در هنگام جستجو کلمه در قسمت عنوان میتوانید کلمات مورد جستجو را با کاراکتر (-) جدا کنید.
کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Nursing and Midwifery Studies
- نوع مقاله: Journal Article
- کلمات کلیدی: Nurses,Hospitals,Social Justice,Health Manpower,General Practice
- چکیده:
- چکیده انگلیسی: Background Justice has gained much attention in social and human studies and has many consequences on employees and the organizations, especially on health system workers such as nurses who are among the key factors in health care systems. Objectives The purpose of this study was to investigate perception of organizational justice among nurses in educational hospitals of Shiraz University of Medical Sciences (SUMS), and to compare the results of general and specialty hospitals. Materials and Methods In this research, 400 nurses at SUMS hospitals were selected by random sampling method. A 19-item questionnaire was applied to measure distributive, procedural and interactional justice. Data analysis was performed using descriptive statistics, including percentage, frequency, mean, and standard deviation. Also, the t-test and one way ANOVA were used to measure the differences between different hospitals and wards. Results Of 400 nurses, 66% perceived a high level of organizational justice. In this study the mean scores of total perceived organizational justice (P = 0.035), procedural justice (P = 0.031), and interactional justice (P = 0.046) in specialty hospitals were higher than general ones. Furthermore, the mean score of interactional justice was higher than the other components of organizational justice, respectively 3.58 ± 1.02 for general and 3.76 ± 0.86 for specialty hospitals. Significant differences were observed between overall perceived justice (P = 0.013) and its components (P = 0.024, P = 0.013, and P = 0.036) in different wards. Conclusions Most nurses who participated in this study had a high perception of organizational justice. The mean score of organizational justice was higher in specialty hospitals. Health care policy makers and hospital managers should support their employees, especially nurses through fairness in distributions, procedures, and interactions.
- انتشار مقاله: 11-10-1348
- نویسندگان: Nahid Hatam,Mozhgan Fardid,Zahra Kavosi
- مشاهده
- جایگاه : پژوهشی
- مجله: Journal of Health Management and Informatics
- نوع مقاله: Journal Article
- کلمات کلیدی: Efficiency,Hospital,Delphi,Indicator,Fuzzy Analytic Hierarchical Process
- چکیده:
- چکیده انگلیسی: Background/Objectives: Selecting the best set of input and output indicators and allocation of correct weights to them is a sensitive step in any efficiency evaluation study. Therefore, the present study aims to determine and rank the efficiency indicators of hospitals.
Method: This mixed-method study was carried out in three steps: comprehensive literature review, application of the Delphi method to determine the best indicators for efficiency evaluation of the hospitals, and utilization of a fuzzy analytic hierarchical process (FAHP) for weighting of final indicators and ranking them.
Results: 8 input and 9 output indicators were selected for efficiency evaluation of the hospitals which were weighted by FAHP. Among the input indicators, the number of physicians and active beds and among the output indicators, length of stay and number of surgeries were identified to be the most important indicators.
Conclusion: According to the proposed indicators and their accurate weights, efficiency evaluation of hospitals can be done more accurately, reliably, and comprehensively.
- انتشار مقاله: 31-03-1399
- نویسندگان: Tahereh Shafaghat,Mohammad Kazem Rahimi Zarchi,Nahid Hatam,Zahra Kavosi
- مشاهده
- جایگاه : پژوهشی
- مجله: Journal of Health Management and Informatics
- نوع مقاله: Journal Article
- کلمات کلیدی: Logistic models,Health Financing,Supplementary Health Insurances,None for Profit Insurance
- چکیده:
- چکیده انگلیسی: Introduction: One of the most reliable sources of financing healthcare costs is health
insurance. Covering all the services by basic health insurance is not affordable economically, so that some services are covered by supplementary health insurances. This study aimed to determine the factors influencing buying the different levels of Kowsar supplementary health insurance by the staff of Shiraz University of Medical Sciences in 2014-2015.
Methods: This is a cross-sectional study. Two data collection forms were used to collect the
data. A sample size of 500 was determined using the rule of thumb. The individuals were
selected via using two-stage stratified and systematic sampling. To do the estimation, the
ordinal logistic regression model (link function was logit) was specified by the one-sided
significant variable tests at the first step. Then, the independent variables were examined by the link test, and the linear relationship among variables was also investigated. The software Excel 2010 and STATA 11.0 (stata corp LLC) were used in this paper.
Results: The findings showed that among the people with supplementary insurance, the
majority were males (60%), married (85%), with the basic Tamin Ejtemaei insurance (72.3%). Among those who have not chosen the supplementary health insurance, the largest number were women (69%), unmarried (53%), and insured by Tamin Ejtemaei (80%), respectively. The findings suggest that some factors such as the age, gender, income and cost of insurance packages are the most influential factors on buying different levels of health care insurance. In the first model that included people with supplementary insurance, the income elasticity was significant and positive (Beta=3, P=0.047) and price elasticity of demand was negative (Beta=-0.06, P=0.001). In the second model that complemented those with and without supplementary insurance, the income elasticity was insignificant (Beta=2.46, P=0.085), and the demand price elasticity was negative (Beta=-0.06, P=0.001).
Conclusion: The economic factor seems to be the most influential factor in choosing
supplementary insurance. Since this problem causes the low-income households not to use
the insurance; therefore, the government is required to allocate some subsidies for low income household to be covered by supplementary health insurance for special services.- انتشار مقاله: 04-02-1398
- نویسندگان: Zahra Kavosi,Effat Norouz Sarvestani,Najmeh Bordbar,Mohsen Bayati,Farhad Lotfi
- مشاهده
- جایگاه : پژوهشی
- مجله: Journal of Health Management and Informatics
- نوع مقاله: Journal Article
- کلمات کلیدی:
- چکیده:
- چکیده انگلیسی: Introduction: The family physician referral system has been determined as a major goal to economic, social, and cultural development in the field of health in Iran. The necessity of implementing this system has been explicitly stated in high-level documents. Hence, the aim of this study was to evaluate the overall performance of the referral system in Fars Province in 2015.Methods: In this cross-sectional study, 20% of family physicians (75 doctors) were randomly selected; then, all patients of these physicians (1289 patients) in one work shift were studied. The data were collected in three parts containing the questions related to the physician and patients using data collection forms. Finally, data analysis was performed through SPSS, version16, using descriptive statistics and Chi-square test.Results: The results showed that 70.3% of the patients (906 patients) had used the referral system to visit specialists. Most of the referral forms had been completed correctly (63.6%). Most of the referrals (820 cases) were recognized as necessary (59.4%) and from the first level of referral, i.e. by the family physician (96.3%: 1241 cases). The patients aged 70 and over had the minimum self-referrals, whereas young people aged lower than 20 had the maximum selfreferrals (P=0.03). Also, more self-referrals were observed among highly educated patients (P=0.001).Conclusion: Based on the findings, the most important problems of the referral system included self-referrals, incomplete referral forms, and unnecessary referrals. Self-referral could be solved through education, establishment of an electronic referral system, and legal measures. Also, educating doctors, making an electronic referral system, and using auxiliary staff and incentive measures can reduce the incompleteness of the referral forms. To reduce the patients’ unnecessary referrals, development of referral guidelines might be very effective.Keywords: Family physician, Referral, Practice management
- انتشار مقاله: 10-04-1397
- نویسندگان: Zahra Kavosi,Elham Siavashi
- مشاهده
- جایگاه : پژوهشی
- مجله: Journal of Health Management and Informatics
- نوع مقاله: Journal Article
- کلمات کلیدی:
- چکیده:
- چکیده انگلیسی: Introduction: Identification of the factors related to the employee’s job stress is very important in any organization, so in this study we investigated these factors by meta-analysis.Methods: In this study, we searched the terms “job-related stress”, “employees’ job stress”and found 637 articles among seven English and five Farsi databases. After reviewing andscreening these articles, sixty-three articles were finally selected. The selection criteria werebased on the surveys which had investigated the correlation between job-related stress andother variables; also, just the variables that were investigated in more than four studies were included in this meta-analysis. The meta-analysis was calculated based on the correlation coefficients integrated with job-related stress and sample size by Stata 11 software, using Rosenthal-Robin method.Results: The meta-analysis results suggested that seven variables had a significant relationship with the employees’ job-related stress (P<0.001). By increasing the workload, role conflict, role ambiguity, work-family conflicts, and total working hours per week increased the employees’ job stress, and conversely increased job satisfaction decreased the employees’ job stress; also, women were more exposed to job stress.Conclusion: Organizations should pay more attention to time management training; thestaff benefits from these skills and can use them in their business affairs and organize largevolumes of work and work-family conflicts in order to reduce the impact of these stressorsto a large extent. Also, description of the tasks that the employee is only obliged to carry out should be established.Keywords: Occupational stress, Job stress, Organization, Meta-analysis
- انتشار مقاله: 09-07-1397
- نویسندگان: Zahra Kavosi,Habibollah Ranaei Kordshouli,Maryam Zare Saadabadi,Azime Ghorbanian
- مشاهده
- جایگاه : پژوهشی
- مجله: Journal of Health Management and Informatics
- نوع مقاله: Journal Article
- کلمات کلیدی:
- چکیده:
- چکیده انگلیسی: Introduction: Patient satisfaction is crucial to the long-run success in health care center. With regard to the highest patients’ referral to the emergency department and the existing challenges due to the patient’s need to urgent care, we aimed to evaluate health care services quality in this unit to find out whether the patients have different expectations from health care providers and if they perceive some dimensions of care more important than others.Method: The SERVQUAL scale method was used in this cross-sectional study on 100 patients in June 2015. Patient satisfaction questionnaire based on SERVQUAL model was evaluated with high content validity and the reliability was 0.97 and 0.81. The data collected were analyzed using SPSS, version 20.0 (IBM, USA). Statistical analyses included descriptive statistics, paired and independence sample t-test and ANOVA at the significance level 0.05.Results:The results showed that the quality gap in all dimensions was significant (P<0.001). The largest quality gap was related to responsiveness (-1.08) and the lowest belonged to assurance (-0.8). Demographic characteristics were analyzed and the number of referrals was significant in tangibility and assurance dimensions (P = 0.04); also, in all cases the patients’ expectations (total Mean=4.35) were higher than their perception (total Mean = 3.295).Conclusion: In order to improve emergency services, it is recommended that the hospital management should provide appropriate facilities, reduce waiting time, increase in attention to ordering system based on the patients’ condition, and improve the behavior of health care personnel to patient is placed on the agenda of hospital management.Keywords: Management, Quality of service, Emergency department, SERQUAL model
- انتشار مقاله: 10-07-1395
- نویسندگان: Maryam Gholami,Zahra Kavosi,Marziye Khojastefar
- مشاهده
- جایگاه : پژوهشی
- مجله: Journal of Health Management and Informatics
- نوع مقاله: Journal Article
- کلمات کلیدی:
- چکیده:
- چکیده انگلیسی: Introduction: Performance measurement is receiving increasing verification all over the world. Nowadays in a lot of organizations, irrespective of their type or size, performance evaluation is the main concern and a key issue for top administrators. The purpose of this study is to organize suitable key performance indicators (KPIs) for hospitals’ performance evaluation based on the balanced scorecard (BSC).Method: This is a mixed method study. In order to identify the hospital’s performance indicators (HPI), first related literature was reviewed and then the experts’ panel and Delphi method were used. In this study, two rounds were needed for the desired level of consensus. The experts rated the importance of the indicators, on a five-point Likert scale. In the consensus calculation, the consensus percentage was calculated by classifying the values 1-3 as not important (0) and 4-5 to (1) as important. Simple additive weighting technique was used to rank the indicators and select hospital’s KPIs. The data were analyzed by Excel 2010 software.Results: About 218 indicators were obtained from a review of selected literature. Through internal expert panel, 77 indicators were selected. Finally, 22 were selected for KPIs of hospitals. Ten indicators were selected in internal process perspective and 5, 4, and 3 indicators in finance, learning and growth, and customer, respectively.Conclusion: This model can be a useful tool for evaluating and comparing the performance of hospitals. However, this model is flexible and can be adjusted according to differences in the target hospitals. This study can be beneficial for hospital administrators and it can help them to change their perspective about performance evaluation.Keywords: Hospital, Balanced scorecard, Performance, Indicator
- انتشار مقاله: 09-10-1395
- نویسندگان: Hamed Rahimi,Zahra Kavosi,Payam Shojaei,Erfan Kharazmi
- مشاهده
- جایگاه : پژوهشی
- مجله: Journal of Health Management and Informatics
- نوع مقاله: Journal Article
- کلمات کلیدی:
- چکیده:
- چکیده انگلیسی: Introduction: Intraoperative radiation therapy device (IORT) is one of the several options for partial breast irradiation. IORT is sent to the tumor bed during surgery and can be replaced with conventional standard therapy (EBRT). The aim of this study was to evaluate the safety and effectiveness of IORT machine compared with EBRT and to determine the dominant option in terms of the cost-effectiveness.Method: This study was conducted in two phases; the first phase was a comprehensive review of the electronic databases search that was extracted after extraction and selection of the articles used in this article on effectiveness outcomes. Data collection form was completed by professionals and experts to estimate the cost of treatment, intraoperative radiotherapy and radiotherapy cost when using external radiation therapy process; direct costs were considered from the perspective of service provider and they were calculated in the second phase to determine the option of cost-effective ICER. Excel software was used for data analysis and sensitivity analysis was performed to determine the strength of the results of cost-effectiveness.Results:18 studies were selected but only 8 of them were shown to have acceptable quality. The consequences like “rate of cancer recurrence”, “seroma”, “necrosis”, “toxic”, “skin disorders and delayed wound healing” and “spread the pain” were among the consequences used in the selected articles. The total costs for each patient during a course of treatment for EBRT and IORT were estimated 1398 and $5337.5, respectively. During the analysis, cost-effectiveness of the consequences of cancer recurrence, seroma, necrosis and skin disorders and delayed wound healing ICER was calculated. And IORT was found to be the dominant supplier in all cases. Also, in terms of implications of toxicity and prevalence of pain, IORT had a lower cost and better effectiveness and consequently the result was more cost effective than EBRT.Conclusion: According to the results of this study, the difference between the two devices in terms of effectiveness was much lesser than that in terms of the cost of the two devices. According to the results of IORT machine, it is the dominant supplier compared with EBRT. From the cost-effectiveness perspective, Iran Ministry of Health can consider IORT system as an option for entering Iranian health system. But the ethical and cultural considerations in the use of the device must be taken into account.Keywords: Health technology assessment, IORT, EBRT, Cost-effective analysis, Systematic review
- انتشار مقاله: 24-12-1394
- نویسندگان: Hedie Mosalanezhad,Zahra Kavosi,Khosro Keshavarz,Majid Akrami,Maryam Sarikhani
- مشاهده
- جایگاه : پژوهشی
- مجله: Journal of Advances in Medical Education and Professionalism
- نوع مقاله: Journal Article
- کلمات کلیدی:
- چکیده:
- چکیده انگلیسی: Introduction: The application of organizational ethics in hospitalsis one of the novel ways to improve medical ethics. Nowadaysachieving efficient and sufficient ethical hospital indicators seemsto be inevitable. In this connection, the present study aims todetermine the best indicators in hospital accreditation.Methods: 69 indicators in 11 fields to evaluate hospital ethicswere achieved through a five-step qualitative and quantitativestudy including literature review, expert focus group, Likert scalesurvey, 3 rounded Delphi, and content validity measurement.Expert focus group meeting was conducted, employing NominalGroup Technique (NGT). After running NGT, a three roundedDelphi and parallel to Delphi and a Likert scale survey wereperformed to obtain objective indicators for each domain. Theexperts were all healthcare professionals who were also medicalethics researchers, teachers, or Ph.D students. Content validitymeasurements were computed, using the viewpoints of twodifferent expert groups, some ethicists, and some health careprofessionals (n=46).Results: survey, 11 main domains were listed including:Informed consent, Medical confidentiality, Physician-patienteconomic relations, Ethics consultation policy in the hospital,Ethical charter of hospital, Breaking bad medical news protocol,Respect for the patients’ rights, Clinical ethics committee,Spiritual and palliative care unit programs in the hospitals,Healthcare professionals’ communication skills, and Equitableaccess to the healthcare. Also 71 objective indicators for these 11domains were listed in 11 tables with 5 to 8 indicators per table.Content Validity Ratio (CVR) measurements were done and 69indicators were highlighted.Conclusion: The domains listed in this study seem to be themost important ones for evaluating hospital ethics programsand services. Healthcare organizations’ accreditation andranking are crucial for the improvement of healthcare services.Ethics programs would also motivate hospitals to improvetheir services and move towards patients’ satisfaction. In thisregard, more involvement of bioethicists can help healthcareorganizations to develop ethics programs and ensure ethicsbasedpractice in hospitals.Keywords: Hospital; Ethics; Accreditation; Evaluation
- انتشار مقاله: 09-04-1394
- نویسندگان: SEYED ALI ENJOO,MITRA AMINI,SEYED ZIAADIN TABEI,ALI MAHBUDI,ZAHRA KAVOSI,MAHBOOBEH SABER
- مشاهده
- جایگاه : پژوهشی
- مجله: Iranian Journal of Medical Sciences
- نوع مقاله: Journal Article
- کلمات کلیدی: Iran,Health Status Indicators,health resource ,Distribution
- چکیده:
- چکیده انگلیسی: The importance of health indicators in the recent years has created challenges in resource allocation. Balanced and fair distribution of health resources is one of the main principles in achieving equity. The goal of this cross-sectional descriptive study, conducted in 2010, was to classify health structural indicators in the Fars province using the scalogram technique. Health structural indicators were selected and classified in three categories; namely institutional, human resources, and rural health. The data were obtained from the statistical yearbook of Iran and was analyzed according to the scalogram technique. The distribution map of the Fars province was drawn using ArcGIS (geographic information system). The results showed an interesting health structural indicator map across the province. Our findings revealed that the city of Mohr with 85 and Zarindasht with 36 had the highest and the lowest scores, respectively. This information is valuable to provincial health policymakers to plan appropriately based on factual data and minimize chaos in allocating health resources. Based on such data and reflecting on the local needs, one could develop equity based resource allocation policies and prevent inequality. It is concluded that, as top priority, the provincial policymakers should place dedicated deprivation programs for Farashband, Eghlid and Zaindasht regions.
- انتشار مقاله: 24-03-1394
- نویسندگان: Nahid Hatam,Shahnaz Kafashi,Zahra Kavosi
- مشاهده