Background: Examination time is a key factor determining the relative value of clinical physicians' examination and care quality. Whereas commitment to standard prescription principles by physicians increases the likelihood of proper treatment, its effectiveness and patients' improvement. This study aimed to determine the relationship between outpatients' examination time and physicians prescribing quality in teaching hospitals of Ahvaz. Methods:This cross-sectional study was conducted in 550 outpatients who visited teaching hospitals of Ahvaz in 2015. The quality of the prescriptions was assessed by WHO checklist. Each prescription was scored with a score range from 0 to 21, they were divided into four equal score categories including low (0-5.25), low intermediate (5.26-10.5), high intermediate (10.5-15.75) and good (15.76-21) and using correlation and regression was analyzed. Results:The total mean of examination time and commitment to prescription principles was 4.88±0.12 min and 15.92±1.14, respectively. Correlation coefficients between outpatients' examination time and dimensions of "legibility", "pharmaceutical form" and "medical orders", and the total quality of prescription were significant (p˂0.005). The relationship between examination time and prescription quality confirmed with the fitting linear regression model. Increase per minute in patient's examination by a physician, which is about 0.33 points, was added to the basic quality scores of prescription. Conclusion:There was a relationship between Examination time and dimensions of legibility, pharmaceutical form, and medical order. Considering commitment to standard prescription principles, examination time, which was declared by the Health Sector Evolution Guideline, improve physicians' prescription quality and quality of provided services of hospitals. Therefore, providing an internet schedule for examination will be extremely helpful in organizing physicians' examination.
IntroductionAssessing service quality is one of the basic requirements to develop the medical tourism industry. There is no valid and reliable tool to measure service quality of medical tourism. This study aimed to determine the reliability and validity of a Persian version of medical tourism service quality questionnaire for Iranian hospitals.MethodsTo validate the medical tourism service quality questionnaire (MTSQQ), a cross-sectional study was conducted on 250 Iraqi patients referred to hospitals in Ahvaz (Iran) from 2015. To design a questionnaire and determine its content validity, the Delphi Technique (3 rounds) with the participation of 20 medical tourism experts was used. Construct validity of the questionnaire was assessed through exploratory and confirmatory factor analysis. Reliability was assessed using Cronbach’s alpha coefficient. Data were analyzed by Excel 2007, SPSS version18, and Lisrel l8.0 software.ResultsThe content validity of the questionnaire with CVI=0.775 was confirmed. According to exploratory factor analysis, the MTSQQ included 31 items and 8 dimensions (tangibility, reliability, responsiveness, assurance, empathy, exchange and travel facilities, technical and infrastructure facilities and safety and security). Construct validity of the questionnaire was confirmed, based on the goodness of fit quantities of model (RMSEA=0.032, CFI= 0.98, GFI=0.88). Cronbach’s alpha coefficient was 0.837 and 0.919 for expectation and perception questionnaire.ConclusionThe results of the study showed that the medical tourism SERVQUAL questionnaire with 31 items and 8 dimensions was a valid and reliable tool to measure service quality of medical tourism in Iranian hospitals.
Background and purpose: Improved life standards, over the past few decades, had led to an increase in health expenditures. The aim of this article was to compare the trend of health expenditure per capita and its association with health indicators in selected countries. Results: Denmark with health expenditure per capita more than the Netherlands had higher life expectancy at birth and more deaths as a result of alcohol abuse and tobacco smoking. Nigeria's health spending per capita was 2.5 times more than that of Liberia, because it had worse results in all health indicators with high mortality rate due to lower vaccination coverage for malaria, AIDS, and tuberculosis, and at the same time, high costs for the labor force and corruption in health system. Iran with health expenditure per capita less than Turkey had lower total mortality rate of infants and children under 5 years and lower total fertility. Well-organized PHC system and highly qualified professionals in the field of healthcare are among the strengths of the healthcare system in Iran. Conclusion: Increasing trend of health expenditures in selected countries did not have a significant impact on the health indicators trend. Countries must identify and invest on their health priorities to improve population health status.
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