[Performance assessment of hospitals affiliated with Iran University of medical sciences: application of economic techniques in health care area]

Introduction: hospitals are considered as one of the main health delivery systems and the largest and most expensive operational units that have specific importance and sensitivity. This study was conducted to assess the performance of hospitals affiliated with Iran University of Medical Sciences applying economical techniques

Methods: this was a cross sectional with a data panel study conducted in 16 hospitals affiliated with Iran University of Medical Sciences in 2006-2012. Two forms according to research objectives were designed one for registering Pabon Lasso indexes and the other for DEA inputs and outputs. Excel software was used for analyzing the former data and Windeap 2.1 for estimating the efficiency and productivity indexes of the hospitals

Results: Pabon Lasso Model shows that in the years 2007 and 2011 the number of hospitals in the third zone was at the maximum level. Furthermore, the mean of technical and managerial efficiency was at the maximum level [0.889 +/- 0.135, 0.909 +/- 0.142] in 2011. Malmquist index shows that during the study period the mean of total productivity changes was 1.018 indicating a decrease in hospital productivity during the study period

Conclusion: it seems that system changes in Iran University of Medical Sciences has led to negative fluctuations in efficiency and productivity indexes of the hospitals. Applying managerial approaches along with reassessing the indexes after managerial status of the University is suggested

Determinants of catastrophic health expenditure in Iran

This study will provide detailed specification of those variables and determinants of unpredictable health expenditure in Iran, and the requirements to reduce extensive effects of the factors affecting households' payments for health and other goods and services inappropriately. This study aims to identify measures of fair financing of health services and determinants of fair financing contribution, regarding the required share of households that prevents their catastrophic payments. In this regard, analysis of shares of households' expenditures on main groups of goods and services in urban and rural areas and in groups of deciles in the statistics from households' expenditure surveys was applied. The growth of spending in nominal values within the years 2002-2008 was considerably high and the rate for out-of-pocket payments is nearly the same or greater than the rate for total health expenditure. In 2008, urban and rural households in average pay 6.4% and 6.35% of their total expenditure on health services. Finally three categories of determinants of unfair and catastrophic payments by households were recognized in terms of households' socioeconomic status, equality/inequality conditions of the distribution of risk of financing, and economic aspects of health expenditure distribution. While extending the total share of government and prepayment sources of financing health services are considered as the simplest policy for limiting out-of-pocket payments, indicators and policies introduced in this study could also be considered important and useful for the development of health sector and easing access to health services, irrespective of health financing fairness

Allocation of health resources according to the type and size of Iranian governmental hospitals

Due to consuming about 50%-80% of health resources, hospitals are the greatest and costly operational units in Iranian Health system. so allocation of resources specially human and space resources as the most expensive ones is really important for further controlling of costs, analysis of costs and making suitable policies for increasing the profitability and allocation of resources and improvement of quality. This paper intends to describe and analyze any allocation of resources in 530 university hospitals in Iran. The final goal of this research is to provide a data bank according which there is a basis for more scientific budget allocation of state's hospitals from the size and type of application points of view. The relevant index of person to bed was 2.04 for human resources. All hospitals more than 300 beds are located in benefiting areas from which 17 cases are educational and 2 cases are therapeutic. This is necessary to mention that the rate of management group forces to total personnel at deprived areas is about 2.5% more than benefiting areas. Because 60-80% of hospital costs are applied for human forces, all managers of hospitals are obliged to revise their policies in attraction and employment of human force in order to benefit from such a valuable resource and prevent from expensive costs. So any employment of personnel should be based upon real needs of hospital

[Similar to me effect among managers of Tehran university of medical sciences]

Introduction: Considering the importance of selecting competent people for governmental organizations to obtain optimal effectiveness and performance, this study aimed to investigate the impact of similar-to-me effect among top and middle managers of Tehran University of Medical Sciences

Methods: The present cross- sectional study was conducted on 130 top and middle managers affiliated to Tehran University of Medical Sciences. A valid and reliable questionnaire was used for data collection. Pearson correlation was used to analyze the data

Results: There was significant statistical relationships between similar-to-me effect and groupthink [p= 0.005], functional conflict [p= 0.001], and narcissism [P < 0.0001]

Conclusion: Based on the results, it is recommended to inform managers about inappropriate impacts of similar-to-me effect by means of education and cultural training

Health related quality of life in breast cancer patients undergoing current chemotherapy protocols

Health related quality of life is one of the important concepts that nowadays is considered along with other quantitative criteria like life expectancy and survival in health service systems, but its significance is more obvious in degenerative diseases and long term treatments such as cancers. In this study we compared health related quality of life in breast cancer patients undergoing either Docetaxel -Adriamicine - Cyclophosphamide [TAG] or 5-FU- Adriamicine - Cyclophosphamide [FAC] regimens. This study was conducted in a double blind cohort design on 100 patients with positive - node breast cancer treated by TAG or FAC regimens. The international standard questionnaire [EORTC QLQ-C30] was used to evaluate health related quality of life at the start and end points of chemotherapy period. Data were analyzed by independent t-test at the significant level of 0.05. Results showed the same scores of quality of life at the first session of chemotherapy in both groups and in 4- month follow up, at the end of chemotherapy, mean score of quality of life in both groups decreased but it reduced more in TAG group. Chemotherapy regimens can decrease patients quality of life greatly. So reinforcing the relationship between patients and their families, society and treatment team in addition with using supportive methods and counseling groups can maintain the level of patients' quality of life greatly

[Study on the prevalence of irritable bowel syndrome in patients with preterm labor]

Irritable bowel syndrome [IBS] is a common functional bowel disorder characterized by abdominal pain and change in bowel movement. On the other hand, preterm labor [PL] is currently one of the most important problems in maternal-child health. The major causes of IBS are yet to be recognized, however some shared factors with PL have been proposed. It is probable that IBS patients are susceptible to have preterm labor. The goal of this study is the evaluation of IBS frequency in preterm labor. In a case-control study, 150 patients with PL [case group] were compared with 150 people with term labor [control group] for the presence of IBS. The Rome II criteria were employed to diagnose IBS. The subgroups of the diarrhea-predominant and the constipation-predominant of IBS were determined as well. A total of 36 IBS patients were diagnosed in which 21[14.7%] were in the case group and 14 [9.3%] were in the control group [p=0.155]. The diarrhea-predominant type was recognized in 3 patients, all in the case group [p=0.247]. The constipation-predominant type was recognized in 11 patients, 9 cases in the case group [p=0.032]