ABSTRACT
Background: Prioritization and resource allocation are the most important processes in managing and developing each organization. Given the high turnover and cost of hospitals in health system, this study aimed to provide a model for
financial resource allocation with the Goal Programming [GP] in Afzalipour teaching medical center in Kerman
Methods: This mixed method and case-study study was conducted in Afzalipour teaching medical center located in Kerman, south-eastern of Iran. Participating key informants and operation research experts, twelve focus group discussions [FGDs] were developed to extract a goal programming model. Then, the hospital accounting data were collected from 2010- 2013 according to the extracted model.The WinQSB software was used for running the model
Results: The findings of this study showed that the share of personnel costs of this hospital was 72% which 28% was devoted to fee-for-service [FFS] and contractual services, current and other costs were 6%, 2%, and 12%, respectively. However, the findings of goal programming model showed that the optimum and satisfactory amount of personnel costs must be 66%, 14% of which were allocated to the FFS cost. The share of contractual services, current and other costs must be 15%, 2%, and 17%, respectively
Conclusion: The results showed that resource allocation in the hospital follow merely the accounting perspective rather than optimum and satisfactory ones. It is suggested in order to achieve the optimum values, the board of trustees should be institutionalized in practice; moreover, the outsourcing services should be addressed more. Therefore, personal costs which include a large part of costs can be reduced
ABSTRACT
Introduction: Hospitals are the most expensive health care organizations. In this study, identifying factors influencing hospitalization costs based on the three aspects of the health system including patients, health care providers, and insurance organizations were considered
Methods: This was a qualitative and phenomenological study. In this study, 12 experts in the field of management and controlling hospital's costs were selected through purposive and snowball sampling method. Data were collected using focused group discussion. Framework analysis was used for data analysis
Results: The factors affecting hospitalization costs were classified into three codes including patients, health care providers, and insurance organizations. Lack of knowledge and awareness and neglecting self-care were the main patient-related factors, and weak management and supervision, lack of medical guidelines, long-term recovery period, lack of implementation of family physician and weak commitments and structural problems of insurance organizations were the main factors related to the health care providers and insurance organizations
Conclusion: The results showed that by increasing and improving self- care programs, providing health-oriented services, implementation of family physician program, specializing the hospital management, improving the quantity and quality of supervisions and reforming expert structure of insurance organizations, the hospitalization costs can be managed
ABSTRACT
Sarcomas are rare tumors account for about 1% of cancers in adult. Soft tissue sarcomas are the most common one. Synovial sarcoma's incident is about 10% of all sarcomas and most commonly rise from para-articular regions in young adults. Based on our knowledge there have been only two reports of thyroid synovial sarcoma in medical literature. We report a 44-year old woman presented with a rapid growing neck mass. The pathology report revealed sarcoma and the immunohistochemistry [IHC] was compatible with synovial sarcoma. It could be understood that synovial sarcoma can be found in various tissues even if there is no synovial cells
ABSTRACT
This study focused on triple-negative breast cancer [TNBC] that is characterized by the lack of expression of estrogen receptor [ER], progesterone receptor [PR], and human epidermal growth factor receptor 2 [HER-2]. The primary goal of this study was to describe the relation between triple-negative receptor status and survival. This is the first study about triple-negative breast cancer in our community of the 1541 patients diagnosed with breast cancer between 2002 and 2007 at the Cancer Institute [Tehran, Iran]. 107 patients were identified as TNBC and 107 patients were randomly selected as non-TNB. HER-2, ER and PR status were assessed by immunohistochemistry [IHC]. Analyses of their collected data were performed retrospectively and then clinical and pathologic parameters were compared between two groups. In multivariate analysis, a significantly decreased overall survival was observed for patients with TNBC compared with non-TNBC [55.7 months versus 60.7 mounts; 95%CI: 51.1-60.3 and 57.9-63.5 for TNBC and non-TNBC respectively, P=0.0008]. The 2- and 5-year estimates for overall survival were 69.8% and 62.3% for TNBC, and 90% and 83% for non-TNBC, respectively. During the study period, 36 [33.6%] patient of TNBC and 14 [13.1%] of non-TNBC presented local recurrence. Significantly decreased disease-free survival was also observed for patients with TNBC compared with non-TNBC [P=0.0004]. The 2- and 5-year estimates for disease-free survival were 68% and 63% for TNBC; and 89% and 82% for non-TNBC, respectively. Significantly decreased distant metastasis free survival was also observed for patients with TNBC compared with non-TNBC [54.4 mounts versus 61.7 mounts; 95%CI: 49.8-59.0 and 59.1-64.4 for TNBC and non-TNBC respectively, P=0.0004]. Triple negative breast cancer has a biologic aggressive behavior and poor prognosis. Therefore aggressive treatment and regular follow-up in early stage of diagnosis can be a significant impact on their prognosis.