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Background: Studies on economic burden demonstrate the impacts of some diseases and provide invaluable information for specifying priorities and resource needs when designing cancer control strategies. The current study aimed to estimate the cost of esophageal carcinoma (EC) in Iran in 2018. Methods: This study was conducted on the prevalence approach to estimate the economic burden of EC in Iran from a social perspective. The direct cost was estimated by summing the diagnosis, treatment, follow-up, terminal care, and transport costs. Additionally, a human capital approach was adopted to estimate productivity losses. Various resources were used for data collection, including the GLOBOCAN 2018 report, and the medical record in the Cancer Institute of Iran. Also, data such as exchange rates, employment, and housekeeping rates were extracted from the Central Bank of Iran Statistics. Results: The economic burden of EC in Iran was $69.2 million in 2018, of which $38.7 million is caused by indirect costs and $30.5 million by direct costs. The mortality cost accounted for 49% of the economic burden, followed by 34% direct medical cost, 10% direct non-medical cost, and 7% morbidity cost. Conclusions: Mortality and medical cost appeared to be the main contributor to the economic burden. Therefore, policy-makers are recommended to adopt early detection and effective treatment as a highly cost-effective strategy for controlling costs
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Introduction: There has been a vigorous change in the healthcare sector with increased patient expectations, technological advancements, and growing competition in the healthcare market. Therefore hospitals have to shift from traditional management approach to more diverse aspects like TQM practices and effective quality management system to augment the performance level. Relationship between TQM practices and performance is multipronged and widely discussed in the literature. Aim: Main purpose of this study was to evaluate the impact of TQM practices on nonfinancial performance elements of performance in different quality management system settings. Methods: This study used an empirical approach to identify and explain the TQM practices and non-financial performance relationship. A cross-sectional survey was conducted in 5 hospitals from different regions with either Joint Commissioned International (JCI) or ISO 9001 based quality management system. Data were collected from 150 hospital managers between October 2018 and February 2019. Descriptive and inferential statistical analysis was conducted using IBM SPSS 20 version. Results: Finding of the study support that TQM practices have a statistically significant and positive relationship with non-financial performance (p<0.05). Result of multiple linear regression analysis shows that TQM practices are a strong predictor of non-financial performance (Beta=0.793, t=15.837, R2=0.629, and p=0.000) and explain 63% variation in the model. TQM practices demonstrate higher overall and individual mean values for JCI accredited hospitals. T-test shows that there is a significant difference (p<0.05) in TQM practices between JCI and ISO-based quality management system. Conclusion: It can be inferred from this study that TQM practices have a leading role in the improvement of the non-financial performance of hospitals. Hospital managers at a different level can achieve improved results with effective implementation of identified TQM practices. TQM practices significantly contribute towards individual dimensions as well as an overall improvement in non-financial performance.
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Introduction: World Health Organization (WHO) recognizes disability as a global public health issue and a development priority, but unfortunately, the evidence shows that people with disabilities (PWD) often have lower levels of health than the general population.This study targeted to identify challenges in providing rehabilitation services for People with Disabilities. Materials and Methods: This article was undertaken on a qualitative content analysis. Twenty one participants were selected through purposeful sampling. Data were collected through semi-structured in-depth interviews from June 2014 to July 2015. Interviews continued until data saturation. Data analysis was performed by MAXQDA version 10. Results: Challenges to providing of rehabilitation services were the most important for PWD that needed to receive medical rehabilitation services. These challenges were grouped into six categories of poor knowledge, negative attitude to disability, insufficient support of PWD, individual problems of providers, problems of accessibility and cost. Conclusions: A proper rehabilitation plan requires common understanding of the challenges in providing of rehabilitation services for PWD. Understanding these challenges will help policy makers, providers, and PWD and their families consider rehabilitation as an effective component of service provision in health system. Based on findings of this study, further research is recommended to elucidate the challenges affecting provision of rehabilitation services for PWD.
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The hospital is one of the main organizations which offering health care and medical services in a high level allocated sources in the health sectors. Therefore, considering to efficiency costs is great importance. This study aims in considering the efficiency of the hospitals of Medical University in Tabriz, Iran, by using Data Exhaustive Analysis Method. The study inspected and analyzed the technical efficiency and also effective factors on it in selected hospitals by using Data Exhaustive Analysis Method during the 3 period years [1384-1387]. In order to conduct this study, the omprehensive Input-oriented Form of Data Exhaustive Analysis Method assuming in the variable return compared with the scale. The variables of the inputs in this study included number of physicians, non-physician staff, and active bed and annual costs of the hospital. The variables of the outputs included the coefficient of the occupied beds, number of admitted patients, and surgeries. To data analyzing, SPSS and data envelopment analysis software were used. It is worth mention that the data in this study were accumulated by using the forms devised by the authors and standardized questionnaire via referring and going to the hospitals. The findings of data exhaustive analysis method showed that there was 5% [TE=0/953] possible capacity augment in the technical efficiency. The findings also suggest that there is a potential frugality in consuming the inputs in order to produce a constant amount of the output. Meanwhile, there is a potential augment of the output by using a constant amount of the input, as well. The findings also represent the effect of the demographic factors and functional factors on the efficiency of the hospitals. It is suggested that to leave out the surplus staff, decrease the surplus costs of the hospital through replacing the energy consumption and a proper management of energy and other surplus inputs, hire sophisticated managers and applying the graduated field of management in health care and medical services and also hire the managers with high quality degrees, create the data envelopment analysis of enhancing efficiency should be one of the useful way to provide qualified medical services in our society as a comprehensive programming. Based on the findings of the data Exhaustive analysis method, improving the efficiency of the hospitals, health care system and medical section are essential as well
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Over the past decade, the number of private centers providing health care services in Iran has had a continuous growth and the highly competitive market in private hospitals industry has caused increasing pressure on them to provide services with a higher quality. The purpose of this study was to assess the quality of services being provided in private hospitals of Tehran as judged by patients. This cross-sectional study was conducted in 2010 in Tehran. The study sample comprised 983 patients, randomly selected from 8 private hospitals. The survey instrument was the standard SERVQUAL questionnaire. Wilcoxon, t-test, and Kruskal-Wallis tests were used for statistical analyses. The total mean scores of patients' expectation and perception were 4.92 and 4.02, respectively. The highest figures were related to the tangible factors dimension and the lowest ones to the empathy dimension. The differences between the perception and expectation for all the 22 items and the 5 dimensions were found to be statistically significant[p< 0.001]. SERVQUAL is valid and reliable in hospital settings as a standard tool for the assessment of quality. The results of the present study have revealed the areas that need to be improved as far as the patients are concerned. Measuring the opinion of patients can help facilitate the provision of hospital services, and improve the quality of such services and patients' satisfaction
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In strategic planning, there are several procedures to perform internal assessment or strength and weakness of organizations. Among other methods created for this purpose, Wiseboard model is the one in which the following six internal dimensions are considered: Organizational Structure, Leadership, Coordination, Reward System and Communication. This study measures three of these variables in hospitals of Tehran University of Medical Sciences [TUMS]. This survey is a descriptive, analytical and crosssectional study conducted during 2010 and 2011. The research population comprised all those working at TUMS hospitals from which a random sample of about 580 people was selected. The questionnaire's reliability was estimated to be 91% and the data were analyzed by the SPSS software. Of the subjects, 75.4% were below diploma level, 13% above diploma, 7.8% higher diploma, 66.4 bachelor holders, 2.6% master holders, and 5.4% had a doctoral degree or higher. Some 72.6% of the subjects were in Clinical and 19.8% in Nonclinical fields. The mean values of Goal Setting, Organizational Structure, and Leadership came out to be 24.47, 20.37, and 22.06, respectively. Based on the findings of this research study, TUMS hospitals have weaknesses in some aspects and they need improvement in some areas in the following order: Organizational Structure, Leadership, and Goal Setting
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Medical tourism has become a challenging Issue in a last few years all over the world. Iran, as one of the developed countries in terms of advanced medical sciences and highly distinguished specialists and physicians, aims to tack part actively in the global market of medical tourism among Middle-Fast countries through empowering effective relationship with other countries and improving its own medical services. According to the health part of the forth national strategic development plan, Iran should reach to the heart of the Middle-Fast countries regarding medical tourism until the end of the mentioned plan. This survey has been conducted to find out current statues of medical tourism in the country and gathering concerned authorities and specialist's opinion for providing required context for medical tourism in Iran to achieve the goal. This qualitative research was done during the summer of 2005 on the 9 provinces in the country. They had been selected randomly as the pilots. Required data were gathered through interviewing with top Health organization's authorities such as medical university chancellors and his/her deputies and hospital managers and so on in each province. Iran had distinguished development in exporting medical products such as drugs and medical equipments in the last few years. The study showed that this figure has been increased about 1.82 and 6.5 times more in terms of weight and worth[$] during the period of 1375-1382. Unfortunately, the researchers could not find any reliable and comperhensive data about exporting medical services at all. Other findings are comments and suggestions of related health authorities and specialist of the provinces on solving existing problems on the way of goal. It is quite evident that although some effective steps have been taken, there is a long way to reach the final target in terms of Iran's medical tourism. To achieve the purpose, first of all a well-developed strategic planning and a proper management of the medical tourism is essential. Nevertheless enjoying by developed medical sciences and distinguished specialists in Iran, delivering medical services are facing to serious problems yet