فهرست مطالب masoume amin esmaeili

 Assessment of quality and cost of medical care has become a core health policy concern. We conducted a nationwide survey to assess these measures in Iran as a developing country. To present the protocol for the Iran Quality of Care in Medicine Program (IQCAMP) study, which estimates the quality, cost, and utilization of health services for seven diseases in Iran.

 We selected eight provinces for this nationally representative short longitudinal survey. Interviewers from each province were trained comprehensively. The standard definition of seven high-burden conditions (acute myocardial infarction [MI], heart failure [HF], diabetes mellitus [DM], stroke, chronic obstructive pulmonary (COPD) disease, major depression, and end-stage renal disease [ESRD]) helped customize a protocol for disease identification. With a 3-month follow-up window, the participants answered pre-specified questions four times. The expert panels developed a questionnaire in four modules (demographics, health status, utilization, cost, and quality). The expert panel chose an inclusive set of quality indicators from the current literature for each condition. The design team specified the necessary elements in the survey to calculate the cost of care for each condition. The utilization assessment included various services, including hospital admissions, outpatient visits, and medication.

 Totally, 156 specialists and 78 trained nurses assisted with patient identification, recruitment, and interviewing. A total of 1666 patients participated in the study, and 1291 patients completed all four visits.

 The IQCAMP study was the first healthcare utilization, cost, and quality survey in Iran with a longitudinal data collection to represent the pattern, quantity, and quality of medical care provided for high-burden conditions.

The aim of the present study is to assess the specific needs of female substance abusers in the treatment of addiction، in order to contribute to the development of plans and policies aimed at improving services to the mentioned group.

62 women with substance dependence and three service providers، from “Chitgar” and Khaneh Khorshid” treatment centers، participated in this qualitative study. The participants were interviewed during seven sessions of focused group discussion as well as 23 sessions of in-depth individual interviews. Data were gathered using a directory list، and the topics of the list were established based on discussions with the authorities of the mentioned centers، as well as text assessment. The problems of addicted females were divided into general problems، problems related to the treatment period، and post-treatment problems. Also، two separate lists were designed for single and married women. Sessions and interviews were continued to the point of data saturation.

Most women considered social stigma، humiliation، family rejection and severe poverty as their major problems. More than one fourth of the subjects were homeless and more than half had experienced physical or sexual abuse in the past. Insufficient numbers of female physicians and the lack of health consultation and education، unsafe environment and inadequate health and welfare facilities، were among the most important limitations. There was also a shortage of psychosocial services، including shelters، vocational activities and care for children in both centers.

The expansion of services specifically geared to women’s needs in general، and psycho-social services in particular، is an absolute necessity for the successful treatment of addiction in women.