Showing 13 results for PourReza
A Pourreza , Z Kavosi , M Mahmoudi , A Batebi ,
Volume 4, Issue 3 (3 2006)
Abstract
Background and Aim: The purpose of this study was the assessment of inappropriate admissions and hospital stays and reasons for this in the hospitals affiliated to Tehran university of Medical Sciences.
Materials and Methods: We used the Appropriateness Evaluation Protocol (AEP) to evaluate the appropriateness of 258 admissions to Dr. Shariati and Imam Khomeini hospitals and 1732 days of hospital stay for the same patients.
Findings indicate that on the whole, 22.8% of admissions were inappropriate and the length of stay for patients who were inappropriately admitted was significantly shorter than for those whose admission was judged to be appropriate.
Results: Results show that 8.6% of the total number of patient stay days were unnecessary the figures differ significantly between the two hospitals. The most frequent reason for inappropriate hospital stay was the delay in the discharge process .Consultations and delay in surgical operations were other causes of inappropriate patient stay.
Conclusion: A substantial proportion of hospital admissions and stays were found to be inappropriate due to hospital procedures and inadequacies in the lower levels of healthcare. Efficient use of hospital resources should be promoted by modifying procedures, improving the performance of the healthcare system and revising insurance policies.
A Pourreza , Z Yousefi , A Rahimi ,
Volume 5, Issue 1 (2 2007)
Abstract
Background and Aim: Health and access to health facilities are now regarded as basic human rights and a fundamental social objective. Reproductive health is essential to promote quality of life and satisfy the need for an enjoyable parenthood.
Material and Methods: This was a descriptive-analytic study on 430 women of reproductive age who were receiving health services from urban PHC clinics run by Tehran, Beheshti and Iran medical universities. With the help of a questionnaire we gathered data on factors related to reproductive health knowledge and attitude and analyzed the data using x2, OR, Parson correlation coefficients.
Results: Knowledge and attitude was found to be significantly related to education and employment (p<0.00). There was also an association between knowledge and attitude on one hand and husband's education and employment on the other (p<0.00). Age was not found to have an influence on knowledge and practice (p<0.757).
Conclusion: This research shows that education can have a major effect on empowering women to demand and exercise their basic rights, including those related to reproduction and childbearing.
O Faraji , A Pourreza , M Hosseini , M Arab , F Akbari ,
Volume 6, Issue 2 (27 2008)
Abstract
Background and Aim: Job enrichment is a method that has been used to increase employee satisfaction and work motivation. The Hackman and Oldham job characteristics model (1976) has served as the foundation for many job enrichment efforts. In particular, a considerable amount of research has been devoted to the study of the job characteristics-job satisfaction relations. Te purpose of this study was to statistically determine the relation between job characteristics and job satisfaction among employees of hospitals affiliated to Tehran University of Medical Sciences (TUMS) in 2007.
Materials and Methods: This study was a cross-sectional one, including 6 TUMS-affiliated hospitals-Emam, Shariati, Baharlo, Ziaeian, Madaen and Azadi. The sample size was 400, consisting of 200 administrative employees (50%), 151 nurses (38%) and 49 physicians (12%). The random sampling and stratified proportional sampling methods were used to select the hospitals and interviewees, respectively. Two questionnaires were developed and used to identify job characteristics and job satisfaction: 1) job diagnostics surveys (JDS) and 2) Hertzberg's job satisfaction questionnaire. The reliability of the questionnaires was ascertained by test-retest using the Pearson correlation coefficient (r = 0.88). Linear-by-linear association and ordinal logistics regression analysis were used for analyzing the data gathered.
Results:The relations between the Motivational Potential Score (MPS) and job characteristics (except for feedback) with job satisfaction were statistically significant (p<0.05). Task identity was the most effective determinant of job satisfaction.
Conclusion: It appears that all the job characteristics (except feedback) are important determinants of job satisfaction of the hospital employees. Although the work environment is in need of restructuring, it is important to note, from a positive perspective, that the job characteristics discussed in this study are readily amenable to change job satisfaction at the organizational level.
B Ahmadi , S Nasseri , M Alimohamadian , M Shams , Z Ranjbar , M Shariat , A Ebrahimpour , A Pourreza , M Mahmoodi , M Younesian ,
Volume 6, Issue 2 (27 2008)
Abstract
Background and Aim: Domestic violence against women is a major health problem, as well as a violation of human rights. It adversely affects the physical, mental, and social well being of women, families and communities. This phenomenon exists in all countries around the world. Although its prevalence, strength, types, effects, and risk factors are different, it is not limited to any geographical zone or distinct social class. This article presents the views of Tehrani couples and experts on underlying factors causing domestic violence against women in Iran and action to be taken for prevention.
Materials and Methods: This qualitative study was carried out through eight FGD meetings, in 2 days, with the participation of 50 couples. The couples were divided into 8 groups based on sex, education, and history of violence. Results of the FDGs were categorized and analyzed. Data were discussed in group meetings of 50 experts in different fields, such as health, medicine, law, education, and Islamic studies, from academic, policy making, governmental executive, and women's affairs organizations, divided into three groups of community general education and information dissemination, health system, and judiciary system. Results were discussed and finalized in a general meeting.
Results: The couples and experts identified underlying factors in 4 categories socio-cultural, economic, legal, and medical. Actions to be taken for prevention and control were believed to be educational, legal, and supporting services.
Conclusion: On the basis of the findings of this study, it was suggested that strategies/actions/services to solve the problem and reduce harm should include providing appropriate information and education for couples and the community emphasizing the health system responsibility empowering physicians and other health personnel to help women who are victims or susceptible to domestic violence legal transparency and reforms meeting legal needs law reinforcement and implementation providing safe shelters for victims and establishment of a national center for research and planning on violence.
A Pourreza, R Khabiri, M Arab, A Akbari Sari, A Rahimi, A Toll,
Volume 7, Issue 2 (4 2009)
Abstract
Background and Aim: Factors determining the health care-seeking behaviors of an individual are social, cultural, and economic (treatment costs). Utilization of a health care system by a person will, on the whole, depend mainly on the socio-economic and demographic factors, cultural beliefs and practices, gender discrimination and women's status, the economic and political systems, environment, patterns of illness, and the health care system itself. The main objective of the present study was to examine current patterns of health care-seeking behavior in residents of Tehran, Iran in 2007.
Methods and Materials: In a cross-sectional study a two-stage cluster sampling method was used to select neighborhoods at the first stage and households at the second. The sample included a total of 1882 individuals over 18 years old in the households. The data were collected using a questionnaire. For analysis of the data the exact fisher test, X2, and multivariate logistic regression were used the software used was SPAA.3
Results: About 22/9% (431 persons) of the participants reported 1-2 illnesses during the previous month. Multivariate logistic regression indicated that age, sex, perceived severity of the illness, educational level, and marital status were all statistically associated with an attempt to seeking care, whether self-treatment or consulting a health center. The effects of different variables on decisions related to seeking care from a health care center versus self-care were also examined. The data showed that age, sex, perceived severity of the illness, income, educational level, household size, and method of payment were statistically the most significant variables affecting seeking care from a health center.
Conclusion: Based on these findings, it may be concluded that increasing social awareness about side effects of medicines, potential dangers of self-treatment, continuous education and training of physicians and pharmacists, improving health insurance systems and universal insurance coverage will be appropriate strategies for better utilization of health care services by the people.
M Arab, R Khabiri, A Pourreza, J Saeedpour, H Zeraati, A Mohammadnegad,
Volume 7, Issue 2 (4 2009)
Abstract
Background and Aim: Organizational centralization, an important concept/system in management, relates to hierarchy of authority and degree of participation in decision-making. In this study we aimed to determine the extent of organizational centralization in hospitals affiliated with Tehran University of Medical Sciences (TUMS), Tehran, Iran and identify factors affecting the organizational centralization at the level of executive managers.
Methods and Materials: All the managers and head nurses of 13 TUMS hospitals (26 subjects) were included in this cross-sectional study in 2005. Data, collected using questionnaires, were analyzed using the following tests: t-test, ANOVA, Pearson and Spearman, the software being the SPSS. The extent of organizational centralization was categorized into centralized, semi-centralized, and uncentralized.
Results: Five of the 5 variables studied were statistically significantly associated with organizational centralization. They were gender (p=0.001), organizational position (p=0.005), attending management courses (p=0.001), and financial burden of decisions (p=0/03) in the hospital managers group, and possibility of controlling the decision (p=0.014) in the head-nurses group.
Conclusion: The average organizational centralization in the hospitals was 75.38% it was 76.3% and 73.38% for hospital managers and head-nurses, respectively. On the whole, the management system of TUMS hospitals is a semi-centralized system.
A Pourreza, A Barat, M Hosseini, A Akbari Sari, H Oghbaie,
Volume 7, Issue 4 (27 2010)
Abstract
Background and Aim: Previous studies show that disability and mortality due to cardiovascular diseases are closely related to socioeconomic status in a community. The objective of this study was to determine the relationships between socioeconomic factors and coronary artery disease (CAD) among people under 45 years old at Shahid Rajaei Hospital, Tehran, Iran.
Materials and Methods: This case-control study was conducted in Shahid Rajaei Hospital, Tehran, Iran in summer 2008. The participants were 100 CAD cases (<45 years old, mean age = 41.2 years 85% men) and 100 controls from among accompanying persons matched for age and gender. In order to assess the risk of factors related to such variables as educational level, occupation, income, social exclusion, social support, stress, exercise, nutritional status, smoking, etc, odds ratio (95% CI) was used. Multinomial logistic regression was used to assess the synchronic effect of the risk factors, and the t-test was used to find differences between means.
Results: The odds ratio (95% CI) for smoking vs nonsmoking was 3.9 (1.9-7.9) for CAD. Individuals with a low educational level showed an odds ratio of 2.7 (1.9-7-9), compared to those with a high educational level. Eating fruits and vegetables at least seven servings a week has an odds ratio of 2.7 (1.01-7.4) vs eating fewer servings. Occupation, job grade and physical activity had statistically significant relationships with CAD. Mean BMI was different between cases and controls. The disease had no significant association with stress, social support, social exclusion or income.
Conclusion: Smoking, a low educational level and eating small amounts of fruits and vegetables were the most important socioeconomic factors contributing to coronary artery disease. Policymaking and planning aiming at improving the socioeconomic situation of the people, particularly those under 45 years old, seem essential.
A Pourreza, Gh Goudarzi, H Azadi,
Volume 7, Issue 4 (27 2010)
Abstract
Background and Aim: The hospital is considered as the biggest and the most costly unit of a health care system. Therefore, paying full attention to its cost efficiency is very important. The objective of this study was to assess the technical efficiency of hospitals affiliated with Tehran University of Medical Science by data envelopment analysis method.
Materials and Methods: Technical efficiency in hospitals affiliated with Tehran University of Medical Sciences was assessed by Data Envelopment Analysis (DEA) from 1996 to 2006. The input-oriented form of variable return-to-scale (VRS) was used to collect the data using 4 inputs (number of beds, nursing staff, medical personnel, and other personnel) and 4 outputs (outpatient admissions, hospitalized-patient days, bed occupations, and the number of surgical operations performed). The software used for data analysis was Deap 2.1.
Results: The DEA results indicate that: 1.There is a potential to improve the hospital technical efficiency by 3 % (the mean technical efficiency of the hospitals was 0.972) 2. Constant return-to-scale (CRS) exists in the production process, meaning that production in the hospitals is at its optimum level 3. Hospital services have suffered from extra production factors, especially human resources (specifically the nursing staff).
Conclusion: With proper planning, limiting the number of personnel can reduce greatly health care costs and hospital expenditures. It is suggested to conduct studies to determine the effects of the quality of services delivered in hospitals and patient satisfaction on hospital technical efficiency.
Farzaneh Valizadeh, Aziz Allah Batebi, Abolghasem Pourreza, Azadeh Deylami,
Volume 14, Issue 2 (9-2016)
Abstract
Background and Aim: Thalassemia major (ThM) is one of the most common autosomal recessive genetic disorders in the world. Its prevention and control is a priority in the disease prevention programs in the Iranian health system. The ThM screening program (screening at the time of marriage) has been an important step in its prevention in Iran. This study aimed to evaluate this program.
Materials and Methods: This was a descriptive-analytical study in Babosar District consisting of two phases. The first phase was a retrospective descriptive study aiming at finding the background causes of the diseases in subjects under 18 years old (born after March 1997). In phase 2, then, in an interventional analytical study, screening was repeated along with laboratory tests before, or at the beginning of, pregnancy (n = 5500).
Results: Phase 1(cross-sectional descriptive): There were 25 cases of ThM under 18 years old, parents of 15 of whom (60%) had married before 1997 and 4 (16%) had children suffering from ThM (S2). The parents of the remaining 10 (40%) had married after 1997 (S1). Phase 2: Considering the findings of Phase1, an interventional program called thalassemia screening was started in September 2006 including 9750 pregnant or pre-pregnanct mothers. The program led to identifying 20 new beta-thalassemia-carrier couples, including 10 couples married before 1997 and 10 married after 1997 (without official marriage registration, laboratory errors and hemoglobinopathies). All the 20 couples were quickly referred to the Genetic Center, which resulted in prevention of the birth of 4 ThM neonates.
Conclusion: The 9-year intervention (2006-2015) resulted in timely action, preventing birth of 4 thalassemia major babies. Considering incidence of the disease during the previous 9 years (1997-2006), it can be concluded that the before-after randomized clinical trial is an effective way to reduce thalassemia major incidence.
Saeid Ebrahimi, Abolghasem Pourreza, Fereshteh Farzianpour, Abbas Rahimi Foroushani,
Volume 15, Issue 2 (9-2017)
Abstract
Background and Aim: Human resources in any organization are its main capital. They are the only unique asset that are not liable to depreciation over time, but they even create more added value. The Social Security Organization (SCO) as a social insurer organization needs urgent assessment of its human resource management. In this regard, it appears that such an essential assessment can be done using the European Foundation for Quality Management (EFQM) model.
Materials and Methods: This project was an applied descriptive study conducted at the Social Security General Department in Tehran, Iran. The data collection tool was a standard questionnaire for performance assessment based on the EFQM model, the reliability of which (0.989) was determined by using the Cronbach's alpha coefficient. A total of 388 questionnaires were distributed, of which 311 were completed and returned to the researcher; the response rate was 81%. Analysis of the data was done using the SPSS-16 software.
Results: The human resource managers in the SCO achieved a score of 495.72. The empowerment and results dimensions rated 261.34 and 198.38, respectively. In the empowerment dimension, policy and strategy criteria had the highest score (56.12) and process the lowest (51.28), while in the results dimension, community criteria had the highest (50.27) and the customers criteria the lowest (51.18) score.
Conclusion: Based on the findings it can be concluded that the European Foundation for Quality Management (EFQM) model is suitable for assessing both the performance, strengths and weaknesses of the Tehran Security General Department human resources and improving its performance. Certainly better implementation of programs and achieving excellence will be possible through sustainable collaboration.
Ebrahim Jaafaripooyan, Abolghasem Pourreza, Fatemeh Kheirollahi,
Volume 15, Issue 3 (12-2017)
Abstract
Background and Aim: Following the deployment of the Health Transformation Plan (HTP) in most of the public hospitals, various changes occurred in the relationships between insurance organizations and hospitals. The purpose of this study was to find the obstacles and challenges facing the two types of organizations and suggest solutions.
Materials and Methods: This was an exploratory study. The research population was a total of 74 participants from Tehran public, private and military hospitals (managers, senior nursing officers, financial officers, and chiefs of accounting) and basic and complementary insuring organizations (insurance agents in hospitals, insurance officers from insuring organizations, and insurance managers). Data were gathered through semi-structured interviews and analyzed using thematic analysis.
Results: The most important challenges were as follows: acting on one’s own preferences, deductions, delays in the payments of hospital expenditures, an insufficient number of insurance agents in some hospitals, insufficient accountability of hospital personnel in expenditure management, lack of sufficient interaction between the two organizations, and lack of contracts between complementary insurance companies and public hospitals and between private hospitals and basic insurance organizations.
Conclusion: Given the importance and sensitivity of the relations between the health service providers and receivers and considering further the complexity and challenges that appeared after HTP and hospital accreditations, a knowledge of the challenges identified in this research can help policy-makers and managers to find suitable, effective strategies for enhancing relations and communication between insurance companies and hospitals.
Jafar Yahyavi Dizaj, Sara Emamgholipour, Abolghasem Pourreza, Farogh Nommani, Somayeh Molemi,
Volume 16, Issue 3 (12-2018)
Abstract
Background and Aims: Population aging is one of the most important economic, social and health challenges of the twenty-first century. The increasing rate of aging in the population will increase the risk of households being confronted with catastrophic health expenditure (CHE). The purpose of this study was to determine the effect of aging on households' CHE in Iran.
Materials and Methods: The data on household income-expenditure were obtained from the annual Iranian Statistical Center reports for the period 2007-2016. The statistical technique used for data analysis was the regression Logit technique, the software for the final data analysis being the Excel and STATA.
Result: The results showed that increased numbers of elderly people in a household would increase the probability of the household being confronted with CHE. Additionally, the following households were also more likely to be at risk of CHE: urban families; female-headed families; those not owning private homes; those with no income or with an unemployed head; and those in the lower income deciles. Moreover, no insurance coverage would decrease the likelihood of a household to be at risk of CHE.
Conclusion: Considering the findings of this study and the aging of the Iranian population, it is essential that the government, in line with fair financing and reducing the economic burden of health expenditures on households with an elderly member, try, through special support packages for the elderly, to prevent confrontation of such families with catastrophic health expenditures.
Ali Mohammad Mosadeghrad, Abolghasem Pourreza, Fatemeh Yaghubi-Fard,
Volume 16, Issue 4 (3-2019)
Abstract
Background and Aim: Burn injuries cause severe devastating losses and early death. Care and treatment of burns patients is very costly. The purpose of this study was to calculate the economic burden of care and treatment of burn injuries in a hospital in Ahvaz, Iran.
Materials and Methods: This descriptive and cross-sectional study was carried out in 2015 in Taleghani Hospital, Ahvaz, Iran. A total of 315 patients participated in the study. Data was collected, using a valid and reliable questionnaire, through interviews with patients or their relatives on the day of discharge and examining their medical records. Data analysis was done using standard statistical tests and the SPSS (V.22) software.
Results: The mean total cost of care and treatment of an inpatient with burns was 117,071,803.00 Iranian Rials (equivalent to US$ 4,063.00), the mean daily cost being 8,501,946.00 Iranian Rials (equivalent to US$ 295.00). Direct medical costs, direct non-medical costs and indirect costs accounted for 94.1%, 1.4% and 4.5% of the total cost, respectively. The patients’ out-of-pocket payment was 7.7% of the total direct costs. Surgery, drug and diagnosis costs accounted for the largest fraction of the total treatment cost.
Conclusion: The total cost of care and treatment of burns patients in the hospital is very high, imposed on patients, their relatives, government and health insurance companies. The government and insurance companies should provide financial protection to facilitate the process of care and treatment of burns patients.
