Journal of Health Information Management
Year:2013 | Volume:10 | Issue:3 (31)|Papers Count:14

Introduction: Discharge against medical advice (DAMA) can be an important indicator of patient dissatisfaction. This study examined the reasons for the DAMA in Shafa hospital (Kerman, Iran).Methods: This was a descriptive cross-sectional study within August 2010 to March 2011 on patients in this hospital. Over 9295 inpatients were discharged, 483 had DAMA and were assigned 190 contacts and out of 3600 outpatients, 382 had DAMA and 128 contacts.Results: The rate of personal satisfaction for discharge in hospital wards was 5.19%. And it was 10.61% in outpatient which showed no statistically significant differences between the men and women.45% of the personal desires to cause of hospital and 55% of hospital discharge with a personal desire reasons.Conclusion: In Shafa hospital, we might decrease the DAMA with treatment strategies such as increasing patient awareness from potential complications of the disease, the treatment plan for patients, creating a good atmosphere to relax patients, appropriate landscape design environment and etc.

Introduction: In a comprehensive health approach, emphasis has been more on education and self-care than care itself, and aims to increase patient's knowledge to give decision making and independence ability to improve quality of lifestyle. These can develop with progress of information technology. The aim of this study was to evaluate hospital information system (HIS) in meeting the patient drug information needs for self-care management.Methods: A descriptive cross-sectional study was done in 2011. As HIS is maintained by 15 software companies and due to contingency software of each, a hospital from each company, was selected by a random simple sampling method. Essential drug data elements determined by a questionnaire (with face and content validity) and Delphi approach on three-step conversations with expert. Then a checklist was prepared and HIS was observed based on the checklist.Results: Finding showed number of repeated description, dosage, duration, time, adverse reaction, drug discontinuation, recommendation use, start date, number of drug, consume method, drug interaction, physicians drug prescription, preparative's methods, food-drug interaction, and drug form and prescription date were essential drug data elements recommended by the experts. History of drug administration was in 8 HIS software (53.33%) and prescription date were in 7 HIS software (46.66%).Conclusion: Feasibility of HIS is very low. HIS software's must be developed and upgraded by their providing companies.

Introduction: One of the most important goals of library and information sciences is the user-oriented organization of information. Thus, the International Federation of Library Associations (IFLA) presents the functional requirements for bibliographic records (FRBR) model. This study examined the bibliographic relationships between Persian medical books based on the FRBR model, during 2006 to 2011 and reviewed the compliance rate of this model with the Persian medical books.Methods: This was a descriptive survey. The study population consisted of all the medical bibliographic records in the National Library of Iran's online public access catalog (OPAC) during 2006 to 2010. The data were collected using National Library of Iran OPAC. Method of data collecting was direct observation of bibliographic records in National Library of Iran OPAC. After collecting data and creating tables and figures in Microsoft Excel Software, the data were analyzed to fulfill the research objectives and also to draw conclusions.Results: The results showed that out of total 105, 926 books published in Persian, 3, 781 books, i.e. equivalent to 3.56% were in the field of medical sciences. In total number of medical Persian books, only 390 books, i.e. equivalent to 10.31%, had the work-to-work bibliographic relationships. The most common types of bibliographic relationships in Persian medical books in the studied years consequently were "summarization", "adaptation" and "supplement".Conclusion: Although the FRBR model is much emphasized, because of substantial differences of medical sciences with other sciences, especially the humanities (e.g. literature and arts), its experimental nature is very low based on scientific methodology [experiment, observation, hypothesis and conclusion by (proof theory)], the rate of "work-to-work bibliographic relationships", as the basic concept of FRBR.At present, according to this survey, implementation of FRBR in cataloging and organizing books in the field of medical sciences would not be cost effective.

Introduction: This study aimed to investigate the association between the emotional intelligence (EI) and organizational culture of university staff due to different dimensions of EI and its effects on different areas such as job progress, job satisfaction, job environment and organizational performance.Methods: This was an analytical and cross-sectional study. It was done on 168 staff of Isfahan University of Medical Sciences using two questionnaires i.e. EI and organizational culture questionnaire. The subjects were selected randomly and asked for cooperation individually and verbally. The data were reported in two descriptive and inferential levels (Pearson correlation coefficient test).Results: The results showed that there was a significant and direct association between EI and organizational culture. There was also a reversed significant association between EI and the masculinity femininity culture. There was no association between EI and the individualism and collectivism culture, EI and trust-risk culture and avoidance of incontinence, EI and the culture of distribution of equitable and non-equitable power.Conclusion: The results show that there was a direct and significant association between EI and organizational culture. So it is recommended to train all the characteristics of EI for developing and increasing EI due to different dimensions of EI and its effects on different parts of personal life, job and also the similarities with organizational culture in some components that show the time association between the two variables. Thus, the components of EI can have affective organizational culture.

Introduction: Given the complexity and dynamic nature of triage and ahead challenges in selecting the required information in emergency environment, this study aimed to improve the registration quality of triage process and shift it from paper-based to computer-based triage assessment through processing of the triage staff expectations data model of emergency information system.Methods: This descriptive study was performed on nurses and physicians working in triage units of affiliated hospital of Tehran and Shahid Beheshti University of Medical Sciences in 2009. This study was conducted in three steps. The first step was to collect data through interviews, the second step was modeling by methods of rational unified process (RUP) and unified modeling language (UML) and the third step was a Delphi approach to confirm the models scientifically using a valid, reliable and researcher-made questionnaire. Descriptive statistics were used to analyze the questionnaire data.Results: Through interviewing with the triage staff based on working process, we found that triage staff required data elements should have coherent and integrated association. In the Delphi, results showed that 82% of the statistical population agreed with the elements and information structure in the triage unit.Conclusion: The findings suggested that the triage unit staff had a broad understanding of the triage and recognized triage as a process in which the severity of disease, screening and data collection about assessment are combined. The results of this study can be used to guide and prioritize required information in the emergency information system in the triage area of victims and patients base on the triage nurses' and doctors' performance.

Introduction: Coding underlying cause of death is associated with both written information on death certificate and interpretation of rules about coding cause of death by coder. This study aimed to review the cause of death coding accuracy in Hormozgan University of Medical Sciences (Hormozgan, Iran).Methods: This was a descriptive cross-sectional study which was performed in 2010-2011 for six months. The study population included the death certificates of all the deceased in Shahid Mohammadi Educational Hospital (n=345) and Pediatrics Educational Hospital (n=59). First, information of death certificates was written on new forms. Then, the residents of the clinical wards determined the sequences and then the researcher took action for recoding death certificates and comparing his codes by original coders. Data were analyzed by descriptive statistics and chi-square test.Results: Coding accuracy rate in Shahid Mohammadi Hospital, Pediatrics Hospital and in total were 51.7%, 54% and 52.1%, respectively. Coding accuracy had a statistically significant association with International Classification of Diseases Tenth Edition (ICD-10) chapters, number of lines and languages used for completing death certificates. The best status of coding was in chapters of genitourinary system diseases (87.5 percent) and neoplasms (69.4%). The worst condition was in chapters of external causes (21.4%) and endocrine, nutritional and metabolic diseases. The most application (36%) and the best coding status (65% accuracy) belonged to general rule. Rule 3 was the most erroneous (85%) and neoplasms coding rules had been observed at rate 65.7%.Conclusion: Coding cause of death in these hospitals had not desirable status and education is essential for both physicians (regarding how to complete the death certificate) and coders (about rules of selecting and coding underlying cause of death).

Introduction: Between 50% to two-third (majority) of medical errors occur in operation room and emergency units in hospitals among which 50% are preventable. To increase the patient safety, consolidated prospective and retrospective method errors from 10 selected processes from operation room in Seyed Alshohada Hospital, Semirom, Iran have been identified, evaluated, prioritized and analyzed.Methods: As a descriptive research, the analyses of mode and effects were carried out in this quantitative qualitative study. Prospective method used in the study was healthcare failure mode and effects analysis (HFMEA) in a 6-month period retrospective method error reporting system. Frequencies obtained by both methods were compared together and error modes and possible causes were identified.Results: Using HFMEA, 187 potential modes in 10 selected processes of operation rooms was selected. Using error report system, 61 reports were survived and subsequent outcome were matched with prospective method and 36 unacceptable errors were identified after decision-making tree analysis and ultimately possible reasons and recommended procedure were proposed.Conclusion: Based on obtained results, using consolidated, retrospective and prospective risk analysis has sufficient efficiency providing a comprehensive view from errors in common process of healthcare units.

Introduction: Plagiarism damages the scientific products. Its effects on sciences producer, such as manufacturers, scientists, authors and the others is that they will not desire to write anymore. Furthermore, research result is so important in medical sciences, because they are dealing with human life. Therefore, this study aimed to identify the methods and types of crime in plagiarism.Methods: This was a qualitative study by in-depth Interview method. Statistical populations included experts of Isfahan University of Medical Sciences, Iran. Data collection method was through purposive sampling and depended upon data saturation. Data were analyzed by thematic analysis method.Results: Data analysis led to extraction of 40 subjects and 6 main subjects such as repetitive research, non-principals adoption, non-principal compliance, forged, and jobbery.Conclusion: Results showed that there were various methods of plagiarism. Therefore, universities must organize institute to education researcher and information authorities in order to decrease plagiarism and update relevant laws and rules.

Introduction: Breast cancer is one of the main causes of mortality and morbidity worldwide. Breast cancer is 21.4% of all cancers among Iranian women. Given the fact that financial and human resources are limited for health care services, the estimation of the direct medical costs of breast cancer can help health policy makers and payers of the cost to understand the burden of breast cancer on their limited financial resources as well as the society.Methods: This was a cross-sectional study to calculate the direct medical costs of managing breast cancer among women in Iran. The medical records of all the registered patients in Seyed Alshohada Hospital (SSH) in Isfahan, Iran were used as data source of the study. The patients' demographic information, disease stages and the received services extracted from the patients' records. The direct medical costs associated with treating patients in both public and private sectors were calculated. Data were analyzed with statistical software SPSS 16.Results: The mean age of the patients was 49 years. The distribution of the patients in the I-IV stages of the disease were 4.1%, 28.8%, 26.6% and 41.1%, respectively. The direct medical cost of treating patients in the four stages of disease were IRR (Iranian Rial) 103, 809, 250, 106, 715, 180, 133, 462, 730, and 109, 538, 070 respectively.Conclusion: The direct medical cost of breast cancer in Iran is more than 304' 836 billion IRR in Iran. The mean age of the patients in Iran is almost 10 years lower than the western countries, which is increased the burden of disease in Iran significantly. Drug therapy is the main cost component of the treatment cost. Cost effectiveness analysis of alternative treatments in breast cancer may improve the efficiency of the breast cancer management.

Introduction: Websites of academic journals have an important role in communicating and providing services to researchers. The present study aimed to determine the number of incoming links of Iranian Journal of Medical Sciences websites. Besides, it aimed to determine the rate of visibility of core websites based on these findings.Methods: This descriptive study was performed using webometrics method in November 2011. We reviewed the site of Research and Technology Deputy of Ministry of Health in order to list the websites of Iranian Medical Sciences Journals. All the 199 websites of these journals searched by Google search engine and only 188 websites were found. Yahoo search engine was used to calculate the incoming links of these sites. Microsoft Excel 2010 was used to analyze the data.Results: The findings proved that of 188 journals’ websites, only 29 journals were at the 1st level indexing. Furthermore, 68 journals were at the 2nd level, 73 journals were at the 3rd level and 18 journals had Iranian indexing. According to the type of website's addresses, 75 journals had independent websites, 78 journals had sub-domain web addresses and 35 journals had web pages of the main websites.Conclusion: The results of this study represented that those journals at the 1st level indexing gained the highest share of core websites and the other journals at the 2nd and 3rd levels indexing gained second and third ranks, respectively. The highest share of core websites belonged to the independent websites and journals’ website with sub-domain web addresses obtained the next rank positions. Journals with web pages of a main website were not among the core websites.

Introduction: Road traffic crashes (RTCs) are very common across the world and in Iran. The aim of this study was to estimate the economic burden of road traffic accidents in Tehran province, Iran in 2009.Methods: This was a descriptive, cross-sectional retrospective study. The study population included all deceased and injuries due to RTCs in Tehran in 2009. The economic burden of RTC was estimated by human capital approach. The costs were divided into three groups: direct costs (pre-hospital, hospital costs, physiotherapy and rehabilitation costs, property damage costs, administrative costs and funeral costs), indirect costs (costs of income loss or potential production lost) and intangible costs. Data were extracted from two databases specially designed at Iran Ministry of Health and Medical Education and at Legal Medicine Organization of Iran for recording traffic road injuries and from available literature. The average cost of each hospitalization was estimated by review of medical records.Results: In 2009, 2410 people died and a further 92, 100 people were injured due to RTC in Tehran. The total annual cost of road accidents in Tehran was 11, 185, 313 Iranian Rials (IRR).64.7% of the total costs were related to the direct costs, %23.3 of the total costs were related to indirect costs and %12 of the total costs were related to direct costs.Conclusion: This study showed that the burden of RTC in Tehran was substantial which included about 0.3 to 0.4 percent of Iran’s gross domestic product in 2009.

Introduction: Nowadays and with the increasing role of the worldwide web as one of the most important sources of information on the one hand, and the enhancement of its usability on the other, it is necessary for the web designers and developers to be familiar with the criteria that make a web portal usable. Therefore, the present study aimed to provide knowledge about the criteria of usability in U.S. National Library of Medicine (NLM) in comparison to Iranian National Library of Medicine (INLM).Methods: Taking a critical approach, this article examined web portal of NLM in comparison to INLM, in order to conduct a reliable assessment. The tools for data collection was an explanatory checklist, developed by the researchers based on the review of the literatures consisted of 159 components. Desired portals were measured by it. In order to analyze research findings, descriptive statistics (frequency and percentage) used.Results: In general, the results showed that the evaluation of usability in NLM portal, compared to the overall assessment in accordance with all the sub-criteria, in index portal, (with 676 points), was 96%, and it was 48% in INLM.Conclusion: Considering the increase of expansion for web portals and their roles, web portal usability evaluation ensures web designers about the usability of their websites for satisfying their general users. According to the value place of national library as the golden gateway to access quick easy and unlimited medical information, considering its web usability can be useful. Obviously, each information service exists for the sole purpose of satisfying its users, and all its activities, services and products are geared towards this purpose. How well this purpose is served is a measure of the usefulness of that information service.