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Background: Perceived organizational justice is a concept used to describe job-related justice. Considering the role of perceived organizational justice in the healthcare system to increase the satisfaction, motivation, and efficiency in providing quality services, this study was conducted to investigate the situation of perceived organizational justice in the Iranian healthcare system through systematic review. Methods: In the present study, an electronic search was conducted on the Persian websites SID, Iranmedex, Medlib, civilica, Irandoc and English Web of science, Pubmed, Scopus, and Google scholar using the Persian and English keywords of ‘Justice, Equality, Equality, Organizational Justice, Perceived Justice, Health System, University of Medical Sciences, Health Centers, Hospitals. As a result, 520 articles were studied and evaluated step by step and 469 papers were removed after reading the title and abstract. Finally, the full text of 51 articles was reviewed. Finally, 30 articles that measured the average level of perceived organizational justice were selected and other articles were excluded due to lack of necessary criteria and irrelevance. To analyze the heterogeneity between the studies, the meta-analysis method was used using Stata 14 software and Q test and I2 index. Results: To study the status of perceived organizational justice in the health care system in a systematic and meta-analysis, all 30 studies were illegible. With regard to the dimensions of distributive, procedural, and interactive justice, 23 studies of 30 studies had the required conditions to enter the research. The total mean score of perceived organizational justice was obtained as 60.71 and the mean scores of 54.74, 58.52, and 62.41were calculated for dimensions of distributive, procedural, and interactive justice, respectively. Conclusion: The findings showed that the situation of perceived organizational justice in the Iranian health care system was favorable. The dimension of interactive justice, related to managers' behaviors and relationships with employees, was relatively more favorable than other dimensions of organizational justice. Moreover, the situation of perceived organizational justice and its dimensions in private hospitals was more favorable than other research environments, including public hospitals, staff units, and hospitals selected using the mixed method.

Introduction: In order to achieve the highest level of effective interaction between the insurance organizations and the health system, efforts should be made to identify existing communication challenges for policymakers and decision makers. The present study was conducted to identify interactive behaviors aimed at designing an insurance mechanism based on game theory to cover the existing gaps. Methods: This study consisted of two phases of qualitative and quantitative. In the qualitative phase, data were collected and classified by a semi-structured interview with a number of insurance professionals in insurance organizations and the health system. In the quantitative phase of the study, interactive behaviors between the two organizations were studied. Finally, with the help of Gambit software, the insurance mechanism was designed. Results: In the qualitative phase, the data were collected in three main categories: behavioral and communicative, structural and financial and deductibles and 11 sub-categories. In the quantitative phase, 35 optimal interactive behavioral strategies were delineated. Conclusion: The best behavioral strategy for interaction between insurance organizations and health system, to fill gaps in insurance system and to improve the interaction between the two organizations, was introduced in the form of 35 strategies to provide an insurance mechanism.

ObjectiveOne of the fundamental goals of health sector evolution plan (HSEP) in Iran is to improve household’s financial protection against catastrophic health expenditure (CHE). The aim of this study was to calculate the percentage of CHE after implementing the plan and compare that with CHE before the plan at the same households.MethodsThe data was collected through face-to-face interview during a single visit. The World Health Survey (WHS) questionnaire was completed by 400 households. The relationships between CHE and variables were examined by the Fisher exact tests, and the impacts of variables on CHE were assessed by logistic regression model.ResultsThe exposure of the households to CHE increased from 8.2% in 2011 to 14.25% in 2020, and percentage of the impoverished households due to health expenditures in 2020 was more than that in 2011(4.3% vs. 7.5%). The economic status, dental services and inpatients services were the key factor determining CHE. The most important determinant affecting the exposure to CHE was dental service utilization in 2011(92.64) and 2020(122.68).ConclusionThe results showed a negative incremental change for the households facing CHE in this period. The dental and inpatients services, as well as the presence of member ≥65 years and economic status were the key determining factors for CHE. The services need to be more widely covered by the basic health insurance and households having members ≥65 years and the poor households should be exempted from paying some of the healthcare expenditures for improving financial protection against CHE.

Background: Reflection has been extensively used in different areas for better thinking about previous experiences and reaching to new behaviors, which leads to an improvement in personal skills and knowledge. Reflection ability is one of the most essential competencies for healthcare professionals and medical students, which is emphasized in several medical courses and references. This ability is improved with practice and repetition. Therefore, reflection in medical education is very important. Thus the aim of the present study was evaluation of reliability and validity of the tool for assessing this skill and determination of reflection ability level of health care management students. Methods: The present descriptive and cross-sectional research, performed in two phases. The study population were 30 students of health care management. In the first phase, after the translation of the questionnaire, the reliability and validity of the questionnaire was determined. In the second phase and for evaluation of reflection ability level in health care management students, the Groningen Reflection Ability Scale questionnaire was completed by students and data analyzed with independent t-test and Pearson correlation statistical tests. Results: The reliability and validity of the questionnaire were confirmed (Cronbach's alpha = 0.73). The reflection ability score of students was 82.13 ± 4.24. After a statistical analysis of data among genders, although the reflection scores of males (83.58 ± 4.37) were higher than females (81.17 ± 3.97), but this difference was not statistically significant (P-value ≥ 0.05). Also, the difference between demographic variables and reflection ability scores was not statistically significant (P-value ≥ 0.05). Conclusion: This study showed that the GRAS questionnaire is a useful tool for assessing the reflection ability and students have medium scores of reflection ability so educational managers should pay serious attention in planning related fields.

The present study was conducted to explore the relationship between transformational leadership style and employee creativity in Shahid Sadoughi University of Medical Sciences in 2014. This was a descriptive cross-sectional study with a sample of 365 workers from Shahid Sadoughi University of Medical Sciences conducted in 2014. Three questionnaires (including transformational leadership style, creative atmosphere, and employee creativity) were used to collect data. Correlation coefficient tests, along with coefficient of determination, scatter diagrams, and regression analysis, were applied to respond the research questions. Findings revealed a significant correlation between transformational leadership style and its components with creative atmosphere and also between creative atmosphere and its components with employee creativity. A direct statistically significant relation between transformational leadership style and its components with employee creativity was also confirmed (P < .05). This study highlights the critical role of transformational leadership in employee creativity and recommends managers to regularly allocate their time in implementation and expansion of such a leadership style to create a creative atmosphere in accordance with organization's goals and subsequently increase personnel creativity.

Introduction: One of the fundamental goals of health transportation plan (HTP) in Iran is to improve household’s financial protection against catastrophic health expenditures (CHE). The aim of this study was to calculate the percentage of catastrophic health expenditures after implementing the plan and compare it with CHE before the plan for the same households. Methods: Data were collected through face-to-face interviews for 400 households. The CHE was calculated using the WHO approach, and relationships between CHE and the variables (having member ≥65 years old, having member ≤5 years old, having disabled member, economic status, health insurance status, dentistry services usage, and inpatient and outpatient services usage) were examined by the Fisher’s exact test. Moreover, the impacts of the variables on CHE were assessed by logistic regression model. Stata version 15 was used for data analyses. Results: The exposure of the households to CHE increased from 8.3% in 2011 to 14.2% in 2020, and percentage of the impoverished households due to health expenditures in 2020 was more than that of the 2011 (4.3% vs 7.5%). The economic status, having members ≥65 years, and using dental and inpatient services were the key factors determining the CHE. The most important determinant affecting the exposure to CHE was dental services utilization in 2011 (92.64) and 2020 (122.68). Conclusion: The results showed a negative incremental change for the households facing CHE in this period. The dental and inpatient services need to be more widely covered by basic health insurance and households having members ≥65 years along with the poor households should be exempted from paying some of the healthcare expenditures for improving their financial protection against CHE.

Introduction: The satisfaction rate of patients is a valuable tool for evaluating the quality of providing health care and gives important data regarding the expectations of patients and the degree to which they are being met. Considering the importance emergency medical service (EMS) centers in providing proper care, this study was carried out aiming to evaluate the satisfaction rate of those receiving services from EMS centers of Yazd and Birjand. Methods: The present cross-sectional study was carried out on 150 of EMS recipients registered on the list of EMS centers of Yazd and Birjand in 2012. Systematic sampling was used and required data were gathered using the standard questionnaire of satisfaction for EMS center recipients that consisted of 2 parts; demographic data and 16 questions regarding satisfaction of recipients. Data were analyzed using SPSS 18 and descriptive tests. Results: 150 participants were studied (56.7% male). The most common reason for calling was trauma due to motor vehicle accidents (32%) in Yazd and weakness and nervous system diseases (18%) in Birjand. 10% of the participants in Yazd province had low satisfaction, 39% had intermediate, and 51% had high satisfaction. In Birjand satisfaction rate was intermediate in 16% and high in 84% of those studied in Birjand. The highest satisfaction rate in Yazd was regarding cooperation of emergencies center with the patient and their manners in facing them. The lowest satisfaction rate belonged to following the condition of the patient until the arrival of ambulance and the waiting time for ambulance arrival. In Birjand, the lowest satisfaction rate belonged to the quality and existence of equipment in the emergency team. Conclusion: The results of the present study showed that satisfaction level of EMS recipients in Yazd and Birjand was intermediate. The lowest satisfaction rate belonged to following the condition of the patient until the arrival of ambulance and the waiting time for ambulance arrival in Yazd, and the quality of equipment in Birjand.

Background: Self-medication is a serious danger in every health sector which potentially brings harmful side effects for the society. The aim of this research was to investigate self-medication and its contributing factors among residents of Yazd province in Iran in 2014. Methods: A descriptive, cross sectional study was conducted in 2014 using a self-constructed questionnaire. A total of 580 families living in Yazd in the time period of study were contributed to fill out the questions organized in two sections of demographic and self-medication factors. Data were analyzed by SPSS software version 16 through appropriate descriptive and analytical statistical tests. Results: Self-medication was reported in 53.4% of the cases. The most frequent self-prescribed medications were related to pain killer drugs (26.6%). There was a significant statistical relation between self-medication and households’ age, occupation and income, level of parents’ education, number of children and place of residence. Among different reasons for self-medication the most important one was reported to be accessibility (3.44+1.3). Conclusion: Due to the considerable prevalence of self-medication and its harmful effects on every society, such an issue should be appropriately controlled through legal regulations particularly in the area of selling dangerous drugs. Furthermore, provision of proper information and warning the population about harmful side effects can be helpful in this regard.

Background: The world is changing continually and organizations as the subsystems of the world should be adapted with these changes by helping to develope of creativity and innovation.This study to evaluate the relationships between conflict management styles and creativity of staff in training hospitals in Kerman province. Materials & Methods:This is a cross-sectional study from aspect of descriptive -analytical. For gathering data, the standard questionnaires of conflict management for managers and creativity for staff applied. The participants in the study were all disciplinary managers from selected hospitals in one group and all disciplinary staff of selected hospitals in another group.Data analysis used in SPSS software. Results:The results showed that there is a significant and opposite assosiation between enforcing styles and negotiating styles between managers (P

مقدمه: میزان رضايتمندي بيماران ابزار سنجش مهمي براي ارزیابی كيفيت ارائه خدمات بهداشتي درماني است و اطلاعات مهمي راجع به انتظارات بيماران و ميزان برآورده شدن آنها فراهم مي كند. با توجه به اهمیت و جایگاه مهم مراکز مدیریت حوادث و فوریت های پزشکی و ارائه موثر خدمات از سوی آنها، این مطالعه با هدف بررسی میزان رضایتمندی گیرندگان خدمات از مرکز مدیریت حوادث و فوریت های پزشکی در شهرستان های یزد و بیرجند انجام پذیرفته است. روش کار: مطالعه مقطعی حاضر در سال 1391 بر روی 150 نفر از گیرندگان خدمت موجود در لیست مرکز مدیریت حوادث و فوریت های پزشکی شهر های بیرجند و یزد انجام پذیرفت. نمونه گیری به صورت سیستماتیک و اطلاعات مورد نیاز توسط پرسشنامه استاندارد رضایتمندی گیرندگان خدمات از مرکز مدیریت حوادث و فوریت های پزشکی که شامل دو قسمت؛ مشخصات دموگرافیک و 16 سؤال مربوط به رضایتمندی گیرندگان خدمت بود، جمع آوری گردید. داده ها با استفاده از نرم افزار SPSS 18 و آزمون های توصیفی مورد تجزیه و تحلیل قرار گرفتند. يافته ها: 150 نفر مورد مطالعه قرار گرفتند (7/56 درصد مرد). شایعترین دلیل برقراری تماس در شهر یزد، ترومای ناشی از تصادفات رانندگی (32درصد) و در شهر بیرجند ضعف و بیحالی و بیماری عصبی (18درصد) بود. 10 درصد از پاسخگویان در استان یزد رضایتمندی کم، 39 درصد رضایتمندی متوسط و 51 درصد رضایتمندی مطلوبی داشتند. به همین ترتیب 16 درصد از پاسخگویان در شهر بیرجند رضایتمندی متوسط و 84 درصد رضایتمندی مطلوب داشتند. بالاترین میزان رضایتمندی در استان یزد از همکاری مرکز فوریت ها با بیمار و رفتار پرسنل با بیمار بود. همچنین کمترین میزان رضایتمندی نیز متعلق به پیگیری وضعیت بیمار تا رسیدن آمبولانس و زمان انتظار بیمار تا رسیدن آمبولانس بود. در شهر بیرجند نیز کمترین میزان رضایتمندی مربوط به کیفیت امکانات و تجهیزات تیم اورژانس بود. نتيجه گيری: نتایج حاصل از این مطالعه نشان داد که میزان رضایتمندی گیرندگان خدمات از مراکز مدیریت حوادث و فوریت های پزشکی، در شهر یزد و بیرجند در سطح متوسطی بوده است. کمترین میزان رضایتمندی از خدمات مرکز مدیریت حوادث و فوریت های پزشکی در شهر یزد مربوط به حیطه پیگیری وضعیت بیمار تا رسیدن اورژانس و نیز زمان انتظار بیمار تا رسیدن آمبولانس و در شهر بیرجند مربوط به کیفیت امکانات و تجهیزات بود.