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Objectives: This study aimed to estimate and analyze the direct medical costs of pediatric patients with asthma in Jordan from the provider's perspective., Methods: A retrospective analysis of a cohort of pediatric patients with asthma treated during 3 years in a teaching hospital was conducted. The prevalence-based, bottom-up approach has been used to estimate the cost-of-illness of asthma. The total annual direct medical cost was stratified by control status and the severity of asthma., Results: The total annual cost for whole the sample (N = 613) in the average of 3 years was Jordanian dinar (JD) 110 874 (US$ 156 382). Pediatrics with uncontrolled asthma had significantly higher annual total direct medical costs than partly controlled and controlled asthma (JD 396 [US$ 558], JD 258 [US$ 364], and JD 150 [US$ 211], respectively) (P < .001). The annual total direct medical cost for severe asthma (JD 455 [US$ 641]) was significantly higher than moderate, mild, and intermittent (JD 176 [US$ 248], JD 35 [US$ 49], and JD 7 [US$ 9.8], respectively) (P < .001). Medications were the most expensive healthcare resource used, accounting for 79.8% of the total cost, followed by outpatient clinic visits and hospitalizations., Conclusions: Healthcare sources utilization and direct medical costs of asthma were highly related to disease severity and control status of the disease. Health policies targeting the achievement of better and stricter asthma control will play a crucial role in the reduction of the economic burden of asthma for society and the patient., (Copyright © 2022 International Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.)

Objective: This study aimed to estimate the association of smoking with the direct medical expenditures for chronic disease management in north of Jordan., Design, Setting and Participants: Retrospective cohort study using hospital database. Patients who were diagnosed with at least one chronic disease,were aged 18 years or older and had attended King Abdullah University Hospital for disease management and procedures from 1 July 2015 through 30 June 2016 were included in the study., Main Outcome Measures: The outcome of interest was the direct medical expenditures for chronic disease management according to smoking status., Results: Data were collected from 845 patients having at least one chronic disease (mean age of 61±10.7 years). Smokers formed 22% of total patients. The back transformed mean total expenditure per patient of smokers, former smokers and non-smokers was 875 JD, 928 JD and 774 JD, respectively. Drugs were the most expensive healthcare resource used, accounting for 43% of total expenditure, followed by inpatient-related and outpatient-related services (19%). Smokers and former smokers were associated with the highest inpatient expenditures and inpatient-related and outpatient-related services expenditures. However, smokers were associated with the lowest outpatient and medication expenditures., Conclusions: Smokers and former smokers presented with higher statistically significant inpatient-related and outpatient-related services expenditures and higher transformed mean total expenditures compared to non-smokers; highlighting this economic burden is useful for promoting tobacco control policies., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The current insurgency warfare in Iraq is of an unconventional or asymmetrical nature. The deteriorating security has resulted in problems recovering and maintaining essential health services. Before the 2003 war, Iraq was considered a developed country with the capacity to routinely perform baseline medical and surgical care. These procedures now are performed irregularly, if at all. Due to the unconventional warfare, traditional Military Medical Civilian Assistance Programs (MEDCAPs) and civilian humanitarian missions, which routinely are mobilized post-conflict, are unable to function. In December 2005, an international medical mission conducted by the Operation Smile International Chapter in neighboring Jordan employed civilian physicians and nurses to provide surgery and post-operative care for Iraqi children with newly diagnosed cleft lip and palates and the complications that had occurred from previous surgical repair. Seventy-one children, their families, and a team of Iraqi physicians were safely transported to Jordan and returned to Iraq across the Iraqi western province war zone. Although complications may occur during transport, treatment within a safe zone is a solution for providing services in an insecure environment.