Background Primary healthcare with the right structure is the base for any highly efficient healthcare system to achieve better health outcomes at the lowest cost. Challenges of this system, including structural weaknesses, are one of the factors of inefficiency. Therefore, the purpose of this study was to identify challenges of the organizational structure of county health network in Iran. Methods An exploratory qualitative face-to-face semi-structured interviews were carried out with 21 key informants including experts and managers in Ahvaz-Iran. Purposive sampling method with maximum diversity were used. Interviews were recorded digitally and transcribed verbatim. Interview transcripts were analyzed based on a thematic analysis approach via NVivo-11. Results In analysis of the interviews, after removing the duplicate codes and merging similar items, finally 6 main challenges and 56 sub-themes were obtained. The themes of structural challenges included formalization, complexity, centralization, culture, environment, and resources. Conclusions Based on the present situation, the challenges in the current organizational structure and a change in the goals and strategies of the healthcare system in Iran, the appropriate structure needs to be designed and implemented at different levels in accordance with the goals and strategies. The separation and independence of health centers management and hospitals (treatment) in the county can provide a basis for understanding the challenges to the provision of health services.
Introduction: The prevalence of psychological disorders has a major impact not only on mental and physical health but also on the process of treatment, recovery and duration of hospitalization and referrals. The aim of this study was to compare obsessive beliefs, depression and anxiety in patients with suspected Covid-19 and healthy individuals in Ahvaz. Methods: This descriptive-analytical study was conducted using purposive sampling method, 150 patients with Covid-19, 150 suspects and 150 healthy patients referred to Razi Hospital. Information using questionnaires Obsessive beliefs, depression and anxiety were collected and data were analyzed using multivariate analysis of variance. Results: The results showed that there were significant differences between patients with Covid-19, suspected patients and healthy individuals in terms of obsessive beliefs, depression and anxiety (p <0.001). Mean obsessive beliefs (132.35±17. 17.64) and depression (11.01±4. 4.17) were higher in patients with Covid-19 than in the other two groups (p <0.001), and anxiety (22.62 ± 5.72) was higher in patients with Covid-19 than in the other two groups. The other two groups were higher (p <0.001).
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