Management Strategies in Health System
راهبردهای مدیریت در نظام سلامت
Manage Strat Health Syst
Medical Sciences
http://mshsj.ssu.ac.ir
1
admin
2476-6879
2538-1563
8888
fa
jalali
1397
9
1
gregorian
2018
12
1
3
3
online
1
fulltext
fa
تبیین چالشهای اجرای طرح تحول نظام سلامت در حوزه درمان در شهر قم
Challenges in Implementation of Health Care Reform in the Area of Treatment Qom City
تخصصي
Special
پژوهشي
Research
<div style="text-align: justify;"><strong><span style="font-family:b nazanin;">زمینه و هدف:</span></strong><span style="font-family:b nazanin;"> طرح تحول نظام سلامت با 3 رویکرد حفاظت مالی از مردم، ایجاد عدالت در دسترسی به خدمات سلامت و نیز ارتقاء کیفیت از اردیبهشت ماه سال 1393 اجرا شد. طرح تحول نظام سلامت، </span><span style="font-family:b nazanin;">همانند</span> <span style="font-family:b nazanin;">هر</span> <span style="font-family:b nazanin;">طرح</span> <span style="font-family:b nazanin;">دیگر،</span> <span style="font-family:b nazanin;">با</span> <span style="font-family:b nazanin;">چالشهایی روبه رو بوده است. این </span><span style="font-family:b nazanin;">مطالعه با هدف تبیین چالشهای طرح تحول نظام سلامت در حوزه درمان در شهر قم انجام گرفت. </span><br>
<strong><span style="font-family:b nazanin;">روش پژوهش:</span></strong><span style="font-family:b nazanin;"> طی نمونه گیری هدفمند، این</span> <span style="font-family:b nazanin;">مطالعه</span> <span style="font-family:b nazanin;">کیفی</span><span style="font-family:b nazanin;"> با مشارکت</span><span style="font-family:b nazanin;"> 23 نفر</span> <span style="font-family:b nazanin;">از</span> <span style="font-family:b nazanin;">ارائه دهندگان خدمت (مدیران و پرسنل درمانی) شاغل</span> <span style="font-family:b nazanin;">در</span> <span style="font-family:b nazanin;">مراکز</span> <span style="font-family:b nazanin;">آموزشی- </span> <span style="font-family:b nazanin;">درمانی</span> <span style="font-family:b nazanin;">وابسته</span> <span style="font-family:b nazanin;">به</span> <span style="font-family:b nazanin;">دانشگاه</span> <span style="font-family:b nazanin;">علوم</span> <span style="font-family:b nazanin;">پزشکی</span> <span style="font-family:b nazanin;">قم</span> <span style="font-family:b nazanin;">و 5 نفر از گیرندگان خدمت در</span> <span style="font-family:b nazanin;">سال</span><span style="font-family:b nazanin;"> 1397-1396 </span><span style="font-family:b nazanin;">انجام</span> <span style="font-family:b nazanin;">شد</span><span style="font-family:b nazanin;">.</span> <span style="font-family:b nazanin;">از</span> <span style="font-family:b nazanin;">مصاحبه</span><span style="font-family:b nazanin;"></span><span style="font-family:b nazanin;">ی</span> <span style="font-family:b nazanin;">نیمه</span> <span style="font-family:b nazanin;">ساختارمند</span> <span style="font-family:b nazanin;">برای</span> <span style="font-family:b nazanin;">جمع</span> <span style="font-family:b nazanin;">آوری</span> <span style="font-family:b nazanin;">دادهها</span> <span style="font-family:b nazanin;">بهره</span> <span style="font-family:b nazanin;">گرفته</span> <span style="font-family:b nazanin;">شد</span><span style="font-family:b nazanin;">. </span><span style="font-family:b nazanin;">تجزیه</span> <span style="font-family:b nazanin;">و</span> <span style="font-family:b nazanin;">تحلیل</span> <span style="font-family:b nazanin;">داده</span><span style="font-family:b nazanin;"></span><span style="font-family:b nazanin;">ها</span> <span style="font-family:b nazanin;">با</span> <span style="font-family:b nazanin;">استفاده</span> <span style="font-family:b nazanin;">از روش</span> <span style="font-family:b nazanin;">تحلیل</span> <span style="font-family:b nazanin;">محتوای</span> <span style="font-family:b nazanin;">قراردادی و با نرم افزا</span><span style="font-family:b nazanin;">ر </span><span dir="LTR"><span style="font-family:times new roman,serif;">MaxQDA <sub>10</sub></span></span> <span style="font-family:b nazanin;">انجام</span> <span style="font-family:b nazanin;">شد</span><span style="font-family:b nazanin;">.</span><br>
<strong><span style="font-family:b nazanin;">یافتهها:</span></strong> <strong><span style="font-family:b nazanin;">از</span></strong><span style="font-family:b nazanin;"> تحلیل</span> <span style="font-family:b nazanin;">دادهها،</span> <span style="font-family:b nazanin;">5 درون مایه اصلی شامل </span><span dir="LTR">"</span><span style="font-family:b nazanin;">چالشهای اقتصادی</span><span style="font-family:times new roman,serif;">"</span><span style="font-family:b nazanin;">،</span> <span style="font-family:times new roman,serif;">"</span><span style="font-family:b nazanin;">تقاضای القایی</span><span style="font-family:times new roman,serif;">"</span><span style="font-family:b nazanin;">، "منابع انسانی"، "پیامدهای منفی طرح" و "عدم </span><span style="font-family:b nazanin;">زیر ساخت مناسب</span><span style="font-family:b nazanin;">"</span> <span style="font-family:b nazanin;">استخراج گردید.</span><br>
<strong><span style="font-family:b nazanin;">نتیجه گیری:</span></strong> <span style="font-family:b nazanin;">نتایج حاصل از مطالعه</span><span style="font-family:b nazanin;">،</span> <span style="font-family:b nazanin;">چالشهای اصلی طرح تحول</span> <span style="font-family:b nazanin;">نظام سلامت در حوزه درمان را تبیین نمود که در صورت عدم برنامه ریزی و توجه ویژه به این چالشها، ادامه اجرای طرح با مشکلات جدی مواجه خواهد شد. لذا تداوم اجرای طرح نیاز به حمایت همه جانبه از طرف مسئولین و برنامه ریزی و سیاستگذاری مناسب دارد.</span></div>
<div style="text-align: justify;"><strong>Background: </strong>The health system reform was implemented with 3 approaches of financial protection of people, creating equity in accessing health services, and improving quality in May 2014. The health care reform, similar to any other plans was faced with some challenges. This study aimed to explain the challenges of health care reform in the area of treatment in Qom city, Iran.<br>
<strong>Methods: </strong>In this qualitative study, purposive sampling was applied to collect the participants. In this regard, 23 service providers (health managers and workers) working in the educational-treatment centers affiliated to Qom University of Medical Sciences and 5 service recipients were selected in 2017-2018. The semi-structured interviews were conducted to collect the required data. Data analyses were performed using conventional content analysis method by MaxQDA <sub>10</sub> software.<br>
<strong>Results:</strong> A total of 5 main themes, including: “economic challenges", “induced demand”, “human resources”, “reform negative outcomes”, and “improper infra-structure” were derived from data analysis.<br>
<strong>Conclusion:</strong> Findings of this study explained the main challenges of health care reform in the area of treatment. Lack of appropriate planning for these challenges will face the implementation of reform with serious problems. Therefore, implementation and continuation of this project require comprehensive support as well as appropriate planning and policy making from the authorities.</div>
طرح تحول سلامت, چالش, مطالعه کیفی
Health care reform, Challenge, Qualitative research
212
224
http://mshsj.ssu.ac.ir/browse.php?a_code=A-10-1-62&slc_lang=fa&sid=1
Zohreh
Khalajinia
زهره
خلجی نیا