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Objectives The most important reason for considering hypertension as a major health problem, especially in older adults, is its severe complications. This study aims to investigate the prevalence of hypertension complications and identify the related factors among older adults in Semnan, Iran. Methods & Materials This cross-sectional study was conducted on 400 older adults with hypertension in Semnan, in January-February 2023. The data collection tool was a researcher-made questionnaire, whose content validity was confirmed based on the opinion of 10 experts (CVR=0.95 and CVI=0.98) and internal consistency was conmfired using Cronbach's alpha (α=0.895). Descriptive statistics (mean, standard deviation, frequency, and percentage) were used to present the data. The statistical difference in hypertension complications based on the demographic and contextual factors was investigated using chi-square test. All the statistical analyses were performed in SPSS software, version 27 and P<0.05 was considered statistically significant Results The mean age of participants was 68.35±5.23 years, ranged 60-94. Participants were 196 men (49%) 204 women (51%). The prevalence of hypertension complications was 26.75% in overall (95% CI: 22.42%-31.08%). Also, the prevalence of heart failure was 14.3% (95% CI:11.13%-17.47%), the prevalence of retinopathy was 7.5% (95% CI:4.92%-10.08%), the prevalence of renal failure was 5.5% (95% CI:3.27%- 7.73%), the prevalence of heart attack was 4% (95% CI:2.08%-5.92%), and the prevalence of stroke was 1.5% (95% CI:0.31%-2.65%). Moreover, the prevalence of hypertension complications had a statistical relationship with age, marital status, educational level, time elapsed since the initial diagnosis, interval between the initial diagnosis and the start of treatment, the disease control, no history of receiving the necessary treatment, and receiving financial aid to cover medical expenses (P≤0.05). Conclusion Most of older adults in Semnan suffer from serious complication of hypertension, which is related to several demographic and contextual factors. The results can help managers and policymakers in the health sector in Iran to make correct decisions and develop effective interventions for the hyspetensive elderly. [ABSTRACT FROM AUTHOR]

Technology commercialization is a critical link between universities, industry, and society because it creates added value and contributes to organizations' sustainability and nations' advancement. Existing studies indicate that technology commercialization is a highly complex and risky endeavor; therefore, addressing all influencing factors can enhance the likelihood of success in this domain. In this study, after conducting situation analysis and identifying existence shortcomings, the practical suggestions were offered. Evidence suggests that medical universities in Iran face significant challenges related to the context, input, process, output, and outcomes of technology commercialization. Prolonged persistence of these issues might result in the inefficient distribution of resources and a deterioration of the institutions' reputation at both national and international scales. Consequently, Iranian medical universities must design and implement comprehensive, effective interventions to overcome the obstacles they face in this area. In this regard, these universities must continuously monitor and assess internal and external organizational environments, focusing on organizational culture and factors such as legal, industrial, marketing, and general economic conditions. They should work to remove identified barriers and promote a culture that supports creativity and quality. Furthermore, ensuring that the informational, financial, human, and physical resources required for technological commercialization are made available promptly and in an adequate quantity and quality is crucial. Universities should also develop their educational, consultative, communicative, and developmental mechanisms within the framework of strategic and operational programs. Moreover, these universities need to establish mechanisms for the continuous monitoring and evaluation of the quantity and quality of commercialized products and services, as well as to assess their short- and long-term impacts on areas such as domestic and international customer satisfaction, organizational partnerships, job creation, exports, and the economic growth and self-sufficiency of the country. [ABSTRACT FROM AUTHOR]

Introduction: Evidence on the impacts of accreditation on primary health care (PHC) services is inconsistent. Thus, this study aimed to assess the impacts of accreditation on the performance of PHC centres. Methods: This study systematically reviewed articles published from 2000 to 2019 in the Web of Science, Scopus, ScienceDirect, Springer, PubMed and ProQuest. The following keywords were used: ((primary care OR primary health care) AND (accreditation) AND (impact OR effect OR output OR outcome OR influence OR result OR consequences)). The database search yielded a total of 41256 articles, among which 30 articles were finally included in the review. Results: Accreditation showed the most positive impacts on the quality, effectiveness, human resource management and strategic management of PHC services. Accreditation also positively affected safety, responsiveness, accessibility, customer satisfaction, documentation, leadership, efficiency and continuity of care. Few negative impacts were noted, including the possibility of accreditation being used as a bureaucratic tool, high cost of acquiring accreditation, difficulties in understanding the accreditation process, high staff turnover rate in accredited PHC centres and weak sustainability of some accreditation programmes. Conclusion: Given its numerous positive impacts, accreditation could be used to effectively improve the performance of PHC centres. [ABSTRACT FROM AUTHOR]

Background. Health systems are responsible for providing healthcare services for all people in a community with reasonable costs. The primary objective was to evaluate and minimize the various expenses the patients incur consistently. The current study aimed to examine the direct non-medical and indirect expenses incurred to hospitalized patients infected with the Omicron variant of COVID-19. Methods. This cross-sectional study was conducted in February 2022 at Kosar Hospital in Semnan, Iran to investigate 400 hospitalized patients infected with the COVID-19 Omicron variant. The data were collected using a standardized instrument and conducting interviews with the patient. The descriptive findings were presented as frequencies (percentages) for qualitative variables and as means (standard deviations) for quantitative variables. The statistical relationship between demographic and background variables and the types of costs imposed on patients was examined performing T-test, ANOVA, and Tukey's post hoc test. Results. The study findings revealed that the patients and their families spent 20,260,000 IRR on direct non-medical treatment and 28,300,000 IRR on indirect treatment. A comprehensive statistical analysis was conducted to examine the correlation between demographic and background variables and the types of the costs incurred by patients and their families. The results indicated that a previous lung disease, asthma, diabetes, an admission to the intensive care unit (ICU), a coma in the patient, and COVID-19-induced heart complications were statistically and significantly associated with the direct non-medical costs. Furthermore, it was found that variables such as age, gender, educational status, employment status, engagement in occupational and physical activities, as well as the occurrence of a coma imposed additional indirect costs on the patients and their families (P<0.05). Conclusion. In sum, an infection with the Omicron variant of COVID-19 placed a substantial financial burden on the individuals and their households. Various factors may have influenced the magnitude of these expenses; therefore, it was recommended that these factors should be considered when implementing the promotional initiatives. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is one of the critical diseases due to its adverse clinical, social, and economic consequences for affected people. This study aims to assess the quality of life (QoL) of patients with MS in East Azerbaijan, Iran. Methods: This cross-sectional study was conducted using the multiple sclerosis quality of life-54 (MSQoL-54) questionnaires to interview 300 randomly selected MS patients in East Azarbaijan Province, Iran. The independent t-test, analysis of variance (ANOVA), and Tukey post hoc test were used to examine the relationship between demographic variables, and QoL, and all analyses were performed using SPSS software, version 19. Results: The QoL score in MS patients is 48.22±22.48. The “life satisfaction” is the best and “physical role limitation” is the worst QoL aspect. Significant relationships were observed between marital status, education level, employment status, age of symptoms onset, and years of illness with QoL (P<0.05). Conclusion: The QoL of the MS patients in East Azarbaijan Province is lower than in other parts of Iran and much lower than in Organization for Economic Co-operation and Development (OECD) countries. [ABSTRACT FROM AUTHOR]

Background: Financial protection of populations against healthcare costs is one of the fundamental responsibilities of governments. This study aimed to investigate the incidence of catastrophic health expenditures (CHE) and it's affecting factors in hospitalized patients with delta variant of COVID-19. Methods: In this cross-sectional study, we included 400 hospitalized COVID-19 patients at Kosar Hospital of Semnan in 2022, using a researcher-made checklist. Based on qualitative nature of the variables, chi-square test was used to investigate the statistical associations between the demographic/background characteristics and the incidence of CHE. Results: On average, COVID-19 imposed 1833.43 USD direct medical costs per one hospitalized patient. The ratio of direct-medical costs to household's non-food expenses was 2.35, and 61% (CI: ± 4.78%) of the patients were subject to CHE. Besides, residence place, basic insurance type, benefitting from supplementary insurance, suffering from underlying diseases, hospitalization in ICU, falling into a coma, facing pulmonary failure, and performing hemoperfusion had significant associations with CHE (P < 0.05). Conclusion: The incidence of CHE in hospitalized COVID-19 patients was undesirable, which may be due to geographical, economical, and occupational inequalities apart from the factors related to the severity of the disease. So, health policymakers should pay attention to the provision of proper financial risk protection policies to make the health insurance system more efficient and appropriate. [ABSTRACT FROM AUTHOR]

Context: Iranian community health workers (known as behvarzes) have played an undeniable role in improving the health status of the rural community in recent decades. Therefore, this study aimed to identify the performance challenges faced by behvarzes using a literature review. Methods: This systematic review searched the Web of Science, Scopus, Science Direct, Springer, PubMed, ProQuest, SID, and Magiran databases/search engines in January 2020. There were 2 inclusion criteria, namely articles published in English or Persian languages and those published in or after 2000. The search strategy resulted in the retrieval of 1,472 primary articles, 16 of which were finally included in the study, and their related contents were entered into extraction tables. Then, the identified challenges were categorized based on the context, input, process, and product (CIPP) model. Results: The study results recognized the major challenges in 5 dimensions, including context (i.e., changes in societal, cultural, demographical, and epidemiological characteristics of rural communities), input (i.e., inadequate number of behvarzes, their insufficient competencies, and limited resources), process (i.e., increase in healthcare process complexity and the number of bahvarzes' tasks and managerial problems), output (i.e., decrease in the quality, efficiency, accessibility, continuity, utilization, and effectiveness of services provided by behvarzes, poor health literacy of rural population and their weak involvement in health affairs, and emerging mental health problems in behvarzes), and outcome (i.e., low equity, urban-rural disparity in the diagnosis and treatment of diseases, and dissatisfaction of behvarzes and caregivers). Conclusions: This study revealed numerous important challenges faced by behvarzes, which need effective intervention by policymakers. [ABSTRACT FROM AUTHOR]

In order to lessen health inequalities, the obstacles to health equity will need to be identified. This study aimed at investigating the barriers to access to health-care services from the medical ethics point of view. Data were collected through a qualitative study by performing semistructured interviews. Purposive sampling was used to recruit participants involved in health provision and/or management. Content analysis was done using MAXQDA software. Overall, 30 interviews were conducted. The content analysis of the interviews identified two themes including “micro factors” and “macro factors”, five sub-themes including “cultural, financial, geographical, social and religious barriers”, and 44 codes. Based on our findings, differences in individuals’ perceptions, cultural control, religious beliefs and social stigmas create cultural barriers. Financial barriers consist of the financial connection between service recipients and service providers, insurance premiums, and inadequate coverage of health-care services. The most important geographical barriers identified in our study were differences in urbanization, inequality in various geographical areas, marginalization, and inequality in resource distribution. Finally, differences in the level of income, education and occupational diversity were among the social barriers. Given the wide range of barriers to access to health-care services, a comprehensive plan covering various dimensions of health equity should be implemented. To this end, innovative and progressive strategies emphasizing the principles of equity and social equality should be developed. [ABSTRACT FROM AUTHOR]