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1.
Journal of Health Administration. 2015; 18 (59): 19-28
in Persian | IMEMR | ID: emr-179685

ABSTRACT

Introduction: decentralization is known an improve process and Promotion of health system and Inevitable part of wide reforms to promote equity, efficiency, quality, Economic justification. Administrative assignment is a method for Decentralization of government. The aim of this study was Comparison of Efficiency and Effectiveness of Karaj Shahid Rajaie Hospital before and after decentralization


Methods: this study was analytical and Comparison. Undertaken work cross - sectional. The data were collected via the questionnaire and Data collection form. After of data collection of before and after decentralization analysis was carried out with the SPSS 19 software and Statistical methods used are descriptive and analytical statistics [Mann-Whitney U]


Results: after of decentralization inpatient beds 4.8%, occupation beds 3.6%, percent of occupation Bed 0.3%, numbers of discharge of those 3.4% rate of rotation of the hospital bed 1.3% was increase . Numbers of inpatient in the after decentralization 3.3% and numbers of outpatient


16.5% increased hospital costs with inflation 2012, 19% decreased and hospital total revenues was increase overall of 6.5% .hospital infection rates in the after decentralization, 0.06% increased employee satisfaction average before of decentralization was mean and after decentralization was high. There are significant differences [P <0.0001], inpatient satisfaction average before of decentralization was low and after decentralization was mean. There are significant differences [P<0.0001]


Conclusion: efficiency and Effectiveness of karaj Shahid Rajaie Hospital after decentralization was Improvement, therefore Politicians and managers of health system should good infrastructure for the use of this mechanism in order to health system reform, especially public Hospitals

2.
Journal of Health Administration. 2014; 17 (57): 68-76
in Persian | IMEMR | ID: emr-180940

ABSTRACT

Introduction: While hospital care has always been one of the basic requirements, Payment Method of treatment is an important factor to create equity in utilization of care. On the other hand, length of stay is one of the key indicators in hospital performance showing the efficiency of hospital care in resource consumption. The purpose of this study was to survey the effect of Payment Method of Treatment cost on the patient length of stay in educational and health centers in Qazvin in 2014


Methods: In this cross-sectional descriptive-analytic study, 640 samples were randomly selected from among inpatients' documents at Qazvin's selected educational and health centers. Data entry form was used for data gathering and Kolmogorov-Smirnov, Mann Whitney and Kruskal- Wallis tests were used for data analysis


Results: The mean and standard deviation for inpatient length of stay were 5.454 and 6.143, respectively. Demographic factors such as age, occupation, marital status affected the length of stay [P <0.001]. The maximum length of stay was related to the patients with insurance from the Committee of Help [8.8days] and the minimum length of stay belonged to the patients without any type of health insurance [3days]. It was also found that basic and supplemental health insurance affected the patients length of stay


Conclusion: Concerning the limited resources of health system in hospital sector and the influence of Payment Method of treatment on patient length of stay, proper use of insurance for appropriate and adequate utilization of hospital care and reducing unnecessary accommodation are undoubtedly necessary

3.
Journal of Health Administration. 2013; 16 (51): 7-18
in Persian | IMEMR | ID: emr-183524

ABSTRACT

Introduction: Patients can determine the quality of services provided by hospitals which are regarded as large and complex service organizations within the health system. This study aimed to assess service quality gaps in Imam Khomeini teaching hospital in Tehran with respect to the differences between patients' perceptions of and expectations from health services


Methods: In this cross-sectional study, the six-dimensional SERVQUAL model questionnaire - the validity and reliability of which were confirmed by the researchers - was used to collect the viewpoints of 116 patients admitted to Imam Khomeini teaching hospital. Samples were estimated using the Cochrane statistical formula and the data were analyzed by means of independent t-test as well as correlation and ANOVA tests


Results: There was a negative gap in all dimensions of the quality of services. The highest and the lowest gaps [-2.55 and -0.697] were observed in the access and assurance dimensions, respectively. However, there was no significant relationship between the variables of quality gap of services and gender, marital status, insurance, visit frequency, age, and education [p value>0.05]. It was also found that in none of the dimensions were the expectations of the patients satisfied


Conclusion: The results indicated that except for the access dimension, expectations can be affected if any of the other variables is changed. Generally, there are lots of opportunities to work on to improve the quality of services provided by health care system

4.
Journal of Health Administration. 2013; 15 (50): 7-17
in Persian | IMEMR | ID: emr-130628

ABSTRACT

Pre-hospital emergency medical services may have an effective role in the survival rate and prevention of serious injuries to patients and victims. On the other hand, increased length of stay can lead to an increase in hospital and patient costs while prolonging the recovery and rehabilitation time. This study aimed to investigate the relationship between pre-hospital care and hospital length stay in patients with acute myocardial infarction in Hazrate Rasool Hospital. The population of this retrospective analytical cohort study constituted the patients diagnosed with Acute Myocardial Infarction hospitalized at Hazrate Rasool Hospital in Tehran in 2009. These patients were diagnosed during the first six month of 2009 and were ultimately discharged alive. The sample was the same as the study population. Data analysis was done by means of SPSS version 16, non-parametric Mann-Whitney, and Kruskal-Wallis tests. The findings showed that 88% of the patients were transferred to the hospital with ambulance and had already received pre-hospital services. The average length of stay in the hospital was found to be 17.6 days [SD = 4.05]. There were no significant differences in length of stay for the two groups of patients; those taken to hospital by ambulance and those who were not. However, a significant difference was observed between patients with various age groups. Moreover, the length of stay in patients with different insurance coverage was statistically significant. [P 0.05] According to the findings, although the means of transportation of the patients as well as pre-hospital services seem to have no impact on the length of stay in hospital, they may, however, affect other consequences such as improvement in overall health of the patient, reduction of injuries, pain, etc. which may not lead to a reduction in hospital stay. It seems that in studies examining factors affecting length of stay in hospitals, researchers should have systemic and holistic views on these factors in order to obtain a realistic contribution of each factor in increasing or decreasing the length of stay


Subject(s)
Humans , Myocardial Infarction , Length of Stay , Retrospective Studies , Cohort Studies
5.
Journal of Health Administration. 2012; 15 (49): 77-87
in Persian | IMEMR | ID: emr-130627

ABSTRACT

Evaluation of financial performance of organizations is regarded as an important financial function of managers since this allows them to make the right decisions and maintain the organizational productivity and control. The aim of this study was to assess the financial performance of medical universities in Iran employing financial ratio analysis. This was a cross-sectional descriptive study. Qualitative and quantitative data analysis techniques were used. Content analysis and Delphi panel qualitative data collection techniques were applied to enrich our understanding of the financial statements and ratios in medical universities in Iran. Additionally, a questionnaire was used to collect quantitative data on the financial statements and ratios of all 38 medical universities. The sampling method used was purposive, and for data analysis standard deviation variation, mean central tendency and frequency were used. Financial ratios [12], grouped in two categories of liquidity ratios, activity ratios and productivity of resources, were identified. The most important financial ratios were: quick ratio [mean=2.53], current ratio [mean=3.58], collection period ratio [mean=114], operating income, divided by total hind [mean=0.44], budget productivity [mean=0.79] and the assets return rate [mean=0.84]. The results indicate that the mean of liquidity ratios in medical universities in Iran was higher than the other sectors. This was due to the inappropriate year-end allocation of annual funds by the government. The other findings on activity ratio and operating cash flow ratio indicate lack of financial resources management regarding the assets conversion and resources and capitals combination within the universities studied. This shows that medical universities in Iran have not used the authoritative power of the board of trustees. We recommend further research on the development and standardization of financial reports in accordance with the type of services, disposable incomes, trade, and financial regulations in medical universities


Subject(s)
Universities , Cross-Sectional Studies , Surveys and Questionnaires
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