Background:Health literacy can be considered as a factor affecting healthcare providers' decision-making. The aim of this study was to investigate health literacy status and its relationship with quality of life among the nurses working in teaching hospitals affiliated with Shiraz University of Medical Sciences in Iran.Materials and Methods:This cross-sectional study was conducted in 2017. To this end, 185 nurses from hospitals were selected by stratified random sampling. The data collection instruments included the standardized Health Literacy Questionnaire and the 36-Item Short Form Health Survey. The data were analyzed through descriptive statistics as well as t test, analysis of variance, Pearson correlation coefficient, and multivariate linear regression analysis using SPSS23 (α = 5%).Results:The mean scores for health literacy and quality of life were 70.06 (12.98) and 60.86 (17.26), respectively. A significant relationship was observed between the health literacy and quality of life (p <0.001), Access (p = 0.004), reading skills (p = 0.004), understanding (p = 0.016), and application of health information (p = 0.012) as the dimensions of health literacy were identified among the predictors of quality of life. In addition, there was a significant relationship among age (r = 0.22, p = 0.008), work experience (r = 0.27, p = 0.002), and employment relationship (F = 3.89, p = 0.005) and the mean score for nurses' health literacy status.Conclusions:A significant relationship was observed between health literacy and quality of life in nurses. Healthcare policy-makers are suggested to take measures to develop programs on promoting health literacy and related skills to improve the status of quality of life among nurses.
Background: Investigating the conditions and the appropriateness of admission of patients in hospitals is an important issue which can improve the efficiency of health care delivery. Intensive care unit (ICU) is important due to applying expensive financial sources; therefore, its efficient application is of great priority. In this regard, the current study aimed to determine the financial burden of inappropriate admissions in internal intensive care units (IICUs). Methods: It was a cross-sectional study conducted in 2014. A total of 294 patients admitted to IICUs of Shahid Faghihi and Nemazee hospitals of Shiraz, Iran, in 2012 were enrolled into this retrospective study. The study was conducted in two phases, using the guidelines of American critical care association (ACCA) and experts' opinion to investigate the financial burden of inappropriate admissions in IICUs of the above-mentioned hospitals. Results:The results showed no statistically significant relationships among insurance status, insurance type, age, gender and inappropriate admission by applying Chi-square. Among 294 admitted patients under the study, the inappropriate admissions were 11.2% based on the guidelines and 13.6% based on the experts' opinion. The level of agreement of the guidelines and experts' opinion for the inappropriate admissions was 0.076 based on Kappa coefficient. The total financial burden imposed on the insurance agencies and the patients by inappropriate admissions was US$ 47867.78 based on the guidelines and US$ 83241.68 based on the experts' opinion. Conclusions: Inappropriate admissions to ICUs may impose additional costs to the health system and the patients on one hand, and deprives other patients from receiving health services. Therefore, it is crucial to effectively plan for the application of ICU beds.
Background: Health Transformation Plan (HTP) was occurred in 2014 to improve access and equity and reduce out of pocket payments in Iranian Health Care System. In this regard the aim of this study is evaluating and ranking the service provider's infrastructures among the country provinces as an indicator of equity before and after implementation of the HTP. Methods: This cross sectional study is conducted in 2017. The study population included 31 provinces of the country. Data related to 4 years from 2012 to 2016 were included from the data bases of Ministry of Health and Medical Education as well as the statistics yearbook of the country. The obtained results of multi-criteria decision-making methods were analyzed as well. SPSS 18 and Excel 2013 software were used for data analysis. Results: Based on the VIKOR method, in 2012, Mazandaran, Tehran and Fars provinces and in 2013, the provinces of Tehran, Fars and Isfahan ranked from first to third respectively. Similarly after HTP, in 2015, the provinces of Tehran, Khorasan Razavi and Fars and in 2016 the provinces of Tehran, Fars and Khorasan Razavi have ranked from first to third respectively. Paramedic, dentist, pharmacist, medical institutions and hospital bed had a significant difference before and after the implementation of Health Transformation Plan, so that the number of these indicators increased after implementation of the HTP (P value < 0.05). Conclusions: According to the results, there are many differences between the provinces and these disparities have not decreased significantly after HTP. Consequently, it is suggested to the health sector policy makers to make regional plans and allocate the budget of HTP, based on the status of the provinces. In addition, responding to these inequalities requires a transparent and systematic approach to provide the budget for allocating to the population, health needs, and the lack of development and geographical isolation of regions.
Background: Outsourcing is a kind of participation between public and private sector. This should be monitored and supervised to enhance the quality of outsourced services and to prevent new problems in this area. Shiraz University of Medical Sciences (SUMS) hospitals increasingly use outsourcing in recent years. Objectives: The present research aimed at comparing outsourced departments of SUMS from economic view, accessibility of services, and service quality during the years 2010-2012. Methods: A before and after descriptive and analytical design was applied in outsourced departments of SUMS in 2014. First, 17 indicators were extracted by Delphi technique. Then, all outsourced units were assessed using economic, access to services, and quality indicators during 2010 to 2012. Results: After outsourcing, in all pharmacies and dentistry units, except one, loss decreased and benefit increased from public sector viewpoint. The number of personnel for one pharmacy and two laboratories was decreased, while it remained unchanged for dentistry units. The total number of clients was increased for all pharmacies and laboratories and decreased for one dentistry unit. Patient satisfaction for pharmacies, laboratories, and dentistry units was 73.4%, 80.3%, and 78.5%, respectively. Also, employer's satisfaction from contraction was 60%, 68%, and 93.3% for pharmacies, laboratories, and dentistry units, respectively. Conclusion: Outsourcing as an effective strategy resulted in increase in the personnel, client, and stakeholder satisfaction. Also, it increased benefit and decreased cost for public sector. It is recommended that rules for the implementation of this strategy and monitoring the private sector should be defined.
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