[ effect of payment method of treatment cost on patient length of stay in educational and healthcare centers in Qazvin]

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

Driving to contract management in health care institutes of developing countries

Public hospitals can privatize management activities by contracting with a private organization or person to perform the work. Management contract is a method which uses private sector for major government projects like hospitals. This study evaluates contract management in health care institutes of developing countries. Information has been collected by reviewing the management contract condition of selected countries. Different forms of public private partnership for private participation in hospitals were surveyed. The effects of management contract is expanding market opportunities to include public sector clients, capturing a market to be protected from competitors and providing a reliable and timely source of revenue. Contracting with non-governmental entities will provide better results than government provision of the same services. Contracting initiatives must be regulated and monitored at the highest level of government by experienced and astute policy makers, economists and operational personnel

[Estimation of willingness to pay for mammographic breast cancer screening tests among women in Tehran, based on contingent valuation method: 2010]

Routine mammography screening and clinical breast examination are effective measures in reducing breast cancer mortality. Contingent valuation method [CVM] is a method for willingness to pay [WTP] estimation for cost benefit analysis in economics. In this study, the mean and the function of WTP for mammographic screening for breast cancer were estimated with CVM. This cross-sectional study was descriptive-analytic in nature. A questionnaire was used to collect data from/ for the households in Tehran selected by stratified sampling in 2010. The correlation between WTP questions and the annual household income was measured for internal validity. There were other questions selected from National Health Accounts questionnaire, a standard questionnaire. The data were analyzed by STATA software [version 11] using Ramsey RESET test, David Sen - Mackinnon test, likelihood ratio test and maximum likelihood method to estimate the bivariate probit model and the marginal effects of variables with Z-ratios. The answer to the first bid was "yes" for some 46% of respondents while about 20% of respondents said "yes" to the upper amount. The probability of positive response for both bids was 0.159 and the average WTP was 300,000 Rails. Women, experiencing mammography in the last 4 years, answered "yes" to both bids with probability of 0.14. If the cost of mammogram were less than 300 thousand Rails for each person, there would be a higher WTP for screening mammography suggesting that individuals, in higher socioeconomic class, have higher WTP for mammographic screening

[Factors affecting the human capital development in hospitals of the Iranian social security organization]

Development of human capital within the healthcare organizations is of vital importance due to their dealing with health and lives of people. The aim of this study was to recognize the main factors affecting the Human Capital Development in hospitals affiliated to Iran social security organization. This was a descriptive and applicable study carried out within the hospitals affiliated to Iran social security organization in 2010. Initially, a conceptual model was designed based on comparative study of Human Capital Development models which was later confirmed by a group of expert. In addition, a questionnaire was designed based on conceptual models of components and variants and filled out by the organization's Education authorities [n=68] in two stages with a 20-day interval to assess the current state of the Human capital Development. After determining the adequacy of sample volume by Kaiser Meyer Olkin method and meaningfulness of coefficient matrix with Bartlott test, the exploration factors analysis using maximum probable method as well as the interpretation of variants by Varimax method were performed. Later, to confirm the acquired factors verifying factor analysis and to determine the direct and indirect relationships of components, the structural equations model method was used. Factors-related commitment component [organization development and management commitment] showed a direct relationship with planning component [career development path and plan for education]. The factors of career development path and master plan for education demonstrated a bilateral relationship in which a direct correlation between these factors and the factors of Human Capital Development [education and personal development] was established. Also, it was found that the Evaluation factor is an effective independent factor influencing all other factors. The factors recognized in this research are suitable for Human Capital Development in hospitals affiliated to Iran social security organization

[ effect of employee training on insurance deduction rate at firoozgar teaching hospital: 2008-2009]

Due to the low tariff of diagnostic and treatment services in hospitals as well as the high costs of delivering the health care services, the necessity of receiving all revenues from the insurance organizations can be justified. The purpose of this study was to investigate the effect of employee training on insurance deduction rate at Firoozgar Teaching Hospital. The present study was longitudinal, analytical, cross-sectional, and applied in nature. The population consisted of the insurance documents of all hospitalized patients insured by the two insurance organizations of 'Social Security' and 'Medical Services' [1685 and 1330 files, respectively] in Firoozgar Teaching Hospital during spring 2007 and spring 2008. Data were processed by SPSS software and were analyzed using paired t-tests. The average percentage of management errors in insurance documents was 1.38 and 3.25 before and after the training, respectively. Furthermore, the amount of deductions decreased from 9.13 to 9.6 before and after the training, respectively. The effect of training on errors was confirmed considering both insurance organization types [P

proton induced X-ray emission [PIXE] analysis of concentration of trace elements in varicose veins

Proton induced X-ray emission [PIXE] has been applied as reliable and improved techniques in this study to compare concentration of various trace elements in normal and abnormal varicose veins. Five samples from normal veins and 13 samples from varicose veins bombarded by 2.0 MeV energy proton beams produced by a Van de Graff accelerator in vacuum. Two specimens from each sample, approximately 1cm, were processed for PIXE [proton induced X-ray emission] analysis. Both qualitative and quantitative analyses of potassium, iron, copper and zinc concentration were performed with respect to calcium concentration. The concentration of potassium and iron in the varicose vein group has been significantly higher than the normal group. Copper and zinc concentration were also higher in the varicose veins, and the elevation of bromine was seen in the normal group. PIXE analysis showed higher concentrations of trace elements in veins derived from varicos patients compared to normal group. The difference in normal and abnormal vein might be independent of age

assessment on internal teaching-curative hospital environment according Wise board's six-dimensions model [Shiraz City, 2006]

The evaluation of the internal environment is included the evaluation of an organization position, evaluation of performances, identified its problems and its potential abilities. If the internal evaluation has been done correctly, it makes a comprehensive view of existing situation in the organization, bring about a correct overview to it in which irrelative and inefficient programs would be replaced by competitive and efficient ones. The aim of present research was evaluation of internal environment in the teaching-curative hospitals in Shiraz city; based on six dimensions Wise board model. Present research is a descriptive cross-sectional applied study. In this study 362 people of personnel of teaching-curative hospital of Shiraz have been involved. Data have been collected by standard questionnaire, and analyzed by SPSS software, using t-tests. The maximum score was 7. All scores under 4 showed the strength; and scores more than 4 showed the weakness points. The average of the variable studied data in this research which included setting goals, organizational structure [organized activates], leadership, coordination, awarding system, staffs' communication and their points' of view according any changes, Ranks of the hospitals are as follows: for Namazi Hospital: 3.80, 4.01, 4.26, 4.39, 4.43, 3.74; for Zaynabiyeh Hospital: 4.04, 4.20, 4.84, 4.72, 5.96, 4.16, 3.68; for Chamran Hospital: 3.84, 3.48, 2.68, 3.76, 4.96, 3.36, 3.6; for Hafez Hospital: 3.24, 4.21, 3.44, 4.12, 4.84, 2.72, 3.52; and for Shahid Faghihi Hospital: 2.75, 4.84, 3.80, 4.36, 5.32, 3.48, 3.80. According to the finding data in this research: in setting a goal: Zaynabiyeh hospital, in organization structure Namazi, Zaynabiyeh, Hafez, and Shahid Faghihi; in awarding system all studied hospitals and in communication Namazi and Zaynabiyeh hospitals had weakness points; in which it is needed more attention. In all the hospitals, the staffs' point of view toward changes had strength points

Relative measurement of heavy elements in the bile, gallbladder and gallstone

PIXE [Particle Induced X-Ray Emission] is a suitable method for the analysis of biological samples in which heavy trace elements are contained in light matrix elements. It is very important to know which factors or probably elements act as initial seed and lead to growing the sands. The goal of this study was to compare the relative values of Fe/K, Cu/K and Zn/K for gallstones, gallbladder, and bile of a specific patient for studying the origination of forming the gallstones. Human gallbladder, bile, and gallstone samples were obtained by surgical operation from 15 patients and are bombarded by 2.0 MeV energy proton beams produced by van de Graff accelerator in vacuum. All the gallstones were chosen of pigment type of stones and, all the patients were adults. In contrast with conventional methods, the shell and center of the sands has been analyzed separately. The PIXE spectrum analysis was performed using the nonlinear least square fitting code AXIL and GUPIX. The results of detected minor and trace elements shows that the precipitation of calcium salt in the bile lead to reduction of crystals' formation. Elemental comparison of pigment type of gallstone and bile shows that the concentration of calcium in the shell of the stones is four times more than that in the bile. Precipitation of the calcium from the saturated bile on the cholesterols as a seed of gallstones led to reduced sands formation. Analysis of the gallbladder of the same patients revealed no relation between elemental concentrations of bile and gallstones

Investigation of heavy trace elements in neoplastic and non-neoplastic human thyroid tissue: a study by proton - induced X-ray emissions

Within the context of developing techniques to facilitate the diagnosis of the thyroid diseases, the elemental composition of pathological thyroid tissue [neoplastic and non-neoplastic] was investigated by proton induced X-ray emission. The PIXE has been widely used as a sensitive technique for trace elemental analysis in both biological and medical fields. Materials and The twenty-eight specimen of thyroid tissue [neoplastic, non-neoplastic and grossly normal tissue] were obtained from operation of 14 patients with different thyroid diseases. Determination of the heavy trace elements distribution [Fe, Co, Ni, Cu, Zn, As, Se, Br, Rb, Mo, I] was carried out by irradiating of the sample surface with a focused proton beam. Fourteen grossly normal, eleven non-neoplastic and three malignant thyroid neoplasm cases were diagnosed. Trace element contents of the International Atomic Energy Agency [IAEA] MA-B-3/TM Fish tissue was used as standard for calibration of PIXE set up. The concentration of the heavy trace elements Co, Cu, Zn and Mo in neoplasm of thyroid were higher than other samples. The concentration of the heavy trace elements, Fe, As, Br, Rb, I, are found to be much lower in neoplasm of thyroid than non-malignant and grossly normal thyroid tissue. The concentration of the Se, Co and I in this study is consistent with the others study but there are differences in the concentration of Fe in our study and others works. Iodine concentrations was 11 times lower, on average in neoplasm compared with non-neoplasmic tissue of thyroid. The low levels of I in thyroid neoplasm are correlated to some pathological factors

concentration of heavy trace elements in pigment and cholesterol human gallstones: comparative studies by PIXE analysis

The method of proton induced X-ray emission [PIXE] has been widely used as a sensitive technique to trace elemental analysis in both biological and medical fields. The sensitivity of this powerful method is in the order of ppm.The aim of this work is to analyze structural composition of 4 heavy trace elements with Z greater than 24 [Mn, Fe, Cu, Zn] in two kinds of gallstones and to compare the results for various ages of patients by PIXE quantitatively. Materials and methods: The pigment and cholesterole gallstones were obtained from 12 patients during surgical operations and were used for in vitro study. The age of the patients were between 22 and 78 years. Both cholesterol and pigmented types were analyzed for shell and center. The samples were bombarded using a 3.0 MeV van-de-Graff accelerator at nuclear research center of Atomic Energy Organization of Iran for the PIXE measurement. In pigment gallstones, the mean value of Mn, Fe, and Zn in shell is greater than in the center and Cu in the shell is smaller than center. In cholesterol gallstones, neither in the shell nor in center, Zn was not observed. The composition of Mn and Fe in center is greater than in shell. In the patients older than 40 years, the concentration of heavy trace elements increases, and those in cholesterol stones are nearly two times larger than in pigment stones. Comparison of two types of gallstones shows that the center of the pigment stones is very similar to cholesterol type.It is concluded that the origination of gallstone in human is common but formation and growth are different