Designing A National Model of Medical Facilities Fair Distribution for Iranian Social Security Organization: Design National Model of Medical Facilities Fair Distribution in the ISSO.

Background: Fair Distribution of Medical Facilities is one of the most critical issues affecting economic and health indicators. Iranian Social Security Organization (ISSO) is a non-governmental organization responsible for providing medical services to insured individuals in 77 hospitals, 265 polyclinics, and clinics that has faced much demand from the insured to build a new medical center. So, Due to the significant role of ISSO in meeting the medical needs and its high coverage (almost 42%) in Iran, we aimed to identify the factors influencing medical facilities' fair distribution in the ISSO. Materials and Methods: This applied study was conducted as a descriptive study in the ISSO in 2018. Variables affecting medical facilities distribution were elicited from the literature review and through an interview with 16 experts who were occupied in the healthcare management field. Then, a Likert scale-based questionnaire with 56 items in 7 sections was developed. Questionnaires were distributed among 456 person received questionnaires, and 415 responded to all questions. All participants were experts in the healthcare section of the ISSO all over the country. Data were analyzed via exploratory and confirmatory factor analysis and structural equations using SPSS 23 and AMOS-24 software. Results: By exploratory and confirmatory factor analysis, seven main factors (demographic factors, geographical factors, functional factors, structural factors, humanistic factors, economic factors, and Contract parties factors) were identified as critical factors affecting medical facilities distribution. Each aspect included many components. AMOS software showed the significance of variables by P-value and critical ratio (CR) indices to analyze the conceptual model of the research. Function factors with standard coefficients of 0.85 had the most, and economic factors with a standard coefficient of 0.53 had a minor effect on the distribution of medical facilities in the ISSO. Conclusion: To have a more efficient medical facilities distribution in the ISSO must consider all identified factors, special attention should be given to the maximum use of available medical facilities. Furthermore, more attention should be paid to distributing human resources, finance, and medical equipment.

Cryoablation Versus Radiofrequency Ablation in AVNRT: Same Goal, Different Strategy.

Catheter ablation is nowadays the first therapeutic option for AVNRT, the most common benign supraventricular tachycardia. Both cryotherapy and radiofrequency energy may be used to ablate the slow pathway. This paper compares both techniques, evaluates results published in literature and gives feedback on some typical aspects of cryo- and RF ablation. Although both techniques have satisfying success rates in AVNRT ablation, with a higher safety profile of cryoablation towards creation of inadvertent atrioventricular block, it remains paramount that the operator respects the distinctive traits of each technique in order to obtain an optimal result in every patient.