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Determining the cost of MRI using the step-down method: A case study 使用降压法确定MRI的成本:一个案例研究
Q3 Medicine Pub Date : 2021-10-01 DOI: 10.52547/jha.24.3.22
Kaveh Houman, B. Nabilou, H. Yusefzadeh
Corresponding Author: Hasan Yusefzadeh e-mail addresses: yusefzadeh.h@umsu.ac.ir Introduction: The MRI is one of the most expensive departments in hospitals due to high number of referrals and use of advanced equipment and diagnostic devices. The purpose of this study was to calculate the cost of services of this unit at Imam Reza Hospital and compare it with the tariffs for their correct pricing. Methods: In this descriptive and applied study, the cost price of selected MRI services was calculated using the step-down costing method for the radiology department of Imam Reza Hospital in Urmia in 2018. Data collection tools were standard forms related to the cost list of MRI services and related activity centers. Also, to estimate the share of costs of other departments in MRI services of the radiology department, appropriate sharing bases were determined and, then, using these bases and Excel software, the costs were calculated. Results: According to the research findings, the cost of selected services of this unit including MRI of the brain without injection was calculated to be 1449224 Rials, brain with injection was 1793634 Rials, brain simultaneous with and without injection was 3121783 Rials, lumbar spine without injection was 1994881 Rials, and lumbar spine with and without injection was 3449832 Rials. Conclusion: Based on the results, there was a difference between the actual price of MRI services and tariffs, and personnel costs had the highest share of MRI costs. Therefore, accurate calculation of the cost of MRI services can help reduce costs and increase efficiency by identifying and modifying, merging, or eliminating costly centers. Received: 27/Jun/2021 Modified: 14/Sep/2021 Accepted: 20/Sep/2021 Available online: 9/Nov/2021
通讯作者:Hasan Yusefzadeh电子邮件地址:yusefzadeh.h@umsu.ac.ir简介:MRI是医院中最昂贵的科室之一,因为有大量的转诊和使用先进的设备和诊断设备。本研究的目的是计算伊玛目礼萨医院该单元的服务成本,并将其与正确定价的价格进行比较。方法:在这项描述性和应用性研究中,使用递减成本法计算了2018年Urmia Imam Reza医院放射科所选MRI服务的成本价格。数据收集工具是与MRI服务和相关活动中心的成本清单相关的标准表格。此外,为了估计其他部门在放射科MRI服务中的成本份额,确定了适当的共享基数,然后使用这些基数和Excel软件计算成本。结果:根据研究结果,该单位的选定服务成本,包括未注射的大脑MRI,计算为1449224里亚尔,注射的大脑为1793634里亚尔;同时注射和未注射的脑为3121783里亚尔,未注射的腰椎为1994881里亚尔,有注射和未注入的腰椎为3449832里亚尔。结论:根据结果,MRI服务的实际价格和关税之间存在差异,人员成本在MRI成本中所占份额最高。因此,准确计算MRI服务的成本可以通过识别和修改、合并或消除成本高昂的中心来帮助降低成本并提高效率。收到时间:2021年6月27日修改时间:2021月14日接受时间:2021 9月20日在线提供时间:2021 11月9日
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引用次数: 0
Challenges of palliative care: A systematic review 姑息治疗的挑战:系统综述
Q3 Medicine Pub Date : 2021-10-01 DOI: 10.52547/jha.24.3.9
M. Mehrolhassani, Vahid Yazdi Feyzabadi, M. Setayesh, Z. Khajeh
1 Associate Professor, Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. 2 Assistant Professor, Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. 3 Assistant Professor, Department of Persian Medicine, School of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran. 4 Msc, Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
1伊朗克尔曼医学科学大学健康未来研究所健康服务管理研究中心副教授。2伊朗克尔曼医学科学大学健康未来研究所健康社会决定因素研究中心助理教授。3伊朗克尔曼医学科学大学波斯医学院波斯医学系助理教授。4伊朗克尔曼医学科学大学健康未来研究所健康服务管理研究中心硕士。
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引用次数: 0
Factors Affecting Patient’s Engagement with Physician in Angioplasty Patients: A Case Study 影响血管成形术患者与医生接触的因素:一个案例研究
Q3 Medicine Pub Date : 2021-10-01 DOI: 10.52547/jha.24.3.32
Zahra Khodadadi, S. Tabatabaee, M. Bakhshi, Fateme Leghaei, J. Moghri
Introduction : Patient engagement is a concept that has gained special importance in medical care today, and is considered as a valuable goal in patient care. With the evolution of modern health from a disease-centered model to a patient-centered model, patient interaction has played an important role in improving the health care processes. This study aims to identify the factors affecting the patient's interaction with the physician. Methods : This is an applied study with a qualitative-descriptive method. First, the information of patients who underwent angioplasty in 2019 was extracted from the hospital information system. Then, in-depth interviews with patients were conducted using a semi-structured interview guide. In the next step, we analyzed the data using qualitative content analysis with MAXQDA. Results : After analyzing data, we were able to extract 1072 codes. Then, we categorized the codes into two sub-categories of supply side (physician) and demand side (patient). We identified 11 factors affecting supply-side interaction (information, physician behavior, education, access, cost, responsiveness, patient perception of physician expertise and skill, managerial weakness, facilities, trust, and satisfaction with physician), as well as seven factors on demand-side (personal problems, patient questioning spirit, response from other sources, financial problems, lack of knowledge and awareness, advice from others, and self-medication). Conclusion : It is expected that the patient's interaction with his/her physician after angioplasty could accelerate the patient's recovery process, prevent possible complications, and reduce costs. Recognizing the effective factors and designing appropriate interventions on the supply and demand side that can lead to improving patient interactions with physicians, and pave the way for promoting community health.
引言:患者参与是一个在当今医疗保健中具有特殊重要性的概念,被认为是患者护理的一个有价值的目标。随着现代健康从以疾病为中心模式向以患者为中心模式的演变,患者互动在改善医疗保健过程中发挥了重要作用。本研究旨在确定影响患者与医生互动的因素。方法:采用定性描述的方法进行应用研究。首先,从医院信息系统中提取2019年接受血管成形术的患者信息。然后,使用半结构化访谈指南对患者进行深入访谈。在下一步中,我们使用MAXQDA对数据进行定性内容分析。结果:在分析数据后,我们能够提取1072个代码。然后,我们将代码分为两个子类别,即供应方(医生)和需求方(患者)。我们确定了11个影响供应方互动的因素(信息、医生行为、教育、获取、成本、反应能力、患者对医生专业知识和技能的看法、管理弱点、设施、信任和对医生的满意度),以及需求方面的七个因素(个人问题、患者质疑精神、其他来源的反应、经济问题、缺乏知识和意识、他人建议和自我治疗)。结论:血管成形术后患者与医生的互动有望加速患者的康复过程,预防可能的并发症,降低成本。认识到有效因素,并在供需方面设计适当的干预措施,以改善患者与医生的互动,并为促进社区健康铺平道路。
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引用次数: 0
Evaluation of clinical effectiveness of cardiopulmonary resuscitation indices in the emergency department: Management intervention using FOCUS PDCA method 急诊科心肺复苏指标的临床效果评价:FOCUS PDCA方法的管理干预
Q3 Medicine Pub Date : 2021-10-01 DOI: 10.52547/jha.24.3.56
Siavash Arian, Abdolali Shariati, Parisa Sheini Jaberi, E. Maraghi
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引用次数: 0
The Effect of Labor Force Education in Health Sector on Economic Growth of Iran 伊朗卫生部门劳动力教育对经济增长的影响
Q3 Medicine Pub Date : 2021-10-01 DOI: 10.52547/jha.24.3.92
meghdad moeini, saeed Daei-Karimzadeh
Introduction : Achieving sustainable economic growth requires investment in infrastructure to increase production capacity. Such investments include not only physical investments, but also human investments, education, and health. In this study, we aim to analyze the effect of labor force education in the health sector on Iran's economic growth. Methods : This is an experimentally analytical-descriptive study conducted using the Autoregressive Distributed Lag Model (ARDL) and annual data for Iran from 1991to 2019. In addition to analyzing the effect of labor force education in the health sector on economic growth, the effect of public education, higher education in the Ministry of Science, physical investment, openness, and export were also examined. Data were extracted by documentary method from the database of the Statistics Center of Iran, and estimates were made using Eviews 10 software. Results : Findings of this study indicated the positive effect of independent variables on Iran's economic growth, in which the coefficients of public education, labor force education in the health sector, labor force education in the Ministry of Science, physical investment, openness, and exports were equal to 0.0125, 0.621, 0.8752, 0.449, 0.218, and 0.2429, respectively. Conclusion : Results of the model estimation indicated the positive impact of public education, labor force education in the health sector, and labor force education in the Ministry of Science. Based on the results of the present study, the adoption of appropriate policies by policymakers in the field of educational investment at the public and higher levels, especially in the health sector, has an effective role in increasing Iran's economic growth.
引言:实现可持续的经济增长需要对基础设施进行投资,以增加生产能力。这些投资不仅包括实物投资,还包括人力投资、教育和健康。在本研究中,我们旨在分析卫生部门劳动力教育对伊朗经济增长的影响。方法:采用自回归分布滞后模型(ARDL)和1991 - 2019年伊朗的年度数据进行实验分析描述性研究。除了分析卫生部门的劳动力教育对经济增长的影响外,还研究了公共教育、科技部高等教育、实物投资、开放和出口的影响。数据采用文献法从伊朗统计中心的数据库中提取,使用Eviews 10软件进行估算。结果:自变量对伊朗经济增长具有正向影响,其中公共教育、卫生部门劳动力教育、科技部劳动力教育、实物投资、开放度和出口的系数分别为0.0125、0.621、0.8752、0.449、0.218和0.2429。结论:模型估算结果显示公共教育、卫生部门劳动力教育和科技部劳动力教育对公共教育有积极影响。根据本研究的结果,决策者在公共和更高层次的教育投资领域,特别是在卫生部门采取适当政策,对促进伊朗的经济增长具有有效作用。
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引用次数: 0
Challenges of managing health centers during the Covid-19 pandemic 新冠肺炎大流行期间管理卫生中心的挑战
Q3 Medicine Pub Date : 2021-10-01 DOI: 10.52547/jha.24.3.79
H. Amin-Tahmasbi, M. Asgharpour
Introduction: The readiness of health centers, especially hospitals for management challenges ahead, has a significant impact on reducing mortality in addition to physical and psychological damage due to the prevalence of viral or infectious diseases with high pandemic potential, including the COVID-19. Given the importance of this issue, this study aimed to identify the challenges of managing health centers and prioritizing them during the COVID-19 pandemic.
简介:由于包括新冠肺炎在内的具有高大流行可能性的病毒性或传染病的流行,除了身体和心理损害外,卫生中心,特别是医院对未来管理挑战的准备程度,对降低死亡率也有重大影响。鉴于这一问题的重要性,本研究旨在确定在新冠肺炎大流行期间管理卫生中心并优先考虑这些中心的挑战。
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引用次数: 1
Components of Employee Relationship System Based on Knowledge-based Organizational Structures at Medical Universities 基于知识型组织结构的医科大学员工关系系统构成
Q3 Medicine Pub Date : 2021-07-01 DOI: 10.52547/JHA.24.2.59
S. Kazemi, Mohammad Javad Mohammadi, N. Yaghoubi, Jalil Jarahi Friz
1 PhD Student, Faculty of Management, Islamic Azad University of Birjand, Birjand, Iran. 2 Assistant Professor, Faculty of Law and Administrative Sciences, Islamic Azad University of Birjand, Birjand, Iran. 3 Professor, Faculty of Management and Economics, Sistan and Baluchestan University, Zahedan, Iran. 4 Assistant Professor, Faculty of Statistics and Mathematics, Islamic Azad University of Birjand, Birjand, Iran.
1名博士生,伊朗Birjand伊斯兰阿扎德大学管理学院。2伊朗比尔詹德伊斯兰阿扎德大学法律与行政科学学院助理教授。3伊朗扎黑丹锡斯坦和俾路支斯坦大学管理与经济学院教授。4伊朗Birjand伊斯兰阿扎德大学统计与数学系助理教授。
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引用次数: 0
Explaining the conceptual framework of career boundaries in medicine using Grounded Theory 用扎根理论解释医学职业界限的概念框架
Q3 Medicine Pub Date : 2021-07-01 DOI: 10.52547/jha.24.2.83
Amir Shojaean, Azar Kaffashpoor, A. Shirazi, G. Malekzadeh
Introduction : Career boundaries are effective in all aspects of the medical profession. Since many factors can shape a junior doctor’s choice of career, the concept of career has always been the focus of medical discussions and has even been able to be used as a perspective in medical education. The aim of the present study was to provide a conceptual framework of career boundaries in the medical profession. Methods : The present study is fundamental in terms of purpose and qualitative in terms of approach. The statistical population of this study included physicians who were selected by non-random snowball sampling. The criterion for entering the sampling was their having more than five years of work experience, and the criterion for completing the sampling was the researchers’ reaching theoretical saturation: a total of 19 people participated in the study. In order to collect the data, a semi-structured interview was held, and for the analysis of the collected data, the systematic grounded theory was used. Results : The research findings indicated that the conceptual framework of career boundaries in the medical profession includes individual differences and social institutions as causal conditions, work-family boundaries, geographical boundaries, social boundaries, organizational boundaries, moral boundaries, and legal boundaries as the central phenomenon. Findings also included understanding boundaries, reviewing boundaries and crossing boundaries under strategies, educational and cultural contexts under the context conditions, macro-factors and micro-factors under the intervening conditions and future of the career, and re-planning the career and work-family balance as the consequences. Conclusion : Paying attention to the conceptual framework of boundaries can be a great help in planning, deciding, managing, and developing a career for physicians and other occupations. In addition, employed physicians, especially physicians who are at the beginning of their careers, job seekers, and university graduates can be aware of the boundaries of their careers. In addition, they become aware of the consequences of their career boundaries to make choices more openly and increase their chances of career success.
职业界限在医学专业的各个方面都是有效的。由于许多因素可以影响初级医生的职业选择,职业概念一直是医学讨论的焦点,甚至可以作为医学教育的一个视角。本研究的目的是为医学专业的职业界限提供一个概念性框架。方法:本研究在目的上是基础性的,在方法上是定性的。本研究的统计人群包括采用非随机滚雪球抽样选择的医生。进入抽样的标准是他们有五年以上的工作经验,完成抽样的标准是研究人员达到理论饱和:共有19人参与了研究。为了收集数据,进行了半结构化访谈,对收集到的数据进行分析,使用了系统扎根理论。结果:研究结果表明,医学职业生涯边界的概念框架包括个体差异和社会制度作为因果条件,工作-家庭边界、地理边界、社会边界、组织边界、道德边界和法律边界作为中心现象。研究结果还包括战略背景下的理解边界、审查边界和跨越边界、教育和文化背景条件下的背景条件、干预条件下的宏观因素和微观因素以及职业生涯的未来,以及作为后果的职业和工作家庭平衡的重新规划。结论:关注界限的概念框架对医生和其他职业的职业规划、决策、管理和发展有很大的帮助。此外,受雇的医生,特别是刚开始职业生涯的医生,求职者和大学毕业生可以意识到他们职业的界限。此外,他们会意识到职业界限的后果,从而更开放地做出选择,增加职业成功的机会。
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引用次数: 0
Investigation of the drivers of abnormal behaviors from the perspective of health managers during the COVID-19 pandemic 新冠肺炎大流行期间健康管理者视角下的异常行为驱动因素调查
Q3 Medicine Pub Date : 2021-07-01 DOI: 10.52547/JHA.24.2.9
Shahpar Zakipour, Behzad Farrokh Sersht, M. Taghipourian, H. Aghajani
Introduction: Considering the COVID-19 pandemic and its severe effects on life, there is no doubt that an analysis of the components and drivers of abnormal behaviors can facilitate the emergence of moral behaviors. Therefore, we conducted this study in order to investigate the drivers of abnormal behaviors from the perspective of health managers during the COVID-19 pandemic. Methods: This research is a cross-sectional, qualitative, and applied study that was conducted using snowball sampling method and semi-structured interviews with 13 managers at different management levels in so called social security hospitals in Mazandaran province in the first half of 2020. Also, validation of Lincoln and Guba reliability criteria and data analysis were performed by combined summary content analysis method with MAXQDA10 software. Results: Findings of this study show that a number of factors are among the drivers that cause the occurrence of abnormal behaviors in hospitals. These factors could be divided into three types: Structural factors that include inadequate payroll system, job characteristics, organizational misconduct, and managerial weakness;behavioral factors include stress, aggression in the organization, antisocial behavior, and individual psychological disorders;and environmental factors as well as internal and external environment of the organization. Conclusion: Through increasing financial supports and incentives, results of this study help managers reduce stressors, create better conditions for employees, increase the quality of performance and services provided to patients, and improve the health level of the country. © 2021. Journal of Health Administration. All Rights Reserved.
简介:考虑到新冠肺炎大流行及其对生活的严重影响,毫无疑问,分析异常行为的组成部分和驱动因素可以促进道德行为的出现。因此,我们进行这项研究是为了从新冠肺炎大流行期间卫生管理者的角度调查异常行为的驱动因素。方法:本研究是一项横断面、定性和应用性研究,采用滚雪球抽样法和半结构化访谈,于2020年上半年对马赞德兰省所谓的社会保障医院的13名不同管理层的管理人员进行了调查。同时,采用汇总内容分析法和MAXQDA10软件相结合的方法,对Lincoln和Guba的可靠性标准进行了验证和数据分析。结果:本研究结果表明,许多因素是导致医院异常行为发生的驱动因素。这些因素可分为三类:结构性因素,包括工资制度不健全、工作特点、组织不当行为和管理薄弱;行为因素包括压力、组织中的攻击性、反社会行为和个人心理障碍;环境因素以及组织的内部和外部环境。结论:通过增加财政支持和激励,本研究的结果有助于管理者减少压力源,为员工创造更好的条件,提高为患者提供的绩效和服务质量,提高国家的健康水平。©2021。卫生管理杂志。保留所有权利。
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引用次数: 0
Hospital-Based Palliative Care Models: Advantages and Limitations 基于医院的姑息治疗模式:优势与局限
Q3 Medicine Pub Date : 2021-07-01 DOI: 10.52547/JHA.24.2.45
A. Jabbari, K. Sohrabi, Asal Sadat Niaraees Zavare
Corresponding Author: Asal Sadat Niaraees Zavare e-mail addresses: asal7447@gmail.com Introduction: Palliative care provides interdisciplinary care focused on patient-centered outcomes such as quality of life, symptom burden, emotional well-being, and caregiver need. With the aging population and the prevalence of chronic diseases, the need for palliative care is increasing. Thus, the need to provide palliative care services at different levels of the health system, especially in hospitals, cannot be ignored. In this study, we intended to examine the types of hospital-based palliative care models and identify the disadvantages and advantages of each of those models. Methods: This study was conducted as a comprehensive review in 2019. The required data were collected through an advanced keyword search, including hospital-based palliative care, palliative care in hospital, inpatient palliative care, palliative care establishment, palliative care development,and palliative care models in English databases such as Web of Science, Science Direct, Scopus, and PubMed as well as Persian databases such as Magiran and SID from 2005-2020. Results: Out of 3877 sources, 164 related sources were selected. Generally, nine hospital-based palliative care models were identified, including outpatient palliative care clinic, palliative care consultation service, palliative care daycare service, dedicated inpatient palliative care unit, palliative care outreach/home-care service, Swing beds, integration with the emergency department, integration with the ICU, and the integrated model. Some benefits and limitations were identified for each of the Hospital-based palliative care models. Conclusion: All hospital-based palliative care identified models can help hospitals to strengthen the palliative care approach, but given the limited resources of each hospital, hospital officials must choose between them and develop the model at their hospital after modifying and adapting that to the existing culture, structure, and facilities. Received: 09/April/2021 Modified: 14/June/2021 Accepted: 20/June/2021 Available online: 05/Sep/2021
通讯作者:Asal Sadat Niaraees Zavare电子邮件地址:asal7447@gmail.com引言:姑息治疗提供跨学科的护理,重点关注以患者为中心的结果,如生活质量、症状负担、情绪健康和护理人员需求。随着人口老龄化和慢性病的流行,对姑息治疗的需求正在增加。因此,不能忽视在卫生系统不同级别,特别是在医院提供姑息治疗服务的必要性。在这项研究中,我们打算检查基于医院的姑息治疗模式的类型,并确定每种模式的缺点和优点。方法:本研究于2019年进行全面回顾。所需的数据是通过高级关键词搜索收集的,包括基于医院的姑息治疗、医院的姑息护理、住院姑息治疗、姑息治疗机构、姑息治疗发展以及英语数据库中的姑息治疗模型,如Web of Science、Science Direct、Scopus,PubMed以及2005年至2020年的Magiran和SID等波斯数据库。结果:在3877个来源中,选择了164个相关来源。总体而言,确定了九种基于医院的姑息治疗模式,包括门诊姑息治疗诊所、姑息治疗咨询服务、姑息治疗日托服务、专门的住院姑息治疗单元、姑息治疗外展/家庭护理服务、摇摆床、与急诊科的整合、与ICU的整合以及整合模式。确定了每种基于医院的姑息治疗模式的一些好处和局限性。结论:所有基于医院的姑息治疗模式都可以帮助医院加强姑息治疗方法,但鉴于每家医院的资源有限,医院官员必须在两者之间做出选择,并在根据现有文化、结构和设施进行修改和调整后,在其医院开发该模式。收到时间:2021年4月9日修改时间:2021月14日接受时间:2021 6月20日在线提供时间:2021 9月5日
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引用次数: 0
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Journal of Health Administration
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