چکیده:
ﻣﻘﺪﻣﻪ: ﯾﮑﯽ از ﮔﻠﻮﮔﺎه ﻫﺎی ﻋﻤﺪه ﻫﺰﯾﻨﻪﺑﺮی ﻧﻈﺎم ﺳﻼﻣﺖ؛ ﺗﺠﻬﯿﺰات ﭘﺰﺷﮑﯽ ﺑـﻮده و ﺑـﯿـﺶ از 30% ﻫﺰﯾﻨﻪ ﻫﺎی ﻫﺮ ﺗﺨﺖ ﺑﯿﻤﺎرﺳﺘﺎن در ﺳﺎل ﺳﻬﻢ ﺗﺠﻬﯿﺰات اﺳﺖ. ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ اﻫﻤﯿﺖ ﻣﻮﺿﻮع، ﻫﺪف اﯾﻦ ﻣﻘـﺎﻟـﻪ ﺑﺮرﺳﯽ وﺿﻌﯿﺖ ﻣﺪﯾﺮﯾﺖ ﻧﮕﻬﺪاﺷﺖ ﺗﺠﻬﯿﺰات ﭘﺰﺷﮑﯽ ﺑﺮای ﺗﺼﻤﯿﻢ ﮔﯿﺮی و ﺳﯿﺎﺳﺖ ﮔﺬاری ﻣﺴﺌﻮﻟﯿﻦ اﺳﺖ. ﻣﻮاد و روش ﻫﺎ: ﭘﮋوﻫﺶ از ﻧﻮع ﻣﺸﺎﻫﺪه ای- ﻣﻘﻄﻌﯽ اﺳﺖ. ﻣﺤﯿﻂ ﭘﮋوﻫﺶ ﺑﯿﻤﺎرﺳﺘﺎن ﻫﺎی ﻧﺎﺟﺎ، ﺑﺎ ﺗﻌـﺪاد ﻧﻤﻮﻧﻪ 190 ﻧﻔﺮ ﮐﻪ ﺑﻪ روش ﺳﺮﺷﻤﺎری اﻧﺠﺎم ﺷﺪ. ﺑﺮای ﮔﺮدآوری اﻃﻼﻋﺎت از ﭘﺮﺳﺸﻨـﺎﻣـﻪ ﺧـﻮدﺳـﺎﺧـﺘـﻪ، ﻣﺼﺎﺣﺒﻪ، ﻣﺸﺎﻫﺪه اﺳﻨﺎد و ﻣﺪارک اﺳﺘﻔﺎده ﺷﺪ و رواﯾﯽ و ﭘﺎﯾﺎﯾﯽ آنﻫﺎ ﺗﻮﺳﻂ آزﻣﻮن ﻫﺎی اﻋﺘﺒﺎر ﻣﺤﺘﻮا و ﺑـﺎز آزﻣﺎﯾﯽ ﺗﺎﯾﯿﺪ ﮔﺮدﯾﺪ. ﺗﺤﻠﯿﻞ داده ﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از آﻣﺎر ﺗﻮﺻﯿﻔﯽ و اﺳﺘﻨﺒﺎﻃﯽ )ﺗﺤﻠﯿﻞ وارﯾـﺎﻧـﺲ ﯾـﮏ ﻃـﺮﻓـﻪ، آزﻣﻮن t ﻣﺴﺘﻘﻞ و ﻫﻤﺒﺴﺘﮕﯽ ﭘﯿﺮﺳﻮن ( و ﺗﻮﺳﻂ ﻧﺮم اﻓﺰارﻫﺎی Excel و SPSS ﺻﻮرت ﮔﺮﻓﺖ. ﯾﺎﻓﺘﻪ ﻫﺎ: ﯾﺎﻓﺘﻪ ﻫﺎ در زﻣﯿﻨﻪ ی اﺑﻌﺎد ﻣﺪﯾﺮﯾﺖ ﻧﮕﻬﺪاﺷﺖ ﻧﺸﺎن ﻣﯽ دﻫﺪ ﮐﻪ ﺑﯿﻦ ﻣﯿﺎﻧﮕﯿﻦ اﻣﺘﯿﺎزات داده ﺷﺪه ﺑـﻪ اﺑﻌﺎد ﻣﺪﯾﺮﯾﺖ در ﺑﯿﻤﺎرﺳﺘﺎن ﻫﺎ اﺧﺘﻼف ﻣﻌﻨﯽ داری وﺟﻮد دارد و ﺑﯿﻤﺎرﺳﺘﺎن 1 )اﯾﺮان( ﺑﺎﻻﺗﺮﯾﻦ ﻣﯿﺎﻧﮕﯿﻦ اﻣﺘﯿـﺎز و ﺑﯿﻤﺎرﺳﺘﺎن 7 )وﻟﯽ ﻋﺼﺮ( ﮐﻤﺘﺮﯾﻦ ﻣﯿﺎﻧﮕﯿﻦ اﻣﺘﯿﺎز را دارا ﺑﻮد و ﻣﯿﺎﻧﮕﯿﻦ اﻣﺘﯿﺎز ﺑﻘﯿﻪ ﺑﯿﻤﺎرﺳﺘﺎن ﻫﺎ در ﺑﯿﻦ اﯾـﻦ دو ﺑﯿﻤﺎرﺳﺘﺎن ﻗﺮار داﺷﺖ. ﻫﻤﭽﻨﯿﻦ ﺑﻌﺪ ﻫﺪاﯾﺖ و ﻫﻤﺎﻫﻨﮕﯽ ﺑﺎ ﻣﯿﺎﻧﮕﯿﻦ 3/28 ﺑﺎﻻﺗﺮﯾﻦ اﻣﺘﯿﺎز و ﺑﺮﻧﺎﻣﻪ رﯾـﺰی ﺑﺎ ﻣﯿﺎﻧﮕﯿﻦ 2/84 ﮐﻤﺘﺮﯾﻦ اﻣﺘﯿﺎز را دارا اﺳﺖ. ﻣﯿﺎﻧﮕﯿﻦ اﻣﺘﯿﺎزات داده ﺷﺪه در ﻣﺮدﻫﺎ ﺑﯿﺸﺘـﺮ از زن ﻫـﺎ ﺑـﻮد. وﺿﻌﯿﺖ ﺗﺄﻫﻞ، ﺗﺤﺼﯿﻼت، ﻧﻮع ﻣﺪرک ﺗﺤﺼﯿﻠﯽ و ﻧﻮع اﺳﺘﺨﺪام ﺗﺄﺛﯿﺮی ﺑﺮ اﻣﺘﯿﺎزدﻫﯽ ﻧﺪاﺷﺖ. ﺑﯿﻦ ﺳـﻦ و ﻨﻮات ﺧﺪﻣﺘﯽ ﺑﺎ اﻣﺘﯿﺎزدﻫﯽ ﺑﻪ اﺑﻌﺎد ﻣﺪﯾﺮﯾﺖ ﻫﻤﺒﺴﺘﮕﯽ وﺟﻮد ﻧﺪاﺷﺖ. در آﺧﺮ اﯾﻨﮑﻪ 68/6 درﺻـﺪ ﻣـﻮاﻓـق ﭼﺎرت ﺳﺎزﻣﺎﻧﯽ ﻓﻌﻠﯽ ﻣﺪﯾﺮﯾﺖ ﻧﮕﻬﺪاﺷﺖ و 31/4 درﺻﺪ ﻣﺨﺎﻟﻒ ﭼﺎرت ﻓﻌﻠﯽ ﺑﻮدﻧﺪ. ﻧﺘﯿﺠﻪ ﮔﯿﺮی: ﺑﯿﻤﺎرﺳﺘﺎن ﻫﺎی ﻧﺎﺟﺎ در اﺑﻌﺎد ﻣﺪﯾﺮﯾﺖ ﻧﮕﻬﺪاﺷﺖ ﺗﺠﻬﯿﺰات ﭘﺰﺷﮑﯽ در وﺿﻌﯿﺖ ﻣﻨﺎﺳﺒﯽ ﻗـﺮار دارﻧﺪ، ﺑﺎاﯾﻦ وﺟﻮد ﺑﺎﯾﺴﺘﯽ در ﺟﻬﺖ ارﺗﻘﺎء اﯾﻦ وﺿﻌﯿﺖ ﺗﻼش ﺑﯿﺸﺘﺮی ﺻﻮرت ﮔﯿﺮد و ﺿﻤﻦ ﺗﻮﺟﻪ ﻣﺴﺘﻤﺮ ﺑـﻪ اﻣﺮ آﻣﻮزش، در راﺳﺘﺎی ﺑﻬﺒﻮد اﺑﻌﺎد ﻣﺪﯾﺮﯾﺖ ﻧﮕﻬﺪاﺷﺖ و ﻫﻤﭽﻨﯿﻦ ﭼﺎرت ﺳﺎزﻣﺎﻧﯽ آن ﮔﺎم ﺑﺮداﺷﺘﻪ ﺷﻮد.
Background: One of the major bottlenecks for costs of health care system is medical equipment, where more than 30% of costs for hos-pital beds are dedicated to medical equipment. Considering the im-portance of the subject, the aim of this paper is to review the status of medical equipment maintenance management for decision- making and policy making authorities.
Materials and Methods: This observational cross-sectional study with sample size of 190 participants who were selected by census method, exerted in the NAJA hospitals. Data gathering was done by questionnaire, interviews and documents. Validity and reliability of questionnaire were approved by content validity and retest. Data analysis was performed by descriptive and inferential statistics (ANOVA, t-test, Pearson correlation).
Results: Results showed that in the dimensions of maintenance management in hospitals, there is a significant difference between mean scores. Iran hospital has the highest rank out of 7 hospitals and Asr has the lowest mean score. In NAJA hospitals, dimensions of directing and coordinating had the highest (3.28), where planning had the lowest score (2.84). Average scores given by men were high-er than women. Marital status, education, type of degree and type of employment had no effect on scoring. There is no correlation be-tween age and years of service with scoring. 68.6 percent of partici-pants were agreed and 31.4 percent opposed current chart of mainte-nance management.
Conclusion: NAJA hospitals are in good condition in aspects of medical equipment maintenance management; however, it is obliga-tory to make more efforts to improve the situation by continuous ed-ucation and reconsidering current organization chart.