الگوي عوامل مؤثر بر زنجيره تأمين خدمات بيمارستاني

Model of Factors Affecting Hospital Services Supply Chain Hospital Services Supply Chain

زﻣﯿﻨﻪ و ﻫﺪف: ﺑﯿﻤﺎرﺳـــﺘﺎنﻫﺎ ﺑﻪﻋﻨﻮان ﯾﮏ ﻧﻬﺎد ﻣﻬﻢ در ﻧﻈﺎم ﻧﻮﯾﻦ درﻣﺎن ﺑﺎ اﺳـــﺘﻔﺎده از ﻣﻨﺎﺑﻊ ﻣﺨﺘﻠﻒ، ﻣﺴـــﺌﻮﻟﯿﺖ ﺗﺄﻣﯿﻦ، ﺣﻔﻆ و ارﺗﻘﺎي ﺳـﻼﻣﺖ اﻓﺮاد ﺟﺎﻣﻌﻪ را ﺑﻪ ﻋﻬﺪه دارﻧﺪ. ﺑﺮاي اﻧﺠﺎم اﯾﻦ ﺧﺪﻣﺖ ﻣﻬﻢ ﻻزم اﺳـﺖ ﮐﻪ ﻧﯿﺎزﻫﺎي آنﻫﺎ ﺑﻪدرﺳﺘﯽ ﺗﺄﻣﯿﻦ ﺷﻮد. اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪف اراﺋﻪ اﻟﮕﻮي ﻋﻮاﻣﻞ ﻣﺆﺛﺮ ﺑﺮ زﻧﺠﯿﺮه ﺗﺄﻣﯿﻦ ﺧﺪﻣﺎت ﺑﯿﻤﺎرﺳﺘﺎﻧﯽ اﻧﺠﺎم ﺷﺪ. ﻣﻮاد و روشﻫﺎ: اﯾﻦ ﭘﮋوﻫﺶ ﺗﺮﮐﯿﺒﯽ )ﮐﯿﻔﯽ– ﮐﻤﯽ( از ﻧﻮع ﮐﺎرﺑﺮدي اﺳـﺖ ﮐﻪ در آن از ﻧﻈﺮات ﭘﺎﻧﺰده ﻧﻔﺮ از آﮔﺎﻫﺎن از ﺷـﺶ اﺳـﺘﺎن ﮐﺸـﻮر در ﻣﻮرد زﻧﺠﯿﺮه ﺗﺄﻣﯿﻦ ﺧﺪﻣﺎت ﺑﯿﻤﺎرﺳـﺘﺎﻧﯽ اﺳـﺘﻔﺎده ﺷـﺪ. ﭘﺲ از اﻧﺠﺎم ﻣﺼـﺎﺣﺒﻪ ﻧﯿﻤﻪﺳـﺎﺧﺘﺎرﻣﻨﺪ، ﻧﻈﺮات آﻧﺎن ﺗﺎ رﺳــﯿﺪن ﺑﻪ ﻣﺮﺣﻠﻪ اﺷــﺒﺎع ﺟﻤﻊآوري و ﺳــﭙﺲ ﺗﺠﺰﯾﻪوﺗﺤﻠﯿﻞ ﮔﺮدﯾﺪ. ﺑﺮاي ﺗﻌﯿﯿﻦ ﻋﻮاﻣﻞ ﻣﺆﺛﺮ از روﯾﮑﺮد ﺗﺤﻠﯿﻞ ﭼﺎرﭼﻮب اﺳﺘﻔﺎده ﺷﺪ. ﺑﺎ اﺳﺘﻔﺎده از روش دﻟﻔﯽ ﻧﯿﺰ ﻣﯿﺰان ﺗﻮاﻓﻖ ﺧﺒﺮﮔﺎن ارزﯾﺎﺑﯽ ﮔﺮدﯾﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﭘﺲ از ﺗﺠﺰﯾﻪوﺗﺤﻠﯿﻞ و ﮐﺪﺑﻨﺪيﻫﺎي اوﻟﯿﻪ، درﻧﻬﺎﯾﺖ ﻫﻔﺖ ﻣﻮﺿﻮع اﺻﻠﯽ ﺷﺎﻣﻞ ﻣﻨﺎﺑﻊ ﻣﺎﻟﯽ، ﻣﻨﺎﺑﻊ اﻧﺴﺎﻧﯽ،ﻓﻨﺎوريﻫﺎ، ﺗﻘﺎﺿﺎي اﻟﻘﺎﯾﯽ، ﻣﺪﯾﺮﯾﺖ، ﺗﺄﻣﯿﻦ و ﺗﻮزﯾﻊ و ﺳﺎﺧﺘﻤﺎن و ﺗﺠﻬﯿﺰات ﻣﺸﺨﺺ ﺷﺪ. در اﯾﻦ ﺑﯿﻦ ﻣﺪﯾﺮﯾﺖ ﺑﺎ )ﻣﯿﺎﻧﮕﯿﻦ 4/42 ± 0/46 و ﻣﯿﺎﻧﮕﯿﻦ رﺗﺒﻪاي 5/56 ( ﺑﻪﻋﻨﻮان ﻣﻬﻢ ﺗﺮﯾﻦ ﻋﺎﻣﻞ ﺗﻌﯿﯿﻦ ﮔﺮدﯾﺪ. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﻣﻨﺎﺑﻊ ﻣﺎﻟﯽ ﯾﺎ اﻧﺴــﺎﻧﯽ و ﺳــﺎﯾﺮ ﻓﺎﮐﺘﻮرﻫﺎي درون ﯾﺎ ﺑﺮونﺳــﺎزﻣﺎﻧﯽ ﺑﺮ زﻧﺠﯿﺮه ﺗﺄﻣﯿﻦ ﺧﺪﻣﺎت ﺑﯿﻤﺎرﺳــﺘﺎﻧﯽ ﺗﺄﺛﯿﺮ دارد اﻣﺎ ﺳــﺮﻣﺎﯾﻪﮔﺬاري ﺑﺮاي ﺑﻬﺒﻮد ﻣﺪﯾﺮﯾﺖ از ﺑﺮوز ﺑﺴــﯿﺎري از ﻣﻌﻀــﻼت ﺟﻠﻮﮔﯿﺮي ﻣﯽﮐﻨﺪ ﯾﺎ اﺛﺮ آﻧﻬﺎ را ﮐﺎﻫﺶ ﻣﯽدﻫﺪ.

Hospitals, as an important unit in the modern treatment system, using various sources, are responsible for providing, maintaining and promoting health for individuals in the community. In order to perform this important service, it is necessary to meet their needs properly. This study was conducted to design a model of factors affecting hospital services supply chain. Materials and Methods: This is a combined (qualitative-quantitative) research in which the opinions of fifteen experts about the hospital supply chain from six provinces of the country were used. After conducting a semi-structured interview, their opinions were collected until saturation and then analyzed. The framework analysis approach was used to determine the effective factors. Using Delphi method, the level of agreement of experts was evaluated. Results: After analysis and coding, finally seven main topics including financial resources, human resources, technologies, induced demand, management, supply and distribution, and construction and equipment were identified. Meanwhile, management (mean4/42±0/46 and mean rank5/56) was identified as the most important factor. Conclusion: Although financial or human resources and other factors inside or outside the organization affect the hospital services supply chain, but investing to improve management prevents or reduces the impact of many challenges.