IntroductionThe length of stay (LOS) in hospitals is a widely used and important criteria for evaluating hospital performance. The aim of this study was to determine factors affecting LOS in teaching hospitals of Qazvin Providence.MethodsIn this cross-sectional study, patients’ health records were randomly selected from archives in teaching hospitals of Qazvin in 2013. Data were collected through a data entry form and were analyzed using Kolmogorov–Smirnov, Kruskal–Wallis, and Mann–Whitney U tests at the significant level of 0.05.ResultsThe mean of hospital LOS was 5.45 ± 6.14 days. Age, employment, marital status, history of previous admission, patient condition at discharge, method of payment, and type of treatment had an impact on LOS (p<0.05). Other factors, including gender, place of residence, and type of admission, did not affect LOS.ConclusionBecause hospitals consume a perceptible part of resources in a health system, controlled and optimized use of its resources help to save a lot. Therefore, this study showed many clinical and nonclinical factors affect LOS in evaluating these factors, which may reduce inappropriate hospital stays and decrease costs.

BackgroundIranian health sector encountered many challenges in resource allocation and health service purchasing during the past decades, the aim of this study was to determine the main challenges of the present process of health service purchasing for national policymakers and other developing countries with the same setting.MethodsIt was a qualitative study carried out via the complete content analysis of all relevant national documents from 2007 to 2014. In order to retrieve the related documents, we searched the official websites related to the Ministry of Health and Medical Education, four main Iranian insurance organizations, the Health Committee of the Parliament Profile, strategic vice president’s site and Supreme Insurance Council. After recognition of documents, their credibility and authenticity were evaluated in terms of their publication or adjustment. For the analysis of documents, the four step-Scott method was used applying MAXQDA version 10.ResultsFindings illustrated that health service purchase challenges in the country can be classified in 6 main themes of policy-making, executive, intersectional, natural, legal and informational challenges with 26 subthemes. Furthermore, 5 themes of Basic Benefit Package, Reimbursement,Decision making, Technology and Contract are considered as the main Challenges in pharmaceutical purchasing area containing 13 relevant subthemes.ConclusionsIt seems that according to documents, Iran has faced many structural and procedural problems with the purchase of the best health interventions. So it is highly recommended to consider consequences derived from the present challenges and try to use these evidences in their policy making process to decrease the existed problems and move to better procurement of health interventions.

Background Hepatitis C virus (HCV) infection is a major public health challenge worldwide. Implementing policies to cope with this challenge requires commitment from all stakeholders at various levels, and all necessary resources should be mobilised. Support for various HCV-related stakeholders can reduce the challenges and obstacles that can be encountered during the programme implementation. The present study aims to identify all stakeholders involved with HCV-related policy-making in Iran at different steps (policy development, implementation and evaluation) and to characterise them in terms of interest, position, power and influence, in order to provide valuable information for appropriate decision-making and design. The present study can also serve as a case study for healthcare systems in other countries. Method An approach based on social network analysis was utilised. Data collected included relevant document searches and in-depth interviews to a sample of 18 key informants. Results Various stakeholders were found to be involved with HCV-related policies in Iran. The extent of their participation and support in policy-making varied. Specifically, international agencies had a high interest for HCV-related policy-making, whereas media and members of the private sector were characterised by a medium interest and governmental and non-governmental bodies by a highly variable interest, ranging from low to high, depending on the specific organism. Moreover, media and members of the private sector, non-governmental institutions and international agencies were rated low in terms of position, whereas governmental actors were rated low to high. Media were rated medium in terms of power, whereas international agencies and members of the private sector were respectively rated low to medium and low. Non-governmental actors were rated low, whilst governmental bodies were rated low to high. Finally, media, members of the private sector and international agencies were rated medium in terms of influence, whereas non-governmental and governmental actors were respectively rated low to medium and low to high. Conclusion Policy-making involves trust, negotiation and integration of the different views of all stakeholders. Social network analysis was critical for identifying stakeholders and showing that, in Iran, involvement in HCV-related policy-making is generally low. This information is of practical implication for policy- and decision-makers regarding the adoption of more favourable and effective strategies.

Background:Succession planning promotes the culture of private ownership, staff loyalty to the organization and develops organizational commitment, and increases organizational stability. The study was conducted to examine the status of succession planning in the Iranian health system in order to highlight the key concepts, provide new insight, and attract the attention of senior managers of the Ministry of Health and Medical Education to the importance of succession planning in achieving organizational goals.Methods:In a qualitative study with a framework analysis approach, semi-structured interviews were conducted with a sample selected using purposive and snowball sampling procedure. The MAXQDA-10 was used to apply the codes and manage the data. The codes were extracted using inductive and deductive methods.Results:Fourteen themes and six main subthemes were identified, including planning, organizational culture, system approach, competency model, career path, and senior managers. Our findings indicate a lack of succession planning in the Iranian health system.Conclusion:lack of succession planning could lead to inefficiency and ineffectiveness in health services provision. Implementation of succession planning could maximize human resources utilization.

BackgroundIn today’s transforming world, increased productivity and efficient use of existing facilities are practically beyond a choice and become a necessity. In this line, attention to change and transformation is one of the affecting factors on the growth of productivity in organizations, especially in hospitals.AimTo examine the effect of transformational leadership on the productivity of employees in teaching hospitals affiliated to Iran University of Medical Sciences.MethodsThis cross-sectional study was conducted on 254 participants from educational and medical centers affiliated to Iran University of Medical Sciences (Tehran, Iran) in 2016. The standard questionnaires of Bass & Avolio and of Hersi & Goldsmith were used to respectively assess transformational leadership and level of productivity. The research assumptions were tested in a significance level of 0.05 by applying descriptive statistics and structural equations modeling (SEM) using SPSS 19 and Amos 24.ResultsResults of the fitting indicators of the assessing model after amending includes Chi-square two to degrees of freedom of 2.756, CFI indicator 0.95, IFI indicator 0.92, Root mean square error of approximation (RMSEA) indicator 0.10. These results indicate that the assessing model is well fitting after the amendment. Also, analysis of the model’s assumptions and the final model of the research reveals the effect of transformational leadership on employees’ productivity with a significance level of 0.83 (p=0.001).ConclusionThis research indicates that the more the leadership and decision-making style in hospitals lean towards transformational mode, the more positive outcomes it brings among employees and the organization due to increased productivity. Therefore, it is essential to pay focused attention to training/educational programs in organizations to create and encourage transformational leadership behaviors which hopefully lead to more productive employees.

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