Cost-effectiveness of radiotherapy during surgery compared with external radiation therapy in the treatment of women with breast cancer
Hedie
Mosalanezhad
author
Zahra
Kavosi
author
Khosro
Keshavarz
author
Majid
Akrami
author
Maryam
Sarikhani
author
text
article
2016
eng
Introduction: Intraoperative radiation therapy device (IORT) is one of the several options for partial breast irradiation. IORT is sent to the tumor bed during surgery and can be replaced with conventional standard therapy (EBRT). The aim of this study was to evaluate the safety and effectiveness of IORT machine compared with EBRT and to determine the dominant option in terms of the cost-effectiveness.Method: This study was conducted in two phases; the first phase was a comprehensive review of the electronic databases search that was extracted after extraction and selection of the articles used in this article on effectiveness outcomes. Data collection form was completed by professionals and experts to estimate the cost of treatment, intraoperative radiotherapy and radiotherapy cost when using external radiation therapy process; direct costs were considered from the perspective of service provider and they were calculated in the second phase to determine the option of cost-effective ICER. Excel software was used for data analysis and sensitivity analysis was performed to determine the strength of the results of cost-effectiveness.Results:18 studies were selected but only 8 of them were shown to have acceptable quality. The consequences like “rate of cancer recurrence”, “seroma”, “necrosis”, “toxic”, “skin disorders and delayed wound healing” and “spread the pain” were among the consequences used in the selected articles. The total costs for each patient during a course of treatment for EBRT and IORT were estimated 1398 and $5337.5, respectively. During the analysis, cost-effectiveness of the consequences of cancer recurrence, seroma, necrosis and skin disorders and delayed wound healing ICER was calculated. And IORT was found to be the dominant supplier in all cases. Also, in terms of implications of toxicity and prevalence of pain, IORT had a lower cost and better effectiveness and consequently the result was more cost effective than EBRT.Conclusion: According to the results of this study, the difference between the two devices in terms of effectiveness was much lesser than that in terms of the cost of the two devices. According to the results of IORT machine, it is the dominant supplier compared with EBRT. From the cost-effectiveness perspective, Iran Ministry of Health can consider IORT system as an option for entering Iranian health system. But the ethical and cultural considerations in the use of the device must be taken into account.Keywords: Health technology assessment, IORT, EBRT, Cost-effective analysis, Systematic review
Health Management & Information Science
Shiraz University of Medical Sciences
2783-302X
3
v.
2
no.
2016
33
38
https://jhmi.sums.ac.ir/article_42663_b80b6093836405039cb1721de3e90074.pdf
Assessing the accessibility and degree of development in health care resources: evidence from the West of Iran
Satar
Rezaei
author
Behzad
Karami Matin
author
Yousef
Chavehpour
author
Negar
Yousefzadeh
author
Sajad
Delavari
author
Ali
Kazemi Karyani
author
text
article
2016
eng
Introduction: Health care is one of the most important sectors in the development of each country and disparities in their distribution will reduce the level of development. The aim of this study was to examine the access to healthcare and degree of development in health care resources in the west of Iran in 2011.Method: This was a cross-sectional and retrospective study. The study setting was 51 cities of five western provinces of Iran, including Kermanshah, Kurdistan, Ilam, Lorestan and Hamadan. For assessing these towns in terms of the degree of development in healthcare resources by the numerical taxonomy technique, 23 indicators of health resources were selected and obtained from the statistics yearbook. The data was analyzed by EXCEL software.Results:Our study showed that the highest and lowest access to health care based on numerical taxonomy belonged to cities of Kermanshah (0.61) and Salas Babajani (1.07). Also, most towns of Ilam, Lorestan and Kurdistan provinces are underdeveloped and developing, while the most towns of Kermanshah and Hamadan provinces were placed in the developed region.Conclusion: This study showed that there was a large gap between the cities of one province and also among the provinces in terms of the access to and degree of development in health care resources. Therefore, it is suggested that a higher priority in terms of health resource allocation should be placed on the developing and underdeveloped areas in order to reduce these disparities.Keywords: Disparity, Degree of development, Health care services, West of Iran
Health Management & Information Science
Shiraz University of Medical Sciences
2783-302X
3
v.
2
no.
2016
39
45
https://jhmi.sums.ac.ir/article_42664_3f3bfb6bc9c0647b71894e9c6925d4e2.pdf
Job satisfaction and social capital in university teachers
Rita
Rezaee
author
Parisa
Nabeiei
author
text
article
2016
eng
Introduction: Social capital is multidimensional and it is about the value of social networks and relations between people. Social capital refers to the relationships that forms the quality and quantity of the society’s social interactions. This study was designed to determine the relationship between social capital and faculty member’s job satisfaction in Shiraz Medical School.Method: Social capital is multidimensional and it is about the value of social networks and relations between people. Social capital refers to the relationships that forms the quality and quantity of the society’s social interactions. This study was designed to determine the relationship between social capital and faculty member’s job satisfaction in Shiraz Medical School.Results: 69 (57%) female and 51 (43%) male faculty members participated in this study. Also the findings indicated that mean±SD of social capital was 67.75±6.67 from 75 and that of job satisfaction was 77.1±6.41 from 100. There was a significant relationship between age and job satisfaction (p=0.002), but no relationship was found with marital status(p=0.24).There was a positive relationship between job satisfaction and social capital (p=0.003).Conclusion: Considering the results obtained from this study, it seems that paying attention to social capital and personal characteristics is a useful approach for behavioral interventions and organizational goals in order to upgrade the job satisfaction.Keywords: Social capital, Job satisfaction, Faculty members
Health Management & Information Science
Shiraz University of Medical Sciences
2783-302X
3
v.
2
no.
2016
46
50
https://jhmi.sums.ac.ir/article_42665_3aa9c428c43076e8d7f99f2d09463e92.pdf
Patient safety culture in teaching hospitals in Iran: assessment by the hospital survey on patient safety culture (HSOPSC)
Mohammad Zakaria
Kiaei
author
Amir
Ziaee
author
Rafat
Mohebbifar
author
Hamideh
Khoshtarkib
author
Elnaz
Ghanati
author
Azadeh
Ahmadzadeh
author
Saeideh
Teymoori
author
Omid
Khosravizadeh
author
Masoumeh
Zieaeeha
author
text
article
2016
eng
Introduction: Patient safety culture is an important part of improvement in the safety of health care. Knowing its present status is required for development of safety culture. The present study aimed to evaluate the current status of Patient safety culture in hospitals of three central provinces of Iran.Method: The present cross-sectional study was performed in teaching hospitals of Tehran, Alborz, and Qazvin provinces. The standard HSOPSC questionnaire was used for evaluation of the patient safety culture from the viewpoint of 522(Qazvin: 200, Tehran: 312, Alborz: 40) individuals who were randomly selected as workers of the hospitals. The collected data were analyzed using Chi-square and ANOVA tests.Results:The mean positive response to 12 aspects of the patient safety was 62.9%. “Organizational learning” had the highest proportion of positive response (71.18%) and “Handoffs & Transitions” had the lowest (54.49%). There was a statistically significant difference in scores of “Teamwork within Units”(p=0.006(,”Manager Expectations & actions promoting”(p=0.014),”organizational learning and continuous improvement”(p=0.001), “Management support”(p=0.007), “Feedback and communication”(p=0.012), and “Communication openness”(p=0.003) among the provinces, respectively.Conclusion: We performed a full assessment of the patient safety culture in the studied provinces. Organizational learning was satisfactory in the hospitals. The studied hospitals need arrangement of safety-based programs and supports of senior administrators to perform more sophisticated efforts and improve the patient safety culture.Keywords: Patient safety, Patient safety culture, Teaching hospitals
Health Management & Information Science
Shiraz University of Medical Sciences
2783-302X
3
v.
2
no.
2016
51
56
https://jhmi.sums.ac.ir/article_42666_cf0964c3bcf6e3cb30c468912129fba7.pdf
Design and validating the nurse-patient communication skills questionnaire
Saadat
Marhamati
author
Mitra
Amini
author
Houri
Mousavinezhad
author
Parisa
Nabeiei
author
text
article
2016
eng
Introduction: Evaluation of nurse-patient communication skills have been strongly emphasized in order to ensure the possibility of effective communication as well as assessment of the effect of communication skills training programs. Reaching this goal requires the use of standard instruments which is based on the native culture of the target group. Due to the absence of native instruments in this field, the aim of this study was to design and assess the validity and reliability of interpersonal communication skills, among nurses at Shiraz Educational Hospitals.Method: A mixed method (Qualitative, Quantitative) was used in two phases. The first phase was designing a descriptive questionnaire for nurse-patient communication skills (consisting of “brain storming” and “Delphi quantitative Research Method”). The next phase was defining the validity and reliability of the questionnaire based on confirmatory factor analysis and Cronbach’s alpha. The target population for the first phase was 15 faculty members of Shiraz University of Medical Sciences and for the second phase, 130 members of nursing staff of both educational and private hospitals of Shiraz. The data were analyzed using SPSS 14 and LISREL software after fulfilling the questionnaires.Results: The findings of the study demonstrated the reliability of the nurse-patient communication skills questionnaires (α=0.810). Except for question No. 17, the others had a significant relationship with the agent based on their validity and T-value.Conclusion: Like other clinical skills, communication requires the theoretical knowledge, evaluation and practice. The findings of this study are the most important indicators from the nurses’ view point which can be assessed in terms of communication skills. These options, as demonstrated, had an acceptable reliability and validity.Keywords: Communication skills, Questionnaire, Validity, Reliability
Health Management & Information Science
Shiraz University of Medical Sciences
2783-302X
3
v.
2
no.
2016
57
63
https://jhmi.sums.ac.ir/article_42667_3c1115b2fe30a42153215a754aaea744.pdf
Criticism of health researches: why and how
Hasan
Ashrafi-rizi
author
Fatemeh
Zarmehr
author
text
article
2016
eng
Research is one of the most important ways of science production (1). The purpose of research is exploring the unknown and explaining the variables that affect the human life. In the health sciences the purpose of which is health promotion, research is valued as much as human life (2). In many scientific texts, there is an emphasis on the importance of health researches in the quality of human life; the lack of attention to the quality of the publishing process is considered as the cause of much damage (3-10). The result of health researches is usually published as a paper, thesis, research project and book, the contents of all needs to be assessed. This process is named Research Review or Research Critique (2). Research critique is done during publishing process or after it, and in this paper we deal with it after publishing health texts. The broker chain between information producer and consumers who is the critic (Reviewer) and critique journals has been less attended. In short, Soltani indicates that the purpose of critique as a defense of society’s cultural rights is to help the reader to choose the appropriate work, help the writer identify his weak points and his strengths (11), and also prevent damage to the society, especially people’s health. In the critique of health researches, there are two essential stages: in the first stage, the work is studied quickly by the critic (Survey study). The aim of this study is gaining knowledge of the text and usually the bibliographic information of work like title, writer, incentive of work, headings and so on is assessed briefly (12). In the second stage, a critical study is done. The critical study is the most important and most critical step in the reviewing the texts. “In this study, the critic judges as to the accuracy, reliability, or value of the text based on criteria or standards. This type of study is the key to the appropriate understanding. This method is necessary to determine the truth and value of literature “(12, 13). The critic also accepts or rejects the content by reason, logic, scientific arguments and citation.” So, to do a critical study, four techniques are essential: asking questions, inferring, relevant content and association between the work content with other works, and evaluation “(12).
Health Management & Information Science
Shiraz University of Medical Sciences
2783-302X
3
v.
2
no.
2016
64
65
https://jhmi.sums.ac.ir/article_42662_e3b7a5a95e1e4e476ccdfb231341003d.pdf