Sajadi Haniye Sadat, Sajadi Zainab Sadat, Sajadi Farkhondeh Alsadat, Hadi Mohammad, Zahmatkesh Maryam
Department of Health Service Management, Management and Medical Information Sciences School, Isfahan University of Medical Sciences, Isfahan, Iran.
Medical Record Office, Farabi Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
J Educ Health Promot. 2017 Oct 4;6:89. doi: 10.4103/jehp.jehp_134_16. eCollection 2017.
Hospital care transformation plan (HCTP) was implemented, in 2014, with the aim of ensuring all Iranians have fair access to hospital care, mainly in the public sector. It was assumed that HCTP would lead to increased quality and effectiveness of health care in public hospitals. To explore whether HCTP has achieved its aim, this study has investigated the impact of this plan on performance indicators (PIs) of the public hospitals.
This cross-sectional descriptive study was conducted in 2016. The study population included all hospitals in the Isfahan City. Data (10 selected PIs) were collected through formal reports which were available at the Isfahan University of Medical Sciences and analyzed using Statistical Package for Social Sciences (version 17). The statistical significant level analysis was 0.05.
After HCTP, it was shown an increase of (1) Bed occupancy, bed turnover, occupied bed-days, inpatients visits, and number of surgeries in all types of hospitals, (2) Outpatients' visits in all hospitals except private ones, (3) Emergency visits in public and social security hospitals, and (4) Natural deliveries in public and semi-public hospitals. Furthermore, the average length of stay and hospital mortality rate has decreased in all types of hospitals after HCTP implementation.
Although, improving PIs of hospitals were not directly stated and known objectives of HCTP implementation, it seems HCTP could improve the performance of all hospitals, including involved and noninvolved ones.
医院护理转型计划(HCTP)于2014年实施,旨在确保所有伊朗人都能公平地获得医院护理,主要是在公共部门。人们认为HCTP将提高公立医院医疗保健的质量和效果。为了探讨HCTP是否实现了其目标,本研究调查了该计划对公立医院绩效指标(PIs)的影响。
本横断面描述性研究于2016年进行。研究人群包括伊斯法罕市的所有医院。数据(10个选定的绩效指标)通过伊斯法罕医科大学可获取的正式报告收集,并使用社会科学统计软件包(版本17)进行分析。统计显著性水平分析为0.05。
HCTP实施后,结果显示:(1)各类医院的床位占用率、病床周转率、占用床日数、住院患者就诊次数和手术数量均有所增加;(2)除私立医院外,所有医院的门诊患者就诊次数增加;(3)公立和社会保障医院的急诊就诊次数增加;(4)公立和半公立医院的自然分娩数量增加。此外,HCTP实施后,各类医院的平均住院时间和医院死亡率均有所下降。
尽管提高医院绩效指标并非HCTP实施的直接既定目标,但HCTP似乎可以提高所有医院的绩效,包括参与和未参与该计划的医院。