JOURNAL OF HEALTH ADMINISTRATION
Year:2010 | Volume:13 | Issue:40|Papers Count:10

Introduction: Chronometry of patients' workflow in emergency department (ED) is influenced by and influencing on many factors. This study was designed to calculate the chronometric indices of patients' workflow in ED of 7th Tir Martyrs Hospital of Tehran, and to determine their associated factors. Methods: In this cross-sectional study, the population study are 649 records of patients attending in ED of 7th Tir Martyrs Hospital of Tehran, during 4-13 October 2008. Demographic data, route of entrance (EMS/Walk-in), traumatic/non-traumatic types, time durations, lab test and imaging request, other services visits, and work shift data were collected and analyzed by SPSS 12 through T-test. Results: We found mean time between triage to visit 22 minutes, visit to disposition 210 minutes, disposition to exit 51 minutes, and triage to disposition 243 minutes. There were no statistically significant relationship between durations and sex, traumatic/non-traumatic patients and shift of work. There were statistically significant relationship between durations and route of entrance, lab test and imaging request, surgery and neurosurgery visits with triage to visit, visit to disposition and disposition to exit. Conclusion: Mean triage to visit, visit to disposition, disposition to exit, and triage to disposition durations were closer to them, and these differences are related to route of entrance, lab tests and imaging request, surgery and neurosurgery visits.

Introduction: IT ability cognition and End-User recognition is necessary. Inappropriate use of new technology for professional knowledge transmission leads to inadequacy of technology and cost waste. This research was aimed to study current status of information technology usage in sample community, and effective usage of technology via End-Users views. Methods: This is a survey research; data collection tools is a researcher made questionnaire. The study population were 816 medical residents, 212 selected as a sample to study. SPSS 17 software used for data analyzing. Results: We found the results as follows: Use of E-Mail (48.6%), personal digital assistant (47%), Athens (44.7%), RSS (38.5%), Alert (35.8%), Web log (35.2%), Small Message Service (33%), pod cast (32.9%) and Chat (31.2%) can be considered as Much and too Much cases for effective application of IT, respectively. Conclusion: Factors like unlimited (time and location) and easy access to the needed information, wide variety and up-to-date sources, consult of expert librarian in classification and transmission of information, traceability of information have a determinant role in IT facilities selection.

Introduction: Information Technologies (ITs) has become a significant resource for dissemination of information and resulted to increase of health knowledge in communities. This study was aimed to determine knowledge of inpatients about ITs. Methods: This descriptive-cross-sectional study carried out on 461 inpatients in Kashan University of Medical Sciences hospitals with a reliable (spearman Brown, r =0.83) and valid (face and content) researcher made questionnaire in two sections: demographic information and study objects. Data collected by interviews, analyzed by SPSS, and presented by descriptive statistics. Results: We found %42.1 and %26.7 of participants had knowledge about computer and the Internet respectively; %41.9 had the Internet access; 86.3% and 88.3% were interested to access and get medical records and their information respectively. They intended to get test (%85.7), refill their prescription (79%), get appointment (%76.4), consult with physicians (%80), and get information about diets (80%) through ITs. Conclusion: ITs attitude in inpatients was relatively good. We recommend providing inpatients information needs especially about prescriptions order and diets by CD, or Internet by hospitals' sites; and introduced them good medical sites to patient were recommended.

Introduction: Expert systems are computer programs that have been designed aimed to make available personnel skills, for non-specialists. These programs are trying to model thinking to simulate human performance, and make correlation between performances of individual experts and software. Nowadays various expert systems have been presented in medical sciences. In diagnosis and treatment of blood cancer patients quickly acts are very influential. But sometimes access to specialists for patients and hence design a system based on knowledge to provide a specialist diagnosis and treatment is important. This make to patients, timely offers. Methods: This article presents an expert system for diagnosis of leukemia using VP-expert shell. That knowledge has been offer rules of knowledge base system for diagnosis and treatment. Results: In this paper, we shown that the absence of experts, using intelligent software can be relatively provide a reliable diagnosis and treatment methods. Conclusion: The use of intelligent systems and semi-intelligent expert systems such as decision support systems can provide for. However, currently experts cannot be replaced by systems.

Introduction: Health policy makers have long been concerned with protecting people from the possibility that ill health will lead to catastrophic financial payments and subsequent impoverishment. Yet catastrophic expenditure is not rare. We investigated the extent of catastrophic health expenditure as a first step to developing appropriate policy responses. Methods: Data from household surveys in Iran were used to explore, variables associated with catastrophic health expenditure analyzed by regression. We defined expenditure as being catastrophic if a household’s financial contributions to the health system exceed 40% of income remaining after subsistence needs have been met. Results: In 2007, 2.5% households were faced with catastrophic payments; and FFCI is 0.833 shows the lack of an efficient and comprehensive health insurance .Among Iranian, these groups are more susceptible to catastrophic health expenditures: rural families, the families with children below 12 years and old above 60 year, the families who have no insurance. Conclusion: People, could be protected from catastrophic health expenditures by reducing a health system’s reliance on out-of-pocket payments and providing more financial risk protection. More availability of health services could raise the proportion of households facing catastrophic expenditure; risk protection policies would be especially needed. National health systems could be financed so that protect households from catastrophic spending and provide access to needed services.

Introduction: Studying organizational culture acts as a tool for gathering information, and enables managers to compare work groups; to prioritize problems and identify staff understandings and expectations to improve the gap between current and optimal situations. This research was aimed to study organizational culture in Hashemi Nezhad Hospital in Tehran based on Denison Model, to evaluate four aspects, as, Involvement, Consistency, Adaptability and Mission. Methods: This is a Cross- Sectional study carried out in summer 2009. The research population are comprised all employees in Hashemi Nezhad Hospital, and the sample 130 employees selected through Randomized-Stratified sampling. Data are collected by Standard Denison Questionnaire; and the analyzed by SPSS software, t-test and ANOVA tests. Results: The majority of employees (%72) evaluated organizational culture situation as suitable. The hospital gained the highest score concerning involvement and the lowest in consistency. The scores gained by the hospital in four main cultural aspects were medium level and above. The highest mean of organizational culture found for Team Orientation, 4.24 and the lowest mean was related to Coordination and Integration, 3.24. But totally most criteria were acceptable. Conclusion: The organizational culture of this hospital was found in acceptable level, which will pave the way for successful changes and can help managers to predict change prioritize systematically and set strategies for successful implementation of management techniques and process.

Introduction: A different factors influence family health care expenditures. This paper was aimed to determine these influential factors on the households in Yazd city (Iran). Methods: a total of 20000 questionnaires were designed, pretested, and used in the province of Yazd, Iran during the three months period of 2007 to collect data; included household per- capita health care expenditures, insurance status, per-capita income, education of household head, household location and incidences of infancy and pregnancy in the household. Households were classified according their insurance status. Each of the two groups were classified whether they earned above the sample average income or below it. Regression analysis was used to measure the effect of explanatory variable on household per-capita expenditure in each group by econometric methods. Results: The effect of all explanatory variables on household per-capita health care expenditures across all groups was positive, and strongly significant (with t values generally close to 2 or above it). However, the effect of household per-capita income is more pronounced in insured households compared to the uninsured in both above and below average income categorist. Furthermore, the effects are more pronounced in the above average income categories in both the insured and uninsured. Conclusion: Household's health care expenditures is affected by many factors; most important household's income. If people have no health insurance with low income, expend low money for using health care.

Introduction: Demand analysis in health sector has a key role on policy making. Although, dental cares are a branch of public health services, but their economy could be distinguished from the other health services due to some reasons. This study was aimed to estimate demand function for family dental services, and to determine their influential factors. Methods: This cross sectional study carried out on 520 households of Sabzevar city. Data collected by using a questionnaire, and demand function estimated by two- stage Logit regression model. Results: Results indicated that 42.7% of the heads of households had academic education, and 52.9% were governmental employees. Only 71% households need to dental cares; demand for taking the related services. The most frequent demand (43.9%) was for teeth extraction, and the less for orthodontic cares (1.4%). Demand for dental cares in 5 Job groups were more than the base group; and 3 educational groups were less than the base group. Gender, educational level, job and household income variables had a significant correlation with demand for dental cares. Regression analysis showed that the level of education, household income and 3 job groups had a significant difference with their base groups. These variables can be used in writing the model equation. Conclusion: The income level had directly; and educational level inverse correlation with demand for dental cares. Demand for dental cares in 3 job groups were more than the base group. There is a certain need to supplementary insure for less income groups.