Showing 40 results for Hospital
E Jaafari-Pooyan , F Akbari-Haghighi , M Mahmoodi ,
Volume 3, Issue 1 (4-2005)
Abstract
Evaluation assures the success of each project, program or activity. It is one of the most important components of any management process. Because of its high importance, loss of an effective evaluation mechanism in a hospital not only increases costs, but also endangers community health. The current study tries to assess the perceptions and expectations of hospital managers and decision-making boards in Hamedan regarding the evaluation system and to determine gap between them.
This is a cross-sectional study. Its target group in each hospital includes: head, manager, matron, emergency administrator, managers of medical records, laboratory, radiology, pharmacy sections plus the afternoon and night shift supervisors. The study took the form of a census, involving a total of about 400 subjects.The data were collected through a questionnaire and analyzed using the SPSS program .
Findings:
1. The highest levels of target group expectation regarding evaluation indices were related to the “patient safisfaction” index.
2. The highest levels of target group perception of the evaluation indices were related to the “ values and norms” index.
3. All the gaps detected between target group’s perception and expectation from evaluation indices were significant.
4.The highest percentage of difference between target group’s perception and expectation was related to the “staff satisfaction” index and the lowest one was related to the “values and norms” Index.
M Arab , M Tajvar , F Akbari , H Zerati,
Volume 4, Issue 3 (6-2006)
Abstract
Background and Aim: One of the most important responsibilities of managers is leadership. Leadership styles are the constant behavioral models used by managers when working with others in organizations.
The main purpose in this research was gaining an insight into the leadership styles of hospital managers (manager and chief) and to see if there is relationship between managers and employers' personality traits and the style of leadership adopted by the hospital manager.
Materials and Methods: This was a cross-sectional study involving all the hospital managers and 385 hospital staff in the province of Qom. We gathered data through a questionnaire based on the Likert system. We thus recognized four different styles of leadership: Exploitive-Authoritative, Benevolent – Authoritative, Consultative, and Participative. Data were analyzed using the SPSS software package.
Results: 1-Overall, the managers’ leadership styles were found to be mostly of the consultative type but the staff regarded their managers’ style of leadership as mainly Benevolent – Authoritative, 2- There was no statistically significant relationship between the managers’ personal characteristics and their leadership styles, 3- There is a significant association between the staff members’ characteristics and their perception of the manager’s leadership styles.
Conclusion: The managers’ personal traits do not appear to have an effect on their leadership styles but the same traits in employees can have a bearing on how they perceive leadership in their managers.
A Pourreza , Z Kavosi , M Mahmoudi , A Batebi ,
Volume 4, Issue 3 (6-2006)
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.
H Rahmani , M Arab , F Akbari , H Zeraati ,
Volume 4, Issue 4 (7-2006)
Abstract
Background and Aim: Nowadays, community health and different methods for health service delivery are among the most important public health issues in many countries. Most developing nations are trying to establish a health care system capable of meeting their basic needs.Hospitals are the most important service delivery points, and they need skilled manpower and adequate equipment for efficient performance of their medical care and educational functions. Today, the health of the mankind is facing greater hazards and challenges than at any other time in history, and within this context, hospitals are supposed to provide service of the highest standards and with minimum delay. Emergency wards are the sections where these principles apply more than anywhere else. These are rightly regarded as the "heart" of any hospital and a quick, efficient workflow in the emergency room can literally save lives.
Material and Methods: This was a cross–sectional (descriptive/analytic) performed in 2005 to assess the structure, process & performance in the emergency wards of 12 teaching hospitals affiliated to Tehran University of Medical Sciences.
Results: 33.3% of the ward chiefs were women the rest were men they were all more than 30 years of age. The average rate for implementing proper managerial standards was 90.6%. The "manpower index" was 69.1%, and the "facilities & equipment" index was 44/5%. The "directions index" and "activities index" were 66.97% and 93.5%, respectively.
Conclusion: The findings show that there is a positive and significant relationship between standards of management at the emergency department and the facilities and equipment index. Also, there are positive correlations between the emergency department's "manpower and rules" index instructions, activities, and years of service in hospitals.
M Salimi, M Arab, F Akbari, H Zeraati, F Farzianpoor ,
Volume 5, Issue 3 (5-2007)
Abstract
Background and Aim: Hospitals are among the most important health and medical institutions responsible for promoting health, and provision of appropriate health services requires a healthy, hygienic and safe environment. This research was done with the aim of assessing the environmental health situation Qom hospitals in 2005.
Materials and Methods: This research is an applied descriptive - analytic study on hospitals in QOM Province. Data were gathered using survey and observation methods and a two-part questionnaire. The first part of the questionnaire consisted of 45 items covering demographic data on hospitals and hospital managers. The second part comprised 363 questions about the environmental health situation as well as diagnostic, treating and support services. The questionnaires were filled after validity and reliability tests in eight hospitals in Qom Province. For statistical analysis, we performed Mann-Whitney and Kruskal-Wallis tests and calculated Spearman's coefficient, using the software package SPSS.
Results: Poor environmental health was observed in 25% of the radiology wards, kitchens and laundries. The situation was assessed as "appropriate" in 12.5% of laboratories and central sterilization (CSR), 25% of emergency services, 50% of ICU wards and 71% of surgery and recovery rooms, and it was intermediate of the other wards. Overall, the level of compliance with the principles of environmental health was average, i.e. about 72.5 percent. Further analysis of data showed that the situation was better in private, non-teaching hospitals compared to government-run and teaching hospitals. However, environmental health was found to improve with an increase in the number of active hospital beds and the managers' experience in their current job. It declined with increasing hospital age and increasing age of the hospital managers.
Conclusion: Overall, the environmental health situation in Qom hospitals was found to be at an intermediate level. Hence, these hospitals have a long way to go before they can achieve the appropriate level of environmental health
Z Zamanian Ardakani, H Kakooei, M Ayattollahi, Sm Karimian, G Nasle Seraji,
Volume 5, Issue 4 (3-2008)
Abstract
Background and Aim: There are no occupational health data concerning the prevalence of mental disorders in Iranian hospital nurses. Such information may be a prerequisite for efficient occupational mental health interventions. The aim of this study was to determine mental health status among shift work hospital nurses.
Materials and Methods: This paper reports the findings of a cross-sectional survey that was part of a larger quasi-experimental study. We selected and evaluated 1195 nurses in 12 general hospitals in Shiraz (capital of Fars Province), using the 28-item version of the General Health Questionnaire (GHQ). We used structured observations in accordance with an occupational health checklist to assess working environment during the work period.
Results: Results indicated that 28.7% of nurses were in poor mental health. Mental disease was more common among females than males (p<0.05). Prevalence rates for anxiety and somatic symptoms were 42.2% and 35.5% respectively. The prevalence of depression was 11.9% and social dysfunction, 79.5%. There was a significant relationship between shift work and anxiety as well as sleep disorders (p< 0.05). Associations were also found between marital status and depression and between gender and social dysfunction (p< 0.001).
Conclusion: Prevalence figures for mental disorders are similar to those from nationwide surveys but it seems that social dysfunction and anxiety disorders are more common in nurses compared to the general population aged 15 and over. More attention must be paid to the health of shift work nurses (especially female staff). This can take the form of shift work health education programs, occupational health counseling, and periodic examinations.
Sm Hosseini Shokouh, M Arab, A Rahimi, A Rashidian, N Sadr Momtaz,
Volume 6, Issue 3 (2-2009)
Abstract
Background and Aim: Hospital disaster-management planning and preparedness are essential, considering earthquake threats in Iran. The objective of this study was to assess preparedness of hospitals affiliated to Iran University of Medical Science (IUMS) in Tehran against earthquakes in 2007 (1386 Iranian year).
Materials and Methods: This was a cross-sectional, descriptive-analytical study, involving 21 governmental and private hospitals affiliated to IUMS selected by random sampling. Data were gathered using checklists, questionnaires, interviews, and observation. The SPSS software was used for analysis of the data, and the Fisher exact test was employed for statistical analysis.
Results: The data showed that, on the whole, 28.6 %, 61.9 %, and 9.5 % of the hospitals were at a weak, moderate, and good preparedness level, respectively. The hospitals preparedness level with regard to equipment safety and hazardous materials planning increases with their degree of specialization, the association being statistically significant (p = 0.038). The findings also show that there is a significant relationship between the hospital preparedness level (as regards planning for building dangers reduction) and crisis management training courses (p = 0.034).
Conclusion: Training courses are very effective for creating hospital preparedness against earthquakes.
E Teymoorzadeh, A Rashidian, M Arab, A Akbari Sari, M Ghasemi ,
Volume 7, Issue 2 (10-2009)
Abstract
Background and Aim: By providing the greatest amount of direct service to patients, nurses play an extremely valuable and unmatched role in the quality and efficiency of care and curative services. Workplace violence is regarded as one of the factors which can reduce job satisfaction and the quality of working life of nurses and their interaction with patients, as well as the work efficiency of nurses and hospitals. In this study, after translating and validating tools of violence measurement in the health sector, the exposure of nurses to psychological violence was measured in a large teaching hospital in Tehran
Methods and Materials: A descriptive-cross sectional design was used in this study in summer of 2009 (1387). The study population included all the nurses (n=413) working in a large teaching hospital in Tehran. The questionnaire used for collecting data was adopted from a standardized questionnaire designed jointly in 2003 by the International Labor Office, the World Health Organization, the International Council of Nurses, and the Public Services International. Analysis of the data was made using the descriptive statistical methods and the Chi square- and t-tests.
Results: Sixty-nine percent of the nurses had experienced workplace violence. The most common forms of violence were verbal abuse (%64) and bullying-mobbing (%29). On the whole, 26% of the nurses had experienced both forms of violence in the previous year, while 335 had not faced any form of violence in their workplace. Nurses working in outpatient clinics and emergency wards experienced the highest number of encounters with verbal abuse. Encounters with bullying and mobbing were more common among female nurses than the male ones. Overall most of the violent behaviors were committed by patients and their relatives.
Conclusion: Exposure of nurses to psychological violence is considerable and comparable to that reported by previous investigators in other countries. Thus it is highly crucial to adopt appropriate management policies aiming, particularly, at educating the medical personnel in ways of preventing and reporting violent behaviors.
M Arab, R Khabiri, A Pourreza, J Saeedpour, H Zeraati, A Mohammadnegad,
Volume 7, Issue 2 (10-2009)
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.
M Ranjbar Ezatabadi, M Arab , H Zeraati , A Akbari Sari , H Dargahi ,
Volume 7, Issue 3 (10-2009)
Abstract
Background and Aim: Domestic violence against women is a serious public health problem and women adopt different solutions to fight against it. This study was carried out to determine the prevalence of intimate partner violence and views of women
on adopting ways to fight against it in Arak city, Iran, year 2008.
Methods and Materials: In a cross-sectional study in Arak city in 2008, a total of 1037 women were interviewed. The data collected were analysed statistically.
Results: Findings showed that the common types of abuse were emotional (64.6%), verbal (57.1%), financial (32.3%), and physical (26.8%). The women mentioned that the most efficient ways they chose to counteract the abuses were as follows: resuming talking after the settlement of quarrels (93%), keeping silent on the part of one of the partners (81%), and seeking advice from the older members of the family (81%). The considered going into a temporary sulk (51%) and reciprocation (46%) ineffective methods. Correlations were found between violence on the one hand and education, job, addiction of the spouse, income of the spouse, mental disorder of the partner, and number of children on the other hand (p<0.05).
Conclusion: Results of this study show that a large number of women are subjected to different types of violence. It seems that increasing awareness of married women and girls concerning effective counteractive methods can be an effective step in solving this social problem.
A Keshtkaran, F Mohabati, S.p Hedayati, A Roshanfard,
Volume 7, Issue 4 (2-2010)
Abstract
Background and Aim: The most important principles in an organization are continuous development and survival. Nowadays, creativity and innovation are vital for survival in a competitive world. The thinking style of a manager in an organization is an important factor in his/her creativity. The purpose of this study was to investigate the relationship between thinking style and organizational innovation in 84 senior and junior managers of Shiraz educational hospitals in 2008.
Materials and Methods: In this descriptive-analytical study 84 top and mid-level managers of Shiraz teaching hospitals were selected by the census method. Data were collected using two standard questionnaires, one for thinking style and one for innovation, the content validity and reliability of which had been confirmed. A preliminary test showed the Cronbach's alpha for the thinking style and organizational questionnaires to be 0.83 and 0.72, respectively. Data analysis was performed using Spearman correlation test.
Results: The Spearman correlation analysis showed a statistically significant, although weak, relationship between thinking style of senior and junior managers of Shiraz teaching hospitals and their organizational innovation. A pragmatic thinking style had the strongest association with organizational innovation.
Conclusion: The thinking style of a teaching hospital manager plays a vital role in his/her creativity. No thinking style is particularly preferred any thinking style may give desirable results as regards creativity of a manger, depending on the circumstances and conditions.
A Pourreza, Gh Goudarzi, H Azadi,
Volume 7, Issue 4 (2-2010)
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.
A Jonidi, M.r Jafaripour, M Farzadkia,
Volume 8, Issue 2 (9-2010)
Abstract
Background and Aim: Inadequate management of biomedical waste can be associated with risks to healthcare workers, patients, communities and their environment. In this study a comprehensive survey was conducted to obtain information on the management of solid wastes in Qom hospitals.
Materials and Methods: Field visits were made to 2 private and 4 governmental hospitals to collect the required information and weighing the solid wastes generated. In addition, supplementary information was collected using a modified World Health Organization questionnaire.
Results: The results showed total the average generation rate of solid waste in Qom hospitals was 3057.55 kg/day. The shares of general, infectious, sharp, and pharmaceutical and chemical solid wastes were 1523.6, 1520.6, 12.72 and 0.93 kg/day, respectively. The results on various aspects of solid waste management indicate that practices in the hospitals do not comply with the principles stated in the respective Iranian regulations. Similarly, the segregation process was inefficient. No information was available concerning the quantity and quality of solid wastes.
Conclusion: Development of suitable waste management schemes and plans are strongly recommended. In addition, establishing training programs on proper waste management for all the personnel involved (managers, physicians, nurses, workers) are essential. These actions, plus effective supervision, will result in considerable reductions in hospital solid waste disposal cost
M Arab, A Zarei, M Hosseini,
Volume 8, Issue 2 (9-2010)
Abstract
Background and Aim: Patients who consult hospital due to physical or mental damages have legal rights. Observation of patients' rights will result in patient satisfaction, which will help to improve hospital services. The aim of this study was to determine awareness and observation of patient's right in hospitals affiliated with medical universities in Tehran.
Materials and Methods: This was a cross-sectional study conducted in 2009 in hospitals affiliated with medical universities in Tehran. A total of 601 patients were randomly selected from 11 hospitals affiliated with three medical universities in Tehran. Data were collected using a 50-item questionnaire the validity and reliability of which had been confirmed. Chi-square and Kruskal-Wallis tests were used for statistical analysis. The software used was SPSS.17.
Results: The mean age of the patients (59% females and 41% males) was 43.3 (SD=18.5) years and the average length of hospitalization 7.1 (SD=7.4) days. Data analysis showed that the proportions of the patients with a poor, intermediate and desirable patients' rights awareness were 71.5%, 22.0% and 5.8%, respectively. Observation of patients' rights was good in 13.8% of the cases, medium in 82.9% of the cases and poor in 3.3% of the cases. There was a significant statistical relationship between observation of patients' rights on the one hand and the hospital ward and length of stay on the other hand (p=0/007). Further analysis of the data showed that the strongest and the weakest observed rights were patient awareness right and the right of making objections and lodging complaints, respectively.
Conclusion: The results of this study showed that patients are not well aware of patients' rights and that observation of patient's rights is not at a desirable level. We recommend organizing public educational programs including components on patients' rights and follow-up of patient' rights violations, as well as passing a comprehensive act to ensure observation of patients' rights and specific programs designed for monitoring and supervising it.
Sh Tofighi, M.r Maleki, M Shahabi, M Delpasand, A Nafis,
Volume 8, Issue 3 (9-2010)
Abstract
Background and Aim: Inequality in the distribution of hospital recourses is a great obstacle in planning and provision of health care. This inequality in mainly observed in the government hospitals in a country. The objective of the present study was to determine the distribution of specialized physicians and active beds in the Iranian government hospitals between 2001 and 2006
Materials and Methods: The method used in the study was retrospective, descriptive- analytical. The data were analyzed (Lorenz Curve and Gini index estimation), using the Excel Software.
Results: Based on the Gini coefficient, the distribution of specialized physicians during the 5-year period (2001-2006) was 0.0876, 0.0874, 0.0909, 0.0329, 0.0951, and 0.0520, respectively. The corresponding figures for active beds were 0.024, 0.0171, 0.0208, 0.0251, 0.0212, and 0.084.
Conclusion: The findings of the study indicate that, in spite of differences in the proportions of specialized physicians and active beds among the provinces with regard to their populations, the distributions in the government hospitals have been equitable. The results of this study can provide useful insights for the country's Health Ministry policy-makers.
R Ravangard, M Arab, A Rashidian, A Akbarisari, A Zare, M Salesi, H Zeraati,
Volume 8, Issue 3 (9-2010)
Abstract
Background and Aim: Length of stay (LOS) in a hospital is one of the best hospital indicators that can be used for various purposes. In this survey, we studied the hospital LOS and its associated factors in Tehran University of Medical Sciences Women's Hospital (a teaching hospital) in Tehran using the Cox proportional hazards semi parametric model and compared the results with the results obtained using the multiple linear regression.
Materials and Methods: This was a descriptive-analytical study in which we reviewed 3421 files of inpatients hospitalized in, and those discharged from, the oncology, surgery and obstetrics units in 2008. The required data were collected using a data collection sheet and inpatient interviews. A P<0.05 was considered statistically significant.
Results: The median of patients' LOS in the hospital was 50.8 hours, that in the obstetrics, surgical and oncology units being 48.5, 54.4 and 94.2 hours, respectively. Of all the patients, 2632 (76.9%) had been discharged with a recovery status and the rest (23.1%) with a no-recovery status. Results of the Cox proportional hazards model showed that the following variables had increased LOS: a distance longer than 200 km between a patent's residence and the hospital, hospitalization in the surgery and oncology units, admission on a Thursday, admission by an internist, hospitalization for neoplastic, endocrine, nutritional, or genitourinary system diseases (P<0.005), as well as a high number of diagnostic laboratory tests, radiographies or sonographies (P<0.001). Patients admitted and hospitalized as an emergency case had a shorter LOS (P<0.001) than others. On the other hand, based on the multiple linear regression model results, some occupations (being a worker, a farmer, a stockbreeder, or a retired spouse) admission on a Thursday, (The first day of the weekend in Iran), suffering from a neoplastic disease, and a high number of diagnostic tests or radiographies or sonographies increased, and admission by a resident decreased, patients' LOS (P<0.05).
Conclusion: Considering having censored data, the Cox proportional hazards model is a more suitable model than the multiple linear regression models for identifying factors influencing patients' LOS in a hospital. From among the LOS Cox model's associated factors as identified in this study, policy-makers and managers can only change admission days and the number of diagnostic tests. That is to say, they should try to prevent admission on a Thursday (unless emergency cases) and also perform the required primary diagnostic tests before admitting a patient into the hospital, which would lead to a more effective utilization of hospital beds and other resources.
F Radfar, Mj Hozoori, S.s Tavafian,
Volume 9, Issue 1 (8-2011)
Abstract
Background and Aim: The objective of this study was to determine and compare the attitude of hospital staff and practice of hospital managers regarding management of conflicts in hospitals affiliated to Tehran University of Medical sciences.
Materials and Methods: The participants in this cross-sectional study were 330 individuals, including 300 nurses and 30 managers, working in hospitals affiliated to Tehran university of Medical Sciences, Tehran, Iran during 2008-2009. Data were collected using a valid self-administered questionnaire containing 30 questions designed by the investigator. The SPSS software was used for data analysis.
Results: The data show that 178 of the staff (59%) and 14 of the managers (47%) were of the opinion that avoidance is not utilized in conflict management. The proportions of the staff and managers believing that problem solution is not utilized in conflict management were 60% and 60%, respectively the corresponding proportions as regards not utilizing avoidance were 178% and 14%. Furthermore, 40% of the staff and 13% of the managers thought that usually compromise is utilized in conflict management. Finally, the proportions of staff and managers who thought that in conflict management accommodation is utilized were 41% and 43%, respectively.
Conclusion: The findings show that the hospital staff believes that hospital managers with an avoidance, problem solution or forcing attitude base their conflict management style accordingly, while managers more inclined to compromise do not utilize a compromising approach in practice.
Azar Hadadi, Mehrnaz Rasoulinezhad, Saeed Jamali, Seyed Ahmad Seyed Ali Naghi, Kousha Paydari, Mohammad Ali Boyer, Esfandiar Shojaie, Alireza Soleymani, Sirous Faraji, Saeed Kalantari, Samaneh Bayrami, Mostafa Hosseini,
Volume 9, Issue 3 (3-2012)
Abstract
Background and Aim: The aim of this study was to assess the adherence to anti-retroviral prophylaxis after occupational and non-occupational exposure to human immunodeficiency virus (HIV) in patients consulting the Voluntary Counseling and Testing Center (VCT) of Imam Khomeini Hospital, Tehran during the period 2008 to 2009.
Materials and Methods: In this prospective study, patients were selected, the required information about them was recorded, and adherence to anti-retroviral drugs (including Ziduvudin, Lamivudin and Efavirens) was determined based on self-report by the patients. Eighty-nine exposed patients were followed monthly for 4 months, and in the case of low-adherence (less than 95%) they were asked for the reason(s) for noncompliance.
Results: Of the 89 patients, 55 were men (61.8%) and 34 (38/2%) were women with a mean age of 30.16± 8.39 years 47 participants (52.8%) were single and 42 (47.1%) married 27 subjects (30.3%) were physicians, 35 (39.3%) nurses and 27 (30.3%) had occupations outside the healthcare system. From among the 36 subjects (40.5%) who stopped the treatment, 24 (27.0%) stopped it correctly (that is, when the serological test proved to be negative), while 12 (13.4%) did not stop it on a sound basis. Fifty-three subjects (59.6%) completed the prophylaxis. Adherence was found to be significantly associated with age and marital status (p<0.05).
Conclusion: The main reason for stopping the prophylaxis (a negative serological test result of the resource patient) was more pronounced than previous studies, which indicates the higher availability of the resource patient.
Marzieh Javadi, Saeed Karimi, Ahmadreza Raiesi, Maryam Yaghoubi, Asadollah Shams, Maryam Kadkhodaie,
Volume 9, Issue 4 (3-2012)
Abstract
Background and Aim: Responsiveness is of extreme importance in every health system, especially for policy-makers and health managers. Responsiveness relates to how the health system responds to legitimate expectations of the patients regarding non-clinical aspects of health care. Furthermore, justice in an organization requires fair treatment of the patients on the part of the health personnel. In other words, organizational justice relates to how to treat the personnel so that they feel they are treated fairly. The objective of this study was to investigate the responsiveness of hospital as perceived by patients and nurses and the relationship between the responsiveness rate and organizational justice as perceived by nurses in the hospitals.
Materials and Methods: This was a descriptive-analytical study aiming at determining the correlation between responsiveness and organizational justice in 8 elected hospitals (4 private and 4 public) in Isfahan, Iran. The study population was patients and nurses. A total of 320 individuals (160 patients and 160 nurses), selected by stratified random sampling, participated in this study. Two questionnaires, namely the adjusted WHO Responsiveness Questionnaire (for patients and nurses) and the Equity Questionnaire (for nurses), the validity and reliability of both of which had been determined, were used to collect data. The software used for data analysis was SPSS
Results: The overall score (out of 4) of organizational justice was 1.9 0.77, while the mean score of responsiveness as perceived by the nurses and the patients was 2.32 0.54 and 2.48 0.58, respectively. There was no statistically significant difference between the 2 groups with regard to responsiveness, but there was a positive association between responsiveness and organizational justice as perceived by nurses (r = 0.2, p = 0.03).
Conclusion: The variables in the hospitals studied are generally at an intermediate level and there are no statistically significant differences between private and public hospitals. There is no difference in organizational justice between private and public hospitals, but responsiveness is higher in private hospitals as compared to public ones. Thus, the public sector needs to attempt to create more incentives in health professionals in the health sector in order to guarantee higher-quality services and better responsiveness.
Hamid Sepehrdust, Elham Rajabi,
Volume 10, Issue 3 (1-2013)
Abstract
Background and Aim: Hospitals as one of the major institutions providing health care services within the health sector utilize a high percentage of the sector's key resources to respond to the needs of consumers. The aim of the present study was to identify factors affecting technical, scale and management efficiency of the Social Security Organization (SSO) hospitals during the period 2007-2009 and find ways to improve the efficiency of inefficient hospitals.
Materials and Methods: A total of 65 SSO hospitals active during the period 2007-2009 were included in the study. Data envelopment analysis was used assuming constant return to scale of production (CRS). To distinguish between management and scale efficiency of hospital units, the study used input-oriented model (BCC) assuming variable return to scale (VRS).
Results: The findings showed that small hospitals with less than, and large hospitals with more than, 100 active beds have 11% and 8.8% surplus inputs, respectively, the surplus inputs being medical and nursing staff, other personnel, as well as active beds for hospital services. In addition, the impact factors of medical staff, nursing staff, other personnel, and active beds were 24%, 9.8%, 11.7% and 16.8% for small hospitals' efficiency and 25.7%, 18%, 21.7% and 30.7% for large hospitals' efficiency, respectively..
Conclusion: Considering the average scale and management scores derived for efficiency measurement, it is recommended that the Social Security Organization hospitals reduce their surplus costs and increase their output products and services to achieve the optimum level of efficiency.
