Prioritizing Public- Private Partnership Models for Public Hospitals of Iran Based on Performance Indicators

Background: The present study was conducted to scrutinize Public- Private Partnership (PPP) models in public hospitals of different countries based on performance indicators in order to se-lect appropriated models for Iran hospitals.Methods: In this mixed (quantitative-qualitative) study, systematic review and expert panel hasbeen done to identify varied models of PPP as well as performance indicators. In the second stepwe prioritized performance indicator and PPP models based on selected performance indicatorsby Analytical Hierarchy process (AHP) technique. The data were analyzed by Excel 2007 andExpert Choice11 software’s.Results: In quality – effectiveness area, indicators like the rate of hospital infections(100%), hospital accidents prevalence rate (73%), pure rate of hospital mortality (63%), patientsatisfaction percentage (53%), in accessibility equity area indicators such as average inpatientwaiting time (100%) and average outpatient waiting time (74%), and in financial – efficiency area,indicators including average length of stay (100%), bed occupation ratio (99%), specific incometo total cost ratio (97%) have been chosen to be the most key performance indicators. In the prioritizationof the PPP models clinical outsourcing, management, privatization, BOO (build, own,operate) and non-clinical outsourcing models, achieved high priority for various performance indicatorareas.Conclusion: This study had been provided the most common PPP options in the field of public hospitals and had gathered suitable evidences from experts for choosing appropriate PPP option for public hospitals. Effect of private sector presence in public hospital performance, based on which PPP options undertaken, will be different

Clinical Governance in Primary Care; Principles, Prerequisites and Barriers: A Systematic Review

Introduction: Primary care organizations are the entities through which clinical governance is developed at local level. To implement clinical governance in primary care, awareness about principles, prerequisites and barriers of this quality improvement paradigm is necessary. The aim of this study is to pool evidence about implementing clinical governance in primary care organizations. Data sources: The literature search was conducted in July 2012. PubMed, Web of Science, Emerald, Springerlink, and MD Consult were searched using the following MESH keywords; “clinical governance” and “primary care” Study selection: The search was limited to English language journals with no time limitation. Articles that were either quantitative or qualitative on concepts of implementing clinical governance in primary care were eligible for this study. Data extraction: From selected articles, data on principles, prerequisites and barriers of clinical governance in primary health care were extracted and classified in the extraction tables. Results: We classified our findings about principles of clinical governance in primary care in four groups; general principles, principles related to staff, patient and communication. Prerequisites were categorized in eight clusters; same as the seven dimensions of National Health System (NHS) models of clinical governance. Barriers were sorted out in five categories as structure and organizing, cultural, resource, theoretical and logistical. Conclusion: Primary care organizations must provide budget holding, incentivized programs, data feedback, peer review, education, human relations, health information technology (HIT) support, and resources. Key elements include; enrolled populations, an interdisciplinary team approach, HIT interoperability and access between all providers as well as patients, devolution of hospital based services into the community, inter-sectorial integration, blended payments, and a balance of clinical, corporate, and community governance

Effects of social and economic factors on the attitudes of diabetic patients towards self-care behaviors in Iran

Background: One of the most common chronic diseases is diabetes, which self-care has a very significant role in reducing its complications. The aim of this study was to investigate the effect of social and economic factors on the attitude of diabetic patients towards self-care behaviors. Methods: The current study is a cross-sectional study conducted in 2019. The sample included 170 patients with diabetes referring to the clinics affiliated to the Tabriz University of Medical Sciences. Data were collected using a previously developed questionnaire through interview. Results: Out of participants in the study, had a positive attitude towards self-care behaviors of type 2 diabetes. We observed significant association between attitude towards self-care behaviors in type 2 diabetes and membership in real and virtual groups (P < 0.001), education (P < 0.001) support of family members (P < 0.001), household income (P = 0.01). Conclusion: Regarding the correlation between certain social and economic variables, and patient attitude towards self-care in diabetes, as well as the effects of attitude in performing self-care behaviors, and the beneficial results of these behaviors in disease control, correct methods must be adapted to control these variables both materially and spiritually. Some of the methods suggested by the researchers are holding frequent educational classes for these people, providing suitable pamphlets, allocating suitable environments and green spaces for diabetic patients, creating suitable and fun virtual groups, identifying type 2 diabetic patients who are not supported by families or do not have enough income and creating suitable group spaces for these people

Selecting Hospital\'s Key Performance Indicators, Using Analytic Hierarchy Process Technique

Introduction: hospitals performance indicators will help monitoring, evaluation and decision making and therefore must be selected and ranked accurately. The aim of present study is identifying and selecting key hospitals performance indicators. Materials and methods: This is a descriptive and mixed (quantitative-qualitative) study. literature review and expert panel has been done to identify all performance indicators. we prioritize performance indicators by Analytical Hierarchy process (AHP) technique. The data were analyzed by Excel 2007 and Expert Choice11 software’s. Results: hospital performance indicators are classified to three areas as quality- effectiveness, efficiency- financing and accessibility – equity. Indicators like the rate of hospital average length of stay in hospital based on different diagnosis and the mean rate of inpatient waiting time are considered with highest priority performance indicators of public hospitals. Conclusion: Identifying hospital’s key performance indicators provides an opportunity for health stakeholders to identify critical and problematic points with lower costs and time and to the best correction action

Prioritizing of performance indicators of quality - effectiveness areas of general hospitals using Analytic Hierarchy Process (AHP)

Background: Quality of health care includes some degree of services provided to individuals and communities to increase the likelihood of desired results and are updated in accordance with professional knowledge. To assess the quality of services provided in hospitals, indicators and performance standards are needed to be identified, because these indicators are the structure of the hospital evaluation. This study aimed to determine the performance indicators in general- public hospitals in area of quality and effectiveness and prioritization of these indicators. Materials and Methods: This descriptive-qualitative and practical research was done through a systematic review of literature and data were obtained from the hospital authorities. In order to prioritize public hospital performance indicators, Analytic Hierarchy Process (AHP) was used and the results were analyzed by the Expert Choice software. Results: In the field of quality and effectiveness, 73 performance indicators were considering at various texts. Indicators such as the rate of hospital infections (100%), the incidence of hospital events (72%), Net hospital mortality(63%), Percentage of patients' satisfaction(53%) selected as key performance indicators. Conclusion: Performance indicators in the field of quality and effectiveness has important place in health system and hospital organization. By evaluating the quality of services in health centers, the problems and shortcomings can be seen, and consequently analyzing information can lead to a try to reduce them