Search

Protection of patients' rights is critical in improving healthcare quality, and hence this study aimed at reviewing patient rights’ practices in healthcare organizations of Iran. Using systematic search, this review was conducted based on Preferred Reporting Items for Systematic Review and MetaAnalysis Protocols (PRISMA-P). Several keywords, including "patient rights", "patient bills of rights" and "patients rights’ charter" were searched bilingually in the databases of SID, Magiran, PubMed, Scopus, and Web of Science from 2010 to 2021, and then, following a three-tier screening using the Critical Appraisal Skills Program (CASP) checklists, 76 articles were extracted. The degree of compliance with the Patients' Rights Charter (PRC) in healthcare organizations was 60.88% on average. As to the observance of the PRC dimensions, respectively, the highest and lowest scores were related to the "right to privacy and confidentiality" (70.16%) and "right to access an efficient complaining system" (53.01 %). Respect for patients' rights in organizations was assessed at a moderate level, and some aspects of patients' rights should be attended to immediately. Therefore, discrepancies in the dimensions of patients' rights and their implementation by organizations should be on the agenda of healthcare managers and policymakers. [ABSTRACT FROM AUTHOR]

BACKGROUND: Diagnostic services are highly critical in the success of treatment processes, overly costly nonetheless. Accordingly, hospitals generally seek the private partnership in the provision of such services. This study intends to explore the incentives owned by both public and private sector in their joint provision of diagnostic services under the public-private partnership agreement. METHOD: A qualitative, exploratory study was employed in Tehran hospitals from October 2017 to March 2018. Around 25 face-to-face, semi-structured interviews were conducted with the purposively recruited hospital managers, heads of diagnostic services and managers of private companies. Interviews were transcribed and analyzed using conventional content analysis, assisted by "MAXQDA-12". RESULTS: Three main categories and nine sub-categories represented the incentives of public sector, and four main categories and seven sub-categories signified those of private sector. The incentives of public sector included the status-quo remediation, upstream requirements, and personal reasons. As such, the individual, social and economic incentives and legal constraints were driving the behavior of the private sector. CONCLUSIONS: Financial problem and gain were the most noted incentives by the partners. Attention to the either side's incentives and aims is likely to ensure the durability and effectiveness of such partnerships in the health sector. [ABSTRACT FROM AUTHOR]

The operational management of healthcare services is expected to directly touch patient experiences. Iranian Ministry of Health and Medical Education (MoHME) for the first time, as such, has sought to improve the operational management of healthcare delivery within a reform agenda by setting benchmarks for 'number of visit per hour' and waiting time in outpatient clinics of about 700 affiliated hospitals. As a new initiative, it has faced with mixed reactions and various doubts have been cast on its successful implementation. This manuscript aims to shed some light on the operational challenges of the initiative and the requirements of its successful implementation. [ABSTRACT FROM AUTHOR]

Hospitals have been at the core of health care in most countries during past decades, in view of the importance and criticality of their services and absorbing the highest quota of health care financial resources. Specific problems associated with these organizations in developing countries, such as Iran, have further added to the attention they have received over the course of those years. Efficiency measurement of hospitals based on simple ratios has long been utilized to remedy these problems in Iran. However, application of data envelopment analysis as an advanced method for measuring efficiency of health care organizations is mostly unexplored in this country. The current study has applied this method to investigate technical efficiency of a group of provincial hospitals in Iran. The findings showed that just under 60% of all hospitals at the province were technically efficient, and the remainder faced excess number of inputs (specifically in their non-clinical human resources) that should be attended to by the managers. Implications for practice and research on the efficiency of hospitals in the country and similar settings are provided. [ABSTRACT FROM AUTHOR]

Background: One of the effective ways in reducing the prevalence Covid-19 is mobile health. Objective: Mobile health provides the possibility of: elimination locative barriers, reducing costs, increasing the capacity & quality of health care services, diagnosis & monitoring & managing the disease for health care providers in order to provide high quality services. Material and Methods: The present study is a systematic review with systematic search in Science database, PubMed, SID, ISMJ, DOI, NMC and meta-search engine Google scholar. Using keywords coronavirus, Mobile Health, Health, Health care, Quality Improvement & Capacity. Performed from 2015 to 2020. The obtained 251 articles were studied and refined step by step and finally 20 articles related to the purpose of the study were selected and presented. Results: Mobile health plays a key role in improving the capacity and quality of health care services. Numerous uses of mobile health to confronting coronavirus include eCAALYX (provide a remote system for monitoring),Telehealth Toolkit(for screening/tracking/diagnosis/treatment/follow-up).Benefit of m-Health is the prevention of direct physical contact between doctors and nurses with patients. Conclusion: Mobile health leading to increases opportunities for access, diagnosis and treatment of infectious diseases, improving the capacity and quality of clinical and health care. In mobile health related technologies, there are many opportunities for improvement people's health and well-being, the ability to monitor and report rapidly on health status changes, help create a healthy lifestyle, quickly diagnose health conditions, facilitate notices and promote health care. [ABSTRACT FROM AUTHOR]

Background: Global payment system is a first example of per-case payment system that contains 60 commonly used surgical operations for which payment is based on the average cost per case in Iran. Objective: The aim of the study was to determine the amount of reduction, increase or no change in the trend of global operations. Methods: In this retrospective longitudinal study, data on the 60 primary global surgery codes was gathered from Tehran Health Insurance Organization within the ten-year period of 2005-2015 separately, for each month. Out of 60 surgery codes, only acceptable data for 46 codes were available based on the insurance documents sent by medical centers. A quantitative analysis of time series through Regression Analysis Model using STATA software v.11 was performed. Results: Some global surgery codes had an upward trend and some were downwards. Of N Codes, N83, N20, N28, N63, and N93 had an upward trend (p<0.05) and N32, N43, N81 and N90 showed a significant downward trend (p<0.05). Similarly, all H Codes except for H18 had a significant upward trend (p<0.000). As such, K Codes including K45, K56 and K81 had an increasing movement. S Codes also experienced both increasing and decreasing trends. However, none of the O Codes changed according to time. Other global surgical codes like C61, E07, M51, L60, J98 (p<0.000), I84 (p<0.031) and I86 (p<0.000) shown upward and downward trends. Total global surgeries trend was significantly upwards (B=24.26109, p<0.000). Conclusion: The varying trend of global surgeries can partly reflect the behavior of service providers in order to increase their profits and minimize their costs. [ABSTRACT FROM AUTHOR]

Background: We aimed to investigate Tehran's University of Medical Sciences (TUMS) affiliated hospitals organizational readiness toward implementing the 'Autonomous Hospitals' program as a change initiative from a managerial perspective in 2020., Methods: A census covering all eligible managers working in TUMS affiliated hospitals, Tehran, Iran (350 individuals) was carried out. Overall, 281 questionnaires were returned (a 30% non-responsiveness rate). A standard construct was adopted for data collection which was validated through a process of translation- back translation, face validity, and content validity (CVI=0.86, CVR=0.76). The reliability was acquired using Cronbach's alpha coefficient (0.87 and over 0.7). Both descriptive and inferential statistics were employed to draw conclusions .SPSS 26 was used for data analysis., Result: Total organizational readiness for change (TORC) in hospitals was 60.75%±10.11 showing a state of medium to upper-medium readiness status. Also, the 'Clear mandate and centralized leadership' theme scored the lowest mean (53.02%±15.78) for ORC. 'Hospital accreditation level' (r=-0.14, P ≤0.05), 'bed occupancy rate' (r=-0.19, P ≤0.05), and 'leadership status' (r=0.26, P ≤0.001), also showed significant association with TORC. In addition, 'standardized bed occu P ancy rate' ( P ≤0.05, B=-2.41), a 'male' leader ( P ≤0.05, B=3.42), and 'academic affiliation' ( P ≤0. 1, B=-9.52), were good P redictors of TORC based on 'Backward Multiple Linear Regression' analysis., Conclusion: Full support from hospital and headquarters executives, delegation of sufficient decision-making authority to hospital managers, and implementation of comprehensive performance evaluation criteria were prerequisites for robust hospital autonomy in TUMS-affiliated hospitals., (Copyright© 2024 Alaei Kalajahi et al. Published by Tehran University of Medical Sciences.)

Background: Since approximately 45% of basic health insurance (BHI) resources are spent and distributed based on the Relative Value of Health Services (RVHS) book, therefore, any revision in this book will most probably affect the behavior of health insurance organizations. The present study was prospected to determine the effect of revising RVHS on behavior of BHI funds as the main providers of treatment resources. Methods: This is a qualitative study in which data were analyzed using content analysis method. Semi-structured interviews were used to gather the required data. 27 interviewees were chosen using purposive sampling method. Finally, MAXQDA software was used to analyze and code the data. Results: According to the results, revision of RVHS influenced the behavior of health insurance organizations. The most important changes in the behavior of health insurance funds involved the following: formation of a committee for cost management and handling the insurance documents, creating a uniform coding system for health services, redesigning the handling process of documents, increased share of insurance funds from health expenditures, with 300 new services added to basic package and revising the package according to the new version of the book. Furthermore, the rest of the changes included in the global payment method based on the new book, delay in paying claims, increased deductions based on the payment of expensive services on treatment protocols, holding periodic training courses, and teaching the new book as well as the procedures for handling the documents. Conclusion: With regard to the revision of RVHS and considering the incremental approach in revision of relative values, the increased claims of health services delivery centers and delay in payment of these claims were the most important changes in the behavior of health insurance funds. Health policy makers can overcome such issues and provide proper financial conditions through reduction of conversion factor and mobilization of resources. Such policies will open the space for best management of the behaviors affected by revision of relative values.

Background: This study aimed to calculate the child labor rate and establish the factors affecting this phenomenon in the less developed provinces of Iran., Methods: This study has used the secondary data of population and housing census gathered by Iranian Statistical Center in 2011. The data belonged to 14859 children between 10 and 14 of 9 less developed provinces of Iran. A multiple regression model was hypothesized drawing on related literature and accordingly using data; the logistic regression was estimated. Data cleaning process was also conducted prior to the analysis., Results: The child labor force participation rate for all children between 10 and 14 years old was 1.7%, of which boys' child labor rate was higher than girls' (2.4% over 1%). As such, the mothers' fertility rate and education were of the strongest, yet converse, effect on child labor supply in the country., Conclusion: A little proportion of children in less developed regions of Iran was suffering from child labor. However, given the diminishing and rising effects of, respectively, variables such as mothers' literacy and working on the child labor; the authorities could restrict child labor attending more to such a group. The factors identified could also be of a high value for the policy-makers at both national and international level such as the Health and Welfare ministries, EMRO, ILO and UNICEF.