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References
1. Awofeso N. Re-defining ‘Health’.
Bulletin of the World Health Organization. 2005; 83: 802.
2. Krug EG, Mercy JA, Dahlberg LL, Zwi AB. The world report on violence and health. The lancet. 2002; 360(9339):
1083-1088.
3. Kelishadi R, Alikhani S, Delavari A, Alaedini F, Safaie A, Hojatzadeh E.
Obesity and associated lifestyle behaviours in Iran: findings from the first national non-communicable disease risk factor surveillance survey. Pub Health Nutr. 2008; 11(3): 246-251.
4. Cetron MJ, Davies O. Trends now changing the world: Technology, the workplace, management, and institutions. The Futurist. 2001; 35(2):
27.
5. Shankar D. Health sector reforms for 21 st century healthcare. J Ayurveda Integr Med. 2015; 6(1): 4-9.
6. Nasiripour AA, Tabibi S, Raeisi P, Jahani MA. Designing a model for Hospital Services Globalization in iran. J Babol Univ Med Sci. 2010; 12(1): 86- 94.
7. Esmailzadeh H, Rajabi F, Rostamigooran N, Majdzadeh R. Iran health system reform plan methodology.
Iranian J Pub Health. 2013; 42(1): 13-17.
8. Moradi-Lakeh M, Vosoogh-
Moghaddam A. Health sector evolution plan in Iran; equity and sustainability concerns. Int J Health Policy Manage.
2015; 4(10): 637.
9. Faridfar N, Alimohammadzadeh K, Seyedin SH. The impact of health system reform on clinical, paraclinical and surgical indicators as well as
patients' satisfaction in Rasoul-e-Akram hospital in 2013 to 2014. Razi J Med Sci. 2016; 22(140): 92-99.
10.Heydarian N, Vahdat s. The impact of healthcare reform plan to pay out of pocket Patients in public hospitals of Isfahan. J Med Council Iran. 2015;
33(3): 187-194.
11.Shojaee Tehrani H, Ebadi Azar F.
Health care principles. Tehran: Samat Pub. 2006.
12.Datobar H, Alijanpour S, Khafri S, Jahani MA, Naderi R. Patient’s Satisfaction of Emergency Department Affiliated Hospital of Babol University of Medical Sciences in 2013-2014. J Babol Univ Med Sci. 2016; 18(4): 56- 62.
13.Naghavian M, Naghshine A, Abdi M, Jahani MA. The Evaluation of Performance Indicators in the Health Care of Babol University Medical of Sciences by the Pabon Lasso Model. J Babol Univ Med Sci. 2015; 17(3): 76- 82.
14.Kalhor R, Amini S, Sokhanvar M, Lotfi F, Sharifi M, Kakemam E. Factors affecting the technical efficiency of general hospitals in Iran: data envelopment analysis. J Egypt Pub Health Assoc. 2016; 91(1): 20-25.
15.Jahani MA, Naghshineh A, Naghavian M, Semnani H. Safety Indicators in the hospitals affiliated to babol university of medical sciences, Iran; 2010. J Babol Univ Med Sci. 2013; 15(2): 95-101.
16.Jannati A, Kabiri N, Asghari JM, Pourasghari B, Bayaz B. Surveying imapct of performance based payment on efficiency of clinical laboratory of
teaching hospital of Imam Reza in Tabriz. J Hospital. 2015; 14(1): 52-62.
17.Moghadamnia A, Jahani MA, Bijani A, Yaminfirooz M, Naghshineh A, Mohammadnia K. Evaluation of Performance Indicators and Frequency of Patient Referrals in the Hospitals Affiliated to Babol University of Medical Sciences in 2013. J Babol Univ Med Sci. 2016; 18(5): 61-69.
18.Khayeri F, Goodarzi L, Meshkini A, Khaki E. Evaluation of the National Health Care Reform Program from the Perspective of Experts. J Client- Centered Nurs Care. 2015; 1(1): 37-46.
19.Yardim MS, Cilingiroglu N, Yardim N.
Financial protection in health in Turkey:
the effects of the Health Transformation Programme. Health Policy Plan. 2014;
29(2): 177-192.
20.Wees PJ, Zaslavsky AM, Ayanian JZ.
Improvements in health status after Massachusetts health care reform.
Milbank Quarterly. 2013; 91(4): 663- 689.
21.Rezaei Sh. Evaluating the challenges and the effects of healthcare reform planon performance indicators university hospitals in Hamedan province. Tehran:
Tehran University of Medical Sciences Pub. 2015.
22.Yasar GY. ‘Health transformation programme’ in Turkey: an assessment.
Int J Health Plan Manage. 2011; 26(2):
110-133.
23.Amiresmaili M, Mosleh A, Isfahani P, Emami M. The Effective Factors in Improving Hospital Performance Indicators from the Viewpoint of Zabol Hospital, Iran, Managers. J Health Develop. 2012; 1(1): 56-66.
24.Afshari S, Ebrahimzadeh J, Yarmohamadian M. Comparative study of cesarean rate in hospitals affiliated to Isfahan University of Medical Sciences.
National Conference of critical of the Eleventh National Congress Critical of the Government in the Field of Health.
2015; 79.
25.Goudarzi L, Khayeri F, Mashkini, EA.
Healthcare reform program design with an emphasis on promoting natural birth in public hospitals affiliated to medical universities and national health services.
Eleventh National Congress Critical of the Government in the Field of Health.
2015; 11-12.
26.Sahin I, Ozcan YA, Ozgen H.
Assessment of hospital efficiency under health transformation program in Turkey. Cent Europ J Operat Res. 2011;
19(1): 19-37.
27.Kasir K, Raeesi A, Ahmadi S, . Examine the role of health development plan based on productivity index Feiz hospital before and after implementation of the plan. The second International Conference on Management Challenges and Solutions. 2014.
28.Piroozi B, Moradi G, Nouri B, Mohamadi Bolbanabad A, Safari H.
Catastrophic health expenditure after the implementation of health sector evolution plan: a case study in the west of Iran. Int J Health Policy Manage.
2016; 5(7): 417-423.
The impact of healthsystem reform plan on the hospital's performance indicators of Lorestan University of Medical Sciences
Dadgar R1, Jahani MA2*, Mahmoudi Gh3
1.MSc Student, Department of Health Services Management, Islamic Azad University, Sari Branch, Sari, Iran 2. Assistant Professor, Department of General Education, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran. [email protected].
3. Assistant Professor, Department of Health Services Managment, Islamic Azad University, Sari Branch, Sari, Iran
Received: 28 March 2017 Accepted: 27 May 2017
Abstract
Background : Health systems in order to confirmity with changing conditions and responding to community needs, community needs to change and continuous improvement of their structure, function, and subsequent evaluationindicators. Therefore the purpose of this study was to evaluate effect of health system reform plan on performance indicators.
Materials and Methods : This study was a cross-sectional descriptive study using data from the years 1392 to 1394, the years before and after the implementation of healthcare reform was carried out. The population consisted of all hospitals of the Lorestan University of Medical Sciences (14 Hospitals). For data analysis using SPSS version 16, Paired sample T tests and Wilcoxon software were used.
Results: After health system reform plan all indicators had better than before and this development was significant in all cases. After health reform plan average length of stay was slightly increased (0.5%), although this was not significant statistically (P = 0.653). Before the health reform plan, the difference between the average bed occupancy indicator only for educational and non-educational centers were significant statistically (p = 0/05), but after the reform mean for all the indicators except indicator of average length of stay (p = 0/038), was significant.
Conclusion: The health system reform plan has been positive changes in indicators of hospital performance. Therefore, while considering the current trend of continuous improvement, the continuity of the project was advised based on the results of this study.
Keywords: Healthcare reform, Performance indicators, Evaluation, Hospitals, Lorestan.
*Citation: Dadgar R, Jahani MA, Mahmoudi Gh. The impact of health system reform plan on the hospital's performance indicators of Lorestan University of Medical Sciences . Yafte. 2017; 19(2): 93-102.
