Do Hospitals Affiliated With the Kurdistan University of Medical Sciences Perform Efficiently? Non-parametric Data Envelopment Analysis

Background: One way to improve the performance of hospitals, the largest resource-consuming units in the healthcare sector, is to continuously evaluate their performance.Objective: The current study assessed the performance of hospitals affiliated with the Kurdistan University of Medical Sciences using data envelopment analysis (DEA).Methods: This retrospective descriptive-analytic study used DEA to assess efficiency types (technical, managerial, and scale) in hospitals of the Kurdistan University of Medical Sciences (n = 12) in the years 2007 to 2011. The number of active beds, nurses, physicians (general and specialist), and other staff were inputs; inpatient admission and occupied bed days were outputs. Stata version 12 was used for data analysis.Results: The mean technical, scale, and managerial efficiency values were 0.85, 0.89, and 0.95, respectively. The highest and lowest slack inputs were nurses and active beds, respectively.Conclusion: The findings indicate that Kurdistan hospitals were less than appropriately efficient during the studied period. They also suggest that there is a capacity of about 15% for enhancing output in hospitals (compared with the most efficient studied hospitals) without increasing costs or inputs

The Status of Outsourcing Services in a Specialized Tehran Hospital Using SWOT

Background: Outsourcing in healthcare is a cost-effective strategy that reduces costs and increases service quality. Managers must attempt to outsource healthcare services using scientific methods. Objective: This study is a strategic analysis of the outsourcing of health services in one specialty and subspecialty hospital in Tehran. Methods: This mixed method study (quantitative-qualitative) was performed in 2014 at one of the biggest specialty hospitals in Tehran. Data was collected through interviews, focus discussion groups (FDG), and the internal and external factors evaluation matrix. The study population comprised managers and directors of the hospital. Data was analyzed using Excel 2010 software and SWOT analysis. Results: The final scores for internal and external factors were 2.16 and 2.68, respectively, indicating the hospital had a conservative strategic position for choosing outsourcing strategies. Conclusion: Since this hospital had a conservative strategic position in outsourcing, managers were able to change their outsourcing strategy while considering its advantages and disadvantages and determining the type of services to be outsourced

Effect of Reengineering on the Information and Statistics Process in the Iran University of Medical Sciences

Introduction: Nowadays, organizations working in dynamic and competitive environments have to change their processes from both the inside and outside of the organization. One of the most effective strategies for monitoring and controlling these changes is re-engineering. This study aimed to refine the collection and classification process of data through re-engineering. Methods: This study was done with an analytical-descriptive approach in 2012, in the Planning and Budget department of the Iran University of Medical Sciences. Data were collected by documents, interviews and observations. Three main process indicators include: number of activities, time, and costs of human resource. These were calculated and compared before and after the implementation of the reengineering. Data were analyzed using Microsoft Excel 2007. Results: The current status of the process included 53 activities that reduced to 27 after reengineering. Total process time was reduced from 79 to 38 days and direct human costs decreased to about 15 million Rls. Thus, by the implementation of reengineering, the number of activities, time and costs were decreased to 49%, 52% and 54% respectively. Conclusion: Based on the findings, re-engineering led to improvements of performance and saved resources. Therefore the use of this technique is recommended in order to have an improvement in different performances, increases satisfaction and saves resources

Health Technology Assessment of the Psychotherapy Effect on Prevention of Suicide and Self-Harm: A Rapid Review of Secondary Studies

Introduction: According to the World Health Organization (WHO) report, acute depression disorders are the second largest health problem in the world which can cause disability and imposes huge costs on individuals and societies. This study aims to investigate the effectiveness and cost-effectiveness of using psychotherapy in patients with depression for prevention of suicide and self harm commitment. Methods: Cochrane library (Issue 10, 2012) and CRD (Centre for Review and Dissemination) were searched using Mesh. Studies that compared psychotherapy with different alternative methods such as antidepressant drugs and used outcomes such as self-harm or suicide rates were included. Results: Eighteen articles were included in this review. Most of them showed that using psychotherapy as only suicide preventive method cannot be sufficiently effective, so that in the one of the included meta-analysis was shown that the effect of psychotherapy on suicide imagination and the risk of suicide were small. In terms of cost-effectiveness, it seems that MACT (Manual-assisted cognitive behavior therapy) is a cost-effective method in prevention of self-harm. Conclusion: Generally, it seems that using combination of therapeutic methods will increase the effectiveness of suicide and self-harm prevention methods

The Dilemma of Irrational Antibiotic and Corticosteroid Prescription in Iran: How Much It Can Affect the Medicine Expenditures?

In recent years the high cost of medicines and the lack of it were one of the major problems in developing countries that despite numerous efforts to solve the root causes of this problem, the issue remains, unfortunately. Therefore, this study aimed to assess the impact of antibiotics and corticosteroids prescription on the medicines expenditures. This was descriptive-analytical study that conducted to assess the function of medical expenditures through prescription letters and analysis the factors affecting medicine expenditures. We used the data of 91,994,667 selected prescription letters that were collected by the Ministry of the Health and Medical Education (MOHME) throughout the country in the year 2011 which was analyzed through a logarithmic regression model and OLS estimator. The average number of prescription items in each prescription letter were varied from 2.7 to 3.6, and the average price of each letter was varied from 30223 to 69986 Rials. Between 39 to 61 percent of prescription letters containing antibiotic items and between 15 and 35% of them contain corticosteroids. Also, the impact of antibiotic and corticosteroid prescriptions on the average expenditure of prescription letters were -1.4 and 0.032 respectively. Excessive and irrational prescribing had the greatest impact on medicine expenditures. On the other hand, the expenditure of prescription letters had the negative elasticity to antibiotics prescription and relatively inelastic for corticosteroids. So, raising the price of medications to reduce the use of them could not play a successful role in a control policy

Assessing the quality of dental services using SERVQUAL model

Background: The measurement of service quality had an important role in managing service provided, diagnosing the problem, and assessing service performance. Patient satisfaction is one of the key indicators of quality in health-care organizations. This study aimed to measure the service quality gap of patients' perceptions and expectations in five dimensions at a military Specialized Dental Clinic in Iran using SERVQUAL tool. Materials and Methods: This was a cross-sectional and descriptive-analytical study conducted at a Specialized Dental Clinic affiliated to the Armed Forces of Islamic Republic of Iran in Tehran in 2013. All 385 patients referring to the studied clinic during two working shifts of morning and evening in one month, August, were selected. The required data were collected using the modified SERVQUAL questionnaire. The collected data were analyzed using SPSS 20.0 through statistical tests including Mann–Whitney and Kruskal–Wallis tests. P < 0.05 was considered statistically significant. Results: The results showed that the quality of services provided to patients was significantly lower than their expectations and the quality gaps were statistically significant in all studied dimensions (P < 0.001). Furthermore, the highest and lowest quality gap was related to empathy (−1.16) and reliability (−0.61), respectively. Conclusion: According to the results, the managers of this clinic should take steps toward improving the quality of services in all dimensions, especially responsiveness and empathy, through planning properly, prioritizing services, and reviewing processes with regard to the patients' expectations