Strategy mapping and introducing the Health System Reform Plan: An Iranian social responsibility-based approach

Background: The main function of the strategy map is to determine the relationship between cause and effect among the strategic objectives, dimensions, and components of an organization, a large project or plan in which programs can be implemented effectively.  The current study aimed to map strategy and introduce the health system reform plan using an Iranian social responsibility-based approach.   Methods: The current study was a qualitative and applied one using the Balanced Scorecard (BSC) principles and the Comprehensive Evaluation Model for Health System Reform Plan in Iran (CEHSRP-IR) model in 2019. the views of 17 experts were selected in management and health issues based on purposive non-random sampling, using Delphi technique paired comparisons, common techniques in strategy mapping, and SPSS and EXPERT CHOICE software, the strategy map of the health system reform plan was designed in Iran.   Results: After elaborating on the fundamental aspects of this research, setting the strategic goals, dimensions, and components, as well as determining the relative weight of the components and dimensions and then prioritizing them, explained their optimal relationships to achieve strategic goals. Finally, using VISIO software, a strategy for the health system reform plan was designed and presented concerning social responsibilities. The present study resulted in designing a strategy map of the health system reform plan in Iran based on 5 dimensions of financial, social responsibility, learning and growth, clients, internal processes, 17 components, and 25 connections.   Conclusion: The current strategy map can be sufficiently comprehensive to effectively implement nationally at various organizational and implementing units’ levels of the health system reform plan in Iran

Designing a Comprehensive Evaluation Model for Health System Reform Plan in Iran: An Approach to Extended Balanced Scorecard

Background: Health and striving to maintain and promote it has always been an important priority in governments, communities, and public policies. To implement health objectives through the Fifth Five-Year National Development Plan of Iran, the health system reform plan with three approaches to the financial protection of the public, creating equity in access to health services, and improving the quality of services has been on the government's agenda since 05.05.2014. Investigations revealed that the lack of a comprehensive and scientific model for evaluating this national program is evident. This study aimed to design a comprehensive model of health reform plan evaluation in Iran. What distinguishes this study from previous studies is the simultaneous attention to the challenges of performance evaluation, social responsibility, and examining them in a comprehensive and coherent model.Materials and Methods: The present study considered as descriptive-survey research in terms of strategy. The research method was a combination that conducted from 2018 to 2019. The sample size of the qualitative part of the research consisted of 17 academic and executive health experts selected by purposive non-random sampling. In the quantitative part of the study, 400 health service providers selected by stratified random sampling. In this study, content analysis and Delphi technique, and Expert choice v24, SPSS V22 and AMOSV14 software were used to collect, classify, deduce and exploit data, and questionnaires.Results: The findings of this study resulted in the design of a 900-scorecard model of the comprehensive evaluation of the health system reform plan in Iran based on 5 dimensions (finance, social responsibility, growth and learning, clients and internal processes), 17 components and 70 indicators.Conclusion: The findings of the quantitative section of the study showed that the indicators, dimensions and levels of the comprehensive evaluation model for health system reform plan in Iran (CEHSRP-IR) qualified for evaluation of the effectiveness of this national program at different organizational levels and executing units of health system reform plan in Iran

Assessing sex differential in COVID-19 mortality rate by age and polymerase chain reaction test results: an Iranian multi-center study

Background The aim of this study is to evaluate the sex differential effect in the COVID-19 mortality by different age groups and polymerase chain reaction (PCR) test results. Research design In a multicenter cross-sectional study from 55 hospitals in Tehran, Iran, patients were categorized as positive, negative, and suspected cases. Results A total of 25,481 cases (14,791 males) were included in the study with a mortality rate of 12.0%. The mortality rates in positive, negative, and suspected cases were 20.55%, 9.97%, and 7.31%, respectively. Using a Cox regression model, sex had a significant effect on the hazard of death due to COVID-19 in adult and senior male patients having positive and suspected PCR test results. However, sex was not found as significant factor for mortality in patients with a negative PCR test in different age groups. Conclusions Regardless of other risk factors, we found that the effect of sex on COVID-19 mortality varied significantly in different age groups. Therefore, appropriate strategies should be designed to protect adult and senior males from this deadly infectious disease. Furthermore, owing to the considerable death rate of COVID-19 patients with negative test results, new policies should be launched to increase the accuracy of diagnosis tests