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اخبار و اعلانات

تبیین سناریوهای مواجهه با قانون تعرفه گذاری خدمات پرستاری بر اساس مدل مثلث تحلیل خط مشی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استاد بیماریهای گوارشی و کبد بالغین، دانشکده پزشکی، دانشگاه علوم پزشکی، شیراز، ایران

2 دانشجوی دکتری، پژوهشگر مرکز رشد، دانشگاه امام صادق (علیه‌السلام)، تهران، ایران

3 کارشناسی ارشد، دانشکده مدیریت، دانشگاه امام صادق (علیه‌السلام)، تهران، ایران

4 دانشجوی دکتری، دانشکده مدیریت، دانشگاه امام صادق (علیه‌السلام)، تهران، ایران

چکیده

مقدمه: قانون «تعرفه­گذاری خدمات پرستاری و تعدیل کارانه­های پرستاری» و «ارتقاء بهره‌وری کارکنان بالینی نظام سلامت» پس از گذشت بیش از ده سال از تصویب هنوز در مسیر صحیح اجرا قرار نگرفته‌اند. لکن فشارهای مختلف بخصوص در سال‌های اخیر، نظام سلامت را در تنگنایی قرار داده است که باید به دقت بررسی شود. هدفِ از پژوهش حاضر تحلیل چندجانبه تعرفه‌گذاری خدمات پرستاری، ابعاد سیاستی و اجرایی آنست از این رو سناریوهای مواجهه با قانون تعرفه‌گذاری خدمات پرستاری تبیین و ارزیابی شده است.
روش‌ها: رویکرد پژوهش حاضر کیفی و روش گردآوری داده‌ها کتابخانه‌ای و مصاحبه‌ با نمونه‌گیری هدفمند بوده‌است. داده‌های کتابخانه‌ای تحلیل و دلالت‌گیری شده‌ و داده‌های مصاحبه‌ها به صورت نیمه‌ساختار‌یافته و عمیق گرد‌آوری و با بهره‌گیری از روش تحلیل ذینفع تحلیل شده‌اند. همچنین برای اتخاذ رویکردی جامع و منسجم -در گردآوری، تحلیل داده‌ها و ارائه یافته‌ها- از مدل «مثلث تحلیل خط‌مشی» استفاده شده‌است.
یافته‌ها: یافته‌های پژوهش در چهار بعد این مدل یعنی محتوا، بستر، فرآیند و نقش‌آفرینان خط­مشی طبقه‌بندی شده­اند که مبانی علمی و نظری مورد نیاز، مستندات موجود در زمینه تعرفه‌گذاری، تاریخچه و اجزای تعرفه‌گذاری و نگاه‌ ذینفعان اصلی در این مسئله را روشن می­سازد.
نتیجه گیری: در بخش نتیجه‌گیری، سناریوهای ممکن با تاکید بر تضمین هم­زمان رضایت­مندی و انگیزه پرستاران در کنار حفظ کیفیت خدمات سلامت ارزیابی شده­است. همچنین با توجه به سیر پژوهشی، پیشنهادهایی جهت اقدامات کوتاه‌مدت و میان‌مدت مطرح شده‌ که بتواند با کاهش شدت بحران وضع موجود، فرصت را برای اصلاحات زیربنایی و اساسی فراهم نماید.

کلیدواژه‌ها

عنوان مقاله [English]

Scenarios for Dealing with the Nursing Services Tariff Setting Act Based on the Policy Analysis Triangle Model

نویسندگان [English]

  • Kamran Bagheri Lankarani 1
  • Hamid Izadbakhsh 2
  • Saeed Nojaba 3
  • Mohammad Azadi Ahmadabadi 4
  • Mohammad Saeed Saffari 4

1 Professor of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

2 Ph.D. Student in Public Policy, Researcher at Rushd Centre, Imam Sadiq (PBUH) University, Tehran, Iran

3 Master in Public Policy, Management Faculty, Imam Sadiq (PBUH) University, Tehran, Iran

4 Ph.D. Student in Public Policy, Management Faculty, Imam Sadiq (PBUH) University, Tehran, Iran

چکیده [English]

Introduction: The Nursing Services Tariff Setting and Adjustment of Nursing Fees Act and Productivity Improvement Act for Clinical Staff have not been adequately implemented after more than ten years of approval. However, various pressures that put the health system in a difficult situation should be considered carefully. This study aims to make a multilateral analysis of nursing services tariff setting, its policy, and executive dimensions. Scenarios confronting the nursing services tariff setting are explained and evaluated.
Methods: The study followed a qualitative approach using library studies. The authors selected the participants using purposive sampling, while they collected data through semi-structured and in-depth interviews. Library data were analyzed and implicated using the stakeholder analysis method. The "policy analysis triangle" model has also been used to take a comprehensive and coherent approach to data collection, analysis, and presentation.
Results: The research findings were categorized into four dimensions of this model, namely policy content, context, process, and actors, which clarified the required scientific and theoretical foundations, the existing documents in the field of pricing, the history and components of pricing, and the views of the main stakeholders on this issue.
Conclusion: In conclusion, possible scenarios have been evaluated to ensure both nurses' satisfaction and motivation while maintaining the quality of health services. Also, some suggestions have been made for short-term and medium-term actions that can provide the opportunity for fundamental reforms by reducing the current crisis severity.

کلیدواژه‌ها [English]

  • Nursing Services
  • Policy Making
  • Pricing
  • Reimbursement Mechanism
  • Tariff Setting
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مجله علوم پزشکی صدرا
دوره 9، شماره 3
تیر 1400
صفحه 253-270
فایل ها
هم رسانی
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