JOURNAL OF HEALTH ADMINISTRATION
Year:2021 | Volume:24 | Issue:1|Papers Count:10

Introduction: Medical tourism is one of the new fields of tourism that plays an important role in sustainable development and, according to international forecasts, will become the most profitable industry in the world. The purpose of this study was to identify and prioritize the dimensions of medical tourism with emphasis on technological entrepreneurship in Iran. Methods: In this applied research study, the quantitative method was used (Fuzzy Delphi and descriptive-analytical). In the first stage, to identify the indicators of medical tourism using the Fuzzy Delphi Method, the opinions of 41 experts, including faculty members, physicians, managers of medical and educational centers, and managers and experts in the field of medical tourism were sought. In the second stage, a questionnaire designed by experts to determine the status of the components of medical tourism was given to 136 experts of certified medical centers, which had international patients, and health tourism companies. The SPSS, LISREL and Expert Choice software were used to analyze the statistical data. Results: According to the experts, the most important dimensions of medical tourism included medical costs, quality and value creation of medical services, individual factors, government agents, informing medical tourists, medical staff attitude towards medical tourism, cultural factors, security issues, identifying group sections, and the conditions of the country. Conclusion: The results of the present study showed that the ten identified indicators were the most important dimensions of the medical tourism industry. It is obvious that the use of these dimensions can pave the way for those in charge of the medical tourism industry in creating and increasing revenue.

Introduction: Human resources play a highly important role in providing health services. The aim of this study was to determine the human resources required for the linear accelerator sector at Reza Radiotherapy-Oncology Center. Methods: This applied analytical-descriptive study utilized human resources determination method based on workload indicator of staffing needs. Expert meetings were held to determine the components of workload and standard time. A survey was used to confirm the standard time of main activities, and interviews and personnel information system were used to determine the amount and factors related to available working time. Furthermore, management system and registries were used to determine the annual workload. The data were analyzed using the Excel and SPSS software version 19. Results: Seven factors related to the annually available working time of employees were identified. Annually available working time for employees was set at 806 hours. Patient preparation, treatment, surgery, and case completion were identified as the main activities. The results of workload index calculations showed that the accelerator sector had a shortage of three people. Conclusion: The results of this study showed that Reza RadiotherapyOncology Center is experiencing a shortage of professional staff in the linear accelerator sector. It seems that using the workload indicator of staffing needs method to determine and distribute the required human recourses is a necessary step for the optimal management of human recourses in specialized sectors.

Introduction: The performance appraisal system is known as one of the factors affecting employees' performance, and organizations are required to consider the components of organizational entrepreneurial orientation toward achieving effective goals and performance. This study aimed to investigate the relationship between performance appraisal and organizational entrepreneurial orientation in selected employees of Health Deputy at Iran University of Medical Sciences. Methods: This descriptive-analytical and sectional study was conducted in 2020. The sample consisted of 102 employees with a score of last year's performance evaluation. The annual performance evaluation score and a standard questionnaire were used to assess the performance of employees and their organizational entrepreneurial orientation, respectively. Data analysis was performed using SPSS statistical software version 25. Results: The organizational entrepreneurial orientation was reported as moderate. The highest and lowest mean scores were related to the autonomy and competitive aggressiveness dimensions, respectively. Although there was a significant and negative relationship between performance and risk-taking, competitive aggressiveness and innovativeness variables, no significant relationship was found between proactive ness and autonomy variables. Conclusion: The results showed that there was a significant negative relationship between performance appraisal and the organizational entrepreneurial orientation. It seems that this inverse relationship is due to the lack of necessary conditions for the tendency toward organizational entrepreneurship and also ignoring entrepreneurship in the axes and indicators of employee performance evaluation.

Introduction: Uncompensated care causes many financial problems for hospitals. It would be helpful to use any interventions to reduce uncompensated costs. This study aimed to investigate factors affecting Iran University of Medical Sciences (IUMS) hospitals' uncompensated costs during 2014-2018. Methods: The present study was an analytical and applied research with monthly data from 2014 to 2018. The study population included all hospitals affiliated to Iran University of Medical Sciences, and the tool was an Excel data collection form. Data analysis was performed using EViews 10 software. Model estimation was carried out using the panel's econometric approach. Results: Uncompensated costs during the study period averaged 25 million dollars. The largest share of uncompensated costs belonged to insurance deductions, debts of poor and foreign patients. The results showed a significant positive relationship between the variables of foreign patients, outpatients, hospital beds, bed occupancy rate, and length of stay with uncompensated costs. There was no significant relationship among the variables of number of surgeries, number of hospitalized patients, and uncompensated costs. Moreover, the bed rotation coefficient variable did not affect uncompensated costs, and the hospital beds had the most positive effect on uncompensated costs, followed by the variables of the length of stay and number of foreign patients. Conclusion: The results of the study showed the high level of uncompensated costs in IUMS hospitals. Due to uncompensated costs’ effect on hospital revenues, it seems that identifying the causes of deductions and subsequently ways to reduce insurance deductions as well as expanding insurance coverage to mitigate non-recoverable costs can be effective.

Introduction: Today, social networks provide a good opportunity for selfcare. The aim of this study was to identify the impact and relationship of virtual social networks on users' self-care of COVID-19 and to achieve a structural equation modeling. Methods: In the present descriptive-analytical study, the measuring instrument was an online questionnaire extracted from Orem’ s self-care model(2011) adapted based on the objectives of study. The study sample included 662 social network users (WhatsApp, Instagram, and Telegram users) in Hormozgan province; they were selected through convenience sampling. Modeling was carried out using SPSS and Amos software. Results: The results of the present research indicated a significant and direct relationship between the independent variables of “ presence and interaction in the social networks” and “ users’ orientation to the type of social network” with the dependent variable of “ self-care towards COVID-19” (p< 0. 0009). In addition, 45 percent of changes in self-care variable was covered by a set of social networking indices. The structural equation Modelling (SEM) showed that in the self-care variable, the dimension of psychological support with a standard coefficient of 0. 99 had the highest effect, and the dimension of awareness and attention to the effects and results of COVID-19 with a standard coefficient of 0. 95 had the lowest effect with regard to the variables of presence and interaction in the network and users’ orientation to the type of network. Conclusion: Since social networks have been able to affect users' self-care, health officials and disease control and prevention centers can use the potential of social networks in self-care.

Introduction: There are many ambiguities and contradictions in the economic consequences of outsourcing services in public hospitals. Therefore, the aim of the present study was to systematically review the economic consequences of outsourcing in public hospitals in Iran. Methods: The information required in this systematic review study was collected using relevant keyword searches in the databases of PubMed, ProQuest, Scopus, Web of Knowledge, Google Scholar, SID, and MagIran without time limit. Textual data were analyzed manually by the content analysis method. Results: Finally, 20 articles were included in the study. Three types of rental outsourcing, managerial, and public-private partnership were reported in the studies. In five studies, the whole hospital was outsourced. None of the studies had a control group. A total of 51 indicators were used, most of which were total revenues, total costs, and personnel costs. The mean study time of the outsourcing effects was 24. 2 months. The results of most studies showed the positive effects of outsourcing in economic terms. The most important achievements of outsourcing included reducing costs and increasing profitability, and the most important obstacles included the existence of hidden costs, imposing additional costs on patients, lack of economic stability, and lack of economic evaluation. Conclusion: The results showed that outsourcing has been economically successful in many wards and services of public hospitals; however, in some cases, outsourcing has led to increased costs. Therefore, more attention should be paid by hospital managers and health policy makers to identify the influencing factors and negative consequences of outsourcing.

Introduction: Patients with colorectal cancer experience disabilities and complications that lead to reduced quality of life. To reduce the symptoms and complications of the disease, reduce the costs, and increase the quality of life, patients should manage and control their disease. The aim of this study was to identify the requirements of a mobile-based application for self-management of patients with colorectal cancer. Methods: The present descriptive-applied research was conducted from 2020 to 2021. The requirements of the colorectal cancer application (including educational content, data elements, and capabilities) were assessed using needs assessments from patients, physicians, and nurses. The questionnaire was distributed among 114 people at the Cancer Institute and Firouzgar Hospital in Tehran. The obtained data (88 cases) were analyzed using the SPSS software, and the required components were identified. Results: Except the need for training for fatigue, other educational needs were considered necessary. In terms of essential data elements and according to the perspective of the patients, physicians, and nurses, the clinical data were more important than the demographic data. In addition, out of 79 features in 10 categories including drug management, nutrition and diet management, pain management, fatigue management, stress reduction and control, anxiety and depression, sleep management, exercise and physical activity, smoking and alcohol cessation, communication, and ancillary tools of a self-management application, 39 features were considered necessary. Conclusion: Applying the requirements mentioned in the present study can improve the self-management of the patients with colorectal cancer. The features provided can be used as a model for designing software, systems, or applications.

Introduction: The central bank of Iran has been under sanction since 2012. According to the debates, these sanctions do not include purchasing medical supplies and equipment. This paper is checking if central bank’ s sanction is effective on health of ordinary people in the long-run from an empirical view. Methods: The present applied study was a descriptive, analytical, and annual longitudinal one conducted between 1980 and 2017. The study population included the whole population of Iran. The dependent variable was the number of annual death, and the independent variable was the dummy variable of sanction. Other control parameters including the growth of age dependency ratio, government expenditure, imports, DPT vaccination, Exports and population density were included in the model. Data analysis was performed using Auto-regressive Distributed Lag (ARDL) model by the Eveiws-10 software. Results: the findings showed that in the long run, the sanctions imposed on the central bank, growth of age dependency ratio, government expenditure, and imports increased mortality. Vaccination decreased mortality, while exports and population density did not have any effect on mortality and health. Conclusion: Based on these findings, the best strategies for reducing the mortality (promoting health status) in the long run are as follows: removing sanctions or reducing its effects, taking good social and population policies, reducing age dependency ratio, using financial resources for government expenditure and imports efficiently, and choosing proper public health policies such as vaccination.