Evidence Based Health Policy, Management and Economics

Value-Based Payment Models in Healthcare: Challenges and Opportunities

2025-08-25T08:07:21+00:00

Payment models for health services are crucial for strategic purchasing, influencing both healthcare delivery and financing. These models vary in complexity depending on the services provided. Value-based payment (VBP) models represent a significant advancement, aiming to enhance quality and reduce costs in inpatient and outpatient settings, as well as for new technologies and medications. VBP incentivizes providers to prioritize patient outcomes over the volume of services, leading to improved care quality, cost savings, and increased stakeholder engagement. However, implementing VBP presents challenges, such as difficulties in accessing integrated health information, defining "value," and managing administrative complexities. Overcoming these obstacles is essential for realizing the transformative potential of value-based payment systems in healthcare delivery.

The Role of Spiritual Health in the Mental Health of Children and Adolescents: Emphasizing the Role of Parents and Educational Environments

2025-08-25T08:07:20+00:00

The Article Abstract is not available.

Identification of Hospital Behavioral Codes: A Case Study of Shahid Sadoughi Hospital in Yazd

2025-08-25T08:07:19+00:00

Background: The development and implementation of ethical and behavioral codes in workplaces, especially in healthcare, are crucial for improving service quality, increasing client satisfaction, and creating healthy work environments. This study aims to identify and analyze behavioral codes in three key areas—general, nursing, and support services—at Shahid Sadoughi Hospital in Yazd, with the objective of enhancing personnel performance and boosting patient satisfaction.

Methods: This qualitative study utilized a focus group method. The participants’ population comprised head nurses, supervisors, and managers from clinical, paraclinical, and support departments of Shahid Sadoughi Hospital. Purposive sampling was conducted based on specific inclusion and exclusion criteria. A total of eight focus group sessions were held, each with 12 to 14 participants. Data were collected through audio recordings and analyzed using qualitative content analysis with MAXQDA2022 software.

Results: The codes of conduct were identified in three areas: general, nursing, and support services. Moreover, the findings were organized into three main themes, each containing several subthemes. The results indicate that adherence to ethical, professional, and legal principles across these areas is essential for fostering healthy, safe, and effective work environments. Key principles include respectful behavior, discipline, confidentiality, trustworthiness, responsibility, and timely task completion. Observance of these principles correlates with improved organizational performance and increased satisfaction among clients and colleagues.

Conclusion: Given the significance of professional ethics and conduct codes, hospital managers should emphasize both general and specific aspects tailored to various job categories. By modeling ethical behavior, they can lead by example in promoting adherence to these principles in practice.

Assessment of Perception Towards the Concept Map Approach in Health Professions Education: A Psychometric Study

2025-08-25T08:07:18+00:00

Background: Concept maps serve as an effective visual and organizational tool that aligns well with the interactive and engaging nature of game-based learning. This study aims to evaluate the validity, reliability, and exploratory factor analysis of a tool for assessing student perception of the concept map approach as a teaching method.

Methods: It was a descriptive cross-sectional study. The study was carried out in three phases: validity assessment, reliability assessment, and factor analysis of the tool. The questionnaire, adapted from Chiou et al., consisted of 10 items on a 5-point Likert scale. The content and face validity of the Persian version were assessed using the Delphi technique with 15 medical education experts over three rounds. Moreover, quantitative content validity was determined using the Content Validity Ratio (CVR) and Content Validity Index (CVI). Reliability was evaluated through internal consistency (Cronbach's alpha) and reproducibility (intraclass correlation coefficient (ICC)). Exploratory factor analysis was performed using the Kaiser-Meyer-Olkin (KMO) index, Bartlett’s test, principal component analysis, and Varimax rotation. Finally, data were analyzed using IBM SPSS₂₄.

Results: The results confirmed the face and content validity, with all items scoring above 0.94 for CVR and above 0.79 for CVI. Internal consistency (Cronbach’s alpha = 0.86) and reproducibility (ICC = 0.83) indicated desirable reliability. Exploratory factor analysis also revealed two domains: "facilitating learning" and "encouraging learning," with significant factor loadings for all items.

Conclusion: The study confirmed the validity and reliability of the tool for measuring students' attitudes toward the concept map approach in Iran. Given the importance of assessing student reactions to innovative teaching methods, this instrument is recommended for evaluating attitudes toward concept map-based teaching.

Socioeconomic Factors Affecting Willingness to Pay for Non-Alcoholic Fatty Liver Care in Isfahan City

2025-08-25T08:07:17+00:00

Background: Non-alcoholic fatty liver disease (NAFLD) is recognized as one of the most common metabolic diseases worldwide. Given the increasing prevalence of this disease and its serious complications, examining the willingness to pay for treatment costs is of particular importance. This study aims to identify and analyze factors affecting the willingness to pay for treatment costs among patients with fatty liver disease.

Methods: This descriptive-analytical study was conducted using a regression model. Patients diagnosed with NAFLD who referred to the lifestyle clinic in Isfahan were studied. Data were collected using a standardized willingness-to-pay questionnaire and analyzed using SPSS₂₅ and statistical tests including Chi-square and multivariate logistic regression.

Results: The mean willingness-to-pay score was 3.25. Findings showed that variables such as age (P-value=0.035), gender (P-value=0.045), income (P-value=0.003), and basic insurance coverage (P-value=0.001) significantly affected willingness to pay (WTP). Moreover, the study indicated that WTP significantly decreased after a 20% tariff increase for NAFLD care services (P-value=0.003).

Conclusion: There was a relative WTP for these services within the studied community, and socioeconomic factors played a critical role in determining this willingness. Moreover, the significant decrease in WTP following tariff hikes reflected consumer sensitivity to price changes. It is recommended that future studies delve deeper into these factors and the long-term impacts of pricing changes on access and utilization.

Exploring the Link between Total Quality Management and Patient Safety Culture: A Nursing Perspective at Shahid Sadoughi Hospital, Yazd (2024)

2025-08-25T08:07:15+00:00

Background: Delivering high-quality services is essential for the success of service-oriented organizations. In today’s competitive global environment, organizations are increasingly focused on enhancing the quality, efficiency, and capabilities of their services and products. The healthcare sector, being a critical component of any society, places a strong emphasis on patient safety, which is a core aspect of care quality. This research investigates how nurses at Shahid Sadoughi Hospital in Yazd perceive the relationship between the implementation of total quality management (TQM) strategies and the prevailing culture of patient safety.

Methods: This applied, descriptive-correlational study was carried out in the year 1403 across multiple departments of Shahid Sadoughi Hospital. A total of 260 nurses working various shifts were randomly selected to participate. Data collection involved standardized questionnaires assessing total quality management and patient safety culture. The results were analyzed using Spearman’s correlation coefficient with SPSS₂₇.

Results: Among the 260 nurses surveyed, 85.83% were female, and the largest age group was 40–50 years (35.77%). Descriptive analysis indicated that there was no statistically significant relationship between total quality management (TQM) and the culture of patient safety. The mean score for TQM stood at 3.69 with a standard deviation of 0.52, whereas patient safety culture was rated lower, with an average of 2.59 ± 0.34. Among the various TQM components, “senior management leadership” achieved the highest average score (3.90 ± 0.65), while the “employee relationships” dimension recorded the lowest (3.32 ± 0.67). In the domain of patient safety culture, "manager/supervisor actions and expectations regarding patient safety" had the highest score (2.76 ± 0.46), while "organizational learning and continuous improvement" received the lowest (2.41 ± 0.52).

Conclusion: The findings indicate that both total quality management and patient safety culture are at a relatively satisfactory level in Shahid Sadoughi Hospital. However, the absence of a significant correlation between them suggests that additional factors may be contributing to the development of patient safety culture and the implementation of TQM practices safety culture and total quality management

Investigating the Direct and Interactive Impact of Government Health Expenditure and Institutional Quality on Iran's Economic Growth

2025-08-25T08:07:14+00:00

Method: This study examines the short-run and long-run impacts of public healthcare expenditure on and institutional quality on Iran's economic growth during the period 2000-2022 are investigated using the autoregressive distribution lag (ARDL) method.

Results: The findings demonstrate that enhanced institutional quality has significantly contributed to Iran's economic growth during the study period. While health expenditure alone exhibited no statistically significant effect on economic growth, the interaction term between health spending and institutional quality yielded a positive and significant coefficient. This suggests that health investments foster economic growth only when coupled with robust institutional frameworks, highlighting the conditional role of governance in mediating health-economic outcomes. The results also demonstrated that in the period studied, household consumption expenditure, Trade openness levels and labor force exerted a statistically significant positive influence on Iran's economic growth trajectory.

Conclusion: Considering the results of this study, which indicate a positive interactive effect of institutional quality on the relationship between health expenditure and economic growth, it is recommended to Iranian economic policymakers to plan to improve institutional quality indicators. In order for government health expenditure to contribute to economic growth, it is essential that resources be allocated effectively and efficiently. Educational and health policies should be designed in a way that not only they do not have negative effects in the short term, but also help to improve the quality of the workforce and promote public health in the long- term.

Mental Health Policies: Comparative Analysis of Mental Health Systems in Iran and Six Selected Countries

2025-08-25T08:07:13+00:00

Background: Mental disorders are recognized as the main cause of disability in the world. It is estimated that mental disorders will be the second leading cause of disabilities in the world by the year 2020. Nowadays, the importance of mental health and its vast effect on the other sections of health (including physical, social, and spiritual health) is not deniable.

Methods: This comparative-descriptive study intends to compare mental health systems of Iran and the selected countries in the year 2019. In order to achieve this goal, two groups of countries were selected to be compared with Iran. The first group consisted of countries similar to Iran in terms of context and texture specifications, including Turkey, Iraq, and Lebanon. Moreover, the second group included countries that are known to be successful in managing and providing health services, including Norway, Canada and Australia. In order to evaluate and compare mental health systems, the authors used the WHO Assessment Instrument for Mental Health Systems (WHO-AIMS). A summarized version of the WHO-AIMS form was implemented for collecting the data.

Results: After evaluation of the data obtained by mental health assessment tool, the results for each country were summarized and presented in comparative tables. Comparing mental health systems in the selected countries and Iran showed that there are a number of differences between countries in different aspects.

Conclusion: While Iran has specific mental health policies, these policies are not implemented desirably because of the lack of executive guarantees in this manner.