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1. A model of the organizational resilience of hospitals in emergencies and disasters

Author

Fatemeh Seyghalani Talab, Bahman Ahadinezhad, Omid Khosravizadeh, and Mohammad Amerzadeh

Subjects
Model, Resilience, Hospital, Disaster, Emergency, Special situations and conditions, RC952-1245, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background In the health system, hospitals are intricate establishments that offer vital medical services. Their resilience plays a crucial role in mitigating the societal repercussions of disasters. A hospital must possess the capacity to withstand risks, preserve its fundamental structure and operations, and enhance its preparedness by augmenting various capabilities and promptly recovering from the impacts of potential risks. It enables the hospital to attain a heightened level of readiness. Therefore, this study aimed to develop a resilience model tailored for hospitals to navigate crises and disasters effectively. Methods This mixed-method study was conducted in 2023 in three phases: (1) Identification of the factors influencing the organizational resilience of the hospital, (2) Evaluation of the influential factors by an expert panel. (3) Following the standardization process, we administered 371 questionnaires to individuals, such as university staff managers and supervisors, nursing managers, and research unit managers. The sample size was determined by multiplying the components by 10, resulting in 360 (10 * 36). Therefore, we selected a sample size of 371 participants. Structural Equation Modeling (SEM) was employed to examine the causal relationships between variables. These steps were performed using SPSS 25.0 and AMOS 22 software. Finally, we identified and presented the final model. We utilized AMOS 22 and applied the SEM to assess the correlation between the variables, with a significance level of 0.05. Results Findings indicate that the appropriate modeling identified five dimensions comprising 36 components. These dimensions include vulnerability, preparedness, support management, responsiveness and adaptability, and recovery after the disaster. The model demonstrates a good fit, as indicated by the X2/d indices with a value of 2.202, a goodness of fit index (GFI) of 0.832, a root mean square error of estimation (RMSEA) of 0.057, an adjusted comparative fit index (CFI) of 0.931, and a smoothed fit index (NFI) of 0.901. Conclusion Enhancing hospital resilience is crucial for effective preparedness and response to accidents and disasters. Developing a localized tool for measuring resilience can help identify vulnerabilities, ensure service continuity, and inform rehabilitation programs. The proposed model is a suitable framework for assessing hospital resilience. Key factors include human resource scarcity, hospital specialization, and trauma center capacity. Hospitals should prioritize efficient resource allocation, information technology infrastructure, in-service training, waste management, and a proactive organizational framework to build resilience. By adopting this approach, hospitals can better respond to crises and disasters, ultimately reducing casualties and improving overall preparedness.

Published
2024
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2. Investigating the Organizational Resilience of Hospitals During Emergencies and Disasters: A Comprehensive Review of the Components

Author

Fatemeh Seyghalani Talab, Bahman Ahadinezhad, and Omid Khosravizadeh

Subjects
emergencies, disaster, hospital, organizational resilience, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Background: A hospital’s ability that is exposed to risk is important for maintaining its basic structure and functions by relying on increasing various capacities recovering from the effects of risks at the right time and reaching a higher level of readiness. Accordingly, the present study investigates the components of organizational resilience of hospitals during emergencies and disasters. Materials and Methods: This comprehensive review was conducted in 2022. Data was collected by searching keywords in PubMed, Web of Science, Science Direct, Magiran, Irandoc, and SID databases from 2012 to 2022. The quality of the articles was evaluated using the strengthening of the reporting of observational studies in the epidemiology checklist by two researchers. The results of the studies were categorized in the form of dimensions and components. Results: A total of 20 studies with various methods were summarized after quality assessment. Subsequently, the identified components were categorized into 5 dimensions as follows: the vulnerability of the hospital (18 components), preparedness (31 components), management and support (33 components), responsiveness and adaptability (35 components), and recovery after crisis (8 components). Conclusion: A review of the studies showed the importance of each component in the field of hospital organizational resilience. In this regard, policymakers at the decision-making level and managers at the executive level should pay attention to the components that affect the organizational resilience of the hospital regarding the structure, process, and expected consequences, and then make the necessary decisions regarding the implementation of policies and solutions.

Published
2024

3. What is the uptake rate of breast self-examination in Iranian women? Estimation based on systematic review and meta-analysis

Author

Bahman Ahadinezhad, Omid Khosravizadeh, Sima Rafiei, Nastaran Habibi, Zahra Karimkhani, and Aisa Maleki

Subjects
Breast self-examination (BSE), Meta-analysis, Iran, Gynecology and obstetrics, RG1-991, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Breast self-examination is a simple, painless, confidential and inexpensive screening method for early diagnosis that does not require specialized tools and equipment. In this study, we have estimated the pooled percentage of breast self-examination (BSE) in Iranian women. Methods All the published literatures between 2012 and 2022 have been reviewed. Searches were performed in PubMed, Web of Science, ProQuest, Science Direct, Google Scholar, Scientific Information and Magiran databases. The effect size was the pooled percentage of breast self-examination (BSE). In order to check the heterogeneity, the estimation of the I2 index and extraction of the Galbraith plot were used, and the drivers of heterogeneity have been identified through meta-regression and estimates were made based on subgroups. All the analysis was done in STATA 15. Results From the initial 294 records, 38 were included in the final analysis in which 9960 women have been studied. The heterogeneity of the studies was high based on the variation in OR (I2 = 98.4%, heterogeneity X2 = 2278.21 (d.f. = 37), p

Published
2023
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4. Are behavioral economics interventions effective in increasing colorectal cancer screening uptake: A systematic review of evidence and meta-analysis?

Author

Bahman Ahadinezhad, Aisa Maleki, Amirali Akhondi, Mohammadjavad Kazemi, Sama Yousefy, Fatemeh Rezaei, and Omid Khosravizadeh

Subjects
Medicine, Science
Abstract

Various interventions have been investigated to improve the uptake of colorectal cancer screening. In this paper, the authors have attempted to provide a pooled estimate of the effect size of the BE interventions running a systematic review based meta-analysis. In this study, all the published literatures between 2000 and 2022 have been reviewed. Searches were performed in PubMed, Scopus and Cochrane databases. The main outcome was the demanding the one of the colorectal cancer screening tests. The quality assessment was done by two people so that each person evaluated the studies separately and independently based on the individual participant data the modified Jadad scale. Pooled effect size (odds ratio) was estimated using random effects model at 95% confidence interval. Galbraith, Forrest and Funnel plots were used in data analysis. Publication bias was also investigated through Egger's test. All the analysis was done in STATA 15. From the initial 1966 records, 38 were included in the final analysis in which 72612 cases and 71493 controls have been studied. About 72% have been conducted in the USA. The heterogeneity of the studies was high based on the variation in OR (I2 = 94.6%, heterogeneity X2 = 670.01 (d.f. = 36), p < 0.01). The random effect pooled odds ratio (POR) of behavioral economics (BE) interventions was calculated as 1.26 (95% CI: 1.26 to 1.43). The bias coefficient is noteworthy (3.15) and statistically significant (p< 0.01). According to the results of this meta-analysis, health policy and decision makers can improve the efficiency and cost effectiveness of policies to control this type of cancer by using various behavioral economics interventions. It's noteworthy that due to the impossibility of categorizing behavioral economics interventions; we could not perform by group analysis.

Published
2024
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5. Investigating the Relationship of Socio-economic Index and Resource Availability Index with the Inequality of Daly in the Provinces of Iran

Author

Bahman Ahadinezhad, Omid Khosravizadeh, Sima Rafiei, Nastaran Habibi, Bahareh Mohtashamzadeh, and Aisa Maleki

Subjects
economic factors, disability-adjusted life years, iran, social class, Medicine, Public aspects of medicine, RA1-1270
Abstract

Introduction and purpose: In order to have more effective programs and social interventions controlling the burden of diseases, it is necessary for policy makers to have valid evidence about the role of socioeconomic determinants. The present study aimed to provide empirical evidence about the relationship of socioeconomic inequalities and the availability of resources with the burden of diseases among the provinces of the country in 2019. Methods: This descriptive and analytical research was carried out using the provincial data of 2019. The required provincial data were extracted from the Statistical Yearbook Report and the Household Income Expenditure Report of the Statistics Center and the data related to adjusted years with disability and early death (DALI) from the 2019 disease burden estimates. DALY's inequality was investigated by estimating the concentration index and extracting the concentration curve at a 95% confidence interval. The analyses were carried out in the Stata software (version 15). Results: In 2019, the average per capita DALY was 18.33±3.98. The average socio-economic index and resource availability index for 31 provinces were obtained at 0.37±0.21 and 0.64±0.20, respectively. Considering the difference in the available resources (covariate), there was a statistically significant difference between the socio-economic quartiles in terms of the distribution of per capita DALY (P

Published
2023

6. Path Analysis of Critical Thinking Effect on Self-Efficiency Among Nursing and Medical Students

Author

Omid Khosravizadeh, Bahman Ahadinezhad, Aisa Maleki, Ailar Hashtroodi, Pariya Vosoughi, and Shahrzad Kohan

Subjects
critical thinking, self-efficiency, path analysis, Medicine, Public aspects of medicine, RA1-1270
Abstract

Background: Critical thinking is the ability to ask appropriate questions and gather relevant information. It enables rational judgment and problem-solving for physicians and nurses. For the first time, this study examined two major groups of caregivers at the patient's bedside in terms of the relationship between critical thinking and self-efficacy. Methods: This was a descriptive-analytical and cross-sectional study conducted in 2021. The sample was taken from QUMS’s nursing and medical students through stratified random method. It was performed using structural equation method (n=377). Data collection tools included: demographic information, Ricketts critical thinking questionnaire, and GSE-17 questionnaire. Finally, data were analyzed through the correlation coefficient and multiple regression tests using SPSS22 software at a significance level of 0.05. Results: Results indicated that the model established at this step demonstrates good fitness. In this model χ2 = 1919.91, df = 89, χ2 / df = 2.14, RMSEA = 0.05, NFI = 0.63, GFI = 0. 77 and CFI = 0. 76. The structural equation model's standard estimation coefficients show that all the existing paths are at a significant level (CTH: CRV 0.96, CTH: COM 0.94, CTH: SFE -0.61; P-value< 0.05). Finally, the regression analysis showed an inverse effect of critical thinking on self – efficacy. Conclusion: The study showed that critical thinking had a direct effect on self-efficacy. In addition, these two features have a significant effect on increasing the efficiency and making the right clinical decisions in medical and nursing groups. Therefore, upgrading these skills by updating curriculum will ultimately improve healthcare outcomes provided by these two specific groups.

Published
2022

7. Effective Dimensions of Medical Equipment Maintenance Management in Educational Hospitals: A Qualitative Study

Author

Bahman Ahadinezhad, Omid Khosravizadeh, Aisa Maleki, Elnaz Ghanbari, Mahla Shafiei pour, and Mahdi Safdari

Subjects
medical equipment, maintenance management, medical center, iran, Medicine, Public aspects of medicine, RA1-1270
Abstract

Background: Medical equipment maintenance plays an important role in improving the equipment's function, increasing its effectiveness and efficiency, providing continuous health services, and improving the quality of services. This study is conducted to investigate the factors affecting medical equipment maintenance management. Methods: The present study was a qualitative investigation based on content analysis that was conducted in 2021. Data collection method was an open ended interview. The interviewees included all medical equipment operators and technicians of educational and medical centers affiliated with Qazvin University of Medical Sciences. The semi-structured interview guide was used as a data collection tool. Qualitative data obtained from interviews were analyzed by the content analysis method. The obtained coded were classified into dimensions and components using MAXQDA Software12 . Results: According to the findings, categories of time constraints, access to information, instructions and programs, type and number of equipment, financial constraints, user, patients, training programs, and equipment repair agencies were the most important factors affecting medical equipment maintenance management. Conclusion: Observing purchasing standards and guaranteed equipment, training all the staff involved, developing and explaining instructions and programs are essential for optimal equipment maintenance. These measurements will reduce the cost of repairing. g medical equipment and the need to purchase equipment; improve equipment, service quality performance, patient and user safety; and increase the device life.

Published
2022

8. The Effect of Intellectual Capital on Innovative Performance with the Mediating Role of Qazvin Health Staff’s Empowerment: A Path Analysis

Author

Omid Khosravizade, Bahman Ahadinezhad, and Bibi Sara Sheikh

Subjects
intellectual capital, empowerment, innovative performance, health, qazvin, Medicine, Public aspects of medicine, RA1-1270
Abstract

Background: Nowadays, since many health care organizations are facing a crisis of declining productivity and labor force stagnation, productivity can be improved through identifying and strengthening the components affecting the labor force productivity and performance. Thus, the present study was aimed at determining the effect of intellectual capital on innovative performance with the mediating role of health staff’s empowerment in Qazvin University of Medical Sciences. Methods: This is a descriptive-analytical cross-sectional study carried out in 2021. Three hundred and four staff of the Health Department and Health Networks participated in the research by the available sampling method. The Bontis questionnaire was employed for measuring the intellectual capital, the Spritzer questionnaire for measuring staff’s empowerment, and the Huang and Li questionnaire for measuring innovative performance. Moreover, for preliminary data analysis, SPSS25 Software was used as well as AMOS software for structural equation modeling at a significance level of 0.050 %. Results: The results of the path coefficient among the model variables on each path, corresponding to the research hypotheses, are positive, revealing a positive relationship among the research variables. The path coefficient of the direct relationship between intellectual capital and innovative performance was equal to 0.767 (P-value < 0.001). Moreover, the relationship between intellectual capital and empowerment was equal to 0.306, and between empowerment and innovative performance was equal to 0.153, both of which were significant (p < 0.001). Furthermore, indices of fit including NFI = 0.652, RMSEA = 0.064, GFI = 0.710, and CFI = 0.769 exhibited a relatively good fit of the final model. Conclusion: Given the direct relationship between model variables, the University of Medical Sciences’ managers and health officials should provide the bed for improving the capacity of human resources and innovative performance through developing intellectual capital besides creating a platform to play an effective role in the organization. Accordingly, effective and innovative performance based on responding to the human resources’ changing needs in all sectors may be imagined.

Published
2022

9. Factors, drivers and barriers to improving hospital cost management: A Systematic review

Author

Elahe Eyshi, Omid KHosravizadeh, Aisa Maleki, and Bahman Ahadinezhad

Subjects
cost management, reducing costs, hospital, Public aspects of medicine, RA1-1270
Abstract

Aim & Background: Cost management is the most important factor affecting the economic performance of the hospital. Good management of costs in the short term stabilizes and balances the operating balance of the hospital and secures the hospital in terms of liquidity. Also, good management of costs in the long term makes the hospital financially stable. According to the mentioned cases and increasing hospital costs, the present study was conducted with the aim of identifying and investigating the factors, drivers and obstacles to improve cost management. Methods & Materials: This systematic review was conducted in 2020. Data was collected through searching keywords in Google scholar, PubMed, Scopus, Web of Science, Science direct, Magiran, SID and Irandoc databases from 2007 to 2020. The classification of the results of the studies was done by the researchers. Results: All the components identified and extracted from the articles were divided into four dimensions (increasing factors, prerequisites, obstacles and solutions) to improve hospital cost management. Conclusion: Reviewing the results of each study showed the importance of each component in managing, improving and controlling hospital costs. In this regard, policy makers at decision-making level and managers at executive level should pay attention to the components and dimensions affecting the control and improvement of hospital costs according to the structure, process and expected consequences, and then decide on their implementation.

Published
2022

10. Investigating the Relationship Between Management Style and Market Orientation in Qazvin University of Medical Sciences

Author

Bahman Ahadinezhad, Omid Khosravizadeh, Fatemeh Vahdati, Mohammadreza Mohammadkhani, Rana Soheylirad, and Sogol Sarikhani

Subjects
management style, market orientation, hospital, qazvin, Medicine, Public aspects of medicine, RA1-1270
Abstract

Background: Hospital management style can affect various aspects of hospital performance. One of these aspects is the level of market orientation of the hospital. Therefore, the present study attempts to answer whether management style makes a difference in the degree market orientation of hospitals or not. Methods: This research is a descriptive-analytical and cross-sectional study conducted in 2020. About 420 people were selected by stratified sampling out of the six medical centers' staff in Qazvin, Iran. A total of 411 people (97.86 %) completed the questionnaires. The collected data were analyzed using STATA15 and SPSS16 software. Robust regression analysis was used to estimate the role of management style in the level of market orientation of hospitals. Mean variables were analyzed using one-way analysis of variance and post hoc test. Results: The score range of the variables was from 1 to 5. Autocratic and delegating styles obtained the highest average (3.22 ± 0.54) and the lowest average (2.87 ± 0.70), respectively. Among the dimensions of market orientation, customer orientation had the highest average (3.32 ± 0.84), while competitor orientation obtained the lowest average (2.80 ± 0.86). The average score of market orientation was 2.88 ± 0.65. A statistically significant difference between hospitals was observed in terms of participative and delegating styles (P-value < 0.05). In addition to market orientation, there was a statistically significant difference between hospitals (P-value < 0.05). The regression coefficient between the level of the hospital market orientation and the participative and delegating styles was 0.10 and 0.09 , respectively (P-value < 0.05). In contrast, the regression coefficient between autocratic style and level of market orientation was estimated to be -0.76. Conclusion: It can be concluded that managers should use more participatory and delegating styles to increase the market orientation of the studied hospitals.

Published
2022

11. Developing decision model for the outsourcing of medical service delivery in the public hospitals

Author

Omid Khosravizadeh, Aisa Maleki, Bahman Ahadinezhad, Saeed Shahsavari, Mohammad Amerzadeh, and Nasibeh Mansouran Tazekand

Subjects
Outsourcing, Hospital, Medical service, Decision model, Public aspects of medicine, RA1-1270
Abstract

Abstract Background The decision to outsource an activity is one of the most complex organizational decisions. This decision is also influenced by several factors and components. In order to facilitate and optimize it, for the first time in this study, a decision model for outsourcing medical service delivery in public hospitals has been developed. Methods We conducted this cross-sectional study in 3 stages: 1) We identified the factors affecting the outsourcing decisions, 2) an expert panel identified the influential factors. After standardization, we distributed 220 questionnaires among university staff managers and heads, nursing managers, and managers of the research units, and 3) Structural Equation Model applied to evaluate the relationship between the variables on AMOS22, at 0.05 significant level. Results Findings indicated the optimal level of all fit indices. The path coefficient between all identified factors with the outsourcing decision was positive (t > 1.96). Factors ranging from the most effective to least effective included monitoring and control, service type, human resource, economic and financial, executive capability, external environment, and terms and conditions. Conclusion The proposed model provides unit evaluation to make the appropriate decision on outsourcing or non-outsourcing. Control and monitoring were the most determining factors. We recommend performing monitoring continuously as a guide and deterrent to error. We also recommend continuous monitoring and control over the quality of outsourced units and stakeholder satisfaction.

Published
2022
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12. Management style of educational and medical centers in Qazvin: Perception of frontline staff from the structure and condition

Author

Sogol Sarikhani, Omid KHosravizadeh, Bahman Ahadinezhad, Mohammadreza Mohammadkhani, Fateme Vahdati, and Rana Soheylirad

Subjects
management style, hospital, perception of frontline staff, Public aspects of medicine, RA1-1270
Abstract

Introduction: Management is one of the most important factors that can affect the performance of an organization such as hospital. Therefore, identifying the management style used in hospitals can be useful empirical evidence to solve many hospital problems. In this study, the management styles used in the educational-medical centers of Qazvin University of Medical Sciences have been studied and determined. Methods: In this descriptive-analytical study, a sample of 411 people was selected using random sampling method from a population of 2265 employees working in university hospitals in Qazvin. The required data were collected using a valid Clark management style questionnaire and through employee perception survey. Finally, the obtained information was analyzed in the space of STATA 15 and SPSS 16 software. Results: Individuals reported the highest frequency (42%) for autocratic style items and the lowest frequency (25%) for delegating style items. Autocratic style had the highest total mean (3.22 of 5) and delegating style had the lowest total mean (2.87 of 5). Apart from autocratic style, there was a significant difference between hospitals in terms of the use of participative and delegating styles (p

Published
2021

13. Assessing the level of market orientation at Qazvin teaching and medical hospitals: Application of the three-dimensional market analysis model

Author

Fateme Vahdati, Mohammadreza Mohammadkhani, Omid Khosravizadeh, Rana Soheylirad, Sogol Sarikhani, and Bahman Ahadinezhad

Subjects
market orientation, customer orientation, competitor orientation, hospital., Public aspects of medicine, RA1-1270
Abstract

Background: In addition to providing effective and equitable services to low-income groups, teaching hospitals must obtain a significant share of the demand of high-income groups in order to have a balanced and positive operational performance. The aim of this study was to investigate the market orientation of teaching and medical hospitals in Qazvin. Materials & Methods: This descriptive-analytical study was conducted at teaching and medical hospitals of Qazvin University of Medical Sciences in a cross-sectional manner in 2020. Data were collected in a one-month period through a questionnaire survey. The study population was the total staff working in 6 hospitals of this university who were selected using quota-random sampling method. The required data were obtained by collecting 411 market orientation questionnaires (Ahmad and Eqbal 2013) and were analyzed in SPSS 16 software. One-way analysis of variance with 95% confidence interval was used to compare the means. Results: The market orientation of all studied hospitals was 2.88 out of 5. Also, customer orientation had the highest average (3.32 out of 5) and paying attention to competitors had the lowest average (2.80 out of 5). The mean for dimension of coordination between tasks was 2.86 out of 5. Apart from paying attention to competitors, there was a statistically significant difference in terms of market orientation, customer orientation and coordination between tasks(P

Published
2020

14. Identifying the Causes and Extent of Insurance Deductions in a Hospital: An Interventional Approach to Cost Management

Author

Roohangiz Taheri, Rohollah Kalhor, Bahman Ahadinezhad, and Mohammad Zakaria Kiaei

Subjects
hospital deductions, cost management interventional approach, six sigma, insurance organizations, Medicine, Public aspects of medicine, RA1-1270
Abstract

Background: A significant amount of revenues and deductions exist in the hospitals each year. This study aimed to determine the number of deductions applied and identify its causes. Furthermore, we aimed to provide management strategies to reduce these deductions in Shafa Takestan hospital. Methods: This applied and interventional study was conducted with a cross-sectional design. The data collection tool was a checklist from the previous studies. Data were analyzed using descriptive statistics such as mean, percentage, and standard deviation as well as analytical statistics of the Wilcoxon test. Results: Before the intervention, among 405 non-global inpatient cases, about 323 (80 %) contained subtractions. After the intervention, among 555 non-global hospital admissions, about 264 (47 %) included deductions. Most deductions were related to health services insurance (75.38 %). Concerning each hospital ward, most deductions were related to surgery ward (38 %). Before and after the intervention, service deductions were included in 5.59 % and 4.57 %, respectively. Conclusion: Therefore, medical personnel should pay more attention to documenting patientschr('39') records and minimizing documentation errors. Moreover, to reduce patient record deductions, the health care staff should be familiarized with proper documentation procedures by conducting training sessions.

Published
2020

15. Effect of health transformation plan on natural childbirth and cesarean section indicators: An Interrupted Time Series Analysis in a Private Hospital of Tehran

Author

Samira Raoofi, Omid khosravizadeh, Bahman Ahadinezhad, Saeed Khan Mohammadi, Sedighe Arefi, and Saeed Shahsavari

Subjects
cesarean section, health transformation plan, interrupted time series, natural childbirth, Gynecology and obstetrics, RG1-991
Abstract

Introduction: Increasing natural childbirth and decreasing cesarean section is one of the strategies for improving maternal and neonatal health to achieve the millennium development goals. In order to achieve this goal, health transformation plan and program for promotion of natural childbirth have been developed and implemented in Iran. Therefore, this study was performed with aim to analyze the trend of natural childbirth and cesarean section indicators in order to realize the goals of the health transformation plan in Madaen Hospital, Tehran. Methods: In this cross-sectional study, the data of delivery and cesarean section were collected from 2013 to 2017. Changes in the level and trend of natural childbirth and cesarean sections before and after transformation plan were evaluated by independent t-test and regression model of cut-off in STATA software (version 15). Results: The trend of natural childbirth after implementation of the plan increased by 0.685% per month (p=0.020) and the trend of cesarean section decreased by 0.749% per month (p=0.011). In the 3-year period after the health transformation plan, the percentage of natural childbirth increased by 0.680 per month (p

Published
2020
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16. Are Price, Income, and Education Expenditure Important in the Iranian households\' Demand of Healthcare Services: 2011 to 2017?

Author

Bahman Ahadinezhad, Omid Khosravizadeh, Najmeh Baghian, Bahareh Mohtashamzadeh, and Saeed Shahsavari

Subjects
healthcare services demand, robust standard error panel regression, health investment approach, Medicine, Public aspects of medicine, RA1-1270
Abstract

Background: In health economics, policymakers need to be aware of the individuals' sensitivity and reaction to change effective factors on the healthcare services demand. This study aimed to estimate the healthcare demand function and extract the price, income, and educational elasticity in Iran. Methods: A panel of macro data was used to estimate the demand function. The data included provincial average of the nominal values of Iranian household healthcare and education expenditure, provincial average of their nominal income, and Consumer Price Index values of the healthcare services from 31 provinces during 7 years (2011 to 2017). This information was obtained from the annual Household Budget Survey Reports and no sampling was performed in this research. The dependent variable was the actual amount of demand for health care services. Robust pre-estimation tests and a robust standard error panel regression were run to estimate the demand function in Stata 15. Results: All variables were stationary at the first-order differential (P-value < 0.01). All four variables were co-integrated (P-value < 0.01). The cross-sectional and fixed effects existed for each province (P-value < 0.01). Income and educational expenditure had a positive association with healthcare demand. Price elasticity of demand was -0.897 (P-value < 0.01), income elasticity was 0.491 (P-value < 0.1), and elasticity of education expenditure was 0.486 (P-value < 0.01). Noteworthy, 1 % increase was observed in the household incomes and their educational expenditure increased the demand for health care services by about 0.49 % and 0.48 %, respectively. Conclusion: Healthcare services have been low elastic to price and education expenditure and have also been the essential commodity in the household budget in Iranian households. Later, the price and income coefficients were consistent with the health investment model, but coefficient of the education expenditure was not matched with predictions of the health investment model.

Published
2020

17. Spiritual Intelligence and Self-Efficacy among Operational Staff of Qazvin\'s Medical Centers: A Path Analysis

Author

Omid Khosravizadeh, Saeed Shahsavari, Bahman Ahadinezhad, Fahimeh Asili Ansari, Roohangiz Taheri, and Shoayb Rafiei

Subjects
spiritual intelligence, self-efficacy, medical centers, path analysis, Medicine, Public aspects of medicine, RA1-1270
Abstract

Background: Self-efficacy and spiritual beliefs can be considered as strong motives for improving the quality of working. Due to the different job description and environment than other service sectors, medical centers need to pay attention to these factors. So, the present study is aimed at identifying the effect of spiritual intelligence components on self-efficacy among operational staff of Qazvin medical centers. Methods: The present research is a descriptive-analytical and cross-sectional study conducted in 2019. About 238 people were selected by stratified sampling out of the medical centers staff in Qazvin, Iran. Spiritual intelligence was measured by King’s questionnaire including four dimensions, and self-efficacy was measured by Sherer’s questionnaires including three dimensions. Primary data analysis was done by Pearson’s correlation test in SPSS20 software, and path analysis was done by structural equation modeling in AMOS software with the significance level of 0.05. Results: There was a significant direct relationship between all dimensions of self-efficacy and spiritual intelligence except persistence in the face of adversity and consciousness expansion (P-value ˂ 0.01). All the relationships were significant in path analysis of the final model. Also, the fit indices including NFI = 0.901, RMSEA = 0.055, GFI = 0.923, and CFI = 0.913 suggest the good fitness of the final model. Conclusion: The managers of the studied hospitals can promote self-efficacy in clinical staff and improve their performance and behavior in service provision by psychological enrichment of the staff and raising their spiritual intelligence.

Published
2020

18. The structure of the pharmaceutical market in Iran using concentration indices

Author

Mohammad Mohseni,, Hasan Abolghasem Gorji, Bahman Ahadinezhad, Omid Khosravizadeh, Meysam Safi Keykaleh, Ahmad Moosavi, and Bahareh Mohtashamzadeh

Subjects
Drug, Pharmaceutical Market, Concentration, Index, Medicine (General), R5-920
Abstract

Background and objective: The efficiency and function of the pharmaceutical sector, as a vital portion of the health system, have a significant effect on intermediate and final indices of health. In this research, the structure of the pharmaceutical market in Iran was examined through the calculation of concentration indices in 2011. Methods: In this cross-sectional study, the needed data was gathered from the Food and Drug Administration in the year 2011. Data were analyzed using SPSS software version 20 and Microsoft Office Excel software. Finally, two common measures of market concentration, the Concentration Ratio and the Herfindahl-Hirschman Index, were calculated. Results: The largest and the smallest shares of the industry were 5.57% and 0.01%, respectively. The average industry share was 1.09%. The share range was calculated to be 5.56%. The Herfindahl-Hirschman Index was 248.5, which indicates a very low concentration of the pharmaceutical market in Iran. Also, based on the Concentration Ratio of 4 companies (18.39%), the concentration of the pharmaceutical market has been too low. Conclusion: The pharmaceutical market in Iran has a very low concentration and it does not have an exclusive mode in terms of market structure. Therefore, it can be attributed to the competitive model. The policy makers in this area can use this characteristic as a leverage to improve efficiency, fairness, revenue and health indices

Published
2017
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19. Analysis Of Management Functional Dimensions Using Weisbord Model In Hospitals Of Tehran University Of Medical Sciences

Author

Sodabe Vatankhah, Lida Shams, Bahman Ahadinezhad, Elham Ameli, Taha Nasiri, and Narges Roustai

Subjects
Analysis, Weisbord Model, Functional Dimention, Hospital, Tehran University of Medical Sciences, Public aspects of medicine, RA1-1270
Abstract

Background and Aim: Analysis of functions enables organizations to identify their special capabilities and weak points accurately and thus they can enhance capabilities and reduce impacts of threats and obstacles through such analysis. The main goal of this work is investigation of status of Weisbord Model's variables (6 variables) as functional dimensions of management in hospitals of Tehran University of Medical Sciences. Materials and Methods: This was a descriptive - analytical study. The study population consisted of 384 staffs from hospitals of Tehran University of Medical Sciences. Standardized questionnaire for organization recognition was used for data collection. Descriptive statistics (frequency distribution, frequency percentage) and inferential statistics (Pearson correlation coefficient and significance level) were used for statistical analysis and data analysis was run using SPSS software. Results: The results showed that there is a significant difference (p=0.0001) in hospitals in terms of the internal situation. Internal situation of all hospitals in the study was evaluated as favorable condition by obtaining 94.5 score out of 125. Among the hospitals, Hashemi-Nejad Hospital with highest score (113) showed the better condition and Rasoul Hospital had the lowest score (87) and lower condition as compared to other hospitals. Conclusion: Necessity of systematic perspective in designing and development of fair compensation mechanism with presence of representatives of employees is an action which can considerably influence improvement of current situation in the hospitals and facilitates achieving predetermined goals of the organization

Published
2013

22. COVID-19 crisis overshadowing the health workforces’ rights and resilience: a systematic review

Author

Omid Khosravizadeh, Bahman Ahadinezhad, Sima Rafiei, Rohollah Kalhor, and Aisa Maleki

Subjects
Health (social science), Public Administration, Sociology and Political Science, Social Psychology, Health Policy
Abstract

Purpose In the time of the COVID-19 crisis, many physical, psychological and spiritual difficulties are imposed on the front line staff and overshadow their rights, resilience and retention. In addition, the loss of this important organizational resource imposes huge costs on the system. The purpose of this study is systemic review of the influential factors, policies and strategies applied to defend the rights of health-care staff and improve the resilience and retention of health system human resources in the COVID-19 crisis. Design/methodology/approach This systematic review was conducted in 2021. Data were collected by keyword search in Google Scholar, PubMed, Scopus, Web of Science, Science Direct, Magiran, SID and Irandoc databases until December 2021. In addition, the quality of the studies was evaluated by three experts using the Strobe checklist. The analysis used in this study to categorize the results was thematic analysis. Findings Factors that cause tension and injustice to employees and also strategies to overcome it and increase their resilience were classified into general categories according to their nature. Factors included factors related to safety, economic and financial, staff characteristics, crisis management characteristics, organizational climate and working conditions. Existing strategies also fall into four categories of physical, psychological and spiritual health promotion strategies; organizational climate and work environment; education and empowerment and economic and financial. Originality/value This study is a systematic review of the factors that affect the health workforce rights and resilience of health-care personnel during the COVID-19 crisis. On the other hand, the policies and strategies used in different countries to overcome the difficulties and increase the resilience and retention of health workers have been summarized and can be used in other crises.

Published
2022

23. Health system performance in Iran: a systematic analysis for the Global Burden of Disease Study 2019

Author

Farshad Farzadfar, Mohsen Naghavi, Sadaf G Sepanlou, Sahar Saeedi Moghaddam, William James Dangel, Nicole Davis Weaver, Arya Aminorroaya, Sina Azadnajafabad, Sogol Koolaji, Esmaeil Mohammadi, Negar Rezaei, Jaffar Abbas, Behzad Abbasi, Mitra Abbasifard, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Hedayat Abbastabar, Amir Abdoli, Mohammad Abdollahi, Sina Abdollahzade, Hassan Abolhassani, Zahra Abrehdari-Tafreshi, Soodabeh Aghababaei, Bahman Ahadinezhad, Ali Ahmadi, Sepideh Ahmadi, Hamid Ahmadieh, Mohammad Esmaeil Akbari, Yousef Alimohamadi, Vahid Alipour, Hesam Alizade, Saba Alvand, Saeed Amini, Sohrab Amiri, Ali Arash Anoushirvani, Fereshteh Ansari, Jalal Arabloo, Morteza Arab-Zozani, Zahra Aryan, Armin Aryannejad, Mehran Asadi-Aliabadi, Ali A Asadi-Pooya, Zatollah Asemi, Samaneh Asgari, Saeed Asgary, Babak Asghari, Mohammad Asghari Jafarabadi, Elham Ashrafi, Zahra Atafar, Seyyed Shamsadin Athari, Abolfazl Avan, Abbas Azadmehr, Hiva Azami, Mohammadreza Azangou-Khyavy, Samad Azari, Amirhossein Azari Jafari, Ghasem Azarian, Alireza Badirzadeh, Elham Bahrami, Mohammad Amin Bahrami, Nastaran Barati, Mohsen Bayati, Gholamreza Bazmandegan, Masoud Behzadifar, Ali Bijani, Somayeh Bohlouli, Shiva Borzouei, Parnaz Daneshpajouhnejad, Abdollah Dargahi, Ahmad Daryani, Jalal Davoodi Lahijan, Mojtaba Didehdar, Shirin Djalalinia, Saeid Doaei, Fariba Dorostkar, Leila Doshmangir, Mohammadreza Edraki, Amir Emami, Babak Eshrati, Sharareh Eskandarieh, Firooz Esmaeilzadeh, Shahriar Faghani, Mahdi Fakhar, Hamid Reza Farpour, Hossein Farrokhpour, Majid Fasihi Harandi, Mohammad Fereidouni, Masoud Foroutan, Mansour Ghafourifard, Azin Ghamari, Seyyed-Hadi Ghamari, Ahmad Ghashghaee, Fariba Ghassemi, Ali Gholami, Asadollah Gholamian, Abdolmajid Gholizadeh, Salime Goharinezhad, Pouya Goleij, Mostafa Hadei, Nima Hafezi-Nejad, Sanam Hariri, Edris Hasanpoor, Hossein Hassanian-Moghaddam, Soheil Hassanipour, Hadi Hassankhani, Mohammad Heidari, Reza Heidari-Soureshjani, Mohammad Hoseini, Mohammad-Salar Hosseini, Mostafa Hosseini, Seyed Kianoosh Hosseini, Ali Hosseinzadeh, Mehdi Hosseinzadeh, Soodabeh Hoveidamanesh, Pooya Iranpour, Seyed Sina Naghibi Irvani, Jalil Jaafari, Roxana Jabbarinejad, Morteza Jafarinia, Hamed Jafari-Vayghan, Mohammad Ali Jahani, Nader Jahanmehr, Mahsa Jalili, Roksana Janghorban, Fatemeh Javanmardi, Farahnaz Joukar, Ali Kabir, Leila R Kalankesh, Rohollah Kalhor, Zahra Kamiab, Naser Kamyari, Behzad Karami Matin, Amirali Karimi, Salah Eddin Karimi, Ali Kazemi Karyani, Leila Keikavoosi-Arani, Maryam Keramati, Pedram Keshavarz, Mohammad Keykhaei, Ali Khaleghi, Mohammad Khammarnia, Javad Khanali, Maryam Khayamzadeh, Sajad Khosravi, Mina Khosravifar, Omid Khosravizadeh, Neda Kianipour, Ali-Asghar Kolahi, Amirhosein Maali, Mokhtar Mahdavi Mahdavi, Afshin Maleki, Mohammad-Reza Malekpour, Kamyar Mansori, Borhan Mansouri, Mohammad Ali Mansournia, Mohammad Reza Maracy, Abdoljalal Marjani, Sahar Masoudi, Seyedeh Zahra Masoumi, Hossein Masoumi-Asl, Mahsa Mayeli, Entezar Mehrabi Nasab, Fereshteh Mehri, Mohammad Miri, Seyyedmohammadsadeq Mirmoeeni, Hamed Mirzaei, Maryam Mirzaei, Roya Mirzaei, Ashraf Mohamadkhani, Heidar Mohammadi, Seyyede Momeneh Mohammadi, Shadieh Mohammadi, Abdollah Mohammadian-Hafshejani, Noushin Mohammadifard, Reza Mohammadpourhodki, Mohammad Mohseni, Amin Mokari, Sara Momtazmanesh, Abdolvahab Moradi, Masoud Moradi, Yousef Moradi, Mohammad Moradi-Joo, Farhad Moradpour, Maliheh Moradzadeh, Rahmatollah Moradzadeh, Abbas Mosapour, Shandiz Moslehi, Simin Mouodi, Mehdi Naderi, Homa Naderifar, Zhila Najafpour, Javad Nazari, Seyed Aria Nejadghaderi, Leila Nemati-Anaraki, Amin Reza Nikpoor, Marzieh Nojomi, Maryam Noori, Hasti Nouraei, Ali Nowroozi, Morteza Oladnabi, Fatemeh Pashazadeh Kan, Majid Pirestani, Meghdad Pirsaheb, Mohammadreza Pourahmadi, Hadis Pourchamani, Hadi Pourjafar, Akram Pourshams, Mohammad Rabiee, Navid Rabiee, Alireza Rafiei, Sima Rafiei, Fakher Rahim, Amir Masoud Rahmani, Sina Rashedi, Vahid Rashedi, Amirfarzan Rashidi, Mahsa Rashidi, Mohammad-Mahdi Rashidi, Ramin Ravangard, Reza Rawassizadeh, Iman Razeghian-Jahromi, Mohammad Sadegh Razeghinia, Sofia B Redford, Maryam Rezaei, Nazila Rezaei, Nima Rezaei, Saeid Rezaei, Hossein Rezaei Aliabadi, Mohsen Rezaeian, Mohammad Sadegh Rezai, Aziz Rezapour, Hossein Rezazadeh, Sahba Rezazadeh-Khadem, Morteza Rostamian, Ehsan Sadeghi, Erfan Sadeghi, Masoumeh Sadeghi, Reihaneh Sadeghian, Saeid Sadeghian, Hamid Safarpour, Mahdi Safdarian, Sare Safi, Maryam Sahebazzamani, Amirhossein Sahebkar, Mohammad Ali Sahraian, Sarvenaz Salahi, Payman Salamati, Hossein Samadi Kafil, Yaser Sarikhani, Maryam Sarkhosh, Arash Sarveazad, Maryam Seyed-Nezhad, Omid Shafaat, Zahra Shaghaghi, Saeed Shahabi, Sarvenaz Shahin, Elaheh Shaker, Saeed Shakiba, MohammadBagher Shamsi, Erfan Shamsoddin, Kiomars Sharafi, Sakineh Sharifian, Maryam Shaygan, Abbas Sheikhtaheri, Amir Shiani, Kiarash Shirbandi, Reza Shirkoohi, Parnian Shobeiri, Azad Shokri, Soraya Siabani, Ali Reza Sima, Ahmad Sofi-Mahmudi, Amin Soheili, Shahin Soltani, Mohammad Sadegh Soltani-Zangbar, Moslem Soofi, Seidamir Pasha Tabaeian, Mohammadreza Tabary, Alireza Tahamtan, Majid Taheri, Amir Taherkhani, Masih Tajdini, Hamed Tavolinejad, Arash Tehrani-Banihashemi, Amir Tiyuri, Seyed Abolfazl Tohidast, Alireza Vakilian, Sahel Valadan Tahbaz, Bay Vo, Seyed Hossein Yahyazadeh Jabbari, Vahid Yazdi-Feyzabadi, Zabihollah Yousefi, Taraneh Yousefinezhadi, Mazyar Zahir, Telma Zahirian Moghadam, Maryam Zamanian, Hamed Zandian, Alireza Zangeneh, Hadi Zarafshan, Fariba Zare, Ali Zare Dehnavi, Kourosh Zarea, Ahmad Zarei, Zahra Zareshahrabadi, Arash Ziapour, Sina Zoghi, Nizal Sarrafzadegan, Vafa Rahimi-Movaghar, Hamid Reza Jamshidi, Ali H Mokdad, Simon I Hay, Christopher J L Murray, Ardeshir Khosravi, Maziar Moradi-Lakeh, Mohsen Asadi-Lari, Reza Malekzadeh, and Bagher Larijani

Subjects
General Medicine
Published
2022

24. Path Analysis of Critical Thinking Effect on Self-Efficiency Among Nursing and Medical Students

Author

Omid Khosravizadeh, Bahman Ahadinezhad, Aisa Maleki, Ailar Hashtroodi, Pariya Vosoughi, and Shahrzad Kohan

Abstract

Background: Critical thinking is the ability to ask appropriate questions and gather relevant information. It enables rational judgment and problem-solving for physicians and nurses. For the first time, this study examined two major groups of caregivers at the patient's bedside in terms of the relationship between critical thinking and self-efficacy. Methods: This was a descriptive-analytical and cross-sectional study conducted in 2021. The sample was taken from Qazvin university of medical sciences’(QUM’s) nursing and medical students through stratified random method. It was performed using structural equation method (n=377). Data collection tools included: demographic information, Ricketts critical thinking questionnaire, and GSE-17 questionnaire. Finally, data were analyzed through the correlation coefficient and multiple regression tests using SPSS22 software at a significance level of 0.05. Results: Results indicated that the model established at this step demonstrates good fitness. In this model χ2 = 1919.91, df = 89, χ2 / df = 2.14, RMSEA = 0.05, NFI = 0.63, GFI = 0. 77 and CFI = 0. 76. The structural equation model's standard estimation coefficients show that all the existing paths are at a significant level (CTH: CRV 0.96, CTH: COM 0.94, CTH: SFE -0.61; P-value< 0.05). Finally, the regression analysis showed an inverse effect of critical thinking on self – efficacy. Conclusion: The study showed that critical thinking had a direct effect on self-efficacy. In addition, these two features have a significant effect on increasing the efficiency and making the right clinical decisions in medical and nursing groups. Therefore, upgrading these skills by updating curriculum will ultimately improve healthcare outcomes provided by these two specific groups.

Published
2023

25. Applying the health belief model and behavior of diabetic patients: A systematic review and meta-analysis

Author

Bahman Ahadinezhad, Zahra Najafpour, Omid Khosravizadeh, Pariya Vosoughi, and Aisa Maleki

Subjects
Gerontology, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, Scopus, Disease, Hygiene, Meta-analysis, Internal Medicine, Forest plot, Health belief model, Dimension (data warehouse), Psychology, Statistic, media_common
Abstract

The patient’s belief and knowledge about his or her illness is the most important factor of disease control; the aim of present study is to perform a systematic review-based meta-analysis of health belief and its dimension’s mean score in diabetic patients. The present systematic review and meta-analysis was conducted in 2020. Data were gathered by searching the Google Scholar, Scopus, PubMed, Web of Science, and Science Direct databases from 2010 to 2020. Key words were “health belief”, “HBM”, “diabetic patients”, “diabetes mellitus”. To estimate the pooled score of health belief and its dimensions, the randomeffects meta-analysis was performed using STATA 15. The presence of heterogeneity across the studies was assessed with the I2 statistic. A forest plot was used to report the results. The mean health belief obtained from the two methods, fixed (3.422, 95% CI: 3.128–3.716) and random (3.422, 95% CI: 3.128–3.716) what are the same, is the same. The strongest dimension is “perceived benefits” with an mean (3.8) and the weakest dimension is “perceived sensitivity” with an mean (3.0). Conclusions. Policymakers and decision makers in the field of hygiene and controlling non-communicable diseases should focus on the role of patients’ awareness of their disease and try to improve it. In the meantime, the dimension of “perceived sensitivity” needs more attention. Strategies such as holding training classes and using technological infrastructure to promote this concept should be used.

Published
2021

26. Rate and Causes of Claim Denials in Iranian Hospitals: A Systematic Review and Meta-analysis

Author

Bahman Ahadinezhad, Omid Khosravizadeh, Aisa Maleki, and Elnaz Ghanbari

Abstract

Context: One of the most important income sources of hospitals is the payment of insurance organizations, part of which is not paid as deductions in Iran. Studies have reported different values for insurance deductions, proposing various reasons. Objectives: The present study aimed to provide the published evidence of these deductions and their causes over the past 13 years. Data Sources: This systematic review and meta-analysis was conducted in 2021. Data were collected via searching in databases such as Google Scholar, Scopus, PubMed, Web of Science, SID, Magiran, and Irandoc until August 2021 using keywords such as “deduction”, “medical deduction”, “hospital”, “medical center”, and “Iran”. Data Extraction: To calculate the pooled values of hospital deductions, a random-effects meta-analysis was performed in the Stata software version 15 at 95% confidence interval. In addition, the possible heterogeneity of the studies was evaluated using the I2 statistic, and a forest plot was also used to report the results. Publication bias was assessed using a funnel plot. Results: In total, 16 articles were included in the meta-analysis. The pooled percentage of deductions (PPCD) based on random effects was 5% (95% CI: 2.88 - 7.124), and the hypothesis was rejected (PPCD = 0; Z = 31.26; P = 0.000). Based on the random-effects method, the pooled prevalence of deductions was 45.21% (95% CI: 17.601 - 72.824). Moreover, the pooled prevalence of deductions (PPVD) was considered statistically significant (PPVD = 0; Z = 251.16; P = 0.000). The variation in ES attributable to heterogeneity (I2) was estimated at 99.6%, and documentation problems were considered the most common cause of deductions (17.96%). Conclusions: According to the results, the prevalence of deductions in Iranian public hospitals is significant, and the share of deductions from the bill claimed by the hospital is manageable, albeit small.

Published
2022

27. Role of Organizational Silence in the Professional Performance of Frontline Staff in the Hospital Structure: A Path Analysis

Author

Omid Khosravizadeh, Bahman Ahadinezhad, Saeed Shahsavari, Maryam Ghiasvand, and Milad Mehri

Abstract

Background: Performance is the primary concern of every organizational manager, and achieving higher performance is a significant goal of every organization. Organizational silence may adversely affect organizational performance. Healthcare centers should pay special attention to this issue due to their different job descriptions and environments compared to other sectors. Objectives: The present study aimed to investigate the effect of organizational silence and its dimensions on the professional performance of health workers in the medical centers in Qazvin province, Iran in 2020. Methods: This was a descriptive-analytical study in terms of objective and a cross-sectional study in terms of design. The study was conducted in the medical centers affiliated to Qazvin University of Medical Sciences. In total, 365 questionnaires were distributed to select a sample of the healthcare workers from the selected centers in proportion to the total number of the staff. Data analysis was performed in SPSS version 22 using path analysis at the significance level of 0.05. Results: A significant, inverse (negative) correlation was observed between organizational silence and the professional performance of the staff (P < 0.05). Among various dimensions of organizational silence, the highest and lowest mean scores belonged to acquiescent silence (15.633 ± 4.291) and altruistic silence (12.180 ± 3.719), respectively. As for the dimensions of professional performance, the highest and lowest mean scores belonged to evaluation (29.675 ± 6.071) and help (15.087 ± 3.206), respectively. Conclusions: Based on the findings, it is recommended that the organizational atmosphere of the medical centers be improved so that the healthcare workers could provide feedback without concerns of being criticized by colleagues and superiors and the fear of consequences.

Published
2022

28. Socioeconomic Inequalities in Cancer Incidence: A Comparative Investigation Based on Population of Iranian Provinces

Author

Bahman Ahadinezhad, Aisa Maleki, Mohammad Amerzadeh, Bahareh Mohtashamzadeh, and Omid Khosravizadeh

Abstract

Background: Cancer is the second important cause of death worldwide. Cancer is one of the top health priorities in Iran. We aimed to study the socio-economic inequality of cancer incidence in Iran provinces. Methods: We conducted this cross-sectional study using provincial data. We obtained the required data from the statistical yearbook report, the Statistics Center Report and the National Cancer Registration Program Report of Iran’s Ministry of Health and Medical Education (MoHME) for 2018. Socio-economic inequality of cancer incidence was analyzed by estimating the concentration index and extracting the concentration curve. Statistical analyzes were performed using STATA 14. Results: Our findings revealed that cancer incidence was unequally distributed in terms of the socio-economic status in Iranian provinces. Cancer incidence is slightly concentrated in the provinces with higher than average literacy, per capita income and insurance coverage and household size below average. The concentration of cancer incidence has been to the detriment of the provinces that have a slightly better ranking in terms of the socio-economic index. The employment rate did not significantly affect cancer's distribution burden.Conclusion: We recommend policymakers facilitate early cancer detection by providing insurance coverage for screening services, payment exemptions, and public awareness.

Published
2022

29. Healthcare services utilization in Iran: a systematic review and meta-analysis

Author

Bahman Ahadinezhad, Omid Khosravizadeh, Sima Rafiei, and Aisa Maleki

Subjects
Health (social science), Public Administration, Sociology and Political Science, Social Psychology, Health Policy
Abstract

Purpose It can be said that the most important function of the health system is to provide health-care services. This directly affects society’s health and justice. To the best of the authors’ knowledge, this study is the first study that has meta-analyzed the percentage of health services utilization among Iranians to answer this question “How much is the percentage of health-care services utilization in Iran?” Design/methodology/approach This study is a systematic review and meta-analysis conducted in 2020. The literature review was done by searching the databases of Google Scholar, Scopus, PubMed, Web of Science, Science Direct, SID, Magiran and Irandoc from January 2010 to August 2020. Pooled utilization percentage (UP) was estimated by STATA 15 through random-effects meta-analysis with 95% confidence interval. The I2 statistic was used to investigate the possibility of heterogeneity of articles (I2 ≥ 50% indicate heterogeneity). A forest plot was applied to report the results. A funnel plot exploited due to publication bias assessment. Findings Approximately 22% of the reviewed articles have been done at the national level of Iran. Most studies have examined the utilization of outpatient and inpatient services. Based on the random effects method, the pooled value of UP was obtained at 47.82%, (95% CI: 39.33–56.31). Also, the pooled percentage of utilization was statistically significant (Test of UP = 0, Z = 456.44, p = 0.000). Practical implications Policymakers can improve the level of utilization from health services by expanding universal coverage, expanding insurance coverage and removing direct and indirect barriers. Originality/value To the best of the authors’ knowledge, this is the first systematic review and meta-analysis on health services utilization in Iran that completely considers the utilization rate in all health services and states the practical solutions to cope with utilization deficiencies and barriers.

Published
2022

30. The branding process for healthcare centers: Operational strategies from consumer’s identification to market development

Author

Bahman Ahadinezhad, Najmeh Baghian, Saeed Shahsavari, Soudabeh Vatankhah, Omid Khosravizadeh, and Mozhgan Sadat Ghaemmohamadi

Subjects
Data collection, Leadership and Management, business.industry, Process (engineering), Health Policy, media_common.quotation_subject, Structural equation modeling, Identification (information), Consolidation (business), Health care, Quality (business), Business, Marketing, Target market, media_common
Abstract

Medicalcentersneedbrandingapproachtoimprovetheirpositioninpatients’minds.Thisstudy wascarriedoutusingmixedmethod.Theparticipantsincludedmainexperts,hospitalmanagers and headquarters of the Ministry of Health. The data collection tool was a semi-structured interview and a researcher-made questionnaire. Branding process was conceptualized in 5steps, including Market Identification, Brand Identity, Brand Positioning, Development and Consolidation Strategy. All path coefficients were defined in the range. The results of the indices showed that the fit was good and the final model was valid. The activities of Medical centers should be based on the identification of the target market. Unique services with new knowledge and equipment and experienced clinical staff to meet patients’ needs with appropriate price and quality have to be provided.

Published
2020

31. Eliciting preference for private health services among patients in Iran: evidence from a discrete choice experiment

Author

Fahimeh Ansari, Sima Rafiei, Edris Kakemam, Mohammad Amerzadeh, and Bahman Ahadinezhad

Subjects
Health (social science), Public Administration, Sociology and Political Science, Social Psychology, Health Policy
Abstract

Purpose The provision of private health-care services by public hospitals is common in Iran. Examining factors associated with patients’ preferences to use private health services and using this knowledge in health planning and policymaking can help expand the use of such services. Thus, this study aims to investigate patients’ preferences for private health services delivered in public hospitals. Design/methodology/approach Based on a discrete choice experiment from a sample of 375 patients in a public training hospital in Qazvin, northwest city of Iran, the authors evaluated participants’ preference over the health-care attributes affecting their choice to use private health-care services delivered in the hospital. The authors also estimated the marginal willingness to pay to determine the maximum amount a patient was willing to pay for the improvement in the level of each health-care attributes. Findings The findings revealed that patients were 2.7 times more likely to choose private hospital services when the waiting time was reduced to less than a week. Furthermore, as patients had complimentary insurance coverage, they were over 60% more likely to receive such services from training hospitals. Finally, continuity of care and reduced health-care tariffs were significant factors that increased patients’ preference to choose private services by 52 and 37%, respectively. Originality/value Examining factors associated with patients’ preferences to use private health services and using this knowledge in policymaking can help expand such services. The findings affirmed that various incentives, including service quality factors, are required to increase the likelihood of patients choosing private services.

Published
2022

32. Global, regional, and national burden of hepatitis B, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author

Brittney S Sheena, Lindsey Hiebert, Hannah Han, Helen Ippolito, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Hedayat Abbastabar, Amir Abdoli, Hiwa Abubaker Ali, Mesafint Molla Adane, Oyelola A Adegboye, Qorinah Estiningtyas Sakilah Adnani, Shailesh M Advani, Muhammad Sohail Afzal, Saira Afzal, Mohamad Aghaie Meybodi, Bahman Ahadinezhad, Bright Opoku Ahinkorah, Sajjad Ahmad, Tauseef Ahmad, Sepideh Ahmadi, Haroon Ahmed, Muktar Beshir Ahmed, Tarik Ahmed Rashid, Gizachew Taddesse Akalu, Addis Aklilu, Tayyaba Akram, Hanadi Al Hamad, Fares Alahdab, Adugnaw Zeleke Alem, Dejene Tsegaye Alem, Fadwa Alhalaiqa Naji Alhalaiqa, Robert Kaba Alhassan, Liaqat Ali, Muhammad Ashar Ali, Yousef Alimohamadi, Vahid Alipour, Motasem Alkhayyat, Sami Almustanyir, Rajaa M Al-Raddadi, Haya Altawalah, Saeed Amini, Hubert Amu, Robert Ancuceanu, Catalina Liliana Andrei, Tudorel Andrei, Amir Anoushiravani, Adnan Ansar, Anayochukwu Edward Anyasodor, Jalal Arabloo, Morteza Arab-Zozani, Ayele Mamo Argaw, Zeleke Gebru Argaw, Muhammad Arshad, Anton A Artamonov, Tahira Ashraf, Daniel Atlaw, Floriane Ausloos, Marcel Ausloos, Sina Azadnajafabad, Mohammadreza Azangou-Khyavy, Amirhossein Azari Jafari, Ghasem Azarian, Sayna Bagheri, Saeed Bahadory, Atif Amin Baig, Maciej Banach, Nastaran Barati, Amadou Barrow, Abdul-Monim Mohammad Batiha, Diana Fernanda Bejarano Ramirez, Uzma Iqbal Belgaumi, Alemshet Yirga Berhie, Devidas S Bhagat, Nikha Bhardwaj, Pankaj Bhardwaj, Krittika Bhattacharyya, Vijayalakshmi S Bhojaraja, Ali Bijani, Antonio Biondi, Belay Boda Abule Bodicha, Hunduma Amensisa Bojia, Archith Boloor, Cristina Bosetti, Dejana Braithwaite, Nikolay Ivanovich Briko, Zahid A Butt, Luis Alberto Cámera, Raja Chandra Chakinala, Promit Ananyo Chakraborty, Jaykaran Charan, Shu Chen, Jee-Young Jasmine Choi, Sonali Gajanan Choudhari, Fazle Rabbi Chowdhury, Dinh-Toi Chu, Sheng-Chia Chung, Paolo Angelo Cortesi, Benjamin C Cowie, Garland T Culbreth, Omid Dadras, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Fernando Pio De la Hoz, Sisay Abebe Debela, Mohammed Gebre Dedefo, Feleke Mekonnen Demeke, Takele Gezahegn G Demie, Getu Debalkie Demissie, Meseret Derbew Molla, Abebaw Alemayehu Desta, Deepak Dhamnetiya, Mandira Lamichhane Dhimal, Meghnath Dhimal, Mojtaba Didehdar, Linh Phuong Doan, Fariba Dorostkar, Thomas M Drake, Fatemeh Eghbalian, Michael Ekholuenetale, Iman El Sayed, Maysaa El Sayed Zaki, Muhammed Elhadi, Mohamed A Elmonem, Aisha Elsharkawy, Shymaa Enany, Daniel Berhanie Enyew, Ryenchindorj Erkhembayar, Sharareh Eskandarieh, Firooz Esmaeilzadeh, Sayeh Ezzikouri, Hossein Farrokhpour, Getahun Fetensa, Florian Fischer, Masoud Foroutan, Mohamed M Gad, Abhay Motiramji Gaidhane, Shilpa Gaidhane, Natalie C Galles, Silvano Gallus, Teferi Gebru Gebremeskel, Eyob Alemayehu Gebreyohannes, Keyghobad Ghadiri, Kazem Ghaffari, Mansour Ghafourifard, Seyyed-Hadi Ghamari, Ahmad Ghashghaee, Ali Gholami, Abdolmajid Gholizadeh, Aima Gilani, Amit Goel, Mahaveer Golechha, Pouya Goleij, Davide Golinelli, Giuseppe Gorini, Yitayal Ayalew Goshu, Max G Griswold, Mohammed Ibrahim Mohialdeen Gubari, Bhawna Gupta, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Rasool Haddadi, Rabih Halwani, Saeed S Hamid, Samer Hamidi, Asif Hanif, Shafiul Haque, Harapan Harapan, Arief Hargono, Sanam Hariri, Ahmed I Hasaballah, S M Mahmudul Hasan, Soheil Hassanipour, Hadi Hassankhani, Simon I Hay, Khezar Hayat, Golnaz Heidari, Claudiu Herteliu, Demisu Zenbaba Heyi, Kamal Hezam, Ramesh Holla, Mohammad-Salar Hosseini, Mostafa Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Mowafa Househ, Junjie Huang, Nawfal R Hussein, Ivo Iavicoli, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Lalu Muhammad Irham, Jessica Y Islam, Nahlah Elkudssiah Ismail, Kathryn H Jacobsen, Farhad Jadidi-Niaragh, Amirreza Javadi Mamaghani, Shubha Jayaram, Ranil Jayawardena, Rime Jebai, Ravi Prakash Jha, Nitin Joseph, Farahnaz Joukar, Billingsley Kaambwa, Ali Kabir, Zubair Kabir, Rohollah Kalhor, 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Subjects
Liver Cirrhosis, Hepatology, Seroepidemiologic Studies, 3121 General medicine, internal medicine and other clinical medicine, Liver Neoplasms, Gastroenterology, Humans, Bayes Theorem, HBV, Global burden of diseases, HCC, Cirrhosis, Child, Hepatitis B, Global Burden of Disease
Abstract

Publisher Copyright: © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Combating viral hepatitis is part of the UN Sustainable Development Goals (SDGs), and WHO has put forth hepatitis B elimination targets in its Global Health Sector Strategy on Viral Hepatitis (WHO-GHSS) and Interim Guidance for Country Validation of Viral Hepatitis Elimination (WHO Interim Guidance). We estimated the global, regional, and national prevalence of hepatitis B virus (HBV), as well as mortality and disability-adjusted life-years (DALYs) due to HBV, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. This included estimates for 194 WHO member states, for which we compared our estimates to WHO elimination targets. Methods: The primary data sources were population-based serosurveys, claims and hospital discharges, cancer registries, vital registration systems, and published case series. We estimated chronic HBV infection and the burden of HBV-related diseases, defined as an aggregate of cirrhosis due to hepatitis B, liver cancer due to hepatitis B, and acute hepatitis B. We used DisMod-MR 2.1, a Bayesian mixed-effects meta-regression tool, to estimate the prevalence of chronic HBV infection, cirrhosis, and aetiological proportions of cirrhosis. We used mortality-to-incidence ratios modelled with spatiotemporal Gaussian process regression to estimate the incidence of liver cancer. We used the Cause of Death Ensemble modelling (CODEm) model, a tool that selects models and covariates on the basis of out-of-sample performance, to estimate mortality due to cirrhosis, liver cancer, and acute hepatitis B. Findings: In 2019, the estimated global, all-age prevalence of chronic HBV infection was 4·1% (95% uncertainty interval [UI] 3·7 to 4·5), corresponding to 316 million (284 to 351) infected people. There was a 31·3% (29·0 to 33·9) decline in all-age prevalence between 1990 and 2019, with a more marked decline of 76·8% (76·2 to 77·5) in prevalence in children younger than 5 years. HBV-related diseases resulted in 555 000 global deaths (487 000 to 630 000) in 2019. The number of HBV-related deaths increased between 1990 and 2019 (by 5·9% [–5·6 to 19·2]) and between 2015 and 2019 (by 2·9% [–5·9 to 11·3]). By contrast, all-age and age-standardised death rates due to HBV-related diseases decreased during these periods. We compared estimates for 2019 in 194 WHO locations to WHO-GHSS 2020 targets, and found that four countries achieved a 10% reduction in deaths, 15 countries achieved a 30% reduction in new cases, and 147 countries achieved a 1% prevalence in children younger than 5 years. As of 2019, 68 of 194 countries had already achieved the 2030 target proposed in WHO Interim Guidance of an all-age HBV-related death rate of four per 100 000. Interpretation: The prevalence of chronic HBV infection declined over time, particularly in children younger than 5 years, since the introduction of hepatitis B vaccination. HBV-related death rates also decreased, but HBV-related death counts increased as a result of population growth, ageing, and cohort effects. By 2019, many countries had met the interim seroprevalence target for children younger than 5 years, but few countries had met the WHO-GHSS interim targets for deaths and new cases. Progress according to all indicators must be accelerated to meet 2030 targets, and there are marked disparities in burden and progress across the world. HBV interventions, such as vaccination, testing, and treatment, must be strategically supported and scaled up to achieve elimination. Funding: Bill & Melinda Gates Foundation.

Published
2022

33. The global burden of adolescent and young adult cancer in 2019: a systematic analysis for the Global Burden of Disease Study 2019

Author

Elysia M Alvarez, Lisa M Force, Rixing Xu, Kelly Compton, Dan Lu, Hannah Jacqueline Henrikson, Jonathan M Kocarnik, James D Harvey, Alyssa Pennini, Frances E Dean, Weijia Fu, Martina T Vargas, Theresa H M Keegan, Hany Ariffin, Ronald D Barr, Yana Arturovna Erdomaeva, D Sanjeeva Gunasekera, Yetunde O John-Akinola, Tyler G Ketterl, Tezer Kutluk, Marcio Henrique Malogolowkin, Prashant Mathur, Venkatraman Radhakrishnan, Lynn Ann Gloeckler Ries, Carlos Rodriguez-Galindo, Garik Barisovich Sagoyan, Iyad Sultan, Behzad Abbasi, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Hedayat Abbastabar, Michael Abdelmasseh, Sherief Abd-Elsalam, Amir Abdoli, Haimanot Abebe, Aidin Abedi, Hassan Abidi, Hassan Abolhassani, Hiwa Abubaker Ali, Eman Abu-Gharbieh, Basavaprabhu Achappa, Juan Manuel Acuna, Isaac Akinkunmi Adedeji, Oyelola A Adegboye, Qorinah Estiningtyas Sakilah Adnani, Shailesh M Advani, Muhammad Sohail Afzal, Mohamad Aghaie Meybodi, Bahman Ahadinezhad, Bright Opoku Ahinkorah, Sajjad Ahmad, Sepideh Ahmadi, Muktar Beshir Ahmed, Tarik Ahmed Rashid, Yusra Ahmed Salih, Wajeeha Aiman, Gizachew Taddesse Akalu, Hanadi Al Hamad, Fares Alahdab, Abdulhadi A AlAmodi, Fahad Mashhour Alanezi, Turki M Alanzi, Adugnaw Zeleke Alem, Dejene Tsegaye Alem, Yosef Alemayehu, Fadwa Naji Alhalaiqa, Robert Kaba Alhassan, Saqib Ali, Gianfranco Alicandro, Vahid Alipour, Syed Mohamed Aljunid, Motasem Alkhayyat, Sunitha Alluri, Nihad A Almasri, Sadeq Ali Al-Maweri, Sami Almustanyir, Rajaa M Al-Raddadi, Nelson Alvis-Guzman, Edward Kwabena Ameyaw, Saeed Amini, Hubert Amu, Robert Ancuceanu, Catalina Liliana Andrei, Tudorel Andrei, Fereshteh Ansari, Alireza Ansari-Moghaddam, Davood Anvari, Anayochukwu Edward Anyasodor, Jalal Arabloo, Morteza Arab-Zozani, Ayele Mamo Argaw, Muhammad Arshad, Judie Arulappan, Armin Aryannejad, Zatollah Asemi, Mohammad Asghari Jafarabadi, Mohammad Reza Atashzar, Prince Atorkey, Alok Atreya, Sameh Attia, Avinash Aujayeb, Marcel Ausloos, Leticia Avila-Burgos, Atalel Fentahun 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R.A., Rafiee A., Rafiei A., Rafiei S., Rahim F., Rahimzadeh S., Rahman M., Rahman M.A., Rahmani A.M., Rajesh A., Ramezani-Doroh V., Ranabhat K., Ranasinghe P., Rao C.R., Rao S.J., Rashedi S., Rashidi M., Rashidi M.-M., Rath G.K., Rawaf D.L., Rawaf S., Rawal L., Rawassizadeh R., Razeghinia M.S., Regasa M.T., Renzaho A.M.N., Rezaei M., Rezaei N., Rezaeian M., Rezapour A., Rezazadeh-Khadem S., Riad A., Rios Lopez L.E., Rodriguez J.A.B., Ronfani L., Roshandel G., Rwegerera G.M., Saber-Ayad M.M., Sabour S., Saddik B., Sadeghi E., Sadeghian S., Saeed U., Sahebkar A., Saif-Ur-Rahman K.M., Sajadi S.M., Salahi S., Salehi S., Salem M.R., Salimzadeh H., Samy A.M., Sanabria J., Sanmarchi F., Sarveazad A., Sathian B., Sawhney M., Sawyer S.M., Saylan M., Schneider I.J.C., Seidu A.-A., Sekerija M., Sendo E.G., Sepanlou S.G., Seylani A., Seyoum K., Sha F., Shafaat O., Shaikh M.A., Shamsoddin E., Shannawaz M., Sharma R., Sheikhbahaei S., Shetty A., Shetty B.S.K., Shetty P.H., Shin J.I., Shirkoohi R., Shivakumar K.M., Shobeiri P., Siabani S., Sibhat M.M., Siddappa Malleshappa S.K., Sidemo N.B., Silva D.A.S., Silva Julian G., Singh A.D., Singh J.A., Singh J.K., Singh S., Sinke A.H., Sintayehu Y., Skryabin V.Y., Skryabina A.A., Smith L., Sofi-Mahmudi A., Soltani-Zangbar M.S., Song S., Spurlock E.E., Steiropoulos P., Straif K., Subedi R., Sufiyan M.B., Suliankatchi Abdulkader R., Sultana S., Szerencses V., Szocska M., Tabaeian S.P., Tabares-Seisdedos R., Tabary M., Tabuchi T., Tadbiri H., Taheri M., Taherkhani A., Takahashi K., Tampa M., Tan K.-K., Tat V.Y., Tavakoli A., Tbakhi A., Tehrani-Banihashemi A., Temsah M.-H., Tesfay F.H., Tesfaye B., Thakur J.S., Thapar R., Thavamani A., Thiyagarajan A., Thomas N., Tobe-Gai R., Togtmol M., Tohidast S.A., Tohidinik H.R., Tolani M.A., Tollosa D.N., Touvier M., Tovani-Palone M.R., Traini E., Tran B.X., Tran M.T.N., Tripathy J.P., Tusa B.S., Ukke G.G., Ullah I., Ullah S., Umapathi K.K., Unnikrishnan B., Upadhyay E., Ushula T.W., Vacante M., Valadan Tahbaz S., Varthya S.B., Veroux M., Villeneuve P.J., Violante F.S., Vlassov V., Vu G.T., Waheed Y., Wang N., Ward P., Weldesenbet A.B., Wen Y.F., Westerman R., Winkler A.S., Wubishet B.L., Xu S., Yahyazadeh Jabbari S.H., Yang L., Yaya S., Yazdi-Feyzabadi V., Yazie T.S., Yehualashet S.S., Yeshaneh A., Yeshaw Y., Yirdaw B.W., Yonemoto N., Younis M.Z., Yousefi Z., Yu C., Yunusa I., Zadnik V., Zahir M., Zahirian Moghadam T., Zamani M., Zamanian M., Zandian H., Zare F., Zastrozhin M.S., Zastrozhina A., Zhang J., Zhang Z.-J., Ziapour A., Zoladl M., Murray C.J.L., Fitzmaurice C., Bleyer A., Bhakta N., Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), HUS Comprehensive Cancer Center, University of Helsinki, Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities, St. Baldrick's Foundation, NIH - National Cancer Institute (NCI) (Estados Unidos), Epidemiologie, and RS: NUTRIM - R3 - Respiratory & Age-related Health

Subjects
adolescent cancer, global burden of disease, epidemiology, Adult, Male, Adolescent, 3122 Cancers, UNITED-STATES, Disability-Adjusted Life Year, Adolescents, Socioeconomic Factor, Global Health, Global Burden of Disease, Young Adult, Life Expectancy, SDG 3 - Good Health and Well-being, Risk Factors, WORLDWIDE, Neoplasms, Cause of Death, Prevalence, Humans, 1112 Oncology and Carcinogenesis, Oncology & Carcinogenesis, Mortality, Cancer burden analyses, Cancer, ACUTE LYMPHOBLASTIC-LEUKEMIA, disease, Global burden, OUTCOMES, CHILDHOOD-CANCER, Incidence, Risk Factor, the GBD 2019 methodology, Disability-Adjusted Life Years, GBD 2019 Adolescent Young Adult Cancer Collaborators, CARE, Cancer control efforts, Socioeconomic Factors, Oncology, Neoplasm, Female, Young adults, Human
Abstract

Funding: J A Loureiro acknowledges support from Base Funding UIDB/00511/2020 of the LEPABE funded by national funds through the FCT/MCTES (PIDDAC) and Scientific Employment Stimulus (FCT) [CEECINST/00049/2018]. Background: In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15–39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods: Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15–39 years to define adolescents and young adults. Findings: There were 1·19 million (95% UI 1·11–1·28) incident cancer cases and 396 000 (370 000–425 000) deaths due to cancer among people aged 15–39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59·6 [54·5–65·7] per 100 000 person-years) and high-middle SDI countries (53·2 [48·8–57·9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14·2 [12·9–15·6] per 100 000 person-years) and middle SDI (13·6 [12·6–14·8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23·5 million (21·9–25·2) DALYs to the global burden of disease, of which 2·7% (1·9–3·6) came from YLDs and 97·3% (96·4–98·1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation: Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Funding: Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities, St Baldrick's Foundation, and the National Cancer Institute. publishersversion published

Published
2022

34. Social distance capacity to control the COVID-19 pandemic: A systematic review on time series analysis

Author

Omid Khosravizadeh, Aisa Maleki, Bahman Ahadinezhad, Zahra Najafpour, and Rohollah Golmohammadi

Subjects
Time Factors, business.industry, SARS-CoV-2, Health Policy, Social distance, Control (management), Physical Distancing, Public Health, Environmental and Occupational Health, Scopus, COVID-19, General Medicine, Interpersonal communication, Public relations, Incentive, Order (exchange), Pandemic, Humans, Sociology, business, Pandemics, Incidence (geometry)
Abstract

BACKGROUND: Reducing interpersonal contact has been one of the least expensive and most widely used COVID-19 control strategies. OBJECTIVE: This systematic review has been conducted with the aim of identifying social distancing strategies and policies and their impact on the COVID-19 pandemic. METHODS: In order to compile this systematic review, Google Scholar, PubMed, Scopus, Web of Science, Science Direct, Magiran, SID, and Irandoc databases were searched from the COVID-19 outbreak until March 2021. Keywords included “social”, “physical”, “distance”, “outbreak”, “incidence”, “prevalence”, “spread”, “new case”, “death*”, “mortality*”, “morbidity*” , “covid-19”, “coronavirus”, “sars-cov-2” and “time series*”. The articles were qualitatively evaluated by two researchers using the STROBE tool. Finally, the study data were divided into three conceptual categories by three researchers, who then agreed on one category. The practical suggestions were also categorized in the same way. RESULTS: The policies and strategies adopted to implement social distancing were included in five categories of restrictions, prohibitions, closures, incentives, and punishments. Transportation and travel restrictions, crowded places and schools closure, use of telecommunications and virtual communications, and financial and psychological support to society members were the main policies in this area. CONCLUSION: Rapid and complete vaccination of all people around the world is out of reach, therefore social distancing and the implementation of physical restraints, especially in crowded and densely populated environments, should be done extensively until COVID-19 is eradicated.

Published
2021

35. Equity in Out-of-Pocket Payments for Healthcare Service Delivery in Urban and Rural Households: Evidence from Iran

Author

Omid Khosravizadeh, Zahra Nejatifar, Milad Mehri, Ahad Alizadeh, and Bahman Ahadinezhad

Subjects
Decile, Index (economics), business.industry, Sample size determination, media_common.quotation_subject, Health care, Equity (finance), Distribution (economics), Healthcare service, Socioeconomics, business, Payment, media_common
Abstract

Background: Out-of-pocket payments for medical services may undermine access to medical services and equity in healthcare financing. Objectives: The present study aimed to determine the distribution of the burden of out-of-pocket payments for healthcare services among the households in Qazvin province, Iran. Methods: This descriptive-analytical study was conducted on the urban and rural households in Qazvin province, Iran during 2019 - 2020. Data were obtained from the Statistics Center of Iran (2019 - 2020). The optimal sample size was calculated to be 992 households, and the households were selected via three-stage random cluster sampling. Data were collected using a valid questionnaire and via face-to-face interviews with the household owners. The fair financial contribution index (FFCI), concentration index, and Kakwani index were estimated in the Stata software. Results: The estimated parameters indicated that during the study period (March 21, 2019-March 20, 2020), the FFCI value of the rural and urban households was 0.782 and 0.854, respectively. The out-of-pocket payment concentration index based on income rank was estimated at 0.188 in rural households (P < 0.05) and 0.031 in the urban households. In addition, the Kakwani index of the urban and rural households was calculated to be -0.165 and -0.84, respectively. Conclusions: According to the results, out-of-pocket payments were unequally distributed among the households in Qazvin province in 2019 - 2020. These payments were mostly concentrated on the 5th - 7th deciles of urban households. On the other hand, the out-of-pocket payments during the study period were regressive. To promote financial equity, Qazvin health policymakers must run payment exemptions for low-income groups and also expand the medical insurance coverage and universal coverage of healthcare services.

Published
2021

36. Implicit racial bias among medical graduates and students by an IAT measure: a systematic review and meta-analysis

Author

Omid Khosravizadeh, Bahman Ahadinezhad, Ailar Hashtroodi, and Aisa Maleki

Subjects
Students, Medical, business.industry, Attitude of Health Personnel, education, Clinical Decision-Making, MEDLINE, Scopus, Implicit-association test, General Medicine, Racism, Meta-analysis, Physicians, Medicine, Humans, Racial bias, Implicit attitude, Implicit bias, business, Statistic, Clinical psychology
Abstract

Racial implicit bias is an unconscious response and behavior that affects interpersonal interactions and clinical decision-making. We attempted to meta-analyze the scores of implicit association test (IAT) to estimate pooled quantity of implicit racial bias among medical graduates and students As far as we know, our study is the first systematic-based meta-analysis estimating the pooled score of implicit racial bias among physicians and medical students. Keywords were searched in Scopus, Web of Science, Google Scholar, PubMed, Science Direct, Cochrane, MEDLINE, Wiley online library, and ProQuest databases from 2011 since 2021. The IAT’s pooled score estimates through a fixed-effect meta-analysis using STATA 15. Also, I2 statistic was used to determine heterogeneity across the articles. Out of 1177 articles, 29 studies entered to analysis. The pooled score of IAT among physicians and medical students was 0.28 (95% CI 0.13 to 0.43) and 0.35 (95% CI 0.03 to 0.67), respectively. The racial bias score of physician ranged from −0.12 to 0.62. While score of implicit association test for medical student ranged from −0.01 to 1.29. Our meta-analysis revealed that there was an implicit anti-black attitude among physicians and medical students, but the size of this implicit racial bias was small. Although the level of racial bias in physicians and medical students was low, it could be reduced to the lowest level through informative programs and training in ways to control implicit attitudes.

Published
2021

37. Developing decision model for the outsourcing of medical service delivery in the public hospitals

Author

Omid Khosravizadeh, Aisa Maleki, Bahman Ahadinezhad, Saeed Shahsavari, Mohammad Amerzadeh, and Nasibeh Mansouran Tazekand

Subjects
Hospital, Cross-Sectional Studies, Hospitals, Public, Health Policy, Surveys and Questionnaires, Research, Medical service, Decision model, Humans, Outsourced Services, Public aspects of medicine, RA1-1270, Outsourcing
Abstract

Background The decision to outsource an activity is one of the most complex organizational decisions. This decision is also influenced by several factors and components. In order to facilitate and optimize it, for the first time in this study, a decision model for outsourcing medical service delivery in public hospitals has been developed. Methods We conducted this cross-sectional study in 3 stages: 1) We identified the factors affecting the outsourcing decisions, 2) an expert panel identified the influential factors. After standardization, we distributed 220 questionnaires among university staff managers and heads, nursing managers, and managers of the research units, and 3) Structural Equation Model applied to evaluate the relationship between the variables on AMOS22, at 0.05 significant level. Results Findings indicated the optimal level of all fit indices. The path coefficient between all identified factors with the outsourcing decision was positive (t > 1.96). Factors ranging from the most effective to least effective included monitoring and control, service type, human resource, economic and financial, executive capability, external environment, and terms and conditions. Conclusion The proposed model provides unit evaluation to make the appropriate decision on outsourcing or non-outsourcing. Control and monitoring were the most determining factors. We recommend performing monitoring continuously as a guide and deterrent to error. We also recommend continuous monitoring and control over the quality of outsourced units and stakeholder satisfaction.

Published
2021

38. Injury burden in individuals aged 50 years or older in the Eastern Mediterranean region, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019

Author

Samar Al-Hajj, Sarah H Farran, Abla Mehio Sibai, Randah R Hamadeh, Vafa Rahimi-Movaghar, Rajaa M Al-Raddadi, Farideh Sadeghian, Zahra Ghodsi, Wael Alhajyaseen, Niveen ME Abu-Rmeileh, Behzad Abbasi, Mohsen Abbasi-Kangevari, Amir Abdoli, Salam Abdulqadir Abdulrahman, Hiwa Abubaker Ali, Eman Abu-Gharbieh, Muhammad Sohail Afzal, Bahman Ahadinezhad, Sajjad Ahmad, Ali Ahmadi, Ali Ahmed, Haroon Ahmed, Tarik Ahmed Rashid, Marjan Ajami, Hanadi Al Hamad, Fahad Mashhour Alanezi, Turki M Alanzi, Suliman A Alghnam, Fadwa Naji Alhalaiqa, Beriwan Abdulqadir Ali, Liaqat Ali, Yousef Alimohamadi, Cyrus Alinia, Syed Mohamed Aljunid, Sami Almustanyir, Tarek Tawfik Amin, Saeed Amini, Sohrab Amiri, Mohammad Hosein Amirzade-Iranaq, Ali Arash Anoushirvani, Alireza Ansari-Moghaddam, Davood Anvari, Muhammad Aqeel, Jalal Arabloo, Morteza Arab-Zozani, Judie Arulappan, Armin Aryannejad, Saeed Asgary, Mohammad Asghari-Jafarabadi, Tahira Ashraf, Seyyed Shamsadin Athari, Maha Moh'd Wahbi Atout, Zahra Azadmanjir, Sina Azadnajafabad, Mohammadreza Azangou-Khyavy, Amirhossein Azari Jafari, Ahmed Y Y Azzam, Sara Bagherieh, Mohammad Hossein Bakhshaei, Abdul-Monim Mohammad Batiha, Neeraj Bedi, Akshaya Srikanth Bhagavathula, Zulfiqar A Bhutta, Sadia Bibi, Ali Bijani, Nadeem Shafique Butt, Zahra Chegini, Omar B Da'ar, Saad M A Dahlawi, Sajad Delavari, Mostafa Dianatinasab, Mojtaba Didehdar, Shirin Djalalinia, Saeid Doaei, Milad Dodangeh, Fatemeh Eghbalian, Elham Ehsani-Chimeh, Iman El Sayed, Maysaa El Sayed Zaki, Hala Rashad Elhabashy, Muhammed Elhadi, Sharareh Eskandarieh, Azin Etemadimanesh, Mohamad Ezati Asar, Shahab Falahi, Farshad Farzadfar, Ali Fatehizadeh, Hamed Fattahi, Masoud Foroutan, Mansour Ghafourifard, Seyyed-Hadi Ghamari, Reza Ghanbari, Reza Ghanei Gheshlagh, Ahmad Ghashghaee, Maryam Gholamalizadeh, Alireza Ghorbani, Syed Amir Gilani, Kimiya Gohari, Pouya Goleij, Michal Grivna, Mohammed Ibrahim Mohialdeen Gubari, Rasool Haddadi, Nima Hafezi-Nejad, Arvin Haj-Mirzaian, Rabih Halwani, Sajid Hameed, Asif Hanif, Ahmed I Hasaballah, Amr Hassan, Hossein Hassanian-Moghaddam, Soheil Hassanipour, Hadi Hassankhani, Khezar Hayat, Mohammad Heidari, Mohammad-Salar Hosseini, Mostafa Hosseini, Mehdi Hosseinzadeh, Mowafa Househ, Soodabeh Hoveidamanesh, Huda Abu-Saad Huijer, Behzad Imani, Seyed Sina Naghibi Irvani, Roxana Jabbarinejad, Mohammad Ali Jahani, Mahsa Jalili, Amirreza Javadi Mamaghani, Seyed Ali Jeddi, Farahnaz Joukar, Ali Kabir, Laleh R Kalankesh, Leila R Kalankesh, Rohollah Kalhor, Aziz Kamran, Leila Keikavoosi-Arani, Mohammad Keykhaei, Yousef Saleh Khader, Rovshan Khalilov, Mohammad Khammarnia, Ejaz Ahmad Khan, Maseer Khan, Moien AB Khan, Javad Khanali, Hamid Reza Khayat Kashani, Omid Khosravizadeh, Ali-Asghar Kolahi, Hamid Reza Koohestani, Sogol Koolaji, Faris Hasan Lami, Savita Lasrado, Farzan Madadizadeh, Muhammed Magdy Abd El Razek, Mahdi Mahdavi, Soleiman Mahjoub, Ata Mahmoodpoor, Razzagh Mahmoudi, Alaa Makki, Mohammad-Reza Malekpour, Reza Malekzadeh, Narges Malih, Ahmad Azam Malik, Fariborz Mansour-Ghanaei, Borhan Mansouri, Mohammad Ali Mansournia, Seyedeh Zahra Masoumi, Entezar Mehrabi Nasab, Ritesh G Menezes, Mohamed Kamal Mesregah, Seyyedmohammadsadeq Mirmoeeni, Mohammad Mirza-Aghazadeh-Attari, Esmaeil Mohammadi, Heidar Mohammadi, Mokhtar Mohammadi, Seyyede Momeneh Mohammadi, Abdollah Mohammadian-Hafshejani, Teroj Abdulrahman Mohammed, Jalal Moludi, Sara Momtazmanesh, Maryam Moradi, Masoud Moradi, Farhad Moradpour, Rahmatollah Moradzadeh, Nazanin Mortazavi, Seyede Salehe Mortazavi, Houshang Najafi, Zhila Najafpour, Zuhair S Natto, Javad Nazari, Hasti Nouraei, Fatemeh Nouri, Hassan Okati-Aliabad, Ahmed Omar Bali, Emad Omer, Fatemeh Pashazadeh Kan, Hamidreza Pazoki Toroudi, Zahra Zahid Piracha, AliMohammad Pourbagher-Shahri, Naeimeh Pourtaheri, Mohammad Rabiee, Navid Rabiee, Saber Raeghi, Hassan Rafieemehr, Sima Rafiei, Fakher Rahim, Shahram Rahimi-Dehgolan, Amir Masoud Rahmani, Vahid Rahmanian, Kiana Ramezanzadeh, Chythra R Rao, Vahid Rashedi, Amirfarzan Rashidi, Mahsa Rashidi, Mohammad-Mahdi Rashidi, Azad Rasul, Reza Rawassizadeh, Seyed-Mansoor Rayegani, Nazila Rezaei, Negar Rezaei, Saeid Rezaei, Zahed Rezaei, Mohsen Rezaeian, Forouzan Rezapur-Shahkolai, Sahba Rezazadeh-Khadem, Mohammad Saadati, Siamak Sabour, Basema Saddik, Umar Saeed, Sahar Saeedi Moghaddam, Hamid Safarpour, Mahdi Safdarian, Amirhossein Sahebkar, Payman Salamati, Marwa Rashad Salem, Abdallah M Samy, Nima Sanadgol, Muhammad Arif Nadeem Saqib, Yaser Sarikhani, Arash Sarveazad, Brijesh Sathian, Mehdi Sayyah, Sadaf G Sepanlou, Saeed Shahabi, Masood Ali Shaikh, Elaheh Shaker, Mehran Shams-Beyranvand, Sakineh Sharifian, Mohsen Shati, Hatem Samir Shehata, Ali Sheidaei, Sara Sheikhbahaei, Rahim Ali Sheikhi, Parnian Shobeiri, Soraya Siabani, Gholam Reza Sivandzadeh, Ahmad Sofi-Mahmudi, Ahmad Sohrabi, Seidamir Pasha Tabaeian, Mohammadreza Tabary, Elnaz Tabibian, Ensiyeh Taheri, Majid Taheri, Arash Tehrani-Banihashemi, Amir Tiyuri, Seyed Abolfazl Tohidast, Saif Ullah, Parviz Vahedi, Sahel Valadan Tahbaz, Rohollah Valizadeh, Mehdi Varmaghani, Bay Vo, Yasir Waheed, Seyed Hossein Yahyazadeh Jabbari, Fereshteh Yazdanpanah, Zabihollah Yousefi, Hossein Yusefi, Telma Zahirian Moghadam, Hamed Zandian, Iman Zare, Arash Ziapour, and Ali H Mokdad

Subjects
Aged, 80 and over, Male, Health (social science), Traffic Safety, Injury prevention, Road Safety, Middle Aged, Global Burden of Disease, Older population, Psychiatry and Mental health, Life Expectancy, Socioeconomic Factors, Risk Factors, Humans, Female, Quality-Adjusted Life Years, Geriatrics and Gerontology, Family Practice, Aged
Abstract

BackgroundInjury poses a major threat to health and longevity in adults aged 50 years or older. The increased life expectancy in the Eastern Mediterranean region warrants a further understanding of the ageing population's inevitable changing health demands and challenges. We aimed to examine injury-related morbidity and mortality among adults aged 50 years or older in 22 Eastern Mediterranean countries. MethodsDrawing on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we categorised the population into adults aged 50–69 years and adults aged 70 years and older. We examined estimates for transport injuries, self-harm injuries, and unintentional injuries for both age groups, with sex differences reported, and analysed the percentage changes from 1990 to 2019. We reported injury-related mortality rates and disability-adjusted life-years (DALYs). The Socio-demographic Index (SDI) and the Healthcare Access and Quality (HAQ) Index were used to better understand the association of socioeconomic factors and health-care system performance, respectively, with injuries and health status in older people. Healthy life expectancy (HALE) was compared with injury-related deaths and DALYs and to the SDI and HAQ Index to understand the effect of injuries on healthy ageing. Finally, risk factors for injury deaths between 1990 and 2019 were assessed. 95% uncertainty intervals (UIs) are given for all estimates. FindingsEstimated injury mortality rates in the Eastern Mediterranean region exceeded the global rates in 2019, with higher injury mortality rates in males than in females for both age groups. Transport injuries were the leading cause of deaths in adults aged 50–69 years (43·0 [95% UI 31·0–51·8] per 100 000 population) and in adults aged 70 years or older (66·2 [52·5–75·5] per 100 000 population), closely followed by conflict and terrorism for both age groups (10·2 [9·3–11·3] deaths per 100 000 population for 50–69 years and 45·7 [41·5–50·3] deaths per 100 000 population for ≥70 years). The highest annual percentage change in mortality rates due to injury was observed in Afghanistan among people aged 70 years or older (400·4% increase; mortality rate 1109·7 [1017·7–1214·7] per 100 000 population). The leading cause of DALYs was transport injuries for people aged 50–69 years (1798·8 [1394·1–2116·0] per 100 000 population) and unintentional injuries for those aged 70 years or older (2013·2 [1682·2–2408·7] per 100 000 population). The estimates for HALE at 50 years and at 70 years in the Eastern Mediterranean region were lower than global estimates. Eastern Mediterranean countries with the lowest SDIs and HAQ Index values had high prevalence of injury DALYs and ranked the lowest for HALE at 50 years of age and HALE at 70 years. The leading injury mortality risk factors were occupational exposure in people aged 50–69 years and low bone mineral density in those aged 70 years or older. InterpretationInjuries still pose a real threat to people aged 50 years or older living in the Eastern Mediterranean region, mainly due to transport and violence-related injuries. Dedicated efforts should be implemented to devise injury prevention strategies that are appropriate for older adults and cost-effective injury programmes tailored to the needs and resources of local health-care systems, and to curtail injury-associated risk and promote healthy ageing. FundingBill & Melinda Gates Foundation. We acknowledge the Bill & Melinda Gates Foundation for funding this study.

Published
2022

39. Identifying the Causes and Extent of Insurance Deductions in a Hospital: An Interventional Approach to Cost Management

Author

Mohammad Zakaria Kiaei, Roohangiz Taheri, Rohollah Kalhor, and Bahman Ahadinezhad

Subjects
cost management interventional approach, lcsh:Public aspects of medicine, lcsh:R, six sigma, lcsh:Medicine, Cost accounting, lcsh:RA1-1270, Operations management, Business, hospital deductions, insurance organizations
Abstract

Background: A significant amount of revenues and deductions exist in the hospitals each year. This study aimed to determine the number of deductions applied and identify its causes. Furthermore, we aimed to provide management strategies to reduce these deductions in Shafa Takestan hospital. Methods: This applied and interventional study was conducted with a cross-sectional design. The data collection tool was a checklist from the previous studies. Data were analyzed using descriptive statistics such as mean, percentage, and standard deviation as well as analytical statistics of the Wilcoxon test. Results: Before the intervention, among 405 non-global inpatient cases, about 323 (80 %) contained subtractions. After the intervention, among 555 non-global hospital admissions, about 264 (47 %) included deductions. Most deductions were related to health services insurance (75.38 %). Concerning each hospital ward, most deductions were related to surgery ward (38 %). Before and after the intervention, service deductions were included in 5.59 % and 4.57 %, respectively. Conclusion: Therefore, medical personnel should pay more attention to documenting patients' records and minimizing documentation errors. Moreover, to reduce patient record deductions, the health care staff should be familiarized with proper documentation procedures by conducting training sessions.

Published
2020

40. Are Price, Income, and Education Expenditure Important in the Iranian households' Demand of Healthcare Services: 2011 to 2017?

Author

Omid Khosravizadeh, Saeed Shahsavari, Bahman Ahadinezhad, Bahareh Mohtashamzadeh, and Najmeh Baghian

Subjects
Public economics, business.industry, health investment approach, lcsh:Public aspects of medicine, lcsh:R, Health care, lcsh:Medicine, lcsh:RA1-1270, Business, robust standard error panel regression, healthcare services demand
Abstract

Background: In health economics, policymakers need to be aware of the individuals' sensitivity and reaction to change effective factors on the healthcare services demand. This study aimed to estimate the healthcare demand function and extract the price, income, and educational elasticity in Iran. Methods: A panel of macro data was used to estimate the demand function. The data included provincial average of the nominal values of Iranian household healthcare and education expenditure, provincial average of their nominal income, and Consumer Price Index values of the healthcare services from 31 provinces during 7 years (2011 to 2017). This information was obtained from the annual Household Budget Survey Reports and no sampling was performed in this research. The dependent variable was the actual amount of demand for health care services. Robust pre-estimation tests and a robust standard error panel regression were run to estimate the demand function in Stata 15. Results: All variables were stationary at the first-order differential (P-value < 0.01). All four variables were co-integrated (P-value < 0.01). The cross-sectional and fixed effects existed for each province (P-value < 0.01). Income and educational expenditure had a positive association with healthcare demand. Price elasticity of demand was -0.897 (P-value < 0.01), income elasticity was 0.491 (P-value < 0.1), and elasticity of education expenditure was 0.486 (P-value < 0.01). Noteworthy, 1 % increase was observed in the household incomes and their educational expenditure increased the demand for health care services by about 0.49 % and 0.48 %, respectively. Conclusion: Healthcare services have been low elastic to price and education expenditure and have also been the essential commodity in the household budget in Iranian households. Later, the price and income coefficients were consistent with the health investment model, but coefficient of the education expenditure was not matched with predictions of the health investment model.

Published
2020

41. Effects of Ellagic Acid on Oxidative Stress Index, Inflammatory Markers and Quality of Life in Patients With Irritable Bowel Syndrome: Randomized Double-blind Clinical Trial

Author

Zahra Mirzaie, Ali Bastani, Ali Akbar Haji-Aghamohammadi, Mohammadreza Rashidi Nooshabadi, Bahman Ahadinezhad, and Hossein Khadem Haghighian

Subjects
History, Computer Science Applications, Education
Abstract

Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine. Oxidative stress and inflammation play a major role in IBS. Considering the antioxidant properties of ellagic acid (EA), this study was designed to evaluate the effect of EA on oxidative stress index, inflammatory markers, and quality of life in patients with IBS. This research was conducted as a randomized, double-blind, placebo-controlled clinical trial; 44 patients with IBS were recruited. Patients who met the inclusion criteria were randomly allocated to consume a capsule containing 180 mg of EA per day (n = 22) or a placebo (n = 22) for 8 weeks. Serum levels of total antioxidant capacity (TAC), malondialdehyde (MDA), C-reactive protein (CRP), and interleukin-6 (IL-6) were measured at the beginning and the end of the study. Also, quality of life was assessed using a self-report questionnaire for IBS patients (IBS-QOL). At the end of the study, we saw a significant decrease and increase in the MDA and TAC in the intervention group, respectively (p0.05). Also, EA consumption reduced CRP and IL-6 levels, and these changes were significant in comparison with placebo group changes (p0.05). The overall score of IBS-QOL significantly decreased, and quality of life was increased (p0.05), but there were no significant changes in the placebo group. According to these findings, receiving polyphenols, such as EA, may help maintain intestinal health by modulating inflammation and oxidative stress and ultimately improving the quality of life in IBS patients.Iranian Registry of Clinical Trials Identifier: IRCT20141025019669N11.

Published
2022

42. The structure of the pharmaceutical market in Iran using concentration indices

Author

Omid Khosravizadeh, Ahmad Moosavi, Mohammad Mohseni, Hasan Abolghasem Gorji, Bahareh Mohtashamzadeh, Meysam Safi Keykaleh, and Bahman Ahadinezhad

Subjects
Concentration, lcsh:R5-920, Leverage (finance), 030503 health policy & services, Pharmaceutical market, Concentration indices, Market concentration, Iran, Concentration ratio, Index, Food and drug administration, 03 medical and health sciences, Market structure, 0302 clinical medicine, Pharmaceutical Market, Statistics, Revenue, Original Article, 030212 general & internal medicine, Business, Drug, 0305 other medical science, lcsh:Medicine (General)
Abstract

Background and objective The efficiency and function of the pharmaceutical sector, as a vital portion of the health system, have a significant effect on intermediate and final indices of health. In this research, the structure of the pharmaceutical market in Iran was examined through the calculation of concentration indices in 2011. Methods In this cross-sectional study, the needed data was gathered from the Food and Drug Administration in the year 2011. Data were analyzed using SPSS software version 20 and Microsoft Office Excel software. Finally, two common measures of market concentration, the Concentration Ratio and the Herfindahl-Hirschman Index, were calculated. Results The largest and the smallest shares of the industry were 5.57% and 0.01%, respectively. The average industry share was 1.09%. The share range was calculated to be 5.56%. The Herfindahl-Hirschman Index was 248.5, which indicates a very low concentration of the pharmaceutical market in Iran. Also, based on the Concentration Ratio of 4 companies (18.39%), the concentration of the pharmaceutical market has been too low. Conclusion The pharmaceutical market in Iran has a very low concentration and it does not have an exclusive mode in terms of market structure. Therefore, it can be attributed to the competitive model. The policy makers in this area can use this characteristic as a leverage to improve efficiency, fairness, revenue and health indices.

Published
2017

43. Health production and determinants of health systems performance in WHO Eastern Mediterranean Region

Author

Jalal Arabloo, Mohsen Bayati, Abolghasem Pourreza, Vahid Alipour, and Bahman Ahadinezhad

Subjects
media_common.quotation_subject, Health Personnel, Efficiency, Organizational, Gross domestic product, 03 medical and health sciences, 0302 clinical medicine, Life Expectancy, Health care, Infant Mortality, Per capita, Humans, 030212 general & internal medicine, Social determinants of health, Socioeconomics, Empowerment, media_common, business.industry, Mediterranean Region, 030503 health policy & services, Infant, General Medicine, Infant mortality, Geography, Socioeconomic Factors, Hospital Bed Capacity, Unemployment, Life expectancy, Health Expenditures, 0305 other medical science, business, Delivery of Health Care
Abstract

This descriptive-analytical study used data envelopment analysis to evaluated the technical efficiency (TE) of health systems in Member States of the World Health Organization Eastern Mediterranean Region during 2004-2011. Life expectancy and infant mortality were used as outputs. Per capita total expenditure on health, and number of physicians, nurses and midwives and hospital beds per 1000 people were used as inputs. The determinants of TE of the health systems were examined using a regression model. United Arab Emirates and Somalia had the most efficient health systems with a TE score of 1. Djibouti and Libya had the most inefficient health systems, with TE scores of 0.346 and 0.435, respectively. The most important determinants of TE were the level of education and gross domestic product per capita. The relationship between unemployment and out-of-pocket health expenditure was not significantly associated with TE of the health systems. To improve TE of the health systems, countries should focus on individuals' empowerment in education and income level, rather than only on providing healthcare services.إنتاج الخدمات الصحية ومحدِّدات أداء النُظُم الصحية في بلدان إقليم شرق المتوسط.أبوالقاسم بورضا، وحيد علي بور، جلال عربلو، محسن بياتي، بهمن احدى نجاد.أجريت هذه الدراسة الوصفية التحليلية لتقييم الكفاءة التقنية للنُظُم الصحية المطبَّقة في إقليم شرق المتوسط في الفرة 2011–2004 ، باستخدام تحليل DEA لتقييم الكفاءة التقنية للنظم الصحية. واستخدم معدل العمر المتوقَّع عند المياد ومعدل الوفيات بن الأطفال دون السنة الأولى من العمر كمخرجات واستخدم إجمالي إنفاق الفرد عى الصحة وعدد الأطباء والممرضات والقابات وأسِّة المستشفيات لكل ألف شخص كمدخات للنُظُم الصحية من أجل تحديد درجة الكفاءة التقنية باستخدام نموذج DEA. وفضاً عن ذلك، جرت دراسة محدِّدات التقييم التقني للنظم الصحية (العوامل الخارجة عن سيطرة النظم الصحية وتلك الخاضعة لسيطرتها) باستخدام نموذج الانحدار. وأظهرت نتائج هذه الدراسة أن أهم محدّدات الكفاءة التقنية في النظم الصحية يتمثَّل في مستوى التعليم وإجمالي الناتج المحي للفرد. وفضاً عن ذلك، لم تثبت دلالة إحصائية للعلاقة بن معدل البطالة والمصروفات الشخصية عى الصحة ومستوى الكفاءة التقنية للنظم الصحية. ولتحسن الكفاءة التقنية للنظم الصحية وزيادة النتائج الصحية، ينبغي للبلدان التركيز عى تمكن الأفراد في مجال التعليم وزيادة مستوى الدخل، وليس التركيز حراً عى توفر خدمات الرعاية الصحية.Production de résultats sanitaires et déterminants de la performance des systèmes de santé dans la Région OMS de la Méditerranée orientale.La présente étude analytique descriptive a été menée pour évaluer l’efficacité technique des systèmes de santé des pays de la Région de la Méditerranée orientale de l’Organisation mondiale de la Santé (OMS) durant la période 2004-2011 au moyen de l'analyse d'enveloppement des données. L’espérance de vie à la naissance et le taux de mortalité infantile ont été utilisés comme extrants et les dépenses de santé totales par habitant, les effectifs de médecins, d’infirmières et de sages-femmes et le nombre de lits d’hôpital par millier d’habitants ont été utilisés comme intrants des systèmes de santé. Les déterminants de l’efficacité technique des systèmes de santé ont été examinés à l’aide du modèle de régression. Les Émirats arabes unis et la Somalie avaient les systèmes de santé les plus efficaces avec un score d’efficacité technique de 1, tandis que Djibouti et la Libye, avec des scores d’efficacité technique de 0,346 et de 0,435 respectivement, avaient les systèmes de santé les plus inefficaces. Les déterminants les plus importants de l’efficacité technique des systèmes de santé des pays étaient le niveau d’éducation et le PIB par habitant. La relation entre le taux de chômage et les dépenses de santé directes n’était pas statistiquement significative du niveau d’efficacité technique des systèmes de santé. Afin d’améliorer l’efficacité technique des systèmes de santé, les pays devraient se concentrer sur l’autonomisation individuelle dans les domaines de l’éducation et du niveau de revenu, plutôt que sur la prestation de services de soins de santé uniquement.

Published
2015

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