Health System's Responsiveness of Inpatients: Hospitals of Iran.

INTRODUCTION: Additional to improving health and ensuring equitable financing that are two predominant goals of health system, another important goal of health systems is responsiveness to people's non-medical expectations. In this study we try to assess the health system's responsiveness in academic and non-academic hospitals. METHODS: This is a cross sectional study done in summer 2014 in Mashhad-Iran, we surveyed a total number of 403 inpatients by multi-stage sampling. A questionnaire of responsiveness and a check list included demographic variables and characteristics of hospitalization were completed by trained interviewers. Scales from 0 to 10 was applied for each questionnaire at the end of assessment of questions. RESULT: 403 participants Took part in this survey from 10 hospitals (6 academic and 4 non-academic hospitals). 124(30.8%) were from non-academic and 279(69.2%) from academic hospitals 140(34.7%) of patients were male and 263(65.3%) were female. mean age of participants was 36.77±1.52 years. The mean total score of responsiveness was 7.12±1.31 in academic hospitals and 6.99±1.38 in non-academic hospitals, considered as good performance. There was no significant difference between total scores of these two groups (p=0.38). Health care responsiveness score was higher in private (8.35±0.95) than other kinds of hospitals and charity hospitals had the lowest score (5.98±0.51). CONCLUSION: Responsiveness of health care system at hospitals is an important parameter for measuring patients' perception of quality of health care. Although responsiveness rate of our hospitals are good but some components such as: choice health care providers, respect to autonomy of individuals, clear communication and confidentiality received lower responsiveness scores, therefore they require more attention and these domains can be the more significant choices that should be considered while designing improvement programs.

A comparison between doxycycline-rifampin and ciprofloxacin-rifampin regimens in the treatment of acute Brucellosis.

INTRODUCTION: Brucellosis, a serious zoonosis, is a widespread disease in many countries, especially the developing ones, with an annual report of 500,000 new cases to the World Health Organization (WHO). Although successful results have been achieved by the combination therapies recommended by the WHO, their relapse rates have been high, and therefore, the most effective agents with least side-effects are still undetermined. MATERIALS AND METHODS: An observational study has been prospectively carried out from 2007 to 2010 in the Infectious Clinics of Hashemi-nejad and Imam Reza Hospitals, Mashhad, Iran. In this study, among the patients of brucellosis, whose diseases were recently diagnosed, 50 patients, receiving one of the two common authentic regimens of doxycycline plus rifampin for eight weeks or ciprofloxacin plus rifampin for six weeks, were selected. The diagnosis was based on the presence of signs and symptoms compatible with brucellosis, including a positive Wright and 2ME tests, with titers equal to or more than 1/160 and 1/40 respectively. RESULTS: The cure rate was the same for the groups (P=0.55). However, the relapse rate was much more for the latter (P= 0.02). CONCLUSION: Doxycycline plus rifampin was considered better than ciprofloxacin plus rifampin for the treatment of acute brucellosis.