Journal of Health Information Management
Year:2020 | Volume:17 | Issue:5 (75)|Papers Count:8

Introduction: Blockchain can be defined as a distributed and immutable digital ledger that provides data transparency and user privacy. According to the applications of blockchain, conducting of each application needs planning and cost management. This study endeavored to identify and rank the uses of blockchain technology in healthcare. Methods: This descriptive study was done in the winter semester of the academic year of 2020. In the first phase, the uses of blockchain technology in healthcare were recognized from library resources using qualitative content analysis. In the next phase, these uses were prioritized by a panel of experts with 17 members. Then, we used fuzzy Stepwise Weight Assessment Ratio Analysis (SWARA) method for ranking the uses of blockchain in healthcare. Results: Electronic health records (0. 43), smart contracts (0. 21), internet of things infrastructure (0. 15), information security and privacy (0. 08), administrative management (0. 06), and electronic voting (0. 04) were the important applications of blockchain technology in healthcare. Conclusion: Finding of this study show that blockchain technology has important applications in healthcare electronic health records and smart contracts. Therefore, health system policymakers should provide the infrastructure for implementation of blockchain technology among medical and health organizations. This study can contribute to the research in the blockchain field, and enrich the literature on the application of this technology in healthcare.

Introduction: Occurrence of medical error by medical staff can endanger patients' safety. Meanwhile, nurses play a role both as one of the main factors in the occurrence of errors and as a barrier against errors, and sometimes face obstacles to reporting errors. In this regard, this study attempted to identify these barriers and provide corrective solutions. Methods: This qualitative quantification study was conducted in two stages. In the first stage, a researcher-made questionnaire was completed by 214 nurses working in teaching hospitals in Kerman City, Iran. In the second stage, to provide a suitable solution to increase reporting by 23 experts, the centralized group discussion method was used, and then the data were analyzed using the framework analysis method. Results: In the first stage, fear of prosecution and criminal punishment was identified as important obstacle to reporting. In the qualitative stage, three major axes of education, culture, and organization and 15 sub-axes including change of attitude, motivation, job culture, religion, belief of officials, appropriate reward system, use of software, planning, respect, environment, public education and media, use of cyberspace, model presentation, advertising, and communication skills of officials were identified. Conclusion: Because the barriers and issues rose in the reporting of clinical errors, it seems that hospitals have the ability to remove barriers to report clinical errors with the help of cultural, educational, and structural solutions presented in this study. This way, by increasing error reporting, hospitals can improve the quality of health services by reducing individuals' errors.

Introduction: Nowadays, estimating efficiency of health expenses and identifying its related factors has become important issue, and due to the increased expenses around the world, has received considerable attention by policymakers in health sector. This study endeavored to assess the factors affecting the efficiency of government health expenses. Methods: This was a descriptive-analytical study using World Bank databases carried out in the distinguished countries (including Iran) during the years 1995 to 2014. In the first stage, according to the Human Development Index (HDI), the distinguished countries were divided into four groups of countries with very high, high, medium, and low HDI. Then, the Data Envelopment Analysis (DEA) approach was employed to estimate the efficiency scores of countries. In the second stage, the Tobit Panel Data model was estimated to identify the influencing factors on the efficiency of the government health expenditures. Results: The average technical efficiencies observed for countries with very high, high, medium, and low HDI were 0. 63, 0. 52, 0. 28, and 0. 48, respectively. The out-of-pocket payment in countries with very high, high, and medium HDI had a positive and significant relationship with the efficiency of government health expenditures. Other variables in countries with very high and high HDI were not statistically significant. Hospital beds had a significant negative relationship with the efficiency of government health expenditures. In countries with low HDI, none of the variables had a relationship with the efficiency of government health expenditures. Conclusion: Findings reveal that the out-of-pocket payment can play a significant role in controlling unnecessary expenditures in very high and high HDI countries. This can be related to the service packages provided in these countries as well. The findings indicate that a service package which is covered by insurance in these countries, and patient do not pay for that, covers essential services for patient, and those services that are not in this package and the patient have to pay for that, are less essential services.

Introduction: Health is the greatest asset of individuals, and choosing a destination to improve individuals' health is an important process requires consideration of various factors. This study attempted to identify and rank the factors related to the development of health tourism. Methods: To conduct this descriptive-survey study, 25 health tourists who traveled to Yazd Province, Iran, were randomly selected and interviewed. Data and scenarios were analyzed using fuzzy cognitive mapping technique, and the research model was developed using social network analysis. Results: To develop health tourism, there were several factors involved such as the factors of financial resources, security, marketing system, and information, respectively; as they were more central. Conclusion: The results reveal that by implementing strategies to increase market share of competitors, reduce treatment costs, facilitate the conditions for obtaining a medical visa in the shortest possible time, it seems possible to increase the number of tourists, reduce Iran phobia, and increase security.

Introduction: Wilms’ tumor is the most prevalent malignant kidney tumor in childhood. Treatment of this tumor imposes a high economic burden on the individuals. This study endeavored to calculate the cost of the treatment process of pediatric Wilms’ tumor using a time-driven activity-based costing model (TDABC), to reduce the costs. Methods: This descriptive study was implemented using a TDABC costing model on the costs of treatment process in 10 patients with Wilms’ tumor selected from Shahid Sadoughi hospital of in Yazd City, Iran, in the academic year of 2016. First, the treatment process and activities were identified through observations, and semi-structured interviews. Then, the cost was calculated for treatment process. Results: The cost of treatment was 420. 512. 183 Iranian Rials (IRRs), 50. 4 % of which was allocated to the staff salaries. The cost per minute of specialist physician services was 54. 401 IRRs in oncology ward that it was identified the most expensive job category in treatment process. Besides, unused capacity cost of overhead was calculated in treatment process as 12. 714. 109 IRRs. Conclusion: Findings revealed that the staff salaries involved great part of the charges. Therefore, it is necessary to manage the costs and human resources charges to be able to increase the productivity.

Introduction: Guilan Province, Iran, owning the advantages of tourism based on its nature, has the potential to develop healthy ecologies. This study endeavored to identify and introduce the suitable areas of these resorts in Guilan. Methods: In this descriptive-analytical study, a pairwise comparison questionnaire was developed and administered to 15 nature specialists, owners of ecotourism resorts, tour guides, and nature guides, as well as tourism professors who were selected using purposeful accessible sampling method. To prioritize susceptible areas, VIKOR model was employed. Results: As a result of examining environmental indicators and based on the overlapping of output maps in Geographic Information System (GIS) environment, 18 potential zones were identified in Guilan and using VIKOR model, prioritization of identified zones was done to develop studies and planning of these tourist destinations. Zone No. 9, located in the geographical area of Rasht City with the least distance from the ideal solution (0. 054), zone No. 6, in the geographical area of Parhosar and Rezvanshahr with a numerical score of 0. 059, and zone No. 11 in the geographical area of Siahkal and Lahijan with a score of 0. 064, were in the first to third priorities of planning and development of health ecologies, respectively. Conclusion: Capitalizing on areas prone to construction and sustainable development of health ecologies in Guilan Province has differentiated the province's tourism market, and can foster a new competitive advantage in the tourism sector.

Introduction: Scientific communities have always been concerned about validity of open-access articles. Given the challenges of quantitative citation analysis in evaluating scientific articles, content-based citation analysis, including opinion mining of citances, can bring about more transparent results about their validity. In view of this, the present study compared the opinions contained in citances about open-access and non-open-access articles. Methods: We used a quantitative content analysis method with citation and opinion analysis approaches. The citances, bibliographic, and bibliometric data were extracted from Colil and PubMed databases. Opinion scores were assigned to the citances through SentiWords. After processing the titles, abstracts, and citances, Cosine similarity of Term Frequency-Inverse Document Frequency (TF-IDF) values were calculated. The open-access and non-open-access articles were then paired by their similarities in abstracts, titles, and citances. The data were analyzed using Friedman test and Spearman correlation. Results: There was no significant difference between the open-access and non-open-access articles in terms of their opinion scores, despite a significant difference in citation advantages. The pairs’ citance and textual similarities had no significant correlation with their opinion distance. Conclusion: Although the open-access studies had citation advantage over their similar non-open-access peers, they showed no significant opinion distance. Besides, similar texts did not necessarily follow the same opinion patterns. Consequently, to complete the results of quantitative citation analysis, the content-based citation analysis is emphasized.

Introduction: Graphical mapping of an academic field make it more accurate to identify the branches of human knowledge and transform the concept of abstraction to concrete objectives. This study aimed to map the related articles in medical sociology field. Methods: The descriptive-analytical study analyzed the content of the texts with a scientometrics approach. The sample included all international scientific articles in the field of medical sociology indexed in PubMed database from 1945-2018. UCINET and NetDraw were used to analyze the data and draw the scientific map. Results: According to the indicators of centrality, the topic of "physician-patient relationship" was ranked first in all three types of centrality. According to the indicators of closeness and degree, the prominent value was given to the thematic categories of "health attitude" and "social and economic factors". Besides, the topic of "medical care delivery" had the most prominent value in terms of betweenness centrality. Conclusion: The social network analysis indexes are effective in analyzing scientific maps. The formed thematic structure and the relationship between them show the interdisciplinary nature of the field of medical sociology. Some important issues related to medical sociology, such as social parameters affecting treatment and rehabilitation, epidemiological research, and healthy behavior, have received less attention.