Reasons for turnover of hospital managers in Iran: A qualitative study.

BACKGROUND: Managerial stability is believed to play a crucial role in the success of health care organisations and health managers. High managerial turnover seems to be a common phenomenon of the Iranian health system. This study thus aimed to investigate the reasons for managerial turnover in Iranian hospitals. METHODS: Following a qualitative approach, 53 semi-structured interviews were conducted with different managerial levels in the hospitals, the high officials of medical universities, and health policymakers. Interviewees were selected using the purposive sampling techniques. Interviews were continued up to the data saturation. Data analysis was conducted thematically using MAXQDA 10. RESULTS: Four groups of reasons were identified leading into the managerial turnover in hospitals, ranging from the micro to macro level factors, that is, those related to the managers, hospitals, medical universities, and the country. Insufficient support from the officials, managerial poor performance, conflict with other managers and colleagues, changes of senior managers, and presidential and parliamentary elections representing the key reasons underlying the turnover of hospital managers in Iran. CONCLUSION: Given the variety of reasons emerged behind the managerial turnover, the efforts to improve the awareness and engage the all actors ranging from health policymakers to organisational decision-makers could be a valuable step to regulate and optimise the managerial turnover and stability in health care organisations in order to enhance the productivity and accountability in healthcare industry, particularly in the hospitals.

Lost productivity among military personnel with cardiovascular disease.

OBJECTIVE: Cardiovascular disease (CVD) is associated with significant productivity loss among all occupational groups. However, the increased occupational requirements of military personnel pose physical and psychological demands that could lead to greater lost productivity of CVD. The aim of this study was to determine the economic cost of lost productivity of military patients with CVD. METHODS: A prospective cross-sectional study was undertaken on all military patients attending a specialist CVD clinic in Tehran, Iran. All participants were interviewed using face-to-face questioning using a Valuation of Lost Productivity questionnaire. Data captured included paid and unpaid time lost due to CVD, military job characteristics and their work environment. Ordered logistic regression was used to examine the determinants of lost productivity. RESULTS: The mean time of lost productivity was 118 hours over a 3-month period, of which 70 and 48 hours were paid and unpaid work, respectively. The average cost per patient of total lost productivity was estimated to be US$303 over a 3-month period. CONCLUSIONS: CVDs are associated with significant lost productivity among military personnel. There is a statistically significant relation between some military occupation characteristics and lost productivity from CVD. Level of income, teamwork and physical activity have the greatest effects on lost productivity. Military workers who were suffering from other chronic conditions (in addition to CVD) were four times more likely to lose productivity. A supportive work environment should be created for military personnel with emphasis on developing teamwork, improving worker's attitudes towards disease and giving priority to workers with comorbidities.

The Quality of Educational Services from Students' Viewpoint in Iran: A Systematic Review and Meta-analysis.

BACKGROUND: Students' view is an important factor in assessing the quality of universities. Servqual pattern is regarded as the most prominent for services quality measurement. This study aimed to review systematically studies that investigated the quality of educational services. METHODS: A systematic review and meta-analysis of studies evaluating students' viewpoint about quality of educational services were conducted. Required data were collected from PubMed, Embase, Scopus, Science Direct, Google Scholar, SID, Magiran, and Iranmedex, without time restriction. Computer software CMA, ver. 2 was applied to estimate the total mean score of students' perception and expectation of services quality and the gap between them. RESULTS: The 18 eligible studies were entered into study. The studies were conducted between 2004 and 2014. Based on the random effect model, the total mean score of students' perception, students' expectation and the gap between them were estimated 2.92 (95% CI, 2.75 - 3.09), 4.18 (95% CI, 3.98 - 4.38), respectively and -1.30 (95% CI= -1.56, -1.04). CONCLUSION: The studied students' expectation level is higher than the current quality of educational services. There is a tangible difference between their expectations and the current quality, which requires officials' efforts to improve quality in all dimensions and effective steps can be taken towards improving the quality of educational services through appropriate training planning and training for empowering employees in colleges and universities.