Cost-utility analysis of adjuvant therapies for breast cancer in iran

Objectives: The aim of this study was to evaluate the cost-utility of Docetaxel with doxorubicin and cyclophosphamide (TAC) and 5-fluorouracil, doxorubicin, cyclophosphamide (FAC) in node-positive breast cancer patients in the south of Iran. Methods: A double blind study was done on a cohort of 100 patients suffering from breast cancer with node-positive over 8 months in the radiotherapy center of Namazi hospital, Shiraz-Iran. Health-related quality of life was assessed using questionnaire (QLQ-C30) from European Organization for Research and Treatment of Cancer (EORTC). QLQ-C30 scale scores were mapped to 15D and EuroQol 5D utilities to measure the quality-adjusted life-years (QALYs). Third party payer point of view was applied to measure and value the cost of treatments. Cost data were extracted from hospital and health insurance organizations. Robustness of the results was checked through a two way sensitivity analysis. Results: TAC was associated with higher deterioration in HRQoL during treatment and higher improvements over 4 months follow-up. On average, the cost of treatment per patient in TAC was 15 times higher than FAC (p < .001). In overall, TA( was resulted in lower QALYs and higher cost over study period.. Conclusions: FAC was a dominant option versus TAC in short-term. The higher improvement in HRQol. over follow-up in TAC may not compensate the more intensive deterioration caused during treatment in short-term. The short time horizon of study may limit the generalizability of our findings and, hence, there is a need to conduct long-term economic evaluation studies whenever data is available to inform decision making

The effect of quality of work life and job control on organizational indifference and turnover intention of nurses: a cross-sectional questionnaire survey

Aim: Attracting and maintaining human resources is one of the most significant responsibilities in human resources management. The aim of this research was to study the effect of Quality of Work Life and Job Control on Turnover Intention and Organizational Indifference. Design: Cross-sectional descriptive study. Methods: The survey was conducted using four standard questionnaires. Data were collected from 395 nurses in Iranian public educational hospitals in 2017. SPSS and Amos 22.0 were used to analyze data and test the theoretical model at a level of significance of 0.5. Results: The results indicated an average level of Quality of Work Life and Job Control, while the Turnover Intention level was higher than average, and participants reported a low level of Organizational Indifference. All hypotheses (except No. 2) were statistically significant, and the fitness indices [ϰ2=14.82 (df = 6; p = 0.037); ϰ2/df = 2.47; CFI = 0.94; IFI = 0.94; SRMR = 0.06; RMSEA = 0.06] indicated the soundness of the model. Conclusion: Planning properly and effectively with regard to Quality of Work Life and Job Control can play a significant role in the retention and performance of nurses – serious concerns for health policy makers. Nursing policy makers and managers can use these results to increase the number of nurses intending to remain in the profession

Readmission Risk Factors in Patients of General Surgery Wards in Shiraz Hospitals: Applying LACE Index as a Predictive Indicator

Background: Today, the effective use of limited health care resources is increasingly regarded. Reduction of&nbsp;the readmission is one of the key tools can improve health outcomes and considered as one of the control levers&nbsp;that reduces health costs. Identifying the causes of readmission to the hospital helps to utilize hospital beds and&nbsp;facilities a more efficiently.Methods: This case-control study had been conducted in general surgery (GS) wards in 2011-2012. Using chisquare test, t-test, and multiple regressions, we studied risk factors associated with readmission in both groups&nbsp;of case and control. Finally, the predictive power of the Length of stay, Acuity of illness, Co morbidity of the&nbsp;patient, Emergency (LACE) index was evaluated using receiver operating characteristic (ROC) curve.Results: About 20% of patients in GS wards were admitted within 30 days. There is a significant difference&nbsp;between the two groups in the following variables: age, sex, length of hospital stay, marital status, discharge&nbsp;season, congestive heart failure, diabetes and renal failure. The rate of readmission with LACE index which is&nbsp;compared with the ROC curve shows that it is significant (P &lt; 0.001 and Kappa = 0.22).Conclusions: Awareness of the prevalence and risk factors of readmission is effective in planning and decision&nbsp;making for using hospital facilities efficiently. Identifying patients at risk of readmission and erforming&nbsp;training plan, ischarging and following up medical programs can reduce the rate of readmission and costs of&nbsp;hospital. Predicting readmission can be very effective but identifying an effective index is very difficult

A comprehensive analysis of drug system money map in Islamic Republic of Iran

This study is the first comprehensive analysis of the money Path of drug system in Islamic Republic of Iran. It has a qualitative methodology applying content analysis to explain and describe drug system monetary path, the studied Population was key informants and experts in the field of finance and insurance, accuracy and robustness of the study was assessed using Guba  and linkelen criteria as well. On developing the money map of drug system in Iran, 28 paths have been identified and described completely. It seems that this track description can be the best way in order to identify strengths and problems of the country's drug money system. Key words: Money path, drug system, Islamic Republic of Ira

Production and consumption financial Process of drugs in Iranian healthcare market

Considering the important role of statistics and information on major policymaking decisions, this study examined financial trends of production and distribution of drugs in the health system of the Islamic Republic of Iran during the last decade.This was a cross sectional trend study. In order to collect the required data, raw form was designed according to the research objectives and required data were collected between the years of 2000 to 2008. Collected data was entered in the 2007 version of Excel software and descriptive diagrams were used to show the occurred changes process.Findings indicate that growth of the domestic pharmaceutical manufacturing from base year 2000 to year 2008 was ascending. Meanwhile, rate of drug sales in the country's pharmaceutical market over these years was steadily upward and finally, in the years 2000 to 2006, it has been faced with upward growth of domestic production sale.In a general conclusion it seems that despite increasing production rate in the country and upward procedure of consumption and sale of inside-produced medicine in the health care market, problems of paying out of pocket, especially in imported and single prescription drugs remain as before which this will require more extensive and more accurate research. Keywords: drug production, drug consumption, health system, out of pocket, catastrophic health expenditur

Identification of the Internship Problems of Health Services Management Students from Perspective of the Faculty Members and Educators: A Qualitative Study

Background & Objectives: Identification and elimination of the internship problems of Health Services Management students is essential for improving the quality and effectiveness of the courses in this field. Therefore, this study aimed to identify the internship problems of Health Services Management students in Shiraz University of Medical Sciences from perspective of the faculty members and educators. Methods: This is a qualitative study which was conducted phenomenological approach in 2018. In this study, 12 educators in the field of Health Services Management in Shiraz University of Medical Sciences, were interviewed. Samples were selected using purposive sampling. Data were analyzed using framework analysis by MAXQDA version 10. Results: In this study, 4 main themes and 25 subthemes were obtained. The main themes included macro-level, faculty and faculty members, hospital, and student problems. Conclusion: According to the results, the interventions at the level of policy-making in the medical education system in order to improve the educational curriculum and internship course, as well as the use of motivating factors for the better interaction of the hospital staff with the educators and students seem essential. Key¬words: Internship, Health services management, Students, Qualitative study, Educational curriculum Citation: Bordbar N, Bikineh P, Ghanbarzadegan A, Bastani P. Identification of the Internship Problems of Health Services Management Students from Perspective of the Faculty Members and Educators: A Qualitative Study. Journal of Health Based Research 2018; 4(2): 181-96. [In Persian

A Survey on the Frequency of Medication Errors Caused Due to Look-Alike Drugs in the Emergency Department of the Educational Hospitals of Shiraz, Iran, 2016

The words “look-alike” and “sound-alike” are used to express the confusion caused by drugs whose names or features are similar. Look-alike/sound-alike (LASA) drugs are one of the most common causes of medication errors. The emergency department is the first place where mistakes related to LASA drugs occur. Medicinal errors increase health care costs by about two billion dollars annually. This study examines the frequency of errors resulting from LASA drugs in the emergency department and identifies the main causes of these errors. This sectional analytical study was conducted in 2016 in the Namazi and Faghihi hospitals of Shiraz. The questionnaire was developed by the researcher and its validity was confirmed by the experts. The stratified sampling method was used and the sample size was determined to be 106 people, based on the Cochran formula. The data were analyzed using the software SPSS 20 by the Pearson correlation coefficient, the independent t-test, and an analysis of variance (ANOVA). Seventy-seven nurses stated that during the past six months they had made at least one error resulting from look-alike medication and a total of 132 errors were reported. The most common errors in medication related to ampoules and vials. The rate of errors was statistically significant in terms of marital status (

Functional Requirements of the Pharmacy Information Systems from the Pharmacists' Perspective: A Qualitative Approach

Introduction: In the field of studying information systems, qualitative approach is one of the ways to extract the system requirements from the perspective of the users. Therefore, this study was performed to identify the functional requirements of the pharmacy information system from the perspective of the pharmacists using a qualitative approach. Method: This qualitative study was performed using conventional content analysis approach. In this study, 15 pharmacists who worked at hospitals affiliated to Fars University of Medical Sciences, were selected using purposive sampling. The data were collected through semi-structured interviews (30-40 min) in 2016. Data were analyzed using Graneheim and Lundman's method by MAXQDA v.10 software. Lincoln and Guba's criteria were used to ensure the accuracy and trustworthiness of the study Results: After analysis of the data obtained from interviews, five main categories and 13 subcategories were obtained. The main categories include the ability to accurately reconcile medication lists (medication reconciliation), update and flexible reporting, systems interoperability, integration with the decision support system, and access to the clinical information. Conclusion: According to the results, evaluation of the systems before purchase and comparing them with the expected functional requirements of the users, are necessary. Also, in the case of intraorganizational design of these systems, skilled analysts who are familiar with health organizations should be employed to extract the users' needs

A Survey on the Frequency of Medication Errors Caused Due to Look-Alike Drugs in the Emergency Department of the Educational Hospitals of Shiraz, Iran, 2016

The words “look-alike” and “sound-alike” are used to express the confusion caused by drugs whose names or features are similar. Look-alike/sound-alike (LASA) drugs are one of the most common causes of medication errors. The emergency department is the first place where mistakes related to LASA drugs occur. Medicinal errors increase health care costs by about two billion dollars annually. This study examines the frequency of errors resulting from LASA drugs in the emergency department and identifies the main causes of these errors. This sectional analytical study was conducted in 2016 in the Namazi and Faghihi hospitals of Shiraz. The questionnaire was developed by the researcher and its validity was confirmed by the experts. The stratified sampling method was used and the sample size was determined to be 106 people, based on the Cochran formula. The data were analyzed using the software SPSS 20 by the Pearson correlation coefficient, the independent t-test, and an analysis of variance (ANOVA). Seventy-seven nurses stated that during the past six months they had made at least one error resulting from look-alike medication and a total of 132 errors were reported. The most common errors in medication related to ampoules and vials. The rate of errors was statistically significant in terms of marital status (