resources and improve the therapeutic processes. If management can reduce patient displacement activity by 20%, it will result in 2.89% reduction of time and 1.86% of the cost of the treatment process.
Rasoul Alinejad, Mahdi Yousefi, Hossein Ebrahimipoor, Ali Taghipour, Amin Mohammadi,
Volume 14, Issue 2 (5-2020)
Volume 14, Issue 2 (5-2020)
Abstract
Background and Aim: The efficiency and effectiveness of any organization depend greatly on proper and effective management and use of human resources. Due to the importance of activities and the motivation of personnel fighting against diseases, as well as the high share of personnel costs in total health expenditures, the use of appropriate methods to determine their workload is important.
Materials and Methods: The present research is a descriptive and applied study, conducted in two quantitative and qualitative dimensions. The research environment was the urban-rural health centers of Savadkuh health network. During the process of calculating the workload, the steps were: identifying activities, correcting and approving activities, determining the percentage of acceptable unemployment, calculating standard time, determining the number of repetitions, calculating work units, determining the workload, and determining the required manpower.
Results: Activities in the field of fighting against diseases were identified and organized in the form of 77 activities. By taking the frequency of each activity into account, the total time of these activities in one month was equal to 10273 work units. The main activities related to vaccine injection and registration of vaccinated specifications in relevant offices and forms included 137 and 115 work units, respectively.
Conclusion: Determining the workload of different health care fields by using this study method creates the potential to estimate the number of manpower required to give all predicted services, and has the potential to reduce the demand for surplus labor and increase employees’ tendency to give more services, if used in current structures.
Materials and Methods: The present research is a descriptive and applied study, conducted in two quantitative and qualitative dimensions. The research environment was the urban-rural health centers of Savadkuh health network. During the process of calculating the workload, the steps were: identifying activities, correcting and approving activities, determining the percentage of acceptable unemployment, calculating standard time, determining the number of repetitions, calculating work units, determining the workload, and determining the required manpower.
Results: Activities in the field of fighting against diseases were identified and organized in the form of 77 activities. By taking the frequency of each activity into account, the total time of these activities in one month was equal to 10273 work units. The main activities related to vaccine injection and registration of vaccinated specifications in relevant offices and forms included 137 and 115 work units, respectively.
Conclusion: Determining the workload of different health care fields by using this study method creates the potential to estimate the number of manpower required to give all predicted services, and has the potential to reduce the demand for surplus labor and increase employees’ tendency to give more services, if used in current structures.
Shahpar Zakipour, Behzad Farrokh Sersht, Mohammad Javad Taghipourian, Hasan Ali Aghajani,
Volume 14, Issue 3 (7-2020)
Volume 14, Issue 3 (7-2020)
Abstract
Background and Aim: In recent decades, increasing productivity and reducing losses by improving abnormal behaviors in the workplace have attracted the attention of organizational behavior experts, especially health researchers. The purpose of the present research is to study the factors influencing the reduction of abnormal behaviors in health workplace.
Materials and Methods: By using meta-synthesis technique, the findings of the related internal and external studies were systematically analyzed using Sandelowski and Barroso seven-step method. The identified codes were classified, analyzed and interpreted by MAXQDA10. Kappa method and SPSS were used to measure reliability and quality control. The calculated kappa coefficient was 0.893, which indicated a good consistency.
Results: From 435 articles investigated in this field, 46 articles were selected, based on which 68 factors were identified. These factors were classified into 3 main categories and 11 pivotal codes. The influential factors identified in this study include individual factors(psychological, demographic, religious, and contextual), group factors(communication, appropriate reward system, and deterrent behaviors) and organizational factors(organizational space, organizational measures, organizational emotions, and job position perception).
Conclusion: The results of this study show that individual factors are the most important ones affecting the reduction of abnormal behaviors. Therefore, the findings of this study emphasize psychological, demographic, religious, and contextual factors in planning and managers’ interventions to increase productivity in health workplace.
Materials and Methods: By using meta-synthesis technique, the findings of the related internal and external studies were systematically analyzed using Sandelowski and Barroso seven-step method. The identified codes were classified, analyzed and interpreted by MAXQDA10. Kappa method and SPSS were used to measure reliability and quality control. The calculated kappa coefficient was 0.893, which indicated a good consistency.
Results: From 435 articles investigated in this field, 46 articles were selected, based on which 68 factors were identified. These factors were classified into 3 main categories and 11 pivotal codes. The influential factors identified in this study include individual factors(psychological, demographic, religious, and contextual), group factors(communication, appropriate reward system, and deterrent behaviors) and organizational factors(organizational space, organizational measures, organizational emotions, and job position perception).
Conclusion: The results of this study show that individual factors are the most important ones affecting the reduction of abnormal behaviors. Therefore, the findings of this study emphasize psychological, demographic, religious, and contextual factors in planning and managers’ interventions to increase productivity in health workplace.
Nahid Einollahi, Reza Safdari, Marsa Gholamzadeh, Elham Haghshenas, Horieh Masourian,
Volume 14, Issue 4 (10-2020)
Volume 14, Issue 4 (10-2020)
Abstract
Background and Aim: Mobile-based programs have been developed as tools to help both patients and physicians in various fields especially in dermatology. Therefore, the main objective of this study was to review the features and contents of dermatology applications.
Materials and Methods: The methodology was comparative and descriptive. Applications in the field of dermatology were evaluated and compared through this research. Inclusion criteria included applications that have been downloaded more than 100 times in Google Play and App Store and applications designed in diagnosis in various fields of dermatology such as treatment, management, remote consulting, and self-care areas. Exclusion criteria included those developed before 2010 and those related to the non-dermatology areas. Besides, different features were considered for comparison based on literature review and expert consultation. Next, the recognized applications were reviewed and compared based on determined categories.
Results: Based on criteria, a total of 33 applications were identified through searching. Of these, 33.3% of Apps were in the field of education, and 24.2% were in self-care. Regarding disease, applications were categorized into nine different domains. Of these, 61% of applications were covering different types of skin diseases. Also, in examining the frequency of the features of the evaluated programs, providing recommendations and suggestions with 57.57% and educational contents and the possibility of uploading images with 51.51%, respectively, had the highest frequency among the features of the programs.
Conclusion: Analysis showed that education and self-care domains have a high rank among others. It indicates that developing such applications could facilitate patient education and self-management by himself or caregivers. However, this area needs more attention and the using health information technology capabilities to make applications smarter in this area.
Materials and Methods: The methodology was comparative and descriptive. Applications in the field of dermatology were evaluated and compared through this research. Inclusion criteria included applications that have been downloaded more than 100 times in Google Play and App Store and applications designed in diagnosis in various fields of dermatology such as treatment, management, remote consulting, and self-care areas. Exclusion criteria included those developed before 2010 and those related to the non-dermatology areas. Besides, different features were considered for comparison based on literature review and expert consultation. Next, the recognized applications were reviewed and compared based on determined categories.
Results: Based on criteria, a total of 33 applications were identified through searching. Of these, 33.3% of Apps were in the field of education, and 24.2% were in self-care. Regarding disease, applications were categorized into nine different domains. Of these, 61% of applications were covering different types of skin diseases. Also, in examining the frequency of the features of the evaluated programs, providing recommendations and suggestions with 57.57% and educational contents and the possibility of uploading images with 51.51%, respectively, had the highest frequency among the features of the programs.
Conclusion: Analysis showed that education and self-care domains have a high rank among others. It indicates that developing such applications could facilitate patient education and self-management by himself or caregivers. However, this area needs more attention and the using health information technology capabilities to make applications smarter in this area.
Mahdi Shahraki, Simin Ghaderi,
Volume 14, Issue 4 (10-2020)
Volume 14, Issue 4 (10-2020)
Abstract
Background & Aim: Physicians as human capital and resources are one of the main components of health production. The imbalance of physician supply and demand affects the health and economics. Therefore, this study aimed to estimate and forecast the supply and demand of physician working in Iranian medical universities.
Materials and Methods: This a descriptive-analytical and applied study was conducted at national level for Iran during 1991-2017. The statistical population was physicians working in Iranian medical universities. ARIMA method was used to estimate and forecast physician supply and Vector Error Correction Models was used for physician demand. The data is annual time series that was extracted from the statistical yearbooks of the Statistical Center of Iran and the World Bank database. Eviews 10 software was used to estimate the models.
Results: The results showed that physician demand in Iran was affected by Gross Domestic Product, age structure and hospital beds, and according to the forecast of supply and demand of physicians, we will be faced to the physician shortage in the years 2018-2030.
Conclusion: In the coming years, Iran is facing with physician shortage. Therefore, it is recommended to adopt policies to increase physician capacity in medical universities and to increase strong incentives to retain physicians and prevent their migration.
Materials and Methods: This a descriptive-analytical and applied study was conducted at national level for Iran during 1991-2017. The statistical population was physicians working in Iranian medical universities. ARIMA method was used to estimate and forecast physician supply and Vector Error Correction Models was used for physician demand. The data is annual time series that was extracted from the statistical yearbooks of the Statistical Center of Iran and the World Bank database. Eviews 10 software was used to estimate the models.
Results: The results showed that physician demand in Iran was affected by Gross Domestic Product, age structure and hospital beds, and according to the forecast of supply and demand of physicians, we will be faced to the physician shortage in the years 2018-2030.
Conclusion: In the coming years, Iran is facing with physician shortage. Therefore, it is recommended to adopt policies to increase physician capacity in medical universities and to increase strong incentives to retain physicians and prevent their migration.
Hamzeh Amin-Tahmasbi, Maede Ghasemi,
Volume 14, Issue 4 (10-2020)
Volume 14, Issue 4 (10-2020)
Abstract
Background and Aim: The growing healthcare expenses, technological advancements and increasing competition in healthcare services, brings up new challenges for healthcare industry in providing appropriate services to customers. The Lean methodology, which is a managerial approach, provides tools necessary to eliminate waste and increase customer satisfaction through increasing quality of the services and decreasing the wait times and costs. The Scope of this paper is to determine and rank the lean criteria for hospitals.
Materials and Methods: 22 base criteria for a lean organization was selected and reconciled to hospitals from literature review. Then they were evaluated by experts in the field using Likert scale, leading to 18 criteria. The correlation of these criteria was found using ISM methodology, followed by ranking of these criteria. Lastly, the criteria were categorized utilizing MICMAC analysis.
Results: utilizing MICMAC analysis, the "defining the flow of processes & continuous improvement", "utilizing visual surveillance to understand the situation & exploit the problems" were identified as the most important variables.
Conclusion: In order to increase quality of services and customer satisfaction and to reduce operating costs, hospitals are advised to utilize lean methodology. In which case the management should pay more attention to the two more important criteria derived by MICMAC analysis, "Defining the processes in order to find problems" and "Continuous improvement and utilizing visual surveillance in order to find problems".
Materials and Methods: 22 base criteria for a lean organization was selected and reconciled to hospitals from literature review. Then they were evaluated by experts in the field using Likert scale, leading to 18 criteria. The correlation of these criteria was found using ISM methodology, followed by ranking of these criteria. Lastly, the criteria were categorized utilizing MICMAC analysis.
Results: utilizing MICMAC analysis, the "defining the flow of processes & continuous improvement", "utilizing visual surveillance to understand the situation & exploit the problems" were identified as the most important variables.
Conclusion: In order to increase quality of services and customer satisfaction and to reduce operating costs, hospitals are advised to utilize lean methodology. In which case the management should pay more attention to the two more important criteria derived by MICMAC analysis, "Defining the processes in order to find problems" and "Continuous improvement and utilizing visual surveillance in order to find problems".
Reza Dehghan, Hamideh Reshadatjoo, Kambeiz Talebi, Hossein Dargahi,
Volume 14, Issue 6 (1-2021)
Volume 14, Issue 6 (1-2021)
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.
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.
Niloofar Mohammadzadeh, Dr Seyed Hadi Sajjadi, Seyed Hasan Sajjadi,
Volume 15, Issue 1 (3-2021)
Volume 15, Issue 1 (3-2021)
Abstract
Background and Aim: Social networks that provide users with health data not only educate them but also play an active role in the health decision-making process. Health social networks, in addition to being a good tool for better patient communication with health care providers, can play an effective role in connecting similar patients with each other to receive social support. Social networking is one of the biggest achievements of Web 2, which facilitates communication between people. Despite the spread of social networks, their use in the field of health is still at its early levels. To implement an information system, it is first necessary to identify, design and model the related processes. The main purpose of this study was to provide technical documentation for the development of social networks in the field of health in order to facilitate future developments.
Materials and Methods: This study was an applied research. Due to the review of texts in the first phase, this research was descriptive. It is also a developmental research due to its technological dimensions in modeling and pattern model presentation. First, extracted features were confirmed based on experts’ opinions. Then, according to the identified features, social network modeling was performed at three levels of data, functional and process. Based on the modeling, a prototype model was designed and evaluated.
Results: In this research, technical documents were prepared for the development of social networks in the field of health in the three axes of data modeling, functional modeling and process modeling. In the usability assessment by Nielsen model, the created prototype based on modeling was evaluated. Finally, the number of problems in each case of the Nielsen model was determined. The case of "Visibility of system status" with 26.31 and "Consistency and standards" with 5.27 were associated with the highest and lowest problems, respectively.
Conclusion: The growing need and expansion of the use of social networks has created a good platform for using this tool in the field of health and exploiting its benefits. The present study focuses on providing technical documentation for the development of health social networks and to facilitate the development of social networks in the field of health.
Materials and Methods: This study was an applied research. Due to the review of texts in the first phase, this research was descriptive. It is also a developmental research due to its technological dimensions in modeling and pattern model presentation. First, extracted features were confirmed based on experts’ opinions. Then, according to the identified features, social network modeling was performed at three levels of data, functional and process. Based on the modeling, a prototype model was designed and evaluated.
Results: In this research, technical documents were prepared for the development of social networks in the field of health in the three axes of data modeling, functional modeling and process modeling. In the usability assessment by Nielsen model, the created prototype based on modeling was evaluated. Finally, the number of problems in each case of the Nielsen model was determined. The case of "Visibility of system status" with 26.31 and "Consistency and standards" with 5.27 were associated with the highest and lowest problems, respectively.
Conclusion: The growing need and expansion of the use of social networks has created a good platform for using this tool in the field of health and exploiting its benefits. The present study focuses on providing technical documentation for the development of health social networks and to facilitate the development of social networks in the field of health.
Faezeh Mahdizadeh, Fatemeh Mahdizadeh, Maryam Tatari, Mostafa Sheykhtayefeh,
Volume 15, Issue 2 (5-2021)
Volume 15, Issue 2 (5-2021)
Abstract
Background and Aim: Medical students, as the largest group of health care providers, should be able to combine their technical skills and professional knowledge to diagnose patients' problems and use it to take a big step towards reducing errors and increase the quality of care. For this reason, a study was conducted to investigate the relationship between health literacy and computer literacy among medical students in Torbat Heydariyeh in 2018.
Materials and Methods: This cross-sectional study with a descriptive-analytical approach was performed in the middle half of 2018 on 201 students of Torbat Heydariyeh University of Medical Sciences (THUMS), who were selected by multi-stage sampling method. Data were collected using the Iranian Adult Health Literacy Questionnaire (HELIA) and the Computer Literacy Questionnaire. Then, the data were analyzed with SPSS software, using descriptive statistics and Chi-square test.
Results: In this study, 175 subjects (87.1%) were female and the rest were male. The mean and standard deviation of age were 21.52±1.30 and 17.11±0/99, respectively. The results of multivariate linear regression showed that the variable dimensions of computer literacy could predict up to 63% of changes in students' health literacy score. The results also showed that the dimensions of basic skills, frequency of computer use and
self-assessment of working skills with Windows had a significant relationship with students' health literacy (P<0.05).
Conclusion: Considering the results, it is suggested that the necessary measures be taken to increase students' computer literacy by holding workshops and Update educational content in universities; in this way, a step towards increasing computer literacy and consequently, increasing the health literacy of students can be taken.
Materials and Methods: This cross-sectional study with a descriptive-analytical approach was performed in the middle half of 2018 on 201 students of Torbat Heydariyeh University of Medical Sciences (THUMS), who were selected by multi-stage sampling method. Data were collected using the Iranian Adult Health Literacy Questionnaire (HELIA) and the Computer Literacy Questionnaire. Then, the data were analyzed with SPSS software, using descriptive statistics and Chi-square test.
Results: In this study, 175 subjects (87.1%) were female and the rest were male. The mean and standard deviation of age were 21.52±1.30 and 17.11±0/99, respectively. The results of multivariate linear regression showed that the variable dimensions of computer literacy could predict up to 63% of changes in students' health literacy score. The results also showed that the dimensions of basic skills, frequency of computer use and
self-assessment of working skills with Windows had a significant relationship with students' health literacy (P<0.05).
Conclusion: Considering the results, it is suggested that the necessary measures be taken to increase students' computer literacy by holding workshops and Update educational content in universities; in this way, a step towards increasing computer literacy and consequently, increasing the health literacy of students can be taken.
Sharareh Mirsaeidi Farahani, Ahmad Vedadi, Ali Rezaeian,
Volume 15, Issue 2 (5-2021)
Volume 15, Issue 2 (5-2021)
Abstract
Background and Aim: Due to the importance and position of the health sector in society and consideration of industry 4.0 during these days, we witness an increase in the spread of state-of-the-art (smart) technologies in various fields, on one hand, and an evolutionary development by integrating healthcare and technology, on the other hand. Thus, the application of smart technologies can help to overcome many of the healthcare sector limitations. This study aimed to propose an appropriate model for deploying smart services in the Iranian healthcare system.
Material and Methods: This was a qualitative research study based on thematic analysis in 2020. The required data were extracted by literature review and expert interviews. A sample of 15 experts were selected using purposive sampling. Sampling was continued until full data saturation was reached. The data were collected using semi-structured interviews. The interviews were implemented and analyzed in MAXQDA. Finally, a qualitative method was developed.
Results: Based on the findings of this research, 202 open codes were extracted and 23 basic themes (sub- themes) were identified to design the model of deployment smart services in the Iranian health sector which categorized in seven organizing themes (main themes) consist deployment planning, execution management, task organization frame work, national preparedness, stage-setting, organizational interventions, and resistance management. Then, according to the above themes, the thematic model was provided which has a suitable model fitness (IFI: 0.934, NFI: 0.959, RMSEA: 0.080).
Conclusion: Providing the model for deploying smart health care and use of these technologies help to significantly improve the quality of health services, improve access to these services, reduce costs and thus improve health of society.
Material and Methods: This was a qualitative research study based on thematic analysis in 2020. The required data were extracted by literature review and expert interviews. A sample of 15 experts were selected using purposive sampling. Sampling was continued until full data saturation was reached. The data were collected using semi-structured interviews. The interviews were implemented and analyzed in MAXQDA. Finally, a qualitative method was developed.
Results: Based on the findings of this research, 202 open codes were extracted and 23 basic themes (sub- themes) were identified to design the model of deployment smart services in the Iranian health sector which categorized in seven organizing themes (main themes) consist deployment planning, execution management, task organization frame work, national preparedness, stage-setting, organizational interventions, and resistance management. Then, according to the above themes, the thematic model was provided which has a suitable model fitness (IFI: 0.934, NFI: 0.959, RMSEA: 0.080).
Conclusion: Providing the model for deploying smart health care and use of these technologies help to significantly improve the quality of health services, improve access to these services, reduce costs and thus improve health of society.
Hossein Dargahi, Farugh Nomani, Mohammad Rahim Ghohestani,
Volume 15, Issue 2 (5-2021)
Volume 15, Issue 2 (5-2021)
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.
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.
Eng. Meisam Fallahnezhad, Reza Safdari,
Volume 15, Issue 3 (8-2021)
Volume 15, Issue 3 (8-2021)
Abstract
Background and Aim: Large amounts of hospital costs are not reimbursed annually by health insurance as deductions. Therefore, reducing deductions is very important for the hospital. In the study of design and implementation of analytical dashboard of insurance deductions based on medical intelligence business, to improve financial management with the aim of focusing on assessing the level of satisfaction and its applicability has been done.
Materials and Methods: To design the questionnaire, first 27 questions were prepared through library studies and interviews with members of the hospital board of directors, and the validity and consistency of its items were determined through content validity and Cronbach’s alpha coefficient. Data were analyzed in SPSS software and the results were used to design and implement the dashboard.
Results: The study is of development-applied type. In the first phase, to determine Content Validity Ratio CVI (Content Validity Index), and CVR (Content Validity Ratio) a researcher-made questionnaire was provided to 20 experts. In the second phase, by building a data warehouse in SQL (Structured Query Language), the information of the tables related to the deductions of the hospital HIS system was transferred to it and the operational information of the organization was extracted and converted into DW format and the map information was tested. OLAP (Online Analytical Processing) services were then loaded on the created analytics database. In the last step, Power BI tool was selected and used to create business intelligence mechanisms, display and visualize information. In the third phase, using the QUIS (Questionnaire for User Interface Satisfaction) standard questionnaire, the level of satisfaction and usability of the dashboard was evaluated by 15 experts.
Conclusion: In this study, two questionnaires were used. CVR was measured in all items of the first questionnaire, more than 0.50 and CVI was measured in the upper areas of 0.90 and Cronbach’s alpha coefficient was obtained between 0.8 and 0.9, which indicated a good level. The second questionnaire was to evaluate the level of satisfaction and usability of the dashboard that the average of the total evaluation based on the indicators of the QUIS questionnaire is equal to 85.40. Therefore, the level of satisfaction and usability of the dashboard was “very good” for the evaluators.
Materials and Methods: To design the questionnaire, first 27 questions were prepared through library studies and interviews with members of the hospital board of directors, and the validity and consistency of its items were determined through content validity and Cronbach’s alpha coefficient. Data were analyzed in SPSS software and the results were used to design and implement the dashboard.
Results: The study is of development-applied type. In the first phase, to determine Content Validity Ratio CVI (Content Validity Index), and CVR (Content Validity Ratio) a researcher-made questionnaire was provided to 20 experts. In the second phase, by building a data warehouse in SQL (Structured Query Language), the information of the tables related to the deductions of the hospital HIS system was transferred to it and the operational information of the organization was extracted and converted into DW format and the map information was tested. OLAP (Online Analytical Processing) services were then loaded on the created analytics database. In the last step, Power BI tool was selected and used to create business intelligence mechanisms, display and visualize information. In the third phase, using the QUIS (Questionnaire for User Interface Satisfaction) standard questionnaire, the level of satisfaction and usability of the dashboard was evaluated by 15 experts.
Conclusion: In this study, two questionnaires were used. CVR was measured in all items of the first questionnaire, more than 0.50 and CVI was measured in the upper areas of 0.90 and Cronbach’s alpha coefficient was obtained between 0.8 and 0.9, which indicated a good level. The second questionnaire was to evaluate the level of satisfaction and usability of the dashboard that the average of the total evaluation based on the indicators of the QUIS questionnaire is equal to 85.40. Therefore, the level of satisfaction and usability of the dashboard was “very good” for the evaluators.
Ali Reza Heidarian Naeini, Ghahraman Mahmoodi Alemi, Jamshid Yazdani Charati,
Volume 15, Issue 3 (8-2021)
Volume 15, Issue 3 (8-2021)
Abstract
Background and Aim: In recent years, the family physician plan has been implemented as a main strategy of health system in Iran. Therefore, the necessity to reform organizational structure based on experiences of other countries is felt more than before. The aim of this study was to explore required structures of Family Physician Program to achieve service quality dimensions in Primary Health care through analyzing country experiences.
Materials and Methods: This study was a systematic review. All relevant databases were searched using appropriate search strategies and keywords (Family Physicians, Primary Health Hare, Quality of Care). To evaluate the quality of selected papers, CASP tool was applied by 4 experts, and their choices were discussed to reach a final decision.
Results: In order to achieve the quality of services in the field of family medicine, based on the findings of this study, eight important executive structures must be considered. These structures are: Organizational and managerial structures, including health system governance, Support mechanisms and referral system, Systematic communication platform, Electronic health services, Service delivery processes,Insurance structure, Supervisory and control structure including financial control mechanisms, competitive control and quantitative control, Payment structure, quantitative and qualitative development structure of service providers, Quality structure that includes the definition and evaluation of quality and accountability mechanisms as well as incentive mechanisms for service quality, Support structure including insurance support, classified support for specific groups, and finally, the cultural structure in the two areas of culture building of the referral system and strengthening the position of family physicians.
Conclusion: Quality improvement in primary health care requires attention to executive structures. Use of executive experiences of other countries will be useful in achievement of quality health care in family physician system.
Materials and Methods: This study was a systematic review. All relevant databases were searched using appropriate search strategies and keywords (Family Physicians, Primary Health Hare, Quality of Care). To evaluate the quality of selected papers, CASP tool was applied by 4 experts, and their choices were discussed to reach a final decision.
Results: In order to achieve the quality of services in the field of family medicine, based on the findings of this study, eight important executive structures must be considered. These structures are: Organizational and managerial structures, including health system governance, Support mechanisms and referral system, Systematic communication platform, Electronic health services, Service delivery processes,Insurance structure, Supervisory and control structure including financial control mechanisms, competitive control and quantitative control, Payment structure, quantitative and qualitative development structure of service providers, Quality structure that includes the definition and evaluation of quality and accountability mechanisms as well as incentive mechanisms for service quality, Support structure including insurance support, classified support for specific groups, and finally, the cultural structure in the two areas of culture building of the referral system and strengthening the position of family physicians.
Conclusion: Quality improvement in primary health care requires attention to executive structures. Use of executive experiences of other countries will be useful in achievement of quality health care in family physician system.
Haleh Mohammadiha, Gholam Reza Memarzadeh, Parham Azimi,
Volume 15, Issue 3 (8-2021)
Volume 15, Issue 3 (8-2021)
Abstract
Background and Aim: Health systems have played an important role in improving and increasing life expectancy. However, there is a large gap between health systems’ potential and their current performance, most of which relate to governance issues. The purpose of this study is to provide a model for improving the governance of the country's health system.
Materials and Methods: The present study is applied-developmental in terms of purpose. After reviewing the theoretical foundations and previous research, the governance strategies of the health system were identified. Then, using Fuzzy Delphi Method (FDM) and surveying 13 academic and executive experts who were purposefully selected, the research model was designed. Finally, in order to validate the model, 169 managers and specialists of health system departments in Tehran were interviewed with a questionnaire, and the data were analyzed using structural equation modeling (SEM) and SmartPLS software. At this stage, the sampling method was available and the sample size was calculated by Cochran's method.
Results: According to the research findings, in order to promote health governance, 10 main strategies and 58 sub-strategies should be considered. Identified strategies include strategic orientation, optimal financial resource management, stakeholder partnership development, knowledge resource development, administrative health promotion, technical knowledge development, value and ethical orientation, executive and operational platform development, Service delivery capacity management and Balanced and integrated stewardship. Also, the coefficient of determination for the outcome variable is 0.549 and the intensity of the effect of intervening/ facilitating and contextual factors on governance strategies is equal to 0.610 and 0.533, respectively.
Conclusion: The results showed that the governance of the health system is a multifaceted and complex phenomenon and in order to improve it, a set of strategies must be implemented. In addition, it is suggested that according to the issues and threats facing the health system, a roadmap and a long-term plan should be developed in order to move towards the governance model proposed in the present study.
Materials and Methods: The present study is applied-developmental in terms of purpose. After reviewing the theoretical foundations and previous research, the governance strategies of the health system were identified. Then, using Fuzzy Delphi Method (FDM) and surveying 13 academic and executive experts who were purposefully selected, the research model was designed. Finally, in order to validate the model, 169 managers and specialists of health system departments in Tehran were interviewed with a questionnaire, and the data were analyzed using structural equation modeling (SEM) and SmartPLS software. At this stage, the sampling method was available and the sample size was calculated by Cochran's method.
Results: According to the research findings, in order to promote health governance, 10 main strategies and 58 sub-strategies should be considered. Identified strategies include strategic orientation, optimal financial resource management, stakeholder partnership development, knowledge resource development, administrative health promotion, technical knowledge development, value and ethical orientation, executive and operational platform development, Service delivery capacity management and Balanced and integrated stewardship. Also, the coefficient of determination for the outcome variable is 0.549 and the intensity of the effect of intervening/ facilitating and contextual factors on governance strategies is equal to 0.610 and 0.533, respectively.
Conclusion: The results showed that the governance of the health system is a multifaceted and complex phenomenon and in order to improve it, a set of strategies must be implemented. In addition, it is suggested that according to the issues and threats facing the health system, a roadmap and a long-term plan should be developed in order to move towards the governance model proposed in the present study.
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