The Effect of the Health System Transformation Plan on Performance and Quality Indicators of Qods Hospital in Paveh

Document Type : Research Paper

Author

Assistant professor , Health and Social Welfare, Faculty of Social Sciences, Payam Noor University, Tehran, Iran

Abstract

Background and Objective: Accreditation is one of the important measures in the evaluation of health and medical services. . Therefore, the present study aims to determine the impact of accreditation on the most important performance and quality indicators of Qods Hospital in Paveh.
Materials and Methods: The present qualitative study was conducted cross-sectionally in the months of October, November and December 2019. Data were collected using semi-structured interviews. The sample units in this study were selected using purposive sampling, and after selecting 28 interviews (7 staff, 7 nurses, 14 patients), the sample size reached saturation. Most of the interviews were recorded and analyzed after implementation using data analysis.
Findings: The findings show that after the implementation of the Health Transformation Plan and the reduction of medical costs, Qods Hospital in Paveh has faced an increase in patient referrals and bed occupancy rates. The results showed that the guideline for reducing out-of-pocket payments was significantly better implemented than the other six guidelines of the Health System Transformation Plan, and this guideline was useful in implementation. However, the least achievements in implementation were in the areas of physician residency, promotion of natural childbirth, and improvement of service quality.
Conclusion: Increasing hospital workload, lack of physical space, facilities, and human resources required in proportion to the increase in referrals to provide care are among the most common causes of reducing service quality in Qods Paveh Hospital.

Keywords


  1. The World Health Report 2010: Health Systems Financing; the Path to Universal Coverage 2010., available at: http://apps.who.int/iris/bitstream/10665/44371/1/9789241564021_eng.pdf, access dat: 4/6/2016
  2. 2. Babashahy S, Akbari Sari A, Rashidian A, Olyaee Manesh A. Payments of Physicians Employed in Public and Private

Hospitals after Modification of Surgical and Invasive Services Tariffs. Hakim Research Journal 2012; 15: 38- 43.

  1. 3. Lozano R, Soliz P, Gakidu E, Abbott-Klafter J, Feehan DM, Vidal C, et al. Benchmarking of Performance of Mexican States with Effective Coverage. Lancet. 2006;368:1729-41.
  2. 4. Minkler M, Wallerstein N. Improving health through community organization. Commun Organ Commun Build Health. 2005;3(2):26-51

5 . Musselwhite C. Further examinations of mobility in later life and improving health and wellbeing. J Transport Health. 2015;2(2):99-100.

  1. 6. Solvang MM, Norekval TM, Tell GS, Berge LI, Iversen MM. Attempts to improve and confidence in improving health behaviour in 40-49 year olds with and without coronary heart disease: The Hordaland Health Study. Eur J Cardiovasc Nurs.

2016;15(3):e60-9. DOI: 10.1177/1474515115583399 PMID: 25888607

7 . Mahdi S, Simin G. The impact of Education and Health Infrastructures on Economic Growth of Iran. Journal of Research in Economic growth and development. 2014;5(19):117-36.

  1. 8. Lewin S, Lavis JN, Oxman AD, Bast.as G, Chopra M, Ciapponi A, et al. Supporting the delivery of cost-eff ective interventions in primary health-care systems in low-income and middle-income countries: an overview of systematic reviews. Lancet 2008;372:928-39.

9 . The Ministry of Health and Medical Education. Evaluation of health system reform plan in the treatment area. 1 ed. Iran: The Ministry of Health and Medical Education; 2015: 4-20. [Persian]

10 . Cooper LA, Ortega AN, Ammerman AS, Buchwald D, Paskett ED, Powell LH, et al. Calling for a bold new vision of health disparities intervention research. Am J Public Health. 2015;105 Suppl 3(0):S374-6. DOI: 10.2105/AJPH.2014.302386 PMID: 25905830

  1. 11. Frenk J. Leading the way towards universal health coverage: a call to action. Lancet. 2015;385(9975):1352-8. DOI: 10.1016/S0140-6736(14)61467-7 PMID: 25458718

12 . Cheng TL, Goodman E, Committee on Pediatric Research. Race, ethnicity, and socioeconomic status in research on child health. Pediatrics. 2015;135(1):e225-37. DOI: 10.1542/peds.2014-3109PMID: 25548336

13 . Shariati M. [Reform the health system, Why and how?]. J Knowl Health. 2015;5(2):12-9.

14 . Hashemi B, Baratloo A, Forouzafar MM, Motamedi M, Tarkhorani M. Patient Satisfaction Before and After Executing Health Sector Evolution Plan. Iran J Emerg Med. 2015;2(3):112-36. 11. Khojasteh A. [The strengths and weaknesses of the healthcare reform plan]: Mehr News; 2015 [updated 20162015]. Available from: www.mehrnews.com/news/2365802.

15 . Frenk, J., Gonzلlez-pier, E., Gَmez-Dantes, O., Lezana, M.A. and Knaul, F.M., 2006. Comprehensive  reform to improve health system performance in Mexico. The Lancet, 368, pp. 1524-1534.

16 . Rajabi F, Esmailzadeh H, Rostamigooran N, Majdzadeh R. What must be the Pillars of Iran’s Health System in 2025? Values and Principles of Health System Reform Plan. Iranian J Publ Health. 2013;42(2):197-205.

17 . Jafari M, Rashidian A, Abolhasani F, Mohammad K, Yazdani S, Parkerton P, et al. Space or no space for managing public hospitals; a qualitative study of hospital autonomy in Iran. Int J Health Plann Manage 2011; 26(3): e121-e137.

  1. 18. 9. National Institute of Health Research. The report of evaluation of health reform in treatment section [Online]. [cited 2014 Oct]; Available from: URL: http://nihr.tums.ac.ir/wp-content/uploads/2015/04/file3.pdf

19 . Haghdoost AA, Mehrolhassani MH, Khajehkazemi R, Fallah MS. Monitoring Indicators of Iranian Health System Reform Plan. Hakim Res J. 2013;16(3):171-81.

 

20 . Wang W, Dillon B, Bouamra O. An analysis of hospital trauma care performance evaluation. J Trauma Acute Care Surgery 2007;62(5): 1215-22.

21 . Gannon B. Testing for variation in technical efficiency of hospitals in Ireland. Economic Soc Rev 2005;36(3): 273.

  1. 22. Kazemi Z, Daliry A, Haghdost H, editors. Measurement of the efficiency and estimation of optimal consumption of resources in selected hospitals through Data Envelopment Analysis . International conference of Management Accounting; 2009.

23 . Mehrolhasani M, Yazdi Feyzabadi V, Barfeh Shahrbabak T. Assessing performance of Kerman province`s hospitals using Pabon Lasso diagram between 2008 and 2010. J Hospital 2014; 12(4): 99-108. [pertain]

24 . Kavosi Z, Goodarzi S, Almasiankia A. Performance evaluation in hospitals of Lorestan University of Medical Sciences using Pabon-Lasso Model. J Payavard salamat 2013;6(5): 365-75.

25 . Khorasani E, Keyvanara M, Karimi S, JafarianJazi M. The Role of patients in induced demand from experts’ perception: A qualitative study. J Qual Res Health Sci 2014; 2(4): 336-45.

  1. 26. Zamanzadeh V, Valizadeh L, Lotfi M, Salehi F. Burn Survivors’ Experience of Core Outcomes during Return to Life: a Qualitative Study. Journal of Caring Sciences. 2014;3(4):227-37.
  2. 27. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24 (2):105-12

28 . Lacey A, Luff D. Qualitative Data Analysis Nottingham: National Institute for Health Research,The NIHR RDS for the East Midlands / Yorkshire & the Humber; 2009.pp: 266-324

  1. 29. Zarezade M, Radabadi M. Future studies health reform plan from the perspective of scripting functions of the health system approach. Abstract Proceedings of the Eleventh National Congress critical of the government in the field of health, 2015; May 5-6; The National Institute for Health Research Islamic Republic of Iran, Tehran, Iran. Tehran, The National Institute for Health Research Islamic Republic of Iran; 2015: 28-29.[Persian]

30 . Goodarzi L, Kheiri F, Meshkini A, Khaki A. Satisfaction of patients and medical staff from the implementation of healthcare reform programs. Abstract Proceedings of the Eleventh National Congress critical of the government in the field of health, 2015; May 5-6; The National Institute for Health Research Islamic Republic of Iran, Tehran, Iran. Tehran, the National Institute for Health Research Islamic Republic of Iran; 2015: 43-44. [Persian]

31 . Narenjiha M, Haghighat SH, Bahador H, Shajari J, Haji Molla Hoseini F. Patients’ Satisfaction from Doctors’ Communication: a survey in Ghods Clinic in Tehran. Iranian Journal of Medical Education. Apr 2012; 12(1):78-85. [Persian]

32 . Mohammadi M. Is it possible to predict the future of reforms plan? Abstract Proceedings of the Eleventh National Congress critical of the government in the field of health, 2015; May 5-6; The National Institute for Health Research Islamic Republic of Iran, Tehran, Iran. Tehran, the National Institute for Health Research Islamic Republic of Iran; 2015: 26-27. [Persian]

33 . Godarzi, L., Khayeri, F., Meshkini, A. and Khaki , A., 2015a. Patient satisfaction and staff development programs of the health system. Criticism of the government in health XI. [In Persian]