جستجوی مقالات مرتبط با کلیدواژه « استان های ایران » در نشریات گروه « پزشکی »

Differences in population transition in the provinces of Iran have led to differences in their aging indicators. The purpose of this study is to identify the differences in the cause of death of the elderly in the provinces of Iran during the years 1390 to 1395.

The study performed a secondary analysis of the cause of death of the elderly in the provinces of Iran. The cause of death data is taken from the current death registration in the Civil Registration Organization and is based on the international classification of the cause of death (ICD10). This data is analyzed by gender and age groups in the elderly population. Years of life lost due to premature death (YLL) were used per thousand to measure the mortality of each disease. Death rate and YLL rate allow comparison over time, sex and age at the provincial level as standard.

The elderly death rate varies from 40 to 72% in the provinces of the country. It shows the difference in the situation of the country's provinces in the epidemiological transition. The share of causes of death in the provinces varies by sex. In less developed provinces, premature death is more common for men.

The provinces of Iran have different climatic, developmental and demographic conditions, which has led to different occurrence of health conditions in them. There is a need to develop appropriate health policies at the provincial and regional levels in the country as the population enters the aging phase and the prevalence of chronic diseases among the elderly.

Many previous empirical studies indicated appropriate implementation of the fiscal decentralization and transfer of resources and expenses from the central government to local governments was an important factor to improve health outcomes in developing countries. Accordingly, the major purpose of this study was to evaluate the impact of fiscal decentralization indicators on the mortality rate (as an indicators of health measurement) in Iranian provinces.

This study uses the statistical data of variables affecting the mortality rate in provinces of Iran to study the spatial effects of fiscal decentralization indicators on the mortality rate during 2006-2015. To this end, the spatial econometric approach was used. Furthermore, the statistical analyses were performed using the Matlab software.

Findings of the model's estimation indicate that indicators of the fiscal decentralization and mortality rate had a negative and significant relationship. In this regard, 1 % increase in fiscal decentralization indicators of income and expenditure decreased  the mortality rate by 0.19 % and 0.10 % in provinces of Iran, respectively. Other results showed that the spatial proximity effect between provinces of Iran had a positive and significant effect on the mortality rate.

By providing the necessary conditions for expansion of fiscal decentralization, the health level can be promoted in provinces of Iran.

Health sector is one of the most important management sectors that improvement of its indicators, leads to increased wellbeing of people, costs reduction and ultimately sustainable development. The purpose of this study was to investigate health status indicators of Iran provinces and to rank the provinces and ten regions of Iran accordingly.
The method of study was descriptive and analytical. The population of the study included 31 provinces and ten regions of Iran. In this study, 20 health indicators were selected. Entropy method was used for weighting. In order to rank provinces and regions of the country, TOPSIS was used and finally for mapping Arc GIS 10.1 was used.
According to the results, Gilan, Semnan and Yazd provinces gained respectively the first ranks and Sistan and Baluchestan, Kermanshah and Khuzestan provinces were respectively ranked as the last ones. In the ranking of regions, in terms of development, north coastal regions and central areas gained respectively the first and the second ranks and the southeastern region was in the last place.
Most of the provinces were grouped as deprived and relatively deprived and in terms of health status indicators were in a state of instability. Political and administrative centralization are the main factors causing this situation. In order to improve the distribution of health sectors and to reduce losses resulting from deprivation, the large south-east region and the provinces of Sistan and Baluchestan, Khuzestan, Kermanshah, Kurdistan and West Azerbaijan should be considered in investment and planning priorities.

Out-of-pocket (OOP) expenditure is one of the main indicators in health financing, indicating risk pooling and risk spreading. This study aimed to calculate the total health expenditure (THE), the THE per capita and share of OOP in each province from 2008 to 2014.
The present cross-sectional study was done by collecting provincial health expenditure data from public and private organizations during 2008-2014. The data were approved by board of trustees or board of directors in each organization. The relevant data on household health expenditures were collected from the Statistical Centre of Iran, as well.
Even though the absolute monetary value (IRR) of OOP in the study years showed an increase, it decreased from 51.9% in 2008 to 40.6% in 2014 in terms of share. The absolute monetary value (IRR) of THE and THE per capita increased about 3.5 times in all provinces. So, during the study years, Tehran and Sistan and Baluchistan Provinces had the highest and lowest absolute monetary values (IRR) in THE per capita and this difference increased from 2.12 million Rials in 2008 to 10.56 million Rials in 2014.
Although the share of OOP decreased in all provinces in the country during the study years, it is still far from the objective of the national development plans (30% OOP). In order to improve the study indices and reduce the provincial inequity, it is suggested to put more emphasis on prepaid-based mechanisms, insurance system improvement, and equitable distribution of financial resources should be compatible with the deprivation of the area and its infrastructures.

Catastrophic health expenditure (CHE) is a key indicator for measuring household's financial protection in the health system. This study was conducted to measure the incidence and intensity of CHE in Iranian provinces 2008-2014.
When the out-of-pocket (OOP) spending of each household amounts to at least 40% of the household's capacity to pay, it is called a catastrophe. The incidence of CHE in Iranian provinces was estimated using the data obtained from household-expenditure-and-income-surveys. The intensity was calculated as the average extent to which OOPs exceeded the 40% threshold. Descriptive statistics and Mann-WhitneyU test were used for data analysis. The index of disparity(ID) was also calculated for geographical disparities across the provinces.
On average, the lowest and highest CHE incidence and intensity were seen in Fars and South Khorasan provinces respectively. However, the highest and lowest rate for CHE households that actually experienced catastrophe at the 40% threshold belonged to Fars and Kurdistan provinces. The incidence of CHE in rural was more than urban areas. ID of CHE incidence for targeted amount was high and had no constant trend.
CHE incidence had a remarkable difference in different provinces and in the rural area compared to the urban area. Due to the importance of this index in promoting health financial protection, like indexes such as OOP, its distribution in rural and urban areas as well as in different provinces is considerable. It requires a structured format to identify the disadvantaged and low-income groups and provide financial-support and insurance for them.

One of the fair financial protection indexes in monitoring health systems is estimating impoverishment due to health care expenditure. The aim of this study was to measure the percentage of households impoverished due to out-of-pocket(OOP) payments in Iran provinces during2008-2014.
The present retrospective descriptive study was conducted based on data from Household Income and Expenditure Survey in both rural and urban households. The proportion of households that moved below the poverty line after deducting health care costs was calculated. The poverty line for urban and rural areas was calculated based on household food expenditure. To show the provincial dispersion of the index during this period, the coefficient of variation(CV) was used. Mann-WhitneyU test and descriptive statistics were used to analyze the data.
Golestan, North Khorasan, and Kerman had the highest impoverishment rate due to OOP Moreover, Alborz, Tehran, and Bushehr had the lowest impoverishment rate due to OOP. In all the study years, the average impoverishment due to OOP was significantly higher in rural areas compared to urban areas. Provincial dispersion CV for this index did not have a constant trend.
The results of this study provide valuable evidence for policy-makers to estimate the impact of OOPs on household impoverishment. In order to reduce impoverishment due to OOP, supportive targeted interventions for vulnerable and low-income households, especially rural households, in addition to decreasing the share of OOP, are essential, such as developing health subsidies and improving insurance service packages.

To achieve overall human health, social health in recent decades has been considered as one of the main health dimensions. Defining and measurement social health of any society varies according to its situation. By determining and measuring its characteristics, social health status of society is determined to make evidence-based interventions.
This study was conducted in two phases of qualitative and quantitative. In qualitative phase, framework and indicators were extracted by literature review. In quantitative phase, the information of provinces was obtained from official sources. The final indicators were extracted by expert's opinions about the importance and accuracy of the information respectively. Through standardization of individual indicators and using additive model, total score of social health is calculated and then provinces were ranked. Using ArcGIs software, geographical view of social health was constructed.
Based on composite index including 39 indicators, the most important characteristics of a healthy society is a society where there are no drug use, child labor, divorce, unemployment academics, discipline and inadequate care for children and smoking. Yazd had highest social health and "Sistan and Baluchestan" Province won the last rank.
This study draws a complete view of the province's social health as an important tool for evidence based policy making. It is suggested that for monitoring future trends, similar studies should be conducted every 3-5 years.