Hasan Gorji - Academia.edu (original) (raw)

Papers by Hasan Gorji

Electronic Physician, 2018

Background: Strategic purchasing in healthcare services is a key component in improving health sy... more Background: Strategic purchasing in healthcare services is a key component in improving health system performance, and it has been one of the most important issues in health system reform around the world, especially Europe in the last decade. Iran health system and insurance, although sometimes considered the issue of strategic purchasing goals, has not been made possible to achieve or even to implement, due to the associated problems. Objective: To determine the associated problems of strategic purchasing in the Iran Health Insurance Organization (IHIO). Methods: This study is a qualitative study, and framework analysis which was conducted in Iran in 2014-15. The participants in this study were 34 individuals from decision-makers and executives in the IHIO purchasing process, and university experts who have been chosen purposefully. This study conducted frame analysis, by using MAXQDA 10. Results: The findings included associated problems of IHIO strategic purchasing in 12 themes and 65 subthemes. The themes included: Laws and regulations for purchasing, Organization of purchasing, Qualified and authorized providers, Right type of services, Right type of contracts, Target groups for purchasing, Resources allocation, financing and pricing system, Purchasing as improving performance and quality, Purchasing as shaping the market and competition, Purchasing as health progress state of people and society, Guided purchasing and stewardship of government, Structure of decision-making process in the health and welfare ministries. Conclusion: The findings of this study showed associated problems in IHIO strategic purchasing. To achieve strategic purchasing goals in Iran, identification of all issues and factors of the total insurers and health system sets which affect strategic purchasing is essential.

Background An effective health headquarters has behaviors, knowledge, skills, and motivations tha... more Background An effective health headquarters has behaviors, knowledge, skills, and motivations that are behavioral, technical, and motivational prerequisites for successful performance in a job. This study aims to identify the general competencies of health headquarters to meet the needs of the health system.Methods To facilitate a consensus-building process on the development of public competencies, a multi-step approach was used. First, to identify the dimensions and components of general competencies in attracting health headquarters, the systematic review and meta-synthesis were used. Then, using a purposive critical case sampling, twenty-six participants were interviewed and the information was analyzed. In the third stage, the health headquarters were classified into three levels. To present the initial model of competencies, the Mini Delphi method was used. Finally, in the fourth step, to validate and finalize the pattern, the three-step Delphi method was used.Results The six ...

PLOS ONE, 2022

Background The “Coronavirus Disease 2019” (COVID-19) pandemic has become a major challenge for al... more Background The “Coronavirus Disease 2019” (COVID-19) pandemic has become a major challenge for all healthcare systems worldwide, and besides generating a high toll of deaths, it has caused economic losses. Hospitals have played a key role in providing services to patients and the volume of hospital activities has been refocused on COVID-19 patients. Other activities have been limited/repurposed or even suspended and hospitals have been operating with reduced capacity. With the decrease in non-COVID-19 activities, their financial system and sustainability have been threatened, with hospitals facing shortage of financial resources. The aim of this study was to investigate the effects of COVID-19 on the revenues of public hospitals in Lorestan province in western Iran, as a case study. Method In this quasi-experimental study, we conducted the interrupted time series analysis to evaluate COVID-19 induced changes in monthly revenues of 18 public hospitals, from April 2018 to August 2021,...

BMC Public Health, 2020

Background The availability of human resources for the health sector is not enough requirement fo... more Background The availability of human resources for the health sector is not enough requirement for addressing health needs. Instead, it is necessary to take effective steps to meet the requirements of the health care system in case the system has the necessary competencies. This study was performed to identify the competencies of health headquarters in meeting the needs of the health system. Methods This thematic synthesis was performed to develop a set of central themes that summarize all the topics raised in the articles reviewed in this study. The quality of the articles was assessed by the Standards for Reporting Qualitative Research. Results We included 12 articles from seven countries. Seven central themes were inductively developed from the analysis: (1) Leadership and management, (2) Analyzing, interpreting, and reporting, (3) Public health knowledge, (4) Interpersonal relationship, (5) Personality competencies, (6) Cultural and community competencies, and (7) International/...

BackgroundAn effective health headquarter worker has behaviors, knowledge, skills, and motivation... more BackgroundAn effective health headquarter worker has behaviors, knowledge, skills, and motivations which are behavioral, technical, and motivational prerequisites for successful performance in a job. This study aims to identify the general competencies of health headquarters workers to meet the needs of the health system.MethodsWe used multiple qualitative methods to facilitate a consensus-building process on developing core competencies. First, we used systematic review and meta-synthesis to identify the dimensions and components of core competencies. Using a critical case sampling, we interviewed twenty-six participants and analyzed the information with thematic content analysis. In the third phase, we divided the health headquarters workers into three levels. Then, to present the initial model of competencies, the Mini Delphi method was used. Finally, in the fourth phase, to reach a consensus on the importance of each competency and determine the level of competencies required fo...

Journal of Preventive Medicine and Hygiene, 2020

Summary Background The role of health systems in the management of disasters, including natural h... more Summary Background The role of health systems in the management of disasters, including natural hazards like outbreaks and pandemics, is crucial and vital. Healthcare systems which are unprepared to properly deal with crises are much more likely to expose their public health workers and health personnel to harm and will not be able to deliver healthcare provisions in critical situations. This can lead to a drammatic toll of deaths, even in developed countries. The possible occurrence of global crises has prompted the World Health Organization (WHO) to devise instruments, guidelines and tools to assess the capacity of countries to deal with disasters. Iran’s health system has been hit hardly by the COVID-19 pandemic. In this study, we aimed to assess its preparedness and response to the outbreak. Methods The present investigation was designed as a qualitative study. We utilized the “COVID-19 Strategic Preparedness and Response Plan” devised by WHO as a conceptual framework. Results T...

Journal of Preventive Medicine and Hygiene, 2020

Summary Background Hepatitis C infection (HCV) can have a harmful effect on the health of people ... more Summary Background Hepatitis C infection (HCV) can have a harmful effect on the health of people and can impose relevant healthcare costs. The World Health Organization has identified the elimination of Hepatitis C by 2030 as an important goal for all countries. This study aimed to identify the HCV-related policies in Iran. Methods A qualitative approach was used for this study. Data was collected through a comprehensive search of documents and interviews with different stakeholders related to the HCV program. Data was analyzed and validated using content analysis based on the policy triangle framework. Results Our findings highlighted that certain social and cultural issues related to stigma can impact on awareness-raising processes. It is also necessary to consider HCV directly in the context of government policies. All relevant stakeholders should be included. Continued talks and interactions need to be made between them for the active participation of all actors. Conclusion The ...

International Journal of Preventive Medicine, 2020

The prevalence of mental disorders in Iran is rising for many reasons including the population gr... more The prevalence of mental disorders in Iran is rising for many reasons including the population growth and its problems, the collapse of the family foundation, the economic problems, etc. Epidemiological studies of psychiatric disorders play an important role in determining the general mental health of the population and policy-making and future planning of service delivery. To identify the relevant studies, two authors independently searched different scholarly databases including Embase, PubMed/MEDLINE, ISI/Web of Science (WOS), Scopus, Psych INFO, and Iranian databases such as MagIran, SID, IranPsych, and Irandoc from 1st January 2007 up to 1st July 2018. The gray literature (through Google Scholar) was also mined. Studies written in English or in the Persian language were searched. After searching the databases and removing duplicates cases, a total of 10 studies were selected and included in the study, which reported a total of 14 prevalence rates. There were a total of 72,262 p...

Journal of Education and Health Promotion, 2019

INTRODUCTION: Disasters are inescapable phenomena. Once they occur, reliable and objective inform... more INTRODUCTION: Disasters are inescapable phenomena. Once they occur, reliable and objective information becomes vital in sound decision-making to respond. Emergency health evaluation of affected population can be used to gather information about the patterns of access to medical care, basic household needs, and other health needs. The objective of this review was to summarize evidence from scientific studies on the various methods of emergency health evaluation following disasters. MATERIALS AND METHODS: A comprehensive list of studies was provided in May 2017 by an extensive search using PubMed, Web of Sciences, Ovid Medline, ProQuest Research Library, and World Health Organization Library. RESULTS: Of the 1592 retrieved articles, 21 articles were included in this review. In a majority of the studies (n = 18), a questionnaire was used and an interview was conducted to collect information, but in three studies, smartphone-based methods were used. Sampling method in most of the studie...

Asian Pacific Journal of Cancer Prevention : APJCP, 2018

Background: Disasters affect all social functions. In particular, hospitals must mobilize their r... more Background: Disasters affect all social functions. In particular, hospitals must mobilize their resources for response to mass injuries. This process can affected treatment of cancer patients and may resulted in delayed care. Considering the importance of continuity of care for cancer patients, the aim of this systematic review was to identify challenges and preparedness measures for cancer patients during and after disasters. Materials and Methods: This systematic review that was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines between January 2000 to December 2017. The keywords searched included: “disaster,” “emergency,” “crisis,” “disruptive event,” “technological disaster,” “natural disaster,” “cancer,” “cancer patient,” “chronic disease,” “continuity of care,” and “patient with chronic disease. “The Google Scholar, ISI Web of Science, Science Direct, PubMed and Scopus databases were searched. Results: After screening ...

BackgroundCOVID-19 was first reported in Wuhan, China, and has spread rapidly around the world. T... more BackgroundCOVID-19 was first reported in Wuhan, China, and has spread rapidly around the world. The purpose of this study was to investigate the effects of implementing social distancing policy, and the impact of its lifting, with the resumption of social contacts and activities, as well as the effects of mandating face masks on the temporal trend of new COVID-19 cases in Iran. Methods We employed the interrupted time series analysis (ITSA), which is a very valuable method that can be used to evaluate the impact of the implementation of various policies in the health sector to help health policy-makers make effective decisions. Daily data were collected from the Ministry of Health and Medical Education and the World Health Organization from 954 public hospitals and health center settings. Data were extracted 14 days before and after the implementation of each policy. Results were computed with their 95% confidence interval (CI) and p-values equal to or less than 0.05 were considered...

Journal of Virus Eradication, 2018

The World Health Organization (WHO) has estimated that about 71 million people in the world have ... more The World Health Organization (WHO) has estimated that about 71 million people in the world have chronic hepatitis C virus (HCV) and 399,000 die every year due to cirrhosis and cancer caused by HCV. Despite efforts to prevent and control hepatitis, there are still many barriers. In September 2000, during a summit in New York organised by the United Nations, world leaders agreed on a set of achievable targets within a limited timeframe, with the goal of combating poverty, hunger, disease, illiteracy, destruction of the environment and of improving the status of women by 2015; these were known as the Millennium Development Goals. The Primary Health Care Network (PHCN) in Iran has played a very important role in health promotion but its achievements could be enhanced further by improving performance and implementing further changes. The WHO strives to achieve goals of sustainable development by 2030 in many countries, thereby raising awareness, encouraging greater community participation, mobilising resources, using evidence-based policies, and increasing screening services, care and treatment. The concept of the PHCN has been very successful in health promotion in Iran, and has provided a basis for accessible and high-quality services for all. Achieving HCV elimination by 2030 could be achieved with the support of the PHCN, and changes in management with regard to screening, prevention and treatment practices.

Journal of Virus Eradication, 2019

Hepatitis C virus (HCV) infection represents one of the major public health challenges worldwide.... more Hepatitis C virus (HCV) infection represents one of the major public health challenges worldwide. HCV is a blood-borne pathogen associated with a high rate of mortality and imposes a dramatic societal and economic burden on health systems. Untreated chronic HCV infection can progress to liver cirrhosis and cancer. Lessons can be learned from countries such as egypt and Georgia that are considered to be 'on-track' for the world Health organization HCV elimination targets, as well as countries such as iran that are 'working towards elimination'. this article compares HCV-related policies and strategies in iran, egypt and Georgia to identify programme strengths and limitations that could inform policy and decision makers in iran. Controlling and eliminating HCV remain a serious public health challenge. the rising HCV incidence could generate a dramatic economic burden in the coming years. therefore, iran requires a strategic plan to fight HCV. Adequate cultural and social infrastructures are needed. Centres specifically devoted to the diagnosis and management of this infection should be used for screening and delivery of inexpensive and high-quality testing. Quick initiation of treatment should take place at lower costs to facilitate access to treatment.

Journal of Multidisciplinary Healthcare, 2018

Introduction: Prehospital emergency medical service dispatchers should make prompt and appropriat... more Introduction: Prehospital emergency medical service dispatchers should make prompt and appropriate decisions to save the life of victims. The complexity of timely and reasonable decision-making in life-threatening conditions has driven researchers to investigate varying aspects of the emergency medical dispatch (EMD) process. The purpose of this study was to explore the contributors to appropriate and prompt decision-making among dispatchers. Methods: A qualitative study through thematic analysis was designed. Data were collected using observation and semistructured interviews with 16 authorities and dispatchers in seven EMDs across Iran. Results: The study found "responsiveness" as the main category contributing to improved decision-making in EMD. The components introduced in this study for dispatchers' responsiveness consisted of two categories. The first was "personal values" including faith and belief, eagerness to help, service excellence, altruism, respect, and impartiality in clinical judgment. The second was "professional attitudes" resulting from education and experience, including the recognition of emergency as a threat to health, sensitivity in triage, response to all requests for help, care for early warnings, commitment to organizational goals and standards, attention to the emergency medical service social support responsibility, and professional temperance. Conclusion: In this study, responsiveness was identified as a main category in improving the decision-making process among dispatchers. To attain responsiveness, institutionalization of its values and establishment of EMD-specific professional attitudes in dispatchers should be taken into consideration.

International Journal of Cancer Management, 2019

Context: Cancer is one of the leading causes of death globally. It changes the patient's life, an... more Context: Cancer is one of the leading causes of death globally. It changes the patient's life, and not only causes many physical and emotional symptoms but also reduces the quality of life (QOL) in patients during the advanced stages of cancer. Today, the main approach in taking care of these patients is to provide supportive and palliative care with the aim of enhancing the QOL in patients and their families and to reduce the cost of treatment and health care. This study was conducted with the aim of comparing the policies and the strategies related to cancer supportive and palliative care in the selected countries, using the World Health Organization (WHO) guideline in the United Kingdom (UK), Malaysia, and South Africa. Evidence Acquisition: This study is a comparative study. The data were collected through reviewing scientific and administrative documents, WHO website and reports, the Ministry of health websites, and other authoritative websites. The search was done through texts in English and the databases, including Science Direct, Scopus, and PubMed between 2000 and December 2018. We used a strategy search according to Medical Subject Headings, using the keywords (cancer, palliative care, supportive care, patients, policies, programs, strategies, UK, Malaysia, and South Africa). The data were analyzed by content analysis approach, using MAXQDA software version 11. Results: The rates of cancer and mortality differed according to the health differences in the selected countries. With regard to palliative care, various policies and programs were implemented. The implementation of more policies was carried out by the Ministry of Health. In some countries, adequate funding was available to support programs. Countries have been trying to provide decent manpower to provide services. Despite the successes achieved in implementing palliative care programs, some factors, such as inadequate healthcare structures and insufficient financial resources have caused problems in implementing programs. Conclusions: Countries should consider palliative care as one of the important priorities of the health system and a way of enhancing QOL in patients with cancer and their families, and with regard to the context of each country, focusing on each area of practical guide, reviewing the status and available facilities, and learning from the experiences of other countries should be considered to achieve this goal.

Evidence Based Health Policy, Management and Economics, 2019

Background: Nearly all of the rationing mechanisms have negative impacts on the poor. If the fair... more Background: Nearly all of the rationing mechanisms have negative impacts on the poor. If the fair service access is not set as the top priority in the rationing choices, the poor will experience service limitation and scarcity. This study aims at investigating the effects of rationing policies on the poor covered by Iran Health Insurance System. Methods: This article is based on a qualitative study conducted in 2017. In total, 32 experts of health system financing participated in the study. A purposeful sampling method was applied till reaching knowledge saturation. Data were collected using semi-structured interviews. Afterwards, data was analyzed by framework analysis based on Bennet and Gilson pro-poor health financing system framework using MAXQDA10 software. Results: The main challenge of rationing through the insurance system in Iran is the rationing only for the poor. As a result of rationing decisions, the poor are mostly the first group affected by service limitation...

Infectious Diseases of Poverty, 2018

Background: Street children are forced to spend a lot of time away from their homes and some of t... more Background: Street children are forced to spend a lot of time away from their homes and some of them do not have homes at all, due to economic and family problems, which makes them exposed to many health problems, such as the hepatitis C virus (HCV) infection. Iran, like many other countries in the world, experiences the burden of street children, however, the rate of HCV among street children is virtually unknown. This study aimed to determine the prevalence of HCV among street children in Iran. Main body: This systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study protocol of this review was registered in PROSPERO under identification term CRD42018082336. A comprehensive literature search was conducted to identify published studies reporting on the prevalence of HCV among street children in Iran. Several international scholarly databases, including Web of Science, PubMed®/MEDLINE®, Embase, Scopus®, Google Scholar and Directory of Open Access Journals, as well as Iranian databases such as MagIran and Barakathns were searched. Studies published between 1988 and December 2017 with any of the following keywords were selected: (street OR homeless OR labour) AND (children OR child OR infant) AND (hepatitis C OR hepatitis C virus OR HCV OR viral hepatitis OR hepatitis OR hepacivirus) AND Iran. Moreover, a grey literature search was performed in order to obtain other potentially relevant studies. The search was carried out without any language restrictions. Four studies, surveying a total of 1691 street children, conducted between 2006 and 2017 were found to be eligible for inclusion in the review and therefore analysed. Three studies were conducted in Tehran and one in Isfahan. The prevalence of HCV among street children in Iran was found to be high, at 2.4% (95% CI: 1.8-3.3). Conclusions: Since the prevalence of HCV among street children in Iran is quite high, health decision-and policy-makers should pay more attention to street children and widen support channels, both social and economic. Further studies should be conducted among street children in different cities of Iran to add to the knowledge base of HCV among street children in the country. The health system should provide facilities for street children to be screened to quickly diagnose illnesses and prevent them from developing complications.

Health Research Policy and Systems, 2019

Background: Hepatitis C virus (HCV) infection causes a large number of deaths annually worldwide.... more Background: Hepatitis C virus (HCV) infection causes a large number of deaths annually worldwide. Policies play an important role in regulating healthcare agendas and prioritising of health-related issues. Understanding these priorities is very important in health. The objective of this study was to investigate HCV-related issues and their influence on agenda-setting in Iran. Methods: A qualitative design was used. Data were collected by carrying out a review of documents and interviews. A comprehensive search was conducted to identify documents related to HCV-related policies in Iran. Semi-structured interviews were conducted with both purposive and snowball sampling of 14 interviewees related to the HCV programme in Iran, including government officials, civil society, development partnership members and academicians. Documents and interview data were analysed manually and using MAXQDA Version 10 software. Kingdon's multiple streams framework was used to guide data analysis. Results: The factors which influenced HCV-related agenda-setting were lack of proper information of the HCV epidemiology before the 1990s, lack of diagnostic facilities, neighbouring countries with high HCV prevalence, the stigma of HCV, high prevalence in prisoners, international evidence and high costs generated by HCV. The factors related to policy were effective treatment methods, drug production inside Iran, Iran Hepatitis Network, support outside government group elites and academicians. The factors related to political will were international influence, changes in the government and parliament support. Conclusion: The findings of this study showed that there are various national and international factors that play a role in shaping HCV-related policies. It seems that, if HCV is put into the agenda, it can be eliminated in Iran by 2030 by supporting and implementing appropriate programmes from decision-and policy-makers.

Health Research Policy and Systems, 2019

Background: Policy-and decision-makers seek to improve the quality of care in the health sector a... more Background: Policy-and decision-makers seek to improve the quality of care in the health sector and therefore aim to improve quality through appropriate policies. Higher quality of care will satisfy service providers and the public, reduce costs, increase productivity, and lead to better organisational performance. Clinical governance is a method through which management can be improved and made more accountable, and leads to the provision of better quality of care. In November 2009, the Iranian Ministry of Health and Medical Education implemented new clinical guidelines to standardise and improve clinical services as well as to increase efficiency and reduce costs. The purpose of this study was to assess the challenges of implementing clinical governance through a meta-synthesis of qualitative studies published in Iran. Methods: Ten databases, including ISI/Web of Sciences, PubMed/MEDLINE, Embase, PsycINFO, the Cochrane Library, CINAHL, Scopus, Barakatns, MagIran and the Scientific Information Database, were searched between January 2009 and May 2018. The quality of the included studies was assessed using the Critical Appraisal Skills Programme tool. This study was reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines. Thematic synthesis was used to analyse the data. Results: Ten studies were selected and included based on the inclusion/exclusion criteria. In the first stage, 75 items emerged and were coded, and, following comparison and combination of the codes, 32 codes and 8 themes were finally extracted. These themes included health system structure, management, person-power, cultural factors, information and data, resources, education and evaluation. Conclusion: The findings of the study showed that there exist a variety of challenges for the implementation of clinical governance in Iran. To successfully implement a health policy, its infrastructure needs to be created. Using the views and support of stakeholders can ensure that a policy is well implemented. Trial registration: CRD42017079077. Dated October 10, 2017.

Ethiopian journal of health sciences, 2018

Effective discharge planning plays a vital role in care continuity and integrated care. Identifyi... more Effective discharge planning plays a vital role in care continuity and integrated care. Identifying and providing infrastructures for discharge planning can reduce avoidable hospital readmissions and finally lead to improvement of quality of care. The current study aimed to identify the requirements of discharge planning from the perspective of professionals in the health system of Iran. For the purposes of this qualitative study, semi-structured interviews and sessions of focus group discussions with experts in the field were conducted. The data were analyzed using a thematic and framework analyses method. The study population was 51 participants including health policy makers, hospital and health managers, faculty members, nurses, practitioners, community medicine specialists and other professionals of the Ministry of Health andMedical Education (MOHME). According to the control knobs (health reforms levels), recruitments of effective hospital discharge planning were divided into ...

Electronic Physician, 2018

Background: Strategic purchasing in healthcare services is a key component in improving health sy... more Background: Strategic purchasing in healthcare services is a key component in improving health system performance, and it has been one of the most important issues in health system reform around the world, especially Europe in the last decade. Iran health system and insurance, although sometimes considered the issue of strategic purchasing goals, has not been made possible to achieve or even to implement, due to the associated problems. Objective: To determine the associated problems of strategic purchasing in the Iran Health Insurance Organization (IHIO). Methods: This study is a qualitative study, and framework analysis which was conducted in Iran in 2014-15. The participants in this study were 34 individuals from decision-makers and executives in the IHIO purchasing process, and university experts who have been chosen purposefully. This study conducted frame analysis, by using MAXQDA 10. Results: The findings included associated problems of IHIO strategic purchasing in 12 themes and 65 subthemes. The themes included: Laws and regulations for purchasing, Organization of purchasing, Qualified and authorized providers, Right type of services, Right type of contracts, Target groups for purchasing, Resources allocation, financing and pricing system, Purchasing as improving performance and quality, Purchasing as shaping the market and competition, Purchasing as health progress state of people and society, Guided purchasing and stewardship of government, Structure of decision-making process in the health and welfare ministries. Conclusion: The findings of this study showed associated problems in IHIO strategic purchasing. To achieve strategic purchasing goals in Iran, identification of all issues and factors of the total insurers and health system sets which affect strategic purchasing is essential.

Background An effective health headquarters has behaviors, knowledge, skills, and motivations tha... more Background An effective health headquarters has behaviors, knowledge, skills, and motivations that are behavioral, technical, and motivational prerequisites for successful performance in a job. This study aims to identify the general competencies of health headquarters to meet the needs of the health system.Methods To facilitate a consensus-building process on the development of public competencies, a multi-step approach was used. First, to identify the dimensions and components of general competencies in attracting health headquarters, the systematic review and meta-synthesis were used. Then, using a purposive critical case sampling, twenty-six participants were interviewed and the information was analyzed. In the third stage, the health headquarters were classified into three levels. To present the initial model of competencies, the Mini Delphi method was used. Finally, in the fourth step, to validate and finalize the pattern, the three-step Delphi method was used.Results The six ...

PLOS ONE, 2022

Background The “Coronavirus Disease 2019” (COVID-19) pandemic has become a major challenge for al... more Background The “Coronavirus Disease 2019” (COVID-19) pandemic has become a major challenge for all healthcare systems worldwide, and besides generating a high toll of deaths, it has caused economic losses. Hospitals have played a key role in providing services to patients and the volume of hospital activities has been refocused on COVID-19 patients. Other activities have been limited/repurposed or even suspended and hospitals have been operating with reduced capacity. With the decrease in non-COVID-19 activities, their financial system and sustainability have been threatened, with hospitals facing shortage of financial resources. The aim of this study was to investigate the effects of COVID-19 on the revenues of public hospitals in Lorestan province in western Iran, as a case study. Method In this quasi-experimental study, we conducted the interrupted time series analysis to evaluate COVID-19 induced changes in monthly revenues of 18 public hospitals, from April 2018 to August 2021,...

BMC Public Health, 2020

Background The availability of human resources for the health sector is not enough requirement fo... more Background The availability of human resources for the health sector is not enough requirement for addressing health needs. Instead, it is necessary to take effective steps to meet the requirements of the health care system in case the system has the necessary competencies. This study was performed to identify the competencies of health headquarters in meeting the needs of the health system. Methods This thematic synthesis was performed to develop a set of central themes that summarize all the topics raised in the articles reviewed in this study. The quality of the articles was assessed by the Standards for Reporting Qualitative Research. Results We included 12 articles from seven countries. Seven central themes were inductively developed from the analysis: (1) Leadership and management, (2) Analyzing, interpreting, and reporting, (3) Public health knowledge, (4) Interpersonal relationship, (5) Personality competencies, (6) Cultural and community competencies, and (7) International/...

BackgroundAn effective health headquarter worker has behaviors, knowledge, skills, and motivation... more BackgroundAn effective health headquarter worker has behaviors, knowledge, skills, and motivations which are behavioral, technical, and motivational prerequisites for successful performance in a job. This study aims to identify the general competencies of health headquarters workers to meet the needs of the health system.MethodsWe used multiple qualitative methods to facilitate a consensus-building process on developing core competencies. First, we used systematic review and meta-synthesis to identify the dimensions and components of core competencies. Using a critical case sampling, we interviewed twenty-six participants and analyzed the information with thematic content analysis. In the third phase, we divided the health headquarters workers into three levels. Then, to present the initial model of competencies, the Mini Delphi method was used. Finally, in the fourth phase, to reach a consensus on the importance of each competency and determine the level of competencies required fo...

Journal of Preventive Medicine and Hygiene, 2020

Summary Background The role of health systems in the management of disasters, including natural h... more Summary Background The role of health systems in the management of disasters, including natural hazards like outbreaks and pandemics, is crucial and vital. Healthcare systems which are unprepared to properly deal with crises are much more likely to expose their public health workers and health personnel to harm and will not be able to deliver healthcare provisions in critical situations. This can lead to a drammatic toll of deaths, even in developed countries. The possible occurrence of global crises has prompted the World Health Organization (WHO) to devise instruments, guidelines and tools to assess the capacity of countries to deal with disasters. Iran’s health system has been hit hardly by the COVID-19 pandemic. In this study, we aimed to assess its preparedness and response to the outbreak. Methods The present investigation was designed as a qualitative study. We utilized the “COVID-19 Strategic Preparedness and Response Plan” devised by WHO as a conceptual framework. Results T...

Journal of Preventive Medicine and Hygiene, 2020

Summary Background Hepatitis C infection (HCV) can have a harmful effect on the health of people ... more Summary Background Hepatitis C infection (HCV) can have a harmful effect on the health of people and can impose relevant healthcare costs. The World Health Organization has identified the elimination of Hepatitis C by 2030 as an important goal for all countries. This study aimed to identify the HCV-related policies in Iran. Methods A qualitative approach was used for this study. Data was collected through a comprehensive search of documents and interviews with different stakeholders related to the HCV program. Data was analyzed and validated using content analysis based on the policy triangle framework. Results Our findings highlighted that certain social and cultural issues related to stigma can impact on awareness-raising processes. It is also necessary to consider HCV directly in the context of government policies. All relevant stakeholders should be included. Continued talks and interactions need to be made between them for the active participation of all actors. Conclusion The ...

International Journal of Preventive Medicine, 2020

The prevalence of mental disorders in Iran is rising for many reasons including the population gr... more The prevalence of mental disorders in Iran is rising for many reasons including the population growth and its problems, the collapse of the family foundation, the economic problems, etc. Epidemiological studies of psychiatric disorders play an important role in determining the general mental health of the population and policy-making and future planning of service delivery. To identify the relevant studies, two authors independently searched different scholarly databases including Embase, PubMed/MEDLINE, ISI/Web of Science (WOS), Scopus, Psych INFO, and Iranian databases such as MagIran, SID, IranPsych, and Irandoc from 1st January 2007 up to 1st July 2018. The gray literature (through Google Scholar) was also mined. Studies written in English or in the Persian language were searched. After searching the databases and removing duplicates cases, a total of 10 studies were selected and included in the study, which reported a total of 14 prevalence rates. There were a total of 72,262 p...

Journal of Education and Health Promotion, 2019

INTRODUCTION: Disasters are inescapable phenomena. Once they occur, reliable and objective inform... more INTRODUCTION: Disasters are inescapable phenomena. Once they occur, reliable and objective information becomes vital in sound decision-making to respond. Emergency health evaluation of affected population can be used to gather information about the patterns of access to medical care, basic household needs, and other health needs. The objective of this review was to summarize evidence from scientific studies on the various methods of emergency health evaluation following disasters. MATERIALS AND METHODS: A comprehensive list of studies was provided in May 2017 by an extensive search using PubMed, Web of Sciences, Ovid Medline, ProQuest Research Library, and World Health Organization Library. RESULTS: Of the 1592 retrieved articles, 21 articles were included in this review. In a majority of the studies (n = 18), a questionnaire was used and an interview was conducted to collect information, but in three studies, smartphone-based methods were used. Sampling method in most of the studie...

Asian Pacific Journal of Cancer Prevention : APJCP, 2018

Background: Disasters affect all social functions. In particular, hospitals must mobilize their r... more Background: Disasters affect all social functions. In particular, hospitals must mobilize their resources for response to mass injuries. This process can affected treatment of cancer patients and may resulted in delayed care. Considering the importance of continuity of care for cancer patients, the aim of this systematic review was to identify challenges and preparedness measures for cancer patients during and after disasters. Materials and Methods: This systematic review that was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines between January 2000 to December 2017. The keywords searched included: “disaster,” “emergency,” “crisis,” “disruptive event,” “technological disaster,” “natural disaster,” “cancer,” “cancer patient,” “chronic disease,” “continuity of care,” and “patient with chronic disease. “The Google Scholar, ISI Web of Science, Science Direct, PubMed and Scopus databases were searched. Results: After screening ...

BackgroundCOVID-19 was first reported in Wuhan, China, and has spread rapidly around the world. T... more BackgroundCOVID-19 was first reported in Wuhan, China, and has spread rapidly around the world. The purpose of this study was to investigate the effects of implementing social distancing policy, and the impact of its lifting, with the resumption of social contacts and activities, as well as the effects of mandating face masks on the temporal trend of new COVID-19 cases in Iran. Methods We employed the interrupted time series analysis (ITSA), which is a very valuable method that can be used to evaluate the impact of the implementation of various policies in the health sector to help health policy-makers make effective decisions. Daily data were collected from the Ministry of Health and Medical Education and the World Health Organization from 954 public hospitals and health center settings. Data were extracted 14 days before and after the implementation of each policy. Results were computed with their 95% confidence interval (CI) and p-values equal to or less than 0.05 were considered...

Journal of Virus Eradication, 2018

The World Health Organization (WHO) has estimated that about 71 million people in the world have ... more The World Health Organization (WHO) has estimated that about 71 million people in the world have chronic hepatitis C virus (HCV) and 399,000 die every year due to cirrhosis and cancer caused by HCV. Despite efforts to prevent and control hepatitis, there are still many barriers. In September 2000, during a summit in New York organised by the United Nations, world leaders agreed on a set of achievable targets within a limited timeframe, with the goal of combating poverty, hunger, disease, illiteracy, destruction of the environment and of improving the status of women by 2015; these were known as the Millennium Development Goals. The Primary Health Care Network (PHCN) in Iran has played a very important role in health promotion but its achievements could be enhanced further by improving performance and implementing further changes. The WHO strives to achieve goals of sustainable development by 2030 in many countries, thereby raising awareness, encouraging greater community participation, mobilising resources, using evidence-based policies, and increasing screening services, care and treatment. The concept of the PHCN has been very successful in health promotion in Iran, and has provided a basis for accessible and high-quality services for all. Achieving HCV elimination by 2030 could be achieved with the support of the PHCN, and changes in management with regard to screening, prevention and treatment practices.

Journal of Virus Eradication, 2019

Hepatitis C virus (HCV) infection represents one of the major public health challenges worldwide.... more Hepatitis C virus (HCV) infection represents one of the major public health challenges worldwide. HCV is a blood-borne pathogen associated with a high rate of mortality and imposes a dramatic societal and economic burden on health systems. Untreated chronic HCV infection can progress to liver cirrhosis and cancer. Lessons can be learned from countries such as egypt and Georgia that are considered to be 'on-track' for the world Health organization HCV elimination targets, as well as countries such as iran that are 'working towards elimination'. this article compares HCV-related policies and strategies in iran, egypt and Georgia to identify programme strengths and limitations that could inform policy and decision makers in iran. Controlling and eliminating HCV remain a serious public health challenge. the rising HCV incidence could generate a dramatic economic burden in the coming years. therefore, iran requires a strategic plan to fight HCV. Adequate cultural and social infrastructures are needed. Centres specifically devoted to the diagnosis and management of this infection should be used for screening and delivery of inexpensive and high-quality testing. Quick initiation of treatment should take place at lower costs to facilitate access to treatment.

Journal of Multidisciplinary Healthcare, 2018

Introduction: Prehospital emergency medical service dispatchers should make prompt and appropriat... more Introduction: Prehospital emergency medical service dispatchers should make prompt and appropriate decisions to save the life of victims. The complexity of timely and reasonable decision-making in life-threatening conditions has driven researchers to investigate varying aspects of the emergency medical dispatch (EMD) process. The purpose of this study was to explore the contributors to appropriate and prompt decision-making among dispatchers. Methods: A qualitative study through thematic analysis was designed. Data were collected using observation and semistructured interviews with 16 authorities and dispatchers in seven EMDs across Iran. Results: The study found "responsiveness" as the main category contributing to improved decision-making in EMD. The components introduced in this study for dispatchers' responsiveness consisted of two categories. The first was "personal values" including faith and belief, eagerness to help, service excellence, altruism, respect, and impartiality in clinical judgment. The second was "professional attitudes" resulting from education and experience, including the recognition of emergency as a threat to health, sensitivity in triage, response to all requests for help, care for early warnings, commitment to organizational goals and standards, attention to the emergency medical service social support responsibility, and professional temperance. Conclusion: In this study, responsiveness was identified as a main category in improving the decision-making process among dispatchers. To attain responsiveness, institutionalization of its values and establishment of EMD-specific professional attitudes in dispatchers should be taken into consideration.

International Journal of Cancer Management, 2019

Context: Cancer is one of the leading causes of death globally. It changes the patient's life, an... more Context: Cancer is one of the leading causes of death globally. It changes the patient's life, and not only causes many physical and emotional symptoms but also reduces the quality of life (QOL) in patients during the advanced stages of cancer. Today, the main approach in taking care of these patients is to provide supportive and palliative care with the aim of enhancing the QOL in patients and their families and to reduce the cost of treatment and health care. This study was conducted with the aim of comparing the policies and the strategies related to cancer supportive and palliative care in the selected countries, using the World Health Organization (WHO) guideline in the United Kingdom (UK), Malaysia, and South Africa. Evidence Acquisition: This study is a comparative study. The data were collected through reviewing scientific and administrative documents, WHO website and reports, the Ministry of health websites, and other authoritative websites. The search was done through texts in English and the databases, including Science Direct, Scopus, and PubMed between 2000 and December 2018. We used a strategy search according to Medical Subject Headings, using the keywords (cancer, palliative care, supportive care, patients, policies, programs, strategies, UK, Malaysia, and South Africa). The data were analyzed by content analysis approach, using MAXQDA software version 11. Results: The rates of cancer and mortality differed according to the health differences in the selected countries. With regard to palliative care, various policies and programs were implemented. The implementation of more policies was carried out by the Ministry of Health. In some countries, adequate funding was available to support programs. Countries have been trying to provide decent manpower to provide services. Despite the successes achieved in implementing palliative care programs, some factors, such as inadequate healthcare structures and insufficient financial resources have caused problems in implementing programs. Conclusions: Countries should consider palliative care as one of the important priorities of the health system and a way of enhancing QOL in patients with cancer and their families, and with regard to the context of each country, focusing on each area of practical guide, reviewing the status and available facilities, and learning from the experiences of other countries should be considered to achieve this goal.

Evidence Based Health Policy, Management and Economics, 2019

Background: Nearly all of the rationing mechanisms have negative impacts on the poor. If the fair... more Background: Nearly all of the rationing mechanisms have negative impacts on the poor. If the fair service access is not set as the top priority in the rationing choices, the poor will experience service limitation and scarcity. This study aims at investigating the effects of rationing policies on the poor covered by Iran Health Insurance System. Methods: This article is based on a qualitative study conducted in 2017. In total, 32 experts of health system financing participated in the study. A purposeful sampling method was applied till reaching knowledge saturation. Data were collected using semi-structured interviews. Afterwards, data was analyzed by framework analysis based on Bennet and Gilson pro-poor health financing system framework using MAXQDA10 software. Results: The main challenge of rationing through the insurance system in Iran is the rationing only for the poor. As a result of rationing decisions, the poor are mostly the first group affected by service limitation...

Infectious Diseases of Poverty, 2018

Background: Street children are forced to spend a lot of time away from their homes and some of t... more Background: Street children are forced to spend a lot of time away from their homes and some of them do not have homes at all, due to economic and family problems, which makes them exposed to many health problems, such as the hepatitis C virus (HCV) infection. Iran, like many other countries in the world, experiences the burden of street children, however, the rate of HCV among street children is virtually unknown. This study aimed to determine the prevalence of HCV among street children in Iran. Main body: This systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study protocol of this review was registered in PROSPERO under identification term CRD42018082336. A comprehensive literature search was conducted to identify published studies reporting on the prevalence of HCV among street children in Iran. Several international scholarly databases, including Web of Science, PubMed®/MEDLINE®, Embase, Scopus®, Google Scholar and Directory of Open Access Journals, as well as Iranian databases such as MagIran and Barakathns were searched. Studies published between 1988 and December 2017 with any of the following keywords were selected: (street OR homeless OR labour) AND (children OR child OR infant) AND (hepatitis C OR hepatitis C virus OR HCV OR viral hepatitis OR hepatitis OR hepacivirus) AND Iran. Moreover, a grey literature search was performed in order to obtain other potentially relevant studies. The search was carried out without any language restrictions. Four studies, surveying a total of 1691 street children, conducted between 2006 and 2017 were found to be eligible for inclusion in the review and therefore analysed. Three studies were conducted in Tehran and one in Isfahan. The prevalence of HCV among street children in Iran was found to be high, at 2.4% (95% CI: 1.8-3.3). Conclusions: Since the prevalence of HCV among street children in Iran is quite high, health decision-and policy-makers should pay more attention to street children and widen support channels, both social and economic. Further studies should be conducted among street children in different cities of Iran to add to the knowledge base of HCV among street children in the country. The health system should provide facilities for street children to be screened to quickly diagnose illnesses and prevent them from developing complications.

Health Research Policy and Systems, 2019

Background: Hepatitis C virus (HCV) infection causes a large number of deaths annually worldwide.... more Background: Hepatitis C virus (HCV) infection causes a large number of deaths annually worldwide. Policies play an important role in regulating healthcare agendas and prioritising of health-related issues. Understanding these priorities is very important in health. The objective of this study was to investigate HCV-related issues and their influence on agenda-setting in Iran. Methods: A qualitative design was used. Data were collected by carrying out a review of documents and interviews. A comprehensive search was conducted to identify documents related to HCV-related policies in Iran. Semi-structured interviews were conducted with both purposive and snowball sampling of 14 interviewees related to the HCV programme in Iran, including government officials, civil society, development partnership members and academicians. Documents and interview data were analysed manually and using MAXQDA Version 10 software. Kingdon's multiple streams framework was used to guide data analysis. Results: The factors which influenced HCV-related agenda-setting were lack of proper information of the HCV epidemiology before the 1990s, lack of diagnostic facilities, neighbouring countries with high HCV prevalence, the stigma of HCV, high prevalence in prisoners, international evidence and high costs generated by HCV. The factors related to policy were effective treatment methods, drug production inside Iran, Iran Hepatitis Network, support outside government group elites and academicians. The factors related to political will were international influence, changes in the government and parliament support. Conclusion: The findings of this study showed that there are various national and international factors that play a role in shaping HCV-related policies. It seems that, if HCV is put into the agenda, it can be eliminated in Iran by 2030 by supporting and implementing appropriate programmes from decision-and policy-makers.

Health Research Policy and Systems, 2019

Background: Policy-and decision-makers seek to improve the quality of care in the health sector a... more Background: Policy-and decision-makers seek to improve the quality of care in the health sector and therefore aim to improve quality through appropriate policies. Higher quality of care will satisfy service providers and the public, reduce costs, increase productivity, and lead to better organisational performance. Clinical governance is a method through which management can be improved and made more accountable, and leads to the provision of better quality of care. In November 2009, the Iranian Ministry of Health and Medical Education implemented new clinical guidelines to standardise and improve clinical services as well as to increase efficiency and reduce costs. The purpose of this study was to assess the challenges of implementing clinical governance through a meta-synthesis of qualitative studies published in Iran. Methods: Ten databases, including ISI/Web of Sciences, PubMed/MEDLINE, Embase, PsycINFO, the Cochrane Library, CINAHL, Scopus, Barakatns, MagIran and the Scientific Information Database, were searched between January 2009 and May 2018. The quality of the included studies was assessed using the Critical Appraisal Skills Programme tool. This study was reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines. Thematic synthesis was used to analyse the data. Results: Ten studies were selected and included based on the inclusion/exclusion criteria. In the first stage, 75 items emerged and were coded, and, following comparison and combination of the codes, 32 codes and 8 themes were finally extracted. These themes included health system structure, management, person-power, cultural factors, information and data, resources, education and evaluation. Conclusion: The findings of the study showed that there exist a variety of challenges for the implementation of clinical governance in Iran. To successfully implement a health policy, its infrastructure needs to be created. Using the views and support of stakeholders can ensure that a policy is well implemented. Trial registration: CRD42017079077. Dated October 10, 2017.

Ethiopian journal of health sciences, 2018

Effective discharge planning plays a vital role in care continuity and integrated care. Identifyi... more Effective discharge planning plays a vital role in care continuity and integrated care. Identifying and providing infrastructures for discharge planning can reduce avoidable hospital readmissions and finally lead to improvement of quality of care. The current study aimed to identify the requirements of discharge planning from the perspective of professionals in the health system of Iran. For the purposes of this qualitative study, semi-structured interviews and sessions of focus group discussions with experts in the field were conducted. The data were analyzed using a thematic and framework analyses method. The study population was 51 participants including health policy makers, hospital and health managers, faculty members, nurses, practitioners, community medicine specialists and other professionals of the Ministry of Health andMedical Education (MOHME). According to the control knobs (health reforms levels), recruitments of effective hospital discharge planning were divided into ...