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Purpose In the time of the COVID-19 crisis, many physical, psychological and spiritual difficulties are imposed on the front line staff and overshadow their rights, resilience and retention. In addition, the loss of this important organizational resource imposes huge costs on the system. The purpose of this study is systemic review of the influential factors, policies and strategies applied to defend the rights of health-care staff and improve the resilience and retention of health system human resources in the COVID-19 crisis. Design/methodology/approach This systematic review was conducted in 2021. Data were collected by keyword search in Google Scholar, PubMed, Scopus, Web of Science, Science Direct, Magiran, SID and Irandoc databases until December 2021. In addition, the quality of the studies was evaluated by three experts using the Strobe checklist. The analysis used in this study to categorize the results was thematic analysis. Findings Factors that cause tension and injustice to employees and also strategies to overcome it and increase their resilience were classified into general categories according to their nature. Factors included factors related to safety, economic and financial, staff characteristics, crisis management characteristics, organizational climate and working conditions. Existing strategies also fall into four categories of physical, psychological and spiritual health promotion strategies; organizational climate and work environment; education and empowerment and economic and financial. Originality/value This study is a systematic review of the factors that affect the health workforce rights and resilience of health-care personnel during the COVID-19 crisis. On the other hand, the policies and strategies used in different countries to overcome the difficulties and increase the resilience and retention of health workers have been summarized and can be used in other crises.

Purpose This purpose of this study was to investigate the role of nurses’ resilience as an indicator of their mental health on sick leave absenteeism during the COVID-19 pandemic. Design/methodology/approach This descriptive-analytical study was conducted in 2020 to identify the predictors of absenteeism among 260 nurses working in two training hospitals delivering specialized services in the treatment of COVID-19 patients. Data was collected through the use of standard questionnaires including demographic information, nurses’ resilience, intention for job turnover and absenteeism from the workplace. To predict sick leave absenteeism, regression analyses were implemented. Findings Study results revealed that the most influencing features for predicting the probability of taking sick leave among nurses were marital status, tenacity, age, work experience and optimism. Logistic regression also depicted that nurses who had less faith in God or less self-control were more likely to take sick leave. Practical implications The resilience of nurses working in the COVID-19 pandemic was relatively low, which needs careful consideration to apply for organizational support. Main challenge that most of the health systems face include an inadequate supply of nurses which consequently lead to reduced efficiency, poor quality of care and decreased job performance. Thus, hospital managers need to put appropriate managerial interventions into practice, such as building a pleasant and healthy work environment, to improve nurses’ resilience in response to heavy workloads and stressful conditions. Originality/value To the best of the authors’ knowledge, this is the first study to examine such a relationship, thus contributing findings will provide a clear contribution to nursing management and decision-making processes. Resilience is an important factor for nurses who constantly face challenging situations in a multifaceted health-care system.

Purpose This study aimed to compare mortality rate, length of stay (LOS) and hospitalization costs at different priority levels for a patient admitted to an intensive care unit (ICU) at a public tertiary hospital in Qazvin, Iran. This study also aimed to predict influencing factors on patients’ mortality, ICU LOS and hospitalization costs in different admission groups. Design/methodology/approach The authors conducted a retrospective cohort study among patients who mainly suffered from internal diseases admitted to an ICU of a public hospital. This study was conducted among 127 patients admitted to ICU from July to September 2019. The authors categorized patients into four groups based on two crucial hemodynamic and respiratory status criteria. The authors used a logistic regression model to predict the likelihood of mortality in ICU admitted patients during hospitalizations for the four prioritization groups. Furthermore, the authors conducted a multivariate analysis using the “enter” method to identify risk factors for LOS. Findings Results showed a statistically significant relationship between the priority of being admitted to ICU and hospitalization costs. The authors’ findings revealed that age, LOS and levels of consciousness had a predictability role in determining in-hospital mortality. Besides, age, gender, consciousness level of patients and type of the disease were mentioned as affecting factors of LOS. Originality/value This study’s findings emphasize the necessity of categorizing patients according to specific criteria to efficiently use available resources to help health-care authorities reduce the costs and allocate the budget to different health sectors.

Purpose Health-care workers (HCWs) are at increased risk of exposure to the COVID-19 virus, which necessitates implementing transmission prevention measures in health-care delivery facilities, particularly hospitals. This study aims to assess COVID-19 risk in a health-care setting and recommend managerial strategies to cope with existing risk procedures. Design/methodology/approach This cross-sectional study was conducted among HCWs working in a general hospital in Qazvin, northwest of the country. A total of 310 employees working at different clinical and non-clinical occupational levels participated in the study. The WHO COVID-19 risk assessment tool categorised HCWs in high- or low-risk groups exposed to COVID-19 infection. Findings Findings revealed statistically significant relationships between workplace exposure to the COVID-19 virus and variables, including job type, performing the aerosol-generating procedure, access to personal protective equipment (PPE) and being trained on Infection Prevention and Control (IPC) guidelines (p < 0.05). HCWs older than 36 years were at 8% more risk of COVID-19 virus. Being a medical doctor or delivering health-care services as a nurse were relatively 28% and 32% times more likely to be at high risk of infection than other hospital staff categories. Having inadequate access to PPE and lack of training on IPC guidelines were also key determinants of high-risk infection. Originality/value As most cases at risk of COVID-19 infection belonged to frontline health-care staff in older age groups, this study recommend limiting the exposure of vulnerable staff to COVID-19 patients, increasing protective measures for HCWs and providing essential information about infection control procedures.

Purpose It can be said that the most important function of the health system is to provide health-care services. This directly affects society’s health and justice. To the best of the authors’ knowledge, this study is the first study that has meta-analyzed the percentage of health services utilization among Iranians to answer this question “How much is the percentage of health-care services utilization in Iran?” Design/methodology/approach This study is a systematic review and meta-analysis conducted in 2020. The literature review was done by searching the databases of Google Scholar, Scopus, PubMed, Web of Science, Science Direct, SID, Magiran and Irandoc from January 2010 to August 2020. Pooled utilization percentage (UP) was estimated by STATA 15 through random-effects meta-analysis with 95% confidence interval. The I2 statistic was used to investigate the possibility of heterogeneity of articles (I2 ≥ 50% indicate heterogeneity). A forest plot was applied to report the results. A funnel plot exploited due to publication bias assessment. Findings Approximately 22% of the reviewed articles have been done at the national level of Iran. Most studies have examined the utilization of outpatient and inpatient services. Based on the random effects method, the pooled value of UP was obtained at 47.82%, (95% CI: 39.33–56.31). Also, the pooled percentage of utilization was statistically significant (Test of UP = 0, Z = 456.44, p = 0.000). Practical implications Policymakers can improve the level of utilization from health services by expanding universal coverage, expanding insurance coverage and removing direct and indirect barriers. Originality/value To the best of the authors’ knowledge, this is the first systematic review and meta-analysis on health services utilization in Iran that completely considers the utilization rate in all health services and states the practical solutions to cope with utilization deficiencies and barriers.

Purpose The provision of private health-care services by public hospitals is common in Iran. Examining factors associated with patients’ preferences to use private health services and using this knowledge in health planning and policymaking can help expand the use of such services. Thus, this study aims to investigate patients’ preferences for private health services delivered in public hospitals. Design/methodology/approach Based on a discrete choice experiment from a sample of 375 patients in a public training hospital in Qazvin, northwest city of Iran, the authors evaluated participants’ preference over the health-care attributes affecting their choice to use private health-care services delivered in the hospital. The authors also estimated the marginal willingness to pay to determine the maximum amount a patient was willing to pay for the improvement in the level of each health-care attributes. Findings The findings revealed that patients were 2.7 times more likely to choose private hospital services when the waiting time was reduced to less than a week. Furthermore, as patients had complimentary insurance coverage, they were over 60% more likely to receive such services from training hospitals. Finally, continuity of care and reduced health-care tariffs were significant factors that increased patients’ preference to choose private services by 52 and 37%, respectively. Originality/value Examining factors associated with patients’ preferences to use private health services and using this knowledge in policymaking can help expand such services. The findings affirmed that various incentives, including service quality factors, are required to increase the likelihood of patients choosing private services.