Journal of Healthcare Management Research
Year:2016 | Volume:7 | Issue:2 (SERIAL 20)|Papers Count:8

Introduction: The epidemiological burden of chronic diseases and their risk factors is increasing worldwide, especially in developing countries. When it comes to the impact of diseases on economic, direct cost include all costs related to the diagnosis and treatment of diseases and indirect costs include loss of productivity and efficiency of the patient, should be taken into consideration. The main purpose of this paper is to explore and demonstrate the cost effect of chronic non-communicable disease, cancer, at the national level.Methods: In this study, we calculate the cost of 22 types of cancer for 18 age group with 5 years interval, for both males and females. Then, the equation that shows the negative impact costs related to cancer treatment on national income, is estimated due to ordinary least squares method. In the next stage, trend of growth for cost of cancers and GDP is computed by ARIMA model during 2004 to 2036.Results: The results show that the cost of cancer treatment examined in this study, will experience a growing trend over the next 20 years. The general trend for Iran, shows that during 2004 to 2036, 2.7 percentage of GDP is lost by cost of different types of cancer.Conclusion: Catching non-communicable diseases, increasing the share of cancer costs in patient’s budget and reducing in his purchasing power prevent his participation in profitable economic activities. Income and GDP of a Country decrease and consequently slow economic growth.

Introduction: Defensive medicine is concerned with decisions made to avoid errors that could result in serious consequences in terms of quality of care and efficient use of scarce health resources. This study aimed to investigate the causes of this phenomenon and provide solutions to reduce it from the perspective of residents in Mashhad University of Medical Sciences.Method: This descriptive analytical study was conducted with all residents in Mashhad University of Medical Sciences in 2015. Data were collected using a researcher-made questionnaire, and analyzed in SPSS-20 using descriptive and analytical statistics including Kruskal-Wallis and Mann-Whitney tests at significance level P<0.05. Content analysis was used for open questions.Results: Defensive medicine was mostly adopted to avoid being sued by patients (87.2%) and least due to lack of liability insurance, to prevent loss of capital, to teach defensive medicine in treatment-diagnostic procedures (43.7%). Furthermore 6 overall strategies to reduce defensive medicine were proposed by residents, which included: applying legal protections for physicians, evidence-based medicine, create a database of patient data, Familiarizing with the concept of community defensive medicine, reinforcing teamwork and improving the treatment of complaints.Conclusion: The results obtained suggest high level of defensive medicine among residents in Mashhad University of Medical Sciences. Accordingly, it is recommended that training be provided to eliminate this phenomenon, and doctors be steered toward its positive aspects. Furthermore, defensive medicine behaviors can be reduced through simple measures.

Introduction: High level of cost for inpatient services made a reasonable reason for Iranian Ministry of Health and Medical Education in order to implement a reform called: “Health transformation plan”; it has been aimed to decrease patient out of pocket. High prevalence of cardiovascular disease and high level of cost for these services have significant contribution to increase health system expenses and patients payments. This study is aimed to investigate and compare the portion of cost payers’ contribution for inpatient services provided to cardiovascular patients before and after health system reform.Methods: This descriptive- analytical study was conducted on 601 CABG patients referred to Al-Zahra Heart hospital in Shiraz before and after Iranian Health transformation plan implementation. Required data gathered by hospital bills. data were recorded in the data sheet then entered excel software for statistical analysis, and they were analyzed by SPSS software and Mann-Whitney U statistical test for non-parametric situation.Results: The mean of patients out of pocket after “Health transformation plan” implementation for CABG cases decreased significantly (p<0.001) from 10, 649, 295 to 6, 971, 268Rials. There was a significant increase for mean of basis insurance share from total cost of a unit CABG (p<0.001) as it rose from 41, 847, 802 to 94, 782, 096Rials.Conclusion: Having implemented the “Health System reform” in Iran leading to decrease patient out of pocket for operations significantly, there is a massive payments and costs must be covered by Iran Ministry of Health which imply huge costs and duties to this organization.

Introduction: Health as defined by World Health Organization (WHO), it is "a state of complete physical, mental and social health and not only the absence of disease". Considering positive emotions, life satisfaction, social welfare and also considering the physical, emotional, spiritual and social dimensions are the issues which in our country little attention has been paid to them; since with attention to this issue, increase operational efficiency, improve performance, job satisfaction will be followed.Methods: In this analytic functional study, to evaluate the health and determine factors affecting it, all managers of Islamic Azad University of Arak have completed physical and mental health questionnaires based on the holistic wellness which includes physical, social, emotional, intellectual, professional and spiritual components.Results: 83 patients participated in the study. The mean score of highest level of safety was 4.1 in the area of spiritual health and 3.4 for the physical health was the lowest. Factors such as the occupation position, physical health, the amount of sleep, heart attack disease, high blood cholesterol, blood pressure and diabetes were identified as risk factors (The mean scores was less than 3).Conclusion: As a result of this research, heart attack, high blood cholesterol, blood pressure and diabetes had the greatest impact on the health.

Introduction: Identify of factors that influence on health costs can be useful in determine the best policy to control and manage the health costs. Previous studies in this area has been done with assumption the certainty of model; While the lack of attention to the problem of model uncertainty can lead to bias and lack of performance in estimation of parameters that result is inappropriate forecasts and incorrect statistical inference. So, the main objective of this study is identify the robust determinants of health sector costs in Iran under uncertainty of model.Methods: This study uses the statistical data of 22 variables that affect health sector costs based on theoretical and empirical studies, is paid to identify the robust determinants of these costs in Iran during 1979-2013. For this purpose is used the Bayesian Averaging of Classical Estimates (BACE) approach (due to favorable characteristics for the assumption of model uncertainty). Also, the statistical analyzes were performed using the R software.Results: estimation of 40000 regression and Bayesian averaging from the coefficients shows that per capita income with the possibility of 0.98 and coefficient of 0.70, urbanization rate with the possibility of 0.93 and coefficient of 1.25, per capita public health costs with the possibility of 0.83 and coefficient of 0.29, dependency ratio with the possibility of 0.50 and coefficient of 0.27, physician per capita with the possibility of 0.49 and coefficient of 0.20 and the unemployment rate with the possibility of 0.38 and coefficient of -0.07, are non-fragile and robust variables.Conclusion: The results indicate that the most important determinants of health sector costs in Iran are respectively: per capita income, urbanization rate, per capita public health costs, dependency ratio, physician per capita and unemployment rate. The effect of all these variables on per capita health sector costs in the long run are sure and strong.

Introduction: As strategic companies with a competitive nature, pharmaceutical companies have a significant contribution to the country's competitive advantage. Thus, competitiveness has become a challenging and important issue in such companies today. In complex competitive environments, just organizations who strengthen their technological innovation capabilities can continue to compete. Technological innovation capabilities utilize the new data and information in the field of technology and needs technology intelligence itself. So, in this research we want to assess the effects of technology intelligence on the efficiency of technological innovation capabilities and competitiveness of pharmaceutical companies.Methods: In terms of objectives, this research is practical and descriptive-analytical, and field and library method is used for data gathering. This research's data is extracted from 55 active companies in the pharmaceutical industry and with the help of network data envelopment analysis (DEA) analyzed and efficiency to companies, with and without technology intelligence assessment.Results: In this research it was found that utilizing technology intelligence has a positive effect on the efficiency of technological innovation capabilities and competitiveness of these companies and has often increased their efficiency. This study showed that the use of technology intelligence, only 54.34 percent of the companies under investigation received full performance score.Conclusion: The approach of this study was to investigate the role of technology intelligence that was studied and compared. The results show that this role was significant and effective role of technology intelligence on the efficiency of technological innovation capabilities and competitiveness to prove.

Introduction: In the way of the policies of the healthcare system of many countries, based on the improvement of the healthcare services, the lean implementation has been taken into consideration as the way of achieving it but no organization can become lean overnight so it needs providing some precondition structures. Therefore, understanding the fundamental factors plays a profound role in successfully and effectively implementing the lean system.Methods: This research is a descriptive survey which has been done in cross-sectional way in the state hospitals of the Hamedan city in the first half of the year 2015. In this study, a questionnaire in two stages, was used for data collection. The population of the first stage 179 members of supervisors, managers and support clinical units were used to randomly sample, 122 subjects were selected randomly. In the second stage of the respondents, 10 master's degree or doctorate senior executive experts in the field of hospital management were at least 5 years. In the first phase analysis using statistical software SPSS22 and secondly ranking factors affecting the purity of the hospital AHP method took Expert Choice software.Results: The hospitals of the Hamadan city are not in a desirable situation in accordance with educational issues, employee participant, and the alignment of the performance and reward system with the lean goals. Also, identifying and eliminating wastes has the greatest weight by the relative weight of 0.234 and the system of evaluating performance and reward has the least weight by the relative weight of 0.032 among the seven readiness factors of lean implementation.Conclusion: Implementing lean without considering the sufficient fundamental conditions will lead to non-performance and wastage of resources. Moreover, considering the readiness factors is essential due to the important role of identifying and eliminating the wastes in lean implementation to achieve performance improvement.

Introduction: One of the factors affecting Organizational Citizenship Behavior, involvement of employees with jobs. People who are involved with their jobs, have higher job satisfaction and high commitment to the organization are expressed. The purpose of study was to investigate the relationship between job involvement and civil - organizational behavior of staff of Bojnourd medical Sciences University.Methods: Research method in terms of purpose, is functional and descriptive and correlational. The population consists of all staff of Bojnourd medical science University colleges. The number of staff was 120 and the sample size was determined 90 people using Morgan' s table and random-stratified sampling method. Data gathering tool for civil-organizational behavior variable was Organ's standard questionnaire (1996) and for evaluation of job involvement we used standardized Knjr and Ldahl's questionnaire (1993) that reliability of questionnaire of job involvement and civil-organizational behavior was calculated 0.71 and 0.71 respectively. It was calculated using Cronbach's alpha coefficient method. Measuring to understanding components of civil-organizational behavior related to job involvement using Pearson correlation coefficient and regretion. The statistical analyses were performed using the SPSS software version 20.Results: The results show that the positive correlation between job involvement and civil-organizational aspects in the staff of Bojnourd University exists.0/433 correlation coefficient indicates a relatively strong direct correlation between variables.Conclusion: Job involvement has a significant relationship with organizational citizenship behavior. Accordingly, management structures and contents with an appropriate design organization, involvement fields provide employees with their jobs to organizational citizenship behaviors occur more.