Tavakoli Farshad, Nasiripour Amir Ashkan, Riahi Leila, Mahmoudi Mahmoud
Department of Health Services Management, School of Medical Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran.
Iran J Public Health. 2020 Nov;49(11):2144-2151. doi: 10.18502/ijph.v49i11.4732.
The purpose of this research was to identify the main dimensions of management of referral systems in family physician program and then introduce them to policymakers of the country primary health care.
This descriptive-correlation study was designed in Mazandaran Province, northern Iran (2017). The participants were employees of health centers of Mazandaran and Fars Provinces, Iran. The dimensions influencing on the referral system were identified systematically in the selected countries by using researcher-made questionnaire according to a statistical method called Factor Analysis. The data sufficiency was evaluated by the Bartlett's and Kaiser-Meyer-Olkin's tests. Reliability of test was calculated and confirmed according to Cronbach's Alpha and Combined Reliability tests. Validity of the test was calculated and confirmed based on the average variance extracted (AVE).
In confirmatory factor analysis, coefficient of effect of Electronic Health Record on referral system (as the most important dimension), coefficient of Family Physician, coefficient of structure of insurance, coefficient of policymaking in health care system, coefficient of proper stewardship of health system, and basic health care services, were 0.887, 0.877, 0.860, 0.804, 0.568, and 0.522, respectively.
Six effective dimensions including Electronic Health Record (as the most important dimension), family physician, structure of insurance, policymaking in health care system, proper stewardship of health system, and basic health care services were identified. According to six effective dimensions on management model of the referral system in the Iranian urban family physician program, the health system authorities pay serious attention to the six identified dimensions of the current study to improve the health of the urban community.
本研究旨在确定家庭医生项目中转诊系统管理的主要维度,然后将其介绍给该国初级卫生保健的政策制定者。
本描述性相关性研究于2017年在伊朗北部的马赞德兰省开展。参与者为伊朗马赞德兰省和法尔斯省卫生中心的员工。通过使用研究人员自制的问卷,根据一种名为因子分析的统计方法,在选定国家系统地确定影响转诊系统的维度。通过巴特利特检验和凯泽-迈耶-奥尔金检验评估数据充分性。根据克朗巴哈系数和组合信度检验计算并确认测试的信度。基于提取的平均方差(AVE)计算并确认测试的效度。
在验证性因子分析中,电子健康记录对转诊系统的影响系数(作为最重要的维度)、家庭医生系数、保险结构系数、医疗保健系统政策制定系数、卫生系统妥善管理系数和基本医疗保健服务系数分别为0.887、0.877、0.860、0.804、0.568和0.522。
确定了六个有效维度,包括电子健康记录(作为最重要的维度)、家庭医生、保险结构、医疗保健系统政策制定、卫生系统妥善管理和基本医疗保健服务。根据伊朗城市家庭医生项目转诊系统管理模式的六个有效维度,卫生系统当局应认真关注本研究确定的六个维度,以改善城市社区的健康状况。