نتایج کوچک سازی واحدهای ستادی در نظام شبکه ی بهداشت و درمان ایران (تجربه ی کلان شهر تبریز )

Introduction: Health system of Iran has been challenged in the so many ways such as equity, relevance, and efficacy in a changing environment rapidly. To answer to this increasing challenge, and to decrease the costs, and increase the outputs, minifying units of health system network in Tabriz Metropolitan have been designed as an experience. Present research have been designed and implemented to find the answers and evidences documented witnesses of metropolitan cities in case of unifying or multiple administrations for provincial health centers and meanwhile separated administration of health centers headquarter unified. Methods: This is an applied study. The community, and the sample of research are health centers headquarters before and after the minifying units.( based on personnel, costs, performances qualities and quantities, and employees' job satisfactions). Results: Even though the number of personnel have been reduced from 248 to 148 after minifying, and the cost flow have been changed from 67/47 % (2002) to 69/93% (2003) qualities and quantities of health performances( the most important tasks of health centers) not only do not decreased, but in some cases have been improved. The personnel s' job satisfactions have not changed either before of after the minifying. Conclusions: Therefore the minifying procedures may be used as an improvement strategy in metropolitan cities and universities units.