The Effect of Health Sector Evolution Plan on the Performance Indices of Emergency Department in Hospitals of Tehran & Iran Universities of Medical Sciences: Interrupted Time Series Analysis
Iranian Journal of Emergency Medicine,
Vol. 5 No. 1 (2018),
,
Page e9
https://doi.org/10.22037/ijem.v2i1.18052
Abstract
Introduction: The health sector evolution (HSE) plan has been implemented since 2014 and includes seven programs. Since one of the goals of this plan was to improve the condition of emergency departments, in this study we evaluated the effect of HSE plan on performance indices of emergency department in hospitals affiliated with Tehran and Iran Universities of Medical Sciences, Tehran, Iran. Methods: The present cross-sectional study was conducted in all Hospitals affiliated with Tehran and Iran Universities of Medical Sciences. Six performance indices of emergency department were collected monthly in two 12-month periods before and after implementation of the HSE plan by referring to the hospitals’ statistics unit. Data were analyzed via SPSS 22 using paired T-test and Interrupted Time Series (ITS) model. Results: The results of ITS showed that implementation of HSE plan had no significant effect on the rate and trend of indices such as percentage of patients who left the emergency department within 12 hours and percentage of patients discharged against medical advice (p > 0.05). On the other hand, HSE plan implementation affected the rate and trend of indices such as percentage of patients who were decided upon within 6 hours and the average turnaround time for emergency tests significantly (p < 0.05). The rate of both indices has increased but their trend has decreased. Conclusion: Implementation of HSE plan has resulted in improved percentage of patients who were decided upon within 6 hours and increased average turnaround time for emergency tests. In addition, although it has significantly increased the trend of successful CPR percentage, it has decreased the rate of successful CPR.How to Cite
References
Vosoogh Moghaddam A, Damari B, Alikhani S, Salarianzedeh MH, Rostamigooran N, Delavari A, et al. Health in the 5th 5-years Development Plan of Iran: Main Challenges, General Policies and Strategies. Iranian Journal of Public Health. 2013;42(Supple1):42-9.
Moradi-Lakeh M, Vosoogh-Moghaddam A. Health Sector Evolution Plan in Iran; Equity and Sustainability Concerns. International Journal of Health Policy and Management. 2015;4(10):637-40.
Health Sector Evolution. Available from: http://tahavol.behdasht.gov.ir/.
Arhami Dolatabadi A, Maleki M, Memary E, Kariman H, Shojaee M, Baratloo A. The use of emergency department services for non-emergency conditions. HealthMED. 2017;11(1):3-9.
Hashemi B, Baratloo A, Rahmati F, Forouzanfar MM, Motamedi M, Safari S. Emergency department performance indexes before and after establishment of emergency medicine. Emergency.
;1(1):20.
Baratloo A, Rahmati F, Forouzanfar MM, Hashemi B, Motamedi M, Safari S. Evaluation of Performance Indexes of Emergency Department. Iranian Journal of Emergency Medicine. 2015;2(1):33-8.
Penfold RB, Zhang F. Use of interrupted time series analysis in evaluating health care quality improvements. Academic pediatrics. 2013;13(6):S38-S44.
Arab M, Mousavi SM, Arian khesal A, akbarisari A. The Effect of Accreditation System on the Key Performance Indicators of Hospitals Affiliated to Tehran University of Medical Sciences: An Interrupted Time Series Analysis in 2012-2014. Hospital. 2017;16(1):17-26.
National conference to review the performance of eleventh government in the field of health. Iran National Institute of Health Research; 2015.
Majidi AM, Sadrolah; Adineh, Vahid Haji. An Epidemiologic Study of Emergency Department Visits before and after Executing Health Sector Evolution Plan; a Brief Report. Iranian Journal of Emergency Medicine. 2016;4(3):130-4.
Hashemi B, Baratloo A, Forouzafar MM, Motamedi M, Tarkhorani M. Patient satisfaction before and after executing health sector evolution plan. Iranian Journal of Emergency Medicine. 2015;2(3):127-33.
Piroozi B, Mohamadi Bolban Abad A, Moradi G. Assessing Health System Responsiveness after the Implementation of Health System Reform: A Case Study of Sanandaj, 2014-2015. Iranian Journal of Epidemiology. 2016;11(4):1-9.
Piroozi B, Moradi G, Esmail Nasab N, Ghasri H, Farshadi S, Farhadifar F. Evaluating the effect of health sector evolution plan on cesarean rate and the average costs paid by mothers: A case study in Kurdistan province between 2013-2015. Journal of hayat. 2016;22(3):245-54.
Razmara Farzaghi H RFM, Javadinia SA. Letter to the Editor: The executing health sector evolution plan and medical education; the need for educational attachment. Strides in Development of Medical Education. 2016;12(5):789-90.
akhondzade R. Health system transformation project, an opportunity or a threat for doctors. Anesthesiology and Pain. 2014;5(1):1-2.
Arrieta A. Health reform and cesarean sections in the private sector: the experience of Peru. Health Policy. 2011;99(2):124-30.
Shen JJ, Zhou S, Xu L, Chen J, Cochran CR, Fisher ER. Effects of the New Health Care Reform on Hospital Performance in China: A Seven-Year Trend from 2005 to 2011. Journal of Health Care Finance. 2014;41(1):1-14.
Anderson T, Catchlove B. Health and hospital reform in Australia—a local health district's perspective. World Hospitals and Health Services. 2012;48(3):21-4.
Bastani P, Lotfi F, Moradi M, AHMADZADEH M. The Performance Analysis of Teaching Hospitals Affiliated with Shiraz University of Medical Sciences Before and After Health System Reform Plan Using Pabon Lasso Model. 2016.
Nabilou B, Salem Safi P, Yusefzadeh H. Performance assessment of health system reform plan in the hospitals affiliated with urmia university of medical sciences. Journal of Urmia Nursing And Midwifery Faculty. 2017;14(11):896-905.
Sajadi HS ZR. An Assessment of the Positive Effects of Health Reform Plan Implementation from the Perspective of Hospital Directors. 2016.
Vahdat S, Heydarian N. The impact of implantation of health care reform plan in patients pay out of pocket in selected public hospitals in Isfahan. J Med Counc Iran. 2015;33.
Mohammadi E, Zareie G. Investigating the Effect of Health Care Improvement Plan on the Payment of the Insured in Iranian Health Insurance Organization (Case Study: Hospitalized Patients in Collegiate Hospitals of Ilam City in December 2013 and 2014). www sjimu medilam ac ir. 2017;24(6):178-88.
Rezaei S, Arab M. Effects of the New Health Reform Plan on the Performance Indicators of Hamedan University Hospitals. Journal of School of Public Health and Institute of Public Health Research. 2016;14(2):51-60.
Faridfar N, Alimohammadzadeh K, Seyedin 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.
Alidadi A, Ameryoun A, Sepandi M, Morteza S, Shokouh H, Abedi R, et al. The Opportunities and Challenges of the Ministry of Health and Medical Education in the Implementation of Healthcare Reform. Health Research. 2016;1(3):173-84.
- Abstract Viewed: 1752 times
- PDF (فارسی) Downloaded: 1008 times
- HTML (فارسی) Downloaded: 380 times