فهرست مطالب v. yazdi feyzabadi

Fair financial protection against health expenditures is one of the most critical goals of health systems. This study was conducted to investigate the most appropriate threshold for measuring the exposure to catastrophic health expenditure (CHE) in Iran. 

The present study was conducted using 2018 national household income and expenditure data of the Iran statistics center. The occurrence and intensity of the householdschr('39') exposure to CHE at different thresholds and for economic quintiles was measured using two World Health Organization (WHO) and World Bank (WB) methodologies. The most appropriate threshold for each methodology was also determined using the Kappa statistics adaptation estimation. 

The occurrence of households’ exposure to CHE was 3.02% and 8.51% in urban households and 4.66% and 9.22% in rural households, respectively. According to asset quintiles, the highest occurrence was in the first quintile and the lowest in the fifth quintile. In addition, the results of adaptation estimation based on Kappa statistics showed that a threshold of 40% in the WHO methodology and 25% in the WB methodology were the most appropriate thresholds. 

The results showed a relatively high rate of exposure to CHE. CHE occurrence was also more in poorer households, and common thresholds were the most appropriate thresholds for estimating CHE.

In the late 2019, the SARS-CoV-2 virus was identified as the cause of an outbreak of acute respiratory illness known as the COVID-19, which began to spread in the world very quickly. Preventive measures have been a significant issue in preventing the spread of COVID-19. This rapid review study was conducted to summarize selected countries' preventive policies and strategies in the East and Southeast Asia, including China, South Korea, Japan, Vietnam, and Singapore, during the COVID-19 epidemic. 

In this rapid review study, the Scopus, PubMed, Embase, and Web of Science databases were searched. The keywords applied in the search strategy were primary health care, public health, prevent* and plan, policy, program, initiative, intervention, measure, and COVID-19 in addition to the name of each country. Furthermore, we searched the World Health Organization (WHO) and the United Nations Development Program (UNDP) websites to retrieve more key sources as grey literature. The relevant data were extracted from the final studies and categorized. 

After screening, 33 studies met the inclusion criteria. Dominant measures implemented in these countries were categorized into different categories including communication and information, physical distancing, quarantine, monitoring, and testing axes. 

Education and information, extensive testing and screening, contact tracing, isolation of infected and suspected cases, and observance of physical distancing has been very effective in reducing Covid-19 transmission and its mortality.

Research plays an important role in solving health problems in the community. One main mission of higher education institutions is developing research tailored to the needs of the community by providing equal and fair opportunities for research sectors. The present study aimed to measure inequality in the rea of research in Iranian medical sciences universities. In this descriptive study, the Gini Coefficient (GC) was used to measure inequality from 2010 to 2016. The indexes included the number of published papers, citations, citation per paper, self-citation, Scimago Journal Rank (SJR), Source Normalized Impact per Paper (SNIP), Citescore, Hirsch
(h-index), number of faculty members, number of students, and educational and research budget. Stata 14 software was used for data analysis. During the study years, the GC of SJR, SNIP, and Citescore varied from 0.65 to 0.73, 0.62 to 0.73, and 0.61 to 0.72, respectively. In addition, The GC of international papers, total articles, self-citation, citation per article, Hirsch index, and total citations varied from 0.62 to 0.70, 0.56 to 0.66, 0.22 to 0.27, 0.12 to 0.28, 0.33 to 0.39, and 0.57 to 0.72, respectively. The GC of the number of faculty members and budget ranged from 0.26-0.40 and 0.34-0.67, respectively. Inequality in self-citation and citation per article was relatively fair, while Hirsh and the number of faculty members had intermediate inequality. Other indicators had a high and very high inequality. To reduce inequality, developing of the balanced research infrastructures in medical universities is recommended.

The higher education system plays an important role in the socio-economic development of the country due to its mission in training the required human resources. Therefore, performance evaluation of different sectors of higher education is of great importance. The present study was conducted to evaluate the educational efficiency and productivity changes of Iranian medical sciences universities. This descriptive study was conducted in 2011, 2014, and 2017 to evaluating the performance of 43 Iranian medical universities using Data Envelopment Analysis and output oriented approach. In addition, productivity changes were measured using the Malmquist index. For this purpose, Deap 2.1 software was used. The Anderson Patterson Model and EMS software were also used to rate the units accurately. The average educational efficiency of medical universities was 0.97 in the study years. The average total productivity based on the Malmquist Index was 1.05, and educational productivity of the universities showed an average growth of 5% over the study years. This growth was 1% from 2011 to 2014 and 10% from 2011 to 2017. The results of the study showed the acceptable efficiency of the education sector of Iranian medical sciences universities. Moreover, a positive increasing trend was observed in the productivity of the education sector during the study years. Further research using quality and quantity measures are necessary to assess the educational performance of medical universities more accurately.

Improving the efficiency and productivity of the higher education, especially in the field of research on health sciences, is one of the characteristics of sustainable development in today's societies. This study aimed to measure the efficiency and productivity of Iran's Medical Sciences Universities (MSU) in the research function. In a descriptive study, the research function of fourty five MSUs in Iran was evaluated using data envelopment analysis (DEA) method and Malmquist index in 2010, 2013, and 2016 years. Measurement of both efficiency and Malmquist index was developed and modeled based on the assumption of variable returns to scale (VRS) and output-oriented. Also, the ranking of efficient units was done using Anderson-Patterson's model. The mean research efficiency was estimated to be 0.86. Findings of Malmquist index showed that between 2010 and 2013, there was a 6% growth in the productivity; while the performance of universities had a 12% drop in research function from 2013 to 2016. Also, the average total productivity during two periods is 0.96, indicating 4% reduction in research efficiency which technology efficiency growth has dropped by 8% and other components of total productivity had a positive growth. The results of the study showed that universities do not work efficiently and average productivity has been decreasing which was mainly due to a decline in the efficiency of technology, which despite the development of technology in recent years could be the result of the lack of effective use of it.

A significant portion of the total health expenditure is related to medicines. Evaluation of medication system indicators forms a basis for modifying the consumption pattern and cost containment. Therefore, the present study was conducted to investigate the trend of medication consumption indicators in Iran. In this descriptive-cross-sectional study, medicine consumption per capita was calculated based on the medicine type, medicine form, and treatment category. The data were extracted from the Pharmacological Statistics of the Food and Drug Administration and the Statistics Center of Iran between 2012 and 2015. Catzung categorization was used for treatment categories. Data were analyzed using descriptive statistics and annual growth index by Excel 2013 software. During the study years, the highest medicine consumption per capita was related to metformin 500 (18.52), ranitidine 150 (15.45), and adult cold (15.29). The highest average consumption per capita in different treatment categories was related cardiac medications (97.65). The lowest and highest growth rates were related to glibenclamide 80 with -12% in 2014 and metformin 500 with 16.9% in 2013, respectively. Tablets were the most widely used form of medicine. According to the results, medicine consumption per capita in Iran is higher than developed countries. Cardiac and diabetes medications have a high consumption per capita in Iran compared to other medications. Therefore, in order to rationalize drug prescription, strengthening the clinical evaluation system is recommended by developing and implementing clinical guidelines for common and high-cost diseases.

Access to equal educational opportunities is one of the fundamental rights in each country, and elimination of inequalities, especially in the higher education system, is one of the most important priorities. This study aimed to measure educational inequality in the medical sciences sector in Iranian provinces. In this study, educational inequality in medical sciences was measured using the Gini coefficient. The study indexes included the number of students, faculty members, staff, majors and educational budget. Data were analyzed using Stata 14 software. During the study years, the Gini coefficient of the number of female students, male students, and faculty members showed a more or less decreasing trend from 0.51 to 0.46, from 0.53 to 0.46, and from 0.59 to 0.53, respectively. However, the values of inequality in the number of personnel working in educational sector and educational budget showed a slight increasing trend from 0.49 to 0.50 and from 0.53 to 0.54, respectively. According to the academic majors, the lowest Gini coefficient was related to non-continuous bachelor’s degree that varied from 0.13 to 0.17, and the highest value was related to fellowship degree ranging from 0.66 to 0.69 in the study years.     Despite reduced inequality in some educational indicators, there is a high inequality in the number of academic majors of some postgraduate degrees, number of students by gender, and educational budget, which requires policy makers to focus more on balanced distribution of educational infrastructures among provinces to provide equal educational opportunities.

Quantitative and qualitative improvement of human resources inequality have a significant effect on achievement to health system goals. The purpose of this study was to investigate the trend of geographic, supply, and gender distribution inequality of human resources of the Ministry of Health and Medical Education (MOHME) in Iran. In this descriptive study, the trend of human resources of the Ministry of Health during the years 2009-2015 was investigated based on gender, level of education, and type of employment. In order to study the inequality, Lorenz curve and Gini coefficient index were used. Data were collected from the Human Resources Office of the Deputy of Management Development and Resources of the MOHME and analyzed by Excel 2013 and Stata-14 software. In the present study, women had the highest portion with a growth rate of 6.66% in 2015 and a Gini coefficient of 0.29 except in 2011. The highest and lowest growth rate compared to the base year in 2010 was related to specialist doctors (83.12) and general practitioners (-19.61), respectively. The lowest and highest Gini coefficient was related to the associate degree (0.26) and subspecialty (0.45), respectively. The present study was the first study to investigate the trend of changes in the human resources characteristics of the MOHME at a national level. Since this study only considered the quantity of the trend of human resources changes, it is recommended that the quality of human resources be investigated in the future studies.

Frequent performance improvement requires evaluating progress of any program، identifying challenges facing it and receiving feedback on the rate of implementation of formulated policies. Family physician (FP) plan plays a significant role in improving community health. This study was carried out to evaluate performance of FP plan implementation in Kerman University of Medical Sciences (KUMS).

This is a descriptive retrospective case study. The study context comprised of all districts covered by KUMS. Data were collected using statistical charts of routine system of statistics and information in three dimensions of technical performance (five indicators)، facility and human resources (six indicators) and financial resources (two indicators). Data analysis was carried out using descriptive statistics (frequency and percent) and charts through Microsoft Excel. Time period of 2006-2010 was considered for studying indicators and the minimum data set of three years was addressed.

The mean of referral to specialist was 9. 09% in three years. Share of active visits from total visits was estimated as 9. 96%. Seventy one percent of centers had facilities for physician living، whereas this figure should be 100 percent according to plan regulation. During the five-year period of program implementation، mean attrition rate of physicians and midwives was 53% and 9. 2% respectively.

In spite of the relative improvements in some indicators، recruitment and attrition rate of physicians in the program indicated that physicians’ retention is not in a good state and since human resources indicators are amongst key indicators in improving plan performance، serious attention is required. Therefore، regarding the quantitative and qualitative expansion of the plan in urban regions with more populations، the plan is in need of special improvement.