Document Type : Research Paper
Hasheminejad Kidney Center, Hospital Management Research Center, Iran University of Medical Sciences, Tehran, Iran
Background and Objective: Despite managerial advances in hospital services, patient admission to hospitals is still one of the problems that in addition to imposing additional treatment costs, consumables and equipment depreciation, wastes time in providing services to New patients and also dissatisfaction of patients and staff. Accordingly, in this study, the effect of each of the factors of patient admission in Hasheminejad hospital has been identified and determined.
Methods: In order to achieve the purpose of the study, first the files of 314 patients admitted in 2019-2020 in this hospital were reviewed and the main reasons for patient admission were extracted. Then, by using fuzzy hierarchical analysis, the effect of each of the identified causes was determined. In the next stage, based on the brainstorming techniques with the presence of 20 experts in this field and also the fish bone technique, the identified causes were identified. In the final stage, based on the opinion of experts and brainstorming technique, executive solutions to reduce patient admission were presented and using the approach of fuzzy hierarchical analysis from the point of view of 3 criteria, cost and time required for implementation and feasibility of implementation. Were prioritized.
Results: In this study, 5 main causes of disease recurrence, treatment follow-up, nosocomial infections, cancellation of surgeries, disease complications and medication for patient admission were identified in three treatment groups: urology, nephrology and vascular surgery. Based on the output of the hierarchical analysis approach, it was found that: Nosocomial infections with an effect of 0.285 and follow-up treatment with an effect of 0.229 had the highest effect on patients' return to the hospital, also cancellation of surgery had the least effect compared to other factors. In the referral of patients to the hospital, seven practical solutions were presented. Based on the output of fuzzy hierarchical analysis approach, the solutions for recording and tracking hospital infections with the help of the Internet of Things, the development of specialized nutritional training programs by hospital nutrition experts, with scores of 0.182 and 0.165 had the highest executive priority.
Conclusion: The use of strategies proposed in this study to reduce patient admission to the hospital is recommended to senior hospital managers.