Health System Reform Plan Research Articles

Inputs of Iranian health system reform plan from health sector managers and policy-makers' points of view.

CONTEXT:Health system reform plan refers to conducting some fundamental, systematic, and sustainable changes.AIMS:The aim of the present study was to evaluate different required inputs of Iran Health Transformation Plan from experts’ viewpoints.SETTINGS AND DESIGN:The data of this qualitative study were collected using semi-structured interviews.SUBJECTS AND METHODS:The purposive sampling method led to 18 participant selection and then they were interviewed. Interviewees were assured about confidentiality of information.STATISTICAL ANALYSIS USED:The thematic analysis method and MAXQDA software were employed for analyzing the data.RESULTS:There were 4 main themes and 35 subthemes extracted including management requirements for health development plan, human resources, information resources, and financial resources. Each theme had subthemes such as “resource allocation,” “development of required standards for human resources,” “human resources’ motivation,” “failures in IT infrastructures,” “hospital information management software,” “guidelines and instructions,” “costs controlling,” and “financing the plan”.CONCLUSIONS:Results of the present study put significant emphasis on the path of improving the effectiveness and efficacy of applying the discussed inputs, which can be a light for revising past policies and taking better future steps, it also can be a resource guide for policy-makers and managers of the health-care system.

The relationship between the quality of nursing care and the satisfaction of pregnant mothers

Context: The Health System Development Plan is one of the key steps taken by the eleventh government to promote health services in the country.Aims: The aim of this study was to determine the relationship between the quality of nursing care and the satisfaction of pregnant mothers from the implementation of the health system development plan.Settings and Design: This research was an analytic cross-sectional study. The study population included 163 mothers who were hospitalized before delivery and 18 nurses from maternity sections who were selected by the census method during the 3 months of September 2017–November 2017.Material and Methods: The data collection tool was a demographic data form, quality patient care scale, and a researcher-made questionnaire on the satisfaction of hospitalized mothers in maternity sections of the implementation of the Health System Reform Plan.Statistical Analysis Used: Data were analyzed using descriptive statistics, Mann–Whitney test, and correlation coefficient in SPSS-16 software.Results: The results showed that the quality of care in nurses at the desired level (63%) and the satisfaction of mother maternity sections of the delivery system had a moderate level of implementation of the Health System Development Plan (56.3%). The results of Pearson's correlation test showed that there is a statistically significant relationship between the quality of nursing care and patient satisfaction (P = 0.001).Conclusions: The satisfaction of the mothers participating in the research was that the quality of nursing care was often modest after implementing the Health System Reform Plan.

Health System Reform Plan and Performance of Hospitals: an Iranian Case Study.

Background:Health system reform is essential to make desired Changes. In Iran, first phase of Health Reform Plan (HRP) was implemented in hospitals affiliated with Ministry of Health and Medical Education (MHME) in 2014.Aim:The present study was carried out to evaluate the performance of hospitals affiliated with Urmia University of Medical Sciences at the time of the implementation of HRP.Methods:This cross-sectional study carried out in two stages, before (2012- 2013) and during (2014- 2015) implementation of the HRP in district and teaching hospitals. Data collection and evaluation of performance of hospitals was performed using indices issued by MHME using graphical and statistical analysis.Results:Average bed occupancy rate and bed turnover rate increased and the average length of stay decreased in the majority of hospitals during the study period. The highest and lowest bed occupancy rate was observed in district hospitals. All hospitals were shifted toward the third zone in Pabon Lasso (PL) diagram.Conclusion:This study confirmed that the implementation of the defined package of HRP in hospitals affiliated with UUMS resulted in increased admissions and hospitalization and improved performance.

Factors influencing the provision of public health services by village doctors in Hubei and Jiangxi provinces, China

The Chinese central government launched the Health System Reform Plan in 2009 to strengthen disease control and health promotion and provide a package of basic public health services. Village doctors receive a modest subsidy for providing public health services associated with the package. Their beliefs about this subsidy and providing public health services could influence the quality and effectiveness of preventive health services and disease surveillance. To understand village doctors' perspectives on the subsidy and their experiences of delivering public health services, we performed 10 focus group discussions with village doctors, 12 in-depth interviews with directors of township health centres and 4 in-depth interviews with directors of county-level Centers for Disease Control and Prevention. The study was conducted in four counties in central China, two in Hubei province and two in Jiangxi province. Village doctors prioritize medical services but they do their best to manage their time to include public health services. The willingness of township health centre directors and village doctors to provide public health services has improved since the introduction of the package and a minimum subsidy, but village doctors do not find the subsidy to be sufficient remuneration for their efforts. Improving the delivery of public health services by village doctors is likely to require an increase in the subsidy, improvement in the supervisory relationship between village clinics and township health centres and the creation of a government pension for village doctors.