Quality Management in Health Systems of Developed and Developing Countries: Which Approaches and Models are Appropriate?
BACKGROUND
Quality Management is one of the most effective strategies for improving the health systems performance in developed and developing countries. The main goal of this study was identifying the most important aspects of quality management and preparing an appropriate model for health system.


METHODS
This research was a comparative study on quality management models in the health systems of different countries. We have selected, as a sample, different countries in Asia, Africa, North America, Europe, and South America having a background in using various samples of total quality models in their health units. The studies also included the experiences of World Health Organization in different countries.


RESULTS
The main goals for promoting quality in the countries are being studied includes service efficiency increase, promoting services delivery, promoting quality of working life, and changing organizational culture. Total approaches used for the countries studied include quality Assurance, Cultural change, ISO 9001, TQM and improving services quality. There are not generally outcomes criteria in 22 cases of the studies done in the developing countries. The most important problems revealed in establishing the quality management, organizational resistance against the change, lack of senior management commitments, lack of strategic planning and lack of required resources.


CONCLUSIONS
The models for quality management should pay attention to the cultural change strategies, staff participation, strategic vision and Strategic planning. Strategic total quality management is the appropriate model in this regard.
Dept. of Health Management, Hamadan University of Medical Sciences, Iran.
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Hamidi
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Zamanparvar