Health policy and management research center, Department of Health Services Management, School of public health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Department of Health Management and Economics, Ilam University of Medical Sciences, Ilam, Iran.
BMC Health Serv Res. 2021 Oct 21;21(1):1133. doi: 10.1186/s12913-021-07164-y.
Health systems need constant changes and reforms in their structure to adapt to changing conditions and meet the needs of society. One of the fundamental changes in the health system of Iran is the health transformation plan (HTP), the effects of which must be examined from different aspects. Therefore, the purpose of this study is to investigate the effect of HTP on the performance indicators of public hospitals in Yazd city, Iran.
This cross-sectional study was carried out in all public hospitals in city of Yazd. Six performance indicators were examined monthly and in two time periods of 12 months before and 12 months after the implementation of Health Transformation Plan (HTP). The data was analyzed by SPSS software program version 22, using the paired T-test, and the Interrupted Time Series (ITS) model.
Findings showed that the performance indicators of the studied hospitals have improved after the implementation of the HTP. According to the ITS model, the implementation of HTP did not have a significant effect on the level and trend of the bed rotation distance, average length of stay and the ratio of surgical operations to bed indicators. However, it had a statistically significant effect on the level and trend of mortality and hospitalization rates. Moreover, the implementation of HTP had a significant effect on the level of the bed occupancy rate, but did not have a significant effect on the trend of this indicator.
Based on the research findings, all the selected indicators changed to some extent after the implementation of HTP, which showed the effect of this plan on the performance of hospitals. However, not all indicators were statistically significant as the findings sub-section revealed.
卫生系统需要不断地进行结构变革和改革,以适应变化的条件并满足社会的需求。伊朗卫生系统的一项根本性变革是卫生转型计划(HTP),必须从不同方面来检验其效果。因此,本研究的目的是调查 HTP 对伊朗亚兹德市公立医院绩效指标的影响。
本横断面研究在亚兹德市所有公立医院进行。在 HTP 实施前和实施后 12 个月的两个时期内,每月检查 6 项绩效指标。使用配对 T 检验和中断时间序列(ITS)模型对数据进行分析。
研究结果表明,实施 HTP 后,医院的绩效指标有所提高。根据 ITS 模型,HTP 的实施对床位周转率距离、平均住院时间和手术与床位比例的水平和趋势没有显著影响。但对死亡率和住院率的水平和趋势有统计学意义。此外,HTP 的实施对床位占用率的水平有显著影响,但对该指标的趋势没有显著影响。
根据研究结果,实施 HTP 后,所有选定的指标都在一定程度上发生了变化,这表明该计划对医院绩效产生了影响。然而,正如研究结果部分所揭示的那样,并非所有指标都具有统计学意义。