Journal of healthcare management: 22 (4)

Open Access Article

1 - An Evaluate of status the Internal Controls system in Educational-Remedial Hospitals of Tehran City After the Implementation of Modern Financial System
Razeyeh Alikhani mehdi Maranjory Noshin Joz Khlil poor

Introduction: The presence of internal control systems leads to an increase of efficiency, reduction of property loss risk levels, achieving the logical assurance in financial statement’ trust factors, and complying with laws and regulations. Internal control mech More

Introduction: The presence of internal control systems leads to an increase of efficiency, reduction of property loss risk levels, achieving the logical assurance in financial statement’ trust factors, and complying with laws and regulations. Internal control mechanisms should be identified as the necessary component of each system which management uses to regulate and guide the activities not as a separate mechanism in an executive body. This paper aims, above all, to evaluate the functioning of Educational- Remedial hospitals in the city of Tehran regarding the use of internal control systems.  Methods: The data for this survey research were acquired through distribution of questionnaire among 107 employees of financial sector in the Educational-Remedial Hospitals of Tehran City. Using the statistical methods of Binomial and One-sample Tests, the data were analyzed to test the hypotheses. Results: Due to the significant threshold test is 0/001 and 0/05 is less than the average calculated (3/500), the average abstention (3), more (H1: μ> 3). Therefore, the implementation of new financial systems, internal control system hospitals - of Tehran, the level is satisfactory. Conclusion: Thefindings of the current study, demonstrate that the degree of familiarity of employees of financial sector in the Educational-Remedial Hospitals of Tehran was tap. To that after implementing the modern financial system, internal controls system possess acceptable level. Introduction: The presence of internal control systems leads to an increase of efficiency, reduction of property loss risk levels, achieving the logical assurance in financial statement’ trust factors, and complying with laws and regulations. Internal control mechanisms should be identified as the necessary component of each system which management uses to regulate and guide the activities not as a separate mechanism in an executive body. This paper aims, above all, to evaluate the functioning of Educational- Remedial hospitals in the city of Tehran regarding the use of internal control systems. Methods: The data for this survey research were aquired through distribution of questionnaire among 107 employees of financial sector in the Educational-Remedial Hospitals of Tehran City. Using the statistical methods of Binomial and One-sample Tests, the data were analyzed to test the hypotheses.Results: The results of the study show that after implementing the modern financial system, internal control system of Tehran’s Educational- Remedial hospitals possess acceptable level.Conclusion: The findings of the current study, demonstrate that the degree of familiarity of employees of financial sector in the Educational-Remedial Hospitals of Tehran was tap. Whih that after implementing the modern financial system, internal controls system possess acceptable level. Manuscript profile

Open Access Article

2 - Survey of the Causes and Solutions to Reduce Defensive Medicine in View of Residents in Mashhad University of Medical Sciences in 2016
Hossein Forati Zahra Mahdiyan

Introduction: Having sufficient and expert Staffing in in health systems, is a key factors in improving the quality of services to citizens. Also, the shortage of human resource in this field may impose costs on the health system and society. Thus, this research aims at More

Introduction: Having sufficient and expert Staffing in in health systems, is a key factors in improving the quality of services to citizens. Also, the shortage of human resource in this field may impose costs on the health system and society. Thus, this research aims at determining the Staffing Need in Pathology of Semnan University of Medical Sciences through WISN. Methods: Research method based on purpose was applied and data collection was descriptive- survey and WISN. The population includes all laboratorial processes in Semnan’ Patholog in which from 85 processes, 72 were selected as samples. Using WISN, the amount of work and standard time were selected as variables. Then, the new situation was compared with the real one and the differences were analyzed and reported. The research data were gathered through prepared time study form and direct observation. Results: According to the results, currently 14 experts and one secretary are working in Semnan’ Patholog. Comparing this real amount with the calculated one reveals that the average is 18.89 in the best situation is 18.05, in the worst situation is 19.76. Conclusion: The staff in the Pathology of Semnan University of MedicalSciences where study was conducted are constantly under pressure to match the existing workload due to shortage of manpower. Appropriate human resources management and planning can contribute greatly to the improvement of efficiency of their work by ensuring optimum workload. Introduction: Having sufficient and expert Staffing in in health systems, is a key factors in improving the quality of services to citizens. Also, the shortage of human resource in this field may impose costs on the health system and society. Thus, this research aims at determining the Staffing Need in Pathology of Semnan University of Medical Sciences through WISN. Methods: Research method based on purpose was applied and data collection was descriptive- survey and WISN. The population includes all laboratorial processes in Semnan’ Patholog in which from 85 processes, 72 were selected as samples. Using WISN, the amount of work and standard time were selected as variables. Then, the new situation was compared with the real one and the differences were analyzed and reported. The research data were gathered through prepared time study form and direct observation. Results: According to the results, currently 14 experts and one secretary are working in Semnan’ Patholog. Comparing this real amount with the calculated one reveals that the average is 18.89( in the best situation is 18.05, in the worst situation is 19.76. Conclusion: The staff in the Pathology of Semnan University of Medical Sciences where study was conducted are constantly under pressure to match the existing workload due to shortage of manpower. Appropriate human resources management and planning can contribute greatly to the improvement of efficiency of their work by ensuring optimum workload. Manuscript profile

Open Access Article

3 - Offering and Testing a Model to Explain the Physician Induced Demand in Iran
Abvalqasem Golkhandan Elaham Fatholahi

Introduction: According to the physician induced demand hypothesis, health care demand may be due to asymmetric information in health market, is influenced by the behavior of health suppliers. This study first assumes that the number of physician reduced health expendit More

Introduction: According to the physician induced demand hypothesis, health care demand may be due to asymmetric information in health market, is influenced by the behavior of health suppliers. This study first assumes that the number of physician reduced health expenditures, because of the increase the supply of health. But to achieve a specified level of physician, called threshold level, because of the physician induced demand hypothesis, competition between physicians, is leading to an increase in health spending. So, the major aim of this study is to evaluate the U shape hypothesis between the number of physicians and health expenditures in Iran. Methods: This study using time series data for 1971-2013, is investigated the possible non-linear relationship between per capita health expenditure (dependent variable), per capita physician (independent variable) and mortality rate (controlled variable). For this purpose, is used the Logistic Smooth Transition Regression (LSTR) model. Also, the statistical analyzes were performed using the EXCEL, EVIEWS and JMALTI soft wares. Results: The results of the model LSTR, in addition to confirm the nonlinear effects of per capita physician on per capita health expenditure, show that the per capita physician per 10,000 population, influence on the per capita health expenditure in the form of two regime structure with threshold level about of 12.24. So that, in the first regime, per capita physician had a negative impact on per capita health expenditure (disapproval the induced demand hypothesis), but this impact is positive in the second regime (confirm the induced demand hypothesis). So, U-shaped impact hypothesis of per capita physician on per capita health expenditure in Iran, is not rejected. Conclusion: Since at the moment the physician per capita per 10,000 population, is most of the threshold level, the country is located in the second regime. Accordingly, adopt more suitable policies to prevent from the induction of demand by physicians, is necessary. Introduction: This study first assumes that the number of physician reduced health expenditures, because of the increase the supply of health. But to achieve a specified level of physician, called threshold level, because of the physician induced demand hypothesis, competition between physicians, is leading to an increase in health spending. So, The major aim of this study is to evaluate the U shape hypothesis between the number of physicians and health expenditures in Iran.Methods: This study using time series data for 1971-2013, is investigated the possible non-linear relationship between per capita health expenditure (dependent variable), per capita physician (independent variable) and mortality rate (controlled variable). For this purpose, is used the Logistic Smooth Transition Regression (LSTR) model. Also, the statistical analyzes were performed using the EXCEL, EVIEWS and JMALTI soft wares.Results: The results of the model LSTR, in addition to confirm the nonlinear effects of per capita physician on per capita health expenditure, show that the per capita physician per 10,000 population, influence on the per capita health expenditure in the form of two regime structure with threshold level about of 12.24. So that, In the first regime, per capita physician had a negative impact on per capita health expenditure (disapproval the induced demand hypothesis), but this impact is positive in the second regime (confirm the induced demand hypothesis). Conclusion: Since at the moment the physician per capita per 10,000 population, is most of the threshold level, The country is located in the second regime. Manuscript profile

Open Access Article

4 - Modeling Customer Evaluations of the Quality of Health Care Using Artificial Neural Network (Case Study of Birjand University of Medical Sciences)
Zahra Hashemi Marzieh Faridi Masuleh

Introduction: The service quality is always one of the managerial concerns to supply customer’s satisfaction. Preparing qualified service needs to exact knowledge about the key factors of service quality and their effectiveness in the level of customer’s sat More

Introduction: The service quality is always one of the managerial concerns to supply customer’s satisfaction. Preparing qualified service needs to exact knowledge about the key factors of service quality and their effectiveness in the level of customer’s satisfaction. So implementing the different methods of measuring service quality could make it more explicit the unknown aspects of this factor effectiveness on the satisfaction. So the aim of this study was to evaluating the health care quality methods with artificial neural network approach. Methods: This study was a descriptive-correlation and an applied research. The statistical population of research consists of customers in hospitals of medical sciences Birjand University with an indefinite number. Referring to Cochran sampling formula a number of 385 individuals were selected using in access approach and validated questionnaires of study distributed among them. To measure the service quality it used the 4 approaches of weighted and un-weighted SERVQL and SERVPRF and the effect of service quality dimensions in each 4 approach were evaluated on the satisfaction. In this study to analyze the data is used of Spss software and the results of four methods to measure service quality using artificial neural networks have been studied. Results: The results showed that the method of measuring the quality of services achieved the lowest level of error for SERVQUAL 0.18 Weighted number That measure the quality of service in terms of weight SERVQUAL model using artificial neural networks have been more accurate in predicting customer satisfaction. Conclusions: methods of measuring service quality have different performance in predicting customer’s satisfaction under the scale of measuring service quality. Also the artificial neural networks regarding to implement predicting algorithm, may contain weaker forecast rather than classic statistical methods. Introduction: uality of service has always been one of the main concerns of managers in providing customer satisfaction. So, employing different methods to measure the effectiveness of this agent's unknown aspects of service quality can be more transparent on customer satisfaction. Methodology: This study was conducted cross-correlation functional investigation. The population of Birjand University of Medical Sciences were all customers that their number was not specified. According to Cochran sampling about 385 of them were selected based on availability of validated questionnaires were distributed among them. To measure the service quality it used the 4 approaches of weighted and un-weighted SERVQL and SERVPRF and the effect of service quality dimensions in each 4 approach were evaluated on the satisfaction. The data were analyzed using multi-layered artificial neural networks.Findings:The results showed that the method of measuring the quality of services achieved the lowest level of error for SERVQUAL 0.18 Weighted number That measure the quality of service in terms of weight SERVQUAL model using artificial neural networks have been more accurate in predicting customer satisfacti Conclusion: methods of measuring service quality have different performance in predicting customer’s satisfaction under the scale of measuring service quality. Also the artificial neural networks regarding to implement predicting algorithm, may contain weaker forecast rather than classic statistical methods Manuscript profile

Open Access Article

5 - Comparative Study of Fair Financing in the Health Insurance
mohammad saadati ramin rezapour naser derakhshani maryam naghshi

Introduction: Fair financing contribution is one of the main objectives the healthcare systems in the world. Insurance system is one of the most common methods of financial protection against the cost of healthy people is considered. This study aimed to evaluate the com More

Introduction: Fair financing contribution is one of the main objectives the healthcare systems in the world. Insurance system is one of the most common methods of financial protection against the cost of healthy people is considered. This study aimed to evaluate the comparative insurance system in different countries were performed. Methods: This comparative study was conducted in 2017. First, a comprehensive literature search was conducted through relevant and valid databases and websites to extract scientific evidence. After the screening of findings, Data related to the fairness financing, including the out of pocket, catastrophic payment and fair financing contribution was extracted. Garden classification framework used to match the indicators with models of health insurance. Results: In countries studied, four model finance and insurance including: national health insurance (NHI), national medical system (NHS), social health insurance (SHI) and private insurance was used. France and Australia are the countries where the two models are used simultaneously. The lowest rate of pay out of pocket and catastrophic health expenditure for households in France (6 and 0.01 percent), which uses public and private health insurance model. Britain, Denmark, Canada and Germany, respectively, have the highest indices were fair participation in financing. Conclusion: According to the study it can be concluded that social insurance, national insurance and national health systems can have a good performance in financial protection of the population, So can say insurance system establishing a significant role in financial protection against the cost of people's health. Of course is to be mentioned for choose the model insurance countries should be based on infrastructure and resources available in every country so well able to play its role. Introduction: Fair financing contribution is one of the main objectives the healthcare systems in the world. Insurance system is one of the most common methods of financial protection against the cost of healthy people is considered. This study aimed to evaluate the comparative insurance system in different countries were performed.Method: This comparative study was conducted in 2017. First, a comprehensive literature search was conducted through relevant and valid databases and websites to extract scientific evidence. After the screening of findings, Data related to the fairness financing was extracted. Garden classification framework used to match the indicators with models of health insurance.Result:In countries studied, four model finance and insurance including: national health insurance (NHI), national medical system (NHS), social health insurance (SHI) and private insurance was used. The lowest rate of pay out of pocket and catastrophic health expenditure for households in France (6 and 0.01 percent), which uses public and private health insurance model. Britain, Denmark, Canada and Germany, respectively, have the highest indices were fair participation in financing.Conclusion: According to the study it can be concluded that social insurance, national insurance and national health systems can have a good performance in financial protection of the population, So can say insurance system establishing a significant role in financial protection against the cost of people's health. Of course is to be mentioned for choose the model insurance countries should be based on infrastructure and resources available in every country so well able to play its role. Manuscript profile

Open Access Article

6 - Estimation the Income Elasticity of Per Capita Health Care Expenditure in D8 Countries: PSTR and MG Approaches
Ali Rezazadeh moohamad Kalamie Saber Khodaverdizadeh Mostafa Shokri

Introduction: Economic welfare is highly dependent on the health expenditure share of national output. In this regard, the purpose of this paper was to investigate the relationship between health expenditure and economic welfare in D8 countries and assessment of commodi More

Introduction: Economic welfare is highly dependent on the health expenditure share of national output. In this regard, the purpose of this paper was to investigate the relationship between health expenditure and economic welfare in D8 countries and assessment of commodity group of health expenditure in this countries. Methods: In order to investigate the relationship between health expenditure and economic welfare in D8 countries during 1995-2014, Panel smooth transition regression method was used. Also to verify the long- run relationship between variables and for selection kind of commodity group Panel mean of group method was used. Results: Moreover, considering one transition function and one threshold parameter, as a two regime model, is sufficient to specification of nonlinear relationship between variables. The results indicate that threshold value is 7.21 and the estimated slope parameter is 17.56. Conclusion: GDP per capita in the first (The linear part) and second regimes (The sum of the linear and nonlinear parts) has positive impact on health expenditure per capita in D8 countries. The public health costs of population 0-14 and 65-years and older group has negative effects in first regime, and after crossing a threshold and enter the second regime, has positive effects on health expenditure per capita in D8 countries. Finally the results of the PMG approach suggests that the income elasticity of health goods in D8 countries is less than the unit and it is not considered a luxury commodity. Introduction: Economic welfare is highly dependent on the health expenditure share of national output. In this regard, the purpose of this paper was to investigate the relationship between health expenditure and economic welfare in D8 countries and assessment of commodity group of health expenditure in this countries.Methods: In order to investigate the relationship between health expenditure and economic welfare in D8 countries during 1995-2014, Panel smooth transition regression method was used. Also to verify the long- run relationship between variables and for selection kind of commodity group Panel mean of group method was used.Results: Moreover, considering one transition function and one threshold parameter, as a two regime model, is sufficient to specification of nonlinear relationship between variables. The results indicate that threshold value is 7.21 and the estimated slope parameter is 17.56.Conclusion: GDP per capita in the first (The linear part) and second regimes (The sum of the linear and nonlinear parts) has positive impact on health expenditure per capita in D8 countries. The public health costs of population 0-14 and 65-years and older group has negative effects in first regime, and after crossing a threshold and enter the second regime, has positive effects on health expenditure per capita in D8 countries. Finally the results of the PMG approach suggests that the income elasticity of health goods in D8 countries is less than the unit and it is not considered a luxury commodity. Manuscript profile

Open Access Article

7 - Studying the Effect of Knowledge Management Components on Trust to Information Technology in Mashhad University of Medical Sciences ‘Staff
Saeed Khayatmoghadam Ismail Zamani Beydokhti Abolfazl Mansourikia Mahbuobe Asadi Maryam Zarehhosseini

Introduction: In recent years, increasing competition in the business environment, the use of information and knowledge are put on top of organizations affairs so that they can gain a Competitive Advantage and persistent presence in business world. This study examined t More

Introduction: In recent years, increasing competition in the business environment, the use of information and knowledge are put on top of organizations affairs so that they can gain a Competitive Advantage and persistent presence in business world. This study examined the impact of knowledge management Components on the level of confidence in the information technology in staff of Mashhad University of Medical Sciences. Methods: This study was conducted as a descriptive-analytical, cross-sectional one, from October to November 2015. Cluster sampling was conducted and in every field of work were selected by simple random sampling. Data were collected by questionnaire. The reliability and validity of the questionnaire was confirmed. Data analysis was performed with software spss version 16. Results: In this study, 600 people were evaluated that 46.8 % were men and 53.2 % were women. Total score of trust in IT and knowledge management among employees was 3.24 ± 0.86 and 3.23 ± 0.67 respectively. There was a direct correlation between knowledge management Initiatives and staff confidence in information technology (p-value ≤ 0.001, r = 0.407). Conclusion: Knowledge management Components had a great impact on the confidence of the staff to information technology. Therefore, it is essential for health managers to focus on promotion of staff’s knowledge, using of information technology and create a climate of confidence culture among employees to be successful in their organizational mission. Background and Aim: In recent years, increasing competition in the business environment, the use of information and knowledge are put on top of organizations affairs so that they can gain a Competitive Advantage and persistent presence in business world.This study examined the impact of knowledge management Components on the level of confidence in the information technology in staff of Mashhad University of Medical Sciences.Material and method: This study was conducted as a descriptive-analytical, cross-sectional one, from October to November 1394. Cluster sampling was conducted and In every field of work were selected by simple random sampling. Data were collected by questionnaire. The reliability and validity of the questionnaire was confirmed. Data analysis was performed with software spss version 16.Result: In this study, 600 people were evaluated that 46.8 % were men and 53.2 % were women. Total score of trust in IT and knowledge management among employees was 3.24 ± 0.86 and 3.23 ± 0.67 respectively. There was a direct correlation between knowledge management Initiatives and staff confidence in information technology (p-value ≤ 0.001, r = 0.407). Conclusion: Knowledge management Components had a great impact on the confidence of the staff to information technology. Therefore, it is essential for health managers to focus on promotion of staffs knowledge,using of information technology and Create a climate of confidence culture among employees to be successful in their organizational mission. Manuscript profile

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