mohammad afrouzi

The long‑term outcomes are important concepts for cost‑effectiveness analysis in patients with premature coronary artery disease after revascularization (coronary artery bypass grafting [CABG] and percutaneous coronary intervention [PCI]) and medical therapy (MT). The finding of this study will be used to calculate the events probabilities for cost‑effectiveness study.

This systematic review will use studies in which patients age must be 18–60 years in eligible studies that obtained from PubMed, Web of Science, Scopus, and Embase. We will assess the long‑term outcomes after CABG, PCI, and MT by random‑effects meta‑analysis and effects will be shown by risk ratio. We will ascertain the probabilities of adverse events during certain periods and then outcomes will compare separately based on specific characteristics.

This study will provide information related to outcomes of CABG, PCI, and MT in patients with premature coronary artery disease. Doing this systematic review is valuable from clinically and economically aspects such as cost‑effectiveness and cost‑utility analysis.

Hospitals are the main axis of health‑care reforms or national health plans; therefore, accurate recognition of hospital costs based on operational indexes to these plans is necessary. The impact of implementing national health plans on the performance of health systems is ambiguous and misleading; therefore, the aim of this study was to assess the impact of Healthcare Reform Plan (HRP) on the micro level (e.g., educational or university hospitals).

This study was a descriptive retrospective study that research variables are checked in 1 year before and mean of 3 years after implementation of HRP by self‑administrated checklist in selected public‑educational hospitals covered by the medical universities in Tehran. The final analysis of the data was performed using cost–performance ratio and independent t‑test for comparing the variables’ changes before and after HRP.

Unlike adjusted hospitalization costs, most operational indexes were not significant. The per capita cost adjusted of hospitalization in first and mean of 3 years after HRP increased 49.49% and 16.31%, respectively (P < 0.001), the adjusted cost per day was increased by 24.48% and 21.46% (P < 0.001), and adjusted cost per bed was increased 47.06% and 20.07% compared to before HRP (P < 0.001).

Given the lack of alignment in adjusted cost changes in exchange for functional indicators, certainly, it cannot be argued that HRP had a favorable or undesirable effect on the hospitals.