Investigtions the functional indicators change due to implementation information system in Sina hospital

زمینه و هدف: سیستم اطلاعات بیمارستانی تکنولوژی ضروری برای مراقبت‌های بهداشتی محسوب می‌شود و در صورت بکارگیری صحیح می‌تواند منجر به بهبود شاخص‌های عملکردی بیمارستان شود. هدف از مطالعه حاضر تعیین میزان تأثیر سیستم اطلاعات بیمارستانی بر شاخص‌های عملکردی بیمارستان سینا وابسته به دانشگاه علوم پزشکی تهران بوده است. روش بررسی: پژوهش توصیفی-تحلیلی حاضر در سال 1391 در 16 بخش بیمارستان سینا انجام گرفت. ابزار گردآوری داده‌ها فیش ثبت اطلاعات بود. کلیه اطلاعات مربوط به سیستم اطلاعات بیمارستان و همچنین شاخص‌های تخت بیمارستانی از روی اطلاعات بایگانی شده در واحد مدیریت آمار و اطلاعات بدست آمد. تجزیه و تحلیل داده ها با استفاده از آمار توصیفی و آزمون‌ تی زوج دو نمونه ای انجام گرفت. یافته ها: شاخص میانگین تخت روز اشغالی قبل از استقرار سیستم اطلاعات بیمارستانی 3617/04± 81/5567 روز و بعد از استقرار به 2646/63±37/5066 روز کاهش یافت. شاخص ضریب اشغال تخت قبل از استقرار سیستم اطلاعات بیمارستانی 44/11±43/74 درصد و بعد از استقرار به 62/14 ±5/76 افزایش یافت. شاخص میانگین طول اقامت بیمار نیز قبل از استقرار سیستم اطلاعات بیمارستانی 51/6 ± 31/8 روز و بعد از استقرار به 70/3 ± 46/6 روز کاهش پیدا کرد. همچنین شاخص فاصله چرخش تخت قبل از استقرار سیستم اطلاعات بیمارستانی 02/1 ± 12/1 روز و بعد از استقرار سیستم اطلاعات بیمارستانی به 42/1 ± 64/1 روز رسید. بین شاخص فاصله چرخش تخت و سیستم اطلاعات بیمارستانی رابطه معناداری وجود داشت (03/0=P). نتیجه گیری: با توجه به نبود تأثیر بین سیستم اطلاعات بیمارستانی و شاخص‌‌های عملکردی بیمارستان، به نظر می‌رسد استقرار سیستم اطلاعات بیمارستانی در بیمارستان‌ها نمی‌توانسته در بهبود شاخص‌‌های مزبور به نحو بارزی موثر واقع گردد

Factors Affecting Patients' Preferences Based on the Mixing Factors of Marketing Services in Hospital Selection

oai:ojs.ijhs.shmu.ac.ir:article/696Background: Today, health care market has become a competitive market. Various factors affect the care of the hospital and the choice of hospital by patients. The present study aimed to investigate the effective factors on patients' preferences based on the mixing factors of marketing services in hospital selection. Methods: This descriptive-analytic study was performed on 300 patients referred to educational hospitals in Iran in 2018. The instrument used was a researcher-made questionnaire include two sections (demographic and Patients' Preferences questionnaire). Data was analyzed using descriptive and analytical. Results: Among the 7 components, the highest and the lowest mean and standard deviation were related to staff (1.03 ± 3.89) and location (1.10 ± 2.96), respectively. The index value of the RMSEA for the compiled model it is equal to 0.059, comparative fit index (CFI) is 0.837 and the IFI index is 0.839. Employee component with coefficient of 1.00 and price component with coefficient of 0.72 had the highest and the least effect. Conclusions: Staff and physicians and hospital space have the greatest role in attracting patients. Therefore, it is expected that the hospital management will make the essential planning, and by intervening in the process of work of physicians and staff. Key words: Patient preferences, mixed Marketing, marketing of health services, Hospital

Analysis of Hospital Costs in Road Traffic Injuries

Objective: To investigate the factors affecting the hospital costs in the road traffic injuries.Methods: This applied study examined the information of patients presenting to Yazd Trauma Center in 2018. The data were extracted from Comprehensive Traffic Injuries System affiliated to the center, which were described with frequency, percentage, mean, and SD, and then analyzed using independent t-test and one-way ANOVA.Results: Most injuries (%66.4) are caused by motorcycle and pertained to head region (%61.8). Some significant correlations were found among gender, type of injury, patient’s final status, site of road accident, patient’s nationality, type of vehicle used at the time of accident, length of stay (hospital stay), patient’s age, and hospital costs (p <0.05). Moreover, the costs were higher in men, and in those with head and neck injuries, dead casualties, suburban high-way accidents, motor cyclists, hospital stay longer than three days, and older patients.Conclusion: Given the significant correlations between demographic and social variables under study, the results may be used in planning and designing strategies for controlling road traffic injuries and reducing the related hospitalization costs

The Inquiry of International Standards for Medical Tourism: A Case Study into Hospitals of Tehran University of Medical Sciences

Introduction: Medical tourism is a rapidly growing industry that has provided special opportunities to gain competitive advantage over international health organizations. This study aimed to investigate the quality requirements based on Joint Commission International (JCI) for medical tourism in selected hospitals of Tehran University of Medical Sciences. Methods: This is a descriptive and cross-sectional study that was conducted at three educational hospitals operated by Tehran University of Medical Sciences in 2013. The data were collected through the last updated checklists (translation of the standards of JCI, comprising 13 axial) completed by the researcher. Data analysis was done using descriptive and analytical tests including frequency, standard deviation and T- Test by means of SPSS 19.0. Results: Studied hospitals met 76.8% of organization-oriented standards plus 75.4% of patient-oriented standards. There were two patient-oriented standards, namely access to care and its continuity 87.2% alongside anesthesia and surgery care 86.6% which were met at the highest level. On the other side, organization-oriented standard of leadership and guidance 69.2% was the item met at the least. Conclusion: It seems that studied hospitals are ready to attract medical tourists by the advantage of service quality. Moreover, it is necessary to give attention to the strengths and improve the weaknesses concerning quality of services. Criteria on service charges, waited time and etc, should be scientifically analyzed and reviewed as well

Prioritization of Factors Affecting Time Management among Health Managers

Introduction: In today's world, having principle and targeted management is one of the progress and development factors of any organization. Effective use of time for each manager is the most important base for managing current affairs and controlling daily activities. The present study aimed to investigate and analyze the relationship between factors affecting time management among the senior, middle and first-line managers of the hospitals in Kermanshah in 2015. Methods: This was a cross-sectional and descriptive-analytical study conducted in 2015 in ten hospitals of Kermanshah. The study population consisted of all senior, middle and first-line managers of the studied hospitals (N=240) which were selected using census method. The required data were collected using a researcher-made pair-wise comparison questionnaire. The collected data were analyzed using the DEMATEL technique through Matlab8.1.0.604 software. Results: The results showed that, from the studied managers’ viewpoints, the variables of goal setting and prioritization of objectives and activities were certainly affecting variables and located in the cause group. Also, the variables of planning, delegation, communication management, and meetings management were affected variables and located in the effect group. Furthermore, in the hierarchy of affecting and affected variables influencing time management, goal setting and meetings management with the coordinates (1.23, 1.23) and (1.06, -1.05) were identified as the highest and lowest priorities and were considered as the most affecting and most affected variables, respectively. Conclusion: The results of the present study showed that among the studied variables influencing time management, goal setting was the highest priority and most affecting variable, and meetings management was the lowest priority and the most affected variable. It is recommended to increase the hospital managers’ knowledge about time management and the need for accurate goal setting through providing management and time management courses, and requiring them to develop a time management plan in order to improve their time management

Analysis of death risk factors among COVID-19 patients in Yazd, Iran: a hospital-based case-cohort study

Introduction: The COVID-19 epidemic control has become a global challenge and many contributing variables are still unknown to policymakers. This case-cohort study was conducted to investigate the risk factors of mortality in COVID-19 patients. Materials and Methods: This case-cohort study was conducted on 956 samples in Ardakan and Meybod counties, Yazd Province, between February 20 and May 20, 2020. Data analysis was done using descriptive statistics and paired t-test, chi-square, and logistic regression analysis. Results: Of a total cohort population of 993 in Ardakan and Meybod counties, 435 were assigned to the control group and 521 were assigned to the case group. The results of outcome analysis showed that 14.4% of the patients in the case group and 11.5% of the patients in the control group died. According to the results of logistic regression analysis in COVID-19 patients, each one-year increase in age increased the risk of mortality by 6% (HR=1.06, p&lt;0.001), each one-day increase in the hospital stay increased the risk of death by 8% (HR=1.08, p&lt;0.001). Moreover, the presence of cardiovascular disease, chronic neurological disease, and chronic pulmonary disease increased the risk of death. The patients who underwent mechanical ventilation had 85% less chance of survival (HR=0.15, p&lt;0.001). Conclusion: The results showed a higher mortality rate in the elderly patients as well as those with underlying diseases. Attention should be paid to at-risk and elderly patients in terms of ensuring a healthy diet, improving their self-care practices, and providing long-term medical and healthcare facilities

Perception and engagement in unprofessional behaviors of medical students and residents: a mixed-method study

Abstract Background The present study aimed to investigate perception and engagement in unprofessional behavior of residents and medical interns and explore the factors affecting their engagement in unprofessional behavior. Method This study has an explanatory (quantitative-qualitative) mixed-method design. This study was conducted at Shahid Sadoughi University of Medical Sciences in 2022–2023. Participants, including residents and medical interns (n = 169), were entered by stratified random sampling. A survey was conducted in the quantitative step. A by an unprofessional behavior in clinical practice questionnaire (29 items) was used. For each behavior, the participants were asked to report whether they (a) participated in the behavior and (b) stated that the behavior Is unprofessional. In the qualitative step, 17 participants contributed. The qualitative data were collected by semi-structured interviews and analyzed according to the conventional content analysis approach Graneheim and Lundman introduced. Results The highest ratio of participants’ engagement in unprofessional behavior was reported in ‘failure to introduce yourself and nurses and physician assistants to the patient and his family’ (n = 145 (85.8%)). The results showed the proportion of participants who engaged in unprofessional behavior more than those who did not participate. There were associations between participants’ engagement in each behavior and their perception of that particular behavior as unprofessional. (p = 0.0001). In the following behaviors, although the participants acknowledged that these behaviors were unprofessional, those who participated in the unprofessional behaviors were significantly more than those who did not participate: failure to comply with clinic regulations and policy (p = 0.01), eating or drinking in the hallway of the clinic (p = 0.01), medical negligence in duties in the clinic setting (p = 0.04) and failure to perform duties in teamwork (p = 0.04). The qualitative results were explored in a theme entitled “internalized unprofessional culture,” including three categories “encouraging contextual risk factors towards unprofessionalism,” “suppressing of unprofessionalism reporting,” and “disbelieving professionalism as a key responsibility.” Conclusion The results indicated that most participants engaged in unprofessional behaviors. The findings resulted from the internalized unprofessional culture in the workplace. The findings showed that engagement in unprofessional behaviors resulted from personal and systemic factors. The weakness of responsibility recognition and identity formation as a professional facilitated the engagement in unprofessional behaviors at the personal level. Furthermore, systemic factors including the contextual risk factors (such as deficiency of explicit and hidden curriculum), and the suppression of unprofessionalism reporting mechanism as a hidden factor played an important role in normalizing unprofessional behavior and promoting engagement in unprofessional behaviors among the participants. Recognition of the nature and extent of students’ unprofessional behaviors facilitates educational discussion among teachers and students in this field. The results might assist to establish an assessment system and feedback mechanism to solve the problem of the “failure to fail” problem. In addition, these results provide medical educators insights into the development of professional courses that equip learners with adherence to professionalism and coping skills to deal with unprofessionalism in the healthcare system

The Relationship between the Distribution of General Practitioners and the Mortality Rate of Children Based on the Gini Coefficient and Lorenz Curve

Background: Equity is one of the most important issues in the distribution of resources and access to health services. Although it is very challenging to address health equity issues, it deeply affects policy making, resource allocation, and generally the legal principles of government and society. This study aimed to determine the inequality of distribution of general practitioner in Tehran province. Methods: This was an applied study that by ecological descriptive method investigated the relationship between the distribution of general practitioners and the mortality rate of children in the cities of Tehran province in 2012-2015. The data collection tool was a researcher-made form including the name of the city, the number of general practitioners, the mortality rate for children under five years old, and the population of each city. The STATA software with the DASP21 version 2.1 was used to draw the Lorenz curve. The SPSS19 software and Pearson correlation coefficient (P-value < 0.05) were utilized for analyzing data. Results: Based on the results the Gini coefficient for general practitioners was not significantly changed and was in a relatively equitable position, the Gini coefficient varied from 0.269 to 0.299. The results of the study did not show a significant relationship between the distribution of general practitioners and the mortality rate of children, although, with an increase in the ratio of general practitioners, the mortality rate of children decreased (P-value ≤ 0.05). Conclusion: The results of the study indicate that the distribution of general practitioners was relatively inequitable. Therefore, it is essential for the Ministry of Health to establish the balance in the distribution of the human resource