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Background and purpose: In order to increase the accountability of hospitals and ensuring proper medical treatments at any time of the day, physicians residing in non-administrative hours have active physical presence in the hospital and perform the diagnostic and therapeutic measures required. The purpose of this study was to assess the implementation of resident physician program in Mazandaran province, Iran. Materials and methods: A qualitative study was carried out in which the participants included 27 individuals from university authorities, hospital managers, and specialists. Data was collected by semistructured interviews using purposeful and snowball methods and continued until data saturation. Then, transcription of interview data was done to determine the meaning units, coding, classification based on similarity and proportion, and identifying themes using content analysis. Results: According to the framework of the resident physician program, 13 primary themes and 47 secondary themes were extracted. This program improved the centers' responses, indicators, and processes. But some themes such as finance, infrastructures, monitoring, implementation of the program, and payments to doctors were found as challenging issues requiring more attention. Conclusion: Considering the opportunities and threats, and the strengths and weaknesses of the resident physicians program, current findings could provide managers and healthcare authorities with a more comprehensive approach to the present situation. [ABSTRACT FROM AUTHOR]

Territorial Agenda is a comprehensive process of planning to use advantage and talent of regional s for their growth and excellence. The development of the education system is one of the most effective action and guarantor of the sustainable development of societies. The implementation of the program on the development and innovation of medical education with the use of the capacity of the territorial planning program began in the country in 2015. The purpose of this study is to explain the Process of Establishment of Territorial Agenda and Development and Innovation in Medical Education in Iran. Using the keyword search about the title or abstract In the books compiled by the Ministry of Health and Education and in the databases like Magiran, SID, Medlib, Iranmedex, Google Scholar databases for Persian language studies and articles in English on the databases as PubMed, Science direct, Google Scholar between 2000 and 2016 The related articles were searched. The results showed that with the implementation of the program, targeted engagement between the universities of the region and the discourse of development and innovation in the academic atmosphere argos. Also, some packages such as the accreditation of institutions and educational centers, the upgrading of the testing system and the monitoring of development packages have made the results more tangible, and in some packages, such as the internationalization of medical education, virtual education and the promotion of professional ethics, good efforts have begun. And in moving packages to third-generation universities, accountable and advocacy education and promotion of educational infrastructure require better attention and planning. Considering the provision of sustainable resources and strengthening of educational infrastructure and faculty members' empowerment to achieve success in the program seems essential. [ABSTRACT FROM AUTHOR]

Background and purpose: Urban family physician was implemented as a pilot project in Fars and Mazandaran provinces in Iran since 2012. This study aimed at SWOT analysis of urban family physician from the perspective of beneficiaries. Materials and methods: This qualitative research was conducted through in-depth and semistructured interviews in 2016. Nine people including faculty members, family physicians, senior managers and health professionals who were fully informed about the family physician project. They were selected via purposive sampling. Verbatim transcription of interview data was done and analyzed using framework method. Results: The main strengths included health services provision, easy accessibility to health services, classification of services, and decrease in unnecessary costs. The weak points according to SWOT analysis included management and planning, human resources, physical resources, referral system, electronic health records, payment mechanism, health services purchasing organizations, intersectoral coordination, and assessment and control systems. Authorities' support, legal backing, educated human resources, and capacity of private section along public section were identified as the opportunities of the project. Furthermore, failure in public-private sector cooperation, health market and, society needs were considered as the threats. Conclusion: This study showed the strengths and weaknesses of family physician plan, and the opportunities and threats it is faced with. Hence, it is necessary to find solutions and perform necessary interventions in order to eliminate the weaknesses and threats and maintain and improve the strengths and opportunities before its implementation throughout the country. [ABSTRACT FROM AUTHOR]

Background and purpose: Hospitals are needed to have enough readiness for apt reaction toward unexpected disasters, therefore, it is important to identify developed healthcare centers in different regions. This study aimed to investigate the developmental levels of educational hospitals for facing unexpected disasters in Mazandaran Province, Iran. Materials and methods: In a cross-sectional study in Mazandaran educational hospitals in 2015, 56 individuals including the heads, chief managers and the officials for unexpected crisis were selected via purposive sampling. Data was collected using a researcher-made questionnaire consisting of 222 items. Data analysis was performed by numerical taxonomy. Results: The participants were 88.5% males (n=23) and the mean age was 46.33±4.47 years. The educational level was Master in 5 (19%), while 21 (81%) hold a PhD degree. Results showed that Imam Khomeini hospital was relatively developed (0≤Fi≤0.5), Bu Ali, Fateme Zahra, Zare, Ayatollah Ruhani, and Amirkola pediatric hospitals were developing (0.5≤Fi≤0.7), and Razi and Shahid Beheshti hospitals were undeveloped (0.7≤Fi). Conclusion: This study showed that most of the educational hospitals in Mazandaran Province are in inappropriate developmental state for facing the unexpected disasters. So, policy-makers must identify developed healthcare centers and enhance all medical centers for confronting the unexpected disasters. [ABSTRACT FROM AUTHOR]

Background and Purposes: Several indices are involved in determining the levels of development in a country or a region. Among them, the most important is believed to be the health equity. The purpose of this study was to assess the level of health equity in selected cities in Mazandaran province, Iran, 2014. Materials and Methods: A descriptive-analytic research was carried out in five cities in Mazandaran province including Babolsar, Sari, Tonekabon, Amol, and Noshahr. Relevant information was obtained from the management and planning organization database and health networks in these cities. Taxonomy was used for ranking the cities. Results: The level of development in different indices ranged as follows: mortality and birth: 0.57 in Noshahr to 0.86 in Sari, disease and accidents: 0.50 in Amol to 0.88 in Tonekanon, environmental health and work: 0.69 in Sari to 0.89 in Babolsar, family health and education: 0.26 in Sari to 0.82 in Amol, and social welfare: 0.82 in Sari to 0.96 in Tonekabon. Conclusion: In this study none of the cities studied had an appropriate level in mortality and birth, and health and social welfare indices. Therefore, efforts should be made to facilitate services that could enhance these developing indices. [ABSTRACT FROM AUTHOR]

Background and purpose: The family physician is obliged to deliver qualified and comprehensive services according to the people`s need for provision, protection and improvement of their physical, mental, and social health. This study aimed at investigating patients' satisfaction from urban family physician program in Mazandaran province, Iran, 2015. Materials and methods: In this cross-sectional study, 1500 patients were sampled through multi-level random method from several cities in Mazandaran province. Data was collected by a researcher-made questionnaire consisting of 6 dimensions and 30 items including services, services delivery, services accessibility, physicians, assistants and picture of services (5 items in each dimension). Its validity was confirmed by experts and its reliability was verified by internal consistency calculated for each dimension; 0.84, 0.86, 0.92, 0.79, 0.83, and 0.85, respectively. Results: We found that patients were only relatively satisfied with physicians (P< 0.001). Factor analysis showed that services (β= 0.48, t-value= 14.07), services delivery (β= 0.46, t-value= 12.68), services accessibility (β= 0.49, t-value= 14.28), physicians (β= 0.58, t-value= 17.09), assistants (β= 0.71, t-value= 20.82) and picture of services (β= 0.37, t-value= 10.39) are the factors that influence patients' satisfaction. Conclusion: According to this study, authorities in health care sector must work on increasing patients' satisfaction with the urban family physician program to deliver better health care services. [ABSTRACT FROM AUTHOR]

Background and purpose: Sense of security in patients is a prerequisite for developments in delivering appropriate health services. It can play a major role in finding solutions to improve the quality of care being delivered. The aim of this study was to design and validate a questionnaire to evaluate the sense of security in hospitalized patients. Materials and methods: This methodology was conducted in 900 patients in selected hospitals in Mazandaran province, Iran. A questionnaire consisting of 78 items and 11 factors based on a Likert scale of 1 to 5 was designed. The content validity of the scale was examined by content validity ratio and content validity index and construct validity was examined by exploratory factor analysis. The reliability of the questionnaire was evaluated by Cronbach's alpha. Results: Only six items were found with no appropriate content validity. Exploratory factor analysis showed that the first factor (11 items) had the maximum of factor loadings (27.66) and factor 11 (4items) exhibited the minimum factor loadings (1.54). The internal consistency in all items was found to be more than 0.80. Conclusion: The questionnaire designed is a valid and reliable scale for evaluating the sense of security in patients. [ABSTRACT FROM AUTHOR]

Background and purpose: Measuring the satisfaction of service recipients and service providers is one of the main key indices for evaluation of rural family physician program. So far, 10 years has passed since this program was implemented and different results have been published. In this study we aimed to estimate the overall level of both service recipients and service providers' satisfaction using meta-analysis. Materials and methods: National and international databases were reviewed and articles published in March 2005 to April 2015 were identified. We also investigated the study references and interviewed some researchers to enhance the search sensitivity. Eligible papers for final meta-analysis were selected after quality assessment and application of inclusion/exclusion criteria. There was a significant heterogeneity between the results of the studies, therefore, random effects model was applied to estimate the total level of stakeholder satisfaction using Stata SE. V.11. Results: This meta-analysis included 18 relevant studies investigating the satisfaction level of 8009 service recipients and 921 service providers. Total levels of satisfaction among service recipients and service providers regarding the rural family physician program were estimated to be 54.03% (40.6- 67.4) and 50.4% (27.8-73.03), respectively. Conclusion: The current study showed a moderate level of satisfaction regarding the rural family physician program among stakeholders. [ABSTRACT FROM AUTHOR]

Background and purpose: Nowadays, human and financial losses caused by natural and nonnatural disasters have a great impact on human health. This research was conducted to determine the ability of selected hospitals in crisis management according to the World Health Organization. Materials and methods: A descriptive study was done in which the authorities (n=45) in three selected hospitals (Razi, ValieAsr, and Shafa) in Mazandaran province, Iran were participated in 2015. Data was collected by world Health Organization check-list and was analyzed using numerical taxonomy in Excel software. Results: The check-list included five scales: general information, identification of the risks and the level of functional safety, structural safety, and non-structural safety. Compared with two public hospitals (Razi and ValieAsr) the overall safety level in private hospital (Shafa) was higher (57.84%). Considering the ranking and developmental status, except Vali-Asr hospital (0.5 0.75). Conclusion: This study showed the need for a standard management system in crisis management and serious attention to general indices, risks and safety levels in hospitals. [ABSTRACT FROM AUTHOR]

Reported rates of awareness and observation of patient's rights inside the country are very different. Likely in this regard, a systematic review can present a closer detail and coordination of subject to better decision-making and policy. So, this systematic review study was performed to determine the health services providers' viewpoint about the awareness and observation of patient's rights in Iran. Iranian prior related studies published in inner and outer databases were searched with keywords such as; patient's rights, patient's rights in Iran, patient bill of right, patient bill Iran and its equivalent Persian word and finally, relevant documents were entered to the study using systematic review studies criteria. Health service providers' average awareness of patient's rights was variable from 5.1 to 95.5 percent and also was variable for patient's rights charter from 1.8 to 93 percent. In other words, health service providers' overall awareness rate was 34.5 percent in good level, 46 percent in moderate percent and 19.5 percent in weak level. Also, health service providers' overall observation rate was 72.5 percent. Simple review of studied documents in this survey showed that average awareness of patient's rights places in low level. So, the compilation of comprehensive educational program in the form of training employee must recurrently consider with the health policy makers till reach to the acceptable level in Iran. [ABSTRACT FROM AUTHOR]

Background and purpose: Leptospirosis is one of the most common zoonotic diseases in the world. Some public health problems and diseases are directly associated with geographic context of places, therefore, geographic information system (GIS) could be of great benefit in management of such issues and planning to control the spread of diseases. The aim of this study was to investigate the spatial distribution pattern of leptospirosis in Mazandaran province during 2011-2013 using GIS. Materials and methods: In this cross sectional study data was collected by GIS. The district division was found to be an inappropriate unit for analysis, therefore, we used Modifiable Areal Unit Problem for correcting the spatial units. Spatial analysis was performed after the integration of spatial data based on network coding within each cell. Results: In our study a cluster distribution of leptospirosis was observed (P< 0.05) and Sari was seen to be the main focus and Qaemshahr and Amol were the next two foci for the disease. Leptospirosis was more common in men. Conclusion: Applying GIS could be useful in determining disease clustering, forecasting the spread of disease and controlling the affecting parameters in Mazandaran province. [ABSTRACT FROM AUTHOR]