The Relationship Between Distribution of Human Resources Distribution and Performance Indicators of Hospitals Before and After Implementation of Health System Evolution Plan in Iran
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Abstract
The implementation of the Health System Evolution Plan has resulted in an increase in the rate of patient’s referral to hospitals of medical universities, and thus, hospitals’ performance indicators. The aim of the present study is to investigate the changes in hospital indicators after the implementation of the Health System Evolution Plan and the relationship between this plan and distribution of human resources in hospitals of Tehran University of Medical Sciences. This was a descriptive-analytical and cross-sectional study. The research population consisted of information about human resources and performance indicators before and after the implementation of the Health System Evolution Plan in the hospitals. The research tool was a data collection form. The collected data were analyzed in SPSS software, and analytical results were obtained using the Pearson correlation test and Two Sample t-test. The results showed that there was a significant relationship between hospitals performance indicators and the distribution of human resources after the implementation of the Health System Evolution Plan. In fact, this plan has increased the deficit of nursing and paraclinical staff. In addition, the results showed as hospitals’ performance indicators have increased, more human resources has been recruited in these hospitals. The success of Implementation of Health System Evolution Plan and development of general hospitals indicators need comprehensive. Planning for retainment of all groups of health workers and paying attention to appropriate distribution of physicians, nurses, and paraclinical staff in public hospitals and finally a comprehensive review of human resources standards by the Iranian Ministry of Health.
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3. Baumann A, Arsenio MC, Danesh NA. Strategic welfare planning for health human resources: a nursing case analysis. Canadian Journal of Nursing Research 2016: 48(3-4): 93-99.
4. Ramaderi D, Gunasekarau A, Roy M, Bharatendera KR. Human resource management in a health care environment: framework and case study. Industrial and Commercial Training 2016: 48(8): 387-393, doi.org/10.1105/ICT-03-2016-0014.
5. Batt R. Managing customer services: human resource practices, quit rates, and sales growth. Academy of Management Journal 2002; 45: 587-597.
6. Rogers SE, Jiang K, Carmen M. Strategic human resource management of volunteers and the link to hospital patient satisfaction. Nonprofit and Voluntary Sector Quarterly 2015. Doi: 10.1177/0899764015596434.
7. Chen L, Evans T, Anand S, Boutford JI, Brown H, et al. Human resources for health: overcoming the crisis. The Lancet 2004; 364(9449):1984-1990. Doi: Org/10.106/SO140-6736(04)17482-5.
8. Hongero C, Mc Pake B. How to bridge the gap in human resources for health. The Lancet 2004; 364(9443): 1451-1456. Doi: org/10.1016/S0140-6736(04)17229-2.
9. West MA, Guthric JP, Dawson JF, Borri II CS, Cartor M. Reducing patient mortality in hospitals: the role of human resource Management. Journal of Organizational Behavior 2006; 27(7): 983-1002, Doi: org/10.1002/job.396.
10. Abhicharttibutra K, Kunaviktikul W, Tural S, Wichaikhum OA, Srisuphan W. Analysis of a government policy to address nursing shortage and nursing education quality. International Nursing Review 2016; 64(1): 22-32. Doi: 10111/inr.12257.
11. Arab M, Fazaeli S, Mohammadpour M, Pirmoazen V, Yousefi M. Estimated the required manpower in the children's medical center of Tehran University of Medical Sciences for using by the work and timing activities method. Hospital 2009; 8(3): 1-7[Article in Persian].
12. Matsumoto M, Inoue K, Farmer J, Inada H & Kajii E. Geographic distribution of primary care physicians in Japan and Britain. Health & Place 2010; 16(1): 164-166. Doi: org/10.1016/j.healthplace.2009.07.005.
13. Sadeghifar J, Pourreza A, Ahmadi B, Zeraati H, Arab M. Survey of estimated required manpower in Ilam University of Medical Sciences hospitals matching the Iranian Ministry of Health standards. Ilam University of Medical Sciences 2011; 19(1): 24-31[Article in Persian].
14. Ghazi Mirsaeid SJ, Mirzaie M, Haghshenas E, Dargahi H. Human resources distribution among Tehran university of medical sciences hospitals. Pyavard Salamat 2013; 7(5): 432-446[Article in Persian].
15. Bahadori M, Arab M, Sadeghifar J, Ahmadi B, Salimi M, Yghoubi M. Estimation of nursing staff in selected hospitals of Ilam and Ahvaz provinces, Western iran. Nurs Midwifery Stud 2013; 2(2): 217-25.
16. Sadeghifar J, Tofighi SH, Hasani M, Rekab Eslami S, Raadabadi M, Moosavi SM. Estimation of the necessary nursing manpower in selected hospitals affiliated with Jundishapour University of Medical Sciences. Jundishapour Journal of Health Sciences 2013; 5(1): 1-8[Article in Persian].
17. Miseda MH, Were So, Murianki CA, Muturoka MP, Mutwiwa SN. The implementation of the shortage of health workforce specialist on universal health coverage in Kenya. Human Resources for Health 2017; 15: 80. Doi: org/10.1186/S12960-017-0253-9.
18. Sheffler RM, Tulenko K. The deepening global health workforce crisis: forecasting needs, shortage, and costs for the global strategy on human resources for health (2013-2030). Annals of Global Health 2016; 82(3): S10. Doi: org/10.1016/j.aogh.2016.04.386.
19. Elarabi HM, Johari F. The impact of human resources management on healthcare quality. Asian J Manag Sci Edu 2014; 3(1): 13-22.
20. Bendoly E, Donohue K, Schultz KL. Behavior in operations management: assessing recent findings and revisiting old assumptions. Journal of operations Management 2006; 24(6): 737-752. Doi: org /10.1016/J.Jom.2005010.001.
21. Barati A, Haghani H, Mohammadi R, Moradi F, Rouhani B, Tarsaki M, et al. The relationship between organizational health & performance indicators of health care in teaching hospitals affaired to Tehran University of Medical Sciences. Health Administration 2012; 14(46): 31-8[Article in Persian].
22. Kakeman E, Dargahi H, Rahimi Forushani A. Association between managers’ competency and technical efficiency in general hospitals in Iran. Patient Safety & Quality Improvement Journal 2017; 5(3): 567-571.
23. Lindllouer I, Schrejogg J. The relationship between hospitals specialization and hospital efficiency: do different methods of specialization lead to different results? Health care Management Sciences 2014; 17: 1-14.
24. Kakeman E, Rahimi Forushani A, Dargahi H. Technical efficiency of hospitals in Tehran, Iran. Iranian Journal of Public Health 2016; 45(4): 494-502.
25. Williams D, Thomas S. The impact of austerity on the health workforce and the achievement of human resources for health policies in Irland (2008-2014). Human Resource Health 2017; 15(1): 62. Doi: 10.1186/S12960-017-0230-3.
26. Afenyade GY, Adegake AA, Findley S. Improving human resources for health means retaining health workers: application of the WHO-recommendations for the retention of health workers in rural Northern-Nigeria. Journal of Health care poor underserved 2017; 28(3):1066-1086. Doi: 10.1353/Lpu.
27. Momeni K, Akbari F, Arab M, Rahimi A, Bahadori M. Situation of the necessary human resources for hospitals of Lorestan province in accordance with proposed model by the Irans’ Ministry of Health. Review of Global Medicine and Health Care Research 2012; 3(2): 135-143. DRUNPP.
28. Rahmani H, Arab M, Akbari F, Zeraati H. Structure, process and activities of emergency departments of Tehran University of Medical Sciences hospitals. Journal of School of Public Health and Researches Institute 2006; 4(4): 13-22 [ Article in Persian].
29. Jahani MA, Rastegar A, Hosseinpour M, Bijani A. The condition of Manpower Structure, space, and the equipments of emergency in Babol university of Medical Sciences hospitals matching the national standards. Journal of Babol University of Medical Sciences 2008; 10(6): 73-79 [Article in Persian].
30. Buerhaus P, Donelan K, Ulrich B, Norman h. Impact of the nurse shortage on hospital patient care: comperative perspective. Health Affairs 2007; 26(3): 853-862.
31. Haddad LM, Toney-Butler TJ. Nursing Shortage. Treasure Island (FL): Stat Pearls; 2019.
32. Khalajnia Z, Gaeeni M. Challenges in implementation of health care reform in the area of treatment Qom city, Iran. Management Strategies Health System Journal 2018; 3(3): 213-223, Doi: 10.18502/mshsj.V3i3.253 [Article in Persian].
33. Bahmani A, Farhanian A. Investigation the challenges affecting the health system development plan from the viewpoint of the managers and employees of Tehran Province hospitals. Management strategies Health System Journal 2018; 3(1): 80-89 [Article in Persian].
34. Sheikh Bardsiri H, Molavi Y, Shirdel A. Condition of distribution and adequacy of manpower in Iran hospitals. Hospital 2015; 14(4): 115-123[Article in Persian].
35. Faridfar N, Alimohammadzade KH, Seyedein SH. Impact of healthcare overhaul plan on clinical, paraclinical, surgery indexes and on the patients satisfaction in Rasul Akram Hospital in 2013-2014. Razi Medical Sciences Journal 2015; 22(140): 92-99[Article in Persian].
36. Datta NR, Khan S, Marder D, Zwahien D, Bodis S. Radiotherapy infrastructure and human resources in Switzerland: present status and projected computations for 2020. Stahlenther Onkol 2016; 192(9): 599-608, doi: 10.1007/S00066-016-1022-8.
37. Jafari Sirizi M, Seyedein SH, Aghlmand S & Seyed Mahmoudi M. Performance indicators of emergency departments following the implementation of specialist residency program under the health sector evolution plan in public hospitals of West Azerbaijan province in Iran. Health Administraction 2017; 20(67): 50-63[Article in Persian].
38. Mousavi Rigi A, Bahrami M, Montazerlofaraj R, Dehghani A, Dorahaki M & Barati O. Reviews and comparisons of hospital performance indicators before and after the implementation of the healthcare reform package design therapeutic hospitals of Bushehr university of medical sciences. Tolooe Behdasht 2016; 15(6): 107-19[Article in Persian].
39. Rezaei S, Rahimi Forushani A, Arab M & Jafari Poyan E. Effects of the new health reform plan on the performance indicators of Hamedan university hospitals. Journal of School of Publich Health & Institute of Public Health Research 2016; 14(2): 51-60[Article in Persian].
40. Faridfar N, Alimohammadzade KH & Seyedein SH. The impact of health system reform on clinical, paraclinical and surgical indicators as well as patients' satisfaction in Rasoul-e-Akram hospital in 2013 to 2014. Razi Journal of Medical Sciences 2016; 22(140): 92-9[Article in Persian].
41. Buerhaus PI, Donelan K, Ulrich BT, Norman L, Des Roches C, Dittus R. Impact of the nurse shortage on hospital patient care: Comparative perspective. Health Affairs 2007; 26(3): 12-20, doi.org/10.1377/ hlthaff.26.3.853.
42. Burns LR, Muller RW. Hospital-Physician collaboration: Landscape of economic integration and impact on clinical integration. Milbank Quarterly 2008; 86(3): 375-434, Doi.org/10.1111/j.1468-0009.2008.00527.X.
43. Azari S, Mokhtari S, Azari GH. Correlation between adequate nursing staffs and the hospital performance: case study in Tehran University of Medical Sciences. Journal of Medicine and life 2015; 8(3): 90-95.
44. Evarhart D, Neff D, Maldona R. The effect of nurse staffing on hospital financial performance: competitive versus less competitive markets. Health Care Management Review 2013; 38(2): 146-155.
45. Clark PA, Fache KL, Drain M, Kaldenberg D. State nursing shortage and patient satisfaction. Journal of Nurse Care Quality 2007; 22(2): 119-127.
46. Abedi GH, Abedini E, Malekzadeh R, Araghian Mojarad F. Medical error management before and after implementation of accreditation in hospital. Iranian Journal of Health Sciences 2014; 2(4):59-66.
47. Yousefinezhadi T, Mosadeghrad AM, Akbari Sari A. An analysis of hospital accreditation policy in Iran. Iranian Journal of Public Health 2017; 46(10): 1347-1358.
2. Sharma N. Rahman AV, Kohli C, Kumar P. A comparative review of evolution of human resources for health in public health in India. Journal of MAMC Medical Sciences 2016; 2(3):116-121.
3. Baumann A, Arsenio MC, Danesh NA. Strategic welfare planning for health human resources: a nursing case analysis. Canadian Journal of Nursing Research 2016: 48(3-4): 93-99.
4. Ramaderi D, Gunasekarau A, Roy M, Bharatendera KR. Human resource management in a health care environment: framework and case study. Industrial and Commercial Training 2016: 48(8): 387-393, doi.org/10.1105/ICT-03-2016-0014.
5. Batt R. Managing customer services: human resource practices, quit rates, and sales growth. Academy of Management Journal 2002; 45: 587-597.
6. Rogers SE, Jiang K, Carmen M. Strategic human resource management of volunteers and the link to hospital patient satisfaction. Nonprofit and Voluntary Sector Quarterly 2015. Doi: 10.1177/0899764015596434.
7. Chen L, Evans T, Anand S, Boutford JI, Brown H, et al. Human resources for health: overcoming the crisis. The Lancet 2004; 364(9449):1984-1990. Doi: Org/10.106/SO140-6736(04)17482-5.
8. Hongero C, Mc Pake B. How to bridge the gap in human resources for health. The Lancet 2004; 364(9443): 1451-1456. Doi: org/10.1016/S0140-6736(04)17229-2.
9. West MA, Guthric JP, Dawson JF, Borri II CS, Cartor M. Reducing patient mortality in hospitals: the role of human resource Management. Journal of Organizational Behavior 2006; 27(7): 983-1002, Doi: org/10.1002/job.396.
10. Abhicharttibutra K, Kunaviktikul W, Tural S, Wichaikhum OA, Srisuphan W. Analysis of a government policy to address nursing shortage and nursing education quality. International Nursing Review 2016; 64(1): 22-32. Doi: 10111/inr.12257.
11. Arab M, Fazaeli S, Mohammadpour M, Pirmoazen V, Yousefi M. Estimated the required manpower in the children's medical center of Tehran University of Medical Sciences for using by the work and timing activities method. Hospital 2009; 8(3): 1-7[Article in Persian].
12. Matsumoto M, Inoue K, Farmer J, Inada H & Kajii E. Geographic distribution of primary care physicians in Japan and Britain. Health & Place 2010; 16(1): 164-166. Doi: org/10.1016/j.healthplace.2009.07.005.
13. Sadeghifar J, Pourreza A, Ahmadi B, Zeraati H, Arab M. Survey of estimated required manpower in Ilam University of Medical Sciences hospitals matching the Iranian Ministry of Health standards. Ilam University of Medical Sciences 2011; 19(1): 24-31[Article in Persian].
14. Ghazi Mirsaeid SJ, Mirzaie M, Haghshenas E, Dargahi H. Human resources distribution among Tehran university of medical sciences hospitals. Pyavard Salamat 2013; 7(5): 432-446[Article in Persian].
15. Bahadori M, Arab M, Sadeghifar J, Ahmadi B, Salimi M, Yghoubi M. Estimation of nursing staff in selected hospitals of Ilam and Ahvaz provinces, Western iran. Nurs Midwifery Stud 2013; 2(2): 217-25.
16. Sadeghifar J, Tofighi SH, Hasani M, Rekab Eslami S, Raadabadi M, Moosavi SM. Estimation of the necessary nursing manpower in selected hospitals affiliated with Jundishapour University of Medical Sciences. Jundishapour Journal of Health Sciences 2013; 5(1): 1-8[Article in Persian].
17. Miseda MH, Were So, Murianki CA, Muturoka MP, Mutwiwa SN. The implementation of the shortage of health workforce specialist on universal health coverage in Kenya. Human Resources for Health 2017; 15: 80. Doi: org/10.1186/S12960-017-0253-9.
18. Sheffler RM, Tulenko K. The deepening global health workforce crisis: forecasting needs, shortage, and costs for the global strategy on human resources for health (2013-2030). Annals of Global Health 2016; 82(3): S10. Doi: org/10.1016/j.aogh.2016.04.386.
19. Elarabi HM, Johari F. The impact of human resources management on healthcare quality. Asian J Manag Sci Edu 2014; 3(1): 13-22.
20. Bendoly E, Donohue K, Schultz KL. Behavior in operations management: assessing recent findings and revisiting old assumptions. Journal of operations Management 2006; 24(6): 737-752. Doi: org /10.1016/J.Jom.2005010.001.
21. Barati A, Haghani H, Mohammadi R, Moradi F, Rouhani B, Tarsaki M, et al. The relationship between organizational health & performance indicators of health care in teaching hospitals affaired to Tehran University of Medical Sciences. Health Administration 2012; 14(46): 31-8[Article in Persian].
22. Kakeman E, Dargahi H, Rahimi Forushani A. Association between managers’ competency and technical efficiency in general hospitals in Iran. Patient Safety & Quality Improvement Journal 2017; 5(3): 567-571.
23. Lindllouer I, Schrejogg J. The relationship between hospitals specialization and hospital efficiency: do different methods of specialization lead to different results? Health care Management Sciences 2014; 17: 1-14.
24. Kakeman E, Rahimi Forushani A, Dargahi H. Technical efficiency of hospitals in Tehran, Iran. Iranian Journal of Public Health 2016; 45(4): 494-502.
25. Williams D, Thomas S. The impact of austerity on the health workforce and the achievement of human resources for health policies in Irland (2008-2014). Human Resource Health 2017; 15(1): 62. Doi: 10.1186/S12960-017-0230-3.
26. Afenyade GY, Adegake AA, Findley S. Improving human resources for health means retaining health workers: application of the WHO-recommendations for the retention of health workers in rural Northern-Nigeria. Journal of Health care poor underserved 2017; 28(3):1066-1086. Doi: 10.1353/Lpu.
27. Momeni K, Akbari F, Arab M, Rahimi A, Bahadori M. Situation of the necessary human resources for hospitals of Lorestan province in accordance with proposed model by the Irans’ Ministry of Health. Review of Global Medicine and Health Care Research 2012; 3(2): 135-143. DRUNPP.
28. Rahmani H, Arab M, Akbari F, Zeraati H. Structure, process and activities of emergency departments of Tehran University of Medical Sciences hospitals. Journal of School of Public Health and Researches Institute 2006; 4(4): 13-22 [ Article in Persian].
29. Jahani MA, Rastegar A, Hosseinpour M, Bijani A. The condition of Manpower Structure, space, and the equipments of emergency in Babol university of Medical Sciences hospitals matching the national standards. Journal of Babol University of Medical Sciences 2008; 10(6): 73-79 [Article in Persian].
30. Buerhaus P, Donelan K, Ulrich B, Norman h. Impact of the nurse shortage on hospital patient care: comperative perspective. Health Affairs 2007; 26(3): 853-862.
31. Haddad LM, Toney-Butler TJ. Nursing Shortage. Treasure Island (FL): Stat Pearls; 2019.
32. Khalajnia Z, Gaeeni M. Challenges in implementation of health care reform in the area of treatment Qom city, Iran. Management Strategies Health System Journal 2018; 3(3): 213-223, Doi: 10.18502/mshsj.V3i3.253 [Article in Persian].
33. Bahmani A, Farhanian A. Investigation the challenges affecting the health system development plan from the viewpoint of the managers and employees of Tehran Province hospitals. Management strategies Health System Journal 2018; 3(1): 80-89 [Article in Persian].
34. Sheikh Bardsiri H, Molavi Y, Shirdel A. Condition of distribution and adequacy of manpower in Iran hospitals. Hospital 2015; 14(4): 115-123[Article in Persian].
35. Faridfar N, Alimohammadzade KH, Seyedein SH. Impact of healthcare overhaul plan on clinical, paraclinical, surgery indexes and on the patients satisfaction in Rasul Akram Hospital in 2013-2014. Razi Medical Sciences Journal 2015; 22(140): 92-99[Article in Persian].
36. Datta NR, Khan S, Marder D, Zwahien D, Bodis S. Radiotherapy infrastructure and human resources in Switzerland: present status and projected computations for 2020. Stahlenther Onkol 2016; 192(9): 599-608, doi: 10.1007/S00066-016-1022-8.
37. Jafari Sirizi M, Seyedein SH, Aghlmand S & Seyed Mahmoudi M. Performance indicators of emergency departments following the implementation of specialist residency program under the health sector evolution plan in public hospitals of West Azerbaijan province in Iran. Health Administraction 2017; 20(67): 50-63[Article in Persian].
38. Mousavi Rigi A, Bahrami M, Montazerlofaraj R, Dehghani A, Dorahaki M & Barati O. Reviews and comparisons of hospital performance indicators before and after the implementation of the healthcare reform package design therapeutic hospitals of Bushehr university of medical sciences. Tolooe Behdasht 2016; 15(6): 107-19[Article in Persian].
39. Rezaei S, Rahimi Forushani A, Arab M & Jafari Poyan E. Effects of the new health reform plan on the performance indicators of Hamedan university hospitals. Journal of School of Publich Health & Institute of Public Health Research 2016; 14(2): 51-60[Article in Persian].
40. Faridfar N, Alimohammadzade KH & Seyedein SH. The impact of health system reform on clinical, paraclinical and surgical indicators as well as patients' satisfaction in Rasoul-e-Akram hospital in 2013 to 2014. Razi Journal of Medical Sciences 2016; 22(140): 92-9[Article in Persian].
41. Buerhaus PI, Donelan K, Ulrich BT, Norman L, Des Roches C, Dittus R. Impact of the nurse shortage on hospital patient care: Comparative perspective. Health Affairs 2007; 26(3): 12-20, doi.org/10.1377/ hlthaff.26.3.853.
42. Burns LR, Muller RW. Hospital-Physician collaboration: Landscape of economic integration and impact on clinical integration. Milbank Quarterly 2008; 86(3): 375-434, Doi.org/10.1111/j.1468-0009.2008.00527.X.
43. Azari S, Mokhtari S, Azari GH. Correlation between adequate nursing staffs and the hospital performance: case study in Tehran University of Medical Sciences. Journal of Medicine and life 2015; 8(3): 90-95.
44. Evarhart D, Neff D, Maldona R. The effect of nurse staffing on hospital financial performance: competitive versus less competitive markets. Health Care Management Review 2013; 38(2): 146-155.
45. Clark PA, Fache KL, Drain M, Kaldenberg D. State nursing shortage and patient satisfaction. Journal of Nurse Care Quality 2007; 22(2): 119-127.
46. Abedi GH, Abedini E, Malekzadeh R, Araghian Mojarad F. Medical error management before and after implementation of accreditation in hospital. Iranian Journal of Health Sciences 2014; 2(4):59-66.
47. Yousefinezhadi T, Mosadeghrad AM, Akbari Sari A. An analysis of hospital accreditation policy in Iran. Iranian Journal of Public Health 2017; 46(10): 1347-1358.
| Files | ||
| Issue | Vol 57, No 8 (2019) | |
| Section | Articles | |
| DOI | https://doi.org/10.18502/acta.v57i8.2428 | |
| Keywords | ||
| Health system evolution plan Distribution of human resources Hospital performance indicators Tehran university of medical sciences | ||
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How to Cite
1.
Dargahi H, Shaham G. The Relationship Between Distribution of Human Resources Distribution and Performance Indicators of Hospitals Before and After Implementation of Health System Evolution Plan in Iran. Acta Med Iran. 2020;57(8):510-517.
