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The medical consultation is one of the requirements in diseases diagnosis and patient treatment. In addition, a high-quality consultation is a fundamental demand of patients, and it is one of the rights of every patient. The purpose of this paper is to identify factors affecting the high-quality consultation in medical communications.

The following electronic databases were searched: MEDLINE (via PubMed), Web of Science, Cochrane, EMBASE, Scopus and ProQuest until December 2018. In addition, the authors searched Google Scholar. Qualitative and quantitative studies were assessed using the Critical Appraisal Skills Programme, Qualitative Checklist and the Center for Evidence-Based Management appraisal checklist, respectively. A stepwise approach was conducted for data synthesis.

Of 3,826 identified studies, 29 met the full inclusion criteria. Overall, after quality assessment of studies, 25 studies were included. The studies were conducted in the USA (n=6), the UK (n=6), the Netherlands (n=4), Canada (n=2), Belgium (n=2), Poland (n=2), Germany (n=1), Iran (n=1), Finland (n=1), Austria (n=1), Qatar (n=1), Denmark (n=1) and China (n=1), and five studies were excluded. Data synthesis showed that high-quality consultation consisted of three main categories: structural (4 main themes with 26 sub-themes), process (2 main themes with 33 sub-themes) and outcome (3 main themes with 12 sub-themes) quality.

Using the indicators of consultation quality improvement can develop physicians’ clinical competence and skills. Decision makers can use them to monitor and evaluate physicians’ performance. A high-quality consultation can be useful in social prescribing that helps patients to manage their disease.

Visit time is a crucial aspect of patient–physician interaction; its inadequacy can negatively impact the efficiency of treatment and diagnosis. In addition, visit time is a fundamental demand of patients, and it is one of the rights of every patient. The purpose of this paper is to determine factors influencing the consultation length of physicians and to compare consultation length in different countries.

MEDLINE (PubMed), Web of Science, Cochrane, ProQuest, Scopus, and Google Scholar were searched. In addition, references of references were checked, and publication lists of individual scholars in the field were examined. We used data sources up to June 2018, without language restriction. We used a random-effects model for the meta-analyses. Meta-analyses were conducted using Comprehensive Meta-Analysis Version (CMA) 3.0.

Of 16,911 identified studies, 189 studies were assessed of which 125 cases (67 percent) have been conducted in the USA. A total of 189 studies, 164 (86.77 percent) involved face-to face-consultations. The effects of three variables, physician gender, patient gender, and type of consultation were analyzed. According to moderate and strong evidence studies, no significant difference was found in the consultation lengths of female and male doctors (Q=42.72, df=8, I²=81.27, p=0.891) and patients’ gender (Q=55.98, df=11, I²=80.35, p=0.314). In addition, no significant difference was found in the telemedicine or face-to-face visits (Q=41.25, df=5, I²=87.88, p=0.170).

In this systematic review and meta-analysis, all of physicians’ visits in 34 countries were surveyed. The evidence suggests that specified variables do not influence the length of consultations. Good relationship is essential to a safe and high-quality consultation and referral process. A high-quality consultation can improve decisions and quality of visits, treatment effectiveness, efficiency of service, quality of care, patient safety and physician and patient satisfaction.

The Iranian patients’ rights charter defines patient rights as a reflection of fundamental human rights in the field of medicine and incorporates all elements of patient rights accepted in international texts. The purpose of this paper is to study the way in which diabetes patients’ rights are being exercised in everyday hospital practice in Birjand, Iran.

A cross-sectional study design was used in 2014. The sample size was estimated 150 patients, out of which 108 diabetes patients completed questionnaire. The questionnaire of diabetes patients’ perspectives on the patients’ rights was used to collect data. The questionnaire consists of 22 questions. Data entry and analysis were carried out using SPSS software (version 22). Descriptive and inferential statistics were calculated with all survey items and total scores, as well as demographic data.

The response rate was 72 percent. Overall, the mean score percentage of diabetes patients’ perspectives on the patients’ rights was 74.04± 8.4. Furthermore, statistical significant differences were found among diabetes patients in relation to patients’ perspectives on the patients’ rights according to highest level of education (F=16.52, p=0.002), their habitat(t=3.49, p=0.001), age groups (F=18.70, p=0.0001) and the duration of the disease (F=5.16, p=0.007). The results showed that no statistically significant differences were observed among diabetes patients in relation to diabetes patients’ perspectives on the patients’ rights according to their gender (F=1.57, p=0.12) and marital status (F=1.56, p=0.09).

Clinicians can provide care based on patients’ rights, and their knowledge of patients’ rights needs to be evaluated. Educational courses, leaflets, booklets and posters can be helpful in this regard. In addition, professional organizations and the Ministry of Health need to be more sensitive to this issue.

Responsiveness is a reaction to the reasonable expectations of patients regarding ethical and non-clinical aspects of the health-care system. Responsiveness is a characteristic of health-care system and the observance of the patient’s rights. The purpose of this study is to compare the responsiveness of the health-care system based on the hospital ownership in Mazandaran province in Iran.

The cross-sectional study design was used on 1,083 patients referred to public and private hospitals and hospitals affiliated to social security organization in Mazandaran province in 2017. The World Health Organization’s responsibility questionnaire was used to collect data. Data were analyzed by using SPSS version 21. Descriptive statistics and one-way ANOVA results are presented is the results section.

All responsiveness dimensions were salient for respondents. The response rate in the selected hospitals was very close, which ranged from 85.7 to 90.2%, and there was no significant difference between public, private and social security hospitals (p > 0.05). The most crucial responsiveness dimension in hospitals was autonomy.

In the current study, the dimensions of communication and confidentiality were identified as priority dimensions based on the least score for breeding actions to improve the responsiveness of the health-care system. At the end, some useful recommendations such as re-engineering the processes, training to engage the employees with patients and encouraging them to fill the gap were suggested.

The regulation defines patients’ rights as a reflection of fundamental human rights in the field of medicine and incorporates all elements of patients’ rights accepted in international texts. Hence, the purpose of this paper is to investigate the relationship between patients’ safety, medical errors and patients’ safety rights with patients’ security feeling in selected hospitals of Mazandaran Province, Iran.

This descriptive cross-sectional study was conducted in selected hospitals of Mazandaran Province in public, social and private hospitals in 2016. In total, 1,083 patients were randomly selected for the study. The developed tool (questionnaire) was used for data collection. Questionnaire validity was verified through experts and its reliability was confirmed by Cronbach’s α coefficient (95 percent). Data were analyzed through multiple regressions by SPSS software (version 21).

The findings of this paper showed that the mean (standard deviation) medical error, patient’s safety, patient’s rights and patient’s security feeling were 2.50±0.61, 2.22±0.67, 2.11±0.68 and 2.73±0.63, respectively. Correlation testing results showed that medical error, patient’s safety and patient’s rights simultaneously had a significant relation with patient’s security feeling in the selected hospitals (p<0.05).

A simultaneous correlation between patient’s safety, patient’s rights and medical errors with patient’s security feeling in social security hospitals was higher than other hospitals. Hence, the authorities and officials of hospitals and healthcare centers were advised to make effective attempts to perceive the patient’s safety, medical errors and patient’s rights to improve the patient’s security feeling and calmness and also to make better decisions to promote the healthcare and therapeutic services.

Respect for human rights is one of the most important criteria for the delivery of medical care in hospitals. Ethical predictability is useful to identify human rights concerns in health-care organizations. The hospital environment and the flow of its processes make the topic of predictability much more sensitive and, at the same time, more difficult than other organizations. The purpose of this paper is to determine and compare the ethical predictive factors in selected hospitals in Mazandaran province.

This cross-sectional survey using multilevel sampling (four hospitals, 938 patients, 186 staff) was conducted in the first half of 2017. The measurement instrument was a researcher-made questionnaire consisting of seven areas of service recipients’ rights, patient safety, patient satisfaction, human resources, governance, organizational and financial commitments. The analysis of the collected data was performed through SPSS V. 22 and one-way ANOVA and post hoc Tukey’s tests.

Ethical predictability was higher in social security hospitals compared to private and public hospitals, and patient safety and patient rights showed higher magnitudes compared to other dimensions. Financial domain, patient satisfaction, governance and organizational commitment formed the middle priorities in ethical predictability, and human resources had the least average in ethical predictability in the selected hospitals in the province.

Identifying the factors which influence ethical predictability, in addition to promoting service recipients’ rights and patient satisfaction, is of great help to the managers and health service authorities, so that they can have a better understanding of these factors and, consequently, make appropriate micro and macro-decisions to provide better services.

It is necessary for organizations to have committed employees to perform properly and be able to survive in a competitive world. One of the key components of organizational commitment is implementation of ethical leadership. The purpose of this study is to examine the relationship between ethical leadership and organizational commitment in fire organizations of Tehran.

A descriptive-correlational study was carried out in 2019. The sample consisted of 200 randomly selected participants, active in executive and headquarters divisions of fire department in Tehran. To collect data, a questionnaire with three different parts: demographics, organizational commitment questionnaire and the ethical leadership scale, was used. Data analysis were performed by AMOS24 and SPSS software, and data are presented as descriptive statistics of frequency, percentages, mean ± standard deviation (SD) and Pearson’s correlation coefficient.

Mean and SD for organizational commitment and ethical leadership were 3.44 ± 0.7 and 3.66 ± 0.62, respectively. Affective commitment had the highest average score among organizational commitment dimensions (3.63 ± 0.75). Among ethical leadership dimensions, ethical management showed the highest average (3.79 ± 0.70). Each component of organizational commitment, i.e. affective commitment, continuance commitment and normative commitment, also showed a significant relationship with ethical leadership (p < 0.05). Model fit results revealed that independent variables could anticipate 87% of changes of dependent variables in organizational commitment.

The results show a significantly positive relationship between ethical leadership and organizational commitment among the firefighters. Therefore, by using ethical leadership method, i.e. being a role model, improving the relations between management and employees, establishing trust and mutual respect, managers of fire departments can increase firefighters’ organizational commitment, affective commitment, continuance commitment and normative commitment and prevent them from quitting.

Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital management. The purpose of this paper is to identify evidence-based management (EBMgt) components and challenges. Consequently, the authors provide an improving evidence-based decision-making framework.

A total of 45 semi-structured interviews were conducted in 2016. The authors also established three focus group discussions with health service managers. Data analysis followed deductive qualitative analysis guidelines.

Four basic themes emerged from the interviews, including EBMgt evidence sources (including sub-themes: scientific and research evidence, facts and information, political-social development plans, managers’ professional expertise and ethical-moral evidence); predictors (sub-themes: stakeholder values and expectations, functional behavior, knowledge, key competencies and skill, evidence sources, evidence levels, uses and benefits and government programs); EBMgt barriers (sub-themes: managers’ personal characteristics, decision-making environment, training and research system and organizational issues); and evidence-based hospital management processes (sub-themes: asking, acquiring, appraising, aggregating, applying and assessing).

Findings suggest that most participants have positive EBMgt attitudes. A full evidence-based hospital manager is a person who uses all evidence sources in a six-step decision-making process. EBMgt frameworks are a good tool to manage healthcare organizations. The authors found factors affecting hospital EBMgt and identified six evidence sources that healthcare managers can use in evidence-based decision-making processes.

Gastric cancer is the fourth most common cancer and the leading cause of death after lung cancer in the world. Considering the economic burden of cancers and their impact on household welfare, this study aims to estimate the cost of gastric cancer in Tabriz (Northwest city of Iran) in 2017.

This was an incidence-based cost of illness study which was conducted from the perspective of society with a bottom-up costing approach. The inclusion criteria for the study were all patients (n = 118) with gastric cancer at the period of the first six months after diagnosis that 102 patients participated. Data were analyzed using SPSS software version 22.

The mean medical direct cost was US$3288.02, 18.19 per cent paid by the patient and 81.81 per cent paid by insurance organizations and governmental subsidies. The estimated out of pocket rate was 18.19 per cent. The mean non-medical direct cost estimated at US$377.54. The mean total direct cost was US$3665.56, 26.61 per cent paid by the patient. The mean indirect cost estimated at US$505.41 and the mean total cost was US$4170.97, 35.5 per cent which imposed on the patient. The mean total cost of gastric cancer within the first six months after diagnosis was equivalent to 0.81 GDP per capita.

Based on the findings, gastric cancer is a highly costly disease that despite insurance coverage imposes a high economic burden on the patients and their families.