A situational analysis of human resources in Iranian hospitals affiliated with ministry of health in 2008.

زمینه و هدف: بیمارستان به عنوان یکی از سازمان های اصلی ارایه خدمات بهداشتی درمانی، یکی از عمده ترین عوامل رشد هزینه ها است. این مطالعه به منظور بررسی و شناخت وضعیت نیروی انسانی شاغل در بیمارستان های کشور انجام گرفت. هدف ما بدست آوردن اطلاعاتی بود که مبنای سیاستگذاری و تصمیم گیری و تخصیص منابع مبتنی بر شواهد قرار گیرند و آنها را تا حدودی به واقعیت نزدیک نمایند. روش بررسی: این پژوهش از نوع مطالعه تجزیه و تحلیل سیاستگذاری سلامت بود که در سال 1387 در 139بیمارستان کشور انجام شد. از نظر تعداد تخت، بیمارستان ها به 4 دسته تقسیم شدند (الف – بیمارستان های زیر 50 تخت، ب– بیمارستان های 51 تا 150 تخت، ج – بیمارستان های 151 تا 300 تخت، د – بیمارستان های بالای 300 تخت). برای جمع آوری داده ها از جداول جامع گردآوری اطلاعات بیمارستان که به صورت تحت وب، طراحی شده بود استفاده گردید. یافته ها: بیمارستان های مورد پژوهش دارای 23674 تخت فعال و 48238 نفر پرسنل بودند. سرانه نفر به تخت 04/2 بود که این نسبت در بیمارستان های آموزشی (09/2) بیشتر از بیمارستان های درمانی (9/1) بود و در مناطق محروم (17/2) اندکی بیشتر از مناطق برخوردار (02/2) بود. از نظر تحصیلات 4/48 فوق دیپلم و کمتر، 40 لیسانس و بقیه بالاتر از لیسانس بودند. گروه پرستاری و مامایی با 1/48 بیشترین گروه پرسنلی را تشکیل می داد. ولی تراکم کارکنان حوزه پشتیبانی از سایر بخش ها بالاتر بود (1/29). نسبت کادر درمانی به کل کارکنـــان در بیمارستـــان های آموزشی (1/71) بیشتر از بیمارستان های درمانی (4/70) و در بیمارستان های مناطق برخوردار (2/71) بیشتر از بیمارستان های مناطق محروم (7/68) بود. میانگین ضریب اشغال تخت کل بیمارستان ها 8/57 بود که کمترین میزان مربوط به بیمارستان های زیر 50 تخت (4/31) بود. نتیجه گیری: تراکم بالای پرسنل در واحد پشتیبانی بیمارستان ها مؤید تاثیر منفی این حجم نیرو بر تولید خدمت در این بیمارستان ها می باشد. با وجود افزایش نسبت کادر درمانی به کل کارکنان، نسبت گروه پزشکی با افزایش تخت های بیمارستانی کاهش می یابد که مطلوب نیست. بیمارستان های بزرگ از نظر اشغال تخت وضعیت بهتری دارند

Real-Life Incentives Driving Public-Private Partnership in Diagnostic Services

BACKGROUND: Diagnostic services are highly critical in the success of treatment processes, overly costly nonetheless. Accordingly, hospitals generally seek the private partnership in the provision of such services. This study intends to explore the incentives owned by both public and private sector in their joint provision of diagnostic services under the public-private partnership agreement.METHOD: A qualitative, exploratory study was employed in Tehran hospitals from October 2017 to March 2018. Around 25 face-to-face, semi structured interviews were conducted with the purposively recruited hospital managers, heads of diagnostic services and managers of private companies. Interviews were transcribed and analyzed using conventional content analysis, assisted by "MAXQDA-12".RESULTS: Three main categories and nine sub-categories represented the incentives of public sector, and four main categories and seven sub-categories signified those of private sector. The incentives of public sector included the status-quo remediation, upstream requirements, and personal reasons. As such, the individual, social and economic incentives and legal constraints were driving the behavior of the private sector.CONCLUSIONS: Financial problem and gain were the most noted incentives by the partners. Attention to the either side’s incentives and aims is likely to ensure the durability and effectiveness of such partnerships in the health sector

Review of the biotechnology research and development (R and D) in OECD countries concerning biological drugs

The pharmaceutical industry is among high technology industries that needs considerable attention in research and development. Overall, the processes that a drug must go through from its production in the laboratory, to clinical trials on certain groups, to the drug being licensed and finally planning for its marketing makes it different to any other product. Boosting research and development capability in this industry as well as saving patients’ lives is also essential in controlling the costs of importing drugs. According to this point of view, having suitable R and D strategies in the pharmaceutical sector becomes very important for every country. In this study, we aimed to review several studies concerning biological drugs R and D in selected countries. Since the discussions in relation to the R and D within the pharmaceutical sector about biological drugs come under the umbrella of innovation system of each country. By reviewing the pharmaceutical innovation system studies of selected OECD countries including Norway, Germany and Japan, we aimed to look at the main factors in national R and D system, the trading system conditions, R and D co-operations, human resources, financial matters, entrepreneurship, the market, R and D policy making and coordination of different organizations and main support policies within the biological drugs system.Key words: R and D, biotechnology, biological drugs

Metal concentrations in selected tissues and main prey species of the annulated sea snake (Hydrophis cyanocinctus) in the Hara Protected Area, northeastern coast of the Persian Gulf, Iran.

This study is the first detailed ecotoxicological study of the annulated sea snake, Hydrophis cyanocinctus. Concentrations of lead, cadmium, nickel and vanadium were evaluated in muscle, liver, kidney, skin and blood of the annulated sea snake (H. cyanocinctus) and in the whole bodies of its main prey species (Periophthalmus waltoni and Boleophthalmus dussumieri) in the Hara Protected Area, the Persian Gulf. The mean concentrations of lead and vanadium were highest in the kidney, which identified the kidney as a target organ for metals in sea snakes as it is in other reptilian groups. Mean concentrations of cadmium and nickel were highest in the liver and skin, respectively. Mean cadmium concentrations were significantly higher in the liver compared to prey species, which indicated that prey items may be a source of cadmium for the annulated sea snake in the study area. Data presented here may be considered as a baseline for further ecotoxicological studies in sea snakes

Estimation of the Cost of Smoking-Attributable Diseases (Five Selected Diseases): A Case in Kerman City, Iran, 2014

Background: Cigarette seems to be the least valuable of addictive drugs. It is easily accessible to the public, and its harmful personal and social effects have attracted less attention. Therefore, the present research was carried out with the aim of presenting cost estimations of smoking-related diseases in smokers who aged 35 or higher in Kerman City, Iran, in 2014.Methods: Using the prevalence approach, the direct and indirect costs of smoking-attributable diseases including lung cancer, gastric cancer, myocardial infarction, stroke, and chronic obstructive pulmonary disease (COPD) were estimated. The initial data were obtained from the information in documents of medical document units as well as the 2014 income statements of teaching hospitals of Kerman University of Medical Sciences, Kerman City.Findings: In this research, total economic costs of diseases attributed to smoking were estimated to be 50 million dollars in 2014 in Kerman City, and calculations suggest that this figure accounts for 0.02% of Iran’s gross domestic product (GDP). Total direct cost of diseases caused by smoking in Kerman City adds up to 17 million dollars, whereas the estimated indirect cost of diseases caused by smoking is 33 million dollars. The yearly per capita cost of any of the selected five diseases is 270 dollars.Conclusion: Smoking places a high economic burden on health system and society as a whole. Therefore, stronger intervention measures against smoking should be taken without delay to reduce the health and financial losses caused by smoking

Health Care Financing for the Victims of Traffic Accidents in Iran; Challenges and Solutions

Background: Traffic accidents are the first cause of death in Iran and due to its necessity in the fourth and fifth Socio-Economic Development plan, two laws (articles No. 92 and 37) were passed to provide immediate and free service to traffic victims. The current study was designed to explore the challenges and complexities related to health care financing for this victims and to provide solutions. Method: In this applied research, the qualitative phenomenological approach was used. All interviews were conducted in 2013 by semi-structured questions with 36 people including the managers at the Ministry of Health, Medical Sciences Universities, trauma specialized hospitals and basic insurances. Sampling was done using snowball, targeted and quota techniques. Data analysis was done using framework method and through Atlas Ti 5.2 software. Results: As a result of qualitative analysis, 3 main themes, 14 codes and 4 sub- codes were identified. The main challenges of health care financing for victims of traffic accidents included challenges of financial integration, accumulation, distribution of financial resources and service purchasing. Conclusions: Creating a process to collect more appropriate resources for article No. 92 at the Ministry of Health, compiling a services package and applying strong monitoring to improve the quality of services were found as mechanisms that can be used to obtain sustainable financing and quality in providing services to victims of traffic accidents. Keywords: Financing, Victims of traffic accidents, Health Car

The Challenges of Implementing Family Physician and Rural Insurance Policies in Kerman Province, Iran: A Qualitative Study

Background: Assessment of policies and determining their challenges are necessary to improve and reform health systems. Family physician and rural insurance policies have been the second important phase of changes in health services provided in Iranian villages and towns with populations under 20,000. This study aimed to identify the challenges of implementing these policies in Kerman Province, Iran. Methods: This qualitative study was carried out in 2010 through semi-structured focus group discussions and document reviews. Purposive sampling was used to select 10 policy executives from Kerman University of Medical Sciences and Medical Insurance Organization and family physicians. Data from the focus groups and document reviews was analyzed by content analysis. Results: The challenges were categorized into seven main groups including improper motivation initiatives, inadequate educational effectiveness, poor comprehensiveness in instructions and arrangements, deficient per capita resources, low efficacy of health information management systems, lack of a suitable referral chain, and inadequate cultural infrastructure. Conclusion: The success of every policy depends on periodical assessments of its implementation challenges. Considering the expansion of family physician policy in larger urban areas, more attention should be paid by the national and local authorities to eliminate the identified barriers and constraints. Keywords: Family medicine, Rural insurance, Assessment, Challenges, Policy implementation, Ira

Measurement Of Atmosopheric Noise Emmision During Heavy Rain Events Using A C-Band Radiometer

Using lessons learned from error control coding, and multiple areas of life science, we propose a general purpose representation and association machine (GPRAM). GPRAM uses a versatile approach with hierarchical representation and association structures, each with different degrees of vagueness, over-completeness, and deliberate variation. GPRAM machines use vague measurements to do a quick and rough assessment on a task; then use approximated message-passing algorithms to improve assessment; and finally selects ways closer to a solution, eventually solving it. We illustrate concepts and structures using simple examples. © 2012 IEEE

Analysis of Cost Price and Net Profit of Paraclinic Services in Private and Public Sectors: A Case Study of Kerman City 2014

Introduction: Cost is becoming a growing concern for the managers of health and treatment institutes both in private and public sectors. Based on the opinions of pathology and radiology specialists and experts, one private and one public center for radiology and laboratory were selected to study in Kerman City. Method: This is a cross-sectional and applied study. The two centers were similar in frequency of their services, different tests they were conducting, and their number of personnel. Afterwards, the costs of services in both fields were determined using the activity-based costing method. This study was carried out from March 21 to September 22, 2014. The costs of services in both private and public sectors were compared to the tariffs of the Ministry of Health in 2014. Results: Laboratory results indicated that the costs in all the selected tests were higher than the tariffs and the largest difference (app. 84,930 Rls) was observed in the TSH test while the smallest difference was observed in the ferritin test (11,940 Rls). However in the private sector, vitamin D and FBS tests were not profitable with differences of about 5500 and 6500 Rls, respectively. In other tests, the costs in the private sector were lower than the tariffs for the private sector. In the private sector radiology center, only the MRI services were not profitable but the other services were. The cost of MRI services in the private sector studied in this research was 190,000 Rls higher than the private sector tariffs. Conclusion: In this study, the results showed that CT scan services were the most profitable services and the price difference was about 203,000 Rls per service. However, all of the radiology services were unprofitable in the public sector and the largest price difference was seen in MRI services which was about 590,000 Rls per service

Cfrsl Rain Measurement Facility, Part I: Radiometer And Rain Gauges

The Central Florida Remote Sensing Laboratory has developed a rain measurement facility to study atmospheric microwave noise emission during heavy rain events. This paper (part-1 of 2) describes the design and primarily results obtained from a 6.8 GHz microwave radiometer, rain rate, and rain drop size sensors. This instrument suite can be used to determine rain absorption coefficient during high rain rate events, tropical storms, and occasional hurricane that occur in Central Florida. Results from this facility will advance the development of an empirical model to predict atmospheric propagation loss during heavy rain (\u3e 50 mm/hr). Preliminary results show measurements obtained from the radiometer and rain gauges are correlated, where a maximum rate of approximately 82 mm/hr is observed. © 2013 IEEE