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  Introduction: The literature and t he experiences of different countries, introduces the implementation of organizational excellence models in health care sector as a way to achie ve a developed health care system. T his study focused on the process of re-conceptualization of Customer Results criterion in organizational excellence model .

  Methods: T he first edition of the criteri on was designed through library studies and synthesizing method. Then, two questionnaire s were designed and Delphi Method was used to collect experts' ideas on the criteri on . Cronbach’s Alpha was used to test t he reliability of the questionnaire s. Content Validity was also used to test its validity . T he second edition of Customer Results criterion was prepare d using Focus Groups and i n the third stage, the second edition was reviewed in National Productivity and Excellence Award committee . For the fourth stage the criterion was uploaded to the website of A ward then the health and treatment committee of award , as well as the managers and experts in the field of organization excellence and award assessors were asked to give their opinions on the criterion which was then revised according to the collected opinions.

  In the final stage , the model was implemented in 23 hospitals to test its validity and then necessary modifications were applied.

  Results: There are more than 200 points f or a better understanding of general organizational excellence model in health and treatment sector . The y are categorized into two groups : 156 guide points for sub criterion of organizational excellence model and 95 complementary points which are supplement guide points.

  Conclusion: The r e-conceptualization process of Customer Results c riterion in the European Foundation for Quality Management Excellence Model for the Health Care Sector covers different aspects of the criterion. Therefore, it can be used by many users and when implemented can help them achieve the most developed health care system.

 

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Introduction: There are many ambiguities and contradictions in the economic consequences of outsourcing services in public hospitals. Therefore, the aim of the present study was to systematically review the economic consequences of outsourcing in public hospitals in Iran.
Methods: The information required in this systematic review study was collected using relevant keyword searches in the databases of PubMed, ProQuest, Scopus, Web of Knowledge, Google Scholar, SID, and MagIran without time limit. Textual data were analyzed manually by the content analysis method.
Results: Finally, 20 articles were included in the study. Three types of rental outsourcing, managerial, and public-private partnership were reported in the studies. In five studies, the whole hospital was outsourced. None of the studies had a control group. A total of 51 indicators were used, most of which were total revenues, total costs, and personnel costs. The mean study time of the outsourcing effects was 24.2 months. The results of most studies showed the positive effects of outsourcing in economic terms. The most important achievements of outsourcing included reducing costs and increasing profitability, and the most important obstacles included the existence of hidden costs, imposing additional costs on patients, lack of economic stability, and lack of economic evaluation.
Conclusion: The results showed that outsourcing has been economically successful in many wards and services of public hospitals; however, in some cases, outsourcing has led to increased costs. Therefore, more attention should be paid by hospital managers and health policy makers to identify the influencing factors and negative consequences of outsourcing.

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