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Article
Publication date: 17 December 2018

Satar Rezaei, Mohammad Hajizadeh, Ali Kazemi Karyani, Shahin Soltani, Heshmatollah Asadi, Mohammad Bazyar, Zahra Mohammadi, Neshat Kazemzadeh and Bijan Nouri

Appropriate access to formally-trained health workers for people living in rural and underdeveloped areas is a continuing challenge worldwide. The purpose of this paper is…

Abstract

Purpose

Appropriate access to formally-trained health workers for people living in rural and underdeveloped areas is a continuing challenge worldwide. The purpose of this paper is to investigate the willingness of formally-trained health workers to practice in underdeveloped areas and its main determinants among medical students in the western provinces of Iran.

Design/methodology/approach

A total of 753 medical students from four provinces in western Iran (Kermanshah, Ilam, Lorestan and Kurdistan) were surveyed cross-sectionally in 2017. A self-administrated questionnaire was used to collect data on sociodemographic characteristics, willingness to practice in underdeveloped areas, intrinsic (e.g. desire to help others and self-interest in medicine) and extrinsic (e.g. the high income of physicians and social prestige) motivations of the study population. Multivariable logistic regression was used to identify the main determinants of willingness to practice in underdeveloped areas among medical students after their graduation.

Findings

The results indicated that 58.3 percent of students were willing to practice in underdeveloped areas. While 59 percent of the study population had a strong extrinsic motivation to study medicine, the remaining 41 percent of the study population had a strong intrinsic motivation to study medicine. The logistic regression results indicated that low parental professional and educational status, an experience of living in rural areas and having strong intrinsic motivation were associated with greater willingness to practice in underdeveloped areas.

Originality/value

This is the first study to investigate the willingness to practice in underdeveloped areas and its main determinants among medical students in the west of Iran.

Details

International Journal of Health Governance, vol. 24 no. 1
Type: Research Article
ISSN: 2059-4631

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Article
Publication date: 12 April 2018

Satar Rezaei, Mohammad Hajizadeh, Mohammad Bazyar, Ali Kazemi Karyani, Behrooz Jahani and Behzad Karami Matin

The Health Sector Evolution Plan (HSEP) is the most recent reform in Iran’s health care system that was launched in May 2014 in all university-affiliated hospitals to…

Abstract

Purpose

The Health Sector Evolution Plan (HSEP) is the most recent reform in Iran’s health care system that was launched in May 2014 in all university-affiliated hospitals to reduce health care expenditure for patients, while improving the efficiency and quality of hospital services. The purpose of this paper is to evaluate the impact of the HSEP on the performance of 15 hospitals affiliated with Kermanshah University of Medical Sciences (KUMS), located in the western region of Iran.

Design/methodology/approach

The Pabon Lasso model was used to measure the performance of hospitals before and after the implementation of the HSEP in 2013-2014 and 2015-2016, respectively. Three indicators of average length of stay (ALoS), bed occupancy rate (BOR) and bed turnover rate (BTR) were analyzed by the Pabon Lasso model.

Findings

The results showed that the average ALoS, BTR and BOR before the introduction of the HSEP were 2.59 days, 92 times and 57 percent, respectively, and the corresponding figures for these indicators after the implementation of the HSEP were 2.61 days, 98.9 times and 59.9 percent. The results indicated that before the introduction of the HESP, 40 percent of hospitals were in zone 1 (poor performance: low BTR and BOR and high ALoS), 27 percent in zone 2, 20 percent in zone 3 (good performance: high BTR and BOR and low ALoS) and 13 percent in zone 4. After the HSEP, the proportion of hospitals in zones 1-4 was 33, 27, 20 and 20 percent, respectively.

Originality/value

This study is the first to use the Pabon Lasso model technique to evaluate the impact of the HSEP on hospitals affiliated with KUMS.

Details

International Journal of Health Governance, vol. 23 no. 2
Type: Research Article
ISSN: 2059-4631

Keywords

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Article
Publication date: 26 January 2021

Mehrangiz Sartipizadeh, Vahid Yazdi-Feyzabadi, Minoo Alipouri Sakha, Aein Zarrin, Mohammad Bazyar, Telma Zahirian Moghadam and Hamed Zandian

Health-promoting schools have been associated with improvements in the health status of students globally. This study is a secondary analysis study assessing Iranian HPSs.

Abstract

Purpose

Health-promoting schools have been associated with improvements in the health status of students globally. This study is a secondary analysis study assessing Iranian HPSs.

Design/methodology/approach

This was a cross-sectional study on routinely collected data using an external audit 63-item checklist, which was utilized to evaluate 440 HPSs between 2014 and 2017. The mean score for each of the checklists' components was calculated. Nonparametric tests were conducted to investigate the association between the presence of a school caregiver, students' educational level and the school's score.

Findings

While the number of five- and four-star schools increased significantly, one- to three-star schools declined. Providing clinical and counseling services had negative growth. Despite the steady growth of the staff's health, this category still had the lowest score among; on the contrary, physical activity had the highest score in 2017. The presence of a full-time school caregiver and middle schools were both significantly correlated with achieving higher scores (p < 0.005).

Originality/value

It seems that in addition to developing school facilities to promote physical activities, measures should be taken to promote access to counseling services, considering health issues of students and staff and finally increasing the number of full-time school caregiver

Details

Health Education, vol. 121 no. 2
Type: Research Article
ISSN: 0965-4283

Keywords

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Article
Publication date: 16 April 2018

Mohammad Hajiazizi and Adel Graili

The purpose of this paper is to extend the scaled boundary radial point interpolation method (SBRPIM), as a novel semi-analytical scheme, to the analysis of the steady…

Abstract

Purpose

The purpose of this paper is to extend the scaled boundary radial point interpolation method (SBRPIM), as a novel semi-analytical scheme, to the analysis of the steady state confined seepage flows.

Design/methodology/approach

This method combines the advantages of the scaled boundary finite element method and the BRPIM. In this method, only boundary nodes are used, no fundamental solution of the problem is required, and as the shape functions constructed based on the RPIM satisfy the Kronecker delta function property, the boundary conditions of problems can be imposed accurately and easily.

Findings

Three numerical examples, including seepage flow through homogeneous and non-homogeneous soils, are analyzed in this paper. Comparing the flow net obtained by SBRPIM and other numerical methods confirms the ability of the proposed method in analyzing seepage flows. In addition, in these examples, the accuracy of the SBRPIM in modeling the velocity singularity at a sharp corner is illustrated. SBRPIM accurately models the singularity point in non-homogeneous and anisotropic soil.

Originality/value

SBRPIM method is a simple effective tool for analyzing various kinds of engineering problems. It is easy to implement for modeling the velocity singularity at a sharp corner. The proposed method accurately models the singularity point in non-homogeneous and anisotropic soil.

Details

Engineering Computations, vol. 35 no. 2
Type: Research Article
ISSN: 0264-4401

Keywords

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Article
Publication date: 19 December 2016

Aidin Aryankhesal, Manal Etemadi, Zahra Agharahimi, Elham Rostami, Mohammad Mohseni and Zeinab Musavi

Exemption from hospital charges may appear as an essential policy in order to support the poor. Such policies can function for the fulfillment of governments’ social- and…

Abstract

Purpose

Exemption from hospital charges may appear as an essential policy in order to support the poor. Such policies can function for the fulfillment of governments’ social- and justice-based responsibilities in public hospitals. The purpose of this paper is to investigate the pattern of offering discounts to the poor and the effect of Iran’s recent Health Sector Evolution Plan on it.

Design/methodology/approach

The authors conducted analytical research longitudinally on the data related to cash discounts offered to the poor within a teaching hospital. Data were collected through the period of four months, September to December 2013, before the establishment of the Health Sector Evolution Plan, and in the similar months through 2014, after the establishment of the Health Sector Evolution Plan, in order to compare the amount of cash discounts. The type of insurance, length of stay, amount of discounts offered to patients, and total costs of hospital charges were studied and compared by referring to the social working department. Data were analyzed using the χ2-test, Mann-Whitney U test, ANOVA, and regression analysis aided by SPSS 20.

Findings

The number of patients offered discounts or exempted from payment in 2014 reduced compared to the number in 2013. The highest rate of demand for discounts was related to patients covered by Emdad Committee followed by those who had no insurance. The ratio of discount to cost in the oncology ward was higher than other groups.

Originality/value

The results of the present study can contribute to the plans of health system policy makers in organizing measures for supporting poor patients toward accessing healthcare services.

Details

International Journal of Human Rights in Healthcare, vol. 9 no. 4
Type: Research Article
ISSN: 2056-4902

Keywords

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Article
Publication date: 9 October 2019

Mohsen Pakdaman, Sara Geravandi, Ali Hejazi, Mobin Salehi and Mahboobeh Davoodifar

Currently, the health system is a treatment-oriented system focused on service providers. In this system, the main focus is on the health market, with little attention on…

Abstract

Purpose

Currently, the health system is a treatment-oriented system focused on service providers. In this system, the main focus is on the health market, with little attention on insured. One way to get out of existing conditions is to empower the insured in order to involve them actively in maintaining and improving health. The paper aims to discuss these issues.

Design/methodology/approach

This qualitative study was done using the content analysis method. Based on the purposive sampling method and theoretical saturation criterion, 24 individuals including 12 health insurance experts and 12 insured participated in the study in 2018. The semi-structured interview method was used to collect data. Data were analyzed using MAXQDA10 software.

Findings

Having analyzed the interviews, 750 codes were obtained. These codes were categorized into two categories of “insurance experts” and “insured” and ten subcategories of “informing and educating, cost reduction, intersectional activities, expectations from the insured, services package, access to services, inability to pay costs, participation, and expectations from the insurance organization.”

Originality/value

This qualitative study was conducted to assess and determine the effective strategies for empowering the insured under health insurance. The results of this study are helpful to the health insurance organizations and health decision makers to detect the effective ways to develop the quality of insurance services, improve the status of insured, and increase access to health care goods and services.

Details

International Journal of Human Rights in Healthcare, vol. 12 no. 5
Type: Research Article
ISSN: 2056-4902

Keywords

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Article
Publication date: 20 August 2018

Satar Rezaei, Abraha Woldemichael, Mohammad Hajizadeh and Ali Kazemi Karyani

Protecting households against financial risks of healthcare services is one of the main functions of health systems. The purpose of this paper is to provide a pooled…

Abstract

Purpose

Protecting households against financial risks of healthcare services is one of the main functions of health systems. The purpose of this paper is to provide a pooled estimate of the prevalence of catastrophic healthcare expenditures (CHE) among households in Iran.

Design/methodology/approach

Both international (PubMed, Scopus and Clarivate Analytics (previously known as the Institute for Scientific Information)) and Iranian (Scientific Information Database, Iranmedex and Magiran) scientific databases were searched for published studies on CHE among Iranian households. The following keywords in Persian and English language were used as keywords for the search: “catastrophic healthcare costs,” “catastrophic health costs,” “impoverishment due to health costs,” “fair financial contribution,” “prevalence,” “frequency” and “Iran” with and without “health system”. The I2-test and χ2-based Q-test suggested heterogeneity in the reported prevalence among the qualified studies; thus, a random-effects model was used to estimate the overall prevalence of CHE among households in Iran.

Findings

A total of 24 studies with a cumulative sample of 301,097 households were included in the study. The estimated pooled prevalence of CHE among households was 7 percent (95 percent confidence interval: 6–8 percent). Meta-regression analysis indicated that the prevalence of CHE was inversely related to the sample size (p<0.05). The results did not suggest a significant association between the prevalence of CHE and the year of data collection.

Originality/value

The findings revealed that the prevalence of CHE among Iranian households is significantly higher than 1 percent, which is the goal set out in Iran’s fourth five-year development plan. This warrants further policy interventions to protect households from incurring CHE in Iran.

Details

International Journal of Human Rights in Healthcare, vol. 12 no. 2
Type: Research Article
ISSN: 2056-4902

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Article
Publication date: 11 December 2017

Farzaneh Maftoon, Batool Mousavi, Mohammadreza Soroush, Davood Rahimpoor and Afsoon Aeenparast

Access to comprehensive, quality health care services is important for the achievement of health equity and for increasing the quality of a healthy life for everyone…

Abstract

Purpose

Access to comprehensive, quality health care services is important for the achievement of health equity and for increasing the quality of a healthy life for everyone. Insurance coverage increases the accessibility of services and is an important factor in health services utilization. Assessing patient satisfaction will be helpful in detecting quality gap and bottlenecks of service providing processes. The purpose of this paper is to to assess the satisfaction of complementary insurance schema of Iran Veterans and Martyrs Affair Foundation (VMAF) for receiving outpatient visits.

Design/methodology/approach

This was a cross-sectional study. The study population was veterans and their families and as well as Martyrs’ families. In this survey, 1,823 cases were selected using the random sampling method. Data were gathered by a questionnaire. The questionnaire validity and reliability was tested. The questionnaires were completed based on telephone interviewing. The questionnaires were completed for the last family use of complementary insurance for receiving medical services. The SPSS statistical software was used for data analysis.

Findings

A total of 1,823 cases used their complementary insurance that were studied. About 32.9 percent of studied cases were Martyrs’ families and the others were veterans and their family members. The satisfaction level was assessed from different dimensions: respondents were highly satisfied from outpatient visits. The satisfaction of process of receiving visit payment was the lowest. The factors associated with the risk of dissatisfaction are tested by using logistic regression. Analysis indicated that living in rural areas and being a martyr family increase the risk of dissatisfaction from the distance to an outpatient center.

Originality/value

Satisfaction is a multi-dimensional factor that reveals different aspects of services. It is possible that the satisfaction level in different dimensions of care was not the same. This study indicated that complementary health care insurance provided by the VMAF is good from care receivers’ perspective. But some consideration is necessary for improving that access of under-coverage population in remote districts and rural areas and process of receiving visit payment.

Details

International Journal of Human Rights in Healthcare, vol. 10 no. 5
Type: Research Article
ISSN: 2056-4902

Keywords

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