مهدی باسخا

The increase in the older population over the past decades has become a global phenomenon, so it is necessary to make appropriate policies for improving the welfare and well-being of this group. There is little consensus in the theoretical field regarding the concept of well-being. Therefore, this study examines the dimensions and indicators of the seniors' well-being in the published studies in this field.

Arksey and O'Malley's six-stage methodological framework for scoping reviews guided this scoping literature review. This study has reviewed all English and Persian papers published in the last 20 years that have examined the dimensions and indicators of well-being in older people. After screening, 25 studies were included in the analysis. 

The dominant approach to study well-being in older people is a multiple approach, exploring a combination of objective and subjective dimensions. The most mentioned dimensions are health status, mental well-being, social relationships, living environment, economic status, resources, and capabilities. The well-being indicators are presented in a multifaceted model according to individual, family, local, and social levels.

Policymaking for seniors' well-being needs to consider objective and subjective dimensions and different indicators based on the context of society.

Today, medical tourism is one of the most important branches of tourism and has many economic and social benefits for the country. Since Iran's rank, despite having suitable opportunities and relative regional advantages in this area, does not have a suitable position at the global level, it is necessary to identify and exploit entrepreneurial opportunities in medical tourism. This research is of a mixed type (combination of qualitative and quantitative methods) and has an exploratory nature, in the first step of interviews with experts, specialists and entrepreneurs of therapeutic tourism, the dimensions and categories affecting the recognition of entrepreneurial opportunities of therapeutic tourism using thematic analysis in MAX QDA software was extracted. These key categories are: environmental factors, business factors, entrepreneurial platforms, technological opportunities, entrepreneurial knowledge, entrepreneurial awareness, entrepreneurial characteristics and identifying entrepreneurial opportunities, then with the interpretive structural modeling (ISM) technique, the levels of key categories and the relationships between them are determined and introduced. became According to the results of the structures of environmental factors, technological opportunities and business factors have high influence and low impact. The constructs of identifying entrepreneurial opportunities and entrepreneurial consciousness have high dependence and low influence. Entrepreneurial knowledge structures, entrepreneurial characteristics, and entrepreneurial platforms have similar influence and degree of dependence. It is recommended that basic infrastructures, including culture building, establishment of information technology, and support for medical tourism startups should be included in the agenda.

Insurance deductions are among the most important causes of hospital resource waste. Insurance deductions cause financial problems for hospitals and create tension between insurance organizations and hospitals. This study, done by the University of Social Welfare and Rehabilitation Sciences, investigates the reasons for deductions of inpatient bills covered by Social Security Insurance in Rofeideh Rehabilitation Hospital

The study was conducted cross-sectionally on 776 cases admitted to Rofeidah Rehabilitation Hospital in 2021. All invoices for inpatient services sent to Social Security Insurance were reviewed using the census method. To collect data, invoices sent to Social Security, inpatient records and checklists, and a 31-question questionnaire of Mohammadkhani et al. were used. The collected data were analyzed by descriptive (frequency and percentage) and analytical statistics (the Spearman correlation coefficient) in SPSS software, version 23.

According to the findings, the highest frequency of inpatient prescriptions was related to November 2021 (7.48%). The most frequent deductions of inpatients’ bills were related to medicine and consumables to the amount of 310815448 Rails and surgeon’s fees in 187728448 Rails. Also, the most common reasons were requesting a surcharge and wrong coding. In this study, there was a significant relationship between the documentation of nurses and doctors and the amount of deductions (P<0.0001).

Multiple causes affect the reduction of insurance deductions. By teaching insurance rules and the book on the relative value of health services to medical and nursing staff groups, electronic documents to Social Security Insurance and creating warning mechanisms in it, continuous interaction with Social Security Insurance to justify the managers of the organization regarding the way of providing services to rehabilitation patients and the reason for the prolonged hospitalization time of such patients could be the potential solutions for preventing patients records deductions and help hospitals achieve financial goals.

One of the basic challenges of health care centers is the inflation of the costs of services. Rehabilitation services play a significant role in restoring disabled people's functional ability. Having knowledge of the unit cost of rehabilitation services can be useful in optimal allocation of resources and budget. This study aims to calculate the unit cost of outpatient rehabilitation services provided by the Nezam-Mafi Rehabilitation Center (NMRC) in Tehran, Iran. 

This is a descriptive, retrospective study with a cross-sectional design. The time-driven activity-based costing (TDABC) method was used to determine the unit cost for 9 outpatient rehabilitation services related to speech therapy, occupational therapy, physiotherapy and audiology provided by the NMRC in 2019. In the first step, the sequence of each activity was mapped in one code (service). Then, the resources needed to perform each activity were identified and the source of cost for each activity was specified. In the next step, the cost driver for each specific sources and the amount of their use in each activity were determined. Due to the importance of personnel costs, this stage was done with more attention on the time required to provide each activity. In this regard, the cost of each minute of service compensation  was calculated by considering the annual attendance time of personnel and their salary expenses. Finally, the costs of each unit of the production factor and the total cost for each code (service) were determined.

In the NMRC, the costs of renting (47.9%), consumable materials and supplies (11.6%), and contracted services (10.5%) made up the highest percentage of costs. The costs of outpatient rehabilitation services (except for speech therapy) were higher than official tariffs for these services. The cost of specialized personnel for physiotherapy services and the cost of building in occupational therapy, speech therapy, and audiology services had the highest share in their unit costs. The total cost of staff personnel was estimated at 3.904 Rials per minute (RPM), which was higher than the specialized professional for pediatric occupational therapy (2046 RPM), occupational therapy (1929 RPM), speech therapy (1899 RPM), and audiology (1974 RPM). The high overhead costs of outpatient rehabilitation services (24.5% of the total cost( were one of the primary reasons for the gap between the average costs and tariffs. 

There is a considerable gap between the cost of some services in the NMRC and the related tariffs. Due to the low capacity of service provision in the NMRC, overhead costs have led to the inflation of the cost of services in this center. Therefore, the consolidation of small institutions and improving the referral system for people with disabilities from medical centers can reduce the unit cost of services. Considering that most rehabilitation services are not covered by the social security insurance and are not affordable for patients, a national-level reform should be prepared in the healthcare system. In addition, using the TDABC method in rehabilitation service centers can be a solution to identify the main sources of costs and control price inflation in the health sectors.

Health equity is a complex and multidimensional concept that refers to the fair distribution of health resources and opportunities. In developing countries, where resources are limited, ensuring health equity is a major challenge. This study aimed to evaluate the level of attention given to health equity in the development plans of Iran.

The full text of Iran's first to sixth development plans was qualitatively analyzed using a directed content analysis approach. The dimensions of health equity (availability, accessibility, adequacy, affordability, and appropriateness) were identified, and the frequency of each dimension was calculated using a cross-tabulation in SPSS software. The validity of the study was ensured through expert opinions and the agreement between evaluators using Cohen's kappa coefficient.

The results showed that the most attention was given to the dimension of accessibility (17.7%), followed by adequacy (12.4%), appropriateness (7.7%), affordability (4.3%), and availability (1.9 %).

Given the intricate and multifaceted nature of health equity, achieving equity in this domain necessitates a comprehensive and well-rounded approach. It is imperative to delve deeper into this matter within the framework of development programs, with program objectives and implementations aligned accordingly.

 Despite the growing population of the elderly in Iran, there is no clear picture of the prevalence of chronic diseases among them. Accordingly, the present study tries to specify the prevalence of the most important chronic diseases and multimorbidity among the elderly. In addition, the homogeneity of these diseases has been considered among different socio-economic groups.

Research data were obtained through a checklist of chronic disease status among the elderly. The sample was selected from the elderly over 60 years old in Tehran in 2019 through multi-stage sampling. The sample size of the study is 1280 persons and the prevalence rate and chi-square tests were used to describe and analyze the data.

The results showed that hypertension (40.2%), musculoskeletal disorders (40.2%) and hyperlipidemia (32.4%) had the highest prevalence rate among the elderly in Tehran. The prevalence rate of chronic disease multimorbidity was 79.8, which was lower among men, never married, college-educated, and working-age seniors. Cardiovascular disease, diabetes, hyperlipidemia, and ear diseases have also been found to have different prevalence rates among socioeconomic classes.

The prevalence of chronic diseases has varied widely among socioeconomic groups; so the importance of the socio-economic status must be accentuated. Therefore, the pattern of prevalence of some chronic diseases can be influenced by lifestyle. As a result, research and policy-making in this field should be based on the inequalities in socio-economic status.

The promotion and prosperity of medical tourism requires the activation of entrepreneurial measures in terms of identifying opportunities in the field of medical tourism. For the growth and development of this industry in the country, it is necessary to identify and study the elements related to identifying opportunities in the field of tourism; Therefore, the aim of this study is to gain a better understanding of the main themes of identifying entrepreneurial opportunities in the field of medical tourism. This research has been done using a qualitative method. It is a development-applied research that has been done by field method. Semi-structured interview tools were used to collect information. Data were analyzed using content analysis method. Fifteen entrepreneurs and experts in the field of medical tourism were selected for interview using purposive and snowball sampling methods. After analyzing the data, 44 basic themes were identified in the form of 5 organizing themes. Organizing themes include typology of opportunity, business environment, technology, individual factors and environmental factors and the network of themes was presented based on the findings.

Many industries with predetermined plans have been completely suffered losses from the Covid-19 pandemic since March 2020, when the World Health Organization recognized it. The inbound tourists to Iran in the first six months of 1399 has decreased by almost 96%, affecting Gross Domestic Product, employment, imports, and income distribution. The purpose of present study is to investigate the effects of the Covid-19 pandemic on the employment of Iran's tourism sector using the labor force statistics of the year 1398 and the updated input-output table of the year 1390. The results extracted from the calculation of the direct, indirect, and induced effects show that 456,000 out of 4,575,000 people working in the 13 sectors related to the tourism industry have lost their jobs. Wholesale and retail services, road passenger services, and transportation support services have the highest ranks of employment lost among the 13 tourism-related sectors.

 The role of the service sector in general and healthcare services in particular have been promoting in Iran’s economy. The implementation of the Health System Transformation Plan and the injection of new financial resources into this sector have raised concerns about the health system function. Thus, this is the first attempt to estimate and evaluate the share of rehabilitation services in the Iranian economic and health systems.

The study utilized longitudinal trend analysis using the National Health Accounts data during 2002-2015. National Health Accounts, through input-output tables, breaks down the share of different sources of financing for different functions of the health system. According to this method, both the share of rehabilitation services in Iran’s economy and the financing sources of these activities have been calculated and compared to other countries. Data on Iran's National Health Accounts has been collected from the Statistical Center of Iran. International data is collected from the World Health Organization's National Health Accounts and the databases of the Organization for Economic Cooperation and Development member countries.

 Expenditures related to rehabilitation services in Iran increased from 884 billion rials in 2002 to more than 2967 billion rials in 1396, equivalent to 0.02% of Iran's GDP in that year. The share of rehabilitation expenditures in total health expenditures in 2007 was at its highest level (0.3%). In the following years, it has always had a decreasing trend. In 1396 it reached about 22.0%, the lowest amount during 16 Last year. Comparing the economic share of rehabilitation of the country's economic activities with different countries shows that the position of this sector is in no way comparable to developed countries and is even lower than many developing countries. Tunisia, Tonga, and Moldova have a similar situation to Iran's economy, with rehabilitation services accounting for about 0.05 to 0.1 percent of their total economic activity. Comparison of the prevalence of disability in these countries with Iran shows that these countries had a lower prevalence than Iran. Examination of the share of various sources shows that out-of-pocket payments with households with 6.37 percent, the most, and the government with 7.18 percent had the least role in financing rehabilitation services. It is noteworthy that this figure was about 65% before implementing the health system transformation plan. Social insurance in 2017 also covered only 6.24% of rehabilitation costs.

 Inaccessibility of people with disabilities to healthcare services is a very serious issue in the world. The rehabilitation services expenditures have always been mentioned as one of the most important barriers of accessing to these services. Following the implementation of the Health Transformation Plan, the share of rehabilitation activities in Iran’s health market has been shrunk.

World Health Organization has proposed age-friendly cities as an urban development approach. Likewise, the spatial distribution of urban facilities can be considered an important issue among urban planners.

In 2019, a sample of 770 elderly people was selected by the multi-stage sampling method. Data collection was accomplished using a standard questionnaire of the World Health Organization. Spatial inequalities of age-friendly indicators were calculated according to the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) using version 22 of SPSS software.

The results showed that the city of Tehran has an average score of 2.07 out of a maximum score of 4 in the index of the age-friendly city. The “outdoor spaces and buildings” (2.33) and the “housing” (1.31) sub-indexes had the highest and lowest average among the components of an elderly-friendly city, respectively. According to the TOPSIS, Lavizan district (score 2.13) and Mehrabad district (score 1.90) was ranked as the best and worst elderly-friendly district from the elderly point of view, respectively.

Spatial inequality in the indicators of age-friendly is evidently intimidating the quality of older adults’ life. Therefore, it is necessary to pay close attention to the spatial distribution of urban features compatible with later life, especially in the southern areas of Tehran.

development plans enhance the economic and social life of communities. Accordingly, present study aimed to review the health-related policies in development plans (first to sixth) of Iran based on the framework of social policy.

This is a quantitative content analysis study. Accordingly, the texts of development plan provisions dealing with at least one of the categories in the field of health, were selected as the sample. SPSS software was used for data analysis.

Results of the study showed given the degree of obligation, the degree of compulsory obligation with 55% had the highest index. Given the Health Ministry’s enforcement agent, treatment and medical education with 31.6% was the main agent. Moreover, the target groups of all members of society with 17.7%, had the highest rate. In terms of policy and service, the service rules with 57.9% had the highest rate. In the field of policy and service, treatment with 13.9% had the highest rate.

As health issues are one of the well-known instances of social policy as a set of actions and policies affecting the well-being and life of people in society, so the results of the study showed that an attempt has been made to take steps towards the realization of social policies and creation of justice in provision of health facilities for all people in the first to sixth development plans.

The health sector is one of the most important service sectors and one of the indicators of development and social welfare. The aim of this study is to evaluate the efficiency of Iranchr('39')s health system compared to developed countries.

This study used data envelopment analysis to evaluate efficiency. All members of the Organization for Economic Co-operation and Development (OECD), along with Iran, were considered as the decision units in the analysis. Outputs are life expectancy at birth and infant mortality rate; and inputs are health expenditure, number of physicians, and number of hospital beds. DEA Solver software was used for the analysis.

The most efficient countries in terms of the health system are Canada, Chile, Estonia, Iceland, Ireland, Israel, Japan, South Korea, Latvia, Luxembourg, Mexico, Slovenia, Spain, Switzerland, Turkey, and Iran. Their inefficiency was calculated using the axial output model. The most inefficient countries were Portugal, Germany, the United States, Poland, the Czech Republic, Slovakia and Hungary.

Iranchr('39')s health system was found efficient, which showed that in terms of life expectancy and infant mortality rate (2 important markers of the health system), Iran performed efficiently comparing to its inputs, health expenditures, physicians, and the hospital bed. However, the Iranian health system was more efficient in this method due to the fewer inputs (physician and hospital bed) with similar outputs to other countries (life expectancy and infant mortality rate). On the other hand, the outbreak of the coronavirus showed that the health systems of the countries should be prepared for such pandemics and be able to increase the number of hospital beds, physicians, and other health system inputs.

The purpose of this empirical study is an investigation of the effect of the economy of tourism experience in the countryside and rural areas of Ramsar and Chalous on place attachment and behavioral intentions through pleasant feelings and positive memories of tourists. This exploratory-descriptive research is of survey type, in which the main tool of data collection is a questionnaire. 184 questionnaires were distributed by available sampling methods in the spring and summer of 2017 among tourists and visitors of the villages and countryside of Chalous and Ramsar in the Northern part of Iran. To analyze the research data, 171 questionnaires were selected and structural equation modeling was used. Research findings show that "The economy of the rural tourism experience has a meaningful relationship with pleasant excitement", "The pleasant excitement derived from experience has a meaningful relationship with memories", and "pleasant excitement has no meaningful relationship with behavioral intentions of tourists”. Therefore, experience economy affects place attachment and, ultimately, the behavioral intentions of the tourists. This research can also guide future researchers towards managerial concepts in the tourism industry, in particular, rural tourism, removing limitations and ultimately provide constructive solutions and suggestions to relevant organizations and centers.

Residential satisfaction is one of the factors affecting the social wellbeing. Residence satisfaction has a complex theoretical structure and infolded concepts from economics, sociology, psychology, planning, and geography. Understanding the important dimensions of residential satisfaction will play an effective role in wellbeing. In addition to personal, physical and peripheral factors, social variables can also affect residential satisfaction. This is more significant in cities and towns without local inherency. One of the important government plans to provide housing for low income families in Iran was “Mehr Housing Project”. It seems that the aforementioned policy has a special emphasis on the quantitative aspect of housing and is more indicative of the social aspect rather than that of housing. Regarding this issue, the present study addresses the status of residence satisfaction among citizens living in Mehr Housing Project in Parand City.

Primary data gathering was accomplished using a questionnaire from 398 participants. Statistical population for the study included residents over the age of 18 who had resided in Parand city for at least 6 month. Based on theoretical and empirical research studies, the most important component of residential satisfaction educed as physical features, facilities, environmental quality, psychological and social security, public services, social interactions, and social problems. The initial version of the questionnaire was reviewed by the experts of the field. The content validity ratio and content validity index for each item were calculated and the validity of the questionnaire was assured. To assess the reliability of the questionnaire, Cronbach’s alpha was used. The value of this coefficient is equal to 0.781, which indicates the suitability of the research instrument. Performing a pilot study shows that the variance of the residential satisfaction was about 262.5. Considering 0.1 standard deviation as error and 95% confidence level, the sample size calculated reduced to 342, which, with 10% probability of defect in questionnaires, the sample size increased up to 398. From among each of the phases of the Mehr project, an area was randomly selected. Then a street and a block were picked out from each area and data were collected from the inhabitants of that block. Finally, the data were entered into the SPSS software and using the correlation tests, the relationship between the various factors and residential satisfaction was measured.

The average total satisfaction of residents of Mehr Project of Parand is 2.39 (out of 5), which indicates the lower medium score for residential satisfaction in Mehr housing of Parand city. Among the different dimensions of residential satisfaction, the highest rate is related to the low social problems in this area and the lowest satisfaction is related to public services and the quality of the surrounding environment.
Study’s findings show a significant correlation between residential satisfaction and predictor variables such the amount of saving, district of residence, access to public transport, access to green space, size of housing units, type of ownership, and population density.

According to the findings, it seems that the promotion of the desirability of Mehr Project Buldings requires comprehensive policy packages in the field of urban development, construction, public services, and social policies. Considering the remarkable difference in the quality and development of the project in different phases, the problems of inhabitants have been very diverse. But the most important policy proposals to increase residential satisfaction for citizens living in Mehr City of Parand can be categorized as: creating sports, recreational and cultural facilities, developing the social gathering centers and encouraging people to attend local communities with appropriate promotions in local media, and enhancement of green spaces and parks for each phase. Along with these things, as aforementioned, it should be noted that creating suitable communities require a comprehensive package of policies in the field of urban development, construction, public services and social policy.

In this study, all ethical considerations related to the study were considered. Full written consent was obtained from the respondents consciously and freely. The questionnaires were completed anonymously and the researcher’s confidentiality and confidentiality were respected.

Considering the importance of assessing living standards in society, the present study aimed to design a living standards questionnaire. We also assessed the validity and reliability of the developed questionnaire in the Iranian elderly population. This was a methodological study. Initially, by reviewing the relevant theoretical and empirical bases like questionnaires in English, 45 questions were selected for developing living standards questionnaire. Then, the content and face validity of the questionnaire were evaluated using the comments of 10 university experts. Moreover, its structural validity (factor analysis by varimax rotation) was investigated. After determining the validity of the scale, the questionnaire was completed by 150 elderly people aged ≥60 years. The internal consistency reliability of it was investigated using Cronbach's alpha coefficient and split-half reliability. The obtained data were analyzed by SPSS.  The Mean±SD age of samples was 63.74±2.99 years. The content validity of the questionnaire was equal to 0.85. In the structural validity assessment, the Kaiser-Meyer-Olkin (KMO) value was obtained as 0.853, and three factors (living facility, housing situation, and household expenditures) together explained 56.8% of the total variances. The Cronbach's alpha coefficient was equal to 0.859 for the total scale and the Gutmann split-half coefficient was calculated as 0.859.  The obtained results revealed that the living standards questionnaire was a valid and reliable scale in Tehran's elderly population.

 Nowadays, Information and Communication Technology (ICT) provides a potential opportunity for communities by changing the concept of distance. Despite the development of communication and information tools and their widespread use, the statistics indicate a digital gap and very low use of these tools by the Iranian elderly. This study aimed to investigate the status of acceptance of ICT and its related factors by elderly people living in Tehran City, Iran.  The cross-sectional study was conducted in summer 2018. A sample of 330 elderly people living in Tehran was selected by multistage sampling method. All obtained data were analyzed by the Shapiro-Wilk test, point biserial correlation test, the Spearman correlation test, and the Pearson correlation test in SPSS 21.   Most participants belonged to the age range of 60 to 70 years (61%), were men (67%), married (85.5%), and had a diploma or lower education (72.5%). The results show that the most popular ICT among the elderly were watching TV, talking on the phone, and readings news, while sending and receiving emails was the least popular one. The Mean±SD technology acceptance score among the elderly was 3.15±0.75 which was above its theoretical average (score 3). The most important barriers of older people to accept ICT was "lack of interest", "feeling no need", and "lack of familiarity with the ICT tools". Acceptance of technology has been strongly associated with education (r=0.325, P<0.001), age (r=0.236, P<0.001), and available time to use ICT tools (r=0.528, P<0.001). In addition, the acceptance of technology has not been significantly correlated with the general health status of the elderly and their economic situation.  The technology acceptance status of older people in Tehran was higher than average and the intention to use ICT tools was significant among them. But the difficulty in using some of these tools has been one of the most important limitations in adopting ICT technologies. Additionally, the adoption of technology among the elderly is not influenced by their economic situation or the health status, and therefore all groups of the elderly can be considered target groups to enhance their ability to use ICT tools.

Today, due to advances in health and economic development, we are witnessing improvements in living standards and life expectancy. On the other hand, after a period of fertility, in recent decades the proportion of the elderly has grown by decreasing women’s fertility rates. The phenomenon of increasing the aging population is one of the most important challenges facing the present century in the economic, social and health spheres. Epidemiological studies predict that by 2050, the population over 60 in Iran will reach over 26 million. Social welfare in every society is one of the most basic social needs. “Living standards” are one of the most important indicators of objective welfare. Living standards relate to the level of economic welfare of individuals, and emphasize the external aspects of life, including ownership of objects and resources, income, and wealth. As defined by the United Nations, living standards include aspects such as participation in social activities, access to services used by most people (public or private), economic resources, such as income, savings and assets, access to health services, leisure, and housing. A review of research shows that the income index has been used frequently to measure living standards. But income is not an appropriate indicator of living standards, because it does not reflect other sources or benefits and does not reflect changes made over time, and  many people refuse to express their exact income. The United Nations Development Program (UNDP) also uses an objective approach to assess the standard of living. This approach includes GDP, employment, health, life expectancy and education, availability of facilities such as libraries and recreational facilities, and the extent to which people participate in the community. The review of living standards studies shows that there is little attention paid to the standard of living of the aging population in Iran, and in this case, there is a lot of information and knowledge gap. Thus, the present study was conducted to examine the standard of living of the elderly population in Tehran. This cross-sectional study was conducted on a population of elderly over 60 years in Tehran. Participants were selected using stratified random sampling method. Twenty two districts of Tehran based on employment rate, gross household expenditure, women’s employment, total employment ratio and household growth rate were divided into three zones, including low, moderate, and high. The sample size for each zone was calculated 50 people with an appropriate formula. The inclusion criteria included age over 60, the ability to understand and respond to the questionnaire, and informed consent. Data were collected via a socio-demographic and standard of living questionnaire. The Living Standards Questionnaire is a self-report scale and includes 17 items in three dimensions. Validity and reliability of the questionnaire was confirmed by Jahan pour et al. (2017). After completing the questionnaires, the data were analyzed with SPSS-22 using one-way ANOVA and independent t-test. The mean±SD age of the participants was 63.7±2.9 years, 54% of them were male, 42% had primary and secondary education, and 57.3% were retired. Table 1 shows the descriptive characteristics of the participants.

Table1: Descriptive statistics of the participants
Variables    N    Percent
Sex        
Male    81    54
Female    69    46
Level of education        
Illiterate    17    11.3
Elementary    63    42
Diploma    48    32
Academic    22    14.7
Employment status        
Retirement    86    57.3
Homey    37    24.7
employed    15    10
Retirement and re-employment     12    8
Income        
10 million Iranian Rials ≥    59    39.3
10-20     51    34
20-40    34    22.7
< 40    6    4
Housing status        
Owner of the house    127    84.7
Tenant    21    14
Organizational Home    1    0.7
Other    1    0.7


The result showed that the mean score of standard of living was 6.73±2.53. The results also showed that the elderly acquired a higher score in the living facilities dimension compared to the other two dimensions. The mean scores of male and female standards of living were 6.65 and 8.28, respectively. However, there was no significant difference between two genders in terms of living standard. There was a direct and significant relationship between the living standards and employment status. The mean score of living standards in the upper, middle, and low socioeconomic zones were 8.72, 6.58 and 4.62, respectively. Therefore, the standard of living in the middle and lower zones were low, but in the upper level was moderate. Table 2 shows the status of living standards and its dimensions in the elderly of Tehran.
Table 2: Status of living standards and its dimensions in the elderly of Tehran
Variables    Minimum    Maximum    Mean    SD
Living standards    1.83    12.42    6.73    2.53
Life facilities    0.58    9.17    3.89    1.50
Housing status    0.50    3.25    1.97    0.49
Household expenses    0.25    1.75    0.86    0.36

The status of studies on objective well-being, living standards and dimensions including education, leisure, economic and social status, living environment, and employment status, especially in the Iranian elderly community, indicate the gap of knowledge in this area. The findings of this study showed that the standard of living for the elderly is at a low level. In the present study, living standards had no significant relationship with gender variable, while some studies showed that in older ages, being males and having lower socioeconomic status decrease the chance of achieving successful aging. It has been suggested that due to inequalities between the two sexes in property ownership, employment and control over income and assets, this age period for women has more economic problems. On the other hand, considering the effect of economic power on the degree of satisfaction with aging, it seems that women’s economic weakness due to their low level of employment and activity makes it difficult for women to have an old age. In this research, there is a meaningful relationship between living standards and the employment status of elderly people because some people may be re-employed during retirement and this may be related to the needs of individuals life and socioeconomic problems. We found that the living standards of elderly people in the upper zone of Tehran were better than moderate and low zones. There is also a significant relationship between variables of living standards and socioeconomic status. Considering the importance of this age group, more research is needed in order to investigate their issues in Iranian society. We proposed that living standards in older people in other cities of Iran be assessed due to cultural, linguistic, and lifestyle differences.  
In the present study, all expenses were borne by the author and he did not have any sponsors
All authors contributed in designing, running, and writing all parts of the research.
The authors declared no conflict of interest
In this article, all rights relating to references are cited and resources are carefully listed.

The recently emerged symptoms of population aging have raised serious concerns in some developed countries. A recent report by the United Nations (UN) indicates that aging is more rapidly growing and is even more serious in developing countries than it is in certain other countries. Therefore, this study is aimed to determine the impression of aging on non-oil economic growth. A simple economic growth model was built which would take demographic variables into account. Then, using the country's data for the years 1967-2011, the researchers tried to estimate autoregressive distributed lags (ADL). The short- and long-term models, and error correction model were estimated using Microfit 4.0 software. The findings show that physical capital, human capital and trade openness have a significant positive effect on per capita income, both in the long and in the short run. Similarly, the regression analysis indicates that “Ageing Index” may have a significant effect on economic growth in Iran’s non-oil sector. Due to the young makeup of Iran's population, the signs of aging economy have not raised sensitiveness; but predictions indicate that the aging process in Iran will be intensified in the coming decades and its negative effects will emerge in near future. Therefore, due to the long-term effects of aging on economic growth, working structure and retiredness reform policies, it is vital to stabilize population growth at an optimal rate, and more importantly, pay attention to capital storage.

Population aging is taking place in developed countries and causes some anxiety in recent decade. United Nations’ most recent report shows that the aging in developing countries are growing more rapidly than other nations and they will confront with the obstacles of this phenomenon in a few decades. Iran has third highest rate of population aging in the world that increases the importance of this issue for policymakers. Thus, it is needed to analyse the sectors that may affected by population ageing. Despite of its importance, there is not a comprehensive study that analyses the economic aspects of aging. This study conducted to specify the economic aspects of the Iran’s aging population. To this end, ageing effects has been investigated in the most important economic sectors and the preventive strategies outlined for policymakers. It is hoped that this study will be a first step toward scientific look at the ageing phenomenon and will stimulate further investigation.

This study estimates quality of life index for provinces by using Sen approach. The empirical results for 30 provinces by totally fuzzy analysis, evaluate and show that West Azerbayjan, Kourdestan and Sistan & Balouchestan are in crises area. Due to this, with mentioning 3 sub indices and 9 variables that used in this research, proposed policies to decrease deprivation in such provinces have explained. The results of Pearson coloration coefficient, show that there is a significant relation between QOL and HDI that explain HDI is a good presenter for welfare; but because QOL encompasses more pervasive variables in, it is more universal. Results show that in spite of country studies, there isn’t significant correlation between human development index and income per capita, and also quality of life and income per capita.

In recent years، population aging causes some concerns among policy makers. Meanwhile، the share of health expenditures (HE) in gross domestic product has been rising rapidly. Some economic theories consider less growth in productivity as main cause of wage increase and absorbing labor force to the health sector. Present study examines that if wage increases in excess of productivity growth can explain health expenditure growth. To this end، unbalanced growth model is used to determine main drivers of health expenditures growth. Beside the main purpose of the study، model setup allows us to concentrate on the role of per capita income and inflation in the health expenditure growth. Estimating a classical econometric model using data period of 1360-1389 shows that wage increases in excess of productivity growth has a significant effect on HE growth. In other words، existence of the unbalanced growth in Iran has not been rejected. By the way، growth in per capita income and price level in health sector have positive and significant effects on the HE growth. According to the unbalanced growth theory and projected population ageing، HE rises can be considered as a main threat to Iranian health system. It is clear that the best palliative against the future rise in health care expenditure is to increase productivity in the health sector.

Efficiency is the missed part of a health sector in developing countries. Moreover، concerns about the Millennium Development Goals (MDGs) lead to specific attention for optimal use of limited resources in health sector. This study utilized data envelopment analysis (DEA) and linear programming methods to evaluate the efficiency of the government health expenditures from 2000 to 2008 for a sample of 88 developing countries. First of all، the countries were classified into two categories using cluster analysis method; and then، the efficiency analysis was applied separately for each group. In addition، by the use of multiple discriminant analysis (MDA)، the importance of each variable in the clustered groups was determined According to the cluster analysis، the first cluster composed of 49 countries and second cluster included 39 countries. MDA revealed that the infant mortality، mortality of children under 5 years، total fertility rate and life expectancy had a main role in disparity of the two clusters. Due to appropriate outputs، Iran took 16th rank among the first cluster countries. Measles vaccine is the most sensitive output in the first cluster countries due to appropriate performance in that indicator. In the second cluster، there was no country without sensitivity; in other words، these countries cannot achieve to the balanced growth in their health sector.

In spite of basic differences in physician market، we have to consider main derivatives of physician services pricing. Analyzing the marginal cost of generalist and specialist shows that the “fee splitting” occurs when there is a divergence between price and the marginal opportunity cost of specialist. We hope that when the prices of such services are equal with marginal costs، the kickbacks will be vanish. In other words، fee splitting becomes a tool for eroding monopoly power; it provides a channel to transfer some part of specialists’ monopolistic power to generalists. In this study we use three economical theoretic instruments to analyze the fee splitting. First of all، by using the “theory of agency” we can discuss about the physician violations from their tasks as an agent. Afterward we apply theoretical principles of behavioral economics to examine the differences between physicians and other economic factors decision making. Finally we analyze the marginal cost differences between generalists and specialists to clarify the main economic origins of fee splitting.

In modern economics, equity objectives are the main reasons for government intervention. Dispensation policies are not only related to economic outcomes (such as income, etc.), but encompass other issues such as education, health and social services. This has led to entrusting the provision of social health and educational needs to the government. The purpose of this study was to investigate how much government expenditures would be effective in achieving better health outcomes. In this study, panel data of a group of Organization of Islamic Countries (OIC) in 1991–2005 was used to explore the effectiveness of government expenditures in health and education sectors. Classical Econometrics Model (CEM) and Covariance Structure Model (CSM) were applied to analyze the relationship between public social expenditures and social indicators. The results of this study showed that the government expenditures in these sectors had significant impact on the health and education indicators in these countries. Furthermore, the superiority of the CSM model to CEM was approved in this study. Since the governments are committed to achieving Millennium Development Goals, it is of prime importance to consider the effectiveness and efficiency of public expenditure. Furthermore, using particular estimation techniques, like CSM, can lead to accurate estimation of social expenditure effects and an improvement of the elasticity magnitudes.

Value added is a criterion for evaluating the performance of economic units. Statistics related to various economic indicators of industrial workshops located in Iranian provinces with their value added are annually obtained by Statistical Centre of Iran via “Industrial Workshops Survey” program. This study is going to find the most important factors affecting the value added of the workshops, by using one of the newest methods for variable selection, called SCAD penalty function. The results show that from 1997 to 2006, the amount of labour education, type of workshops management, audit fee, research and propaganda cost, and land value are of the highest important for producing value added of the industrial workshops.