Patient absconding from emergency department and its financial burden: a study in a large public hospital, Tehran

Background and Aims: Patient absconding is a major health issue with economic, social, and health costs and consequences. The present study aimed to investigate the absconding rate from a emergency department and its financial burden in a public hospital in Tehran, IRAN.Materials and Methods: This retrospective and descriptive study was carried out in the emergency department of a large public and teaching hospital in Tehran. Data were collected using the absconded patient records from 23 September 2013 to 22 September 2014. Data were analyzed using descriptive statistics.Concerns about medical ethics, including patient’s confidentiality and hospital name were observed at all stages of study.Results: The results of this study indicate that 774 patients had left the hospital without permission or a notice to staff, so the absconding rate in this study was about 2.4 percent. Young, male, married and uninsured patients were more absconded. Average billing per absconded patient was 1,449,738 Iranian Rials (IRR). The hospital was consequently incurred financial losses amounted to 1,122,097,212 IRR as a result of patientabsconding.Conclusion: In order to preventing and reducing the abscond rate, the following strategies are recommended: the identification of high-risk patients for further care, regular monitoring of emergency departments, good communication and interaction with the patient and his family, introducing the discharge against medical advice (DAMA) policy to patients, accurate recording of patient information to reduce the risk of abscond oraccess to him/her after the absconding.Key words: Patient Absconding, Emergency Department, Retrospective Study*Correspondin

Comprehensive organizational diagnosis of Imam Hussein Hospital (Shahid Beheshti University of Medical Sciences- affiliated) based on Weisbord model in 2015

AbstractBackground and Aims: Hospital, considered as a complex organization with high accountability, plays an important role in the health care system. In the present study, based on Weisbord model, we carried out a comprehensive assessment of Imam Hussein hospital affiliated to Shahid Beheshti University of MedicalSciences in 2015.Materials and Methods: This study is considered as a descriptive and analytical research. Study population consists of hospital staff among which the numbers of participants were determined at the 0.05 error level using Cochran formula. In order to collect the required data standard organizational diagnosiswas used. Data were analyzed using independent t-test and ANOVAs tests using SPSS software version 21. Compliances with ethical standards were also considered.Results: A total of 306 staff participated in the study. An overall average of studying 7 dimensions score was 4.14 showing the weakness of the hospital management in terms of inner organizational elements.Sample T-test results showed hospital status was desirable in dimensions of goal setting, leadership and attitudes towards changes. Dimensions of “goal setting” and “reward” with the average scores of 3.88and 4.85 were the strongest and the weakest, respectively. A significant relation was observed between educational level and scores given to rewards dimension.Conclusion: Results indicated that the organizational status of this hospital is generally not desirable. Although, managing a hospital cannot be considered as managing other organizations, by adjusting the strengthening of organizational dimensions and reducing barriers and obstacles the conditions can beimproved.Keywords: Hospital, Organizational Diagnosis, Assessment, Weisbord ModelFor downloading the full text please click here

Explaining Management Status of Intensive Care Units Beds: A

Introduction: Access to intensive care unit (ICU) beds varies in different countries. Due to the population growth, aging, and longer survival of chronic patients, demand for these beds is increasing all over the world. The present study was performed to assess the management status of ICU beds in selected teaching hospitals affiliated to Shahid Beheshti University of Medical Sciences. Method: This qualitative study was conducted using conventional content analysis method in 2016. In this study, 25 participants were selected by purposive sampling and with maximum variation, and were interviewed by semi-structured interviews with open-ended questions. The interviews were performed in the participants' workplace and lasted between 30 and 60 min. Data were analyzed using conventional content analysis approach. Results: After data analysis, 4 main themes including human capacities related to bed management, the relevant organizational and managerial requirements, ICU prioritized patients' admission and discharge manner, and strategies for promotion and improvement of ICU bed management status and 12 subthemes related to the management status of ICU beds were extracted. Conclusion: According to the results, in our country, bed management in the intensive care units faces many challenges, especially in the areas related to human capacities, ICU admission and discharge prioritization method, and ICUs' monitoring and control, which need to be paid more attention. These challenges can be addressed through training more ICU specialists, observing international admission and discharge criteria, and using appropriate monitoring and control systems

Spiritual health status in students of Shahid Beheshti University and Shahid Beheshti University of Medical Sciences

For downloading the full-text of this article please click hereBackground and Objectives: Spiritual health is one of the aspects of human health, in addition to physical, mental and social health and causes the integrated relationship among internal forces. The aim of this study is determination of the spiritual health status in Students of Shahid Beheshti University and Shahid­ Beheshti University.Materials and Methods: This study was a cross-sectional and descriptive - analytic that conducted on 367 students in 2015. The sampling method was quota sampling. Data were collected using valid and reliable measure of spiritual health questionnaire with 48 questions, in the form of two components of cognitive-emotional (insight and orientation) and behavior; and three concept of relationship with God, with oneself and around. The data were analyzed with software SPSS21.Results: From 367 participants in the study, 59.1 percent were tempfemale and 12.3 percent were married and 66.4 percent of them lived in Tehran. 47.2% of participants were studying for BS and the rest in graduate and PhD. The mean age (standard deviation) ) was reported 22.64 (3.88). The mean (SD) of insight and spiritual orientation, behavior and spiritual health were 79.94 (15.34) 71.96 (14.28) and 76.62 (13.89), respectively.Conclusion: The mean scores of students were relatively high in the field of vision and spiritual orientation, moral behavior and spiritual health. The average of spiritual health indicators and its performance was more in girls and married students than boys and unmarried. As well as there was a significant relationship between spiritual insight  and orientation with behavior.Keywords: Spiritual Health, Religious, StudentsFor downloading the full-text of this article please click here

Geographic distribution and time trends of water-pipe use among Iranian youth and teenage students : A meta-analysis and systematic review

Water-pipe tobacco smoking is harmful to health, yet its rate of prevalence remains uncertain. Recent evidence has shown that the prevalence of water-pipe smoking among students is higher than in the general population. In this study, a systematic review of related literature on water-pipe use was conducted, and for this purpose, 76 articles were examined in the study. In this vein, geographic distribution and time trends of water-pipe consumption in Iran were considered. The results of this study showed that lifetime, last-year, and last-month prevalence of water-pipe smoking use among Iranian students were 28.78 (25.07–32.49), 20.84 (16.01–25.66), and 16.36 (11.86–20.85), respectively. The results also showed a wide variation by the region and sex in Iran. This study has shown the importance of addressing public prevention and alerting programs in schools and universities.acceptedVersionPeer reviewe

Effect of workload on quality of work life among staff of the teaching hospitals of Shahid Beheshti University of Medical Sciences (2014)

Background: Quality of work life is the reaction of employees to their work specially the individual results at work and mental health that affects their personal experience and work results. Objective: The aim of this study was to determine the effect of workload on quality of work life in staff of the teaching hospitals affiliated to Shahid Beheshti University of Medical Sciences, Tehran. Methods: This analytical study was conducted in 530 staff of four hospitals affiliated to the Shahid Beheshti University of Medical Sciences that were selected by Cochrane sampling method during 2014. The measurement tools were demographic questionnaire, Walton's quality of work life questionnaire (including 32 questions and eight dimensions), and the NASA TLX workload scale. Data were analyzed using Pearson’s correlation coefficient. Findings: The mean scores of quality of work life and workload were 48.21±13.34 and 64.70±11.44, respectively. There was negative significant correlation between workload and quality of work life (r= -0.0161). Conclusion: With regards to the results, it seems that high workload is one of the most important factors of reduced quality of work life that can be reduced through proper organization and planning. Keywords: Quality of life, Workload, Hospital

Improving graduation rates and subsequent health through the creation of an Accountable Care Community in Robeson County, North Carolina

Social determinants of health (SDoH) are conditions that affect the places where people live, learn, work, and play, and impact a wide range of health risks and outcomes (CDC, 2018). Education is a SDoH, with higher levels of education contributing to better jobs, higher incomes, and access to health-promoting resources (NCIOM, 2009). In North Carolina (NC), low levels of education are a challenge for many communities. Within Robeson County, NC, the link between low educational attainment and poor health outcomes is evident (UWPHI, 2019). To address this, we performed a systems analysis to develop an Accountable Care Community (ACC) in Robeson County. The goal of the ACC is to define school indicators that are required for imposing an equitable system for resource allocation among county schools. By doing this, we hope to promote equity in establishing well-resourced learning environments and to improve educational attainment in Robeson County.Master of Public Healt

فرار بیماران از بخش اورژانس و بار مالی آن در یک بیمارستان بزرگ عمومی شهر تهران : یک مطالعه مقطعی

Background and Aims: Patient absconding is a major health issue with economic, social, and health costs and consequences. The present study aimed to investigate the absconding rate from a emergency department and its financial burden in a public hospital in Tehran, IRAN.Materials and Methods: This retrospective and descriptive study was carried out in the emergency department of a large public and teaching hospital in Tehran. Data were collected using the absconded patient records from 23 September 2013 to 22 September 2014. Data were analyzed using descriptive statistics. Concerns about medical ethics, including patient’s confidentiality and hospital name were observed at all stages of study.Results: The results of this study indicate that 774 patients had left the hospital without permission or a notice to staff, so the absconding rate in this study was about 2.4 percent. Young, male, married and uninsured patients were more absconded. Average billing per absconded patient was 1,449,738 Iranian Rials (IRR). The hospital was consequently incurred financial losses amounted to 1,122,097,212 IRR as a result of patient absconding.Conclusion: In order to preventing and reducing the abscond rate, the following strategies are recommended: the identification of high-risk patients for further care, regular monitoring of emergency departments, good communication and interaction with the patient and his family, introducing the discharge against medical advice (DAMA) policy to patients, accurate recording of patient information to reduce the risk of abscond or access to him/her after the absconding.زمينه و هدف: فرار بیمار از بیمارستان، یک مسئله بهداشتی درمانی مهم با هزینه‌های اقتصادی، اجتماعی و بهداشتی است. این مطالعه با هدف بررسی میزان فرار بیماران از بخش اورژانس و بار مالی آن در  یک بیمارستان عمومی در شهر تهران انجام شد. مواد و روش‌ها: این مطالعه توصیفی و گذشته‌نگر در بخش اورژانس یک بیمارستان بزرگ عمومی و آموزشی شهر تهران انجام شد. با استفاده از پرونده‌های بیماران فراری در محدوده زمانی یکم مهر ۱۳۹۲ تا ۳۱ شهریور ۱۳۹۳، اطلاعات مورد نیاز جمع آوری شد. تحلیل داده‌ها با استفاده از روش‌های آمار توصیفی انجام شد. موازين اخلاقي از جمله محرمانه بودن نام بيماران و بیمارستان مورد پژوهش رعايت گرديد.   يافته‌ها: براساس یافته‌ها، 774 نفر از بیماران بدون تسویه حساب و اطلاع به کارکنان، بیمارستان را ترک کرده بودند و نرخ فرار از اورژانس در این مطالعه 4/2 درصد بود. میزان فرار در بین بیماران جوان، مرد، متاهل و بدون بیمه بیشتر بود. میانگین صورتحساب پرونده هر بیمار فراری ۱،۴۴۹،۷۳۸ ریال و بیمارستان مذکور در مجموع مبلغ ۱،۱۲۲،۰۹۷،۲۱2 ریال متحمل خسارت مالی ناشی از فرار بیماران شده بود.  نتيجه گيري: شناسایی افراد پرریسک برای مراقبت‌های بیشتر، کنترل منظم بخش‌های اورژانس، تجهیز این بخش به نیروی انسانی جهت رسیدگی سریع‌تر به وضعیت بیماران، ارتباط مناسب و تعامل با بیمار و همراهان او، آشنا کردن بیمار به سیاست ترخیص به میل شخصی و ثبت دقیق اطلاعات بیمار برای کاهش ریسک فرار یا دسترسی داشتن به او پس از فرار از استراتژی‌های پیشگیری و کاهش این رفتار است