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Background and objective: Equitable distribution of health resources is important to achieving equity, guaranteeing access to healthcare services, and improving societies’ health status. This study aimed to examine equity in the distribution of health resources and its association with the mortality caused by COVID-19 in South Khorasan province, east Iran. Method: This was a secondary analysis of data from a cross-sectional study conducted in South Khorasan province in 2022. Data were drawn from an existing online database (Farabar) provided by the Public Health Department of the Ministry of Health in Iran. Data related to the number of hospital beds, medical specialists and practitioners, nurses, paramedical workers, health watch, community health workers (Behvarz), healthcare financial resources, and COVID-19 mortality rate were extracted from the Farabar system for each city separately. The equity in the distribution of resources was analyzed by calculating the Gini Coefficient index and using EXCEL software. The Gini Coefficient was used to measure the distribution of health resources and services (i.e. financial resources, human resources, hospital beds, ICU beds) against population size and geographic size. Data were analyzed using SPSS software, version 25. Results: The Gini Coefficient ranged between 0.006 and 0.320. The Gini Coefficient of health care system financial (0.006) resources distribution was more equitable, while that of hospital beds (0.229) and intensive care beds (0.320) was more inequitable. The Gini Coefficient of the distribution of human resources was estimated at less than 0.3, which is relatively equitable. The COVID-19 mortality rate per 100,000 population was estimated at 113.6, lower than the national average. After controlling the confounding variable (rural population (as % of the total population)), there was no significant correlation between COVID-19 mortality and the distribution of human resources, hospital beds, and healthcare financial resources. Conclusion: According to the results, the distribution of resources relative to the province’s population was relatively equitable, and there was no significant correlation between the COVID-19 mortality rate and the distribution of human resources, hospital beds, and healthcare financial resources. This can be due to the equitable distribution of health resources. Having a better and deeper understanding of the regions and populations disproportionately impacted by COVID-19 can help with intervention and resource allocation. [ABSTRACT FROM AUTHOR]

Background and objective: In Iran, Health Sector Evolution Plan, the most significant reform in the healthcare system in recent decades, has been launched since 2014 with the objective of achieving universal health coverage, decreasing out-of-pocket health expenditures and improving access to health services in hospitals and clinics affiliated to the Ministry of Health and Medical Education (MOHME). This study aimed to estimate the hospitalization costs of lung cancer and the impact of HSEP on hospitalization costs of lung cancer and patients' contribution in Iran between 2010 and 2017. Methods: This was a prevalence-based cost of illness study with a bottom-up costing approach. The sample size included 1778 lung cancer patients hospitalized in the Imam Reza hospital in Tabriz, Iran, between May 5, 2010, to May 5, 2014, and four years after the implementation of Health Sector Evolution Plan: from May 5, 2014, to May 5, 2017. The analysis was conducted from a societal perspective. Data were extracted from the electronic medical records of patients and were analyzed using SPSS V22.0, STATA V13.0 and Microsoft Excel 2016. The Interrupted Time-Series design was applied to estimate the impact of the implementation of HSEP on hospitalization costs and patient contribution rate for reimbursement of costs. Results: The mean hospitalization costs of lung cancer before and after the implementation of Health Sector Evolution Plan was estimated at 2860 ± 4575 and 5300 ± 8880 PPP (Current International $), respectively. Moreover, the amount of out-of-pocket payments reduced from 705 PPP (Current International$) (22.16%) before the implementation of Health Sector Evolution Plan to 480 PPP (Current International $) (10.5%) after its implementation. the hospitalization costs went up moderately before the HSEP (increased from 2320 $ in 2010 to 3025 $ in 2013). After the HSEP, it continued to rise, but with a more significant increase until 2016. Then, in 2016, it reached a peak (6395 $) before dropping in 2017 (5005 $). Regarding patient contribution, before the HSEP, the percentage of patient contributions increased from 19.45 in 2010 to 24.28 in 2013. With HSEP's implementation, this fell dramatically to 14.47 and continued to decline, reaching 7.99% in 2016. In 2017, patient contribution increased again and reached 9.58%. Conclusion: Overall, hospitalization costs experienced an upward trend over the course of study, but this trend considerably intensified further after the HSEP. The patient contribution demonstrated an upward trend before HSEP, followed by a significant decline post-HESP, and the percentage of out-of-pocket payments reduced after implementation of HSEP. Therefor this plan has been successful in achieving the goal of financial protection of patients. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the performance of medical tourism in Iran using importance–performance analysis (IPA). In this cross‐sectional study, five hundred ninety‐six medical tourists from West Asian countries (Iraq, Azerbaijan, Kuwait, Qatar, Bahrain, Oman, Syria, Lebanon, Oman, Saudi Arabia, and Yemen) referring to health centers to receive medical services in Iran in 2020 were recruited. A standard IPA questionnaire was used for data collection. IP gaps were negative in all three attributes (medical treatments and service attributes, destination attributes, and tourism‐specific attributes). Respondents attached the highest importance to medical treatments and service attributes. The highest IP gap was related to medical treatments and service attributes. The results highlighted that the Iranian tourism industry is not performing well in many areas. Tourism managers and stakeholders should adopt useful strategies for improving those areas with high importance and low performance. [ABSTRACT FROM AUTHOR]

Given the rapid growth of the medical tourism industry worldwide, competition among different countries to increase market share has risen sharply. The success of this industry largely depends on the correct segmentation of the market and the right choice of target segments. There are numerous approaches for market segmentation, each of which has its pros and cons. This study, therefore, aimed to compare and contrast the strengths, limitations, and practical considerations of different approaches, variables, and statistical techniques employed for the health market segmentation. Moreover, a framework to segment the health tourism market is ultimately recommended. This systematic review was carried out according to the PRISMA checklist in the following databases: PubMed, Embase, Web of Science, and CINAHL. The quality appraisal of included studies was conducted using Mixed Methods Appraisal Tool (MMAT) Checklist. We retrieved 239 articles, and finally, 22 articles were eligible and included in the final analysis. The majority of studies (n = 20) applied posteriori approaches for market segmentation, except two, which applied a priori and a mix approach. Profile-based and value-based variables were used for market segmentation in 13 and 9 studies, respectively. The majority of reviewed articles employed a two-step clustering with hierarchical clustering (ward algorithm) (n = 14) or neural network clustering (SOM) (n = 1), and non-hierarchical clustering (K-means algorithm) (n = 15), and comparatively a smaller number employed a single method for clustering (n = 7). This effort reviewed several market segmentation approaches and concluded that a combined approach and value-based variable might better serve health tourism market segmentation. [ABSTRACT FROM AUTHOR]

Background and objective: The COVID-19 pandemic placed considerable pressure on the health care systems and caused many disruptions to the care hospital system around the globe. This study aimed to analyze the performance of hospitals affiliated with the University of Medical Sciences and Health Services of South Khorasan Province before and during COVID-19. Method: This cross-sectional study tracked the financial performance (FP) and service performance (SP) of 12 hospitals affiliated with South Khorasan University of Medical Sciences and Health Services using the Farabar system and Hospital Information System (HIS). Our study covered two time periods: from February 2018 to February 2020 (pre-COVID-19) and from February 2020 to February 2021 (during COVID-19). SP analysis of hospitals was performed by examining the trend of monthly changes before and during the COVID-19 pandemic and analyzed using SPSS software version 22 and Paired Sample T-Test. FP of hospitals was analyzed through relevant ratios and analyzed using Microsoft Office Excel. Results: Most SP indicators decreased considerably in all hospitals during COVID-19. FP ratios (e.g., activity and leverage ratios) increased during either or both pre-COVID or COVID periods. Compared to before COVID-19, the operating margin ratio and operating expenses coverage from operating income increased from -0.50 and 66.55 to -1.42 and 41.32, respectively, during COVID-19. Moreover, the net profit margin ratio and Return On Assets (ROA) ratio were increased during COVID-19. Conclusion: COVID-19 has decreased the FP and SP of hospitals due to limitations in providing services to patients since the beginning of COVID-19. Measures such as providing various financing resources and improving the financial resilience of hospitals are essential. Funds should be disbursed to offset hospitals' losses due to reduced elective and outpatient revenue. Policymakers should come up with holistic policies to tackle the adverse impact of such crises in the future, support hospitals financially, and consider allocating additional funding to them during emergencies. [ABSTRACT FROM AUTHOR]