[ level of propensity to outsource study: based on hospital services features by managers and staff perspective in hospitals of Shiraz university of medical science, 2010]

The inefficiency of financing health care in developing countries made led in many health policy-makers to consider alternate means of service provisions. Outsourcing public financed health services in private sector organization is one of the interventions. Advocates claim that the contracting out of health care services will improve the service delivery performances through stimulating competition among providers and also by creating economic incentives to improve performance through linking payment to provider performance. The purpose of this cross sectional study was to provide decision matrix to guide decision-makers whether outsource hospital services or not. Tow kind of questionnaire were developed and used. Findings showed that the most propensities of outsource is in nutrition services [87%], and the least is in nursing services [43.4%] based on administrators' attitude. Shaping of decision matrix showed propensity to outsourcing of nursing, radiology, laboratory services are high while nutrition services is been low. Some differences between of decision matrix and administrators' propensity to outsourcing in radiology and laboratory services. Lack of attention in characteristics of the hospital services might be one of the reasons. Cost saving is the main reason for outsourcing the services while administrators should consider as an effect and side effect of outsourcings

Patients length of stay in women hospital and its associated clinical and non-clinical factors, Tehran, Iran

Length of Stay [LOS] is an appropriate hospital indicator to evaluate hospital resource utilization rate, efficiency, and quality of services delivered. In this survey, we aimed to study hospital LOS and determine its association with clinical and non-clinical factors in Women Hospital in Tehran. In this cross-sectional study, we reviewed all 3421 charts of patients admitted in Oncology, Surgery and Obstetrics units in 2008. We used a data collection sheet and conducted interviews to collect the following data: distance from living area, medical insurance coverage types, admission and discharge months, days and times, inpatient units, final diagnoses and the number of diagnostic tests. The overall median of the LOS in the studied hospital was 50.8 hours. The medians were 48.5, 54.4, and 94.2 hours in the Obstetrics, Surgical and Oncology units, respectively. Results showed that the associated factors with the LOS were patient admissions on Thursdays, admitting by residents, the number of performed diagnostic tests [p<0.001], suffering from neoplastic diseases [p=0.005] and spouse jobs. Among the associated factors, policy makers and managers can only change the admission days and the number of diagnostic tests to decrease the LOS. Further researches are needed to find other factors associated with LOS