نقش و جایگاه مهندسی ارزش در نظام سلامت در 20 سال اخیر (سالهای 1996تا 2016)
الموضوعات :زین العابدین روحانی 1 , حامد کاظمی پور 2 , سیدعلیرضا میرمحمد صادقی 3 , محمد فلاح 4
1 - دانشجوی دکترای مهندسی صنایع، واحد تهران مرکز، دانشگاه آزاد اسلامی، تهران، ایران
2 - استادیار، گروه مهندسی صنایع، واحد تهران مرکز، دانشگاه آزاد اسلامی، تهران، ایران
3 - استادیار، گروه مهندسی صنایع، دانشگاه امام حسین (ع)، تهران، ایران
4 - دانشیار، گروه مهندسی صنایع، واحد تهران مرکز، دانشگاه آزاد اسلامی، تهران، ایران
الکلمات المفتاحية: هزینههای بیمارستانی, مهندسی ارزش, نظام سلامت, آنالیز ارزش, بیمارستان,
ملخص المقالة :
مقدمه: مهندسی ارزش، که در صنعت بهداشت و درمان با نام آنالیز ارزش شناخته میشود، امروزه به ابزاری استراتژیک برای کاهش هزینههای سازمان در زمینه خرید و چرخه ارزش مواد تبدیل شده است. با بهرهگیرى از مهندسى ارزش میتوان به صورت گام به گام، فرصتهاى مطلوب و موانع موجود را شناسایى کرده و به بهبود عملکرد وکاهش هزینه و صرفهجویى در منابع و امکانات دست یافت. در حقیقت در مطالعات مهندسی ارزش تلاش می شود هزینههای غیرضروری طرح، شناسایی شده و با تشویق خلاقیت و همافزایی کارشناسان در کارگاههای مهندسی ارزش راه حلهای خلاقانه برای حداقل کردن هزینههای غیرضروری و ارتقاى کارکرد خدمات مورد نظر ارائه گردد. این تحقیق به منظور شناخت و تعیین کاربردهای مهندسی ارزش در نظام سلامت صورت گرفته است. روش پژوهش: مطالعه حاضر از نوع مروری بوده که مقالات و گزارشهای مطالعه مهندسی ارزش در بین سالهای 1996 تا 2016 در سایتها و پایگاه علمی دادههای آنلاین، کتب، نشریات و کنفرانس های داخلی و خارجی در زمینه مهندسی ارزش با استفاده از کلید واژههای مختلفی از جمله: بیمارستان، بهداشت و درمان، مهندسی ارزش، آنالیز ارزش به جستجو پرداختهایم. در این مطالعه ابتدا کارایی سیستم مهندسی ارزش در جهان و ایران را بررسی نموده و پس از آن کارایی مهندسی ارزش در نظام سلامت در جهان و ایران را مورد بررسی قرار دادهایم. یافتهها: در مدت 7 سال اجرای این تکنیک در مراکز درمانی آمریکا، توانستند نسبت به سیستمهای قبلی تا 11 برابر بیشتر صرفهجویی داشته باشند و صرفهجویی در پروژههای بهداشت و درمان از 10000 دلار به بالاست. این تکنیک میتواند به عنوان یک ابزار استراتژیک در سازمان عمل نموده و در استفاده بهینه از منابع و کاهش هزینهها به خصوص در بخش سلامت نقش مؤثری داشته باشد. بیش از 95 درصد از مطالعات مهندسی ارزش در ایران در زمینههای تولیدی و عمرانی بوده و کمتر به مقوله مهندسی ارزش در بخش خدمات و به خصوص نظام سلامت پرداخته شده است. نتیجهگیری: بکارگیری آنالیز ارزش یا مهندسی ارزش در بهداشت و درمان موثر بوده و میتواند به ابزاری مدیریتی برای کاهش هزینهها و بهبود کیفیت تبدیل و تمرکز سازمان را به سمت حیاتی ترین نواحی هدایت کند.
1- Aspen Healthcare Metrics. Value Analysis101: How to Construct a Solid Foundation for Changee; 2005.
2- Azadi H and Goudarzi Gh. The system of financing the health sector and challenges in developing countries, health services management students Conference, Shiraz; May 2007. [Persian]
3- Asefzadeh, S. Medical education and health services; Scientific and Cultural Publications, Tehran; 1997.
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5- Mehrara H. The Relationship between health costs and economic growth in the Middle East and North Africa [MENA], Journal of Health Management, Volume 12 / Issue 35/ Spring World Bank. World Development Report. Washington: World Bank Press; 2005. [Persian]
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13- Orr, Tom P.E. A Value Analysis Approach to Healthcare Revenue improvement, Georgia Institute of Technology; 2010.
14- Rouhani AM, khayat Ardestani SS. Value engineering applications in transportation, Third National Conference on Value Engineering, Tehran University, Faculty of Engineering, 2009. [Persian]
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16- Ghergherehchi M. A model of value engineering establishment in Iran Power Development Company, Third National Conference on Value Engineering, Tehran University, Faculty of Engineering, Azar 2008. [Persian]
17- Maki M. Value Engineering Bridge Construction Project, the Third National Conference on Value Engineering, Tehran University, Faculty of Engineering, Azar 2010. [Persian]
18- darehshire MR. Empowerment of project management through value engineering methodology [Case Study defense industry, the third National Conference on Value Engineering, Tehran University, Faculty of Engineering, Azar 2008. [Persian]
19- Khayat Ardestani SS. Value engineering applications in transportation, Third National Conference on Value Engineering, Tehran University, Faculty of Engineering, Azar 2008. [Persian]
20- Mohammadi, S. The application of value engineering in the design and implementation of housing projects and buildings with an emphasis on the application of value engineering in the design process and construction of housing, the third National Conference on Value Engineering, Tehran University, Faculty of Engineering, Azar 2008. [Persian]
21- Navedan K. Reviews proposed changes to the way their projects, value engineering, the third national conference on value engineering, Tehran University, Faculty of Engineering, Azar 2008. [Persian]
22- Qamarnya H. Value Engineering on optimization of irrigation and drainage network Santa conductor Qasr-e Shirin, the third National Conference on Value Engineering, Tehran University, Faculty of Engineering, Azar 2008. [Persian]
23- Karamoze, M. Evaluation of the sustainability of water resources development projects with a value engineering approach, the Third National Conference on Value Engineering, Tehran University, Faculty of Engineering, Azar 2008. [Persian]
24- Ministry of Transportation [mava]. Available http://www.mava.ir/2806/may2014 [Persian]
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26- Abgheneh M. Implementation of value engineering to reduce energy in cement plants. Case Study: Cement West, the eighth National Conference on Energy, Tehran, Islamic Republic of Iran National Energy Committee; 2011. [Persian]
27- Hesami S. Enjoying the diversion tunnel, dam design, value engineering review Haraz, the first Asian Conference and the Ninth National Conference for Sustainable Development tunnel underground spaces, Tehran Olympic Hotel Conference Center, Persian date, Aban 2011. [Persian]
28- Boroujerdi M. Value engineering in airport master plans, the Third National Conference on Value Engineering, Tehran University, Faculty of Engineering, Azar 2009. [Persian]
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31- Falah Rastegar A. Need for value engineering studies in projects of irrigation and drainage networks, the twelfth Conference of the National Committee on Irrigation and Drainage, Tehran; 2010. [Persian]
32- Sarang M. Value Engineering on the optimization of waste management Case Study: Industrial Complex waste management (2) Mashhad Municipality, the Fifth National Conference on Value Engineering, University of Tehran, November 2015. [Persian]
33- Alam Tabriz A & Munire MR. Applying value engineering approach fuzzy MADM to performance improvement project in mechanical wave tower project Sadaf town, Journal of Management, School of Management, Tehran University, 2011; 3(6). [Persian]
34- Abbas A. Select the type of pipe for irrigation and drainage network Sahand with value engineering approach and multi-criteria decision, the Fifth National Conference on Value Engineering, Tehran, November 2015. [Persian]
35- Azher HR & Haji Mohammad M. Proposed changes to the way in project value engineering, Isfahan, Shiraz third piece freeway, the Fifth National Conference on Value Engineering, Tehran, November 2015. [Persian]
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38- Abdollahi A. Proposed changes to the way the system value management, value engineering, value Engineering Conference, Tehran, January 2010. [Persian]
39- Shayanfar M. The study of urban rail project value engineering case study, value engineering is the second national conference, Tehran, Iran University of Science and Technology, Industrial Engineering, 2005.
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48- Slamtyan MS. Revie value engineering, undergraduate thesis, Yazd, 2008[Persian]
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50- Tady Bani Z. Using value engineering process improvement and quality in manufacturing pipes used in oil and gas lines, the National Conference of value engineering and cost management, Tehran, Institute for designers, gamers, reference value engineering knowledge; 2014. [Persian]
51- Rezapour H & Hussein F. Performance indicators to evaluate the cost of hospital bed days in hospitals of Iran University of Medical Sciences, 2004, Journal of management and medical informatics, Year Issue seventeenth; 2004. [Persian]
52- Donald SH. Analysis of hospital costs, translation A. sustainable oath Publications, Tehran; 1998. [Persian]
53- Haghparast H. Estimate the production function of public hospitals of Iran University of Medical Sciences during 2002-1998, Master of Science, University of Medical Sciences, School of Management and Medical Information; 2002. [Persian]
54- Nahid H. Compare the cost - effectiveness of general teaching hospitals of Shiraz in the second 6 months of 1993, MSc thesis, University of Medical Sciences, School of Management and Medical Information, Iran, 2001[Persian]
55- Ebadifardazar F. Check the status of hospital bed-day cost and performance indicators in selected hospitals of Iran University of Medical Sciences, Journal of Health Management, 2014; 7(18). [Persian]
56- Rouhani ZA & Mirbhadr Quli A. Value Engineering on improving outpatient admissions process, the Seventh International Conference on Industrial Engineering, Isfahan, Iran Institute of Industrial Engineering, University of Technology; 2010.
57- Jabal amali, Mir Mohammad Sadeghi SA. Role in achieving the goals of the project value engineering, value engineering and Cost Management Conference, Tehran, Institute for designers, gamers, reference value engineering knowledge; 2014.
58- Gulshan M & Rihani SM. Performance analysis value engineering, in the power industry, the third National Conference on Value Engineering, Iran, Tehran, 2010. [Persian]
59- Naserian SM & Jafarpoor A. A Critical study of Rahvshhrsazy a decade of experience in value engineering and development strategies, the Third National Conference on Value Engineering; 2010.
60- Jabalameli MS & Mir Mohammad Sadeghi SA. The use of value engineering in power plant projects (beyond the pattern of saving costs), the first national conference hydro power plants, Tehran, Iran Water and Power Resources Development Company; 2003.
61- Jakyal A. The industry and academia in the implementation of value engineering, devise magazine, May 2010.
62- Panahi R & Khsrqy Nasser H. The application of risk management and value engineering in ports, while emphasizing the study of two successful examples, the second International Conference on Advances Research in Rmran, Architecture and Urban Management, Tehran; 2016.
63- Medghalchi A, Sadeghi A & Mir Mohammad Sadeghi SA. The combined value engineering and total quality management in order to optimize development projects, the Seventh International Conference of Quality Managers, Tehran, international conferences meeting; 2006.
64- Zarabad S. Role in reducing the cost of the project life cycle Value Engineering) Case Study: Engineering projects worth a combined cycle power plant auxiliary equipment), the National Conference of value engineering and cost management, Tehran; 2014.
_||_1- Aspen Healthcare Metrics. Value Analysis101: How to Construct a Solid Foundation for Changee; 2005.
2- Azadi H and Goudarzi Gh. The system of financing the health sector and challenges in developing countries, health services management students Conference, Shiraz; May 2007. [Persian]
3- Asefzadeh, S. Medical education and health services; Scientific and Cultural Publications, Tehran; 1997.
4- http://www.bornanews.ir/282206/dec2015 [Persian]
5- Mehrara H. The Relationship between health costs and economic growth in the Middle East and North Africa [MENA], Journal of Health Management, Volume 12 / Issue 35/ Spring World Bank. World Development Report. Washington: World Bank Press; 2005. [Persian]
6- Webda "Ministry of Health / health reform plan," the beginning of the path to optimal health system" available www.webda.ir/2016. [Persian]
7- Web site of the Supreme Leader, the overall health policy, issued by the Supreme Leader, 2.10 Persian date, Farvardin 2014. [Persian]
8- Mehrara H. The relationship between health costs and economic growth in the Middle East and North Africa [MENA], Journal of Health Management, Volume 12 / Issue 35/ Spring World Bank. World Development Report. Washington: World Bank Press; 2005. [Persian]
9- Ghazezadeh hashemi H. Personal website Minister of Health and Medical Education.Available http://www.hhashemi.com/fa [Persian]
10- Care services management/archive .Health system in Iran and the world/Available http://hcsm.ir/ Health./2013. [Persian]
11- VE.concept and definition-misronet website, available at: www.Misronet.com [Persian]
12- Ezedshnas AM, farzanegan begdeli H. An overview of lean thinking and value engineering, value engineering community, 2011. [Persian]
13- Orr, Tom P.E. A Value Analysis Approach to Healthcare Revenue improvement, Georgia Institute of Technology; 2010.
14- Rouhani AM, khayat Ardestani SS. Value engineering applications in transportation, Third National Conference on Value Engineering, Tehran University, Faculty of Engineering, 2009. [Persian]
15- Emami K, Esmaeili R. Comprehensive implementation key to applying effective and efficient Engineering Case Study: master plan Kymyab Khuzestan, the Fifth National Conference on Value Engineering, Tehran University, October 2015. [Persian]
16- Ghergherehchi M. A model of value engineering establishment in Iran Power Development Company, Third National Conference on Value Engineering, Tehran University, Faculty of Engineering, Azar 2008. [Persian]
17- Maki M. Value Engineering Bridge Construction Project, the Third National Conference on Value Engineering, Tehran University, Faculty of Engineering, Azar 2010. [Persian]
18- darehshire MR. Empowerment of project management through value engineering methodology [Case Study defense industry, the third National Conference on Value Engineering, Tehran University, Faculty of Engineering, Azar 2008. [Persian]
19- Khayat Ardestani SS. Value engineering applications in transportation, Third National Conference on Value Engineering, Tehran University, Faculty of Engineering, Azar 2008. [Persian]
20- Mohammadi, S. The application of value engineering in the design and implementation of housing projects and buildings with an emphasis on the application of value engineering in the design process and construction of housing, the third National Conference on Value Engineering, Tehran University, Faculty of Engineering, Azar 2008. [Persian]
21- Navedan K. Reviews proposed changes to the way their projects, value engineering, the third national conference on value engineering, Tehran University, Faculty of Engineering, Azar 2008. [Persian]
22- Qamarnya H. Value Engineering on optimization of irrigation and drainage network Santa conductor Qasr-e Shirin, the third National Conference on Value Engineering, Tehran University, Faculty of Engineering, Azar 2008. [Persian]
23- Karamoze, M. Evaluation of the sustainability of water resources development projects with a value engineering approach, the Third National Conference on Value Engineering, Tehran University, Faculty of Engineering, Azar 2008. [Persian]
24- Ministry of Transportation [mava]. Available http://www.mava.ir/2806/may2014 [Persian]
25- Azeri M. Performance management and value engineering techniques in the desalination industry Qeshm, Proceedings of the Fifth National Conference on Value Engineering, Tehran University, October 2015. [Persian]
26- Abgheneh M. Implementation of value engineering to reduce energy in cement plants. Case Study: Cement West, the eighth National Conference on Energy, Tehran, Islamic Republic of Iran National Energy Committee; 2011. [Persian]
27- Hesami S. Enjoying the diversion tunnel, dam design, value engineering review Haraz, the first Asian Conference and the Ninth National Conference for Sustainable Development tunnel underground spaces, Tehran Olympic Hotel Conference Center, Persian date, Aban 2011. [Persian]
28- Boroujerdi M. Value engineering in airport master plans, the Third National Conference on Value Engineering, Tehran University, Faculty of Engineering, Azar 2009. [Persian]
29- Hosseini T. Value Engineering in Kermanshah Absheron river improvement plan, the Fifth National Conference on Value Engineering, Tehran University, October 2015. [Persian]
30- salahshor J. Great value engineering on the project siphon Karkhe National Conference of irrigation and drainage networks, Shahid Chamran University, Faculty of Water Sciences, May 2008. [Persian]
31- Falah Rastegar A. Need for value engineering studies in projects of irrigation and drainage networks, the twelfth Conference of the National Committee on Irrigation and Drainage, Tehran; 2010. [Persian]
32- Sarang M. Value Engineering on the optimization of waste management Case Study: Industrial Complex waste management (2) Mashhad Municipality, the Fifth National Conference on Value Engineering, University of Tehran, November 2015. [Persian]
33- Alam Tabriz A & Munire MR. Applying value engineering approach fuzzy MADM to performance improvement project in mechanical wave tower project Sadaf town, Journal of Management, School of Management, Tehran University, 2011; 3(6). [Persian]
34- Abbas A. Select the type of pipe for irrigation and drainage network Sahand with value engineering approach and multi-criteria decision, the Fifth National Conference on Value Engineering, Tehran, November 2015. [Persian]
35- Azher HR & Haji Mohammad M. Proposed changes to the way in project value engineering, Isfahan, Shiraz third piece freeway, the Fifth National Conference on Value Engineering, Tehran, November 2015. [Persian]
36- Akbari D. A means to reduce costs and increase productivity value engineering, Fifth National Conference value engineering of Tehran, November 2015. [Persian]
37- Ashor A. Value Engineering Construction Project training Rfahy- set in a typical company, the third National Conference on Value Engineering, Tehran, December 2010. [Persian]
38- Abdollahi A. Proposed changes to the way the system value management, value engineering, value Engineering Conference, Tehran, January 2010. [Persian]
39- Shayanfar M. The study of urban rail project value engineering case study, value engineering is the second national conference, Tehran, Iran University of Science and Technology, Industrial Engineering, 2005.
40- Mahtab DG & Nayebi Erfan H. Case Study Workshop on E-132 400 kV Khorramshahr value engineering, the third national conference value engineering, Tehran, value engineering, engineering management tel optimization Tehran University, 2010. [Persian]
41- SVAH, Strategic Value Analysis in Healthcare. Available www. SVAH.com
42- Savanneh district services, Available www.sas.usace.army.mil
43- Yokl Robert T. Are you sure you're realty practicing value analysis or are you doing something else and simply calling it that? Healthcare Purchasing New, 2006.
44- Value Management in Healthcare. www.value-eng.org.
45- Saydi AR. Introduction to value engineering, Proceedings of the club 6m, 2007 available: www.sheshmim.com. [Persian]
46- AHVAP introduction brochure, Available www.ahvap.org.
47- Zulghadir H. The new tool of value engineering, value engineering challenge, Journal of Industrial Engineers, Proceedings, December 2006.
48- Slamtyan MS. Revie value engineering, undergraduate thesis, Yazd, 2008[Persian]
49- Jabalameli Mohammad Saeed, the Value Engineering in Project Management, Management and Planning Organization Publishing, Printing, 2004. [Persian]
50- Tady Bani Z. Using value engineering process improvement and quality in manufacturing pipes used in oil and gas lines, the National Conference of value engineering and cost management, Tehran, Institute for designers, gamers, reference value engineering knowledge; 2014. [Persian]
51- Rezapour H & Hussein F. Performance indicators to evaluate the cost of hospital bed days in hospitals of Iran University of Medical Sciences, 2004, Journal of management and medical informatics, Year Issue seventeenth; 2004. [Persian]
52- Donald SH. Analysis of hospital costs, translation A. sustainable oath Publications, Tehran; 1998. [Persian]
53- Haghparast H. Estimate the production function of public hospitals of Iran University of Medical Sciences during 2002-1998, Master of Science, University of Medical Sciences, School of Management and Medical Information; 2002. [Persian]
54- Nahid H. Compare the cost - effectiveness of general teaching hospitals of Shiraz in the second 6 months of 1993, MSc thesis, University of Medical Sciences, School of Management and Medical Information, Iran, 2001[Persian]
55- Ebadifardazar F. Check the status of hospital bed-day cost and performance indicators in selected hospitals of Iran University of Medical Sciences, Journal of Health Management, 2014; 7(18). [Persian]
56- Rouhani ZA & Mirbhadr Quli A. Value Engineering on improving outpatient admissions process, the Seventh International Conference on Industrial Engineering, Isfahan, Iran Institute of Industrial Engineering, University of Technology; 2010.
57- Jabal amali, Mir Mohammad Sadeghi SA. Role in achieving the goals of the project value engineering, value engineering and Cost Management Conference, Tehran, Institute for designers, gamers, reference value engineering knowledge; 2014.
58- Gulshan M & Rihani SM. Performance analysis value engineering, in the power industry, the third National Conference on Value Engineering, Iran, Tehran, 2010. [Persian]
59- Naserian SM & Jafarpoor A. A Critical study of Rahvshhrsazy a decade of experience in value engineering and development strategies, the Third National Conference on Value Engineering; 2010.
60- Jabalameli MS & Mir Mohammad Sadeghi SA. The use of value engineering in power plant projects (beyond the pattern of saving costs), the first national conference hydro power plants, Tehran, Iran Water and Power Resources Development Company; 2003.
61- Jakyal A. The industry and academia in the implementation of value engineering, devise magazine, May 2010.
62- Panahi R & Khsrqy Nasser H. The application of risk management and value engineering in ports, while emphasizing the study of two successful examples, the second International Conference on Advances Research in Rmran, Architecture and Urban Management, Tehran; 2016.
63- Medghalchi A, Sadeghi A & Mir Mohammad Sadeghi SA. The combined value engineering and total quality management in order to optimize development projects, the Seventh International Conference of Quality Managers, Tehran, international conferences meeting; 2006.
64- Zarabad S. Role in reducing the cost of the project life cycle Value Engineering) Case Study: Engineering projects worth a combined cycle power plant auxiliary equipment), the National Conference of value engineering and cost management, Tehran; 2014.