محسن بیاتی

General practitioners (GPs) are one of the main healthcare providers. The purpose of this study is to determine the factors affecting the job and financial satisfaction of GPs in Iran.

In this study, participants were 666 GPs in Iran in 2016 who were selected by simple random sampling method. Data collection was done during two national conferences of the Iranian General Practitioners Association. The data collection tool was a researcher-made questionnaire. To analyze the collected data, t-test, ANOVA, Pearson correlation test, and logistic regression analysis were used.  

It was reported that 56.25% of GPs had high job satisfaction, and 39.66% had high financial satisfaction, respectively. Job and financial satisfaction was higher in female GPs (60.40% and 46.18%) than in male GPs (52.87% and 27.27%). Married GPs had higher job and financial satisfaction (57.50% and 36.29%) than single GPs (51.28% and 34.7%). Job satisfaction of GPs working in the private sector (24.15%) was higher than in the governmental sector (17.83%), while the GPS working in the governmental sector had higher financial satisfaction.

Gender, job status, economic expectations, perceived relative income, patient satisfaction, and marital status are factors affecting with job satisfaction of GPs in Iran, while gender, job sector, the ratio of actual income to target income, perceived relative income, and age are factors affecting their financial satisfaction.

 Coronavirus disease (Covid-19) can have several psychological effects. This research aimed to investigate mental health status and its relationship with the sleep quality of healthcare workers during the covid-19 pandemic in southern Iran. 

 This descriptive-analytical cross-sectional study was conducted in 2021 on 496 personnel of Hazrat Ali Asghar (AS) Hospital, the center of COVID-19 in Fars province. The participants were selected using the census method. The online General Health Questionnaire (GHQ) and Pittsburgh Sleep Quality Index (PSQI) were provided for participants. Data were analyzed using t-test, ANOVA, and Pearson correlation coefficient in SPSS23 at a significance level of 0.05. 

 The mean mental health and sleep quality scores were 48.73±17.14 (of 84) and 8.43±6.21 (of 21), respectively. It indicates a high probability of developing mental health disorders and poor sleep quality among participants. We saw a positive and significant correlation between mental health and sleep quality (p= 0.01, r= 0.33). The level of mental health disorders was significantly higher in single participants (p= 0.02) and participants with bachelor's degrees (p= 0.04). Also, the sleep quality of males (p= 0.03) and single employees (p= 0.04) was significantly lower than the others.

 The participants had high mental health disorders, and their sleep quality seems unfavorable. Supportive interventions, counseling, and psychological services are recommended to reduce mental health disorders and improve sleep quality.

The widespread prevalence of new coronavirus (COVID-19) worldwide can lead to many mental disorders. COVID-19 Care Frontline Staff, are one of the groups most strongly affected by the mental disorders caused by this disease. This study aimed to assess the correlation between the level of depressive disorder and quality of life in employees working in Covid-19 reference hospital in 2020.

This was descriptive-correlation census study performed on 496 employees of Hazrat Ali Asghar (AS) Hospital in Shiraz as the reference hospital for treatment of COVID-19 in southern Iran. Data collection tools were standard Beck Depression Inventory (BDI) and WHOQOL-BREF quality of life questionnaires. Data were analyzed using descriptive and inferential statistical methods, Pearson correlation coefficient and t-test and ANOVA by SPSS v. 23 software at a significance level of α=0.05.

The Mean±SD score of depression and quality of life of the studied employees were 35.8±9.2 (out of 63), 60.7±14.8 (out of 120) respectively. 49.6% and 87.5% of the employees had moderate levels of depression and quality of life, respectively. There was a significant and inverse correlation between depression and employees' quality of life (r=-0.612, P<0.001). Also between depression with education level (P=0.04), marital status (P=0.01), and type of occupation (P=0.03), and between quality of life and marital status (P=0.03) were observed a statistically significant relation.

Depression and quality of life of the employees were moderate level. Planning is recommended to improve the mental health of employees, use psychotherapy techniques such as cognitive behavioral therapy and mindfulness, develop and implement stress and anxiety management programs, and provide counseling services.

Estimation of cost functions is an appropriate tool for optimal resource allocation in hospitals. The present study aimed at estimating cost function for hospitals affiliated to Shiraz University of Medical Sciences.                              

 In the current cross-sectional study, inputs, costs and resources data for 28 hospitals were gathered from hospital statistics and information system. Required data were collected monthly for two years (2015-2016). Then, The Cobb-Douglas cost function was estimated using panel data analysis. STATA 14 was used for data analysis.

Estimates showed that hospitalschr('39') cost elasticity concerning the inpatient and outpatient admission were 0.555 and 0.058 for large hospitals, and 0.769 and 0.099 for small hospitals (P<0.01). Among hospitals inputs, the cost of a physician with coefficient 0.175 in large hospitals and 0.481 in small hospitals (P<0.01) was most cost driver. In studied hospitals, average cost (36,406,480 Rial) was higher than marginal cost (26,548,020). Moreover, scale economies index were in small, large, and all hospitals were 0.868, 0.613 and 0.729, respectively. The number of active bed, length of stay and teaching activity had a positive effect on hospitals cost (P<0.01).

According to the findings, to control costs, the hospital should manage most cost drivers, such as physicians and pharmaceutical costs. Moreover, According to the average and final cost and scale economies index, hospitals should expand their service provisions with current inputs and resources in order to reach the optimum point of output.

Understanding the behavior of drug demand in health sector is very important for health policy makers. In this regard, the present study aimed to estimat the pharmaceutical expenditure function during 1991 to 2010 in Iran.
This was an analytical study. The study population was urban households in the country. The required data were collected from the published statistics of Iran Statistics Center for a time series of 20 years. The time series ARDL(AutoRegressive Distributive Lag) model, the Stationary Augmented Dickey Fuller Test and Bound Cointegration Test were applied to estimate the models. The Eviews 7 and Microfit5 software were used.
At short-term and long-term, impact of the price on expenditure of pharmaceutical was statistically insignificant. Income elasticity of pharmaceutical demand at short–term and long–term was 0.27 and 0.41, respectively (Pvalue 0.01). Elasticity of pharmaceutical expenditure with respect to expenditure of physician visit at short-term and long-term was more than 1.05 and 0.33, respectively, (Pvalue 0.01). Error Correction Coefficient [ecm (-1)] also was equal -0.66. Almost 66% of imbalance error disappeared in the first year after the imbalance (Pvalue 0.05).
According to inelasticity of pharmaceutical demand to price and low elasticity to income, health policy makers should consider different issues (e.g. tariffs, household income and Subsidizing) when they make policy.

General practitioners (GPs), as a main provider of primary health care, play a pivotal role in resource flows and responsiveness of healthcare systems. In this regard, a main issue in health policy making is how much money is considered desired by GPs (target income). Therefore, the current study was performed to analyze the GPs’ target income in Iran.
This is a cross sectional and descriptive study. The questionnaire was designed based on the literature review and expert opinion. The data were gathered by a survey on 666 GPs using convenience sampling in 2015. Descriptive statistics, t-test, as well as ANOVA were used for statistical analysis. The analysis was performed using STATA 12.
The mean of monthly target income and actual income of studied GPs were 14613138 (SD= 10323692) and 6555573 (SD = 5299751) TOMAN, respectively. In average, the GPs reached to approximately 50% of their financial expectations. The GPs’ target income was almost 10 times Iran’s income per capita. There was a significant difference (P While the average of GPs’ financial expectations with regard to the Iran economic capacity is high, there are large inequalities in financial expectations between GPs, so that the large percent of the GPs have low and reasonable financial expectations.

Approximately, more than 60% of the hospital cost allocate to hospital human resources. The study aimed to examination the number of nurses in the poisoning ward in a general hospital in Shiraz. This applicable study was conducted as a descriptive-analytical study. Study population was the patients who referred to a hospital poisoning ward in Shiraz in 2012. The medical records were examined. Each month selected as a stratum and in each stratum samples selected through a simple random sampling. Data collected from the statistics office and patient records (physician's orders and nursing notes) using a data collection form. Linear programming techniques in lingo (version 8) software were used to the data analysis. Two nurses in morning, two in evening, three in night and seven in all shifts were at least required nurses in the poisoning ward of the general hospital. The number of available nurses in the ward was more than estimation. The nurses in the morning and evening shifts were over the examined number in the ward. Moreover, the nurses obtained from quantitative methods such as linear programming were lower than those calculated experimentally by nursing managers. It is recommended to Hospital administrators to use these techniques to the appropriate distribution of staff in wards.

Equitable distribution of resources in health sector is one of the prerequisites of social justice in any society. The aim of this study is to determine inequality in the distribution of specialists and hospital beds in West Azerbaijan Province. This was a descriptive study. The population of the study consists of all hospital beds in the public sector and all specialists working in the health sector of West Azerbaijan Province in 2012. The required data were collected after referring to health and treatment d eputies of Urmia University of Medical Sciences and Statistical Center of Iran. To determine inequity in the distribution of specialists and hospital beds، per capita resource indicators، the Gini coefficient، and Lorenz curve were employed. Distribution of specialist physicians in the province was not equitable; the situation was the same as regards hospital beds، too. It seems that neither the distribution of specialist physicians nor the number of hospital beds is proportional to the population. Besides، measures such as p roviding special welfare facilities، paying higher wages، and considering the health needs of people in the province can better attract physicians and modify the existing shortcomings.

An important priority in society is attention to health and longevity، and trying for its maintenance and improvement. In current study the effects of social، economic، and environmental determinants of life expectancy were estimated for West Pacific Region (WPR) based on the Grossman (1972) theoretical model. Multiple long-linear regression model and Panel data of 1995-2007 periods for WPR countries was used. Based on Hausman test، Parameters were estimated by fixed effect model (Least Squares Dummy Variable). The results of WPR estimated model have shown a positive and significant relationship between per capita income، education، employment rate، One-year-old immunized with Measles-Containing Vaccine (p<0. 01)، urbanization (p<0. 05) and life expectancy. The economic stabilization policies such as increasing productivity and economic growth، and reducing unemployment، play a significant role in people’s health in these regions. On the other hand، policies related to improving health system efficiency، particularly revision on financing and health services provision systems، are keys for health and longevity improvement

Patient/customer satisfaction and loyalty have gained increasing attention from executives across the healthcare industry. Discharge against medical advice (DAMA) can be considered as one of the indicators of patient dissatisfaction. It has negative effects on patient treatment and leads to increased hospital costs. Study of predictors of DAMA in a teaching hospital was the aim of this research.

In this retrospective, case-control study during the winter if 2009, a total of 9463 discharged patient medical records were reviewed. They were selected based on kind of discharge using systematic sampling. Data was analyzed using chi-square test and t-test and binary regression in SPSS.

Overall, 9% of discharges in this period were against medical advices. There were significant associations between DAMA and health insurance status, hospital wards, and kind of disease. Emergency ward patients and patients with no health insurance were more likely to DAMA.

High rate of DAMA should be considered by hospital managers. They should try to find out the causes of DAMA to prevent it and finally improve satisfaction and loyalty of patients.

Objective (s): To determine economics cost of diabetes in type II diabetic patients under the cover of Naderkazemi clinic in Shiraz in the first half of 2008. this study is an applicable one and the way of study is descriptive-analytic.the study society includes type II diabetic patients that referred to Naderkazemi clinic and made file. in this study among the 4900 files related to type II diabetic patient, at first, in the pilot study,30 files chosen by the way of systematic sampling and examined. standard deviation these files was ±/38.that in respect to received standard deviation,220 files were chosen as samples that eventually with the help of statistics advisor,288 file were chosen as samples and were studied in a systematic way. the needed information in this study were gathered from observing the existing information in patient´s files, interviewing with personnel and manager and also from existing information and ducuments in provision, accounting and personnel departments. results were classified as charts and graphs and were expressed descriptively. in this study, total economic costs of type II diabetes calculated 37942315040 Rials (4079818.8 $), that medical direct costs and indirect costs share was 3994348680(429499.9 $) and 33947966360(3650319 $) Rials, respectively. Medical direct and indirect costs of diabetes in a type II diabetic patient in first half of 1387 was 815173/2(87.65 $) and 6928156/4(744.96 $) Rials respectively, and altogether was 7743329/6 Rials (832.61 $). Economic cost of type II diabetes is very high and complications of this disease can important influence on patient and their family. Be cause of restricting resources of medical-health in society, diabetes is one of medical-health priority in our country and should have large actions to reducing costs and complications of this disease.