scholarly journals Performance evaluation and ranking of regional primary health care and public health systems in Iran

2020 ◽  
Author(s):  
Arash Rashidian ◽  
Nader Jahanmehr ◽  
Farshad Farzadfar ◽  
Ardeshir Khosravi ◽  
Mohammad Shariati ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Health Systems ◽  
Average Score ◽  
Medical Sciences ◽  
Frontier Analysis ◽  
Average Performance ◽  
Public Health Systems ◽  
Primary Health

Abstract Background The present study has been undertaken with the aim to evaluate performance and ranking of various universities of medical sciences that are responsible for providing public health services and primary health care in Iran. Methods Four models; Weighted Factor Analysis (WFA), Equal Weighting (EW), Stochastic Frontier Analysis (SFA), and Data Envelopment Analysis (DEA) have been applied for evaluating the performance of universities of medical sciences. This study was commenced based on the statistical reports of the Ministry of Health and Medical Education (MOHME) census data from the Statistical Center of Iran, indicators of Vital Statistics, results of Multiple Indicator of Demographic and Health Survey 2010, and results of the National Survey of Risk Factors of non-communicable diseases. Results The average performance scores in WFA, EW, SFA, and DEA methods for the universities are 0.611, 0.663, 0.736 and 0.838, respectively. Based on the ranking of Gilan University, with an average score of 4.75, and Rafsanjan University, with an average score of 0.41, these universities have obtained the first and the last rank in the performance of their primary health care and public health systems, respectively. According to the results of all four models, the Universities of Gilan, Ardebil, and Bojnourd were the strongest ranking in this regard and the Universities of Rafsanjan, Kerman, Ahvaz, and Jiroft ranked weakest in performance. Conclusions The average performance of the universities of medical sciences is not acceptable at the present level in which they stand in Iran. Of course, this condition is not prevalent in all universities and there is much dispersion in the performance of universities at the country level today. Designing the evaluation system and annual ranking of universities of medical sciences by using the methodology of the present study can lead to the improvement of performance of this system and, consequently, the improvement of heath indicators, by attracting the society and attention of policymakers to the domain of primary and public health care and creating a healthy competition among different regions of the country.

scholarly journals Performance evaluation and ranking of regional primary health care and public health Systems in Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arash Rashidian ◽  
Nader Jahanmehr ◽  
Farshad Farzadfar ◽  
Ardeshir Khosravi ◽  
Mohammad Shariati ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Stochastic Frontier Analysis ◽  
Census Data ◽  
Medical Sciences ◽  
Public Health Services ◽  
Frontier Analysis ◽  
Average Performance ◽  
Primary Health

Abstract Background The present study has been undertaken with the aim to evaluate performance and ranking of various universities of medical sciences that are responsible for providing public health services and primary health care in Iran. Methods Four models; Weighted Factor Analysis (WFA), Equal Weighting (EW), Stochastic Frontier Analysis (SFA), and Data Envelopment Analysis (DEA) have been applied for evaluating the performance of universities of medical sciences. This study was commenced based on the statistical reports of the Ministry of Health and Medical Education (MOHME), census data from the Statistical Center of Iran, indicators of Vital Statistics, results of Multiple Indicator of Demographic and Health Survey 2010, and results of the National Survey of Risk Factors of non-communicable diseases. Results The average performance scores in WFA, EW, SFA, and DEA methods for the universities were 0.611, 0.663, 0.736 and 0.838, respectively. In all 4 models, the performance scores of universities were different (range from 0.56–1, 0.53–1, 0.73–1 and 0.83–1 in WFA, EW, SFA and DEA models, respectively). Gilan and Rafsanjan universities with the average ranking score of 4.75 and 41 had the highest and lowest rank among universities, respectively. The universities of Gilan, Ardabil and Bojnourd in all four models had the highest performance among the top 15 universities, while the universities of Rafsanjan, Ahvaz, Kerman and Jiroft showed poor performance in all models. Conclusions The average performance scores have varied based on different measurement methods, so judging the performance of universities based solely on the results of a model can be misleading. In all models, the performance of universities has been different, which indicates the need for planning to balance the performance improvement of universities based on learning from the experiences of well-performing universities.

scholarly journals The impact of COVID-19 on primary health care and antibiotic prescribing in rural China: qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tingting Zhang ◽  
Xingrong Shen ◽  
Rong Liu ◽  
Linhai Zhao ◽  
Debin Wang ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Rural Areas ◽  
Rural China ◽  
Antibiotic Prescribing ◽  
Epidemic Control ◽  
Primary Health ◽  
Tract Infections ◽  
The Impact

Abstract Background In China, the primary health care (PHC) system has been designated responsible for control and prevention of COVID-19, but not treatment. Suspected COVID-19 cases presenting to PHC facilities must be transferred to specialist fever clinics. This study aims to understand the impact of COVID-19 on PHC delivery and on antibiotic prescribing at a community level in rural areas of central China. Methods Qualitative semi-structured interviews were conducted with 18 PHC practitioners and seven patients recruited from two township health centres and nine village clinics in two rural residential areas of Anhui province. Interviews were transcribed verbatim and analysed thematically. Results PHC practitioners reported a major shift in their work away from seeing and treating patients (due to government-mandated referral to specialist Covid clinics) to focus on the key public health roles of tracing, screening and educating in rural areas. The additional work, risk, and financial pressure that PHC practitioners faced, placed considerable strain on them, particularly those working in village clinics. Face to face PHC provision was reduced and there was no substitution with consultations by phone or app, which practitioners attributed to the fact that most of their patients were elderly and not willing or able to switch. Practitioners saw COVID-19 as outside of their area of expertise and very different to the non-COVID-19 respiratory tract infections that they frequently treated pre-pandemic. They reported that antibiotic prescribing was reduced overall because far fewer patients were attending rural PHC facilities, but otherwise their antibiotic prescribing practices remained unchanged. Conclusions The COVID-19 pandemic had considerable impact on PHC in rural China. Practitioners took on substantial additional workload as part of epidemic control and fewer patients were seen in PHC. The reduction in patients seen and treated in PHC led to a reduction in antibiotic prescribing, although clinical practice remains unchanged. Since COVID-19 epidemic control work has been designated as a long-term task in China, rural PHC clinics now face the challenge of how to balance their principal clinical and increased public health roles and, in the case of the village clinics, remain financially viable.

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