International Hospitals’ Performance Variables: A Comparative Study

Background: To define a series of variable that separates international hospitals from other ones is the main aim of this study.Materials and Methods: After choosing some countries in the worldwide, two hospitals, which were the leaders on international patients’ admissions, were selected for investigating their main indicators according to world health organization framework for demonstrating performance assessment to attract patients from the universe.Results: Under the first performance assessment dimension clinical effectiveness and safety, in chosen hospitals of Australia as Malaysia found (4), New Zealand (9), India (7) and Iran (1) indicator (s). The production efficiency and staff orientation dimensions concluded no difference in terms of quantity and type of indicators via countries. Next aspect as patient centeredness was consisted of 4 indicators in Australia, New Zealand (2), India (6) and Iran (5). Eventually, eight indicators asset from Australia, New Zealand (2), India (6) and Iran (6) for responsive governance.Conclusion: Although the variables of international hospital’s performance assessment were the same with others, these should be more highlighted for attracting worldwide patients and strongly recommends the international authority for quality assurance

Factors Affecting on Development of Age_Friendly Hospital in Iran: Factor Analysis

Background & Aim: Developing countries such as Iran experience a growing phenomenon of aging, and the elderlies are at a risk of longer hospital stay. The increasing number of elderly patients necessitates the establishment of age-friendly hospitals. This study aimed to determine the factors affecting the development of age-friendly hospitals in Iran using factor analysis. Materials and Methods: This descriptive, analytic and cross-sectional study was performed during three months in 2018. The statistical population included physicians, nurses, and paramedical staff  of hospitals from across the country. In total, 408 subject were selected by cluster sampling. Data were collected using a demographic characteristics questionnaire (seven items) and the researcher-made age-friendly hospital questionnaire (57 items). In addition, data analysis was performed in SPSS version 22, and the exploratory factor analysis was confirmed by AMOS. Results: The exploratory analysis identified seven main components, including ethics in care (eight variables and variance 8.84%), physical environment (nine variables and variance 7.75%), care process (six variables and variance 7.69%), emotional and behavioral environment (six variables and variance 7.38%), organizational support (six variables and variance 7.33%), healthcare systems (six variables and variance 5.99), and policy-making (six variables and variance 5.56%). All the seven factors explained 50.56% of total variance. Conclusion: According to the results of the study, attention to factors including ethics in care, physical environment, care process, emotional and behavioral environment, organizational support, healthcare systems, and policy-making factors can lead to the development of age-friendly hospitals in Iran

Design of the Pattern of Effective Environmental Factors For Outsourcing the Services in Public Hospitals

Background: Hospitals are considered as the most important consumer units in healthcare and one of the main organizations of health services. Therefore, paying attention to their performance and effectiveness is of special importance. The aim of this study is to design an effective and efficient pattern for determination of effective environmental factors to outsource the services in public hospitals of country to increase the success rate in delivering the health services and improve the performance level and increase productivity by using them. Materials and Methods: Considering the results, this is an applied study and has an exploratory purpose. A questionnaire with 20 questions has been used for data collection, the variables of which are derived from comparative studies, its validity has been evaluated by the experts and its Cronbach's alpha coefficient was %86 in final measurement. The research community of the study was science committee of the universities, health system policy makers, experts in outsourcing and public hospital managers. Stratified sampling method was used for sampling. Data was analyzed by IBM SPSS statics 23 and LISREL 8.8. Findings: According to collected information, Important environmental factors on outsourcing were policy factor with the average of 3.67%, risk assessment 3.38, background 3.25 and development 2.83, in order of importance. The average of total score of environmental factor effect was 3.21 and was meaningfully more than the average amount of 3 (p<0.001). It shows that environmental factors are of important factors in outsourcing the hospital services. Conclusion: For achieving the desirable goals in outsourcing the services and avoiding the assignment problems, it is important to evaluate the external environment of hospital carefully based on the extracted components from this study and using an appropriate pattern for decision making in outsourcing the services

The effect of clinical factor on the health system integration

Introduction: Integration in the health system can improve the coordination and continuity of care for the patient. Clinical integration can facilitate the continuous, comprehensive, and coordinated provision of services at the individual level. This study was conducted to determine the effect of clinical variables on the integration of Iran's health system in 2017–2018. Methodology: This is an applied research which has been used in different stages of review, comparative, and quantitative methods in terms of necessity. In the first stage, various patterns of the theory and practice of integration of the health system were studied through library studies. Then, the common and noncommon dimensions of these patterns were set in a comparative table. After determining the variables of various patterns of integration, a questionnaire was developed, and its validity and reliability were confirmed. At the field stage, a survey of 506 experts and management experts of hospitals, data were collected, and exploratory and confirmatory factor analysis was performed. Results: Based on the results of the exploratory factor analysis in the clinical field, “the development of multifaceted care plans and team meetings” with the highest score of 0.649 was the most important. Regarding the standard coefficients of correlation analysis, the effect of the clinical factor on integration was 0.91. Furthermore, “case management,” “providing continuous care,” and “using protocols and clinical guidelines” with 0.79 factor load are the most important factors in the clinical integration of the health system. Conclusion: The health system can increase the quality of care through the development of multifaceted care plans and multiple team meetings, the development of coordination and continuity of care, focusing on the needs of patients, and step up the development of integration in the health system