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Seyyedeh Fatemeh Sagha Abolfazl, Sara Emamgholipour, Mehdi Yaseri, Mohammad Arab,
Volume 2, Issue 3 (12-2019)
Abstract

Introduction: To achievement Universal Health Coverage, one of the target groups is refugees that have been provided basic health insurance for this population. The purpose of the present study was to compare the inpatient costs, in drugs, surgery, laboratory and other paraclinic, imaging, and resource allocation of inpatient costs and burden of inpatient in the two years before and after basic health insurance.
Methods: This study is a descriptive-analytic and applied type. The research environment was the university hospitals of Tehran province and the statistical population of the refugee hospitalization records during two years before and after the implementation of insurance. Cluster sampling was performed in two stages. At first, 55 hospitals of the province, 15 hospitals and then 1575 samples in each period, were randomly selected. Data were analyzed by SPSS.
Results: By implementation of basic health insurance, the average share of refugees from inpatient costs was 13.50% (P <0.001), the share of supplementary insurance was 0.04% (P <0.001), the share of hospital discounts was 9.99% (P <0.001). Burden of inpatient increased by 52% (P <0.001). The average share of drug and surgery costs decreased by P = 0.002 and P <0.001, respectively, and imaging services increased by P <0.001. Laboratory and other para clinics did not show a significant difference.
Conclusion: Basic health insurance reduced patient share and hospital discounts and increased burden of inpatient. However, given the low population coverage, it seems necessary to reconsider the dimensions of Universal Health Coverage, and especially population coverage.

Sara Emam Golipoure, Mohammad Arab, Jafar Yahyavi Dizaj,
Volume 3, Issue 2 (8-2020)
Abstract

Introduction: Health has always been one of the most important concerns of mankind, and without oral and dental health, the body's general health cannot be guaranteed. Having health insurance has always been one of the factors facilitating the use of health services and this study is aimed to identify and investigate the impact of insurance coverage on the use of family dental services in Iran.
Methods: The present study is a descriptive-analytical and cross-sectional study based on data from National Expenditure Survey by Statistics Center of Iran during 2013-2012. Logistic regression model was used to estimate the effect of independent variables on the dependent variable. The sample size of the study was 116469 households in rural areas and 112685 households in urban areas and 229154 households in the country as a whole. Data were analyzed using Microsoft Access, Microsoft Excel and 14 STATA software.
Results: Of the 229,154 households surveyed, 11,392 households (4.98%) had dental services during the 6-year periodThe results show that provinces with a high level of development (in terms of access to health services) had higher use of dental services (p-value<0/001). Urban households with insurance coverage, more literate people, and households with fewer elderly people have used dental services (p-value<0/001). Wealthier households (higher income quintiles) than poor households (lower income quintiles.  And families that had self-care (using floss, toothbrushes and toothpaste) had more dental services than families who did not (p-value<0/001).
Conclusion: Effective evidence-based interventions to improve the use of dental services among uninsured households, elderly people, low education status, residents of less developed provinces, and rural households should be prioritized by policy makers and planners.

Maryam Arab, Mohammad Fathian, Hosein Aliahmadi Jeshfaghani,
Volume 4, Issue 4 (3-2022)
Abstract

Introduction: Accurate funding in order to better manage costs is one of the main concerns of managers. The Health Insurance Organization of Iran, as one of the largest basic insurance organizations, is no exception to this and certainly needs to identify and accurately predict the costs of treatment in order to provide financial resources and obtain the necessary funds in its field of treatment. Using machine learning methods to create a model for predicting treatment costs can be a great help in accurately financing.
Methods: This study has provided a model and method for predicting the costs of the organization by using the cost data available in the medical documentation systems of the provinces of the organization during the years 2007 to 2020 and using the SARIMAX and LSTM methods. This method can help to more accurately predict the costs of the organization.
Results: Determining the method with better performance based on the MAPE index alone did not meet the desired model; therefore, by creating a combined method and using the criterion of percentage of realization of the forecast, the optimal model for cost forecasting is presented.
Conclusion: Due to the need for a scientific method to more accurately predict the costs of the organization, the proposed method and model was able to predict the costs of the organization with minimal errors compared to the errors accepted in manual processes.

Maryam Seyed-Nezhad, Batoul Ahamadi, Mohammad Moradi-Joo, Mohammad Javad Kabir, Alireza Arabi, Samaneh Parsa, Ali Akbari-Sari,
Volume 5, Issue 3 (10-2022)
Abstract

Introduction: Referral system is one of the principles and foundations of primary health care services. One of the most important challenges and problems of the referral system is the lack of public awareness of its nature, services and benefits. The aim of this study was to provide a model for accepting the referral system from the perspective of patients.
Methods: This study was a mixed method that was conducted in three steps in 1400. The first step included the development of a questionnaire, the second step was a survey study, and the third step was the design of the acceptance model of the referral system from the perspective of patients. The statistical population included 384 patients covered by the Rural Insurance Fund referring to the Imam Khomeini Hospital Complex. The data were analyzed using SPSS v20 software. Also, Second-order Confirmatory Factor Analysis (S-CFA) was performed using LISREL v8.5 software.
Results: Cronbach's alpha ratio for the whole questionnaire was 0.85 and intra-cluster correlation coefficient was 0.69. The results of confirmatory factor analysis showed that patient-centeredness, rules and regulations, responsiveness, coordination, security, accessibility, effectiveness, efficiency, personal beliefs and social influence significantly affected the acceptance of the referral system from patients' perspectives.
Conclusion: It is necessary for managers and policy makers before and during the implementation of the referral system to consider the factors affecting the acceptance of the referral system from the perspective of patients. For the appropriate implementation of the referral system, special attention should be paid to all the influencing factors so that patients can easy and convenient access health services anywhere and anytime.

Nasim Nabipour Jafarabad, Ali Maher, Amin Ghasem Begloo, Ali Fakhr-Movahedi,
Volume 6, Issue 4 (Winter 2024)
Abstract

Introduction: The rapid growth of technology, demographic changes, increasing patients’ demand, and changes in the nature of diseases, increased competition among hospitals and healthcare providers, and constraints in budget allocation necessitate adopting a novel approach to the management of medical centers based on international standards.
Methods: This qualitative study was conducted in two stages by a content analysis approach in the year 2022 in teaching hospitals affiliated with the Islamic Azad University nationwide. The statistical population in the first stage included all studies addressing various aspects of the factors affecting the optimal management of hospitals. In the second stage, it included 10 executive managers of hospitals purposively selected as experts until reaching data saturation. The validity and reliability of the interviews were confirmed using the Lincoln and Guba methods. The data analysis method involved a comprehensive review of studies to identify factors affecting the optimal management of hospitals and a contractual content analysis to identify, analyze, and report themes.
Results: In the first stage, a comprehensive review of studies was conducted, encompassing a total of 96 research papers, including 36 in Persian and 60 in English. Following the examination of the titles and abstracts of these research papers and aligning them with the predefined inclusion and exclusion criteria, a total of 18 studies were selected for final analysis, comprising 11 in Persian and 7 in English. After identifying the factors affecting the optimal management of hospitals, three main dimensions were extracted, including strategic planning (12 components), reengineering (8 components), and supply chain engineering (14 components) for the optimal management of hospitals affiliated with the Islamic Azad University using the content analysis method.
Conclusion: Managers should implement each of the identified components of strategic planning, reengineering, and supply chain engineering for the optimal management of hospitals in line with the hospitals’ structure. By examining the excellence and efficiency of hospitals over time, as well as evaluating the trends of each of them, they should take steps towards adopting reform policies and their experiences should be utilized in other hospitals.


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