mohammad meskarpour-amiri

Identifying the risk factors of NCDs and the impact of socio-economic inequalities on exposure to these factors can play a significant role in controlling these diseases. This study was conducted with the aim of investigating socio-economic inequalities in the prevalence of metabolic risk factors of NCDs in the households of the Iranian Armed Forces.

This research is of an applied study type conducted cross-sectionally in the year 2021. The study population included 1205 households of armed forces participants in the national survey of NCDs risk factors (STEPs) in Iran, all of which were examined. After going through legal procedures, data on the national program for controlling NCDs risk factors were obtained from the NIHR. Logistic regression models in STATA 14 software were used to analyze the socioeconomic inequalities.

The prevalence of hypertension, overweight, increased blood sugar based on HbA1c, and increased blood cholesterol levels in armed forces households were 64/6%, 63/4%, 21/8%, and 15/7%, respectively. On the other hand, a significant statistical disparity was observed between different age groups and the prevalence of hypertension (P<0/05), as well as between the employment status and the prevalence of overweight (P- value<0/023). The probability of having diabetes in illiterate people is 2/36 times that in people with diploma and university education (OR=2/36, P-value= 0/046). Under the condition of keeping other variables constant, the probability of having a high cholesterol level in people with a bachelor's degree is 2/82 times that of people with a diploma and university education (OR=2/82, P-value= 0/041).

The prevalence of metabolic risk factors for NCDs in households of armed forces members shows a significant association with socioeconomic inequalities. The results of this study emphasize the necessity of reducing socioeconomic inequalities and improving access to healthcare services to reduce the prevalence of metabolic risk factors for NCDs.

Outsourcing is considered a vital economic tool for managing hospitals. This study aimed to conduct an economic evaluation of hospital services outsourcing in a military hospital in Tehran.

This study involved an economic evaluation through cost analysis (cost minimization) conducted in a military hospital in Tehran in 2019. The financial implications of outsourcing services to contracted employees were compared with the costs of direct employment under four different scenarios. Data analysis was performed using Excel 2019 software.

The study found that outsourcing, when the contractor fully complies with labor laws, resulted in a financial benefit of 5.1 million IRR per month for the hospital per outsourced job. However, non-compliance with labor laws by contracting companies led to a financial loss of 5.4 million IRR per month for each outsourced job.

The findings suggest that outsourcing can bring significant financial benefits to the hospital when the contractor complies with labor laws. Conversely, inadequate supervision of the contractor and a lack of commitment from the private sector can result in financial losses associated with outsourcing.

The proper selection of financial indicators can assist in making optimal decisions in financial resource management and enhancing the efficiency of universities. Therefore, the aim of this research was to identify the required financial indicators for designing and developing a comprehensive financial management system of the selected medical university.

The present cross-sectional study was conducted in 2022 in 2 stages. In the first stage, the required financial indicators for designing and developing a comprehensive financial management system were identified through a literature review and financial theoretical foundations. In the second stage, the content validity of the indicators for application in the financial system was assessed through a survey of experts using the Waltz and Bausell and Lawshe questionnaires. The research population consisted of a group of university experts from Tehran medical sciences universities with a minimum of 10 years of work experience and at least a bachelor's degree, and a proper recognition of relevant affairs in the field of financial management, auditing, and accounting. Among them, 21 individuals were purposefully selected. Data analysis was performed using MaxQDA 12 and Excel software.

A total of 17 financial indicators were identified and classified into 6 main areas, including "liquidity," "profitability," "revenue generation," "capital structure," "investment," and "financial risk." The highest level of Content Validity Ratio pertained to the "profit" and "human capital value added" indicators (CVR= 90 %), and the highest level of Content Validity Index was also related to the "labor cost” and “human capital value added" (CVI = 100 %).

University managers and policymakers can have a desired evaluation of the university financial performance using the proposed indicators in this research. Therefore, it is suggested to design software for recording indicators based on this model (17 indicators in 6 main areas) and establish a database for the assessment of the university financial performance and the mechanism for collecting and analyzing information based on it.

The outbreak of the Covid-19 pandemic has had a devastating effect on the provision and receipt of health services around the world. The present study was conducted with the aim of investigating the effects of this disease on referrals and services of one of the hospitals in Tehran.

In this historical cohort study, the number of referrals and services in 26 hospital departments in the first 6 months of 2018 and the first 6 months of 2018 were investigated and analyzed. The data in the form of a pre-designed Excel form received from the statistics unit and quality improvement unit of the hospital were entered into SPSS software version 26 and analyzed using non-parametric Wilcoxon test.

The load of referrals and services of the studied hospital was reduced by 30 percent during the Covid-19 epidemic. The highest rate of decrease was related to clinics and clinics (55/07 percent) and the lowest rate of decrease was related to emergency services (7/67 percent). CT scan services and referrals increased by 84/5 percent on average. These changes were statistically significant.

The reduction of the burden of referrals and services of the studied hospital is evaluated as medium to high. Healthcare providers should monitor hospital activity and develop strategies to mitigate the indirect effects of the COVID-19 pandemic resulting from reduced overall hospital activity

The COVID-19 caused many changes in the performance and productivity of health service providers. The purpose of this study was to investigate the effects of the COVID-19 pandemic on the financial and performance indicators of one of the hospitals in Tehran.

This historical cohort study was conducted in the first 6 months of 2018 as the pre-pandemic period and the first 6 months of 2019 as the post-pandemic period. 13 performance indicators of inpatient departments; 9 operational indicators of the whole hospital and 3 financial indicators were included in the study. The data were received in a pre-designed Excel form from the statistics unit and quality improvement unit of the hospital, and after entering SPSS and checking their normality, they were analyzed with Wilcoxon's non-parametric test.

Average indices of bed circulation (P=0.028), discharged patients (P=0.028) and hospitalized patients (P=0.046) were significantly reduced. The index of death before 24 hours (P=0.027) and after 24 hours (P=0.028) and ED discharge (P=0.028) also increased significantly. The average profit of the hospital at the current price and the actual price had increased significantly (P=0.028). Total current income increased, but real income decreased, which were not significant. Current and real costs were also reduced, only the real cost reduction was significant (P=0.028).

The COVID-19 had a significant impact on the hospital's financial and performance indicators. It’s necessary for hospital managers to have an appropriate model for the development of services and the sustainability of resources during a crisis.

Understanding the prevalence of risk factors for non-communicable diseases and the extent of socio-economic factors affecting their occurrence is very important in order to plan to reduce the burden of disease. The aim of this study was to investigate the impact of socio-economic factors on exposure to behavioral risk factors for non-communicable diseases in Military Households.

This research is an applied study that was performed cross-sectionally on 1204 families of the Armed Forces participating in the National Survey of Risk Factors for Non-Communicable Diseases in Iran (STEPS). The data collection tool was a questionnaire adapted from a standard questionnaire (non-communicable disease care system questionnaire in the Islamic Republic of Iran). Data analysis was performed using estimation of logistic regression models using Excel and STATA software.

The prevalence of smoking, unhealthy diet, and sedentary lifestyle in Iranian military households were 5.7%, 34%, and 58.6%. The probability of smoking among middle-aged people (45-59 years) was 2.19 times higher than the elderly (60 years old) (P=0.016). The probability of unhealthy diet in illiterate people was significantly 2.13 times higher than those with diploma and university education (P<0.001). The probability of sedentary lifestyle in women was significantly 1.77 times higher than men (P<0.001), 1.34 times higher in those with undergraduate degrees (P<0.033), and in unemployed people 2.07 times higher than retirees (P<0.033).

The results of this study showed that to address health challenges and reduce the burden of non-communicable diseases, attention to the socio-economic status of households, and reduce socio-economic inequalities of households should be considered along with controlling the risk factors for non-communicable diseases.

The increase in the workload of healthcare workers during the coronavirus disease 2019 (COVID-19) pandemic has added further responsibilities for their health.

This study was conducted to measure the amount and economic value of COVID-19-related absenteeism and presenteeism and its affecting factors among physicians, nurses,and paramedics working frontline with COVID-19 patients.

This cross-sectional study was conducted in a COVID-19 tertiarycentral hospital in Tehran, Iran. Totally, 250 hospital staff whowere working frontline with COVID-19 patients between October to December 2020 were entered in the study. The samples included 100 physicians, 96 nurses, and 56 paramedics. The Valuation ofLost Productivity Questionnaire was used to measure job characteristics, absenteeism, and presenteeism. The human capital approach was employed for the valuation of absenteeism and presenteeism. Data were analyzed using ordered logistic regression with backward elimination and the removed value of 0.1 in Stata 14.

Based on the results, the COVID-19 infection rate was 14.4% among healthcare workers, 8% among physicians, 18.6% among paramedics, and 18.7% among nursing staff.A significant association was found between the amount of absenteeism and working in intensive units (odds ratio [OR]: 3.511, P=0.000). A higher amount of absenteeism was related to first-time COVID-19 infection among all participants (OR: 4.918, P=0.000). Current smoker staff, in comparison to quitted smoking staff, was 2.995 times more likely to have a higher amount of presenteeism (OR: 2.995, P=0.030).

COVID-19 had a significant effect on both absenteeism and presenteeism of healthcare workers and its amount and value were unequal among physicians,nurses, and paramedics. Policymakers should do their best to minimize the productivity loss of healthcare workers.

Health is determined by a wide range of factors including environmental, economic and social factors, which are becoming a key focus for policy-makers in terms of reducing health inequity and improving overall health outcomes. The aim of this study is to estimate the effects of some socio - economic factors on health in Iran.

The present study is an analytical cross - sectional study. In the first step, the dependent and explanatory variables were identified to answer the research questions. Then in the second step, the required data for the analysis were extracted from available resources. Next in the third step, using statistical and regression models, the correlation between dependent and explanatory variables were tested. Data were extracted from multiple sources including annual reports of the national statistical center (census), STEPwise approach to NCD risk factors surveillance survey -STEPS 2016 (n=30541) and the study of the children’s health profile 2017: anthropometry, development, nutrition (n=19270).

The study variables included a range of socio - economic and health factors including, household income, unemployment rate, family size, health price, mortality rate of children under age 1, malnutrition rates of children under age 5 and years of lost life due to the mortality of children under 1 year. The estimation of the elasticity coefficients indicated that the elasticity of life expectancy in relation to income, health price, unemployment rate and family size was (0.023), (0.060), (-0.010), (-0.171), respectively and all variables except unemployment rate were statistically significant with a p-value <0.04. the coefficient of elasticity of malnutrition among children under 5 years of age in relation to the income, health price, economic participation rate and family size was (0.601), (1.430), (-1.733), (2.268) respectively and all variables, except economic participation rate, were statistically significant with a p-value <0.08.

In this study, the effect of a number of socio-economic factors on health were evaluated through the estimation of the health functions. The results showed that most of these factors could affect health and hence, policy makers should consider them to address health inequity and improving overall health outcomes.

The socioeconomic factors affecting health include various variables that are not clearly and consistently classified in the studies. This study aimed to identify and classify the main socioeconomic variables affecting household health.

This applied study was conducted with a quantitative approach and a systematic review method in 2019. A systematic review of the studies with PRISMA protocol was used to search and identify the main socioeconomic variables affecting household health in international and national scientific databases. The inclusion criteria included focusing on socioeconomic variables affecting health at the household level, providing a specific model for influencing socioeconomic variables on health, publishing in English or Persian, and accessing the full text of the study. The qualitative evaluation of the studies as well as their conformity with the inclusion and exclusion criteria, were performed by peer review. All socioeconomic variables were extracted in researcher-made form, classified using MAXQDA 2018 software and finally synthesized narratively.

Twenty-one conceptual models were identified to influence socioeconomic factors on household health. Researchers and international organizations provided all models, and no native models were found in Persian regarding socioeconomic factors affecting household health. Content analysis of the studies showed that the three main variables of education, income and employment in all models (100%) were used as socioeconomic factors affecting health. After that, household health behaviors (81%), age (71%), family support (71%), housing area per capita (67%), place of residence (67%), social capital (62%) and gender (57%) were the most commonly used socioeconomic variables affecting household health respectively.

In addition to vital socioeconomic variables (education, income, and employment), other contextual variables such as household health behaviors, family support, per capita housing area, and social capital need to be considered for policy interventions. In addition, it is suggested that a native model of socioeconomic factors affecting health be designed for Iranian households' socioeconomic conditions.

Human health is a fundamental right and a valuable asset at all levels and social classes. All countries have mentioned this right as the most basic right of the people of their country, and governments have made maintaining and promoting it one of the most important endeavors in their daily lives. During the 1970s, the World Health Organization proposed new solutions to problems. Alma Ata conference in 1978 is considered as one of the milestones in the delivery of health care in the world. At this conference- which was attended by most countries of the world - the emphasis on health actions compared to treatment was identified as one of the most important ways to ensure health. Subsequently, and for many years, the World Health Charter and Report and PHC-related conferences emphasize the need for the role of this approach as an equitable approach to accessing health services and health promotion. Finally, the World Health Report 2008, stressed the need primary health care (PHC) at this time more than ever it is important and it knows the key to achieving health equity. This approach has been used simultaneously in Iran and other countries of the world. In this article, briefly and in two parts, first, the historical course of primary health care and in the second part, its course in Iran and some selected countries of the world are mentioned. Covid-19 pandemic, reiterates the need to pay serious attention to the principles of primary health care in countries around the world, and showed that resorting to approaches to promote health and health governance is the main and least costly strategy in combating and controlling this disease.

Receiving a quick response is not only one of the important factors affecting the satisfaction of emergency patients but also one of the indicators for evaluating the quality of emergency services. The aim of this study was to compare the selected national indicators of hospital emergency with the standards in a selected military hospital in Tehran. 

This descriptive-analytical and cross-sectional study performed in 2020 with random selection of patients referred to the emergency department of a military hospital in Tehran. Data collection tool was a researcher-made form whose validity and reliability were confirmed. Data were analyzed by t-test using SPSS software with α= 5%.

Results showed that the average waiting time to receive the service until the assignment was 267 minutes.  Also, the percentage of patients assigned within 6 hours, the index of patients discharged from the emergency department within 12 hours and the index of leaving with personal responsibility were in accordance with national standards and the average of the relevant values ​​was statistically significant (P <0.05).

According to the results of this study, the indicators were in good condition. Hospital managers should pay special attention to these indicators and study them periodically. Also, in order to avoid long waiting times and reducing costs, proper and optimal management of resources are seeming essential.

Identifying factors affecting the financial aspects of hospital is an important step for its strategic control. Therefore, this study aimed to assessment the trend and determinants of inpatient and outpatient revenue in a COVID-19 patient s’ treatment center.

The present study was a descriptive-analytical research by applying time series analysis. Raw data on the hospital income (by inpatient and outpatient) and the potential factors were gathered monthly by referring to the administrative departments of the hospital, during 2015-2020. Dickey-fuller unit root test was used to measure stationary trend of the variables. The auto-regression distributed lagged model (ARDL) was used to study the effect of independent variables on hospital income. All analyzes were performed in Eviews software.

During the study period, on average 73.65% of hospital revenues were related to inpatient income and the rest were outpatient income. The total revenue trend of the hospital at the current price has increased significantly from April 2015 to august 2020
(P<0.0001), while this at the fixed price has decreased significantly (P<0.0001). At the beginning of the admission of a Covid-19 patient (February 2020), the hospital income has decreased significantly and after three months in May 2020, it has returned to its long-term trend. The results showed that inpatient and outpatient income was significantly affected by the variables of quantity of service, quality of care and hospital performance indicators (P<0.05).

Hospital revenue was significantly declined at the commence of Covid-19 pandemic. Increasing the capacity of intensive care beds, raising hotel service tariffs, changing insurance policies and supporting upstream organizations can be effective strategies to control the economic consequences of the Covid-19 epidemic on hospitals.

Predicting the trend of changes in health expenditures in Iran can provide the necessary basis for controlling and managing health expenditures and creating a planned and balanced growth in expenditures. The purpose of this study was to predict the growth trend of health expenditures in Iran until 2025.

The present study was a descriptive-analytical and applied research. To predict the growth trend of total health expenditures, an equilibrium function for household health service demand was fitted using the econometric method. Two-stage least squares (2 SLS) method was used to estimate the equilibrium function of household demand. Before fitting the model, the presence of mania in the studied variables was confirmed using the generalized Dickey-Fuller test (ADF). The absence of serial correlation was also assessed and confirmed by the Watson-D-W camera test. All estimates were performed using Eviews 7 econometric software.

The growth of health expenditures during the first 3 years (2017-2019) is between 1.3 to 4.7, after which it will decrease over a period of 4 years (2020-2023) and then pursues its long-term growth again; In 2024 and 2025, it will grow again by 3.3 and 5.6 percent, respectively.

Continued long-term growth in health expenditures, in conditions of limited government funding, can lead to an increased risk of households facing catastrophic health expenditures. The country’s health policy makers must allocate new financial resources to finance household health expenses by expanding the financial sector of the health sector.

The macro-policies of resistance economy emphasize reducing foreign dependencies and preventing unnecessary currency outflows. The purpose of this study was to calculate the amount of currency outflow resulting from the publication of articles in foreign journals and provide the necessary strategies in the field of research.

The present study was a mixed (quantitative-qualitative) study. In the first step, all articles published in foreign journals indexed in Scopus with the affiliation of selected universities during 2008, 2013 and 2018 were selected by census method, and then the cost of publishing was calculated. In the second step, through holding a focus group discussion (FGD) with the participation of 15 research experts, the strategies for reducing currency outflow in medical science research were examined. Data were analyzed using SPSS 16 and MAXQDA 2018.

In 2013 and 2018, the average outflow of currency was 328 and 290$ per article for university A as well as 111 and 258$ per article for university B, respectively. In 2013 and 2018, there was no statistically significant difference between universities in terms of currency outflow due to the publication of articles (P> 0.05). Strategies for reducing currency outflow and developing resistance economy in the area of article publication were identified in 3 main areas (including scientometrics, economic evaluation of publication and policy making of scientific publications) with 9 sub-areas.

Publication of articles in scientific journals published outside of Iran can lead to currency outflow and economic effects. Policy-making institutions in Iran can help universities by developing national citation databases, building a strong communication network between domestic journals and quantitative and qualitative development of national journals to publish articles at reputable national journals to prevent currency outflow.

Lack of attention to hospital efficiency, in addition to increasing medical costs, limits public access to health care. The purpose of this study was to draw a picture of the resource efficiency status of inpatient units and its changes over the years 2015 to 2018 in a large specialized hospital in Tehran, Iran.

This is a multiple cross-sectional and applied study. The efficiency of inpatient services was evaluated using the Pabon Lasso model in four periods (2015-2018). The study population consisted of all hospitalized units (36 inpatient units) that all were studied. In this study, hospital performance indicators were collected using a data collection form. Excel 2019 software was used to draw Pabon Lasso charts.

On average, in 4 years, only 24% of inpatient units were fully efficient. Over the 4-year period, there were positive changes in the efficacy of internal gynecology, obstetrics, men general surgery, and NICU1. In addition, the efficacy of vascular and thoracic surgery, kidney transplant, NICU2 and VIP1 units had declined over the study period. There was no change in the efficiency status of the other units (27 units).

Many of the hospital units are far from the optimal performance point. Given the sporadic movement of hospital units towards efficiency, it is necessary to study separately the causes of positive and negative efficiency changes in each hospital unit. In this context, the use of the Pabon Lasso model is suggested monitoring changes in the efficiency of inpatient units.

Investigating the dimensions and components of research management satisfaction can identify appropriate executive solutions for the qualitative and quantitative enhancement of research projects. The purpose of the present study was to provide an appropriate theoretical and practical framework for evaluating satisfaction with research management and its application for evaluating researcherschr('39') satisfaction in a selected military medical university.

The present study was an applied study in terms of purpose and was a mixed qualitative-quantitative study in terms of methodology. In the first step, the main dimensions and components of researcherschr('39') satisfaction with research management extracted using literature review and expert opinion survey. In the second step, a structured questionnaire designed and standardized to measure the satisfaction of researchers in each of these dimensions. Qualitative and quantitative methods were used to assess the content validity of the questionnaire. Cronbachchr('39')s alpha used to assess questionnaire reliability. Finally, the questionnaire distributed randomly among 150 researchers and faculty members of a military medical university. The relationship between satisfaction with demographic and occupational characteristics of the respondents evaluated by ANOVA at SPSS-16 software.

Six dimensions and 15 components were identified to measure satisfaction with the research management system. The main dimensions of measuring satisfaction with research management included research leadership, capacity building, creating hope, organizational communication, research organization, and resource allocation. The highest satisfaction was related to creating hope (2.71±0.82) and the least satisfaction was related to resource allocation (1.79±0.31). There was no statistically significant relationship between demographic and occupational variables of respondents and satisfaction with research management (P>0.05).

Given that the least satisfaction of the researchers were in two dimensions of resource allocation and capacity building, it is recommended that research managers pay more attention to equitable distribution of resources in addition to creating new resources and developing financial and non-financial research capacities simultaneously.

The COVID-19 pandemic has generated considerable knowledge in this regard in reputable international citation databases. The purpose of this study is to analyze subjects clustering analysis and science mapping on published research to identify the current state of sciences in the field of COVID-19 in Scopus.

This was a quantitative and applied study conducted by scientometric methods including words co-occurrence and network analysis. The study population was all published documents in the field of COVID-19 and SARS-CoV-2 in the Scopus citation database by 31 May, 2020. VOSviewer software was used to analyze the data.

As of May 31, 2020, the United States (2,819), China (2,342), Italy (1,466), and the United Kingdom (1,264) had the highest number of scientific publications in the field of COVID-19 in Scopus. Iran was ranked 12th with 318 scientific publications. The three main clusters of research activities in the field of COVID-19 were health, basic science and clinical research clusters.

With the existing scientific capacities, the role of Iran and its medical universities in publishing scientific experiences related to the COVID-19 pandemic can be enhanced. Accurate and comprehensive planning must be done in this regard. Determining research needs and developing applied research in three main areas, including health and prevention, basic and clinical sciences, should be considered in the management and leadership of COVID-19 research.

Coinciding with the onset of Covid-19, known as Corona in Iran, there have been many scattered reactions from the Iranian health system to the management of the disease. The aim of this study is to identify and categorize the dimensions of the Iranian health system response in order to identify points that have not yet been overlooked and ignored. The results of this study can be used as a primary framework for analyzing the strengths and weaknesses of epidemic management in Iran.

This qualitative study was carried out by content analysis of documents related to SARS-CoV-2 pandemic. First, by reviewing the electronic resources, all existing documents, protocols and guidelines related to the management of corona disease in Iran were identified. All national media files, including audio, text, and video related to Covid-19, were collected over the period from 18 February 2020 to 27 March 2020, by searching the Internet & University of Medical Sciences and the Ministry of Health websites. Four JUPP criteria were used to select the documents, and finally 82 documents were selected after multi-stage screening. Document information was coded and analyzed with MAXQDA2018.2 software.

The response of the Iranian health system to addressing the Covid-19 pandemic is in seven main areas of hygiene, treatment, education, logistic, crisis management, research management and the management of communication & information which has been identified and recorded in 46 sub-areas.

In the area of crisis management, the issue of contact tracing and control on the chain of disease transmission is still neglected. There are also no comprehensive guideline for reducing or stopping social contacts and limiting population mobility within urban. It is also suggested that a comprehensive instructions be developed to monitor the performance of the corona epidemic crisis management in the country.

Investigating the effect of macroeconomic variables on health indicators can provide the ability to predict the effect of economic fluctuations on health in addition to health policy makers' awareness of the impact of economic variables on health level. The purpose of this study was to analyze the trend of the main variables of Iran's macroeconomics and their impact on Iran's health indicators.

The present study was a descriptive-analytical study. In this study, in order to identify the impact of economic fluctuations on public health, the trend of 4 decades (19712011-) fluctuation of macroeconomic and public health indices were analyzed. Health indicators were collected from the World Bank database and macroeconomic indicators from the Central Bank of the Islamic Republic of Iran and the Iranian Statistics Center. To identify the relationship between variables, the VAR model estimated and the Granger causality test used. Regression models and statistical tests run by using eviews7 econometrics software.

The growth of "per capita income", "income inequality", and "unemployment rate" had statistically significant effect on life expectancy and mortality in children under 5 years (P <0.05) and Granger causality test also confirmed the effect. Although the "exchange rate disorder" had a statistically significant effect on life expectancy (P <0.05), its effect on mortality of children under 5 years was not significant (P> 0.05). Among macroeconomic variables, the effect of income inequality on health indicators was more than other variables.

Among macroeconomic variables, the effect of income inequality is larger and long lasting than other variables. By adopting income redistribution policies, the government can control the effects of economic fluctuations on the society's health through reducing income inequality.

Promoting productivity of military personnel has a key role in enhancing security-defense capabilities and reducing costs. Musculoskeletal disorders are one of the most common causes of disability and lost productivity of military personnel. The aim of this study was to measure the lost productivity due to knee osteoarthritis and identify its influencing factors in military personnel. This was a descriptive-analytic study that included140 military personnel with knee osteoarthritis who visited the military physical therapy clinic in Tehran in 2018. Subjects were randomly selected and entered in the study after completing the informed consent form. All data related to days and hours of absenteeism, hours of work without productivity and disability in doing military tasks were collected using the Valuation of Lost Productivity (VOLP) questionnaire and analyzed by Stata software. Factors affecting lost productivity and its importance were investigated through the estimation ordered logistic regression and through calculation of odds ratio. Of the participants, 63.4% were male and more than half (59%) were37‒46 years old. 40% of patients had been absent from work in the past three months due to their knee osteoarthritis. The maximum length of time of work in this period was 5 days. A total of 104 participants (74.3%) reported that due to knee osteoarthritis, in the last 3 months they have had difficulty at work, compared to their colleagues. 50% of participants (N=70) believed that they would be able to do their jobs in less time if they had no disease. The average amount of lost productivity due to knee osteoarthritis in a 3 month period was 76 hours, or 9 working days for each participant. The average value of lost productivity due to knee osteoarthritis in the past three months was estimated at 9,527,271 Rial or 226 US$ for each participant. This lost productivity was significantly affected by sex, household size, time of onset of illness and the level of teamwork (P<0.05). Knee osteoarthritis leads to a significant reduction in working efficiency of military personnel. More attention should be paid to screening chronic diseases, especially the knee osteoarthritis, at the time of recruitment of military personnel. Strategies should be developed for the prevention and timely diagnosis of chronic diseases to reduce disability and occurrence of musculoskeletal disorders in the armed forces.

Despite a lot of studies carried out on catastrophic and impoverishing health expenditures, exposure to these expenditures have not been studied among health staffs and their families yet. So that our study has analyzed exposure to CHE (Catastrophic Health Expenditures) and factors affecting them among the health staffs affiliated to army medical universities in Tehran.

This study was a descriptive-analytical and cross-sectional study implemented in 2016. Among all health staffs of a university of medical sciences, the full details of 240 households (838 individuals) were collected by using a stratified random sampling method. The data gathering and analyzing process have been done based on WHO standard guideline. Finally, the odds ratio of CHE determinants is reported using logistic regression by backward elimination method and chi-square test.

The results of this study showed that 7.5% (CI: 7.3-7.7) of health staff households (54 individuals) are faced with CHE. The odds of exposure to CHE for households with 3 members and less, households with lower education level and households with two or more outpatient visits were significantly more than others (p<0.05). Households who have used dental services during the past year were 8.77 times (p<0.001) more at risk of CHE. Also, households with 3 members and less, households with lower education level and households with two or more outpatient visits were 8.59, 7.96, and 3.39 times more at risk of such payments, respectively.

CHE is a common financing dilemma even among health staffs.  Families who have more referring to health centers and less education level and also dental service users are more at risk of exposure. Health policy-makers should pay more attention to such vulnerable and high-risk groups. Finally, our study results recommended the increase of dental insurance coverage as an effective strategy to reduce exposure to CHE.

In recent years the high cost of medicines and the lack of it were one of the major problems in developing countries that despite numerous efforts to solve the root causes of this problem, the issue remains, unfortunately. Therefore, this study aimed to assess the impact of antibiotics and corticosteroids prescription on the medicines expenditures. This was descriptive-analytical study that conducted to assess the function of medical expenditures through prescription letters and analysis the factors affecting medicine expenditures. We used the data of 91,994,667 selected prescription letters that were collected by the Ministry of the Health and Medical Education (MOHME) throughout the country in the year 2011 which was analyzed through a logarithmic regression model and OLS estimator. The average number of prescription items in each prescription letter were varied from 2.7 to 3.6, and the average price of each letter was varied from 30223 to 69986 Rials. Between 39 to 61 percent of prescription letters containing antibiotic items and between 15 and 35% of them contain corticosteroids. Also, the impact of antibiotic and corticosteroid prescriptions on the average expenditure of prescription letters were -1.4 and 0.032 respectively. Excessive and irrational prescribing had the greatest impact on medicine expenditures. On the other hand, the expenditure of prescription letters had the negative elasticity to antibiotics prescription and relatively inelastic for corticosteroids. So, raising the price of medications to reduce the use of them could not play a successful role in a control policy.

Road traffic accidents (RTA) are the third-leading cause of death in Iran after coronary heart disease and stroke.1 Based on reports by the Iranian Legal Medicine Organization, RTA cause more than twenty thousand mortalities as well as eighty thousand major traumas each year in Iran. In 2010 alone, 22,974 Iranians lost their lives because of RTA (63 deaths per day on average). Moreover, 806,922 people had major trauma, and perhaps 4-5 times this number had minor traumas... (Read more...)

There are little attention about health spending and public health outcomes especially in the WHO’s Eastern Mediterranean Region. This  paper  presents  an  overview  on  health  spending  and  public health  outcomes  in the WHO Eastern Mediterranean countries during 1995-2011.

This study conducted in 2013 use of health expenditure and public health outcome of 19 WHOs Eastern Mediterranean Region countries during 17 years (1995-2011). Data were including: Per capita health expenditure in current US dollar, Life expectancy at birth, Infant Mortality Rate per 1,000 live births, Under-5 years Mortality Rate per 1,000 live births. Data collected from the latest World Bank published data until 2013. The Descriptive statistics were used to study by using Excel 2007.

In this region, the minimum spending on health (by Pakistan) was about 60 times less than maximum spending (by Qatar). Maximum amount of infant and children mortality rate were respectively 9 and 10 times more than the minimum. Also a decreasing returns to scale of health spending seen between countries. So that countries with better public health status need to pay much more than countries with poor public health status to increase 1 year life expectancy or to save 1 infant or child from premature death.

There is a large inequality among countries of the WHO Eastern Mediterranean region in both health spending and public health outcomes. Due to a decreasing return to scale, allocation financial aids to countries with poor health status can help converging health status in the region and decrease inequalities.