مهدی شهرکی

Childbearing is a pivotal factor influencing women’s engagement in the labor market, particularly in countries like Iran, where socio-economic norms and cultural expectations significantly shape women's roles. While a decrease in birth rates and an increase in educational attainment among women are generally associated with enhanced labor market participation, the Iranian context presents a unique scenario. This study seeks to elucidate the effects of childbearing on the Female Labor Force Participation rate among urban households in Iran.

This research was conducted cross-sectionally at the national level, utilizing advanced statistical methods, specifically Probit and Probit with instrumental variable techniques, implemented through Stata 16 software. A robust dataset comprising 16,969 observations from various sections of the standard cost and income questionnaire of Iranian urban households was analyzed in 2023.

The variable for childbearing had a negative coefficient of -2.28 for the total sample size. However, the coefficients for first and second childbearing were 2.20 and 2.17, respectively. An increase in the father's wage, household income, father's education, and mother's age, as well as owning a private house, having a child under two years old, and having an elderly person over 60 years old, all led to a decrease in the probability of Female Labor Force Participation in Iran.

The findings suggest that the birth of a third child or subsequent children has a negative impact on women's labor market participation, while the first two births appear to encourage employment. This challenges the common belief that having children reduces women's job opportunities in Iran, and proposes policies to increase childbearing for this purpose.

 With the process of economic development, environmental destruction and financial development of MENA member countries have increased. Therefore, in order to protect the environment, it is necessary to identify the factors affecting environmental degradation, especially the impact of financial development and its adjustment mechanisms. In addition, the impact of financial development on the ecological footprint was also investigated through the channel of human capital and institutional quality. This descriptive-analytical study was conducted at the international level for MENA member countries. The data was panel data for the years 2000-2020, which was extracted from the World Bank database. Im, Sons, Shin and Levin, Lin and Chu tests were used to check reliability, Pedroni and kao tests to check co-collinearity, and fully modified ordinary least squares (FMOLS) methods were used to estimate models in Eviews 10 software. The Financial development and GDP increased and human capital and institutional quality decreased environmental degradation. Also, financial development reduced the destruction of the environment through the channel of human capital and institutional quality, so it is suggested that governments, while expanding the capacity of good governance, move the laws governing the financial development of countries in favor of nature-friendly industries and human capital as an important factor in quality Increase the environment.

In recent years, engineers have faced many structural problems, such as buckling, corrosion and excessive loading in damaged steel structures. The labor force's mistakes during welding and the destruction of the weld are among the many problems in steel structures. Therefore, strengthening and repairing the welding place in steel structures is inevitable. In this article, the influence of polymers reinforced with carbon fibers for strengthening steel studded double columns with defects caused by welding has been investigated. For this purpose, seven steel columns were modelled in Abaqus finite element software. A CONTROL column was modelled as the first sample with no defects and welded all over. The rest of the defective samples were reinforced using CFRP fibers. On the other hand, strengthening using CFRP fibres to improve the location of the defect was investigated in detail for three samples. Reinforcement of these sections using CFRP fibers is not only an effective method to increase the maximum axial force in these columns, but it has also helped to improve resistance and delay local buckling in them. According to the results, it was observed that among all the samples, the maximum bearing capacity is related to the 2UW3 model, and it has increased by 29.9% and 21.7% in the laboratory sample and numerical modelling, respectively, compared to the 2UW3C1 sample. In addition, 2UW3C1 and 2UW1C1 samples have the highest hardness among laboratory and numerical modelling samples, respectively.

One of the valuable technologies that promises optimal solutions to many problems in the field of health care, etc., is the Internet of Things. Increasing the use of this technology in smart cities requires improving the IT infrastructure for the security and privacy of users. This has led to the use of blockchain technology alongside the Internet of Things. One of the applications of blockchain is its use in e-health, which is used to create a secure framework for managing patient records and to use its financial transactions to pay for services. The purpose of this article is to use one of the unique features of blockchain called micropayment to facilitate patient-related matters in e-health. This paper provides a framework for micropayments to pay for sensors and applications used to discuss patient health care in smart cities. The framework is designed to reduce the transaction fees of IoT users. It also reduces data processing, reduces the need for separate payment channels for each entity, and ultimately reduces payment time.

Objective (s):

 Financial development is an important factor in economic growth and health. It not only directly but also indirectly affects the health status through the quality of the environment; Therefore, this study aimed to determine the impact of financial development and environmental quality on health status in MENA member countries.

A descriptive study was performed at international level for the MENA member countries. The panel data for the years 1990-2019 was extracted from the World Bank databases. Im, Pesaran and Shin (IPS) and Levin, Lin, and Chu (LLC) tests for stationary; Pedroni and Kao tests for co-integration and Fully Modified Ordinary Least Squares (FMOLS) and Dynamic Least Squares (DOLS) estimators were used to analyze the data using the Eviews 10 software.

The mean (SD) life expectancy was 71.5 (5.05) years and the mean (SD) financial development index and carbon dioxide were 39.82 (25.09) and 81.91 (21.47) in the sample countries, respectively. The logarithm of financial development coefficient on logarithm of life expectancy in FMOLS and DOLS methods was equal to 0.02 and 0.03, respectively, and the logarithm of carbon dioxide coefficient in FMOLS and DOLS methods was -0.03 and -0.002, respectively. The logarithm of globalization in both methods had an effect coefficient of 0.30 on logarithm of life expectancy.

The expansion of financial development, globalization and GDP per capita had a positive effect and the increasing of carbon dioxide had a negative impact on health status. Therefore, policies to reduce environmental pollution and expand financial development and globalization seem necessary. In this regard, limiting the use of fossil fuels, replacing renewable energy, the use of air quality measuring instruments are proposed. It is also proposed to expand financial development in infrastructure, industries and technological services in the health sector and appropriate incentives for private sector investment.

Seaweeds are ecologically important and have many applications economically. Inorganic carbon, nitrogen and phosphorus are the main elements needed for photosynthesis and growth of seaweed. Different concentrations of urea and phosphate as fertilizers with the ratio of 1:10 urea to phosphate (P: N = treatment one = 0.2: 2, treatment two = 0.4: 4, treatment three = 6: 0.6 and treatment four = 0.8: 8 mg/l) made treatments and compared to control (without nutrient, as fifth treatment), and their effects on growth of red macro algae, Hypnea musciformis were evaluated in triplicates. Algae sampled from the tidal area of the Oman Sea offshore at the time of the maximum tide and cultured to get optimum biomass for running the experiment. The algae were inoculated into experimental units and cultured for 45 days. A transparent plastic tank containing 40 liters of filtered seawater considered as the experimental unit. At the end of the experiment, the highest and lowest daily growth rate recorded in treatments 2 and control at the rates of 3.3±0.04 and 2.19 ± 0.02 g/day, respectively (p <0.05). These rates in third and fourth treatments were 2.87 ± 0.01 and 2.8 ± 0.01 g/day, respectively, and had a significant increase on growth of algae in comparison to the control (p <0.05). The results indicated that the concentrations of urea and phosphate rates and their ratios in the medium affecting on growth of this alga under outdoor conditions, and at the concentration of 0.4: 4 mg/l and ratio of 1/10 of phosphate to urea algae had the highest growth.

Gender equality and good governance are the most important social indicators affecting health status and well-being. Therefore, the present study aimed to investigate the impact of gender inequality and good governance on health status in upper-middle-income countries.

The present ecological and applied study was conducted on upper-middle-income countries using the cross-sectional data method and the Common Correlated Effect Means Group estimator by STATA software (version 16). A total of 33 upper-middle-income countries were selected non-randomly. Data for 2000-2019 were extracted from the databases of the World Bank and the United Nations.

The mean of life expectancy index, under-five mortality rate, gender inequality index and good governance were 71.25, 25.28, 0.42 and -1.26. The impact of gender inequality index, good governance index, health expenditures and women's participation rate on life expectancy were equal to -1.15, 0.031, 0.040 and 0.009, respectively, and impact of gender inequality index and per capita GDP on the infant mortality rate were 12.062 and -5.183, respectively.

Gender inequality index had a negative effect and good governance, health expenditures and women's participation rate in the labor market had a positive effect on life expectancy; Gender inequality index also had a positive effect and per capita GDP had a negative effect on child mortality rate. Therefore, policies to reduce gender inequality, such as improving women's education, increasing women's participation in parliament, and increasing women's employment are proposed.

Achieving environmentally sustainable development goals requires identifying new sources of environmental degradation. Therefore, in this study, the impact of shadow economy, information globalization, trade and market size on emissions during the years 1990-2020 in developing countries has been investigated using the Threshold (TAR) model. The results showed that in the short and long term, the shadow economy has a negative impact on environmental pollution in developing countries. In the long run, the co-integration results showed a long-term relationship between the variables in the study. The existence of a long-term relationship between the variables showed that with the increase of the shadow economy, the emission of polluting gases also increased. In the long run, policymakers can use the shadow economy as a tool to influence environmental pollution. In addition, the effect of the threshold index of globalization, trade, market size and shadow economy were estimated in four models. In general, the results of the estimation showed that the shadow economy (SE) has more weight in the output and the emission of pollutant gases increases. Therefore, environmental policymakers and planners to reduce emissions should consider informal and covert activities to make regulations more effective for the environment, as well as the globalization of information and trade to improve the performance of companies and individuals.

Considering the growth of the elderly population and the need of the elderly for health services and the importance of supplementary insurance on improving the quality of life of the elderly households, this study aimed to investigate the effect of supplementary health insurance on out-of-pocket payments for elderly households in urban areas of Iran.

 This descriptive-analytical and applied study was conducted at the national level using the two-stage Hackman econometric method in Stata 16 software in 2021. The sample size was 6171 elderly households which data was extracted from different sections of the cost and income questionnaire of Iranian urban households in 2019.

Increasing age, education, and employment of the head of the household, increasing household size, having a private home, increasing per capita health expenditures and income of household had a positive effect on the probability of purchasing medical insurance.Increasing the age, level of education and employment of the head of the household led to an increase in out-of-pocket payments for the elderly household by 61164, 84466 and 140032 Rials per month, respectively. Having supplementary health insurance, living in provinces with high human development and being an elderly head of household increased the out-of-pocket payments to 606207, 849739 and 109274 Rials per month, respectively.

 Elderly households were less likely than other households to purchase supplementary health insurance and having supplementary health insurance by an elderly household led to an increase in out-of-pocket payments compared to other elderly households. Therefore, to reduce out-of-pocket payments, increase coverage Insurance of health goods and services required by the elderly as well as reduction of the elderly franchise is offered.

Determining the income elasticities of the household health expenditures, especially for income deciles, leads to adoption of appropriate policies to control and manage health expenditures among income deciles. Therefore, the main purpose of this study was to estimate the income elasticities of urban household health expenditures by income quintiles, and also calculate inequality in distribution of urban household health expenditures in Iran.

This was a descriptive-analytical and applied study performed cross-sectionally with the Hackman two-stage method in Stata 16 software in 2021. The sample included 16,943 urban households in Statistics Center of Iran, and the data was extracted from the raw data of different sections of the cost and income questionnaire regarding urban households. Health expenditure inequality was measured by Gini coefficient, Robin Hood and Herfindal-Hershman indices.

The results showed that the income elasticity of health expenditures was 0.31 for the entire sample and 0.28, 0.66 and 0.36 for the first, second and fifth quintiles, respectively. The Gini, Robin Hood and Herfindal Hirschman indices were 0.240, 0.272 and 0.231, respectively. The increase in parents' educational level and household income, and having a child under seven and a private home had a positive effect and maternal employment had a negative effect on the increase of household health expenditures.

Health is an important asset for urban households and the income quintiles; therefore, the adoption of redistributive policies is recommended to support households, especially the ones in the 2 lowest quintiles. The results of inequality indicators demonstrate the existence of inequality in the distribution of health expenditures; so, it is recommended to upgrade health insurance programs for low-income deciles, expand the coverage of essential medical services and receive premiums based on their ability to pay.

Circulation in the fetus has some anatomical features which is of clinical importance. The present study was carried out to investigate the great vessels and duct in the circulatory system of fetal sheep by three techniques of rhodopas cast, angiography, and dissection techniques. Thirty-six male and female fetuses were studied. The age estimation of fetuses was calculated through Crown Rump Length (CRL) measurements and by use of formula for sheep fetus. All fetuses were divided in three groups; group 1 (CRL=12.54±0.52 Cm, Age= 62.08±2.08 days), group 2 (CRL=22±1.31 Cm, Age= 81.9± 5.7 days) and group 3 (CRL=34.6±1.19 Cm, Age= 108.5± 5.38 days), respectively. The structure of the umbilical cord, course of the umbilical vein and arteries, portal vein, ductus venosus, caudal vena cava, aorta, pulmonary trunk, ductus arteriosus, and great arteries and veins of the neck, thoracic and abdominal cavity were studied. The results showed, the vessels and duct of arabian fetal sheep are similar to other ruminants, but there were some differences in arrangment of umblical cord and ductus venosus with equines, dromedary camel and human. Also the fetal sex and age had no effect on the arrangement of vessels and ducts. On the other hand, the results showed that all of the mentioned techniques are capable of assessing the blood vessels and ducts, but are complementary to each other.

Public health expenditures are one of the important factors in improving health status. Considering the importance of health status in promoting human development indicators and consequently increasing social welfare as well as the impact of institutional and social factors on social welfare status, the main purpose of this study was to investigate the impact of public health expenditures and the quality of democracy on social welfare in countries with high human development index.

This descriptive-analytical and applied study was performed by Panel data with Panel-Corrected Standard Errors (PCSE) estimator for the years 2000-2019 in 2021. The statistical population was 39 countries with a high human development index and the annual time series data were extracted from the databases of the World Bank, the International Country Risk Guide and the United Nations. The models and required tests were estimated in Stata 16 software.

The mean of human development index for all sample countries during the period was 0.70 ± 0.04, for Iran was 0.73 ± 0.04 and the mean of Inequality-adjusted Human Development Index for all sample countries was to 0.58 ± 0.06 and for Iran was equal to 0.56 ± 0.08. The variables of public health expenditures to GDP, GDP logarithm, Openness and democracy index had a positive effect of 0.26, 9.02, 0.08 and 0.17% on the human development index, respectively. Also, the variables of public health expenditures to GDP, Democracy index and the product of public health expenditures to GDP and democracy index had a positive effect of 0.34, 0.09 and 0.15% on the Inequality-adjusted Human Development Index, respectively.

Inequality in human development in Iran was higher than other countries with high human development index, and public health expenditures and the quality of democracy had a positive effect on social welfare. Improving the quality of democracy also increased the efficiency of public health spending on social welfare; therefore, policies to increase public health expenditures are proposed in order to more invest in infrastructure and increase the level of health services in different regions to eliminate inequality, improve and upgrade health technologies that depend on public expenditures. It is also proposed to increase government transparency and accountability to the people in order to increase social welfare and increase the efficiency of health expenditures.

Military spending, education and health are among the most important components of the government budget, and achieving a balance between them is a bit complicated. Increasing military spending can increase or decrease health spending and health status. Therefore, the purpose of this study was to investigate the effect of military spending on health status in Middle Eastern countries.

The present descriptive-analytical and applied study was performed for Middle Eastern countries (including Iran) using the Paneldita method with cross-sectional dependence. Among Middle Eastern countries, 13 countries were selected as the statistical population by systematic sampling method. The data required for the study was an annual time series that was extracted from the World Bank databases for selected countries in 1990-2019. Boys CD, Boys Unit Root (CIPS test), Westerlund aggregation and model estimation with common mean group correlation effect estimators (CCEMG), generalized group mean (AMG), fully modified ordinary squares (FMOLS) and dynamic ordinary squares (DOLS) ) In Eviews 10 and STATA 16 software.

The co-integration results of the models showed that Military expenditures as a percentage of GDP has a negative effect on life expectancy of -0.037 and -0.004 in AMG and CCEMG estimators, respectively, and a positive effect of 0.22 and 1.91 on the mortality rate of children under five years of age in FMOLS and DOLS estimators, respectively. The logarithm of GDP per capita had a positive effect on life expectancy of 0.553 and 0.588 in the AMG and CCEMG estimators, respectively. The annual growth rate of the urban population also had a positive effect of 0.048 on life expectancy with the AMG estimator.

military expenditures as a percentage of GDP had a negative effect on life expectancy and a positive effect on the under-five mortality rate in the Middle East. GDP and urbanization rates also had a positive effect on life expectancy and a negative impact on the under-five mortality rate; Therefore, it is suggested to maintain a certain and appropriate ratio of military expenditures to other social expenditures. Also, some solutions to achieve greater security by reducing military expenditures are proposed.

Due to the necessity of careful planning in the human capital of health and the effect of imbalance of general physician supply on economy and health status, this study aimed to estimate general practitionerschr('39') (GPs) demand and predict general practitioners’ shortage and surplus in Iran.

This study was an analytical and applied study conducted at the national level for Iran in 2019 using ARIMA (5,1,1) method for projecting supply and Vector Error Correction (VEC) models for projecting demand with Gross Domestic Product (GDP), out-of-pocket, aging and hospital beds variables. Data were annual time series from 1991 to 2017, extracted from the statistical yearbooks issued by the Statistical Center of Iran and the World Bank database. The required models and tests were estimated by Eviews 10 software at a 0.05 significance level.

The general practitioners’ elasticity to GDP, aging, and out-of-pocket were 0.33, 1.77, and -0.81, respectively. GDP per capita (0.11), aging (0.14), and the number of hospital beds (0.0007) had a positive impact, and out-of-pocket payments (-0.0001) had a negative impact on demand for GPs in Iran. Also, from 2018 to 2030, the mean GPs demand (0.23) was higher than the mean supply (0.20), and there was a shortage of GPs in these years (0.03).

Iran is facing a shortage of GPs by 2030. Therefore, there are suggested policies for increasing the admissions capacity at medical universities, maintaining and preventing the migration of physicians with appropriate incentives, establishing rules, and providing job satisfaction for physicians.

With the increase of female-headed households and the vulnerability of the mental and physical health of these households, as well as the need to control and manage the health expenditures of female-headed households, this study aimed to investigate the determinants of health expenditures of female-headed households in urban areas of Iran.

This descriptive-analytical and applied study was conducted cross-sectional with the microeconomics approach. The sample size included 2645 female-headed households, which were randomly selected based on three-stage sampling method, city, block and household selection, and data were collected by the Statistics Center of Iran using the cost and income questionnaire of urban households. The models were estimated in Stata 14 software using the two-step Hackman method.

The results showed that the monthly health expenditures of the female-headed households were increased by an increase in income, insurance expenses and head household’s age by 0.099, 0.71 and 16046 Rials, respectively. Also, these expenditures with having a child under seven years old and an elderly person over 60 years old were increased by 737587 and 691909 Rials, respectively. Increasing in the female-headed households’ education level led to a decrease in monthly household health expenditures by 37,839 Rials.

Female-headed households with children or the elderly had higher health expenditures than other female-headed households, so it is recommended to increase insurance coverage for healthcare and services to reduce health expenditures and not face to catastrophic health expenditures. These households also allocated a large share of the increased income on health expenditures, so policies to increase the income of female-headed households through employment, increase in grants, and health subsidies are proposed.

Public health expenditures and the quality of governance are among factors affecting the health status of a population. Therefore, the purpose of this study was to investigate the interaction effects of good governance and public health expenditures on the health status of children in upper-middle income countries.

This descriptive-analytical applied study was performed using the panel data regression with the fixed effects method and quantile regression for panel data for the years 2000-2017 in 2020. The statistical population was upper-middle income countries, and annual time series data were extracted from the World Bank databases. The models and required tests were determined using the Stata-16 software.

The coefficient of good governance variable and the index of interaction effects of good governance and the public health expenditures for the under-five child mortality as the dependent variable were -0.002 and -0.003, and for the infant mortality as dependent variable -0.002 and -0.002, respectively. Also, the coefficient of the index of the interaction effects of good governance and public health expenditures in the quantiles of 0.25, 0.50 and 0.75 for the under-five child mortality as the dependent variable were -0.0333, -0.0447 and 0.048, and for the infant mortality as the dependent variable were was -0.044, -0.048 and -0.049, respectively.

Improvement of governance indicators will increase the efficiency of public health expenditures and improve the children’s health status. Therefore, in order to improve health status, especially in countries with higher child mortalities, it is recommended to improve good governance, increase public health expenditures and government investment in health infrastructure, as well as increase gross domestic product and womenchr('39')s employment.

Physicians as human capital and resources are one of the main components of health production. The imbalance of physician supply and demand affects the health and economics. Therefore, this study aimed to estimate and forecast the supply and demand of physician working in Iranian medical universities.

This a descriptive-analytical and applied study was conducted at national level for Iran during 1991-2017. The statistical population was physicians working in Iranian medical universities. ARIMA method was used to estimate and forecast physician supply and Vector Error Correction Models was used for physician demand. The data is annual time series that was extracted from the statistical yearbooks of the Statistical Center of Iran and the World Bank database. Eviews 10 software was used to estimate the models.

The results showed that physician demand in Iran was affected by Gross Domestic Product, age structure and hospital beds, and according to the forecast of supply and demand of physicians, we will be faced to the physician shortage in the years 2018-2030.

In the coming years, Iran is facing with physician shortage. Therefore, it is recommended to adopt policies to increase physician capacity in medical universities and to increase strong incentives to retain physicians and prevent their migration.

Maintaining and enhancing the capacity of health resources are key factors in reducing health crises and making sustainable growth and development. Given the important role of health resources and their unequal distribution on health status, this study aimed to investigate the effect of health resources on health status in Iran.

This study is a descriptive-analytical, applied, and correlational study that used a vector error correction model for Iran at the national level. The annual time series data were extracted from the World Bank database and statistical yearbooks of the Iranian Statistical Center for the years 1990–2017. The estimates of the research model and required tests were performed in Eviews 10 software.

The results showed that if the physician supply increased by one percent in the previous year, life expectancy would increase by 0.11 percent. Also, with each one percent increase in the gross national income, health expenditures, and average years of schooling, life expectancy increases by 0.0005, 0.001, and 0.04 percent, respectively.

Physician supply, gross national income, health spending, and mean years of education had positive impacts on life expectancy in Iran. Thus, adopting policies to optimize physician supply if does not lead to induced demand, as well as enacting and enforcing laws to prevent induced demand, can improve the health status in Iran.
 

Economic growth and sustainable development is the ideal goal of all nations and directly leads to improving the health of society. However, indirectly and through environmental degradation can have a negative impact on health status, so the main purpose of this study was to investigate the impact of economic growth and environmental quality on health expenditures in Iran.

The present descriptive-analytical and applied study at the national level was performed using the autoregression econometric method with distributive intervals in Eviews 10 software. The data were of the annual time series that were extracted for the years 2006-2006 from the databases of the World Bank, the Statistics Center of Iran and Yale University.

There was a long-term relationship between economic growth, environmental quality and health spending in Iran. The long-term elasticity of health expenditures to GDP, environmental performance index and government health expenditures were 0.85, -0.13 and 1.18, respectively. Also, physician supply had a positive effect of 0.38 on health expenditures. The error correction factor was also estimated to be -0.22.

Increasing economic growth, government health expenditures and the supply of physicians had a positive effect, and improving the environmental performance index had a negative effect on health expenditures. Therefore, policies to maintain sustainability and reduce environmental pollutants, as well as invest in advanced equipment to purify pollutant gases will be useful.

geographical distribution of physicians is essential for achieving social justice and reducing inequality. In this study, the distribution of physicians, general practitioners and specialist according to population and need adjustment index in Khorasan Razavi province was investigated.

This was descriptive, cross-sectional and applied study including all of physicians, general practitioners and specialist of Khorasan Razavi province in 2006, 2011 and 2016 that Sampling was not done. Data were extracted from the yearbooks of Statistical Center of Iran and Gini and Robin Hood indices based on population and need adjustment index were calculated in Stata 14 and Excel 2019 software.

The ratio of physician, specialist and general practitioners per 10000 population in the province was 5.08, 2.12 and 1.84, respectively, which was lower than the national average despite high growth. Gini coefficient for physician, specialist and general practitioner by population in 2006 was 0.38, 0.13 and 0.71 respectively, which decreased to 0.24, 0.06 and 0.69 in 2016, respectively. The distribution of physicians and specialist based on the need adjustment index was also more unequal than the population index.

Inequality of physician, specialist and general practitioners per population has decreased, so it is recommended to adopt long-term policies and programs to increase the number of physicians by increasing the quota in universities for long-term service in the province as well as recruiting physicians with the necessary incentives. Also In the short term, it is recommended to distribute specialist between cities temporarily.

The optimal and appropriate ratio of nurses is essential to an efficient healthcare system. In addition to decreasing the quality of health care, the shortage of nursing staff adversely affects the physical and mental characteristics of nurses. On the other hand, the supply surplus of nurses leads to high costs of medical service provision and waste of resources. In case of the surplus or shortage of nurses that could lead to the inefficiency of the healthcare system, adopting appropriate policies and proper planning to maintain equilibrium in the supply and demand of nurses are paramount. The present study aimed to evaluate the influential factors in the demand of nurses, predict the number of the required nurses, and determine the surplus or shortage of nurses in the public hospitals in Iran during 2018- 2025.

This analytical study aimed to determine the required nurses and the surplus/shortage of nurses in the hospitals affiliated to Iran University of Medical Sciences during 2018- 2025. To determine the number of the required nurses, the nurse demand function was initially estimated based on the most important influential factors using the autoregressive distributed lag (ARDL) method during 1994- 2017. The obtained results were used to predict the number of the required nurses during 2018- 2025. Before the estimation of the model, the stationary of the variables had to be ensured, for which the augmented Dickey-Fuller (ADF) test was used. The nurse short-term demand function was defined by selecting the optimal lags based on the Schwarz criterion (SIC) in the ARDL method, as follows:
natural logarithm of the number of nurses per 1,000 population;
natural logarithm of the number of nurses per 1,000 population with a one-time lag;
natural logarithm of the number of nurses per 1,000 population with a two-time lag;
natural logarithm of the gross domestic product (GDP) per capita based on the purchasing power parity;
the ratio of people aged more than 65 years to those aged 14-65 years;
the ratio of the out-of-pocket payments for health expenditures to the total health expenditures;
the ratio of the out-of-pocket payments for health expenditures to the total health expenditures with a one-time lag;
the number of hospital beds per 1,000 population;
the coefficients of the model variables
To estimate the long-term demand function of nurses, the presence of long-term correlations had to be ensured, for which the F-test was used. If the F statistic value was higher than the critical value of the upper bound, the null hypothesis that there is no long-term correlation would be rejected, and if the F statistic value was less than the lower bound, the null hypothesis could not be rejected. Finally, if the F statistic value was between the two bounds, the result would be uncertain. To determine the surplus or shortage of nurses during 2018- 2025, the difference between the predicted values of the supply and demand of nurses was used. To predict the supply of nurses, the autoregressive integrated moving average (ARIMA) method was used based on the Box-Jenkins methodology in four steps of identification, estimation, diagnostic checking, and forecasting. The required data were the annual time series that were collected for the period of 1994- 2017. In addition, data on the GDP per capita, ratio of the out-of-pocket payments for health expenditures to the total health expenditures, and ratio of the people aged more than 65 years to those aged 14- 65 years were obtained from the World Bank databases, and the data on the number of nurses and hospital beds were extracted from the statistical yearbooks of the Statistics Center of Iran. The required models and tests were estimated in the EViews software version 10.

The number of the nurses in the public hospitals per 1,000 population in 1994 was 0/207, while it was 1.12 in 2016 with the mean of 0/55±0/26 during this period. The natural logarithm of the GDP per capita during this period had an upward trend, with the mean value of 9/63 ± 0/13 per person. In addition, the mean ratio of the people aged more than 65 years to those aged 14- 65 years in this period was 7/33 ± 0/5, and the mean of the out-of-pocket payment for health expenditures to the total health expenditures was 53/53 ± 6/36. Before estimating the nurse demand function, the stationary of the variables had to be ensured using the ADF test, and the results showed that all the variables were non-stationary at the level, while they were stationary at the first difference. After determining the stationary of the variables, the short-term demand function of nurses was estimated using the ARDL method, and the results of the short-term nurse demand function indicated that the natural logarithmic coefficient of the number of nurses per 1,000 population with a one-time lag was 0/46 (i.e., 1% increase in the demand of this year would increase the demand of the next year by 0/46%). On the other hand, the natural logarithmic coefficient of GDP per capita was equal to 0/874. The coefficients of the ratio of the people aged more than 65 years to those aged 14- 65 years and the ratio of the out-of-pocket payments for health expenditures to the total health expenditures in the previous year were 0/37 and -0/015, respectively. To estimate the long-term demand function, the presence of a long-term correlation was initially evaluated using the F-test, and the nurse long-term demand function was estimated using the ARDL method. The F statistic value was 9/38, which was higher than the upper bound value at the significance of 5%; therefore, the null hypothesis regarding the lack of a long-term correlation was rejected. Furthermore, the obtained results indicated that the coefficients of the natural logarithmic of GDP per capita, ratio of the people aged more than 65 years to those aged 14- 65 years, and ratio of the out-of-pocket payments for health expenditures to the total health expenditures were 1/77, 0/76, and -0/0332, respectively. To determine the surplus or shortage of nurses during 2018- 2025, the difference between the predicted values for the supply and demand of nurses was used, and the obtained results showed that the predicted value of nurse demand was higher than the predicted value of nurse supply during 2018- 2025. In addition, the mean predicted values of the supply and demand of nurses during this period were 1/1622 and 1/3254 nurses per 1,000 population, respectively, which indicated the shortage of nurses by 0/17 per 1,000 population.

According to the results, the GDP and ratio of the people aged more than 65 years to those aged 14-65 years had a positive impact on the nurse demand, while the ratio of the out-of-pocket payments for health expenditures to the total health expenditures had a negative impact on this variable. Furthermore, a shortage of nurses is expected by 2025, and there is an urgent need for effective policies and proper planning to control this issue. In this regard, increased GDP and employment rates, strong incentives, and flexible employment contracts are proposed to prevent the early retirement of nurses.

The rate of substitution for private and public health expenditures is one of the factors that can explain the different effects of public and private health expenditures on health and life expectancy. Therefore, the purpose of this study was to estimate the return to scale, share, and elasticity of the substitution for public and private health expenditures in Iran.

In this descriptive-analytical study, linear and nonlinear least squares methods were applied to study the share and elasticity in substitution of private and public health expenditures at national level in Iran during 2000-17. The study data included the annual time series data extracted from the World Bank website. The Stata 14 software was used to estimate the economic model.

In the nonlinear and linear models of Elasticity of Substitution Constant (CES) health function in Iran, elasticity of substitution for public and private health expenditures were 0.30 and 0.17, respectively. The return to scale in nonlinear and linear models was 0.07 and 0.15, respectively. The share of public health expenditures on life expectancy in the nonlinear and linear model was 54 and 53 % and the share of private health expenditures in these models was 46 and 47 %, respectively.

Public and private health expenditures are poor substitutes of each other in Iran and increase of these health expenditures leads to an increase in life expectancy. A decreasing return exists to scale in public and private health expenditures on life expectancy in Iran. The share of public health expenditures is higher than the share of private health expenditures on life expectancy in Iran.

The purpose of this study was to measure inequality of physician and general practitioner distribution in Sistan and Baluchestan province, Iran.

This was a descriptive cross-sectional study including all physicians and general practitioners in Sistan and Baluchestan provinces, Iran (2009-2017). Data were extracted from yearbooks of Statistical Center of Iran and inequality of physician and general practitioner distribution were calculated by Gini, Robin Hood, Herfindahl-Hirschman and Theil indices in Stata 14 and Excel 2019 software.

The mean physicians and general practitioners in the province during 2009-2017 was 0.438 and 0.223, per thousand habitants, respectively. Also the mean of Gini, Robin Hood, Herfindahl-Hirschman and Thiel indices for the physician were 0.21, 0.19, 0.20, 0.24, and those for the general practitioner were 0.06, 0.10, 0.13 and 0.13, respectively. The indices had the same trend over the study period.

Inequality in general practitioner distribution was decreased but for physician was not. The findings suggest that in addition to maintaining general practitioners and increasing proportion to population growth, to reduce inequality in physician distribution, resources such as specialized hospitals, beds and medical equipments in the province should be increased and appropriately distributed among cities. Financial and tariff incentives and student admissions in specialized fields for long-term employment in the province will also be useful.

Despite the importance and impact of health and education on economic growth in countries, the causal relationship between education and health is important to policymaking. This study aimed to investigate the causality relationship between education and health in the short and long runs using the Vector Error Correction Model (VECM) in Iran.

This was an analytical and applied study, conducted at the national level using Vector Error Correction Model for Iran. The data type was annual time series which extracted from the World Bank website between the years of 2017-1996. The VECM and the required tests were estimated in Eviews 10 software.

the result showed that there was a cointegration vector for the health function of Iran in these years, i.e., current health was not only a function of independent variables of the model but also a function of health and education variables in previous periods. Also, in the short and long run, the years of schooling had the causal effect on life expectancy and, life expectancy had a causal effect on years of schooling in Iran. GDP and health expenditures per capita had a positive effect and the carbon dioxide production per capita had a negative impact on life expectancy.

According to the results, there was a two-way causality relationship between education and health in the short and long runs in Iran, so that in the short and long runs, increased education can lead to improved health status, and improved health status can lead to increased education. Therefore, the policies of the education and health sectors are complementary.