Journal of Health Information Management
Year:2010 | Volume:7 | Issue:1 (13)|Papers Count:13

Introduction: The performance evaluation of healthcare system in macro-level is important. This paper evaluates performance of health service of Asian countries in 2006.Methods: In the first step, the initial data for performance evaluation has been collected from the site world health organization (WHO) and are weighted by Analytical Hierarchy Process (AHP) and finally they were reduced to a desirable output, an undesirable output, a controllable input, a fix input, a social and an economic indicator. Applying eigenvector procedure in AHP needs the use of maple software to calculate the weight of each component in each group.Then, the technical efficiencies of healthcare system of countries are measure by standard input oriented DEA linear programming model.Writing the linear programming model in GAMS (General Algebraic Modeling System) does the execution of DEA models: that we enter the value of introduced indicators in first step for each country.Results: For fair evaluation of healthcare systems of countries in competitive space produced by DEA, environmental factors is effective so in the next step the influence of socio-economic indicators is shown on evaluated technical efficiency in the previous step. The effect of environmental factors is done by composition of two DEA model suggested by Banker & Morey in 1986 and Kao & Liu in 2000. Finally, we will present the results of efficiency of countries in the tables and the manner of being efficient for country with non-efficient healthcare system by suggesting as lower the expenditure on healthcare system.Conclusion: The healthcare system of each country is ranked according to the efficient usage of resources to deliver the health service and the reducing the expenditure results to excess the efficiency.

Introduction: Providing free access to the latest research and more publishing channels, Open Access (OA) is hoped to decrease the South countries' information poverty and professional isolation. Due to its particular importance, it is necessary to investigate how they exploit Open Access resources.Methods: Applying a citation analysis method, the present study explores Iranian scientists approach to publishing in and to citing Open Access journals. Using Science Citation Index, we extracted data related to Iranian scientific outputs. Using the list of prestigious Open Access journals previously identified, we then labeled Iranian Open Access papers and Open Access references. Applying regression analysis, we try to investigate the mathematical models that best fit the data to predict the growth rate of Iranian Open Access papers and references.Results: Iranian scientists in Material Engineering and Multidisciplinary Sciences are most inclined to Open Access journals, while those in Medicine and Health Sciences and Physical Sciences are the least. The results reveal that Iranians' approach to Open Access journals has been growing based on an exponential model. Open Access papers, plotted versus total Iranian papers, grow at a linear rate. However, Open Access references plotted versus total papers yield a power model. The same is true for papers citing Open Access Journals.Conclusion: Iranian scholars widely benefit from Open Access journals. However, disciplines differ in their patterns, as proved at international level, too. Generally, the number of Iranian Open Access papers are growing based on a constant rate, compared to that of their total papers; while the number of Open Access references is growing at a relatively more rapid rate. The difference may be due to differences in publication strategies. While scientists experience journal limitations in getting their papers accepted, they have few limitations, if any, in referencing to an accessible paper.

Introduction: Some of the most frequently used webometric indicators for evaluating and ranking academic web sites are web impact factor, number of web pages and number of inlinks.The present study evaluated and ranked top Iranian Medical universities according to the webometric indicators.Methods: The present cross-sectional study has been done on top Iranian medical universities.The number of web pages, inlinks and external inlinks were identified using AltaVista search engine. Then their overall and absolute web impact factors were calculated. Finally, the universities were compared and ranked according to the size, inlinks, external inlinks and also the overall and absolute web impact factors.Results: The results showed that Tehran University of Medical Sciences ranked first according to the size and inlinks while ranked last according to the overall and absolute web impact factors.Ahwaz University of Medical Sciences got the highest position according to the overall and absolute web impact factors compared with the other universities.Conclusion: The study revealed that even top Iranian medical universities have not wide presence over the web and are not internationally well known. Having few English web pages and short web history are the major reasons for Iranian universities poor presence on the web.

Introduction: Medical Records Department (MRD) is an important source for evaluating and planning of care services. The main goal of this research was performance evaluation of medical records department with Balanced Scorecard (BSC) approach in a hospital of Isfahan, Iran.Methods: This research was a descriptive, cross sectional in which data were collected by questionnaires, observation and forms. The population was medical records department of a hospital in Isfahan, Iran. To analyze data first of all objectives of medical records department according to mission and perspectives was setting. Then objectives were measured. Subsequently, findings from the performance will compare with expected score. If necessary, reform for the programs, activities, and plans in order to achieve the final target will be done.Results: The medical records department of this hospital was successful in providence of customer suggestion value (satisfaction). In customer perspective was customer satisfaction of admission 82%, statistics satisfaction 83%.Conclusion: Researcher proposes that it had better improve quality and period length of services, for achiving the mission of medical records department.

Introduction: Use of a computerised system improves the effectiveness and efficiency of a medical record department on condition that managers and medical record staff design it according to needs.Methods: The present investigation was an applied-descriptive study. A checklist was provided from professional texts, articles and internet. This checklist included general requirements of HIS such as general requirements of medical record department, medical records management, admission, discharge, statistics, coding, filing and chart completion. Then Researcher distinguished compatibilities of systems with checklist, with observation and question. Finally data were analyzed using descriptive statistics.Results: Total average of compatibility of hospital information systems with the list of requirements in medical record department were general requirements of HIS (65.4%), general requirements of medical record department (50.3%), medical records management (85.7%), admission (59.6%), discharge (75.8%), statistics (64.1%), coding (32.2%), filing and chart completion (28.7%).Conclusion: It is imperative that venders regard more and more to users needs with support of managers to improve systems.

Introduction: There are many demands for accuracy coded data with purpose of the systemic recording, analysis, interperation and comparison of morbidity and mortality data collected in different countries. Therefore the importance of accurate coding cannot be ignore. Meaningful and comparative statistics needs accurate and comprehensive coding and it requires knowledge of rules and guidelines for ICD. So coders must be knowledge about guidelines for producing quality data. Goal of the research was determining coder's knowledge of coding Isfahan hospitals.Methods: It is a descriptive study carried out on all coders (N=32) in hospitals affiliated with Isfahan University o Medical Sciences. The data was collected by a researcher-made questionnaire which was validated by experts and its reliability was confirmed by test retest.Results analyzed by SPSS.Results: The mean of accurate response of coders was approximately 45%. Maximum of the coders awareness of the questions was about selection of main diagnosis and related procedures (69%) and procedures guidelines (51%). Also minimum of the coders awareness was about selection main diagnosis among other diagnoses (32%) and general coding guidelines (35%).Conclusion: The coders awareness about axes except the first goal was lesser than 50%. It resulting in not missing of information but inaccurate classification and unreliable reporting.Outcome of its is inefficiency of coding units and alteration their mission specially research in educational hospitals.

Introduction: There is not enough time for any organization to experience everything by itself but it is possible to compare its processes with other organizations in order to fulfill its functions effectively. The main aim of this research was to assess and compare discharge processes in Aliebne Abitaleb and Quaem hospitals.Methods: A cross-sectional survey was carried out on discharge department of Ali-ebne Abitaleb and Quaem hospitals in first half 2005. In order to assess discharge processes quantitative criteria including discharge manner, number of staff, characteristics of staff, equipment and process time and patient satisfaction as a qualitative criterion were applied. Data were collected by documents surveying, observation, time measuring and questionnaire.50 internal and surgical inpatients that have stayed at hospital for at least 48 hour have been approached randomly and their satisfaction was measured through a reliable and valid questionnaire. Also for time measuring 60 aforementioned inpatients were surveyed. Statistical significance was considered with a P value of less than 0.05.Results: In two hospitals, discharge manner of patients was different. Mean time of processes fulfillment were significantly different. Total sum scores of equipment of discharge unit were 3.028 in Ali-ebne Abitaleb and 5.030 in Quaem hospitals. Total sum scores of staff characteristics of discharge unit were 2.24 in Ali-ebne Abitaleb and 8.90 in Quaem hospitals.Mean of patients' satisfaction was 2.37 in Ali-ebne Abitaleb and 3.85 in Quaem hospitals and were significantly different.Conclusion: Because of the differences between two hospitals regarding to time of processes fulfillment, equipment, staff number, staff characteristics and patients satisfaction it is recommended that Ali-ebne Abitaleb hospital benchmark itself with Quaem Hospital.

Introduction: Organizations planned in-service trainings for updating of personnel’s information.ICDL (international computer driving license) is one of the most important trainings. The purpose of this research is Evaluation the some aspects of ICDL in-service trainings from the viewpoints of administrators and personnel of Tabriz University of Medical Sciences and health services.Methods: This research is a field descriptive study. The statistical population studied included all of formal and contracted personnel and administrators of Tabriz University of Medical Sciences and health services (4345 persons). Which 4220 ones were personnel and 125 persons were administrators among this total. In this research 351 personnel and 94 administrators were selected through simple random sampling. Two separate questionnaires were used for data gathering. Validity and reliability of tools determined through content validity and Chronbach's Alfa. Descriptive statistics (Frequencies, Mean and Standard Deviation) and inferential statistics (Mann Whitney U, Kruskal-Wallis and independent t-test) were used for data analysis.Results: The findings of this research showed that administrators more than personnel believed in role and importance of ICDL (P<0.05). There were no meaningful difference between views of personnel and their administrators regarding ICDL training periods effects on increasing of personnel skill and knowledge as well as their coordination with personnel job needs (P>0.05).Administrators more than personnel believed in role of material and nonmaterial incentives for participating at ICDL training classes (P<0.05). Personnel mentioned ICDL trainers had highlevel skill and knowledge in presenting the lessons matters. Statistical meaningful difference was detected about beneficially of ICDL trainings between different job subgroups of medical sciences university (P>0.05). (ICDL had more benefit in financial-official subgroups).Conclusion: Based upon the results it is concluded that the personnel of Medical Sciences University is needed to be more knowledgeable concerning role and importance of ICDL inservice trainings. Besides considering material and nonmaterial factors for participating at ICDL training classes is necessary. Finally for returning on personnel investment, ICDL in - service trainings are needed to be applicable.

Introduction: Death-related information is source for identifying the health prerequisites and formulating the related programs.Due to importance of data for decision making, evaluation of it to determine the rate of documentation and errors is necessary.Methods: In this descriptive, cross-sectional study, all issued certificates in 5 teaching hospitals of Mazandaran University of Medical Sciences during March 2004-5 were reviewed. The characteristics of certifying and deceased and the documentation error were checked with a checklist according to the WHO introduced death certificate and for associated factors a self administration questioner was used. The rate of documentation and errors calculated. Four types of error were classified. Error 1, only the mechanism (s) of death or mode of dying is given. Error 2, multiple causal sequences are given. Error 3, a single sequence is given but is not specific enough. Error 4, a single sequence is given but the order was incorrect. The questionnaire was designed according to aims of research and reliability was tested with Cronbach's alpha=0.87 in a pilot study. Data analyzed with SPSS software.Results: Documentation rate was 51 percent. In 137 (16.4%) death certificates cause of death was documented correctly. The error 3 was the most, (38.1%) and the error 2 has the lowest (3.4%) rate. According to the certifier opinion, the most significant factors associated with the error rates were related to inadequate equipment (35.2%) for determining the diagnosis such as autopsy, undiagnosed. (22%), and nor teaching program for physicians with the documentation subject.Conclusion: Findings show that documentations in death certificate have problems. Training program in death certificate completion for physicians and improvement of diagnostic tests for better documentation are suggested.

Introduction: Health care organizations have begun applying six sigma methods into their operations. On the other hand, the difficulty of using indicators to compare health care providers in a meaningful way has led to an increased focus on using information about “adverse events”-that is, events that should not happen in a hospital - as a measure of quality. This information is required to perform Six Sigma methods.By nesting the Lean flow methodology within the six sigma methodology, a synergy can be attained that provides results that are much more significant than the results of the individual approaches. When Lean is added to six sigma, slow processes are challenged and replaced with more streamlined workflows.Additionally, the data gathered during Lean Flow implementation helps identify the highest–impact six sigma opportunities. When six sigma is added to Lean flow, a much-needed structure is provided that makes it easier to consistently achieve optimum flow.Organizations that use a combination of Lean and six sigma (Lean-sigma) methods incorporate a testing phase during the fourth step of DMAIC cycle (improve). In this step, teams create solutions, develop tests of change, learn from the test, improve the change, and then test again, eventually finding the best - fit solution. By the time a solution is ready to be implemented, it has undergone many tests of change and has a greater chance of acceptance.The Charleston area medical center used six sigma methodology to evaluate and improve its rate of colon and vascular surgical site infections.

Introduction: Disasters whether natural or man-made can inflict widespread damage in every society. Disaster effects on hospitals were discussed by many specialties in many fields. The aim of this article was discussion disasters effect on medical records department, which responsible for safeguard keeping of patient medical records. Researches on scientific journal and internet have shown that the reports of disasters and their effects on medical records were rarely. So this article, for the first time discusses the flood effect on patient medical records from Iran.