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In order to answer why and how some individuals identify opportunities, the purpose of this paper is to offer a comprehensive framework of key effective factors that investigates the role of prior knowledge and cognitive characteristics of entrepreneurial alertness and learning in the entrepreneurial opportunities recognition process.

First, the authors identified key effective factors and developed research hypotheses and conceptual model. Second, the authors considered research methodology including sampling and data collection, measurement model. The third section presents a report of the results from the analysis of the structural model and the hypotheses tests.

The findings show that all the three factors had positive impact on opportunity recognition. It is also confirmed that prior knowledge has significant impact on entrepreneurial alertness and learning. Finally, the results demonstrate that both entrepreneurial alertness and learning partially mediated the relationship between prior knowledge and opportunity recognition.

Possible effects of other cognitive characteristics such as creativity and innovation can be considered in the model to increase accuracy of the findings. Also, comparative studies with the proposed framework in different industrial domains can be conducted in order to compare the possible differences concerning the role of the factors in opportunity recognition.

By using this model, entrepreneurs will be able to identify and enhance the factors that influence opportunity recognition, thus honing this entrepreneurial ability. Also, this framework can be employed in the field of education to identify opportunity recognition problems in individuals and to foster entrepreneurs.

This paper presents a new integrated model that would examine the impact of key effective factors of entrepreneurial opportunity recognition simultaneously while taking into account the interactions among them.

Education is a human right and access to high quality education is key to sustainable socioeconomic development. Improving the quality of higher education institutes is essential for generating the productive human resources. Assessing the quality of higher education from the students’ perspective can be considered a crucial factor in the monitoring of service quality in universities. The purpose of this paper is to evaluate the quality of educational services in a higher education institute, the Kermanshah University of Medical Sciences (KUMS), in the west of Iran.

A multistage sampling method was used to select 346 students from the KUMS, who were enrolled in the second semester of the academic year 2015-2016. The SERVQUAL questionnaire was used to gather data on students’ perceptions and their expectations about the quality of educational services. The authors used a statistical significance level of 0.05 to examine the gap between the students’ expectations and their perceptions of service quality in five dimensions, namely tangibles, responsiveness, reliability, empathy and assurance.

The results showed that there was a negative service quality gap in all five dimensions. The overall mean score of students’ expectations and their perceptions was 3.19±0.44 and 2.4±0.45, respectively. The score gap between the overall mean score of perceptions and expectations of students was −0.79, which was statistically significant (p<0.0001). The highest and lowest quality gaps were related to the assurance (−0.84) and tangible (−0.70) dimensions, respectively.

The study indicated that the quality of educational services provided in the KUMS did not meet students’ expectations in five dimensions of service quality. Thus, it warrants further investigations to determine how to improve the quality of educational services in higher education institutes such as the KUMS.

Protecting households against financial risks of healthcare services is one of the main functions of health systems. The purpose of this paper is to provide a pooled estimate of the prevalence of catastrophic healthcare expenditures (CHE) among households in Iran.

Both international (PubMed, Scopus and Clarivate Analytics (previously known as the Institute for Scientific Information)) and Iranian (Scientific Information Database, Iranmedex and Magiran) scientific databases were searched for published studies on CHE among Iranian households. The following keywords in Persian and English language were used as keywords for the search: “catastrophic healthcare costs,” “catastrophic health costs,” “impoverishment due to health costs,” “fair financial contribution,” “prevalence,” “frequency” and “Iran” with and without “health system”. The I²-test and χ²-based Q-test suggested heterogeneity in the reported prevalence among the qualified studies; thus, a random-effects model was used to estimate the overall prevalence of CHE among households in Iran.

A total of 24 studies with a cumulative sample of 301,097 households were included in the study. The estimated pooled prevalence of CHE among households was 7 percent (95 percent confidence interval: 6–8 percent). Meta-regression analysis indicated that the prevalence of CHE was inversely related to the sample size (p<0.05). The results did not suggest a significant association between the prevalence of CHE and the year of data collection.

The findings revealed that the prevalence of CHE among Iranian households is significantly higher than 1 percent, which is the goal set out in Iran’s fourth five-year development plan. This warrants further policy interventions to protect households from incurring CHE in Iran.

The Health Sector Evolution Plan (HSEP) is the most recent reform in Iran’s health care system that was launched in May 2014 in all university-affiliated hospitals to reduce health care expenditure for patients, while improving the efficiency and quality of hospital services. The purpose of this paper is to evaluate the impact of the HSEP on the performance of 15 hospitals affiliated with Kermanshah University of Medical Sciences (KUMS), located in the western region of Iran.

The Pabon Lasso model was used to measure the performance of hospitals before and after the implementation of the HSEP in 2013-2014 and 2015-2016, respectively. Three indicators of average length of stay (ALoS), bed occupancy rate (BOR) and bed turnover rate (BTR) were analyzed by the Pabon Lasso model.

The results showed that the average ALoS, BTR and BOR before the introduction of the HSEP were 2.59 days, 92 times and 57 percent, respectively, and the corresponding figures for these indicators after the implementation of the HSEP were 2.61 days, 98.9 times and 59.9 percent. The results indicated that before the introduction of the HESP, 40 percent of hospitals were in zone 1 (poor performance: low BTR and BOR and high ALoS), 27 percent in zone 2, 20 percent in zone 3 (good performance: high BTR and BOR and low ALoS) and 13 percent in zone 4. After the HSEP, the proportion of hospitals in zones 1-4 was 33, 27, 20 and 20 percent, respectively.

This study is the first to use the Pabon Lasso model technique to evaluate the impact of the HSEP on hospitals affiliated with KUMS.

Appropriate access to formally-trained health workers for people living in rural and underdeveloped areas is a continuing challenge worldwide. The purpose of this paper is to investigate the willingness of formally-trained health workers to practice in underdeveloped areas and its main determinants among medical students in the western provinces of Iran.

A total of 753 medical students from four provinces in western Iran (Kermanshah, Ilam, Lorestan and Kurdistan) were surveyed cross-sectionally in 2017. A self-administrated questionnaire was used to collect data on sociodemographic characteristics, willingness to practice in underdeveloped areas, intrinsic (e.g. desire to help others and self-interest in medicine) and extrinsic (e.g. the high income of physicians and social prestige) motivations of the study population. Multivariable logistic regression was used to identify the main determinants of willingness to practice in underdeveloped areas among medical students after their graduation.

The results indicated that 58.3 percent of students were willing to practice in underdeveloped areas. While 59 percent of the study population had a strong extrinsic motivation to study medicine, the remaining 41 percent of the study population had a strong intrinsic motivation to study medicine. The logistic regression results indicated that low parental professional and educational status, an experience of living in rural areas and having strong intrinsic motivation were associated with greater willingness to practice in underdeveloped areas.

This is the first study to investigate the willingness to practice in underdeveloped areas and its main determinants among medical students in the west of Iran.

Behavioral economic analysis of health-related behavior is a potentially useful approach to study and control non-communicable diseases. The purpose of this paper is to explore the time preferences of individuals and its impact on obesity in an adult population of Iran.

A structured questionnaire was completed by 792 individuals who were randomly selected from the participants of an ongoing national Prospective Epidemiological Research Studies in IrAN cohort study in West of Iran. The quasi-hyperbolic discounting model was used to estimate the parameters of time preferences and a probit regression model was used to explore the correlation between obesity and time preferences.

There was a statistically significant correlation between obesity and both the long-run patience and present-biased preferences of participants. Individuals with a low level of long-run patience were 10.2 percentage points more likely to be obese compared to individuals with a high level of long-run patience. The probability of being obese increased by 11 percentage points in present-biased individuals compared to future biased individuals.

The long-run patience and time inconsistent preferences were significant determinants of obesity. Considering the time-inconsistent preferences in the development of policies to change obesity-related behavior among adults might increase the success rate of the interventions.

The purpose of this paper (systematic review and meta-analysis) is to synthesize and analyze studies that assessed Iranian hospital efficiency.

A systematic literature search was conducted using both international (the Institute for Scientific Information, Scopus and PubMed) and Iranian scientific (Magiran, IranMedex and Scientific Information Database) databases. The review included original studies that used the Pabon Lasso Model to examine Iranian hospital performance, published in Persian or English. A self-administered checklist was used to collect data. In total, 12 questions were used for quality assessment.

In total, 34 studies met our inclusion criteria. The fixed-effects meta-analysis indicated that 19.2 percent (95% confidence interval (CI): 15.6–23.2 percent) of hospitals were in Zone 1 (poor performance: low bed turnover rate (BTR) and bed occupancy rate (BOR) and high average hospital stay (ALoS)), 23.7 percent (95% CI: 20.1–27.8 percent) were in Zone 2, 31.7 percent (95% CI: 27.7–36 percent) in Zone 3 (good performance: high BTR and BOR and low ALoS) and 25.4 percent (95% CI: 21.7–29.5 percent) in Zone 4.

Results help Iranian health policymakers to understand hospital performance, which, in turn, may lead to promoting greater awareness and policy attention to improve Iranian hospital efficiency.

This study indicated that most Iranian hospitals had sub-optimal performance. Further studies are required to understand factors that explain the country’s hospital inefficiency.