Objectives To increase the efficiency of hemodialysis, an appropriate vascular pathway must be created, and its function must be maintained. This study aimed to identify the effects of an arteriovenous fistula (AVF) stenosis prevention program on upper muscular strength, blood flow, physiological indexes, and self-efficacy among patients receiving hemodialysis.
Methods The participants were patients receiving hemodialysis at Keimyung University Dongsan Medical Center in Daegu, Republic of Korea. They were divided into experimental and control groups based on the day of the week they received hemodialysis at the outpatient department and included 25 participants each. The study was conducted for 8 weeks.
Results The AVF stenosis prevention program was effective in improving upper extremity muscle strength (F=15.23, p<0.001) and blood flow rate (F=36.00, p<0.001). As a result of the program, the phosphorus index level, which is a physiological indicator in hemodialysis patients, decreased (F=8.64, p<0.001). Encouragement and support through text messages and practice lists also resulted in an increase in self-efficacy (F=18.62, p<0.001).
Conclusion The AVF stenosis prevention program in this study resulted in an increase in upper extremity muscle strength through grip strength exercises and was effective in preventing AVF stenosis by increasing the blood flow rate.
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Objectives This study aimed to examine the effect of the coronavirus disease 2019 (COVID-19) outbreak on the hospitalization rate, emergency department (ED) visits, and outpatient clinic visits in western Iran.
Methods We collected data on the monthly hospitalization rate, rate of patients referred to the ED, and rate of patients referred to outpatient clinics for a period of 40 months (23 months before and 17 months after the COVID-19 outbreak in Iran) from all 7 public hospitals in the city of Kermanshah. An interrupted time series analysis was conducted to examine the impact of COVID-19 on the outcome variables in this study.
Results A statistically significant decrease of 38.11 hospitalizations per 10,000 population (95% confidence interval [CI], 24.93–51.29) was observed in the first month of the COVID-19 outbreak. The corresponding reductions in ED visits and outpatient visits per 10,000 population were 191.65 (95% CI, 166.63–216.66) and 168.57 (95% CI, 126.41–210.73), respectively. After the initial reduction, significant monthly increases in the hospitalization rate (an increase of 1.81 per 10,000 population), ED visits (an increase of 2.16 per 10,000 population), and outpatient clinic visits (an increase of 5.77 per 10,000 population) were observed during the COVID-19 pandemic.
Conclusion Our study showed that the utilization of outpatient and inpatient services in hospitals and clinics significantly declined after the COVID-19 outbreak, and use of these services did not return to pre-outbreak levels as of June 2021.
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Objectives
Coronavirus disease 2019 (COVID-19) is a novel pandemic. Considerable differences in disease severity and the mortality rate have been observed in different parts of the world. The present study investigated the characteristics and outcomes of patients hospitalized with COVID-19 in Iran.
Methods
We established a retrospective cohort to study hospitalized COVID-19 patients in Iran. Epidemiological, imaging, laboratory, and clinical characteristics and outcomes were recorded from medical documents. The chi-square test, t-test, and logistic regression models were used to analyze the data. A p<0.05 was considered to indicate statistical significance.
Results
In total, 364 cases (207 males and 157 females) were analyzed. The most common symptoms were cough, fever, and dyspnea. Multifocal bilateral ground-glass opacities with peripheral distribution were the predominant imaging finding. The mean age of patients was 54.28±18.81 years. The mean age of patients who died was 71.50±14.60 years. The mortality rate was 17.6%. The total proportion of patients with a comorbidity was 47.5%, and 84.4% of patients who died had a comorbidity. Sex, history of diabetes mellitus, and dyslipidemia were not significantly associated with mortality (p>0.05). However, mortality showed significant relationships with body mass index; age; history of hypertension, chronic kidney disease (CKD), ischemic heart disease, cerebrovascular accident (CVA), pulmonary disease, and cancer; and abnormal high-resolution computed tomography (HRCT) findings (p<0.05 for all). Cancer had the highest odds ratio.
Conclusion
Comorbidities (especially cancer, CKD, and CVA), severe obesity, old age, and abnormal HRCT findings affected the health outcomes of patients hospitalized with COVID-19.
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<sec>
<title>Objectives</title>
<p>The purpose of this study was to analyze the characteristics and factors affecting the survival of inpatients admitted following a suicide attempt.</p></sec>
<sec>
<title>Methods</title>
<p>A total of 3,095 cases retrieved from the Korean National Hospital Discharge In-depth Injury Survey data (from 2011 to 2015) were grouped according to survival and death and analyzed using descriptive statistics chi-square and logistic regression analysis.</p></sec>
<sec>
<title>Results</title>
<p>The following factors had statistically significant risks on reducing survival: female (OR = 2.352, <italic>p</italic> < 0.001), 40–59 years old (OR = 0.606, <italic>p</italic> = 0.014), over 60 years old (OR = 0.186, <italic>p</italic> < 0.001), poisoning (OR = 0.474, <italic>p</italic> = 0.009), hanging (OR = 0.031, <italic>p</italic> < 0.001), jumping (OR = 0.144, <italic>p</italic> < 0.001), conflicts with family (OR = 2.851, <italic>p</italic> < 0.001), physical diseases (OR = 1.687, <italic>p</italic> = 0.046), mental health problems (OR = 2.693, <italic>p</italic> < 0.001), financial problems (OR = 3.314, <italic>p</italic> = 0.002), 2014 (OR = 2.498, <italic>p</italic> = < 0.001) and 2015 (OR = 2.942, <italic>p</italic> = 0.005).</p></sec>
<sec>
<title>Conclusion</title>
<p>The survival group that had a history of attempted suicide (high-risk suicide group), should be further characterized. It is necessary to identify the suicide methods and risk factors for suicide prevention management policies and to continuously expand the management policy according to these characteristics.</p></sec>
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Objectives
Providing high service quality is one of the main functions of health systems. Measuring service quality is the basic prerequisite for improving quality. The aim of this study was to evaluate the quality of service in teaching hospitals using importance–performance analysis matrix. Methods
A descriptive–analytic study was conducted through a cross-sectional method in six academic hospitals of Qazvin, Iran, in 2012. A total of 360 patients contributed to the study. The sampling technique was stratified random sampling. Required data were collected based on a standard questionnaire (SERVQUAL). Data analysis was done through SPSS version 18 statistical software and importance–performance analysis matrix. Results
The results showed a significant gap between importance and performance in all five dimensions of service quality (<i>p</i> < 0.05). In reviewing the gap, “reliability” (2.36) and “assurance” (2.24) dimensions had the highest quality gap and “responsiveness” had the lowest gap (1.97). Also, according to findings, reliability and assurance were in Quadrant (I), empathy was in Quadrant (II), and tangibles and responsiveness were in Quadrant (IV) of the importance–performance matrix. Conclusion
The negative gap in all dimensions of quality shows that quality improvement is necessary in all dimensions. Using quality and diagnosis measurement instruments such as importance–performance analysis will help hospital managers with planning of service quality improvement and achieving long-term goals.
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Objectives
Hospitals as integrated parts of the wide-ranging health care systems have dominant focus on health care provision to meet, maintain and promote people's health needs of a community. This study aimed to assess the service quality of teaching hospitals of Yazd University of Medical Sciences using Fuzzy Analytical Hierarchy Process (FAHP) and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). Methods
A literature review and a qualitative method were used to obtain experts' viewpoints about the quality dimensions of hospital services to design a questionnaire. Then, using a self-made questionnaire, perceptions of 300 patients about the quality of delivered services were gathered. Finally, FAHP was applied to weigh each quality dimension and TOPSIS method to rank hospital wards. Results
Six dimensions including responsiveness, assurance, security, tangibles, health communication and Patient orientation were identified as affecting aspects of hospital services quality among which, security and tangibles got the highest and lowest importance respectively (0.25406, 0.06883). Findings also revealed that in hospital A, orthopedics and ophthalmology wards obtained the highest score in terms of quality while cardiology department got the lowest ranking (0.954, 0.323). In hospital B, the highest and the lowest ranking was belonged to cardiology and surgical wards (0.895, 0.00) while in hospital C, surgical units were rated higher than internal wards (0.959, 0.851). Conclusion
Findings emphasized that the security dimension got the lowest ranking among SERVQUAL facets in studied hospitals. This requires hospital executives to pay special attention to the issue of patients’ security and plan effectively for its promotion.
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Objectives
Organizational learning is defined as creating, absorbing, retaining, transferring, and application of knowledge within an organization. This article aims to examine the mediating role of organizational learning in the relationship of organizational intelligence and organizational agility. Methods
This analytical and cross-sectional study was conducted in 2015 at four teaching hospitals of Yazd city, Iran. A total of 370 administrative and medical staff contributed to the study. We used stratified-random method for sampling. Required data were gathered using three valid questionnaires including Alberkht (2003) organizational intelligence, Neefe (2001) organizational learning, and Sharifi and Zhang (1999) organizational agility questionnaires. Data analysis was done through R and SPSS 18 statistical software. Results
The results showed that organizational learning acts as a mediator in the relationship of organizational intelligence and organizational agility (path coefficient = 0.943). Also, organizational learning has a statistical relationship with organizational agility (path coefficient = 0.382). Conclusion
Our findings suggest that the improvement of organizational learning abilities can affect an organization's agility which is crucial for its survival.
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Objectives
This study provides information to aid decision making for managers and the staff of national university hospitals through analyzing their financial statements. Methods
In order to analyze the finances of national university hospitals, this study used the report of final accounts announced by each hospital from 2009 to 2012 as baseline data. The research participants were 10 national university hospitals. Results
According to the results of the analysis, most hospitals (except for a few) had medical expenses exceeding their medical revenues, resulting in a net deficit; however, there were significant differences amongst the hospitals. The result of adjustments based on a standard size of 100 beds showed that most hospitals had medical revenue deficits, and there were significant differences between hospitals in terms of medical revenues and medical costs. Conclusion
It is not clear whether an expansion of national university hospitals is always beneficial for increasing net revenues, and it is necessary to establish a differentiation strategy to increase profitability by securing financial soundness instead of externally-oriented growth.
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Objective
The commitment of employees is affected by several factors, including factors related to the organizational climate. The aim of this study was to investigate the relationship between organizational commitment of nurses and the organizational climate in hospital settings. Methods
A cross-sectional study was conducted in 2014 at two teaching hospitals in Yazd, Iran. A total of 90 nurses in these hospitals participated. We used stratified random sampling of the nursing population. The required data were gathered using two valid questionnaires: Allen and Meyer's organizational commitment standard questionnaire and Halpin and Croft's Organizational Climate Description Questionnaire. Data analysis was done through SPSS 20 statistical software (IBM Corp., Armonk, NY, USA). We used descriptive statistics and Pearson's correlation coefficient for the data analysis. Results
The findings indicated a positive and significant correlation between organizational commitment and organizational climate (<i>r</i> = 0.269, <i>p</i> = 0.01). There is also a significant positive relationship between avoidance of organizational climate and affective commitment (<i>r</i> = 0.208, <i>p</i> = 0.049) and between focus on production and normative and continuance commitment (<i>r</i> = 0.308, <i>p</i> = 0.003). Conclusion
Improving the organizational climate could be a valuable strategy for improving organizational commitment.
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Objectives
This paper provides information for decision making of the managers and the staff of national university hospitals. Methods
In order to conduct a financial analysis of national university hospitals, this study uses reports on the final accounts of 10 university hospitals from 2008 to 2011. Results
The results of comparing 2008 and 2011 showed that there was a general decrease in total assets, an increase in liabilities, and a decrease in total medical revenues, with a continuous deficit in many hospitals. Moreover, as national university hospitals have low debt dependence, their management conditions generally seem satisfactory. However, some individual hospitals suffer severe financial difficulties and thus depend on short-term debts, which generally aggravate the profit and loss structure. Various indicators show that the financial state and business performance of national university hospitals have been deteriorating. Conclusion
These research findings will be used as important basic data for managers who make direct decisions in this uncertain business environment or by researchers who analyze the medical industry to enable informed decision-making and optimized execution. Furthermore, this study is expected to contribute to raising government awareness of the need to foster and support the national university hospital industry.
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Objectives
We characterized and assessed public health measures, including intensive vaccination and antiviral treatment, implemented during the 2009 influenza pandemic in the Republic of Korea. Methods
A mathematical model for the 2009 influenza pandemic is formulated. The transmission rate, the vaccination rate, the antiviral treatment rate, and the hospitalized rate are estimated using the least-squares method for the 2009 data of the incidence curves of the infected, vaccinated, treated, and hospitalized. Results
The cumulative number of infected cases has reduced significantly following the implementation of the intensive vaccination and antiviral treatment. In particular, the intensive vaccination was the most critical factor that prevented severe outbreak. Conclusion
We have found that the total infected proportion would increase by approximately six times under the half of vaccination rates.
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Objectives
To investigate predictors for specific dimensions of service quality perceived by hospital employees in long-term care hospitals. Methods
Data collected from a survey of 298 hospital employees in 18 long-term care hospitals were analysed. Multivariate ordinary least squares regression analysis with hospital fixed effects was used to determine the predictors of service quality using respondents’ and organizational characteristics. Results
The most significant predictors of employee-perceived service quality were job satisfaction and degree of consent on national evaluation criteria. National evaluation results on long-term care hospitals and work environment also had positive effects on service quality. Conclusion
The findings of the study show that organizational characteristics are significant determinants of service quality in long-term care hospitals. Assessment of the extent to which hospitals address factors related to employeeperceived quality of services could be the first step in quality improvement activities. Results have implications for efforts to improve service quality in longterm care hospitals and designing more comprehensive national evaluation criteria.
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Objectives
The incidence of anal disease is higher among persons with human immunodeficiency virus (HIV) infection than among the general population. We surveyed the status of seroprevalence in colorectal hospitals in Korea. Methods
The survey was conducted in colorectal hospitals in Korea from November to December 2008. The questionnaire was comprised of six topics about the status of HIV testing in colorectal hospitals. We gathered the data by website (<ext-link ext-link-type="uri" xlink:href="http://hivqa.nih.go.kr/risk">http://hivqa.nih.go.kr/risk</ext-link>) or fax. Results
Among 774 colorectal hospitals contacted, 109 (14%) hospitals participated in the survey. Among these, 48 hospitals (44%) performed HIV tests in their own hospitals and 11 (23%) took HIV testing by rapid method. The main reason for recommending an HIV test was surgical operation (54%) followed by endoscope (11%) and health checkup (9%). The annual number of HIV tests increased from 58,647 (at 21 hospitals) in 2002 to 246,709 (at 58 hospitals) in 2007. HIV seroprevalence was >3.0 per 10,000 individuals during 2002–2005, decreased to 2.2 per 10,000 individuals in 2006 and rose to 2.8 per 10,000 individuals in 2007. Conclusions
HIV seroprevalence of colorectal hospitals was more than twice that of general hospitals in Korea. HIV surveillance systems based on colorectal hospitals for HIV/AIDS transmission prevention by early HIV diagnosis are needed.
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