The productivity and its barriers in public hospitals: Case study of Iran

Background: Due to the increasing health care costs, the issue of productivity in hospitals must be taken into great consideration in order to provide, preserve and promote public health services. Thus, increasing the level of productivity must become the main aim of any hospital. Objective of this study is to determine the total factor productivity and its components over the period under the study. Methods: In this cross sectional study, total factor productivity changes of hospitals affiliated to Tehran University of Medical Sciences were measured according to Malmquist index over the period 2009-2014. To estimate total productivity changes using Data Envelopment Analysis method, inputoriented and variable return to scale assumptions were applied and Deap2.1 software was used. Results: The mean value of total productivity changes was 1.013. It means that during the study period the productivity experienced a 1.3 decrease. Technological efficiency changes have the greatest influence on productivity decrease than the other factors. Scale efficiency, managerial efficiency and technical efficiency changes were ranked. Conclusion: Lack of knowledge of hospital personnel on proper application of technology in patient treatment is the main factor leading to productivity decrease resulting from technological changes in the studied hospitals. Therefore, holding courses for personnel in order to teach them the proper use of technology in diagnosis and patient care can be helpful

The effect of study preparation on test anxiety and performance: a quasi-experimental study

Hasan Yusefzadeh,1 Jamileh Amirzadeh Iranagh,2 Bahram Nabilou31Department of Health Management and Economics, School of Public Health, Urmia University of Medical Science, Urmia, West Azerbaijan, Iran; 2Department of Public Health, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran; 3Social determinants of health Research Center, Department of Health Management and Economics, School of Public Health, Urmia University of Medical Sciences, Urmia, IranBackground: Health care education is an important issue in the development of countries, and student’s academic achievement plays an important role in this respect. Test anxiety can affect the academic performance of students. This study aimed to investigate the effect of study preparation on test anxiety and performance of public health students.Methods: This quasi-experimental study investigated the effect of study preparation on reducing test anxiety and improving the performance of public health students at Urmia University of Medical Sciences, Urmia, Iran, in the academic year 2016–2017.All second- and third-year bachelor’s students in public health major were assigned into the intervention (n=20) and control groups (n=25). The assignment was based on the study preparation items and the defined benchmark.Data on general stress and test anxiety were collected by subjective self-assessment via paper-and-pencil surveys in the first week of the semester and before the final exam, respectively.Results: No significant difference was found in the level of general stress between the two groups at the beginning of the semester (p=0.55) based on the study preparation items. The level of test anxiety in the intervention group (47.90) was lower than in the control group (34.64) at the end of the semester (p=0.001). The mean value of exam scores was higher in the intervention group (p=0.015).Conclusions: The intervention reduced the level of test anxiety and improved the performance of students. Faculty members and heads of the departments should help students learn about the study preparation over the semester with engagement in learning-oriented approaches and class activities.Keywords: performance, education, anxiety, study preparation, Ira

Supplemental Material for the study: Patients with autoimmune liver disease have glucose disturbances that mechanistically differ from steatotic liver disease

AbstractAutoimmune liver diseases are associated with an increased risk of diabetes, yet the underlying mechanisms remain unknown. In this cross-sectional study, we investigated the glucose-regulatory disturbances in patients with autoimmune hepatitis (AIH, n=19), primary biliary cholangitis (PBC, n=15), and primary sclerosing cholangitis (PSC, n=6). Healthy individuals (n=24) and patients with metabolic dysfunction-associated steatotic liver disease (MASLD, n=18) were included as controls. Blood samples were collected during a 120 min oral glucose tolerance test. We measured the concentrations of glucose, C-peptide, insulin, glucagon, the two incretin hormones glucose insulinotropic peptide (GIP) and glucagon-like peptide-1 (GLP-1). We calculated the homeostasis model assessment of insulin resistance (HOMA-IR), whole body insulin resistance (Matsuda index), insulin clearance, and insulinogenic index. All patient groups had increased fasting plasma glucose and impaired glucose responses compared with healthy controls. Beta-cell secretion was increased in AIH, PBC, and MASLD but not in PSC. AIH and MASLD patients had hyperglucagonemia and hepatic, as well as peripheral, insulin resistance and decreased insulin clearance, resulting in hyperinsulinemia. Patients with autoimmune liver disease had an increased GIP response, and those with AIH or PBC had an increased GLP-1 response. Our data demonstrate that the mechanism underlying glucose disturbances in patients with autoimmune liver disease differs from that underlying MASLD, including compensatory incretin responses in patients with autoimmune liver disease. Our results suggest that glucose disturbances are present at an early stage of the disease.</p