background: world health organization (who) defines three goals to assess the performance of a health system: the state of health, fairness in financial contribution and responsiveness. we assessed the responsiveness of health system for patients with diabetes in a defined population cohort in tehran, iran. methods: total responsiveness and eight domains (prompt attention, dignity, communicatio...

background: except in emergency cases, all patients should be seen first by a primary healthcare physician who decides whether a referral to secondary care is necessary. the present study examined the reasons for patient self-referral to specialists. methods: a random sample of 1036 individuals was selected from people attending public outpatient clinics and specialists’ offices in the private ...

background health literacy presents an enormous challenge in the delivery of effective healthcare and quality outcomes. we evaluated the impact of low health literacy (lhl) on healthcare utilization and healthcare expenditure.   methods database analysis used medical expenditure panel survey (meps) from 2005-2008 which provides nationally representative estimates of healthcare utilization and e...

background and objectives: quality services delivery in the health settings is contingent on hospital administrative staff organizational commitment. inspired by previous research indicating the prominent role of psychological empowerment in organizational commitment, this study aimed to explore the relationship between the two variables in hospital administrative staff. methods: a random sampl...

background equity of access to health and provider payment mechanism in healthcare is a worldwide debated. healthcare reforms are primarily designed to improve productivity, economic efficiency and quality of care; however, an appropriate reimbursement of healthcare providers for services offered to patients and marinating a robust payment mechanism are not elucidated yet. conclusions no single...

mcdonough’s perspective on healthcare reform in the us provides a clear, coherent analysis of the mix of access and delivery reforms in the affordable care act (aca) aka obamacare. as noted by mcdonough, this major reform bill is designed to expand access for health coverage that includes both prevention and treatment benefits among uninsured americans. additionally, this legislation includes s...

Background: Iran has a high C-section rate (40.6% in 2005). The objective of this study was to assess the associations and population-attributable risks (PAR) of risk factors combinations and C-section in the Southwest Iran. Methods: We performed a population-based cohort study using the reports provided by Shiraz University of Medical Sciences. The cohort included pregnant women within Sept...

Recent years have witnessed a parallel and seemingly contradictory trend towards both the standardization and the customization of healthcare and medical treatment. Here, we explore what is meant by ‘standardization’ and ‘customization’ in healthcare settings and explore the implications of these changes for healthcare delivery. We frame the paradox of these divergent and opposing factors in te...

for more than three decades healthcare decentralization has been promoted in developing countries as a way of improving the financing and delivery of public healthcare. decision autonomy under healthcare decentralization would determine the role and scope of responsibility of local authorities. jalal mohammed, nicola north, and toni ashton analyze decision autonomy within decentralized services...