[ responsiveness of board of trustees hospitals according to the world bank's organizational reform model In Isfahan]

Transforming government hospitals into autonomous units improved hospitals. This study was performed to evaluate the responsiveness of board of trustees hospital according to the world bank's organizational reform model [Preker Model] in Isfahan city. The study was a qualitative research method. In this research, depth and semi-structured interviews were carried out and purposive sampling was used. The study population were top managers of Amin and Alzahra hospitals. Sampling was started with the first participant until saturated level of information, participants completed the 8 cases. According to interviews, the current role and contribution of non-university institutions [e.g. municipalities representatives] in hospital board of trustees is neither bold nor transparent. These hospitals can address minimum changes in their mechanisms of accountability after developing board of trustees. It is rational for hospitals as they undergo organizational reform and developing board of trustees, to have more rights for decision making. Further more, their accountability mechanism should change accordingly

[Study of payment methods to doctors in the referral system in selected countries and suggestions for Iranian social security organization- direct medical service provision]

Payment method is one of the most important control knobs in the health system. All organizations that mobilize funds for health sector must be decided: who should be paid? Why this money should be paid to them? And how much should be paid? So the main purpose of this study is to identify different methods of paying to the doctors in referral system of selected countries, and ultimately providing some suggestions for Iranian social security organizations- direct medical service provision. This was a comparative study designed in 2008. First we studied theoretical issues and analyzed them within the framework of the current situation. Then we conducted a comparative study to find some solutions for it. Then we validated selected suggestions using by Delphi technique. Most selected countries use a combination of methods to pay to the physicians. Usually for employed physicians in insurance organizations, salary makes a large part of doctor`s income. In countries where GPs play the role of gatekeeper, the per capita payment method has a special room. In American Health Maintenance Organizations [HMOs], based on employment or contractual relationship, they pay physicians by one of three "Per Capita", "Salary Monthly" or "Prepayment". In addition to Salaries [if any employment relationship], specialists usually receive some fees for their Services widely. Bonus payment in exchange for quality indicators is considered as a recently developed payment method for both GPs and specialists, but due to wide infrastructures, it needs accurate designing and plenty of arrangements

Outsourcing Effectiveness of Admission Units of imaging centers in Ayat o Allah Kashani Hospital to Non-Governmental Sector

Public hospitals spend 80% of health system resources and produce only 20% of the output section always had technical inefficiency and Allocative inefficiency. So in response to these growing pressures, Outsourcing strategy to non-governmental sector with cost-reduction and Growing Efficiency purpose has been designed and implemented. But the need to evaluate and control the outsourced activities is inevitable, that in many cases with regard to judgments and superficial thought, has been subjected to preferences and experts opinion. This study has been evaluated different angles of Outsourcing of the services to non-government sector. descriptive and Case study. The study populations are admissions units of CT scan, Radiology and Sonography of Isfahan Ayatollah Kashani Hospital. Data have been extracted with Triangulation method and through the questionnaire [Satisfaction Survey of internal customers], Check list [admission assessment services] and semi-structured interviews with officials and review financial documents and evidence. After Defining of Outsourcing goals from the perspective of the authorities, based on reduce insurance deductions, manpower shortage and improve response times and quality of response that offered to patients, findings indicate dramatic declines in reduce insurance deductions and also reduce Unit costs. However, 78% increase in performance of outsourced units and improve internal customer satisfaction are other results of study. It seems Outsourcing Para clinic Services, can lead to improve efficiency and increase satisfaction of hospital staff and patients