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Dabbagh A,(md) , Ghasemi M,(md) , Zolfaghari B,(phd) , Jamshidi Hr,(phd) ,
Volume 8, Issue 4 (1-2006)
Volume 8, Issue 4 (1-2006)
Abstract
Introduction: Community orientation is an important indictor in assessment of the functions of a health system and implementing this in pharmaceutical care, needs the roles and functions of pharmacists to be defined apparently. Augmented the professional relationships of the pharmacists and executing the community oriented principles, would lead in improved health care delivery.
Methods: In a cross-sectional descriptive-analytical study, 480 physicians and pharmacists practicing inside the territory of Isfahan were selected. A self administered attitude assessment questionnaire was designed and its validity and reliability were calculated and improved in the pre-pilot and pilot stages. An amount of 0.8 was calculated for the Cronbach’s α, as a measure of reliability. Data entry and analysis was done through SPSS software (version 10). Student t-test, Chi-square and ANOVA were employed for data analysis. Factor analysis and Eigen value measurement were used for more complex data analysis and interpretation. The final questionnaire was validated and corrected as 35-item one, with defined validity and reliability.
Results: After deleting 13 items from the preliminary questionnaire, the Cronbach’s α improved to 0.8. The 2 professions had significantly different views regarding educational curricula in medicine and pharmacy for the related issue as well as, the community oriented pharmacy. Also, the 2 groups agreed on the revision of the role of pharmacists to improve the profession in practice.
Discussion: Most physicians and pharmacists agree that pharmacist should be able to handle their professional role in practice also, they should deliver the pharmaceutical care in a community oriented setting. More targeted education and curricular revision can help reaching the goal.
Hakim Research Journal 2006 8(4) 26-36.
Zare M, (phd) , Shamszadeh Pt ,(bs) , Najjari A(md). ,
Volume 9, Issue 1 (4-2006)
Volume 9, Issue 1 (4-2006)
Abstract
Introduction: Information and its major effect on strengthening the process of management decision-making cause the maximum efficiency in a system. Thus, if information is made available to managers with required speed and in a proper way, it will help them to make correct and proper decisions. Unavailability of such conditions will cause irretrievable problems, especially in the health sector. Geographical Information System (GIS) makes required information available for users more rapidly, accurately and up-to-date in order to make decision. The objective of applying GIS in health management is to show its advantages practically compared to other information systems e.g. MIS.
Methods: After necessary studies and organizing experts' meetings, three districts (Farsan from Chaharmahal Bakhtiari province, Dashti from Boushehr province and Bam from Kerman province) were chosen where on the basis of their ecological variety and environmental related diseases. First descriptive information was collected then the required information layers were adjusted on spatial information by selecting and modifying the base maps.
Results: The data model of this project was designed in the form of geographical databank on the basis of descriptive information of health network and need assessment. For example, the health and medical facilities with their descriptive information were specified on the district geographical map in a way that different information layers of health centers are visible dynamically and simultaneously. The incidence of important diseases such as tuberculosis, malaria, cholera, etc. can be also determined on the map so proper and prompt action can be taken for their prevention and surveillance.
Conclusion: The system was accountable to information needs of health system and there is the possibility of its development and improvement from many aspects.
Hakim Research Journal 2006 9(1): 58-63.
Malekafzali H, (phd) , Bahreini Fs, (msc) , Alaedini F, (md, Phd) , Forouzan As, (md) ,
Volume 10, Issue 1 (4-2007)
Volume 10, Issue 1 (4-2007)
Abstract
Introduction: Nowadays, there is a growing demand for prioritizing research activities based on the subjects associated with health care. In fact, health resources have not increased in developing countries, and despite the increased burden of diseases in these countries, the research budget allocated to dealing with health related issues has not increased in developing countries. Priority setting in health system is a response to the current challenges. For the priority setting process to be collective and participative, involvement of all stakeholders concerned could prove helpful. In the present article, the priorities in health system were set through needs assessment.
Methods: This project was formulated by needs assessment and involvement of the interested stakeholders as well as users of the health services with the aim of priority setting in health care system in 7 provinces of the country. A unique guideline was proposed to the executing universities as a preliminary guide. The project was implemented using qualitative and quantitative methods.
Results: Results of the prioritization of the problems in health system indicate that accidents have the highest frequency, with the environment, water and food health ranking second in frequency.
Conclusion: It is the duty of health care system of a country to resolve its health problems. To this end, primarily, problems should be identified. Accordingly, the limitations of the priorities set by the health system must be recognized, and research titles have to be determined for each. The basis of this process is the consensus of the stakeholders concerned on the priority lists.
Hakim Research Journal 2007 10(1):13- 19.
Pourmalek F , Abolhassani F , Naghavi M , Mohammad K , Majdzadeh R , Holakouie K , Fotouhi A ,
Volume 10, Issue 4 (1-2008)
Volume 10, Issue 4 (1-2008)
Abstract
Introduction: Healthy life expectancy (HALE) for every country is estimable in global and national level studies, in which the used data, methodologies, and hence the estimates’ values are not necessarily completely identical. Therefore, the current study was performed to estimate healthy life expectancy for Iran’s population, with use of the national-level studies’ data and methodologies for the first time.
Methods: For estimation of life expectancy for 23 out of 28 provinces of Iran (in 2003), registered deaths for 23 provinces were used. For population of 23 provinces, information from Ministry of Health was used and its distribution was taken similar to the results of Demographic and Health Survey of year 1379 (2000), and taken also equal to results of graduation of population from year 1375 (1996) census. Life expectancy was estimated with direct method. Years Lived with Disability (YLD) was calculated from prevalence of diseases and their disability weights, and used in
Results: HALE at birth was 62.13 years for total population (95% Confidence Interval [CI]: 61.02-63.16), 61.55 years for males (95% CI: 60.61-62.50), and 62.79 years for females (95% CI: 61.84-63.71).
Conclusion: National estimate of healthy life expectancy is 4.5 years higher than similar model-based estimate by World Health Organization. The reason is difference in direct and indirect estimation methods for specific mortality rates and hence the life expectancy, and difference in burden of disability estimation methods used in national and global burden of disease studies.
Hakim Research Journal 2008 10(4): 66- 76.
Jafari Sirizi M, (msc) , Rashidian A, (md, Phd) , Abolhasani F, (md) , Mohammad K, (phd) , Yazdani Sh, (md) , Parkerton P, (phd) , Yunesian M, (phd) , Akbari F, (phd , Arab M, (phd) ,
Volume 11, Issue 2 (7-2008)
Volume 11, Issue 2 (7-2008)
Abstract
Introduction: The aim of this study was to determine the key organizational dimensions that influence the autonomy of university hospitals and the level of granted autonomy in each dimension.
Methods: Six hospitals were randomly selected from those affiliated with three medical universities of Tehran, Iran and Shahid Beheshti. In this qualitative study, we interviewed 27 hospital managers (response rate of 82%). The semi-structured interview guide was developed based on the results of four initial in-depth interviews and the organizational reform model of the World Bank. We used the framework method for the analysis of qualitative data.
Results: Nine themes were identified as the key factors influencing hospital autonomy: decision right in strategic management, decision right in human resources management, decision right in financial management, decision right in physical resources management, product market exposure, procurement market exposure, financial residual claim, governance arrangements and accountability mechanisms, and social functions of the hospitals. Limited decision rights in strategic, human resources, and physical resources management were granted to hospitals. Hospitals were not the financial residual claimant, but were exposed to competitive product market. Autonomy was limited regarding the procurement market. Governance systems were hierarchical and accountability mechanisms were supervisor-supervisee oriented. Some of the social functions of the hospitals were defined, but the expenses of these functions were not totally reimbursed by the government and the insurance industry.
Conclusion: The autonomy granted to the hospitals is unbalanced and paradoxical. More decision rights should be granted for management of strategic, human resources and physical resources as well as hospitals entry to the procurement market. Hospitals need to be the financial residual claimant. The hierarchical administrative systems should be transformed to cooperative ones. Instead of supervisor-supervisee oriented control measures, Ministry of Health and Medical Education needs more regulatory mechanisms for controlling hospitals’ performance and social functions.
Hakim Research Journal 2008 11(2): 59- 71.
Tahani B, Yazdani Sh, Khoshnevisan Mh,
Volume 17, Issue 2 (7-2014)
Volume 17, Issue 2 (7-2014)
Abstract
Tahani B1 (DDS, PhD), Yazdani Sh2 (MD, MSc.), Khoshnevisan MH3 * ( PhD, DMD, DPHDent, DrPH )
1 Torabinejad Dental Research Center, Department of Oral Public Health, School of Dentistry,
Isfahan University of Medical Sciences, Isfahan, Iran
2 School of Medical Sciences Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Preventive Dentistry Research Centre. Dental Research Institute Community Oral Health Department,
School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Received: 5 Jan 2014, Accepted: 14 Apr 2014
Abstract
Introduction: The aim of this two-phase study was to develop standards for stewardship of oral health system of Iran and to evaluate the current attainments regarding them.
Methods: Based on the modified RAND-UCLA method, a comprehensive review of related electronic databases and the official web-site of international organizations, effective policy statements related to stewardship components were selected. Standards were categorized according to the six sub-functions of stewardship including generating and disseminating intelligence defining strategic policy direction ensuring alignment of policy objectives and organizational structure, regulation exerting influence over all related sectors via inter-sectoral leadership and ensuring accountability. Then the level of relevancy and importance of standards were assessed using the experts’ opinions. In phase two, using the finalized list of standards, semi-structured interviews with key stakeholders in oral health system at different levels of policymaking were conducted and the stewardship of oral health system was critically evaluated. The results of regulation sub-function are presented in this study.
Results: From 38 finalized standards appropriate for evaluating the stewardship of oral health system according to the opinion of experts, 18 were related to regulation. Most of the standards rejected were included in dental health insurance regulation. Evaluation of this sub-function determined that currently there are deficiencies in meeting regulations concerned with evaluating the safety and cost effectiveness of dental materials, and quality of provided dental care to patients. Also it was shown that implementation of penalties and sanctions commensurate with instances of malpractice at individual and institutions were not completed attained. Regulations such as water fluoridation, property rights and regulations to ensure the basic conditions of market exchanges were either absent or only partially implemented. There were also some weaknesses in regulations concerning the supply of dentists, especially their distribution. The fields that currently had some regulations, were those in relating to labeling on products used in dentistry and covering the needs of disadvantaged populations .
Conclusion: While the Ministry of Health and Medical Education has achieved some stewardship measures in the field of regulation, there are some problems in enforcing the regulatory framework especially in the private sector.
Key words: oral health system, evaluation, stewardship, legislation
Please cite this article as follows:
Tahani B, Yazdani Sh, Khoshnevisan MH. Proposed Standards for Evaluating the Stewardship of National Oral Health System Part 1: Evaluation of Regulation. Hakim Health Sys Res 2014 17(2): 108- 117.
* Corresponding Author: Daneshjoo B l vd., Evin, Tehran, 19834 IR-Iran. F ax:+98-21-22421813 E-mail: khoshmh@gmail.com
Shiyani M, Rashidian A, Mohammadi A,
Volume 18, Issue 4 (1-2016)
Volume 18, Issue 4 (1-2016)
Abstract
A Study of the Challenges of Family Physician Implementation in Iran Health System
Shiyani M1 (PhD), Rashidian A2 (PhD), Mohammadi A1* (MA)
1 Department of Social Welfare Planning, University of Tehran, Tehran, Iran
2 Department of Health Management and Economics. Tehran University of Medical Science. Research Center of Regional Office of World Health Organization
Original Article
Received: 15 Aug 2015, Accepted: 8 Dec 2015
Abstract
Introduction: Family physician project is one of the most significant policies in health system during the recent decade which was already supposed to be applied nationally legally, however its implementation has been limited rural areas and two provinces of Fars and Mazandaran, as pilot locations. This study was conducted to achieve a better understanding of the challenges of family physician projects implementation using the conflict theory.
Methods: The qualitative study was conducted using convenience sampling method. Data was collected using interviews and documents analysis techniques, and was analyzed using content analysis. Total number of 26 interviews were conducted with national politicians and high level executives, and key informants in family physician project.
Results: Family physician implementation challenges are identified in five main categories: challenge caused by the governing structure which affects health system, challenging nature of family physician, medicalization of management, conflict of interests, relationships among related ministries and organizations involved in family physician project.
Conclusion: A better understanding of different aspects of the family physician implementation challenges would be achieved under magnificent conflicts, tension and inconsistency among health system components. The family physician project challenges would be explained better using conflicts theory compared to the other significant medical sociology theories; however some data was beyond the conflicts theory.
Key words: Family Physician Project, Referral system, Health system, Conflict
Please cite this article as follows:
Shiyani M, Rashidian A, Mohammadi A. A Study of the Challenges of Family Physician Implementation in Iran Health System. Hakim Health Sys Res 2016; 18(4): 264- 274.
*Corresponding Author: Department of Social Welfare Planning, University of Tehran, Tel: +98- 912- 7720978,
E-mail: azar.mohammadi88@yahoo.com
Atefeh Ghanbari, Fatemeh Moaddab, Abtin Heydarzade, Fatemeh Jafaraghaee, Fatemeh Barari,
Volume 20, Issue 1 (4-2017)
Volume 20, Issue 1 (4-2017)
Abstract
Health System Evolution Plan; a New Approach to Health Care Delivery: The Challenge Ahead
Atefeh Ghanbari (PhD)1, Fatemeh Moaddab (MSc)2*, Abtin Heydarzade (MD)3, Fatemeh Jafaraghaee (PhD)4,Fatemeh Barari (BSc)5
1 PhD in Nursing Education, Associate Professor, Nursing Department,
Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
2 MSc in nursing education, Instructor, Department of Nursing,
Social determinants of health research center, Guilan University of Medical Sciences, Rasht, Iran
3 Social medicine specialist, Associate professor, Social Medicine Department,
Guilan University of Medical Sciences, Rasht, Iran
4 PhD in nursing education, Assistant professor, Nursing Department,
Social determinants of health research center, Guilan University of Medical Sciences, Rasht, Iran
5 Bachelor of Educational Sciences, Social Determinants of Health Research Center,
Guilan University of Medical Sciences, Rasht, Iran
Atefeh Ghanbari (PhD)1, Fatemeh Moaddab (MSc)2*, Abtin Heydarzade (MD)3, Fatemeh Jafaraghaee (PhD)4,Fatemeh Barari (BSc)5
1 PhD in Nursing Education, Associate Professor, Nursing Department,
Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
2 MSc in nursing education, Instructor, Department of Nursing,
Social determinants of health research center, Guilan University of Medical Sciences, Rasht, Iran
3 Social medicine specialist, Associate professor, Social Medicine Department,
Guilan University of Medical Sciences, Rasht, Iran
4 PhD in nursing education, Assistant professor, Nursing Department,
Social determinants of health research center, Guilan University of Medical Sciences, Rasht, Iran
5 Bachelor of Educational Sciences, Social Determinants of Health Research Center,
Guilan University of Medical Sciences, Rasht, Iran
Abstract
Background: In the past 2 decades, following the failure of health systems to fulfill new needs and expectations of the community, a strong international motion to health system reform is formed. According to the new plan for this reform, the current study aimed at evaluating the challenges ahead of the health system evolution plan in Guilan University of Medical Sciences, Rasht, Iran.
Methods: The current study was conducted based on a content analysis approach. A total of 43 managers of health care systems and hospitals directors completed a researcher-designed open-ended questions questionnaire. The qualitative data were analyzed using the content analysis method.
Results: Based on the obtained results, a total of 672 initial codes were extracted. After the analysis of initial codes, they were categorized into 4 main classes: “the health system: a need for the country”, “prerequisites”, “sustained monitoring” and “challenges”. The health system: a need for the country focused on regional necessities, health-oriented goals of the government, achieving health; a human priority; prerequisites focused on planning, culture-making, and infrastructures; sustained monitoring focused on polls and continuous supervision, and challenges focused on current and future challenges.
Conclusions: The health system evolution plan was implemented emphasizing the accessibility of health care services to everybody. Based on the viewpoint of manager, the plan was aimed to reduce the health care costs for the people, which is of great importance in Guilan province with regard to the problem of tourism industry. Of course, given the prerequisites and sustained monitoring of plan to carry out it better, it can play an effective role.
Keywords: Health System; Health Care Delivery; Health
Methods: The current study was conducted based on a content analysis approach. A total of 43 managers of health care systems and hospitals directors completed a researcher-designed open-ended questions questionnaire. The qualitative data were analyzed using the content analysis method.
Results: Based on the obtained results, a total of 672 initial codes were extracted. After the analysis of initial codes, they were categorized into 4 main classes: “the health system: a need for the country”, “prerequisites”, “sustained monitoring” and “challenges”. The health system: a need for the country focused on regional necessities, health-oriented goals of the government, achieving health; a human priority; prerequisites focused on planning, culture-making, and infrastructures; sustained monitoring focused on polls and continuous supervision, and challenges focused on current and future challenges.
Conclusions: The health system evolution plan was implemented emphasizing the accessibility of health care services to everybody. Based on the viewpoint of manager, the plan was aimed to reduce the health care costs for the people, which is of great importance in Guilan province with regard to the problem of tourism industry. Of course, given the prerequisites and sustained monitoring of plan to carry out it better, it can play an effective role.
Keywords: Health System; Health Care Delivery; Health
Please cite this article as follows:
Ghanbari A, Moaddab F, Jafaraghaee F, Heydarzade A, Barari F. Health System Evolution Plan; a New Approach to Health Care Delivery: The Challenge Ahead. Hakim Health Sys Res 2017; 20(1):1-8
*Corresponding Author: Guilan University of Medical Sciences, Shahid Beheshti Nursing and Midwifery school of Rasht, Rasht, Iran.
Tel: +98-1333555058. Fax: +98-1333550097, E-mail: f.moaddab89@gmail.com
Hakimeh Mostafavi, Arash Rashidian,
Volume 20, Issue 1 (4-2017)
Volume 20, Issue 1 (4-2017)
Abstract
The Role of Lobbying and Conflict of Interests on the Iranian Health System Decision-making
Hakimeh Mostafavi (PhD)1, Arash Rashidian (MD, PhD)2*
1 Health Economy, Standard and Health Technology Department, Vice-Chancellor’s Office in Treatment Affairs,
Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Professor, Department of Health Management and Economics, School of
Public Health,Tehran University of Medical Sciences, Tehran, Iran
Abstract
Background: Health systems attempt to fulfill health goals through evidence-based and value-oriented approaches, but decision-making in this sector is under the influence of some unknown and unexpected factors. The current study aimed at examining the role of lobbying and conflict of interests on the Iranian health system decision-making.
Methods: The literature review and interview with key experts were used in the current qualitative study to collect data. Thirty semi-structured interviews were carried out at micro, meso, and macro levels. Data were analyzed and interpreted through a mixed (inductive/deductive) thematic framework.
Results: Two themes and 6 subthemes were categorized based on the analyses; the theme of “the effects of conflict of interests on health system” with subthemes of effect on plans implementation, effect on intersector relations of national bodies, effect on public decisions, and also the theme of “effects of lobbying on health system” including subthemes of effect on attaining more budget or obtaining extra resources, effect on health technologies buying, and effect on implementation or non-implementation of special plans.
Conclusions: Conflict of interest indicates insufficient monitor of health system authorities, but lobbying can protect patients’ rights, if it is principally and ethically aligned with utilitarianism.
Keywords: Conflict of Interest; Lobbying; Health System; Qualitative Study; Decision-Making
Background: Health systems attempt to fulfill health goals through evidence-based and value-oriented approaches, but decision-making in this sector is under the influence of some unknown and unexpected factors. The current study aimed at examining the role of lobbying and conflict of interests on the Iranian health system decision-making.
Methods: The literature review and interview with key experts were used in the current qualitative study to collect data. Thirty semi-structured interviews were carried out at micro, meso, and macro levels. Data were analyzed and interpreted through a mixed (inductive/deductive) thematic framework.
Results: Two themes and 6 subthemes were categorized based on the analyses; the theme of “the effects of conflict of interests on health system” with subthemes of effect on plans implementation, effect on intersector relations of national bodies, effect on public decisions, and also the theme of “effects of lobbying on health system” including subthemes of effect on attaining more budget or obtaining extra resources, effect on health technologies buying, and effect on implementation or non-implementation of special plans.
Conclusions: Conflict of interest indicates insufficient monitor of health system authorities, but lobbying can protect patients’ rights, if it is principally and ethically aligned with utilitarianism.
Keywords: Conflict of Interest; Lobbying; Health System; Qualitative Study; Decision-Making
Please cite this article as follows:
Mostafavi H, Rashidian A.The Role of Lobbying and Conflict of Interests on the Iranian Health System Decision-making. Hakim Health Sys Res 2017; 20(1): 27-34
*Corresponding Author: Department of Health Management and Economics, School of Public Health, Tehran University of Medical
Sciences, Tehran, Iran. Tel: +98-2188989129, E-mail: arash.rashidian@gmail.com
*Corresponding Author: Department of Health Management and Economics, School of Public Health, Tehran University of Medical
Sciences, Tehran, Iran. Tel: +98-2188989129, E-mail: arash.rashidian@gmail.com
Jamshid Kermanchi, Mohammad Aghajani, Marjan Ghotbi, Ali Shahrami, Alireza Olyaeemanesh, Saeid Manavi, Leila Poraghasi, Et Al Et Al,
Volume 20, Issue 1 (4-2017)
Volume 20, Issue 1 (4-2017)
Abstract
A review of the Program to Improve the Quality of Visiting Services in
Government Hospitals in Line with the Development of the Health System
Through Focusing Its Achievements
Jamshid Kermanchi 1, Mohammad Aghajani 2*, Marjan Ghotbi 3, Ali Shahrami 4, Alireza Olyaeemanesh 5,
Saeid Manavi 6, Leila Poraghasi 7, Ali Maher 8, Mosa Tabatabaei 9, Farah babaei 10, Peirhossein Kolivand 11,
Hassan Vaezi 12, Marziyeh Zangeneh 13, Arezoo Dehghani 14, Seyedeh Sana Hosseini 15
1 Adviser of Curative Affairs in the Disease Management
2 Deputy for Curative Affairs. Ministry of Health and Medical Education
3 Executive Vice-President of the Office of Hospital Management and Clinical Services Excellence,
Ministry of Health and Medical Education
4 Executive Vice of Curative Affairs, Ministry of Health and Medical Education
5 Director General of the Office of Technology Assessment, Standards and Health Tariffs,
Ministry of Health and Medical Education
6 Head of the Tariff Policy Department and Payment System, Ministry of Health and Medical Education
7 Expert of Tariff Policy Department, Payment and Treatment Resources. Ministry of Health and Medical Education
8 Vice Deputy of Curative Affairs, Ministry of Health and Medical Education
9 Head of the Department of Economic Planning and Health Insurance, Ministry of Health and Medical Education
10 Head of Department of Midwifery, Ministry of Health and Medical Education
11 Head of the Emergency Department of the Country, Ministry of Health and Medical Education
12 Head of Hospital Emergency, Ministry of Health and Medical Education
13 Expert of Coordination Office and Planning of Health Insurance. Ministry of Health and Medical Education
14 Director of Public Relations of Curative Affairs, Ministry of Health and Medical Education
15 Expert of Curative Affairs. Ministry of Health and Medical Education
Ali Dehghan, Mohammad Reza Mirjalily, Mohammad Hosein Zare Mehrjardi, Malihe Raghebian, Azam Samiyezargar, Seyed Kazem Kazemeini,
Volume 20, Issue 3 (10-2017)
Volume 20, Issue 3 (10-2017)
Abstract
Patients’ Satisfaction Referred to University Hospitals of Quality of Medical Services After the Implementation of Healthcare Reform in Yazd
Ali Dehghan (MD)1, Mohammad Reza Mirjalily (MD)2, Mohammad Hosein Zare Mehrjardi (MD)3, Malihe Raghebian (MSc)4, Azam Samiyezargar (MSc)5, Seyed Kazem Kazemeini (MD)6*
1 Assistant Professor, Deputy Treatment, Shahid Sadoughi University of
Medical Sciences and Health Services, Yazd, Iran
2 Associated Professor, University President, Shahid Sadoughi University of
Medical Sciences and Health Services, Yazd, Iran
3 Deputy Treatment, Shahid Sadoughi University of Medical Sciences and
Health Services, Yazd, Iran
4 Clinical Psychology, Deputy Treatment, Shahid Sadoughi University of
Medical Sciences and Health Services, Yazd, Iran
5 Executive Mamagement, Deputy Treatment, Shahid Sadoughi University of
Medical Sciences and Health Services, Yazd, Iran
6 Traditional Medicine, Deputy Treatment, Shahid Sadoughi University of
Medical Sciences and Health Services, Yazd, Iran
Medical Sciences and Health Services, Yazd, Iran
2 Associated Professor, University President, Shahid Sadoughi University of
Medical Sciences and Health Services, Yazd, Iran
3 Deputy Treatment, Shahid Sadoughi University of Medical Sciences and
Health Services, Yazd, Iran
4 Clinical Psychology, Deputy Treatment, Shahid Sadoughi University of
Medical Sciences and Health Services, Yazd, Iran
5 Executive Mamagement, Deputy Treatment, Shahid Sadoughi University of
Medical Sciences and Health Services, Yazd, Iran
6 Traditional Medicine, Deputy Treatment, Shahid Sadoughi University of
Medical Sciences and Health Services, Yazd, Iran
Abstract
Introduction: The main axis in the hospital is the patient and all hospital services are carried out to serve him. His satisfaction can show the right performance service, which cannot be obtained merely with high technology, but rather be achieved from public services and effective relationships between physicians and
staff with patient. Recent evaluations have become more relevant due to the implementation of the health transformation plan in order to increase quality of care and access as well as financial protection of people. Therefore, the present study was conducted to evaluate the satisfaction of patients in university hospitals from hospital services after the implementation of healthcare reform in Yazd.
Methods: This cross-sectional study was conducted in June 2015. The study population included all patients referred to university hospitals in Yazd province that were referred to hospitals before HTP (Period 1392- 1389). A total of 162 patients were randomized and participated in this study. The data collection tool was a questionnaire that was analyzed with the SPSS 21 software.
Results: During the survey, 91% of patients were more satisfied than before the implementation of HTP of the hospital environment, 95.7% of nurse’s behaviors and services, 85.4% of emergency services, and 88.3% of improving health and quality of services. Also, 100% of patients stated that they have paid no money as complementary to their insurance services and kickbacks to doctors. Ultimately, 96.9% of the patients were not sent out of the hospital to purchase their medication or medical equipments.
Conclusions: According to the results, it can be evaluated that patient satisfaction of hospital services after the implementation of health transformation plan is high.
Keywords: Patient Satisfaction; Quality of Care; Health System Reform Plan
*Corresponding Author: Deputy Treatment, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran. Tel: +98-9131546103, E-mail: sk_kazemeini@yahoo.com
Introduction: The main axis in the hospital is the patient and all hospital services are carried out to serve him. His satisfaction can show the right performance service, which cannot be obtained merely with high technology, but rather be achieved from public services and effective relationships between physicians and
staff with patient. Recent evaluations have become more relevant due to the implementation of the health transformation plan in order to increase quality of care and access as well as financial protection of people. Therefore, the present study was conducted to evaluate the satisfaction of patients in university hospitals from hospital services after the implementation of healthcare reform in Yazd.
Methods: This cross-sectional study was conducted in June 2015. The study population included all patients referred to university hospitals in Yazd province that were referred to hospitals before HTP (Period 1392- 1389). A total of 162 patients were randomized and participated in this study. The data collection tool was a questionnaire that was analyzed with the SPSS 21 software.
Results: During the survey, 91% of patients were more satisfied than before the implementation of HTP of the hospital environment, 95.7% of nurse’s behaviors and services, 85.4% of emergency services, and 88.3% of improving health and quality of services. Also, 100% of patients stated that they have paid no money as complementary to their insurance services and kickbacks to doctors. Ultimately, 96.9% of the patients were not sent out of the hospital to purchase their medication or medical equipments.
Conclusions: According to the results, it can be evaluated that patient satisfaction of hospital services after the implementation of health transformation plan is high.
Keywords: Patient Satisfaction; Quality of Care; Health System Reform Plan
Please cite this article as follows:
Dehghan A, Mirjalily MR, Zare Mehrjardi MH, Raghebian M, Samiyezargar A, Kazemeini SK. Patients’ Satisfaction Referred to University Hospitals of Quality of Medical Services After the Implementation of Healthcare Reform in Yazd. Hakim Health Sys Res 2017; 20(3): 142- 148.
*Corresponding Author: Deputy Treatment, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran. Tel: +98-9131546103, E-mail: sk_kazemeini@yahoo.com
Haniye Sajadi, Masoumeh Hosseini, Arezo Dehghani, Rahim Khodayari, Hamed Zandiyan, Hosna Hosseini,
Volume 21, Issue 2 (7-2018)
Volume 21, Issue 2 (7-2018)
Abstract
The Policy Analysis of Iran’s Health Transformation Plan in Therapeutic Services
Haniyeh Sadat Sajadi 1, Masoumeh Hosseini 2*, Arezo Dehghani 3, Rahim Khodayari 4, Hamed Zandiyan 5,
Seyede Sana Hosseini 3
1 Iran National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran
2 Social Affairs Deputy, Iran Ministry of Health and Medical Education, Tehran, Iran
3 Health in Emergencies and Disaster, School of Public Health and Safety,
Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
5 School of Management and Medical Informatics, Ardebil University of Medical Sciences, Ardebil, Iran
Abstract
Background: Health Transformation Plan (HTP) is the most important effort done in Iran to achieve Universal Health Coverage. This study aimed to conduct a policy analysis of HTP in therapeutic services in Iran.
Methods: To qualitative analysis of HTP, Walt and Gilson’s Policy triangle and Kingdon’s multiple streams were employed. Data was collected through key informant interviews with stakeholders as well as a review of relevant documents and was analyzed using framework analysis. MAXQDA software was used.
Results: Legal, political, socioeconomic, international factors, and health system problems were the main factors triggering HTP. Challenges of therapeutic services implementing the second phase of the subsidy program and change of the government opened the political window of opportunity. The main strengths in HTP policy making process were using evidence, aligning with upstream documents, analyzing the situation, attracting the views of senior political leaders, planning simultaneously in different areas of the health service delivery, and prioritizing the urgent problems. Using a “top-down” approach in planning, ignoring some stakeholders, and the lack of coordination between the two areas of health service delivery were identified as weaknesses. The main objective of the HTP interventions was increasing the financial risk protection.
Conclusions: Developing a master plan based on health priorities, the efficient way of resource use and constructive collaboration with relevant stakeholders is needed to make sustainable and purposeful change in next steps of HTP. The implementation of this plan undoubtedly will require sustained financing and on-time resource allocation.
Keywords: Health Reform; Health System; Policy Analysis; Therapeutic Services; Health Policy Making
Methods: To qualitative analysis of HTP, Walt and Gilson’s Policy triangle and Kingdon’s multiple streams were employed. Data was collected through key informant interviews with stakeholders as well as a review of relevant documents and was analyzed using framework analysis. MAXQDA software was used.
Results: Legal, political, socioeconomic, international factors, and health system problems were the main factors triggering HTP. Challenges of therapeutic services implementing the second phase of the subsidy program and change of the government opened the political window of opportunity. The main strengths in HTP policy making process were using evidence, aligning with upstream documents, analyzing the situation, attracting the views of senior political leaders, planning simultaneously in different areas of the health service delivery, and prioritizing the urgent problems. Using a “top-down” approach in planning, ignoring some stakeholders, and the lack of coordination between the two areas of health service delivery were identified as weaknesses. The main objective of the HTP interventions was increasing the financial risk protection.
Conclusions: Developing a master plan based on health priorities, the efficient way of resource use and constructive collaboration with relevant stakeholders is needed to make sustainable and purposeful change in next steps of HTP. The implementation of this plan undoubtedly will require sustained financing and on-time resource allocation.
Keywords: Health Reform; Health System; Policy Analysis; Therapeutic Services; Health Policy Making
Please cite this article as follows:
Sajadi HS, Hosseini M, Dehghani A, Khodayari R, Zandiyan H, Hosseini SS. The Policy Analysis of Iran’s Health Transformation Plan in Therapeutic Services. Hakim Health Sys Res 2018; 21(2): 71- 88.
Sajadi HS, Hosseini M, Dehghani A, Khodayari R, Zandiyan H, Hosseini SS. The Policy Analysis of Iran’s Health Transformation Plan in Therapeutic Services. Hakim Health Sys Res 2018; 21(2): 71- 88.
*Corresponding Author: Ph.D., Social Affairs Deputy, Iran Ministry of Health and Medical Education, Shahrak Ghods, Simaye Iran St., Ministry of Health and Medical Education, Building C, Floor 14, Social Determinant of Health office, Tehran, Iran. Tel: +98-9125265873, Email: hosseini.maso@gmail.com
Zahra Toosi, Elahe Soori, Latif Zamanian, Gholamhossein Fallahinia,
Volume 21, Issue 3 (10-2018)
Volume 21, Issue 3 (10-2018)
Abstract
Implementation of the Health System Reform Plan in Two Contexts of “Promoting Vaginal Delivery and Reducing Out-of-Pocket Payment of Hospitalized Patients” in Hospitals Affiliated to Hamadan University
of Medical Sciences
of Medical Sciences
Zahra Toosi 1 2, Elaheh Soori 3 *, Latif Zamanian 4, Gholamhosein Fallahinia 5
1Program Headquarters, Hamadan University of Medical Sciences, Hamadan, Iran
2Health Services Management, Tehran University of Medical Sciences, Tehran, Iran
3Department of Treatment, University of Medical Sciences and Health Services, Hamadan, Iran
4Faculty of Nursing and Midwifery, University of Medical Sciences, Hamadan, Iran
5Internal Nursing and Surgery, Faculty of Nursing, University of
Medical Sciences and Health Services, Hamadan, Iran
Abstract
Background: The increasing costs of health care, the limited capacity of financial systems, and the inefficiency of the traditional health sector practices led to more government investment in health and paved the way for necessary reforms through the implementation of the health system reform plan by the Ministry of Health. The aim of this study was to evaluate the implementation of health system reform plan in two contexts of “promoting vaginal delivery” and “reducing the payment of hospitalized patients” in Hamadan University of Medical Sciences affiliated hospitals in 2014.
Methods: This cross-sectional study was conducted in 2015. Information about the bills of hospitalized patients and the statistics of the delivery type in 15 hospitals was extracted from the registration forms of admitted patients and vaginal delivery data system. The plan was evaluated by comparing the data before and after the implementation of the plan and by concerning the criteria set by the Ministry.
Results: The results showed that the program for promoting vaginal delivery led to a 2.3% decrease in cesarean section cases. In addition, out-of-pocket payment of hospitalized patients in university hospitals dropped to 8.86%.
Conclusions: The implementation of the health care reform plan has been successful in hospitals of Hamadan University of Medical Sciences and has achieved its goals. However, in some cases, it is possible to achieve the full success of the program by taking serious measures to identify and resolve the existing problems.
Keywords: Health System Reforms; Cesarean Section; Out-of-Pocket Payment of Hospitalized Patients
Please cite this article as follows:
Toosi Z, Soori E, Zamanian L, Fallahinia Gh. Investigating the implementation of the health system reforms plan in two contexts of “Promoting Natural Delivery and Reducing Payments for Hospitalized Patients” in Hamadan University of Medical Sciences affiliated hospitals. Hakim Health Sys Res 2018; 21(3): 173-179.
*Corresponding Author: M.Sc., Department of Treatment, University of Medical Sciences and Health Services, Hamadan, Iran. Email: darman_neonatal@yahoo.com
Efat Mohamadi, , , Ali Hasanzadeh, Mohammadreza Mobinizadeh, Taraneh Yousefinezhad, Sara Mohammadi,
Volume 21, Issue 3 (10-2018)
Volume 21, Issue 3 (10-2018)
Abstract
Identification of Basic Indicators for Monitoring and Assessment of the Sixth Development Plan in the Health Sector
Efat Mohamadi 1, Alireza Olyaeemanesh 1, 2 *, Amirhossein Takian 1, 3, Ali Hassanzadeh 4, Mohammadreza Mobinizadeh 2, Taraneh Yousefinezhadi 5, Sara Mohamadi 6
1Health Equity Research Center (HRC), Tehran University of Medical Sciences, Tehran, Iran
2National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran
3Deportment of Global Health and Public Policy, School of Public Health,
Tehran University of Medical Sciences, Tehran, Iran
4Health Insurance Organization of Iran, Tehran, Iran
5Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, Iran
6School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Background: Many health problems and the slow progress of development plans root in the absence of indicators to measure and monitor the achievement of the goals. This study aimed to identify the categorized indicators for monitoring and assessment of goal achievement in the Sixth Development Plan in the health sector.
Methods: This qualitative applied study was conducted in the following stages: Identifying the goals of the Sixth Development Plan in the health sector; identifying the inputs and outputs of the programs; initial compilation of indicators; evaluation of the indicators, and designing a conceptual model for health policy assessment. During the implementation of the study, the qualitative methods including high-level documents examination, literature review, and expert consensus were used.
Results: After being analyzed, the content of the development plan was divided into 12 topics. Then, a set of indicators were determined for each topic, which led to the emergence of 80 indicators after the final analysis. The highest score was related to the maternal and child health indicators (giving the scores of more than 63 out of 70).
Conclusions: Concerning its generalities and details, the progress evaluation of the sixth development plan can be done using small to large-scale indicators. The optimal mode is to compile indicators for each level individually and professionally.
Keywords: Plan Assessment; Indicator; Development Plan; Health System
Please cite this article as follows:
Mohamadi E, Olyaeemanesh AR, Takian AHm, Hassanzadeh A, Mobinizadehh MR, Yousefinezhadi T, Mohamadi S. Identification of health indicators to monitor and evaluate the health policies in sixth development five years plan. Hakim Health Sys Res 2018; 21(3): 242- 254.
*Corresponding Author: Associate Professor, National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran.
Tel: +98-9124117610, Email: arolyaee@gmail.com
Efat Mohamadi 1, Alireza Olyaeemanesh 1, 2 *, Amirhossein Takian 1, 3, Ali Hassanzadeh 4, Mohammadreza Mobinizadeh 2, Taraneh Yousefinezhadi 5, Sara Mohamadi 6
1Health Equity Research Center (HRC), Tehran University of Medical Sciences, Tehran, Iran
2National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran
3Deportment of Global Health and Public Policy, School of Public Health,
Tehran University of Medical Sciences, Tehran, Iran
4Health Insurance Organization of Iran, Tehran, Iran
5Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, Iran
6School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Background: Many health problems and the slow progress of development plans root in the absence of indicators to measure and monitor the achievement of the goals. This study aimed to identify the categorized indicators for monitoring and assessment of goal achievement in the Sixth Development Plan in the health sector.
Methods: This qualitative applied study was conducted in the following stages: Identifying the goals of the Sixth Development Plan in the health sector; identifying the inputs and outputs of the programs; initial compilation of indicators; evaluation of the indicators, and designing a conceptual model for health policy assessment. During the implementation of the study, the qualitative methods including high-level documents examination, literature review, and expert consensus were used.
Results: After being analyzed, the content of the development plan was divided into 12 topics. Then, a set of indicators were determined for each topic, which led to the emergence of 80 indicators after the final analysis. The highest score was related to the maternal and child health indicators (giving the scores of more than 63 out of 70).
Conclusions: Concerning its generalities and details, the progress evaluation of the sixth development plan can be done using small to large-scale indicators. The optimal mode is to compile indicators for each level individually and professionally.
Keywords: Plan Assessment; Indicator; Development Plan; Health System
Please cite this article as follows:
Mohamadi E, Olyaeemanesh AR, Takian AHm, Hassanzadeh A, Mobinizadehh MR, Yousefinezhadi T, Mohamadi S. Identification of health indicators to monitor and evaluate the health policies in sixth development five years plan. Hakim Health Sys Res 2018; 21(3): 242- 254.
*Corresponding Author: Associate Professor, National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran.
Tel: +98-9124117610, Email: arolyaee@gmail.com
Efat Mohammadi, Alireza Olyaeemanesh, Seyedreza Majdzadeh, Mohamad Javad Kabir, Mojtaba Atri, Kamran Asghari, Mohammad Reza Mobinizadeh, Mousa Tabatabai, Mani Yousefvand, Zahra Goudarzi,
Volume 21, Issue 4 (1-2019)
Volume 21, Issue 4 (1-2019)
Abstract
Effect of the Health Transformation Plan (HTP) on Implementation Processes, Rules and Regulations of Basic Health Insurance Organizations in Iran
Efat Mohamadi 1, Alireza Oliaeemanesh 1, 2 *, Reza Majd Zade 3, 4, 5, Mohamad Javad Kabir 6, Mojtaba Atri 7, Kamran Asghari 8, Mohammad Reza Mobini Zadeh9, Mosa Tabatabaei 10, Mani Yusefvand 11, Zahra Goudarzi 12
1 Health Equity Research Center, Tehran University of Medical Sciences, Tehran, Iran
2 National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran
3 Center for Community Based Participatory Research Centre,
Tehran University of Medical Sciences, Tehran, Iran
4 Center for Knowledge Utilization Research Centre,
Tehran University of Medical Sciences, Tehran, Iran
5 Iran’s National Institute of Health Research, Tehran, Iran
6 Department of Health Services Management, Golestan University of Medical Sciences, Gorgan, Iran
7 Dana Insurance Company, Central Insurance, Tehran, Iran
8 Social Security Organization, Tehran, Iran
9 National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran
10 Deputy Treatment, Ministry of Health and Medical Education, Tehran, Iran
11 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
12 Department of Health Management and Economics, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Introduction: From the first year of implementation, the Health Transformation Plan (HTP) has had many effects on the practice of health system actors. The present study was designed to investigate the effect of the HTP on the implementation processes, rules, and regulations of the basic health insurance organizations.
Methods: This qualitative study was conducted using semi-structured interviews and document analysis. Data were analyzed using qualitative content analysis with an inductive approach. The interviews were analyzed using MAXQDA version 11 software. The research population consisted of experts and senior managers of the health insurance sector selected using purposive sampling.
Results: Four topics and 11 themes were identified, including population coverage, service coverage, cost of services, process of arranging and manipulating documents, the process of paying claims, the impact of HTP packages, the interactions of insurance companies with the Ministry of Health and hospitals, rules and regulations, structures, and workload of insurance agencies. They all constituted 75 subthemes.
Conclusions: The experience of implementing the HTP in Iran shows that primary access to healthcare services for all is an achievable goal for any middle-income country although there are always questions about their sustainability and quantity. Major reforms in the financing of plans need changes that require government investment and long-term commitment to overcome challenges.
Keywords: Transformation Plan; Reform; Health System; Health Insurance
| Please cite this article as follows: Mohamaadi E, Oliaeemanesh AR, Majdzade R , Kabir MJ, Atri M, Asghari K et al. Identification of the Impact of the Health Transformation Plan on processes, standards and regulations of the Basic Health Insurance Organizations in Iran. Hakim Health Sys Res 2019; 21(4): 255- 265. |
*Corresponding Author: Associate Professor, National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran.
Tel: +98-9124117610, Email: arolyaee@gmail.com
Ali Mohammad Mosadeghrad, Maryam Tajvar, Fatemeh Ehteshami,
Volume 22, Issue 1 (4-2019)
Volume 22, Issue 1 (4-2019)
Abstract
Background: Iran’s health system faces rising costs and resource scarcity. Donors’ financial contribution is one of the ways to strengthen the country’s health system financing. The purpose of this study was to explore the ways of donors’ participation in financing Iran’s health system.
Methods: This qualitative study was performed using semi-structured interviews with 38 donors and 26 managers in Social Affiars Deputy of the Ministry of Health and universities of medical sciences in 2017 - 2018. In addition, document analysis was performed using related laws, regulations, policies, plans, etc. Content analysis was used to analyze the data.
Results: Donors are involved in collecting charitable funds and spending them in the health system. They participate in collecting charitable funds through health charity organizations and councils, distributing donation boxes among the community, crowdfunding in social networks, and holding purposeful events. Donors spend the collected money for developing and expanding healthcare organizations, purchasing healthcare technologies and equipment, paying employees, and paying for poor patients’ healthcare bills.
Conclusions: Donors have a significant role in financing the health system. Hence, healthcare policymakers and managers should plan, organize, direct, and supervise donors and charities to maximize their participation.
Alimohammad Mosadeghrad, Fatemeh Ehteshami,
Volume 22, Issue 4 (12-2019)
Volume 22, Issue 4 (12-2019)
Abstract
Explaining and Predicting Donors’ Participation Behavior in Iranian Health System
Ali Mohammad Mosadeghrad1, Fatemeh Ehteshami2*
1Department of Health Management and Economics, Health Information Management Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
2Department of Health Management and Economics, School of Public Health,
Tehran University of Medical Sciences, Tehran, Iran
Abstract
Introduction: Donors can contribute to the funding, resource generation, and provision of healthcare services in the Iran health system. Several factors can influence the donors’ contribution to the health system. This study aimed to explain and predict the donors’ participation in the Iran health system.
Methods: A qualitative and inductive study was performed using semi-structured interviews with 38 donors and 26 policymakers and managers in the Social Affairs Department of the Ministry of Health and the Universities of Medical Sciences in 2018. The interviewees were recruited using a purposeful and snowball method. The thematic content analysis method was used for data analysis. All major ethical considerations were observed in this research.
Results: Healthcare donors followed a purposeful and planned behavior for contributing to the health system. Nine factors can influence a donor’s charitable behavior in the health system, including goal, intention, attitude, norms (ethical, descriptive, and subjective norms), personal characteristics, background knowledge, experience, past behavior, and control of perceived behavior. The donors’ participation in the health system is a function of their goals, intentions, attitudes, and their control of perceived behavior. The donors’ attitude is shaped by their characters, background knowledge, experience, past behavior, and ethical, descriptive, and subjective norms.
Conclusion: The purposeful and planned behavior model developed in this study guides healthcare managers and policymakers in explaining and predicting the donors’ charitable behavior in the health system.
Keywords: Purposeful and Planned Behavior Theory; Donors; Iranian Health System; Modelling
| Please cite this article as follows: Mosadeghrad AM, Ehteshami F. Explaining and predicting donors’ participation behavior in Iranian health system. Hakim Health Sys Res. 2019; 22(4): 284-297. |
*Corresponding Author: Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2181455832, Email: fateme.eht@gmail.com
Bahareh Tahani, Reza Rezayatmand, Arezoo Rahim Zamani,
Volume 23, Issue 2 (6-2020)
Volume 23, Issue 2 (6-2020)
Abstract
Introduction: Health reform plan in dentistry has been implemented systematically in Iran since 2014 in villages and cities with a population lower than 20,000 inhabitants. This study aimed to evaluate the impact of this plan on the utilization of dental services in Isfahan province.
Methods: Ten health centers with dentists contracted with the health reform plan were recruited. The frequency of dental services (examination, preventive care, restorative care, and extraction) was assessed. Four centers not in contract with this plan were considered as the control centers. To compare the frequency of provided services, the non-parametric tests of Mann-Whitney and Wilcoxon (α=0.05) were used (SPSS 22).
Results: In the control centers, the cumulative frequency of provided care demonstrated no significant difference between 2014 and 2017. In the centers subject to the reform plan, there were increases in examination (p=0.02), amalgam (p=0.04), and composite restoration (p=0.04) in the age group of 6 years, and examination, extraction, amalgam, and composite restoration (p=0.007) in the age group of 6-12 years. In pregnant women, extraction (p=0.017), composite restoration (p=0.04), and scaling (p=0.012) increased significantly. In the six-year-old group, the means difference of extraction (p=0.036) and amalgam restoration services (p=0.024) and in the age group of 6-12 years, the means of extraction (p=0.014) and amalgam restoration (p=0.008) were significantly increased in the centers subject to the reform plan than in the control group.
Conclusion: After the implementation of the reform plan in health centers, dentists were more willing to provide preventive and restorative care that could be partially due to financial incentives.
Methods: Ten health centers with dentists contracted with the health reform plan were recruited. The frequency of dental services (examination, preventive care, restorative care, and extraction) was assessed. Four centers not in contract with this plan were considered as the control centers. To compare the frequency of provided services, the non-parametric tests of Mann-Whitney and Wilcoxon (α=0.05) were used (SPSS 22).
Results: In the control centers, the cumulative frequency of provided care demonstrated no significant difference between 2014 and 2017. In the centers subject to the reform plan, there were increases in examination (p=0.02), amalgam (p=0.04), and composite restoration (p=0.04) in the age group of 6 years, and examination, extraction, amalgam, and composite restoration (p=0.007) in the age group of 6-12 years. In pregnant women, extraction (p=0.017), composite restoration (p=0.04), and scaling (p=0.012) increased significantly. In the six-year-old group, the means difference of extraction (p=0.036) and amalgam restoration services (p=0.024) and in the age group of 6-12 years, the means of extraction (p=0.014) and amalgam restoration (p=0.008) were significantly increased in the centers subject to the reform plan than in the control group.
Conclusion: After the implementation of the reform plan in health centers, dentists were more willing to provide preventive and restorative care that could be partially due to financial incentives.
| Please cite this article as follows: Tahani B, Rezayatmand R, Rahimzamani A. Dental care utilization after the implementation of “Health Reform Plan” in Isfahan province. Hakim Health Sys Res. 2020; 23(2): 201-210. |
*Corresponding Author: Department of Oral Public Health, School of Dentistry, Isfahan University of Medical Sciences, Hezar Jarib St, Isfahan, Iran. Tel: (+98)9133183633, E-mail: tahani@dnt.mui.ac.ir
Nasime Shafie, Samaneh Hajihoseini,
Volume 23, Issue 2 (6-2020)
Volume 23, Issue 2 (6-2020)
Abstract
Introduction: The purpose of this study was to evaluate the satisfaction of urban and rural populations of Larestan with the family physician plan.
Methods: The present study was conducted with a quantitative approach. The data collection tool was a researcher-made questionnaire. The statistical population consisted of all households covered by the plan in Larestan city. A sample of 383 people was selected using the Cochran formula. Data were analyzed by SPSS21 software using Pearson analysis, regression analysis, and T-test. The face validity and Cronbach’s alpha were used to assess the validity and reliability of the research instrument, respectively.
Results: The overall satisfaction with the family physician plan was moderate to high (62.7%). There was no relationship between gender (P=0.074), occupation (P=0.424), and residential homeownership (P=0.338), and satisfaction with the plan. There were significant direct relationships between residence place, marital status, age, education, insurance coverage, income, level of service coverage, medical costs, physician’s clinical expertise, and access to physician, and satisfaction with the plan. The results of multivariate regression analysis showed that service coverage (r=0.925), treatment costs (r=0.928), age (r=0.930), and clinical expertise (P=0.931) explained a total of 86% of changes in the satisfaction with the family physician plan (P<0.001).
Conclusion: The quality of services and satisfaction with the plan can be increased by allocating resources, implementing educational programs for increasing physician skills, holding training courses for villagers to get them acquainted with the goals of the plan, and careful monitoring and surveillance of the program.
Methods: The present study was conducted with a quantitative approach. The data collection tool was a researcher-made questionnaire. The statistical population consisted of all households covered by the plan in Larestan city. A sample of 383 people was selected using the Cochran formula. Data were analyzed by SPSS21 software using Pearson analysis, regression analysis, and T-test. The face validity and Cronbach’s alpha were used to assess the validity and reliability of the research instrument, respectively.
Results: The overall satisfaction with the family physician plan was moderate to high (62.7%). There was no relationship between gender (P=0.074), occupation (P=0.424), and residential homeownership (P=0.338), and satisfaction with the plan. There were significant direct relationships between residence place, marital status, age, education, insurance coverage, income, level of service coverage, medical costs, physician’s clinical expertise, and access to physician, and satisfaction with the plan. The results of multivariate regression analysis showed that service coverage (r=0.925), treatment costs (r=0.928), age (r=0.930), and clinical expertise (P=0.931) explained a total of 86% of changes in the satisfaction with the family physician plan (P<0.001).
Conclusion: The quality of services and satisfaction with the plan can be increased by allocating resources, implementing educational programs for increasing physician skills, holding training courses for villagers to get them acquainted with the goals of the plan, and careful monitoring and surveillance of the program.
| Please cite this article as follows: Shafiei N, Hajihoseini S. Survey of satisfaction of people in urban and rural areas with the family physician plan. Hakim Health Sys Res. 2020; 23(2): 238-245. |
*Corresponding Author: Larestan University of Medical Sciences, Karmandan street, North Ghadir Blvd, Shahr e Jadid, Larestan, Fars. Postal code: 74318896629, Tel: (+98)9173811673, Fax: (+98)7152255484. E-mail: shajihoseini@yahoo.com
Ali Mohammad Mosadeghrad, Ebrahim Jaafaripooyan, Soodeh Hajihashemi,
Volume 23, Issue 2 (6-2020)
Volume 23, Issue 2 (6-2020)
Abstract
Introduction: The health system reform is a course of targeted, fundamental, and sustainable changes to increase accessibility, efficiency, quality, equity, resilience, sustainability, accountability, and satisfaction, and to reduce cost. Iran’s Health Transformation Plan (HTP) was implemented in May 2014 to reduce patients’ costs, improve the quality of services, and provide equal access to hospital care. The objective of this study was to evaluate the HTP effect on patient satisfaction.
Methods: A retrospective, descriptive-analytical research was conducted using patient satisfaction data from 2012 to 2016 in a specialized hospital in Isfahan, Iran. About 538 and 873 patients were examined before and after the HTP implementation, respectively. A 29-item questionnaire was used to measure patients’ satisfaction with medical, nursing, supportive, and welfare services. Data were analyzed using SPSS-V24.
Results: Patient satisfaction increased from 84% in 2012 to 89.7% in 2016. The HTP implementation increased patient satisfaction by 6.3%, which was statistically significant (p<0.05). Patient satisfaction was increased in all medical, nursing, supportive, and welfare dimensions. The most increase occurred in supportive and welfare services and the least increase happened in nursing services. Patient satisfaction increased by 5.5%, 0.37%, and 0% after one, two, and three years of HTP implementation in the hospital.
Conclusion: Patient satisfaction increased in the hospital following HTP implementation. Evaluating the HTP effects regularly reveals its strengths and weaknesses and policy-makers can apply necessary and on-time changes to sustain its positive results.
Methods: A retrospective, descriptive-analytical research was conducted using patient satisfaction data from 2012 to 2016 in a specialized hospital in Isfahan, Iran. About 538 and 873 patients were examined before and after the HTP implementation, respectively. A 29-item questionnaire was used to measure patients’ satisfaction with medical, nursing, supportive, and welfare services. Data were analyzed using SPSS-V24.
Results: Patient satisfaction increased from 84% in 2012 to 89.7% in 2016. The HTP implementation increased patient satisfaction by 6.3%, which was statistically significant (p<0.05). Patient satisfaction was increased in all medical, nursing, supportive, and welfare dimensions. The most increase occurred in supportive and welfare services and the least increase happened in nursing services. Patient satisfaction increased by 5.5%, 0.37%, and 0% after one, two, and three years of HTP implementation in the hospital.
Conclusion: Patient satisfaction increased in the hospital following HTP implementation. Evaluating the HTP effects regularly reveals its strengths and weaknesses and policy-makers can apply necessary and on-time changes to sustain its positive results.
| Please cite this article as follows: Mosadeghrad AM, Jaafaripooyan E, Hajihashemi S. Effect of Iran Health Transformation Plan on patient satisfaction. Hakim Health Sys Res. 2020; 23(2): 228-237. |
*Corresponding Author: Health Economics and Management Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Tel: (+98)2142933006, E-mail: shajihashemi@yahoo.com
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