Background Workplace violence is one of the factors which can strongly reduce job satisfaction and the quality of working life of nurses. The aim of this study was to measure nurses’ exposure to workplace violence in one of the major teaching hospitals in Tehran in 2010. Methods We surveyed the nurses in a cross-sectional design in 2010. The questionnaire was adapted from a standardized questionnaire designed collaboratively by the International Labor Office (ILO), the International Health Organization (IHO), the International Council of Nurses (ICN), and the Public Services International (PSI). Finally, in order to analyze the relationships among different variables in the study, T-test and Chi-Square test were used. Results Three hundred and one nurses responded to the questionnaire (a response rate of 73%). Over 70% of the nurses felt worried about workplace violence. The participants reported exposure to verbal abuse (64% CI: 59-70%), bullying-mobbing (29% CI: 24-34%) and physical violence (12% CI: 9-16%) at least once during the previous year. Relatives of hospital patients were responsible for most of the violence. Nurses working in the emergency department and outpatient clinics were more likely to report having experienced violence. Nurses were unlikely to report violence to hospital managers, and 40% of nurses were unaware of any existing policies within the hospital for reducing violence. Conclusion We observed a considerable level of nurse exposure to workplace violence. The high rate of reported workplace violence demonstrates that the existing safeguards that aim to protect the staff from abusive patients and relatives are inadequate.

Objective: This study was aimed to present a conceptual framework about the misinformation surrounding COVID-19 outbreak in Iran. For this purpose, discourse analysis of two of the most common social virtual networks were conducted via a four step approach as follows: defining the research question and selecting the content of analysis, gathering information and theory on the context, content analysis for establishing the themes and patterns and, presenting the results and drawing conclusions. Results: Cultural factors, demand pressure for information during the crisis, the easiness of information dissemination via social networks, marketing incentives and the poor legal supervision of online content are the main reasons for misinformation dissemination. Disease statistics; treatments and prevention are the main subjective categories of releasing misinformation. The consequences of misinformation dissemination include psychosocial, economic, health status, health system and ethical ones. The most recommended strategies for dealing with the issue could be divided into demand and supply-side strategies.

The practice style variation (PSV) incurs undesirable clinical and economic consequences for patients and the healthcare system. This review aims to analyze the economic consequences of PSV in medical interventions. A comprehensive electronic search was conducted through PubMed, Web of Sciences, EBSCO, EMBASE, and Cochrane databases to retrieve studies on economic consequences of PSV within 1975–2018. The studies were independently assessed by two reviewers. The quality of studies was assessed by Strengthening the Reporting of Observational Studies in Epidemiology checklist. No language restriction was applied. Only four studies met the eligibility criteria. These studies have been conducted retrospectively in developed countries. Most of the included studies used consumer demand theory to measure the economic consequences of PSV. Findings showed 12%–74% of all variations in healthcare services are related to PSV, thereby incurring up to 23 million dollars for the healthcare system. The PSV is related to the total expenditure, price elasticity, and coefficient of variation of healthcare services. PSV associated with huge inefficiency and inequity in access to healthcare services. To mitigate the consequences of PSV, policymakers should consider PSV in both developing the medical education plans as well as cost management. Using multilevel analysis to investigate the determinants of PSV would be beneficial.

Purpose: The purpose of this paper is to identify the most important factors for strategic purchasing of health services in the health sector by the Iran Health Insurance Company and to provide an applicable model for other similar organizations in developing countries. Design/methodology/approach: The present qualitative study was conducted in 2017 to identify the factors affecting the implementation of strategic purchasing of health services in the health sector by the Iran Health Insurance Company and to provide an indigenous and practical model through two phases: semi-structured interview followed by a Delphi process. Findings: According to the findings of this study, Ministry of Welfare, Labor and Social Security plays a central role in the strategic purchasing. In addition, this was also approved by the representatives of citizens in communities concerning professional associations, insurance agencies and representative of the Council of Ministers. Model development explored 9 themes and 54 sub-themes. Research limitations/implications: Based on the model, most attention has been paid to consumer role and inter-sector leadership of the company with other relevant organizations and systems including other insurance organizations and the welfare ministry. More importantly, the health insurance company should be able to communicate with providers and to choose the best providers, receiving price information through competition in the most appropriate mechanism. Guided by this model, it can strategically buy the best and the most effective services for its insured population. Social implications: It might help developing societies to promote their health systems based on targeting the health budgeting and financial constraints so that it is prioritized according to the strategic purchasing criteria and consequently, economic evaluation. Originality/value: The linchpins of the present study are as follow: first, the pragmatic model presented in the paper could help developing health systems to overcome the impediment in the implementation progress of strategic purchasing. Second, the model satisfies the need of enough knowledge to apply strategic purchasing in the health system. Third, the indigents have long been given special protection and consideration in the model that has continued to capture the attention of every policy-maker, in particular, developing countries, the portion of which is significant. Fourth, based on this model, attention has been paid to consumer role and inter-sector leadership of organization with other relevant organizations and systems. Fifth, this model could be correspondent for every insurance company in countries with similar developing conditions.

Due to the sanctions imposed by the USA government upon the Iranian health system, achieving the UHC might face some financial problems. This study aimed to make the best solution for the Iran health care system to overcome not only the temporary sanctions but also a program to reach the UHC goals through the strategic purchasing approach. This was a qualitative study carried out from 2015 to 2017 containing two phases: a comparative analysis and a three-step Delphi technique. In the first phase, the Garden model was applied to select the countries. In the second phase, 20 experts who specialised in health management, health economics, and health insurance science were asked. Data were analyzed with SPSS (version 20.0) and STATA (version 15.0) In the threat of trade and economic sanctions imposed on the Iranian health care system, the experts identified and emphasized that the vulnerable groups to receive financial assistance can be the retired, fecund women, teenagers and people with lower wages. The experts thought that, in the context of resource constraints, different payment systems are proposed for cities and villages based on the different needs of local population. Considering the difficult situation, this study focused on how Iran can cope well in a dangerous situation and economies the health expenditure applying strategic purchasing as one of the key tools in controlling costs to achieve universal health coverage. Economic evaluation, payment system, and priority population are the linchpins of the UHC. Universal health coverage, if it is to be considered, not only is applicable, but it could also be a solution for future generations. Therefore, the proposed policy proposals can provide both a short-term and long-term basis for the health care system of countries that are facing budget constraints or are basically low-income.