Iranian Social Security Organization Research Articles

Longitudinal Analysis of Social Welfare Situation in Iran (1967–2010)

The last few decades have seen increased theoretical and empirical interest in multidimensional measures of social welfare. The objective of this paper is to introduce social welfare index (SWI) and its trend for Iran. In this mix method study, Delphi technique was conducted to evaluate expert opinion on choice of priority social welfare indicators (study variables) for Iran in 2013. Then, we have used OECD methodology of constructing composite indicators to develop SWI. SWI as well as its trend have been measured for 1967–2010 (sample size = 44 years). Data were obtained from the Central Bank of Iran, Statistical Center of Iran, and Social Security Organization of Iran. Data were analyzed using SPSS software ver. 20 and exploratory factor analysis, Kaiser-Meyer-Olkin (KMO), and Bartlett test. Based on KMO (0.710), data was adequate for underlying analysis and result of Bartlett’s test of sphericity (757.75, df = 45, p < 0.001) imply that correlation matrix of variables was not an identity matrix. Furthermore, the first two factors explained 77.58 % of total variances, together. The results showed that SWI generally has been increasing during the study period. Furthermore, the best and worst performances were devoted to 1971 and 1988, respectively. Due to having more and diverse dimensions and indicators, SWI can help as a more realistic measure of social welfare.

An investigation of the influence of managerial factors on industrial accidents in the construction industry using the gray FTA method

Purpose – The statistical report published by the Iranian Social Security Organization in 2012 showed that, of all industries, the construction industry is associated with the highest number of work-related accidents. Furthermore, as this sector contains a large human workforce, identification of the factors contributing to the occurrence of such accidents is vital. The paper aims to discuss these issues. Design/methodology/approach – Furthermore, as this sector contains a large human workforce, identification of the factors contributing to the occurrence of such accidents is vital. In the present study, such factors were initially identified, after which the most important of these, managerial factors, were selected. Subsequently, the identification of the causes of the managerial factors was carried out with the use of the fault tree analysis (FTA) method and application of OR and AND entries. Findings – Since it is difficult to determine the probability of occurrence of events in this industry with certainty, and because gray numbers (numbers of which the exact value is unknown, and which represent uncertain information) have a strong relationship with human expressions, the probability of occurrence of the main undesired events was also evaluated using the gray numbers as input entries, in addition to ranking the probability of occurrence of intermediate events. Originality/value – The findings revealed that FTA using gray numbers is a useful and effective tool in risk assessment.

Economic impact of surgery cancellation in a general hospital, Iran

Abstract Background: Cancellation of surgical procedures creates a financial burden to health providers and patients. It also causes a potential emotional stress and a negative impact on perception of quality of care. It should be a priority to identify risks of surgery cancellations in view of modification to assure timely and efficient delivery of care. Objective: To identify and estimate costs borne by cancelation of elective surgeries in a general hospital. Methods: Data were collected from a general hospital of social security organization of Iran. In-patient medical records were reviewed for all patients scheduled for elective surgeries in a period of 1 year, starting from 21stof March 2011 to 20th of March 2012. The costing data were collected in 2014. Patients undergoing out-patient surgery and emergency surgical procedures were excluded from the study. Results: During the study period, 14,687 cases were scheduled to undergo inpatient elective surgical procedures. Of those 274 cases were cancelled, among the cancelled cases, 242 were cancelled during the preparation in the surgery ward and 32 cases were cancelled in operation room. The total cost of surgery cancellation was US$ 92, 049.0. Out of this: US$ 42,668.0 (46.4%) was related to bed expense; 32,363.0$US (35.1%) for direct costs related to resources and supplies; and US$ 16,569 (18.5%) was related to physician visits. Conclusion: The study demonstrated that cost of surgery cancelation was considerably high in the studied general hospital. More than half of the cost (62.1%) of surgery cancelation was due to avoidable reasons. [Ethiop. J. Health Dev. 2016;30(2):92-95] Keyword: Cost of illness; Cost of Cancelation; Direct Cost; Surgery Cancelation Cost.

Work-related accidents among the Iranian population: a time series analysis, 2000-2011.

Work-related accidents result in human suffering and economic losses and are considered as a major health problem worldwide, especially in the economically developing world. To introduce seasonal autoregressive moving average (ARIMA) models for time series analysis of work-related accident data for workers insured by the Iranian Social Security Organization (ISSO) between 2000 and 2011. In this retrospective study, all insured people experiencing at least one work-related accident during a 10-year period were included in the analyses. We used Box-Jenkins modeling to develop a time series model of the total number of accidents. There was an average of 1476 accidents per month (1476·05±458·77, mean±SD). The final ARIMA (p,d,q) (P,D,Q)s model for fitting to data was: ARIMA(1,1,1)×(0,1,1)12 consisting of the first ordering of the autoregressive, moving average and seasonal moving average parameters with 20·942 mean absolute percentage error (MAPE). The final model showed that time series analysis of ARIMA models was useful for forecasting the number of work-related accidents in Iran. In addition, the forecasted number of work-related accidents for 2011 explained the stability of occurrence of these accidents in recent years, indicating a need for preventive occupational health and safety policies such as safety inspection.

Burden of Occupational Accidents in Tehran during 2008-2011

Background and purpose: Work-related accidents are causing distress and economic losses. This study was conducted to estimate the burden of occupational accidents by the use of disability-adjusted life year (DALY) calculation in Iranian Social Security Organization (ISSO), Tehran province, between 2008 and 2011 time frame. Materials and Methods: This descriptive analytical study was conducted based on the provided data by the Social Security Organization. Subjects consisted of all workers who had a work-related accident during 2008-2011 and were registered in the ISSO database. In order to maintain the comparability of the methodology for the calculation of years lost due to premature mortality and years lived with disability and DALYs, the global burden data of diseases were collected. Results: The rate of DALY was 399.552 years; 63% and 37% of which were due to premature mortality and disability, respectively. About 29% of life which accounted for the highest frequency was lost between the ages 25 and 34. In terms of gender, 99% frequency DALY was related to male workers. The most common type of accident was injury and fracture with 119.609 years lost. The most affected organs were hands and legs with 112.46 and 102.48 years lost, respectively. Fall recognized as the season with the highest DALY burden (108.85 years). Conclusion: Since majority of the incidents observed were preventable, accidental preventing programs, by the use of physical protection, training and oversees of workshops and are known to be effective in injuries reduction. [*Chorom H,Taghdisi MH, Nassiri P. Burden of Occupational Accidents in Tehran during 2008-2011. IJHS 2014; 2(2): 45-51] http://jhs.mazums.ac.ir

An empirical study based on BSC-DEA to measure the relative efficiencies of different health care centers in province of Semnan, Iran

In this paper, we present an empirical investigation to measure the relative efficiency of seven health care centers in province of Semnan, Iran, which were under the coverage of social security organization of Iran. The proposed model of this paper uses a hybrid of balanced score card and data envelopment analysis for performance measurement. The proposed sudy uses four perspectives of balanced score card including learning and growth, internal process, customer and financial perspectives and within each perspective, data envelopment analysis is adopted so that the outputs of each perspective are used as inputs of the other perspective. The preliminary results indicate that all seven units perform relatively well and the overall efficiency of all units in this province is 0.769.

Epidemiology of occupational accidents among Iranian insured workers

Work-related accidents are considered as a major health problem worldwide. The aim of present study was to determine the epidemiological pattern of occupational accidents among workers insured by the Iranian Social Security Organization (ISSO) between 2001 and 2005.Subjects consisted of all workers and drivers who had a work-related accident during 2001–2005 and were registered in the Iranian Social Security Organization (ISSO) database according to the inspection reports. An ordinal logistic regression model (proportional odds regression model) was used to assess the concurrent effects of independent variables on accident outcomes.Overall, 86,437 work-related accidents were investigated. The accidents were more frequent in metal workplaces and electrical industries, respectively. More than half of the accidents were due to incautious activities. Workers’ age (age at the time of accident) (OR=0.99, CI: 0.989–0.994), gender (OR=1.3, CI: 1.191–1.683), marital status (OR=1.25, CI: 1.143–1.675) as well as accident setting (OR=1.88, CI: 1.728–1.975) had significant effect on accident outcomes. Pattern of occupational injuries in Iran was consistent with the global pattern for accident outcomes.

Factors affecting process orientation in Iranian Social security organization’s hospitals

Process orientation was one of the new approaches in managerial topics, which were recently considered by the Iranian healthcare centers. The study’s aim is to identifies the main factors of process orientation in health care management arena in Iranian hospitals. To achieve this objective, the main variables were recognized and the questionnaire was determined. Iranian Social security organization’s hospitals were chosen as a sample among all Iranian healthcare centers (n=48).The validity of questionnaire were assured with expert judgment and the reliability was determined using Cronbach’s alpha and Pearson correlation (1st and 2nd times). Cronbach’s alpha coefficient and Pearson correlation were 0.819 and (p<0.001) 0.951 respectively. The questionnaire was filled out by the research community. After the sample size was proved to be sufficient, the exploratory and confirmatory factors were analyzed. The findings of the present research showed that, after conducting the factor analysis of “process orientation” in health care management, 2 factors were extracted. The factors were “design and implementation of processes” and “control and improvement of processes”. The calculated fitness indexes proved the desirability and appropriateness of structural relations. It may be concluded that these factors have substantial roles in the performance of process orientation and are considered to be the main factors while performing process orientation approach in these organizations. Key words: Process orientation, Iranian healthcare, social security organization, health care management.

Variables Affecting the Payment Mechanism for Strategic Purchasing in the Indirect Health Section of Iranian Social Security Organization

The present study was conducted to define the variables affecting payment mechanism for strategic purchasing in the indirect health section of Social Security Organization, by which the Organization can provide the insured with better services while controlling the cost. 13 variables affecting payment mechanism for strategic purchasing were determined. A questionnaire was prepared based on above variables and completed by experts. The data was analyzed by SPSS and LISREL through confirmatory and exploratory analysis factor. The results indicate that payments mechanism is important in the process of strategic purchasing and three partial dimensions including performance-based payment mechanism, time-based payment system and risk coverage should be considered: 1-performance-based payment system includes variables such as financial incentives for health service providers, prospective payment system and performance-based motives for health service employees. 2-Time-based payment system includes variables such as the time of receiving service. 3. Risk coverage includes variables such as justice and financial protection against disease risk.

Exploring health professionals' perspectives on factors affecting Iranian hospital efficiency and suggestions for improvement

While numerous studies have been undertaken in many developed countries and in a few developing countries, there has so far been no systematic attempt to identify factors affecting efficiency in the Iranian hospitals. This study was designed to elicit the perspectives of a group of health professionals and managers so as to analyse factors affecting the efficiency of hospitals owned by the Iranian Social Security Organization (SSO), which is the second largest institutional source of hospital care in that country. This study also aimed to identify actions that would improve efficiency. Using purposive sampling (to identify key informants), interviews with seventeen health professionals and hospital managers involved in the SSO health system were conducted. The respondents identified a number of organizational factors affecting efficiency, particularly the hospital budgeting and payment system used to fund physicians, and the lack of the managerial skills needed to manage complex facilities such as hospitals. The interviewees stressed the necessity for reforms of the regulatory framework to improve efficiency. A few participants recommended the concept of a funder-provider split. The results of this exploratory study have provided meaningful insight into Iranian health professionals views of factors affecting efficiency, and of possible remedial actions. It is expected that the findings will provide guidance for health policy makers and hospital managers in the Iranian SSO to analyse factors affecting efficiency and to identify remedial actions to improve efficiency. Hospitals in other developing countries may be affected by similar factors.

Management development in health care setting: a training model for hospital managers.

This study was conducted to design an on job-training model for the managers of the Iranian Social Security Organization (ISSO) hospitals and any other similar setting. A five dimensional model (i.e. knowledge, ability, managerial skills, personality attributes and attitudes) with 187 components was designed. The model was validated through seeking the view of experts and a field test. For the field test, a survey was done on 31 ISSO hospital managers to explore their views on the structure of the model and its components. The managers were asked to score each component on a five- point Likert scale as they thought it would affect their job performance. The model with 5 dimensions and 165 components was verified in the field test, and 104 out of 165 components of this model got high, 52 medium and nine low mean scores for influencing job performance of the managers. These findings reveal that most of the components selected in this project are justified to be included in the model. It also reflects the managers' needs for any formal and informal training program in future. The needs of hospital managers at work go far beyond the knowledge and skills, which they have gained, via formal education in school. Therefore, in designing a training program for this group of professionals one should consider a multi-dimensional model in which "knowledge, ability, managerial skills, personality, and attitude dimensions" are all taken under consideration.

Efficiency Measurement for Hospitals Owned by the Iranian Social Security Organisation

This study used Data Envelopment Analysis (DEA) to examine the relative efficiency of hospitals owned by the Iranian Social Security Organization, which is the second largest institutional source of hospital care in that country. Using data for the year 2002, 26 of the 53 hospitals were deemed to be efficient. Inefficient hospitals had an average score of 90%, implying a potential reduction in all inputs on average by about 10% with no impact on output levels. In addition to the conventional DEA measurement, efficient hospitals were ranked by calculating super-efficiency scores, by identifying weak efficient hospitals, and by determining the frequency of peers. The study provides useful information for improving hospital management, rationalizing resource allocation, and improving services provided by hospitals.