Showing 14 results for Physician
Shahrokh Reiesian, Maryam Eslamian, Mohammad Azmal , Peivand Bastani , Rohollah Kalhor,
Volume 7, Issue 1 (5-2013)
Abstract
Background and Aim: Family physician is the core in the world efforts for quality improvement, cost effectiveness, and equity in the health care systems. The main purpose of this present study was to investigate situation of the family physician program and identify referral route in this program in six pilot cities in Khuzestan province .
Materials and Methods: A cross-sectional descriptive study was conducted in 2011. Pre-designed checklists were used for collecting data. In this study, 15 healthcare team in six pilot cities for family physician program in Khuzestan province were examined and their specified referral levels for each city was investigated and compared with the national instruction to identify current gaps.
Results: The least number of staff belonged to nutrition, nurses and physicions respectively. In the second referral level cities, Specialists did not welcome the program . In Mahshar, a second level city, five specialists have been registered to family physician program. In the third level, 28/5 percent of specialist were enrolled in this program.
Conclusion : It seems that it is necessary to facilitate patient access to physicians under contract with family physician program and referral system in second and third levels. Therefore, establishing a motivation system for attracting specialist and improving their maintenance situation can also be beneficial.
Marjan Ghazi Saeedi, Reza Safdari, Roya Sharifian, Niloofar Mohammadzadeh,
Volume 7, Issue 5 (1-2014)
Abstract
Background and Aim: If the evaluation is done from the perspective of users, Successful development of measures and features related to use and implementation of hospital information system and identify areas that need further consideration is to be provided. The main purpose of this study was assessment the views of physicians and nurses of hospital information system identify the effective criteria for the use of it and their satisfaction.
Materials and Methods: Present research is a descriptive cross-sectional study and was applied in public- education hospitals of Tehran University of Medical Sciences in 2012- 2013. The main tool was a questionnaire prepared by reviewing relevant literature in databases Iranmedex, Magiran, SID, PubMed, Science direct, Google scholar, and surveys by experts. In order to determine the validity, a questionnaire was distributed among 5 experts in the area of information technology. After completion of the questionnaires, results were analyzed using software SPSS17.
Results: Information systems in half of the hospitals surveyed from the perspective of research community have an average of 30 - 60 percent capabilities in order management. Also users in all surveyed hospitals with more than 43 % agree the ease of using hospital systems.
Conclusion : User satisfaction is a guarantee for the implementation of information system. To improve the situation and move towards the ideal condition we suggest users needs in hospital information systems should be considered. Also design and system should be Compatible with the skills and knowledge of users as possible.
Hakimeh Mostafavi , Siamak Aghlmand, Hamed Zandiyan, Minoo Alipoori Sakha , Mohsen Bayati , Sahar Mostafavi ,
Volume 9, Issue 1 (5-2015)
Abstract
Background and Aim: Equitable distribution of resources in health sector is one of the prerequisites of social justice in any society. The aim of this study is to determine inequality in the distribution of specialists and hospital beds in West Azerbaijan Province.
Materials and Methods: This was a descriptive study. The population of the study consists of all hospital beds in the public sector and all specialists working in the health sector of West Azerbaijan Province in 2012 . The required data were collected after referring to health and treatment d eputies of Urmia University of Medical Sciences and Statistical Center of Iran . To determine inequity in the distribution of specialists and hospital beds, per capita resource indicators, the Gini coefficient, and Lorenz curve were employed.
Results: Distribution of specialist physicians in the province was not equitable the situation was the same as regards hospital beds, too.
Conclusion: It seems that neither the distribution of specialist physicians nor the number of hospital beds is proportional to the population. Besides, measures such as p roviding special welfare facilities, paying higher wages, and considering the health needs of people in the province can better attract physicians and modify the existing shortcomings.
Aram Rostami, Mohamad Reza Cheshmyazdan, Mahdi Payande Vafa , Leila Kia, Fateme Saadat Ghoreishi ,
Volume 10, Issue 1 (4-2016)
Abstract
Background and Aim: The first step in reducing patient dose can be administered at the radiological examinations are taken. Since physicians request radiological tests, this study examined physicians' knowledge of the risks of radiological examinations.
Materials and Methods: This descriptive, analytical and cross-sectional study was conducted in 160 general practitioners and specialists' physicians. Based on the estimated dose posterior-anterior hand X-ray, and put it as a single exposure, medical information of physicians about the patient dose in diagnostic radiology tests were examined. The validity of the questionnaire was confirmed by expert panel, and its reliability was 0.80 by Alpha-Cronbach technique.
Results: Most of the general practitioners and specialists did not estimate correctly the radiation dose received by patients in the posterior-anterior hand X-ray, and majority of them underestimated the radiation dose of other radiological examination. The results showed that 48% of General Physician and 5/53% of specialist physicians were familiar with the unit dose.
Conclusion: Training of physicians in the field of radiology patients received doses can be an effective measure for reducing doses to patients.
Mohammadhiwa Abdekhoda, Maryam Ahmadi, Mahmodreza Gohari, Alireza Noruzi,
Volume 10, Issue 2 (5-2016)
Abstract
Background and Aim: Inclusive implementation of Electronic Medical Records (EMR) is more serious because of physicians’ perception. This study was carried out to identify the effects of organizational contextual factors on physicians’ perception regarding EMR’s adoption in 2013 (The merger of Tehran University and Iran).
Materials and Methods: This was a descriptive, analytical and cross- sectional study in which a sample of 270 physicians working in hospitals affiliated to Tehran University of Medical Sciences was selected. Physicians’ perception toward adoption of EMR has been assessed by Technology Acceptance Model or TAM questionnaire and organizational context variables. Collected data were analyzed by SPSS. The study model was tested by Structural Equation Modeling (SEM) and represented by AMOS.
Results: The findings showed that perceived usefulness (PU), perceived ease of use (PEOU), management support, physicians’ involvement, physicians’ autonomy, and physician- patient relationship have direct and significant effect on physicians’ attitudes toward EMR adoption. However, training has no significant effect on TAM variables. Moreover, the results showed authorizing proposed conceptual path model explained about 56 percent of the variance of EMR adoption.
Conclusion: The present study revealed that organizational context factors had significant effect on physicians’ attitude toward EMRs’ adoption. The study clearly identified six relevant factors that affected physicians’ perception regarding EMR adoption. These factors should be considered when comprehensive implementation is pursued.
Marjan Ghazi Saeedi , Leila Shahmoradi, Safieh Ilati Khangholi, Mahdi Habibi-Koolaee ,
Volume 10, Issue 3 (7-2016)
Abstract
Background and Aim: Computerized physician order entry system is the process of entering orders electronically. It is a replacement for manual system and is considered as a part of a clinical information system. The appropriate design of this system leads to the enhancement of its capabilities, ensures orders accurately and comprehensively, and transfers information to different parts rapidly. Therefore, transfer time and the error related to the wrong path or misinterpretations will be omitted; in the end, efficiency will increase. This study aims to present different perspectives on design principles of computerized physician order entry system for stakeholders.
Materials and Methods: In this review article, Google, Google Scholar, Pub Med, Web of Science and Scopus databases were searched with some keywords related to design principles of computerized physician order entry system.
Results: Based on the performed studies, factors such as inappropriate design of links, display page, set of orders content, drug database, structure of order environment, rules, formats, mechanism of getting reports of errors, and finally clinical decision support system have led to the decrease of doctors’ performance, increase of new errors, and reduction of patients’ safety.
Conclusion: Inappropriate design leads to the increase of new errors after the implementation of system; therefore, proper and principled design of this system can lead to the improvement of practitioners’ function, decrease of prescription errors and drug side effects, reduction of costs, efficiency increase, workflow
Mansoureh Baqeripour, Ahmadreza Khazaei,
Volume 13, Issue 3 (9-2019)
Abstract
Background and Aim: Because of its direct connection with human life, medicine is a sacred profession that has been considered by infallible imams (pbuh) and stories have been told about it from the beginning of Islam. With the increasing progress of technology, the study of the relationship between a patient and his/her doctor and of patients' familiarity with their rights has expanded. However, what has been the focus of legislators' attention more than ever is the compensation of damages caused by medical acts.
Materials and Methods: First, using library resources and validated research articles, we conducted a comparison method. Then, the collected documents were studied with descriptive and analytical method. In addition to books, articles, and the writings of law and jurisprudence sites, the researcher benefited from the opinions of jurists, lawyers, physicians, and the losers of medical affairs to explain the purpose of this research.
Results: With certain rules, the legislator has removed the causes of physician's commitment and responsibility; obtaining the consent of the patient or his/her guardian before treatment is among them.
Conclusion: This article considers full support for the physicians' acts in curing patients. However, it is necessary to highlight the responsibilities of the medical team; in fact, non-compliance with medical regulations as well as technical standards and regulations will have legal consequences.
Reza Safdari, Farnoosh Larti, Kamyar Fathi Salari, Saman Mohammadpour,
Volume 14, Issue 3 (7-2020)
Abstract
Background and Aim: Cardiovascular diseases and medication errors are among the leading causes of morbidity and mortality around the world. Electronic prescribing and Medication Administration(ePMA) systems can prevent medication errors to some extent. This study aimed to determine the information requirements of ePMA systems.
Materials and Methods: This descriptive study was conducted in Imam Khomeini Hospital of Tehran and School of Allied Medical Sciences affiliated to Tehran University of Medical Sciences (TUMS) in the summer of 2019 in two phases: literature review and survey-based questionnaire. Information items obtained from reviewing the texts of 100 articles were organized in three questionnaires. In the survey phase, questionnaires were distributed among physicians, nurses, and the experts of health information management(HIM) and medical informatics, using census sampling method. The reliability of the questionnaires was measured using Cronbach's coefficient alpha. Statistical analysis was done using SPSS.
Results: The findings showed that based on specialists’ point of view, patients' demographic information items and unique identifiers gained the highest average, above 4.7. Physicians agreed most with clinical information, including medication history and generic names. From the nurses’ point of view, the information items of the patients’ problems and the procedures performed and the types of drug doses obtained a complete average of 5.
Conclusion: The need for information items varies among different users of ePMA systems, but there may be items that are common for them. Future studies should further investigate financial and pharmaceutical information requirements based on the perspectives of other hospital pharmacy and accounting staff.
Mahdi Shahraki, Simin Ghaderi,
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.
Mehrnoosh Jafari, Mahmoud Tavasoli, Khalil Ali Mohamadzadeh,
Volume 14, Issue 5 (1-2021)
Abstract
Background and Aim: The fair access to health services is one of the most important challenges of the country health system. The family physician was designed to increase access to services, reduce parallel work, and make optimal use of the country’s health resources. The aim of this study was to investigate the factors related to the longevity of physicians in the family physicians
Materials and Methods: The applied study was descriptive, survey. The 32 family physicians working in the comprehensive rural health services centers of Sabzevar was selected by census method. The research tool was a research-made pairwise comparison matrix consisting of 87 questions. The validity of the questionnaire was confirmed by examining the incompatibility rate of the questions. Dematel technique and Excel software were used for data analysis.
Results: The finding showed that environmental factor is the most important factor in the survival of family physicians(R=-0.1558), The managerial factors were also determined as the highest factor that affecting other factors (R=-0.09118). The environmental factors are (affective factor -0.006), managerial factor are (influential factor -0.003) and human factor are (effective factor 0.0037)
Conclusion: Environmental factor was the most effective factor on the survival of physician in this study. Creating suitable facilities, proper communication between family physician and villagers, education and culture of more villagers have the greatest impact on the survival of physicians. It is necessary for managers to planning more carefully by allocating more fund to environment factors.
Ali Reza Heidarian Naeini, Ghahraman Mahmoodi Alemi, Jamshid Yazdani Charati,
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.
Ehsan Zarei, Kheyrollah Chavosh Sani, Mohammad Saadati, Soheila Khodakarim,
Volume 16, Issue 4 (10-2022)
Abstract
Background and Aim: In recent years, public trust in health system has been considered one of the performance evaluation indicators of health systems. However, most of the research on public trust in health system is related to developed countries, and research in this regard is limited in Iran. A better understanding of trust in health system and some influential factors helps to develop targeted interventions to increase trust. The present study was conducted to investigate the level of public trust in health system in Rasht County.
Materials and Methods: In this cross-sectional study, 680 households (510 urban and 170 rural) were included. The data collection tool was a questionnaire to measure public trust in health system with 30 items and six dimensions, whose validity and reliability were confirmed. Mann-Whitney and Kruskal-Wallis tests were used to compare and analyze the difference in public trust in health system between groups.
Results: The overall score of trust in health system was 66.7 out of 112. The highest score for the quality-of-care dimension was 16.38 out of 28, and the lowest for the cooperation quality of providers dimension was 7.47 out of 12. Among service providers, the highest trust was in nurses and specialist doctors, and the least was in traditional medicine service providers. Women, government employees, people without health insurance, people with excellent and good health status, those who had used hospital services, and those who were satisfied with the last service received had a high level of trust in the health system (P<0.05).
Conclusion: The results showed that despite people’s trust in the expertise and knowledge of physicians and other providers, public trust in health system was relatively moderate, indicating deficiencies in the health system’s performance. Focusing on physician-patient communication and improving communication skills, establishing electronic records and sharing patient information between health service providers, and respecting patient rights can build greater trust in the health system.
Seyyed Morteza Mojtabaeian, Fatemeh Monfared,
Volume 16, Issue 5 (12-2022)
Abstract
Background and Aim: The participation of doctors and clinical leadership in organizational strategies to improve quality performance is a necessary precondition for providing safe and high-quality care, and since improving the quality of health care services and increasing the participation of doctors in accreditation is very necessary, the present study was conducted with the aim of explaining the obstacles of doctors' participation in the accreditation programs of Iranian hospitals with a qualitative approach.
Materials and Methods: In this study, using the snowball sampling method, interviews were conducted with 11 managers, 9 doctors and 8 officials and experts in the field of quality management (a total of 28 people) in the field of hospital accreditation. Interviewees were selected through purposive snowball sampling. To collect data, unstructured and semi-structured in-depth interviews were conducted. The obtained data were analyzed using the conceptual framework method in ATLAS.ti.
Results: The results of this research extracted 3 main issues including cultural, organizational and behavioral factors. Also, this research found 12 sub-themes and 57 items. Subtopics in the cultural area were motivation, patient demand, mutual trust, and evaluation system. The organizational field included seven sub-topics, including high workload, understanding the role of the quality management unit, unrealistic accreditation, the nature of accreditation, empowering doctors in the field of quality, effective communication, and limited resources. Subthemes in the behavioural dimension were role ambiguity and uncertainty about how to participate in the accreditation program. The most repeated challenges in the interviews were expressed in the field of effective communication and the least in the field of role ambiguity.
Conclusion: Physicians' participation in accreditation programs can be increased through culture building and proper training in accreditation activities in the medical community. By revising the categories of activities performed in the hospital by doctors and including a specific time to perform activities to improve quality and accreditation and create a balance between the quantity and quality of services provided in the hospital, it is possible to increase the participation of doctors in the accreditation program.
Saeed Nateghi, Ali Ganjali Khan Hakemi, Soheila Damiri, Samira Raoofi, Elham Haghshenas, Sara Akhavan Rezayat, Shamsi Ekhtiyar, , Maryam Radin Manesh,
Volume 16, Issue 5 (12-2022)
Abstract
Background and Aim: Effective monitoring and evaluation of human resources in countries require an agreed set of indicators and measurement tools. Due to the existence of different payment mechanisms, this study aimed to identify performance evaluation indicators in hospitals affiliated with the Tehran University of Medical Sciences.
Materials and Methods: A qualitative phenomenological study was conducted in 2022. Data were collected using semi-structured interviews, purposive sampling, and participation of 23 members of the Senior executives and financial team of hospitals affiliated to Tehran University of Medical Sciences and analyzed by content analysis method using MAXQDA-10 software.
Results: Twenty-three experts participated in this research, 78.2% were men and 21.7% were women, and a total of 526 final codes were identified and according to the balanced scorecard management tool in 4 main themes of finance, customers, internal processes, and growth and Development. Also 8 sub-themes of resource efficiency with 86%, medical tourism with 52%, professional ethics with 65%, satisfaction with 78%, accreditation with 48%, diagnosis and treatment with 78%, education with 56% and The research was categorized with 78%.
Conclusion: The provision of optimal medical services requires managers to be aware of the performance of subordinate personnel, which makes it possible to choose the appropriate criteria, develop performance evaluation systems and conduct correct evaluation, informing Doctors regarding the indicators considered for more accurate evaluation are among the suggestions that can be a solution to the existing problems. Another important point considering the limited available resources is the role of doctors in the field of health tourism to which attention will lead to an increase in financial resources.
