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Background Patients with transfusion-dependent thalassemia (TDT) require lifelong blood transfusions and iron chelation therapy. Thus, patients afflicted with TDT often have to undergo blood transfusion and iron chelation therapy, which causes a major economic burden on them. However, this topic has not been reported in Dubai, United Arab Emirates (UAE). Hence, this study aimed to evaluate healthcare resource utilization and associated direct costs related to patients with TDT in Dubai, UAE. Methods For this study, a retrospective prevalence-based cost-of-illness analysis based on the UAE healthcare system and patient perspectives was conducted among patients with TDT treated at the Dubai Thalassemia Center in 2019. Information regarding healthcare resource utilization and direct medical costs was collected from the billing system connected to the electronic medical record system. Patients and their families were interviewed for direct non-medical cost estimations. Results A total of 255 patients with TDT were included in the study. The mean annual direct medical cost was estimated at AED 131,156 (USD 35,713) (95% CI: 124,735 – 137,578). The main driver of the medical cost for the participants as iron chelation therapy AED 78,372 (95% CI: 72,671 – 84,074) (59.8%), followed by blood transfusions, which accounted for AED 34,223 (95% CI: 32,854 – 35,593) 26.1% of the total direct medical costs. The mean annual direct non-medical costs was AED 2,223 (USD 605) (95% CI: 1,946 – 2,500). Age (p p = 0.016), the presence of complications (p p Conclusion Transfusion-dependent thalassemia poses a substantial economic burden on the healthcare system, patients, and their families. Our results show that the highest medical cost proportion was due to iron chelation therapy. In this regard, efforts must be made to improve the patients’ acceptance and satisfaction with their iron chelation therapy to increase their compliance and improve the effectiveness of treatment, which could play an essential role in controlling the economic burden of this disease. Moreover, greater support is essential for families that suffer catastrophic out-of-pocket expenses.

Shaikha Alshamsi,1 Samer Hamidi,2 Hacer Ozgen Narci3 1School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates; 2School of Health and Environment Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates; 3Department of Health Management, Istinye University, Istanbul, TurkeyCorrespondence: Shaikha AlshamsiHamdan Bin Mohammed Smart University, Academic City, Dubai, United Arab EmiratesEmail Shaikha_Alshamsi@hmbsu.ac.aeObjective: The aim of this study was to assess the indirect burden of patients with transfusion-dependent thalassemia (TDT) in Dubai, the United Arab Emirates (UAE).Methods: Adult patients with TDT were enrolled during blood transfusion sessions. Productivity loss for patients in the preceding four weeks was reported using the validated iMTA Productivity Cost Questionnaire (iPCQ).Results: A total of 161 adult patients with TDT were included in the study. The annual total productivity loss cost at paid work among 79 employed patients was AED 17,230 (USD 4691) (95% CI: 12,302– 22,159), out of which absenteeism contributed AED 10,328 (USD 2812) and presenteeism contributed AED 6902 (USD 1879), whereas the annual total productivity loss cost at unpaid work was AED 4053 (USD 1104) (95% CI: 3471– 4661). The annual mean total indirect cost for paid and unpaid work was AED 21,283 (USD 5795). Monthly income, nationality, and having two and more disease complications were the significant predictors of higher productivity loss costs. Having previously had a splenectomy was a negative and significant predictor of productivity loss costs.Conclusion: TDT was associated with substantial productivity loss and indirect costs in the UAE. Health policies that aim to control transfusion-dependent thalassemia effectively are necessary and could result in cost savings for patients and employers.Keywords: productivity loss, friction cost approach, transfusion-dependent thalassemia, Dubai, United Arab Emirates

Sağlık yöneticilerinin verdikleri kararlar sadece yönettiği sağlık kurumunu değil, toplumu da etkilemektedir. Ülkemizde Sağlıkta Dönüşüm Programı ile başlayan değişim ve dönüşüm, sağlık hizmetlerinin kaliteli, etkili ve verimli sunulmasını ve karar verme davranışı ile bu unsurlar üzerinde doğrudan etkili olabilen sağlık yöneticisini ve yöneticinin karar verme stilini önemli hale getirmiştir. Bu çalışma, il düzeyinde görev yapan kamu sağlık yöneticilerinin karar stillerinin incelenmesi amacıyla yapılmıştır. Çalışmada ayrıca yöneticilerin kararlarında rol oynayan faktörlerin ve farklı kurumların yöneticileri arasında karar stillerinde farklılık olup olmadığının belirlenmesi de amaçlanmıştır. Çalışma, Çankırı İl ve ilçelerinde 2016/Ağustos-Aralık döneminde İl Sağlık Müdürlüğü, İl Halk Sağlığı Müdürlüğü, Kamu Hastaneleri Birliği ve bağlı hastanelerinde üst, orta ve alt kademe yönetim pozisyonlarında görev yapan toplam 55 yönetici ile gerçekleştirilmiştir. Çalışmada, yöneticilerin karar verme stilleri Karar Verme Stilleri Ölçeği ile ölçülmüştür. Yöneticilerin büyük çoğunluğunun rasyonel karar verme eğiliminde olduğu belirlenen bu çalışmada, karar stillerinin yöneticilerin yaş, cinsiyet, medeni durum, eğitim durumu, eğitim alanı, mesleği, görevi, hiyerarşik pozisyonu ve meslekte, çalıştığı kurumda, yöneticilikte ve çalışma hayatı boyunca yönetici olarak toplam çalışma yıllarını içeren çeşitli özellikleri itibariyle istatistiksel olarak anlamlı farklılık göstermediği bulunmuştur. Bir istisna, bağımlı karar verme davranışının yaşa göre farklılık göstermesidir. Genel olarak, farklı kurum ve pozisyonda görev yapan yöneticilerin karar verme davranışlarında benzerlik tespit edilmiştir. Verilecek kararın mevzuata uygunluğu, hakkında karar verilecek konunun özellikleri ve konu hakkında daha önce yapılan uygulamalar, sahip olunan tecrübe ve uzman görüşü yöneticilerin karar vermelerinde rol oynayan önemli faktörler olarak belirlenmiştir. Ayrıca dış çevredeki gelişmelerin üst düzey yöneticilerin kararlarında etkili olduğu belirlenmiştir. Decisions that are made by health managers potentially influence not only the health care institutions that they manage but also the society as a whole. The change and transformation that was launched with Health Transformation Programme have made healthcare managers and their decision-making styles prominent as they have a direct impact on quality, effective and efficient delivery of health services. The purpose of this study was to examine decision-making style of provincial health managers in the public sector. The study also aimed to determine the factors that play a role in decisions of managers and possible differences in decision styles of managers among three different health institutions. This study was carried out with a total 55 health managers holding top, middle and lower level managerial positions in the three publicly owned health instutions situated within the border of Çankırı province. decision-making styles of managers were measured using the Scale of Decision-Making Styles. In this study, where the vast majority of managers were identified to be rational decision makers, none of the decision styles had statistically significant association with managers’ age, gender, marital status, education, major, profession, job, hierarchical position, and working years in the profession and the institution surveyed, and working years as a manager, except the one between dependent decision style and age. In general, similarities were found in the decisionmaking behaviors of managers in different institutions and positions. Legislative appropriateness of the decision to be taken, the characteristics of the decision to be made about it, previous applications, the experience gained and the expert opinion have been determined as important factors in the decision making of the managers. Additionally, changes in the external environment are particularly affecting the decisions of senior managers.

Surgery is considered as an integral part of any health system, comprising 30% of global burden of disease along with serious access problems and catastrophic payments across the world. More than 230 million major surgeries are done every year. Surgical innovations typically represent the greatest part of innovations in terms of their contributions to ensuring safer and high-quality care and thus saving lives in the field of healthcare management. Such innovations also contribute significantly to the knowledge society. Correctly identifying innovations in surgery and enabling them to be known and adapted by other surgeons is a critical concern for all stakeholders in healthcare. There exists no information on surgical innovations from a managerial perspective in Turkey. This study aims to explore how surgeons identify surgical innovations based on their real experiences of past surgeries using a semi-structured questionnaire distributed to surgeons in a major hospital chain in Istanbul, Turkey. The results shed light on recognising and evaluating surgical innovations provided by the practicing surgeons via a management perspective. WOS: 000512898900002