JOURNAL OF HEALTH ADMINISTRATION
Year:2006 | Volume:9 | Issue:23|Papers Count:10

Introduction: In many countries, especially the developing countries, the primary health care have been done by government. Limited resources, high costs, and low quality of the governmental provided services forced reform changes, and the improvement that could point to such as the private sections activations in health care. This study carried out aimed the comparing patient and non contagious disease care; and patients' satisfactions in governmental and cooperatives health center. Methods: This is an analytical study; in which two groups are compared: The health centers with governmental management (18 units), and health co operations (9 units) have been compared based on their non contagious diseases surveillances; and patients cares. Data have been collected using a check list and patients' files reviews, and the follow up documents; and analyzed, by EPI INFO & SPSS soft wares with c2 and t-tests. Results: The study showed that the ratios of visited population during the study period for the cooperation and governmental health centers were 53.8% and 23.2% respectively. And the ratios of case findings were 10.3% and 15.9% respectively. The averages of diabetic patients care in cooperative health centers were 6.5% times; and in governmental health center; 6.8% times per year. Conclusions: Our finding showed this fact that private cooperation participation to providing primary health care, and continues governmental supervision on their activities could yield an effective system to provide satisfactory services. 

Introduction: The importance of medical equipments in preventive, diagnostic, treatment, and medical education; and also need to their development are evident. Evidences show that with no control and managing for equipments maintenance, leads to poor and ineffective performances. Control and management of medical equipment to accede the rising lifetime of medical equipment, decrease of cost control, presenting the service with the best quality, arising of the satisfactory of patients. This study is aimed on assessing the medical equipment maintenance management at selected hospitals affiliated with the medical sciences universities in Tehran ( ), and communicate its findings to responsible authorities. Methods: This is cross-sectional study, conducted in the years (2003-2005). The studied community are equipments located on six universities hospitals, and three health deputy chancellors: the Valiasr & Tebbi koodakan hospitals of TUMS, Hazrat Rasool & Shohaday Yaftabad hospital of IUMS, Loghman & Moddarres hospitals of SUMS. The data are collected by a self-constructed questionnaire, interviews, and observing documents. Content validity and test-retest were used to confirm validity and reliability of the instruments. Data analysis was carried out through SPSS. Results: The findings of the study showed that the continuous planning for maintenance management was passable in 38.9% and in 61.6% of cases, systematic planning of maintenance management not founded. Only 26.7% of study population believed that the planning for the maintenance management was permanent and continuous. But 50% of respondents assessed it as poor. From the viewpoint of 50% of respondents, co-ordination and communication on maintenance management was found to be appropriate. From the viewpoint of respondents, purchase systems were appropriate. Conclusions: Our study showed that there is no study in planning, controlling, assessment, co-ordination, and communication areas for medical equipment maintenance management principal, and results to occur some problems and irregularities in medical equipment maintenance management system. 

Introduction: Job satisfaction is an emotional reaction to the work, physical and social of job environment. In the other words, job satisfaction is a positive emotion that comes from person's job or his/her experience. Job satisfaction has been considered, because it affects on one's upgrading, performances, and the quality of one's job. This study carried out to evaluate the employees' satisfactions, and also to determine the degree of the satisfaction of each ares of job satisfaction in Iran university of Medical Sciences Koodakan medical centre in 1382 (2002). Methods: This is a descriptive cross-sectional study, The research environment was a super specialty governmental kids' hospital .The research community were all the employees of the hospital. The samples including 50 subjects have been determined with statistical estimates and selected randomly from the employees' lists. The tools for the collecting information are standardized questioner for the job satisfactions, then the data were passed to SPSS software. Results: Our findings showed that among four influencing factors job satisfaction (included environmental and convenience, social, job nature, and structural and managerial factors) that has been evaluated in this study, social factors had the most, and environmental and convenience had the least effects. Second and third degree of job satisfaction went to job nature, job structural and management factors. In average satisfaction in all job areas of studied hospital were evaluated in intermediate level in which it is variable for each of the mentioned factors. Conclusions: Given to employees' unsatisfaction of the convenience and environmental factors, this employees, needs must paid more attention. The most important factor of satisfaction is social and to improve this strength point, we suggest that relation between employees and authorities of hospital need to be strengthened. Due to the low employees satisfaction of administrative and organizational structure and their governing rules it is needed, that administrators put the management and fundamental improvement as their priority. 

Introduction: Health care unit cost is as base for budgeting of function, determining real tariff, and privatization in health sector. Nevertheless, in our country, there is no specific approach for it. This study used Activity Based Costing (ABC) to calculate unit cost of health care services delivered in pilot health care center. Methods: The present study is a research-practical study and carried out in cross sectional style. The data collection tool was a bound of specific designed forms and tables. Data gathered from 2006 fiscal year and then entered to EXCEL software and finally analyzed by ABC system in 8 steps. Results: There are 120 unit cost quantities in 15 separated tables for any final functional department in health care center. Results showed that Iodometeric of salt has the lowest unit cost (3506Rials) and treatment of Tuberculosis has highest unit cost (1092325 Rials). Conclusions: given to high portion of personnel costs, improvement of staff productivity, merging same department and merging same activity in different health care process have an important role for decreasing total expenditure .Regarding the result of the research, Implementation of ABC system is an effective approach to calculate unit cost in health sector. Because this system is process-oriented, result is more precise than other costing system. Nevertheless current information system in health care centers doesn't meet unit cost analysis, and should be restructured. 

Introduction: Entrepreneurship is a long term educational and training process which necessitates the planning in Iran's educational system especially in universities and higher education institutes. Thereby since 2001, the KARAD project (Entrepreneurship Development in Universities) was started by ministry of sciences, research and technology. However in universities affiliated to health ministry, there are no similar settings with defined organizational structure.Methods: This is a comparative and cross-sectional study carried out to developing organizational structure of entrepreneurship centers in universities affiliated to Ministry of Health (MOH). The study population included 12 entrepreneurship centers affiliated to Ministry of Sciences, Research and Technology in Iran; and 10 centers from selected universities in USA, Netherlands, and Malaysia. Interview and observation methods were used to collect data, and the study tool was a valid and reliable questionnaire. Results: Present study identified the organizational structure, goals, duties, programs, resources, appraisal methods, strengths, and weaknesses of selected entrepreneurship centers. The above-mentioned organizational structures were tested and confirmed by Delphi Technique. At last, considering mentioned variables, health ministry structure, and related socioeconomic conditions, we designed an applied organizational structure to initialize an entrepreneurship center in medical sciences universities. Conclusion: Our findings showed that it is necessary to establishment of entrepreneurship centers in medical sciences universities. The organizational structure of these centers should be scientific, dynamic, and flexible; and conform to mission of center. The model designed in present research, can help to initiating the entrepreneurship centers in medical sciences universities in Iran and it is important for entrepreneurship development for health fields.

Introduction: Health system of Iran has been challenged in the so many ways such as equity, relevance, and efficacy in a changing environment rapidly. To answer to this increasing challenge, and to decrease the costs, and increase the outputs, minifying units of health system network in Tabriz Metropolitan have been designed as an experience. Present research have been designed and implemented to find the answers and evidences documented witnesses of metropolitan cities in case of unifying or multiple administrations for provincial health centers; and meanwhile separated administration of health centers headquarter unified. Methods: This is an applied study. The community, and the sample of research are health centers headquarters before and after the minifying units. (based on personnel, costs, performances qualities and quantities, and employees' job satisfactions). Results: Even though the number of personnel have been reduced from 248 to 148 after minifying, and the cost flow have been changed from 67.47% (2002) to 69.93% (2003); qualities and quantities of health performances (the most important tasks of health centers) not only do not decreased, but in some cases have been improved. The personnel s' job satisfactions have not changed either before of after the minifying. Conclusions: Therefore the minifying procedures may be used as an improvement strategy in metropolitan cities and universities units. 

Introduction: Recommendation system is a documented system for using the personnel ideas and improvement the organization activities. Nowadays this system due to some specifications and its inherent advantages is one of the most prorating, safest and accessible programs in Iran. By using the participatory administration system, the idea of improving incentives and revaluating would be arise among all the governmental organization's personnel and their performance would be improved. The aim of present research was achieving the possibility of evaluation of acceptability of recommendations system and impacts of its one year performances at Tabriz University of Medical Sciences. Methods: Present research was a descriptive-cross-sectional and applied study; carried out in Tabriz University of Medical Sciences. In present research first, the recommendations system and its applied procedures have been designed. And then based on scientific lectures and other organizations experiences, have been performed as a pilot study for a one year period, at the end the intervening results have been selected based on the received collected and analyzed and approved suggestions concluded. Then personnel's' and managers' points of views and comments have been collected by a self-made questioners which its validation and reliability have been confirmed. Collected information analyzed and evaluated by SPSS and Access software. Results: Finding showed that, capital suggestion in Tabriz University of Medical Sciences was 0.45, and the percentage of approved suggestions was 15.7% of total received suggestions. The applied suggestion ratio to approved one were 21%, which showed a weaken acceptability comparing to other similar organizations. Collected data by management and personnel questioners showed that received suggestions to admission committee and university's suggestions evaluation could save in time and resources. (p=0.99). Also collected data by management and personnel questioners showed received suggestions have no effect on improving job procedures and organization and human resources relations.(p=0.99). Conclusions: Due to the research findings and in comparing with other similar organizations, it would be concluded that even though it is necessary to apply the recommendations system, it is important to change the organization culture and prepared a suit environment. Best way to approach successful result is to upgrade management and personnel knowledge about the benefits of this type of management method.

Inroduction: Medical records departments using the modern systems and standards to keep the patients' medical records, and make them available for the future services or collecting statistical data and conducting research. The collected statistics will be used in the advancement of medical education, and achieving its objectives. Object The purpose of this study was to find out the situation in medical records departments in the hospitals affiliated to (IUMS). Methods: This is a descriptive study; its data is collected by taking a census. All of the medical records departments in the IUMS hospitals and clinics have been reviewed by direct observation, interview and filling out a questionnaire consisting of 334 open and closed questions in the year 2000. Results: Our results of show that 4.3% of the of medical records departments heads have an M.Sc. degree, 52.1% a B.Sc., 8.6% an A.S.(associate's degree), 30.4% a high school diploma, 4.3% have less than a high school diploma. And 82.6% are female and 17.4% are male. The survey on the methods of giving an appointment to the patients in the studied hospitals show that 52.1% give their appointments by admittance,8.6% by department secretary, 4.3% according to a calendar,13%according to the physician's fixed time, and 21.7% give daily appointments. Considering the reference system and getting patient satisfaction, 44% of the centers adhere the internal regulations. Also regarding the patient's rights in admittance, medical emergencies, trauma and reference system, 5% of the centers consider the oral regulations. Conclusions: The findings show that there is no written policy and regulations concerning the day to day works of the medical records departments.