Beneficial and Adverse Effects of the Integration of Medical Education and Health Service in IR. Iran; A Delphi Exercise

Hekmat, Somayeh Noori; Tourani, Sogand; Haghdoost, Ali Akbar; Ebrahimipo, Hossein; Mehrolhass, Mohammad Hossein; Dehnavieh, Reza

doi:10.3923/jms.2014.21.28

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…In 1985 in Iran, medical sciences research and education were integrated with the Ministry of Health. Consequently, all of the government hospitals in large cities became teaching hospitals ( 42 ). Teaching hospitals have various functions such as treatment of patients, educating students, and conducting research projects ( 43 ).…”

Section: Discussionmentioning

confidence: 99%

Assessing the performance of hospitals before and after the implementation of Iran’s Health Sector Evolution Plan (HSEP) using the Pabon Lasso model

Rahimisadegh

Haghdoost

Emadi

et al. 2021

mjiri

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Background: The health sector evolution plan was implemented in 2014 in government hospitals across the country as a part of the universal health coverage achievement programs. This study assessed the performance of hospitals before and after the implementation of this plan, using the Pabon Lasso model. Methods: The population of this study consisted of the hospitals of the country in the 2013-2015 time frame; overall, 874 hospitals (94.5% of the population) were included in the study. In order to assess performance, we used the Pabon Lasso model and hospital performance indicators (Average Length of Stay, Bed Turnover, and Bed Occupancy Rate). The data were collected from the Hospital Information System and provincial deputies of curative affairs and were then analyzed using the descriptive indicators of mean, frequency, and median in SPSS 22. Also, Paired Student T-test and ANOVA were used to compare the performance of different groups of hospitals before and after the implementation of the health sector evolution plan. Results: The implementation of the health sector evolution plan has led to a significant improvement in the three performance indicators in the hospitals of the country. Before the implementation of the health sector evolution plan, the most inefficient, inefficient, fairly efficient, and most efficient zones included 31%, 18%, 17%, and 33% of the studied hospitals, respectively. However, the implementation of the health sector evolution plan changed the percentages to 29%, 21%, 20%, and 30%, respectively. Teaching hospitals, which are governmental and are mostly located in capital cities of the provinces, were overall more inefficient than non-teaching hospitals. Conclusion: The number of the most efficient and most inefficient hospitals has decreased, and the number of average performance hospitals has increased after the implementation of the health sector evolution plan. Therefore, the health sector evolution plan has not led to an overall increase or decrease in the performance of hospitals but has reduced the difference in the performance of hospitals. Equal support of government hospitals along with financial protection against health expenses, improves the performance indicators of hospitals and reduces performance differences among them.

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Section: Discussionmentioning

confidence: 99%

Assessing the performance of hospitals before and after the implementation of Iran’s Health Sector Evolution Plan (HSEP) using the Pabon Lasso model

Rahimisadegh

Haghdoost

Emadi

et al. 2021

mjiri

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show abstract

“…In Iran, there is at least one medical science university in each province, which acts as an official representative of the Ministry Of Health and Medical Education (MOHME) in that province Hekmat et al, 2014;Turani et al, 2011). Hospitals can be divided into categories based on different criteria.…”

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confidence: 99%

Evaluation of Hospital Information Systems in Iran: A Case Study in the Kerman Province

Hekmat¹,

Dehnavieh²,

Behmard³

et al. 2016

GJHS

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The Hospital Information system (HIS) is a comprehensive solution that offers complete data integration for different administrative levels in hospitals. To the extent that this system is close to its aim, the efficiency and quality of health care would increase in hospitals. The performance of HIS systems in 13 hospitals in Kerman province that they were evaluated based on four major criteria of ownership, location, education and software design. Seven hospitals were located in the capital city of Kerman province. According to teaching status of hospitals, four were teaching and based on their ownership three were public. The checklist of Iranian ministry of health and medical education, containing 20 indexes were used to evaluate each hospital's HIS system in three main supportive, diagnosis and clinical sectors. Spearman correlation coefficient was used to assess the association between major sectors. The highest score (mean±SD) was observed in laboratory information systems (88.19±13.69), resource management (84.47±8.94), and registration information systems (84.47±18.06); the lowest scores were for telemedicine (45.58±3.86), staff information and timing systems (40±16.64), and decision support systems (23.6±4.97). The total score of HIS software was positively correlated with all its three components. There were strong positive correlations between all three components. The three factors of decision support systems, staff information systems and telemedicine have an important role in providing solutions for non-structured management problems and for leading decision-makers to insights, improving human resource management and solving the problem of access to services. Thus, based on the survey findings, those three factors need to be improved in the Iranian hospital information system.

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An Investigation of Prescription Indicators and Trends Among General Practitioners and Specialists From 2005 to 2015 in Kerman, Iran

Amini

Hekmat

Dehnavieh

et al. 2018

Int J Health Policy Manag

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Background: The World Health Organization (WHO) aims to promote strategies that ensure efficacy, safety, suitability, and cost-effectiveness of medicine prescription. Health systems should design effective mechanisms to monitor prescription and rational use of medicines at all healthcare settings. This study aimed to determine and analyze prescription patterns of general practitioners and specialists in Kerman/Iran from 2005 to 2015. Methods: This is an explanatory mixed method study. Data were gathered during two phases. At the first phase, prescriptions issued by physicians during 2005-2015 were reviewed to extract information required to develop eight main prescription indicators. In the second phase, the indicators trends were presented to experts participating in expert panel to have their opinions and analyses on the data obtained in the first phase. Experts were selected based on their experience and expertise in medicine and/or health policy and/or experience in implementation of polices to promote rational use of medicines. Some experts attending the panel were a sample of physicians whose prescriptions were included in the first phase. Results: Findings revealed that two indicators of the average price of prescriptions and the maximum number of medicines in each prescription had an increasing trend over the study period. Reasons including unprecedented devaluation of the Iranian Rial and willingness of young physicians to prescribe more medications were proposed as the primary contributors to the observed increasing trends. However, other indicators including types of prescribed medicines, average number of medicines per prescription, the percentage of prescriptions with more than four medications, a percentage of encounters with a corticosteroid prescribed, a percentage of encounters with an antibiotic prescribed, and a percentage of encounters with an injection prescribed decreased in the study period. Reasons of controlling initiatives adopted by the Ministry of Health, the higher responsibility of physicians, adoption of continued medical education (CME) programs, and improved knowledge of pharmacists, physicians, and patients about irrational use of medicines were proposed by participants as the main reasons for the decreasing trend. Conclusion: Findings indicated that prescription indicators were better in Kerman than those of country average over the study period based on comparing the results of this study and others in Iran. However, they were non-desirable when compared to the international average. The number of factors contributes to the irrational use of medicines, including lack of knowledge among healthcare providers and patients, patients’ misunderstanding about the efficacy of some particular medicines, the high cost of drug development and manufacturing, and unavailability of effective medicines.

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Beneficial and Adverse Effects of the Integration of Medical Education and Health Service in IR. Iran; A Delphi Exercise

Cited by 3 publications

References 4 publications

Assessing the performance of hospitals before and after the implementation of Iran’s Health Sector Evolution Plan (HSEP) using the Pabon Lasso model

Assessing the performance of hospitals before and after the implementation of Iran’s Health Sector Evolution Plan (HSEP) using the Pabon Lasso model

Evaluation of Hospital Information Systems in Iran: A Case Study in the Kerman Province

An Investigation of Prescription Indicators and Trends Among General Practitioners and Specialists From 2005 to 2015 in Kerman, Iran

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