Journal of Rafsanjan University of Medical Sciences
مجله دانشگاه علوم پزشکی رفسنجان
JRUMS
Medical Sciences
http://journal.rums.ac.ir
69
journal69
1735-3165
2008-7268
10.66224/jrums
fa
jalali
1403
2
1
gregorian
2024
5
1
23
1
online
1
fulltext
other
آسیبشناسی بخش بهداشت در نظام سلامت ایران با نگاهی به آینده: نقطه نظر
Pathology of the Health Sector in Iran's Health System: A Future Oriented Viewpoint
بهداشت
Environmental Health
پژوهشي
Research
<span style="font-size:10pt"><span style="line-height:125%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="font-size:12.0pt"><span style="line-height:125%"><span b="" nazanin="" style="font-family:">مهم­ترین کارکردهای بهداشت در نظام سلامت فعلی کشور عبارتند از:</span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:125%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="font-size:12.0pt"><span style="line-height:125%"><span b="" nazanin="" style="font-family:">1- نظام مراقبت: مدیریت آمار و اطلاعات سلامت و بیان شاخص­های سلامت، در حال حاضر این کارکرد با اشکالات جدی از جمله کم­شماری، عدم یکپارچگی و ایراد در سامانه­ها مواجه است. </span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:125%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="font-size:12.0pt"><span style="line-height:125%"><span b="" nazanin="" style="font-family:">2- ارائه خدمات بهداشت اولیه: خدمات پایه بهداشتی و درمانی که برای همه اقشار، اما اتصال آن به سطح دوم ضعیف است.</span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:125%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="font-size:12.0pt"><span style="line-height:125%"><span b="" nazanin="" style="font-family:">3- ارتقاء سلامت: که وظیفه اصلاح سبک زندگی را دارد، اما علی­رغم اهمیت بسیار زیاد آن، جایگاه مناسبی نداشته و به صورت کلی تولیت اصلاح سبک زندگی در کشور مشخص نیست. </span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:125%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="font-size:12.0pt"><span style="line-height:125%"><span b="" nazanin="" style="font-family:">4- بهداشت عمومی: یا بهداشت فردی و فرافردی شامل بهداشت محیط، بهداشت حرفه­ای، بهداشت مدارس و مانند آن­ها است. ولی موانع جدی به خصوص در مواجهه با صنایع بزرگ و یا اصلاح وضعیت آلودگی هوا وجود دارد.</span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:125%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="font-size:12.0pt"><span style="line-height:125%"><span b="" nazanin="" style="font-family:">بعد از تحلیل کارکردهای فوق و با نگاه به آینده، این پیشنهادات طرح گردیده است: 1) شکل­گیری ساختاری منسجم برای پزشکی خانواده جهت مدیریت یکپارچه خدمات، 2) جداسازی ساختارهای جدیدی از معاونتهای بهداشت و درمان تحت عنوان الف) مرکز مدیریت نظام مراقبت سلامت، ب) مرکز نظارت، پایش و اعتباربخشی، ج) ارتقاء سلامت و اصلاح سبک زندگی؛ تا بتوانند مستقل و با کمترین تضاد منافع وظایف سازمانی خود را انجام داده و پزشکی خانواده (ترکیب باقی­مانده معاونت­های بهداشت و درمان) چابک­تر به وظیفه اصلی خود بپردازد. 3) تقویت زیرساخت­های الکترونیک و خدمات از راه دور و اصلاح جدی در مدیریت آن­ها</span></span></span></span></span></span></span></span><br>
<b><span dir="RTL" lang="FA" style="font-size:12.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">واژههای کلیدی:</span></span></span></b><span dir="RTL" lang="FA" style="font-size:12.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:"> بخش بهداشت، چالش­ها، راه­کارها، آینده</span></span></span>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><a name="_Hlk114425361"><span style="font-size:9.0pt"><span style="line-height:150%">The most crucial roles of the health deputy in the health system of the country include:</span></span></a></span></span></span></span></span>
<ol>
<li style="margin-right:12px; text-align:justify"><span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt list 36.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><span style="font-size:9.0pt"></span><span style="font-size:9.0pt"><span style="line-height:150%">The surveillance system is in charge of managing health data and displaying indicators, but there are serious concerns such as underestimation, segmentation problems, and drawback in the platforms.</span></span></span></span></span></span></span></li>
<li style="margin-right:12px; text-align:justify"><span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt list 36.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><span style="font-size:9.0pt"></span><span style="font-size:9.0pt"><span style="line-height:150%">Providing primary health care services for all people using public funds, but it also suffers from barriers such as lack of effective communication with the secondary health care services.</span></span></span></span></span></span></span></li>
<li style="margin-right:12px; text-align:justify"><span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt list 36.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><span style="font-size:9.0pt"></span><span style="font-size:9.0pt"><span style="line-height:150%">Health promotion plays a significant role in modifying people's lifestyle, but it is not given enough attention as a part of the healthcare system and generally, the responsible oragn in this domain is not obviously known.</span></span></span></span></span></span></span></li>
<li style="margin-right:12px; text-align:justify"><span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt list 36.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><span style="font-size:9.0pt"></span><span style="font-size:9.0pt"><span style="line-height:150%">Public hygiene, which encompasses personal and transpersonal concerns, entails monitoring hygiene in the environment, work places, schools, and other similar sites. Today, there are actual concerns about air pollution, water, and food safety, and the hazards of large industries.</span></span></span></span></span></span></span></li>
</ol>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><span style="font-size:9.0pt"><span style="line-height:150%">After exploring the functions mentioned above, it is important to update the system to meet future needs. This viewpoint may lead us to suggest the following: 1) Designing a comprehensive and integrated system for health service delivery at all levels to implement the family physician. 2) Creating separate sub-organizations to reduce the risk of conflict of interest in the healthcare system and allow the family physician to work more agilely: <a name="_Hlk162624498">a) a center for disease control (CDC), b) a center for monitoring and evaluation, and validation, and c) division for health promotion and life style modification</a>. 3) Fundamentally improving and updating databases and electronic platforms.</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:150%">Keywords:</span></span></b> <span style="font-size:9.0pt"><span style="line-height:150%">Health sector, Challenges, Solutions, Future</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><span dir="RTL" lang="FA" style="font-size:1.0pt"><span style="line-height:150%"></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span lang="EN" style="font-size:9.0pt"><span style="line-height:150%">Funding</span></span></b><b><span style="font-size:9.0pt"><span style="line-height:150%">:</span></span></b><b> </b><span style="font-size:8.0pt"><span style="line-height:150%">None declared.</span></span><b><span lang="EN" style="font-size:9.0pt"><span style="line-height:150%"></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span lang="EN" style="font-size:9.0pt"><span style="line-height:150%">Conflict of interest</span></span></b><b><span style="font-size:9.0pt"><span style="line-height:150%">:</span></span></b><b> </b><span style="font-size:8.0pt"><span style="line-height:150%">None declared.</span></span><b><span lang="EN" style="font-size:9.0pt"><span style="line-height:150%"></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span lang="EN" style="font-size:9.0pt"><span style="line-height:150%">Ethical </span></span></b><b><span style="font-size:9.0pt"><span style="line-height:150%">considerations: </span></span></b><span lang="EN" style="font-size:9.0pt"><span style="line-height:150%">Not applicable.</span></span><b> </b><span lang="EN" style="font-size:9.0pt"><span style="line-height:150%"></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:150%">Authors’ contributions: </span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:150%">- Conceptualization: </span></span></b><span class="MsoHyperlink" style="color:#0563c1"><span style="text-decoration:underline"><span style="text-decoration:none"><span style="text-underline:none"><a href="https://pubmed.ncbi.nlm.nih.gov/?sort=date&term=Haghdoost+AA&cauthor_id=37934078" style="color:#0563c1; text-decoration:underline" target="_blank">Ali Akbar Haghdoost</a></span></span></span></span>, Reza Dehnavieh<b><span style="font-size:9.0pt"><span style="line-height:150%"></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:150%">- Methodology: </span></span></b><span class="MsoHyperlink" style="color:#0563c1"><span style="text-decoration:underline"><span style="text-decoration:none"><span style="text-underline:none"><a href="https://pubmed.ncbi.nlm.nih.gov/?sort=date&term=Haghdoost+AA&cauthor_id=37934078" style="color:#0563c1; text-decoration:underline" target="_blank">Ali Akbar Haghdoost</a></span></span></span></span>, Reza Dehnavieh<b><span style="font-size:9.0pt"><span style="line-height:150%"></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:150%">- Data collection: </span></span></b><span class="MsoHyperlink" style="color:#0563c1"><span style="text-decoration:underline"><span style="text-decoration:none"><span style="text-underline:none"><a href="https://pubmed.ncbi.nlm.nih.gov/?sort=date&term=Haghdoost+AA&cauthor_id=37934078" style="color:#0563c1; text-decoration:underline" target="_blank">Ali Akbar Haghdoost</a></span></span></span></span>, <span class="MsoHyperlink" style="color:#0563c1"><span style="text-decoration:underline"><span style="text-decoration:none"><span style="text-underline:none"><a href="https://pubmed.ncbi.nlm.nih.gov/?sort=date&term=Naghibzadeh-Tahami+A&cauthor_id=38404072" style="color:#0563c1; text-decoration:underline" target="_blank">Ahmad Naghibzadeh-Tahami</a></span></span></span></span>, <span class="MsoHyperlink" style="color:#0563c1"><span style="text-decoration:underline"><span style="text-decoration:none"><span style="text-underline:none"><a href="https://pubmed.ncbi.nlm.nih.gov/?sort=date&term=Barooni+M&cauthor_id=37891547" style="color:#0563c1; text-decoration:underline" target="_blank">Mohsen Barooni</a></span></span></span></span>, Reza Dehnavieh<b><span style="font-size:9.0pt"><span style="line-height:150%"></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:150%">- Formal analysis: </span></span></b><span style="font-size:8.0pt"><span style="line-height:150%">None declared.</span></span><b><span style="font-size:9.0pt"><span style="line-height:150%"></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:150%">- Supervision: </span></span></b><span class="MsoHyperlink" style="color:#0563c1"><span style="text-decoration:underline"><span style="text-decoration:none"><span style="text-underline:none"><a href="https://pubmed.ncbi.nlm.nih.gov/?sort=date&term=Haghdoost+AA&cauthor_id=37934078" style="color:#0563c1; text-decoration:underline" target="_blank">Ali Akbar Haghdoost</a></span></span></span></span>,<b><span style="font-size:9.0pt"><span style="line-height:150%"></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:150%">- Project administration: </span></span></b><span class="MsoHyperlink" style="color:#0563c1"><span style="text-decoration:underline"><span style="text-decoration:none"><span style="text-underline:none"><a href="https://pubmed.ncbi.nlm.nih.gov/?sort=date&term=Haghdoost+AA&cauthor_id=37934078" style="color:#0563c1; text-decoration:underline" target="_blank">Ali Akbar Haghdoost</a></span></span></span></span>,<b><span style="font-size:9.0pt"><span style="line-height:150%"></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:150%">- Writing - original draft: </span></span></b><span class="MsoHyperlink" style="color:#0563c1"><span style="text-decoration:underline"><span style="text-decoration:none"><span style="text-underline:none"><a href="https://pubmed.ncbi.nlm.nih.gov/?sort=date&term=Haghdoost+AA&cauthor_id=37934078" style="color:#0563c1; text-decoration:underline" target="_blank">Ali Akbar Haghdoost</a></span></span></span></span>, <span class="MsoHyperlink" style="color:#0563c1"><span style="text-decoration:underline"><span style="text-decoration:none"><span style="text-underline:none"><a href="https://pubmed.ncbi.nlm.nih.gov/?sort=date&term=Naghibzadeh-Tahami+A&cauthor_id=38404072" style="color:#0563c1; text-decoration:underline" target="_blank">Ahmad Naghibzadeh-Tahami</a></span></span></span></span><b><span style="font-size:9.0pt"><span style="line-height:150%"></span></span></b></span></span></span></span></span><br>
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" style="position:absolute; left:0; text-align:left; margin-top:19px; width:494.7pt; height:35.7pt; z-index:-251665920; v-text-anchor:top"> <w:wrap anchorx="margin"> </w:wrap></v:roundrect><b><span style="line-height:150%"> - </span></b><b><span style="font-size:9.0pt"><span style="line-height:150%">Writing - review and editing:</span></span></b><b> </b>Reza Dehnavieh, <span class="MsoHyperlink" style="color:#0563c1"><span style="text-decoration:underline"><span style="text-decoration:none"><span style="text-underline:none"><a href="https://pubmed.ncbi.nlm.nih.gov/?sort=date&term=Barooni+M&cauthor_id=37891547" style="color:#0563c1; text-decoration:underline" target="_blank">Mohsen Barooni</a></span></span></span></span><b><span dir="RTL" lang="FA" style="line-height:150%"><span style="font-family:Nazanin"></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b> </b><b><span style="line-height:150%">Citation:</span></b><span style="font-size:9.0pt"><span style="line-height:150%"> Haghdoost AA, Naghibzadeh-Tahami A, Barooni M, Dehnavieh R. Pathology of the Health Sector in Iran's Health System: A Future Oriented Viewpoint</span></span><span lang="EN" style="font-size:9.0pt"><span style="line-height:150%">. </span></span><i><span style="font-size:9.0pt"><span style="line-height:150%">J Rafsanjan</span></span></i><span style="font-size:9.0pt"><span style="line-height:150%"> <i>Univ Med Sci</i> 2024; 23 (1): 76-87. [Far</span></span><span style="font-size:9.0pt"><span style="line-height:150%">si]</span></span></span></span></span></span></span><br>
بخش بهداشت, چالشها, راهکارها, آینده
Health sector, Challenges, Solutions, Future
76
87
http://journal.rums.ac.ir/browse.php?a_code=A-10-3470-1&slc_lang=other&sid=1
Ali Akbar
Haghdoost
علی اکبر
حقدوست
ahaghdoost@gmail.com
6900319475328460057100
6900319475328460057100
Yes
دانشگاه علوم پزشکی کرمان
Ahmad
Naghibzadeh-Tahami
احمد
نقیب زاده تهامی
6900319475328460057101
6900319475328460057101
No
دانشگاه علوم پزشکی کرمان
محسن
بارونی
6900319475328460057102
6900319475328460057102
No
دانشگاه علوم پزشکی کرمان
Reza
Dehnavieh
رضا
دهنویه
6900319475328460057103
6900319475328460057103
No
دانشگاه علوم پزشکی کرمان