Systematic review of priority setting studies in health research in the Islamic Republic of Iran

Background: Several research priority-setting studies have been conducted in different countries, including the Islamic Republic of Iran.

Aims: We conducted a systematic review and evaluated the quality of the priority-setting reports about health research in the Islamic Republic of Iran.

Methods: English and Farsi databases were searched from January to July 2016 to extract reports [up to December 2015] about priority setting in health research in the Islamic Republic of Iran. We constructed a checklist to extract data from the identified studies. Articles were studied in detail and content analysis was carried out. Relevant items were scored and analysed using Microsoft Excel.

Results: We identified 36 articles. Eight articles involved all the main stakeholders. About half the articles used valid criteria for ranking. Transparency was fulfilled in 13 articles. Upstream rules and regulations were ignored in 26 articles. An implementation plan was considered in 9 articles and context analysis was demonstrated in only 3.

Conclusions: Developing standard packages for priority setting, training of researchers and improving the capacity of organizations may improve the quality of priority-setting studies in the future.

Identifying weaknesses in undergraduate programs within the context input process product model framework in view of faculty and library staff in 2014 / 한국의학교육

PURPOSE: Objective of this research is to find out weaknesses of undergraduate programs in terms of personnel and financial, organizational management and facilities in view of faculty and library staff, and determining factors that may facilitate program quality-improvement. METHODS: This is a descriptive analytical survey research and from purpose aspect is an application evaluation study that undergraduate groups of selected faculties (Public Health, Nursing and Midwifery, Allied Medical Sciences and Rehabilitation) at Tehran University of Medical Sciences (TUMS) have been surveyed using context input process product model in 2014. Statistical population were consist of three subgroups including department head (n=10), faculty members (n=61), and library staff (n=10) with total population of 81 people. Data collected through three researcher-made questionnaires which were based on Likert scale. The data were then analyzed using descriptive and inferential statistics. RESULTS: Results showed desirable and relatively desirable situation for factors in context, input, process, and product fields except for factors of administration and financial; and research and educational spaces and equipment which were in undesirable situation. CONCLUSION: Based on results, researcher highlighted weaknesses in the undergraduate programs of TUMS in terms of research and educational spaces and facilities, educational curriculum, administration and financial; and recommended some steps in terms of financial, organizational management and communication with graduates in order to improve the quality of this system.

A Qualitative Inquiry Into the Challenges of Medical Education for Retention of General Practitioners in Rural and Underserved Areas of Iran / 예방의학회지

OBJECTIVES: General practitioners (GPs) retention in rural and underserved areas highly effects on accessibility of healthcare facilities across the country. Education seems to be a critical factor that affects GPs retention. Thus, the present study aimed at inquiry into medical education challenges that limit their retention in rural and underserved areas. METHODS: A qualitative approach was applied for the aim of this study. Data were gathered via 28 semi-structured interviews with experts at different levels of Iran’s health system as well as GPs who retained and refused to retain working in rural settings. Interviews mainly were performed face-to-face and in some cases via telephone during 2015 and then coded and analyzed using content analysis approach. RESULTS: Iran’s medical education is faced with several challenges that were categorized in four main themes including student selection, medical students’ perception about their field of study, education setting and approach, curriculum of medical education. According to experts this challenges could results in making GP graduates disinterested for practicing in rural and underserved areas. CONCLUSIONS: Challenges that were found could have negative effects on retention. Modification in student’s perception about rural practice could be done via changing education setting and approach and curriculum. These modifications could improve GPs retention in rural and underserved areas.

[Study of conflict management styles in Tehran university affiliated hospitals]

Introduction: Conflicts in hospitals, in addition to reducing Employee's productivity and satisfaction, and also increasing hospital's costs, has a negative effect on the treatment process. Therefore, acquiring necessary knowledge and skills for conflict management are essential for hospital managers. The present study aimed to investigate the conflict management strategies used by managers of hospitals affiliated with Tehran University of Medical Sciences [TUMS]

Methods: This is a descriptive - analytic study conducted as a cross-sectional one in 2015. The sample consisted of 563 managers of three levels of management including senior, middle, and executive managers in hospitals affiliated with TUMS. Using a high valid and reliable self-made questionnaire based on Thomas and Kilman's model, the data was collected. Data analysis was performed by SPSS software 19, and using descriptive [Mean, Standard Deviation, Frequency and Percentage] and inferential statistics [Regression, Spearman and ANOVA]

Results: The results show that collaborating style was the dominant style used by hospital managers. Compromising and accommodating styles were the next management strategies in order. There were significant statistical relationship between management style and management level [P=0.038], age [P=0.016], manager's work experience [P=0.019], management experience [P= 0.021] and conflict management training courses [P=0.001]

Conclusion: The nature of healthcare organizations requires that managers use collaborating, compromising and accommodating styles in order to interact with various stakeholders. Holding suitable training course in the field of conflict management has a significant role in reducing devastate effects of conflict in the hospitals

Estimating economic burden of cancer deaths attributable to smoking in Iran in 2012

Background: There is a broad consensus among health policy-makers that smoking has a significant impact on both heath system and society. The purpose of this study was to estimate the economic burden of major cancer deaths caused by smoking in Iran in 2012

Methods: Number of major cancer deaths due to smoking by sex and age groups in 2012 was obtained from GLOBCAN database. The life expectancy and retirement age were used to estimate years of potential life lost [YPLL] and cost of productive lost attributable to smoking, respectively. Data on prevalence of smoking, relative risk of smoking, life expectancy table, annual wage and employment rate were extracted from the various resources such as previous studies, WHO database and Iranian statistic centers. The data analysis was conducted by Excel software

Results: Smoking was responsible for 4,623 cancer deaths, 80808 YPLL and $US 83,019,583 cost of productivity lost. Lung cancer accounts for largest proportion of total cancer deaths, YPLL and cost of productivity lost attributable to smoking. Males account for 86.6% of cancer deaths, 82.6% of YPLL and 85.3% of cost of productivity lost caused by smoking

Conclusions: Smoking places a high economic burden on health system and society as a whole. In addition, if no one had been smokers in Iran, approximately two out of ten cancer deaths could be prevented

Hospitals productivity measurement using data envelopment analysis technique

This study aimed to measure the hospital productivity using data envelopment analysis [DEA] technique and Malmquist indices. This is a cross sectional study in which the panel data were used in a 4 year period from 2007 to 2010. The research was implemented in 12 teaching and non-teaching hospitals of Ahvaz County. Data envelopment analysis technique and the Malmquist indices with an input-orientation approach, was used to analyze the data and estimation of productivity. Data were analyzed using the SPSS.18 and DEAP.2 software. Six hospitals [50%] had a value lower than 1, which represents an increase in total productivity and other hospitals were non-productive. The average of total productivity factor [TPF] was 1.024 for all hospitals, which represents a decrease in efficiency by 2.4% from 2007 to 2010. The average technical, technologic, scale and managerial efficiency change was 0.989, 1.008, 1.028, and 0.996 respectively. There was not a significant difference in mean productivity changes among teaching and non-teaching hospitals [P>0.05] [except in 2009 years]. Productivity rate of hospitals had an increasing trend generally. However, the total average of productivity was decreased in hospitals. Besides, between the several components of total productivity, variation of technological efficiency had the highest impact on reduce of total average of productivity

study on the direct and indirect costs of multiple sclerosis based on expanded disability status scale score in Khuzestan, Iran

Multiple sclerosis is a common and chronic neurologic disorder. This disorder imposes physical, economic, and psychosocial burden on individuals, their families and society. This study aims to analyze the costs of multiple sclerosis disease based on the severity of disability. We performed a cross-sectional cost of illness study. This study was conducted in 332 patients of Khuzestan province of Iran. Data were included: Patient's characteristics, disability status, medical, and nonmedical costs and were gathered by using the questionnaire during 3 months period. Costs analysis was performed in the basis of expanded disability status scale [EDSS]. Data were analyzed by using SPSS 18 software. Mean age of the patients was 33.5 [standard deviation [SD]: 9.1] and 70.5% of patients were female. Mean EDSS score of the patients was 2.2 [SD: 1.6]. Most patients [92.1%] had relapsing remitting multiple sclerosis [MS] form of the disease. Costs mean per patients was 8.6 +/- 7.9 million Rial. The direct and indirect costs were 93.1% and 6.9% of total costs, respectively. The major cost of the disease belongs to the pharmaceutical treatment [22% of costs]. The majority costs [approximately 62%] attributed to EDSS of 6-7 and >7. Furthermore, there was strong significant relationship between cost of illness and disability severity of patients [P < 0.05]. Cost mean per MS patients was relatively high. Furthermore, the results showed that cost of disease had positive and significant relationships with EDSS score that is, progression of disability increase costs of patients

Iran' multiple indicator demographic and health survey [irmidhs-2010]: study protocol

There is an international emphasis on providing timely and high quality data to monitor progress of countries toward Millennium Development Goals. Iran's Multiple Indicator Demographic and Health Survey [IrMIDHS] aimed to provide valid information on population and health outcomes to monitor progress in achieving national priorities and health programs and to assist policy makers to design effective strategies for improving health outcomes and equity in access to care. A cross-sectional multi-stage stratified cluster-random survey is conducted through face-to-face household interviews. The sampling frame is developed using Iran's 2006 population and housing census. Provincial samples ranging are from a minimum of 400 households per province to 6400 households in Tehran province. Cluster size is 10 households. The target sample includes 3096 clusters: 2187 clusters in urban and 909 clusters in rural areas. IrMIDHS instruments include three questionnaires: Household questionnaire, women aged 15-54 questionnaire, children under five questionnaire, supervision and quality assessment checklists and data collection sheets and standard weight and height measurement tools for under-five children. A cascading decentralized training method is used for training data collection and supervision teams. Quality assurance procedures are defined for the five steps of conducting the survey including: Sampling, training data collection and training teams, survey implementation, data entry and analysis. A multi-layer supervision and monitoring procedure is established. All the questionnaires are double entered. IrMIDHS will provide valuable data for policymakers in Iran. Designing and implementation of the study involve contributions from academics as well as program managers and policy makers. The collaborative nature of the study may facilitate better usage of its results

Validation of the mother-generated index in Iran: a specific postnatal quality-of-life instrument

The mother-generated index [MGI] is one of only a few existing specific questionnaires for assessing the postnatal quality of life [QoL]. MGI is a single-form questionnaire that asks postnatal mothers to specify up to eight areas of their lives which have been affected by giving birth to a baby. Using this tool, it is possible to score and rank the QoL of mothers. This study aimed to validate the questionnaire for use in Iran. Forward translation was used to translate the questionnaire from English to Farsi [Persian]. The questionnaire was then administered to a sample of postnatal women attending two teaching hospitals in Tehran, Iran. Face validity and criterion validity were performed to establish the validity for the Iranian version of the MGI. Face validity was assessed by asking women to indicate whether they understood the wording of the questions, how easy the questionnaire was, and so on. Criterion validity was examined using the Short Form 36-item [SF-36] Health Survey. It was hypothesized that the MGI would significantly correlate with the SF-36. In all, 124 women were approached. Of these, 119 women were eligible and 96 women agreed to take part in the study. Face validity was good and all of the women found the MGI straightforward to complete; as criterion validity, the MGI scores and the subscales of the SF-36 were moderately correlated [for all subscales: Pearson r > 0.4; P < 0.001]. The mean MGI primary score was 5.38 [SD = 3.05]. Women who had comorbidity had significantly lower MGI scores than women without comorbidity [P = 0.04]. Correlation between aggregate of comments and primary score was high [r = 0.68, P < 0.01]. In general, the Iranian version of the MGI performed well and our data suggest that it is a valid measure to assess health-related QoL among postnatal women

Patient rights: Knowledge of managers of private hospitals

To determine awareness of managers of private hospitals about patient rights and its effective factors in Tehran, Iran. This cross-sectional study was conducted among all managers of private hospitals in Tehran [N = 35], using a questionnaire including 32 questions. Data were analyzed using descriptive and analytical statistical procedures. The results showed that 23% of managers had good level of awareness. However, 54% and 23% of them had intermediate and low level of awareness regarding patient rights, respectively. There were four effective factors on awareness of the managers about patient rights including educational degree, discipline, academic institute and training in management. 77% of the managers had less than good level of awareness regarding patient rights. As awareness could be a proxy of consequent behavior, therefore it could be predicted that the managers might perform inadequately in their responsibilities related to patient rights. It seems that there is need to promote awareness on patient rights among hospital managers