Perception and expectation of iran neonatal transport expert regard to developing neonatal transport system in iran: a qualitative research.

INTRODUCTION: This study was aimed to reach expert's expectations of neonatal transport system for developing neonatal transport system in Iran. MATERIALS AND METHODS: This is a qualitative study conducted by using focus group discussion (FGD) to present expert's perspectives and expectancy about neonatal transport system. Participants was selected from all experts and specialist about neonatal transport in Iran countryside. Finally 48 experts, participate in this study. To data collection 4 FGD were conducted, data were analyzed by content analyses. All subthemes were categorized in main themes according to conceptual relationship as an expert panels opinions. In order to comply with the ethical issues involved in the study was voluntary, also permission for the recording session were taken and confidentiality was also ensured. RESULT: According to FGD results, 11 themes and 90 subthemes were founded related to neonatal transport system, the main identified themes included: Aims, necessity and models of neonatal transport system, organizing the transport system, management and quality of instruments in the transport system, Neonatal transport system staff, Human resource management and issue related to human resources, conditions and requirements of neonatal transport system, facilitating factors in neonatal transport system, information management and communication system and weakness of neonatal transport system. CONCLUSION: Neonatal transport systems in different countries must adapted according to situation and component of each country have different strength and weakness and in implementing a system must attend to geographical conditions, financial ability and access to professionals, health system structure, facilities related to neonatal health care, antenatal services in regain, health care related, health care program about neonates and pregnant women and epidemiological status and mortality and morbidity in deferent locals and regains in countryside.

Public and private hospital services reform using data envelopment analysis to measure technical, scale, allocative, and cost efficiencies.

BACKGROUND: The aim of this study was to suggest a suitable context to develop efficient hospital systems while maintaining the quality of care at minimum expenditures. METHODS: This research aimed to present a model of efficiency for selected public and private hospitals of East Azerbaijani Province of Iran by making use of Data Envelopment Analysis approach in order to recognize and suggest the best practice standards. RESULTS: Among the six inefficient hospitals, 2 (33%) had a technical efficiency score of less than 50% (both private), 2 (33%) between 51 and 74% (one private and one public) and the rest (2, 33%) between 75 and 99% (one private and one public). CONCLUSION: In general, the public hospitals are relatively more efficient than private ones; it is recommended for inefficient hospitals to make use of the followings: transferring, selling, or renting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals or other health centers; pensioning off, early retirement clinic officers, technicians/technologists, and other technical staff. The saving obtained from the above approaches could be used to improve remuneration for remaining staff and quality of health care services of hospitals, rural and urban health centers, support communities to start or sustain systematic risk and resource pooling and cost sharing mechanisms for protecting beneficiaries against unexpected health care costs, compensate the capital depreciation, increasing investments, and improve diseases prevention services and facilities in the provincial level.

Emergency department patient satisfaction survey in Imam Reza Hospital, Tabriz, Iran.

INTRODUCTION: Patient satisfaction is an important indicator of the quality of care and service delivery in the emergency department (ED). The objective of this study was to evaluate patient satisfaction with the Emergency Department of Imam Reza Hospital in Tabriz, Iran. METHODS: This study was carried out for 1 week during all shifts. Trained researchers used the standard Press Ganey questionnaire. Patients were asked to complete the questionnaire prior to discharge. The study questionnaire included 30 questions based on a Likert scale. Descriptive and analytical statistics were used throughout data analysis in a number of ways using SPSS version 13. RESULTS: Five hundred patients who attended our ED were included in this study. The highest satisfaction rates were observed in the terms of physicians' communication with patients (82.5%), security guards' courtesy (78.3%) and nurses' communication with patients (78%). The average waiting time for the first visit to a physician was 24 min 15 s. The overall satisfaction rate was dependent on the mean waiting time. The mean waiting time for a low rate of satisfaction was 47 min 11 s with a confidence interval of (19.31, 74.51), and for very good level of satisfaction it was 14 min 57 s with a (10.58, 18.57) confidence interval. Approximately 63% of the patients rated their general satisfaction with the emergency setting as good or very good. On the whole, the patient satisfaction rate at the lowest level was 7.7 with a confidence interval of (5.1, 10.4), and at the low level it was 5.8% with a confidence interval of (3.7, 7.9). The rate of satisfaction for the mediocre level was 23.3 with a confidence interval of (19.1, 27.5); for the high level of satisfaction it was 28.3 with a confidence interval of (22.9, 32.8), and for the very high level of satisfaction, this rate was 32.9% with a confidence interval of (28.4, 37.4). CONCLUSION: The study findings indicated the need for evidence-based interventions in emergency care services in areas such as medical care, nursing care, courtesy of staff, physical comfort and waiting time. Efforts should focus on shortening waiting intervals and improving patients' perceptions about waiting in the ED, and also improving the overall cleanliness of the emergency room.

Self-medication and storage of drugs at home among the clients of drugstores in Tabriz.

OBJECTIVE: This study was conducted with four objectives in mind, including: (1) characteristics of self-medication; (2) storage of drugs at home; (3) factors associated with storage of drugs at home; and (4) comparison of the level and sources of knowledge between over-the-counter (OTC) and prescription-only (POM) medication consumers. METHODS: A cross-sectional survey was conducted in 2007 using a semi-structured questionnaire on 300 clients of 21 drugstores (from a total of 214 drugstores in the city of Tabriz, Iran). RESULTS: The highest demand for drugs was for analgesics (from OTC drugs) and antibiotics (from POM drugs). Of 325 requests for medications by 300 customers of drugstores in Tabriz, aged 15 years or higher, 50.8% (165 requests) were for OTC drugs and 49.2% (160 requests) were for POM drugs, twenty-five cases requested both OTC and POM medications. There were 246 customers (82%) who reported that they stored drugs at home. Physicians were reportedly the most common source of information about medications, while the highest-quality information was obtained from pharmacists. CONCLUSION: The frequency of home storing of medications was very high in this study. Customers, especially the lower education groups, had very little information about the side effects of drugs and differentiation of OTC and POM medications. Wayward use of antibiotics was very high among the drugstore clients. It seems that the information provided by the pharmacists can be one of the most effective ways for advancing the level of knowledge among the consumers of medications.