Background: Inappropriate prescriptions can lead to adverse consequences for patients. It also im... more Background: Inappropriate prescriptions can lead to adverse consequences for patients. It also imposes excessive cost on the patients, payers and health systems. The current study aimed at estimating of the rate of brain Magnetic Resonance Imaging (MRI) inappropriate prescriptions and their financial burden in Iran.Methods: Using systematic stratified sampling method, this cross-sectional study recruited 385 participants from three public teaching hospitals in Shiraz, Iran. Demographic information, questions related to brain MRI prescription and its indications checklist were collected using study-specific data collection tools. The completed indications checklist was compared to the appropriateness status table of indications and scenarios to detect the percent of the appropriateness of prescriptions. Results: About 21 % of total brain MRI prescriptions are inappropriate. Previous treatment, number of referrals to physician, having other diagnostic tests and the applicant of MRI (P<0.01) had significant relationships with prescription appropriateness. The estimated financial burden of inappropriate brain MRIs in Shiraz teaching hospitals was 99988 US dollar in 2017. Conclusions: More than one-fifth of brains MRIs were inappropriate (i.e., prescriptions without medical indications). It caused about one hundred thousand United States Dollar (USD) financial burden which is 17 times of Iran's Gross Domestic Product (GDP) per capita. To better allocation of health system resources for provision of MRI services rationing policies for controlling consumer moral hazard and reducing provider induced demand can be helpful.
Background: Ectopic pregnancy is one of the most important causes of maternal mortality and infer... more Background: Ectopic pregnancy is one of the most important causes of maternal mortality and infertility that may impose many costs on patients. Today, Surgery and pharmaceutical treatments are the common methods of treating the disease. The aim of this study was to evaluate the cost-effectiveness of different methods of treating tubal ectopic pregnancy in the south of Iran.Methods: This study was an economic evaluation which analysed and compared the cost-effectiveness and cost-utility of three treatment methods, including single-dose methotrexate, double-dose methotrexate, and surgery in patients with tubal ectopic pregnancy. In this study, a decision tree model was used. The outcomes included in the model were the percentage of successful treatment and the average utility score of each treatment method. The study was conducted from the social perspective and a one-way and probabilistic sensitivity analysis was performed to measure the effects of uncertainty. The analysis of the co...
Background: Given the increasing availability of internet, it has become a common source of healt... more Background: Given the increasing availability of internet, it has become a common source of health information for all population including students. However, the actual effect of this increased access to information on the health status and its different aspects needs to be studied more. This study aimed to investigate the correlations between online health information seeking behavior and health related quality of life in a sample of high school students of Iran. Methods: A survey was conducted among secondary school girl students of Yazd province, Iran in 2019. A total of 295 students participated in the study. The required data were gathered using two valid questionnaires including eHIQ (Kelly et al., 2015) to measure the online health information seeking experience and validated Persian version of SF-36 to measure the health related quality of life. The collected data were analyzed through descriptive statistics and Pearson correlation coefficient using SPSS version 23. Results...
Background Healthcare settings are complex, and the decision-making process is usually complicate... more Background Healthcare settings are complex, and the decision-making process is usually complicated, too. Precise use of best evidence from different sources for increasing the desired outcomes is the result of EBM. Therefore, this study aimed to map the potential facilitators and barriers to EBM in health systems to help the healthcare managers to better implement EBM in their organizations. Methods The present study was a scoping review (SR) conducted in 2020 based on the integration of the frameworks presented by Arksey and O’Malley (2005) and Levac et al. (2010) considering the Joanna Briggs Institute guideline (2015). These frameworks consist of 6 steps. After finalizing the search strategy, 7 databases were searched, and the PRISMA-ScR was used to manage the retrieval and inclusion of the evidence. Microsoft Excel 2013 was used to extract the data, and the graphic description was presented. The summative analysis approach was used applying MAXQDA10. Results According to the sys...
Background: The hospital is a significant part of health systems that presents a complex and vita... more Background: The hospital is a significant part of health systems that presents a complex and vital services. Therefore, performance management of hospitals should be considered especially. BSC model is so helpful and popular for performance management. In using BSC, cause and effect relations is very important, since it helps to apply non-financial to forecast financial performance. Objectives: This study aims to analysis systematic relations between key indicators of hospital performance evaluation, identifying causal relations and prioritizing indicators. Methods: Based on the 4 perspectives described by the balanced scorecard (BSC), the evaluation indicators of hospital performance and key performance indicators (KPIs) were adopted from the related literature and selected by experts' panel, respectively. Then, the decision making trial and evaluation laboratory (DEMATEL) method was employed for the determination of the cause-and-effect relationships between the indicators, differentiation of the effective and significant factors, and construction of the strategy map to ameliorate hospital performance. Results: According to the BSC perspectives, 21 KPIs were selected for evaluation of hospital performance. The highest relationship was found between bed occupancy having the largest R + D value and other indicators, thus illustrating its fundamental role among the indicators. Clinical errors with the greatest value of R-D showed the strongest impacts on the other indicators and was thus named as the "main cause factor" among the indicators. In contrast, the percentage of patient satisfaction with the smallest R-D value was most strongly influenced by the other indicators and therefore, it was known as the "main effect factor" among the indicators. Conclusions: Assessment and improvement of the hospital performance is a complex and multi-dimensional activity. In order to have a powerful assessment system and success in improving hospital performance, instead of a single-dimension, it should be paying attention to all dimensions of performance.
This study aimed to estimate both direct medical and indirect costs of treating the Coronavirus d... more This study aimed to estimate both direct medical and indirect costs of treating the Coronavirus disease 2019 (COVID-19) from a societal perspective in the patients at a referral hospital in Fars province as well as the economic burden of COVID-19 in Iran in 2020.Methods:This is a partial economic evaluation and a cross-sectional cost-description study conducted descriptively-analytically and based on the data of the COVID-19 patients referred to a referral university hospital in Fars province between March and July 2020. The data were collected by examining the patients' records and accounting information systems. The subjects included all the inpatients with COVID-19 (477 individuals) who admitted to the medical centre during the four months. Bottom-up costing, incidence-based and income-based human capital approaches were used as the main methodological features of this study.Results: The mean direct medical costs were estimated 28,240,025,968 Rials ($ 1,791,172) in total and ...
Background: Scientific evidence is the basis for improving public health; decision-making without... more Background: Scientific evidence is the basis for improving public health; decision-making without sufficient attention to evidence may lead to unpleasant consequences. Despite efforts to create comprehensive guidelines and models for evidence-based decision-making (EBDM), there isn`t any to make the best decisions concerning scarce resources and unlimited needs. The present study aimed to develop a comprehensive applied framework for EBDM. Methods: This was a meta-synthesis including two phases of a Scoping Review (SR) and a Best-Fit Framework (BFF) synthesis conducted in 2019. A scoping review was done for the comprehensive review of the existing published studies in this area. The six-stage approach of Arksey and O’Malley was applied. Six main databases including PUBMED, Scopus, Web of Science, Science Direct, EMBASE, and ProQuest were searched using related keywords. Data were extracted and analyzed via thematic analysis. Results of the scoping review were then synthesized to ach...
Introduction: HIV infection is one of the main public health problems in the world. This study ai... more Introduction: HIV infection is one of the main public health problems in the world. This study aimed to assess the knowledge and attitudes of young couples married in the city of Shiraz, and eventually suggest an Operational Program for the prevention of HIV in Iran. Method: the data collection tool was a questionnaire consisted of 32 questions on transmission and prevention of HIV infection. The young couples were selected through simple random sampling, and the sample size was The data analysis was performed using SPSS 19 software. Results: Of the total of 400 cases, 201 (50.25%) were male and 199 (49.75%) were female. The mean age of the couples was 25.96±5.95 years. The most frequent correct answer was related to the knowledge of transmission through sharing needles among drug users (87.4%). Regarding attitude, 94.6% of the subjects agreed with the struggle against HIV. Examining the relationship between knowledge and age showed that they had a significant relationship (P=0.0...
Background: Although all jobs can be stressful, occupational stress is an important issue in jobs... more Background: Although all jobs can be stressful, occupational stress is an important issue in jobs that deal with human health. Evidence indicates that nursing is a stressful occupation. Objective: This research evaluated factors affecting occupational stress and strategies for coping with it. Methods: This cross-sectional descriptive-analytic study was conducted in 2015. The study population comprised all nurses at Shahid Rajaee hospital, from whom 190 nurses were selected by random sampling. Data was collected by questionnaire and analyzed using SPSS software (version 19), Pearson correlation coefficient tests, Mann-Whitney tests, and t tests. Results: Occupational stress was rated as moderate among the studied nurses. Significant positive correlations were found between occupational stress level and less effective coping method, occupational stress level and work experience level, and ineffective coping methods and age. Moreover, a significant difference was seen between men and women in terms of emotion-focused coping. Conclusion: According to the research findings, occupational stress was at a moderate level among the studied hospital nurses, indicating that the authorities need to focus on efforts to reduce occupational stress for nurses.
Quarterly Journal of Management Strategies in Health System
Background: The optimal use of research findings is crucial. One of the activities that improves ... more Background: The optimal use of research findings is crucial. One of the activities that improves application of research-derived knowledge is the knowledge translation. This study aimed to investigate the status of knowledge translation in Shiraz University of Medical Sciences. Methods: This cross-sectional and descriptive-analytical study was conducted in 2018. The sample size included 143 faculty members of Shiraz University of Medical Sciences selected using the stratified sampling and simple random sampling methods. The required data were collected using a standard knowledge translation questionnaire consisting of 50 items in 4 dimensions. The validity and reliability of the questionnaires were confirmed in the previous studies. The collected data were analyzed using SPSS 21 by descriptive and analytical statistics. Results: The results showed that overall status of the knowledge translation was weak (2.46 ± 0.67). In this regard, producing useful evidence for decision making (2...
Complementary health insurance is a means to decrease outof-pocket expenses and increase health s... more Complementary health insurance is a means to decrease outof-pocket expenses and increase health service utilizations in the world. The amount of service utilization after covering by complementary health insurance is related to the socioeconomic and cultural factors of each country. →What this article adds: Complementary health insurance in Iran did not change outof-pocket expenses because people did not change the share of health care expenses in the family budget, and they decided to use more health care services instead.
Background: There are various criteria and methods to develop Basic Health Benefit Package (BHBP)... more Background: There are various criteria and methods to develop Basic Health Benefit Package (BHBP) in world health systems. The present study aimed to extract criteria used in health systems in different countries around the world using scoping review method. Methods: A systematic search was carried out in Cochrane Library, PubMed, Scopus, Science Direct, Web of Science, ProQuest, World Bank, World Health Organization, and Google databases between January and April 2016. Papers and reports were gathered according to selected keywords and were examined by two authors. Finally, the criteria were extracted from the selected papers. Results: The primary search included 8876 papers. After studying the articles' titles, abstracts, and full texts, 9 articles and 14 reports were selected for final analysis. After the final analysis, 19 criteria were extracted. Due to diversity of criteria in terms of number and nature, they were divided into three categories. The categories included intervention-related criteria, disease-related criteria, and community-related criteria. The largest number of criteria belonged to the first category. Indeed, the most widely applied criteria included cost-effectiveness (20), effectiveness (19), budget impact (12), equity (12), and burden of disease (10). Conclusion: According to the results, different criteria were identified in terms of number and nature in developing BHBP in world health systems. It seems that certain criteria, such as cost-effectiveness, effectiveness, budget impact, burden of disease, equity, and necessity, that were most widely utilized in countries under study could be for designing BHBP with regard to social, cultural, and economic considerations.
The number of outsourcing contracts continues to rise. Outsourcing is one of the strategic tools ... more The number of outsourcing contracts continues to rise. Outsourcing is one of the strategic tools in healthcare administrations for cost saving and quality improvement. The outsourcing decision is complex with many factors involved. →What this article adds: This study identified the key factors affecting decision making on outsourcing services in Iran's health system for the first time, which can help to make the right decision for outsourcing health services in Iran and other countries.
A common method used to examine the relationship between internal preferences and caring external... more A common method used to examine the relationship between internal preferences and caring externalities is willingness to pay (WTP) approach. We aimed to estimate WTP for health status with different severity level and identify determinant factors on WTP. For determining main factors in WTP, a cross-sectional study was conducted in Shiraz in the southeast of Iran, in March to April 2015. The open-ended method was used to estimate monthly WTP in private and altruistic section. Multivariate regression analyses using ordinary least squares were applied to examine the effect of Scio-demographic factors on WTP using SPSS software 21. Participants were willing to pay an average amount of $ 295 in health status 1 and an average amount of $ 596 in health status 6 (worst status) for internal preferences. Altruistic WTP for health status 1 was $ 294 and participants were willing to pay an average amount of $ 416 in health status 6. Multiple regression analysis identified monthly income as the ...
Background: Health workforce distribution is so important in access posture, coverage and equity.... more Background: Health workforce distribution is so important in access posture, coverage and equity. Following millennium development goals (MDGs), special attention to health workforces in relation with maternal and child health is required. Objective: The aim of the current study was to determine distribution of maternal and child health related workforces in Iran during 2010-2012, using inequality measures. Methods: In this cross-sectional study, data about the number of physicians and midwives obtained from Ministry of Health reports and demographic statistics were obtained from the Statistical Center of Iran. Gini coefficient and Robin Hood index were calculated in terms of population ratio, need adjusted index for birth (NAIB) and need adjusted index for mortality (NAIM). For calculations, DAD software version 4.6 was used. Results: Gini coefficient was reduced for general physicians (GPs) and pediatricians, and had increasing and decreasing trends for gynecologists. For achieving equality within provinces, the number of transferable health workforces was more than 1 person per 10 health workforces. Conclusion: Health workforce distribution had various trends in Iran. Special attention to deprived provinces is required. Most of the reduction in Gini coefficient is due to the increase in health workforce in developing provinces, and deprived provinces still have serious problems. The health system could achieve better equality by considering deprived provinces and using Gini coefficient and Robin Hood index together.
The importance of health indicators in the recent years has created challenges in resource alloca... more The importance of health indicators in the recent years has created challenges in resource allocation. Balanced and fair distribution of health resources is one of the main principles in achieving equity. The goal of this cross-sectional descriptive study, conducted in 2010, was to classify health structural indicators in the Fars province using the scalogram technique. Health structural indicators were selected and classified in three categories; namely institutional, human resources, and rural health. The data were obtained from the statistical yearbook of Iran and was analyzed according to the scalogram technique. The distribution map of the Fars province was drawn using ArcGIS (geographic information system). The results showed an interesting health structural indicator map across the province. Our findings revealed that the city of Mohr with 85 and Zarindasht with 36 had the highest and the lowest scores, respectively. This information is valuable to provincial health policymak...
Background: Inappropriate prescriptions can lead to adverse consequences for patients. It also im... more Background: Inappropriate prescriptions can lead to adverse consequences for patients. It also imposes excessive cost on the patients, payers and health systems. The current study aimed at estimating of the rate of brain Magnetic Resonance Imaging (MRI) inappropriate prescriptions and their financial burden in Iran.Methods: Using systematic stratified sampling method, this cross-sectional study recruited 385 participants from three public teaching hospitals in Shiraz, Iran. Demographic information, questions related to brain MRI prescription and its indications checklist were collected using study-specific data collection tools. The completed indications checklist was compared to the appropriateness status table of indications and scenarios to detect the percent of the appropriateness of prescriptions. Results: About 21 % of total brain MRI prescriptions are inappropriate. Previous treatment, number of referrals to physician, having other diagnostic tests and the applicant of MRI (P<0.01) had significant relationships with prescription appropriateness. The estimated financial burden of inappropriate brain MRIs in Shiraz teaching hospitals was 99988 US dollar in 2017. Conclusions: More than one-fifth of brains MRIs were inappropriate (i.e., prescriptions without medical indications). It caused about one hundred thousand United States Dollar (USD) financial burden which is 17 times of Iran's Gross Domestic Product (GDP) per capita. To better allocation of health system resources for provision of MRI services rationing policies for controlling consumer moral hazard and reducing provider induced demand can be helpful.
Background: Ectopic pregnancy is one of the most important causes of maternal mortality and infer... more Background: Ectopic pregnancy is one of the most important causes of maternal mortality and infertility that may impose many costs on patients. Today, Surgery and pharmaceutical treatments are the common methods of treating the disease. The aim of this study was to evaluate the cost-effectiveness of different methods of treating tubal ectopic pregnancy in the south of Iran.Methods: This study was an economic evaluation which analysed and compared the cost-effectiveness and cost-utility of three treatment methods, including single-dose methotrexate, double-dose methotrexate, and surgery in patients with tubal ectopic pregnancy. In this study, a decision tree model was used. The outcomes included in the model were the percentage of successful treatment and the average utility score of each treatment method. The study was conducted from the social perspective and a one-way and probabilistic sensitivity analysis was performed to measure the effects of uncertainty. The analysis of the co...
Background: Given the increasing availability of internet, it has become a common source of healt... more Background: Given the increasing availability of internet, it has become a common source of health information for all population including students. However, the actual effect of this increased access to information on the health status and its different aspects needs to be studied more. This study aimed to investigate the correlations between online health information seeking behavior and health related quality of life in a sample of high school students of Iran. Methods: A survey was conducted among secondary school girl students of Yazd province, Iran in 2019. A total of 295 students participated in the study. The required data were gathered using two valid questionnaires including eHIQ (Kelly et al., 2015) to measure the online health information seeking experience and validated Persian version of SF-36 to measure the health related quality of life. The collected data were analyzed through descriptive statistics and Pearson correlation coefficient using SPSS version 23. Results...
Background Healthcare settings are complex, and the decision-making process is usually complicate... more Background Healthcare settings are complex, and the decision-making process is usually complicated, too. Precise use of best evidence from different sources for increasing the desired outcomes is the result of EBM. Therefore, this study aimed to map the potential facilitators and barriers to EBM in health systems to help the healthcare managers to better implement EBM in their organizations. Methods The present study was a scoping review (SR) conducted in 2020 based on the integration of the frameworks presented by Arksey and O’Malley (2005) and Levac et al. (2010) considering the Joanna Briggs Institute guideline (2015). These frameworks consist of 6 steps. After finalizing the search strategy, 7 databases were searched, and the PRISMA-ScR was used to manage the retrieval and inclusion of the evidence. Microsoft Excel 2013 was used to extract the data, and the graphic description was presented. The summative analysis approach was used applying MAXQDA10. Results According to the sys...
Background: The hospital is a significant part of health systems that presents a complex and vita... more Background: The hospital is a significant part of health systems that presents a complex and vital services. Therefore, performance management of hospitals should be considered especially. BSC model is so helpful and popular for performance management. In using BSC, cause and effect relations is very important, since it helps to apply non-financial to forecast financial performance. Objectives: This study aims to analysis systematic relations between key indicators of hospital performance evaluation, identifying causal relations and prioritizing indicators. Methods: Based on the 4 perspectives described by the balanced scorecard (BSC), the evaluation indicators of hospital performance and key performance indicators (KPIs) were adopted from the related literature and selected by experts' panel, respectively. Then, the decision making trial and evaluation laboratory (DEMATEL) method was employed for the determination of the cause-and-effect relationships between the indicators, differentiation of the effective and significant factors, and construction of the strategy map to ameliorate hospital performance. Results: According to the BSC perspectives, 21 KPIs were selected for evaluation of hospital performance. The highest relationship was found between bed occupancy having the largest R + D value and other indicators, thus illustrating its fundamental role among the indicators. Clinical errors with the greatest value of R-D showed the strongest impacts on the other indicators and was thus named as the "main cause factor" among the indicators. In contrast, the percentage of patient satisfaction with the smallest R-D value was most strongly influenced by the other indicators and therefore, it was known as the "main effect factor" among the indicators. Conclusions: Assessment and improvement of the hospital performance is a complex and multi-dimensional activity. In order to have a powerful assessment system and success in improving hospital performance, instead of a single-dimension, it should be paying attention to all dimensions of performance.
This study aimed to estimate both direct medical and indirect costs of treating the Coronavirus d... more This study aimed to estimate both direct medical and indirect costs of treating the Coronavirus disease 2019 (COVID-19) from a societal perspective in the patients at a referral hospital in Fars province as well as the economic burden of COVID-19 in Iran in 2020.Methods:This is a partial economic evaluation and a cross-sectional cost-description study conducted descriptively-analytically and based on the data of the COVID-19 patients referred to a referral university hospital in Fars province between March and July 2020. The data were collected by examining the patients' records and accounting information systems. The subjects included all the inpatients with COVID-19 (477 individuals) who admitted to the medical centre during the four months. Bottom-up costing, incidence-based and income-based human capital approaches were used as the main methodological features of this study.Results: The mean direct medical costs were estimated 28,240,025,968 Rials ($ 1,791,172) in total and ...
Background: Scientific evidence is the basis for improving public health; decision-making without... more Background: Scientific evidence is the basis for improving public health; decision-making without sufficient attention to evidence may lead to unpleasant consequences. Despite efforts to create comprehensive guidelines and models for evidence-based decision-making (EBDM), there isn`t any to make the best decisions concerning scarce resources and unlimited needs. The present study aimed to develop a comprehensive applied framework for EBDM. Methods: This was a meta-synthesis including two phases of a Scoping Review (SR) and a Best-Fit Framework (BFF) synthesis conducted in 2019. A scoping review was done for the comprehensive review of the existing published studies in this area. The six-stage approach of Arksey and O’Malley was applied. Six main databases including PUBMED, Scopus, Web of Science, Science Direct, EMBASE, and ProQuest were searched using related keywords. Data were extracted and analyzed via thematic analysis. Results of the scoping review were then synthesized to ach...
Introduction: HIV infection is one of the main public health problems in the world. This study ai... more Introduction: HIV infection is one of the main public health problems in the world. This study aimed to assess the knowledge and attitudes of young couples married in the city of Shiraz, and eventually suggest an Operational Program for the prevention of HIV in Iran. Method: the data collection tool was a questionnaire consisted of 32 questions on transmission and prevention of HIV infection. The young couples were selected through simple random sampling, and the sample size was The data analysis was performed using SPSS 19 software. Results: Of the total of 400 cases, 201 (50.25%) were male and 199 (49.75%) were female. The mean age of the couples was 25.96±5.95 years. The most frequent correct answer was related to the knowledge of transmission through sharing needles among drug users (87.4%). Regarding attitude, 94.6% of the subjects agreed with the struggle against HIV. Examining the relationship between knowledge and age showed that they had a significant relationship (P=0.0...
Background: Although all jobs can be stressful, occupational stress is an important issue in jobs... more Background: Although all jobs can be stressful, occupational stress is an important issue in jobs that deal with human health. Evidence indicates that nursing is a stressful occupation. Objective: This research evaluated factors affecting occupational stress and strategies for coping with it. Methods: This cross-sectional descriptive-analytic study was conducted in 2015. The study population comprised all nurses at Shahid Rajaee hospital, from whom 190 nurses were selected by random sampling. Data was collected by questionnaire and analyzed using SPSS software (version 19), Pearson correlation coefficient tests, Mann-Whitney tests, and t tests. Results: Occupational stress was rated as moderate among the studied nurses. Significant positive correlations were found between occupational stress level and less effective coping method, occupational stress level and work experience level, and ineffective coping methods and age. Moreover, a significant difference was seen between men and women in terms of emotion-focused coping. Conclusion: According to the research findings, occupational stress was at a moderate level among the studied hospital nurses, indicating that the authorities need to focus on efforts to reduce occupational stress for nurses.
Quarterly Journal of Management Strategies in Health System
Background: The optimal use of research findings is crucial. One of the activities that improves ... more Background: The optimal use of research findings is crucial. One of the activities that improves application of research-derived knowledge is the knowledge translation. This study aimed to investigate the status of knowledge translation in Shiraz University of Medical Sciences. Methods: This cross-sectional and descriptive-analytical study was conducted in 2018. The sample size included 143 faculty members of Shiraz University of Medical Sciences selected using the stratified sampling and simple random sampling methods. The required data were collected using a standard knowledge translation questionnaire consisting of 50 items in 4 dimensions. The validity and reliability of the questionnaires were confirmed in the previous studies. The collected data were analyzed using SPSS 21 by descriptive and analytical statistics. Results: The results showed that overall status of the knowledge translation was weak (2.46 ± 0.67). In this regard, producing useful evidence for decision making (2...
Complementary health insurance is a means to decrease outof-pocket expenses and increase health s... more Complementary health insurance is a means to decrease outof-pocket expenses and increase health service utilizations in the world. The amount of service utilization after covering by complementary health insurance is related to the socioeconomic and cultural factors of each country. →What this article adds: Complementary health insurance in Iran did not change outof-pocket expenses because people did not change the share of health care expenses in the family budget, and they decided to use more health care services instead.
Background: There are various criteria and methods to develop Basic Health Benefit Package (BHBP)... more Background: There are various criteria and methods to develop Basic Health Benefit Package (BHBP) in world health systems. The present study aimed to extract criteria used in health systems in different countries around the world using scoping review method. Methods: A systematic search was carried out in Cochrane Library, PubMed, Scopus, Science Direct, Web of Science, ProQuest, World Bank, World Health Organization, and Google databases between January and April 2016. Papers and reports were gathered according to selected keywords and were examined by two authors. Finally, the criteria were extracted from the selected papers. Results: The primary search included 8876 papers. After studying the articles' titles, abstracts, and full texts, 9 articles and 14 reports were selected for final analysis. After the final analysis, 19 criteria were extracted. Due to diversity of criteria in terms of number and nature, they were divided into three categories. The categories included intervention-related criteria, disease-related criteria, and community-related criteria. The largest number of criteria belonged to the first category. Indeed, the most widely applied criteria included cost-effectiveness (20), effectiveness (19), budget impact (12), equity (12), and burden of disease (10). Conclusion: According to the results, different criteria were identified in terms of number and nature in developing BHBP in world health systems. It seems that certain criteria, such as cost-effectiveness, effectiveness, budget impact, burden of disease, equity, and necessity, that were most widely utilized in countries under study could be for designing BHBP with regard to social, cultural, and economic considerations.
The number of outsourcing contracts continues to rise. Outsourcing is one of the strategic tools ... more The number of outsourcing contracts continues to rise. Outsourcing is one of the strategic tools in healthcare administrations for cost saving and quality improvement. The outsourcing decision is complex with many factors involved. →What this article adds: This study identified the key factors affecting decision making on outsourcing services in Iran's health system for the first time, which can help to make the right decision for outsourcing health services in Iran and other countries.
A common method used to examine the relationship between internal preferences and caring external... more A common method used to examine the relationship between internal preferences and caring externalities is willingness to pay (WTP) approach. We aimed to estimate WTP for health status with different severity level and identify determinant factors on WTP. For determining main factors in WTP, a cross-sectional study was conducted in Shiraz in the southeast of Iran, in March to April 2015. The open-ended method was used to estimate monthly WTP in private and altruistic section. Multivariate regression analyses using ordinary least squares were applied to examine the effect of Scio-demographic factors on WTP using SPSS software 21. Participants were willing to pay an average amount of $ 295 in health status 1 and an average amount of $ 596 in health status 6 (worst status) for internal preferences. Altruistic WTP for health status 1 was $ 294 and participants were willing to pay an average amount of $ 416 in health status 6. Multiple regression analysis identified monthly income as the ...
Background: Health workforce distribution is so important in access posture, coverage and equity.... more Background: Health workforce distribution is so important in access posture, coverage and equity. Following millennium development goals (MDGs), special attention to health workforces in relation with maternal and child health is required. Objective: The aim of the current study was to determine distribution of maternal and child health related workforces in Iran during 2010-2012, using inequality measures. Methods: In this cross-sectional study, data about the number of physicians and midwives obtained from Ministry of Health reports and demographic statistics were obtained from the Statistical Center of Iran. Gini coefficient and Robin Hood index were calculated in terms of population ratio, need adjusted index for birth (NAIB) and need adjusted index for mortality (NAIM). For calculations, DAD software version 4.6 was used. Results: Gini coefficient was reduced for general physicians (GPs) and pediatricians, and had increasing and decreasing trends for gynecologists. For achieving equality within provinces, the number of transferable health workforces was more than 1 person per 10 health workforces. Conclusion: Health workforce distribution had various trends in Iran. Special attention to deprived provinces is required. Most of the reduction in Gini coefficient is due to the increase in health workforce in developing provinces, and deprived provinces still have serious problems. The health system could achieve better equality by considering deprived provinces and using Gini coefficient and Robin Hood index together.
The importance of health indicators in the recent years has created challenges in resource alloca... more The importance of health indicators in the recent years has created challenges in resource allocation. Balanced and fair distribution of health resources is one of the main principles in achieving equity. The goal of this cross-sectional descriptive study, conducted in 2010, was to classify health structural indicators in the Fars province using the scalogram technique. Health structural indicators were selected and classified in three categories; namely institutional, human resources, and rural health. The data were obtained from the statistical yearbook of Iran and was analyzed according to the scalogram technique. The distribution map of the Fars province was drawn using ArcGIS (geographic information system). The results showed an interesting health structural indicator map across the province. Our findings revealed that the city of Mohr with 85 and Zarindasht with 36 had the highest and the lowest scores, respectively. This information is valuable to provincial health policymak...
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