TEB VA TAZKIEH
Year:2001 | Volume:- | Issue:42|Papers Count:16

Six distribution companies carry out drug distribution in Iran: Alborz, Darupakhsh, Razi, Hejrat, Ferdows and Qasem - Iran. In fact these companies distribute locally produced medicines by more than 50 pharmaceutical manufacturers and imported medicines between more than 6000 different daily, 24 hours service and hospital pharmacies in the country. Based on national drug policies made after the victory of the Islamic revolution in Iran, drug distribution is carried out according to a central planning mechanism by Drug Department in the Ministry of Health and Medical Education. The drug share of each province in the country is decided according to a formula based on the population and the number of physicians in each province developed in 1365 AH(1986). This formula has not been revised so far.In this study different criteria such as population, number of physicians, pharmacies, hospital beds and etc in each province which influence drug consumption were determined. The drug consumption in each province for the five year period of 1372 -1376 AH (1983- 1987) was also determined. Using Pearson correlation, the correlation between drug consumption and each criterion was studied. It was shown that the correlation between drug consumption and different criteria such as population, number of physicians, pharmacies, and hospital beds in each province was very high. At the end, a model for determining the drug share of each province in the country was proposed. It should be noted that this formula is proposed to be used as long as central planning for drug distribution is used and the market mechanism is not practiced.

Continuous medical education (CME) is recognized as a necessary measure for promoting and maintaining the level of knowledge and skills of medical student's graduates. This has been the case in our country for the last decade. For the purpose of determing the opinion of the participants in these continuous programs regarding the law, method of training, up to dating programs, registration fees, and attendance policy, this study was conducted at Babol University of Medical Sciences in 1999.208 graduates were selected through simple sampling method for this descriptive-analytic study and a questionnaire was used to collect the data. SPSS: PC was used to analyze the data and X2 test was employed to compare the proportions. The results of the research showed that 13.3% of the participants took part in CME for the first time. 75% stated that eliminating the privilege for participation would reduce the rate of participation. 44.7% were aware of the law regarding CME and 61.7% had complete knowledge about its objectives. 30.3% believed that checking for attending was necessary and 45.2% stated the registration fee must be compulsory. 71.6% of the general physicians and 59.7 of the specialists believed that the programs contained new information. Considering the appreciation of the participants regarding CME, the executive authorities responsible for this program should consider new methods in planning and executing according to the present needs of these individuals.

Background: Though participation thinking has been admitted commonly in different societies from long time ago, using importance of participation in public and private organizations has been a focal matter in mid 20th century.Objective: This study is done to assess the managers performance of Isfahan teaching hospital about their staffs participation during 1999-2000.Methods: In a descriptive, cross-sectional, and case study 194 managers of teaching hospital of Isfahan University of Medical Sciences were examined through a questionnaire SPSS: pc was used to analyze the data.Findings: The results of the analysis including all types of managers duties (planning, organizing, leadership and control) showed that 8.7% were authoritative, 59.1% benevolence and 38.8% were consultative. In the case of the top managers the ratio were 8.1%, 32.4%. and 59.5%, respectively. In the case of intermediate level managers the ratio were 8.9%, 57.3%, and 33.8%, respectively. There was no significant relationship between the age, sex, management background, education, and management training with the managers performance.Conclusion: In the field of leadership and planning, the managers use less authoritative manner in decision making and they rely more on democratic manner. But, in the case of organizing and control, the managers were more authoritative and benevolence and less consultative or democratic it seems that for establishing an efficient management system in the hospitals-based on shared-decision making manner, we need to concentrate more on the reform of the structure and management style of our hospitals than the personal characteristics of the managers.

Breast cancer is the most common cancer occurring among women and the second leading cause of death from cancer. among them. The mortality rate of breast cancer is directly related to the stage, at which the cancer is diagnosed, it reduces by regular breast cancer screening programs. In this survey 1/1000 of total country population i.e. 13325 dwellings were studied and reproductive history, knowledge, attitude and practice about breast cancer were investigated through face -to - face interview from 20-40 year old women. 52.7% of 20-40 year old women had knowledge about breast cancer and 42.9% of them believed in breast self-examination for early detection of breast cancer. 20.3% of women had practiced breast self-examination at least once, but the duration of their latest exam were more than three month in 54.8% of them. Using the logistic Regression model, it is concluded that as level of education and/or age of women increase, knowledge of breast cancer, attitude: and practice of breast examination improve.Qualitative researches could be recommended to recognize the effective factors to improve acceptability of breast cancer screening methods by women.

This study was conducted to determine the condition of medical records of teaching hospitals affiliated to Tehran University of Medical Sciences. The study included the following objectives: 1- Assessing the condition of the records from the prospect of policy, admission affairs, medical records, filling, coding, and statistics.2-Comparing the present condition with the accepted national and international standards, Data for this study was collected by employing a questionnaire that included questions related to admission affairs, medical records, filling, coding, statistics, general activities and policy of managing and educational activities.The analysis of data showed the following results:1- In most cases, the medical record section in hospitals do no have any policies for their activities.2- There was insufficient room for medical records in all hospitals.3- No evaluative steps for activities of medical records were taken.4- None of the centers attempted to modify or update their executive policies due to the lack of sources.5- No controlling system existed that could prevent the filing of incomplete files by physicians.6- Except a re-training course that was presented by the Deputy of Research of the Ministry of Health and Medical Education to the medical record group, no other educational activities was carried to improve the quality of medical record centers.The medical records are considered confidential in all hospitals, but no specific policy regarding the release of information exist or in no case the permit of patient for releasing information was considered necessary.None of the educational centers in this study forms a committee except a specialized center that has the mortality committee ant the person in charge of medical record is an active member of that committee.

In a prospective study, we evaluated the effect of wearing lab coat on the reliance of patients.In an obstetric Dept. all mothers were guided about their baby care after children by a pediatrician. They pediatrician attended in the mothers room with or without lab coat. The guided them about feeding jaundice, immunization and care of umbilical cord each week alternatively with or without lab coat. The mothers also were recommended to bring their babies to the clinic again after 4-5 days to be rechecked for hyperbilirubinemia and other problems. The acceptance of the physicians advice and coming back again was the index of the mothers reliance to the doctor. The study continued for 12 months during the year 1999.After exclusion of patients with stillbirth, premature babies, and newborns with congenital diseases and malformations and mothers from cities other than Ourmia, 275 mothers were included in the study. 143 mothers were visited with lab coat (group 1) and 132 mothers were visited without wearing lab coat (group 2).93 newborns from group 1 (65%), and 63 babies from group 2(47%) were brought for second-visit after 4-5 days after the first visit, (p<0.0005).As the study showed, there was an obvious relation between doctors disciplinary on wearing lab coat and the patients reliance.

The modern and international approach toward health promotion is the result of historical need for fundamental changes in strategies of attaining complete health and it has been developed for the purpose of securing, maintaining, and promoting health.In early approaches toward general health, the problem of infectious diseases kept the authorities responsible for health busy and in this direction the authorities resorted to the means to strengthen the populations, resistance to deal with the health problems. The physicians also paid less attention to the factors influencing the health and well being of people and frequently attempted to treat their patients. But, later other problems and health needs they faced that were due to the conditions that people faced following the industrialization era. Problems such as psychological disease, all kinds of cancers, accidents, cardiovascular disease, addiction to narcotic and other substances such as alcohol... were not treatable by increasing the resistance and prescription and therefore, the need for new strategies were felt. The new movement for health promotion was a response to this need; and for the purpose of reaching these objectives and putting its strategies into action, the cooperation of all segments of society is necessary. In the other words, if the steps are to be taken toward the health promotion, certainly it will be better for all including the general physicians, who should improve their skills, go beyond of solely treating patients. They should enter into socio-economical scene and gain new experiences. The present article introduces the role that general physician have in the new movement for health promotion.