زهرا خطیرنامنی

The goals of the family physician program include creating a referral system in the country, increasing accountability in the health market, increasing people's access to health services, reducing unnecessary costs in the health market, and increasing service coverage. This study was conducted with the aim of evaluating the implementation of the family medicine program from the point of view of managers and staff experts with a process approach in 2022.

In a descriptive-analytical study, 231 heads of health centers of the city and deputies, heads of technical and administrative units (managers) and experts of technical and administrative units (staff experts) in the west of Golestan province participated by census method. The data collection tool was the valid and reliable questionnaire of Abedi et al. In order to analyze the data, descriptive statistics and inferential statistics methods such as Pearson's correlation coefficient, independent t test and one-way analysis of variance were used in SPSS-23 software.

The overall score of the questionnaire was 332.53 ± 56.25, which is slightly higher than the average. The highest average score among the dimensions related to the process area was 4.99 ± 0.85. The highest scores were in the area of the structure related to the design and compilation of the electronic health record, in the area of the process related to the implementation of family doctor services in the form of the electronic health record, and in the area of results related to the level of knowledge of the health team.

The implementation process of the family physician program in the west of Golestan province was evaluated slightly higher than the average level in general and separately in terms of structure, process and results. In order to improve the current situation, it is necessary to solve the financial problems of the implementation of the program and the full implementation of the referral system should be prioritized in the programs of health managers.

Health workers should be trained based on the real needs of the society in terms of quantity and quality, so that af ter graduation, they can be employed in organizational positions related to their field of study and solve the health problems of the society by providing relevant services within their scope of duties. The purpose of this study was to explain the required knowledge and skills for public health undergraduates.

This qualitative study was conducted with the content analysis approach and by holding three focus group discussion sessions with 30 health network managers; managers, heads and experts of the technical groups of the deputy of health and the headquarters of health networks, and health care workers of comprehensive urban and rural health service centers in Golestan province. Data analysis was done using thematic content analysis method and MAXQDA software.

After merging the similar codes with each other, finally 55 codes were extracted and classified into 19 subthems and finally categorized into 4 thems. Management information needed by public health graduates included work mission in health, planning and supervision, work ethics and executive processes. Specialized and field information included re-emerging and emerging diseases, population youth, crisis management, mental health, reproductive health, aspects of social health and immunization. The practical skills of individual development included teamwork, communication skills and expression techniques, attracting social participation, using virtual networks and familiarity with information technology. Skills needed to work in the health system included regional situation assessment, operational planning, and first aid.

The required knowledge of public health students can be provided by including the results of the study in the educational curricula and in accordance with the new instructions. Also, the combination of practical skills with theoretical topics during academic semesters and paying more attention to internship courses can train public health students according to the needs of the health system.

Perceived mental workload is a set of factors that affect the mental processes of information processing, decision-making and individual reactions in the work environment. Patient safety refers to the prevention of injuries caused by medical errors that occur due to negligence in the performance of duties. The present study was conducted to determine the perceived workload and its relationship with the culture of patient safety in nurses.

  This analytical cross-sectional study was conducted among the nurses of Shahid Sayad Shirazi and 5 Azar teaching hospitals in Gorgan city in 2022. In total, 280 nurses of the mentioned hospitals participated in the study. The random stratified sampling was applied and the ethics code was obtained. The data were collected by means of mental workload and patient safety culture questionnaires and it was analyzed using descriptive and inferential statistics methods in SPSS-24 software.

The average age and standard deviation of the nurses was 34.9 ± 9.2 years. Most of the nurses had a bachelor's degree (90.4%) and were married (71.6%). The average score and standard deviation of perceived workloads was 73.80 ± 14.74. The overall score of patient safety culture was 3.30 ± 0.26. There was no significant relationship between perceived workload and patient safety culture (P = 0.204).

The perceived workload was high among the nurses and the safety culture status was moderate.

Organizational commitment has been considered as the objective and efficient achievement of the organization's goals and values, the achievement of the individual's role in relation to the goals and values, and the achievement of the organization for its own sake. This study was conducted to investigate the quality of work life and organizational commitment and their relationship with each other.

A descriptive-analytical cross-sectional study was conducted in 2022. 280 employees of the health service delivery levels of Gorgan City participated in the study in a random stratified method. The data were collected using valid and established questionnaires of Walton's quality of work life and Allen and Mayer's organizational commitment and were analyzed with descriptive methods and statistical tests in SPSS-23 software.

The average age of the participants was 40.11 ± 9.04 years. The majority of participants were female (69.3%) and the rest were male. In general, 18.9% of people had a low quality of work life (QWL), 66.8% had an average QWL, and 14.3% had a high quality of life. Also, 11.1 percent of people had low organizational commitment, 77.1 percent had medium organizational commitment, and 11.8 percent had high organizational commitment. There was a statistically significant relationship between the QWL and organizational commitment (P-Value = 0.001).

The QWL and organizational commitment of employees were evaluated at moderate levels, and with the increase in the QWL, organizational commitment also increases.

Medications are the most common therapeutic intervention, and the safe use of medication and the existence of processes to improve the safety of medicine are of prime importance. Since nurses have a major role in implementing medication orders, they play a vital role in promoting safety and reducing medication harm to patients. Therefore, the present study was conducted to determine the barriers to reporting medication errors by nurses of teaching hospitals affiliated with Gorgan, Iran, in 2021.

In this cross-sectional study, 340 nurses from Gorgan teaching hospitals were selected by a randomized stratified method in 2021. The data collection tool was a demographic information checklist and a valid questionnaire of barriers to reporting medication errors. The collected data was analyzed using SPSS software (version 16). Moreover, descriptive statistics, Kolmogorov-Smirnov tests, Spearman, Mann-Whitney, and Kruskal-Wallis correlation coefficients were used.

The average age of the nurses was 33.11 ± 7.36 years, and 290 (85.3%) participants were female. The average score of reporting obstacles in the area of "fear of management factors" was higher than other areas (3.20±0.50), followed by the areas of "fear of reporting consequences" (3.17±0.35) and "factors related to the reporting process" (2.87±0.63) were in the next ranks. The highest average in the areas of "fear of the consequences of reporting", "factors related to the reporting process" and "fear of managerial factors", were respectively related to "fear of legal issues" (3.94±1.11), "unclear definition of medication error" (3.54±1.05), and "disproportionality of the officials' reaction with wrong hierarchy of importance" (3.75±0.96). The service sector had a significant relationship with the overall score of barriers to reporting medication errors (P=0.020) and the area of fear of managerial factors (P=0.017) in a way that the barriers to reporting medication errors by the nurses of the Emergency Department were higher than the other parts.

Among all reporting barriers, "fear of legal issues" had the highest score. Due to the existence of factors such as fear of judicial issues and the inappropriate reaction of hospital officials, it is suggested to define the error reporting process and how to handle medication errors and train hospital managers on how to deal with the person at fault.

The emergency department (ED) of hospitals is of special importance due to receiving a high number of critically ill patients. This study aims to determine the prevalence and costs of non-urgent visits to the ED of public hospitals in Golestan, Iran.

This is a descriptive cross-sectional study. The study population includes all patients referred to the ED of hospitals affiliated to Golestan University of Medical Sciences in 2019. Patients who did not require emergency care and were in the fourth and fifth levels of triage were considered patients with non-urgent emergency needs. The cost of ED services were extracted from the hospital information system and using the top-down costing method. To describe the data, descriptive statistics were used in SPSS software, version 23.

Out of 519,204 patients referred to the EDs, 218,037 (42%) had non-urgent visits. Among these patients, 43% were male and 57% were female. The total cost of services for non-urgent ED visits was 43,856,887,000 Iranian Rials. For patients with the fourth level of triage, it was 42,094,000,000 Iranian Rials, and for those with the fifth level of triage, the cost was 1,762,887,000 Iranian Rials.

The number of non-urgent visits to the ED of public hospitals in Golestan is considerable. It can lead to a significant waste of hospital resources. Reducing unnecessary ED visits in hospitals can reduce the costs of the health system and improve the quality of hospital services.

High perceived organizational support can make employees feel that they belong to the organization and have less intention to leave their jobs. This study aims to determine the relationship between turnover intention and perceived organizational support in nurses working in hospitals in Gorgan, Iran.

This cross-sectional study was conducted in 2021 on 293 nurses from 16 hospitals affiliated to Golestan University of Medical Sciences who were selected by stratified sampling method, proportional to the population. The data collection tool was a three-part questionnaire including demographic/occupational form, Kim et al.’s turnover intention questionnaire (TIQ), and Eisenberger et al.’s Perceived Organizational Support Questionnaire (POSQ). The data were analyzed using SPSS software, version 16. 

The mean scores of TIQ was 39.91±12.18 and the mean score of POSQ was 23.66±6.6. There was a negative significant relationship between turnover intention and perceived organizational support (P<0.001).

The turnover intention and perceived organizational support of nurses in Gorgan are at a moderate level. As the nurses’ perceptions of organizational support decrease, their turnover intention can increase. It is necessary to create a supportive environment for nurses, in such a way that this support be tangible and understandable to them and can cause job satisfaction and prevent them from leaving the job.

occupational hazards in nurses are very high, which leads to increased absenteeism from the workplace, more visits to the doctor, reduced service provision, loss of working hours and disability. Improper safety climate can be one of the causes of occupational accidents. This study was conducted to determinate the prevalence, causes of occupational hazards and the existing safety climate in Gorgan educational hospitals from the nurses' point of view.

This was a cross-sectional study and was conducted in teaching hospitals of Gorgan city. 267 nurses participated in the study by stratified random sampling. The data were collected using valid and reliable questionnaires on the frequency of occupational hazards, causes of occupational hazards, and safety climate and were analyzed using Spearman, Mann-Whitney, and Kruskal-Wallis correlation coefficient tests.

In terms of physical injuries, 94% of nurses had suffered from musculoskeletal disorders. 90.3% expressed that they were threatened and verbally and physically attacked by the patient and his companions. The large amount of nursing work (61%) was the main and most common cause of occupational injuries in the workplace of nurses. The average score of the existing safety climate was 3.10 ± 0.6.

A high percentage of nurses reported physical and mental injuries caused by work, and the safety atmosphere among nurses was relatively moderate. To reduce physical injuries, nursing managers must pay attention to injury prevention methods and how to deal with this problem.

The notion of educational service quality is multifaceted and arises from the perceived variance between students' expectations from the educational system and the services they actually receive. The progression of universities has shifted from a quantitative phase to a qualitative one, and as such, it has become necessary to assess the quality of university services. This research was conducted to evaluate the educational service quality at Gorgan Dental School.

A cross-sectional descriptive study was conducted in 2021, among dental students attending Gorgan Dental School, Golestan University of Medical Sciences. Data were collected using the SERVQUAL model questionnaire, which was devised considering the five domains of service quality. Descriptive statistics and inferential statistics were used in SPSS 23 to analyze the data.

 A total of 103 students, with an average age of 23. 09±3. 31 years, participated in this study. Most of the students were female (59%) and the rest were male (44%). The average overall score of expected service quality was 4.52±0.49 and the overall average score of perceived service quality was 3.09±0.71. The overall average gap in service quality was -1.44±0.79. The greatest gap was noticed in the responsiveness domain (-1.58±1.05) and the least gap was found in the tangible domain (-23.1±0.92).

There was a gap in all aspects of the quality of educational services and related terms, which shows that the expectations of students have not been completely met. In order to resolve this gap, meticulous planning and effective management of educational services should be enacted.

Work stress is a negative physical and mental reaction that is the second most common work-related problem after musculoskeletal disorders. Fatigue is a state that occurs during a work period and because of that, a person loses his efficiency. This study was conducted to determine the relationship between job stress and job fatigue in nurses.

It was a cross-sectional descriptive-analytical study that was conducted in teaching and therapeutic hospitals of Gorgan city including Sayad Shirazi Hospital, 5 Azar Hospital, and Taleghani Hospital in 2021.277 nurses were included in the study after random stratified sampling. Data were collected by OSIPOW job stress questionnaires and Swedish SOFI job fatigue questionnaires.

The mean score of job tension was 180.05 ± 23.4 that was classified as moderate to severe.    The highest score was related to the role workload dimension and the lowest was related to the physical environment dimension. The mean score of job fatigue was 53.18 ± 22.5 and was evaluated at a lower than average level. The highest score was related to the dimension of lack of energy and the lowest was related to the dimension of physical effort.

Considering the relationship between job stress and job fatigue, it is suggested to provide the necessary infrastructure and facilities to reduce the stress in nurses and provide training on how to deal with the stress to the hospital staff.

Nurses' fatigue is defined as a mental and multidimensional feeling of fatigue that is physically and mentally penetrating and may even remain despite periods of rest. In addition to fatigue, nurses suffer from lack of sleep and its poor quality more than other occupational groups. This study was conducted to determine the relationship between occupational fatigue and sleep quality in nurses.

This was a correlational and cross-sectional descriptive study that was conducted at Golestan University of Medical Sciences, Golestan, in 2021. A total of 277 nurses were included in the study after random stratified sampling and obtaining the code of ethics. The required data were collected by Swedish Occupational Fatigue Inventory and Pittsburgh Sleep Quality Index, and analyzed in SPSS-23 software using descriptive statistics and Spearman correlation, Mann-Whitney, and Kruskal-Wallis tests.

The mean scores of the nurses' age and work experience were obtained at 28.75 ± 4.8 years and 5.66 ± 4.6 years, respectively. In total, 68.6% of the nurses were women. The mean of the total occupational fatigue score was 53.18 ± 22.5, which was evaluated at a lower-than-average level. The mean of nurses' sleep quality was 18.14 ± 1.77, which indicated poor sleep quality in nurses. There was an inverse and significant relationship between the score of occupational fatigue and all its dimensions and sleep quality.

The level of occupational fatigue in nurses was lower than the average and their sleep quality was poor, and with the increase in occupational fatigue, the quality of sleep decreased. It is suggested to implement individual and organizational solutions to reduce and eliminate occupational fatigue and improve sleep quality.

The assessment of the length of hospital s tay until recovery of patients with Covid-19 and its related factors in different areas can help manage the treatment process and prepare for the epidemic. This s tudy aimed to model the survival time until the recovery of COVID-19 definite patients.

This descriptive-analytical s tudy was retrospective. The s tatis tical population included all COVID-19 definite hospitalized in the educational and medical hospitals of Goles tan University of Medical Sciences from 20 February to 20 July 2020. The outcome variable was discharging confirmed cases of Covid-19. All analytical tes ts and charting were performed in R3.6.2 software.

From a total of 3480 confirmed patients, 77.5% recovered, and 22.5% experienced death at the end of the s tudy or were undergoing treatment. The median length of hospitalization in patients was 6 (IQR: 3-10) days. The mean age of all patients was 52.93±19.20 years; 58.2% of patients were over 49 years old, and half of the population were male. Women infected with Covid-19 survived and recovered 1.16 times more than men. Patients with an age group above 49 years of age had more recovery than their counterparts aged under 49 years.

As evidenced by the obtained results, apart from older adults, the prevalence of the disease needs to be evaluated more closely in young people and men, and these people should be monitored and screened frequently.

One of the characteristics of the favorable situation in the university is the fulfillment of students' expectations from the process of educational services. This study aimed to determine the gap of quality of educational services in the medical school of Golestan University of Medical Sciences. This study was a cross-sectional study that was performed by the descriptive-analytical method. Hence, 179 students studying in Faculty of Medicine during 2021 through an accessible way were entered the study. The data collection tool was adjusted according to the SERVQUAL model questionnaire, too. Moreover, among all students, 62% were male and the mean age was 23.64 ± 3.28 years. The result showed that the overall gap in service quality was -1.43 ±0.94, whereas the largest gap in the confidence dimension was -1.51 ±0.96. The biggest gap in the tangible dimension was related to "the existence of modern and efficient equipment in the faculty"; in the dimension of assurances related to "performing activities by teaching staff at the time promised"; in the dimension of accountability related to "easiness of students' access to authorities to convey opinions and suggestions about education issues"; "; in the guarantee dimension related to "preparing students for future employment by professors and counselors by providing theoretical and practical training in the faculty"; and finally the empathy dimension was related to "education staff treatment of students" In all aspects of providing educational services, there were seen some shortcomings that necessitated planning to reduce or eliminate them. To be more aware of the educational needs of students, periodic surveys have been needed to identify the deficiencies as soon as possible and to take the necessary measures to improve the situation.

The payment system of specialist physicians has significant effects on the country's health costs and the provision of medical care at a fair, sufficient and high-quality level. This study was conducted to design the payment system's implementation guidelines for providing specialized services in the electronic referral system.

A qualitative study was conducted in 2021. The participants were hospital managers, top managers and experts in charge of health, treatment and development departments of Ministry of Health and Golestan University of Medical Sciences, Health Insurance Organization of Golestan province, specialist physicians and faculty members. Fourteen focus group discussion and six in-depth individual interviews were conducted. The content analysis method was used to analyze the data.

The requirements for the establishment of an efficient and effective payment system were classified into 6 main themes (legal, political, managerial, executive, economic, cultural and social) and 32 subcategories. The executive mechanism was classified into 3 main themes (executive structure, executive process and monitoring and evaluation method) and 16 subclasses.

The implementation of the designed instruction can lead to increasing the access and benefit of services, improving the quality of providing specialized services, cost management and finally increasing the satisfaction of service providers and receivers.

The primary health care program for the suburbs is being implemented in Iran after the Health Transformation Plan where services are delivered with the priority of outsourcing and purchasing services from non-governmental sectors. In this program, different payment methods have been used. This study aimed at addressing the challenges associated with payments made to urban primary health care providers in Iran.

This qualitative study was conducted using a framework analysis approach through semi-structured interviews with 30 experts and service providers. Data were analyzed using MAXQDA.10 and Gale framework analysis method.

The study showed that lack of proper financing of the program is one of the most important challenges of the payment system. Other challenges included insufficient and late payments to providers, impossibility of recording all activities and inability to exchange data between electronic information registration systems (both horizontally and vertically), improper contracting method, incompatibility of service package volume with the amount of payment, the impossibility of applying the monitoring result on the amount of payment due to paying the minimum amount of labor law payment, and inflexibility of payment instructions.

The payment system for urban primary care providers does not have a suitable structure in various dimensions, including financing, payment, contracting method, data registration system, and monitoring and evaluation system. If these problems continue to exist, providers would leave the service system and the quantity and quality of services are reduced.

Accidents are one of the main causes of death that impose a great socioeconomic burden on society. This study aimed to model and predict the trend of mortality due to accidents in Golestan province, Iran, from 2011 to 2020.

The study was a secondary analysis based on the available data. The required information was obtained from the statistics unit of the Health Department of Golestan University of Medical Sciences (Gorgan, Iran) and was cleaned after being entered into the Microsoft Office Excel software (2016). Afterward, all the steps of analysis and fitting of the Lee-Carter model were performed using the Demography (version 18/1) and StMoMo packages in the R/3/62 software.

The death rate due to accidents in 2011 was 0.51 in the total population, 0.23 in women, and 0.78 in men per 1,000 population. It is predicted that in 2028, the age group of over 80 will reach 2.17 in the total population, 2.12 in men, and 1.77 in women (per 1,000 population). Both men and women over 50 years of age had the highest increase in deaths from accidents.

Based on the findings of the study, the trend of deaths due to accidents in Golestan province is upward. Therefore, it is necessary to plan to reduce accidents, and in this regard, specific strategies should be formulated and implemented by explaining the role of all stakeholders.

Because students receive a variety of educational services during their studies, their view of the services provided can be considered as one of the characteristics of quality in the university. This study was conducted to determine the quality of educational services from the perspective of nursing students.

A cross-sectional study was performed in the School of Nursing of Golestan University of Medical Sciences with a sample of 164 people. The data collection tool was a valid and reliable SERVQUAL questionnaire. Data analysis was performed using SPSS-23 statistical software.

In all five dimensions of educational services (physical dimensions, guarantee, accountability, confidence, and empathy) there was a negative gap between the current and desired status of students and the quality of educational services. The highest mean gap was in the dimension of empathy and responsiveness (-1.73) and the lowest mean gap was related to the tangible dimension (-1.43). The age of students was directly and significantly related to the quality gap in the dimensions of confidence (P = 0.028) and empathy (P = 0.046). Gender of students with total quality gap (P = 0.004) and in the dimensions of confidence (P = 0.018), accountability (P = 0.003), guarantee (P = 0.013) and empathy (P = 0.001) P) and students' education also had a significant relationship in terms of confidence (P = 0.001).

Students' expectations are beyond their perception of the current situation and in none of the dimensions, their expectations have been met. Holding effective communication training courses and receiving feedback can play an effective role in improving the quality of educational services.

An Internship in the field is one of the courses that students should be trained in a real work environment. Internship course plays a key role in shaping students' core skills and professional competencies. The purpose of this study was to determine the executive strategies of internship training program in the field of public health in the School of Health of Golestan University of Medical Sciences. This descriptive qualitative study was conducted in 2019-2020 in Golestan province. Participants in the study were 31 undergraduate public health graduates who completed their internship at the School of Public Health, undergraduate public health students who had completed at least one semester of internship, instructors, and faculty members of the Department of Public Health. They were purposefully selected. Data were collected by group and individual interviews and Analyzed by content analysis method in Atlas.ti 8 software. The executive strategies to improve the internship situation in the field of public health were explained in 5 main topics (Upgrading the educational system, planning and preparation before internship, internship management, improving the situation in the internship area and monitoring and evaluating students) and 24 sub-topics. The selection of appropriate strategies to improve the current situation in the framework of the operational plan, can lead to quantitative and qualitative improvementof internship in public health at Golestan University of Medical Sciences.

Work-family conflict leads to reduced productivity, increased employee tardiness, absenteeism, reduced work and organizational commitment. This study aimed to determine the relationship between work-family conflict and the desire to stay in the job from the perspective of employees of comprehensive health service centers in Gorgan.

This descriptive- analytic, cross-sectional study was conducted in 2021. 344 employees of Comprehensive Health Service Centers in Gorgan participated in the study. After sampling by stratified random method, Nete Meyer work-family conflict questionnaire and the tendency to stay in the job of Wiener & Vardi were collected and with the help of descriptive and inferential statistical methods in SPSS-23 software at a significance level of 0.05 Were analyzed.

The mean of work-family conflict was 32.77 ±10.32. The mean of work-family conflict (16.97 ±7.31) was higher than family-work conflict (15.80 ±6.55), (P = 0.014).  The mean desire to stay in the staff of comprehensive health service centers was strong (13.17 ± 3.51). 9.3 percent tended to stay in a weak job, 33.4% had a moderate tendency and 57.3 percent had a strong tendency. There was a significant weak and inverse correlation between the overall score of work-family conflict with the tendency to stay in the job (P <0.001).

The rate of work-family conflict in this study was moderate to low. The desire to stay on the staff of Gorgan Comprehensive Health Service Centers was evaluated as strong.

Job stress can be considered as a combination of stressors. The aim of this study was to determine the relationship between occupational stressors and demographic variables in the staff of Gorgan health network in 2021.

In this cross-sectional study, 192 employees of comprehensive urban and rural health centers, health centers and health centers participated in the study. In this study, stratified random sampling method was used. A valid and reliable Job Stress Scale  questionnaire was used to collect data. Data were analyzed by SPSS-23 software using Mann-Whitney and Kruskal-Wallis tests.

Of the total staff, 59.9% were women, 34.4% were in the age group of 31-40 years, 68.8% were married and 50% had a bachelor's degree. The highest score was in the role dimension (3.86± 0.80) and the lowest score was in the relationship dimension (2.40± 0.78). The overall score of job stress was 22.06± 2.65. Only between the age group and the amount of job stress in the staff of health centers in Gorgan in 1400 was observed a significant relationship (P = 0.032). Also, other demographic variables had no significant relationship with job stress (P>0.05).

The results of the present study showed the average level of the overall score of the occupational stressors scale in the staff of health centers. Therefore, it is necessary to investigate the prevalence of mental disorders and identify the factors affecting it in employees and take the necessary interventions to improve their mental status and prevent its increase and prevalence.

Healthcare policymakers and planners use the economic burden of the disease to determine the total cost of an outcome, illness, or accident imposed on the country. The aim of this study was to calculate the direct and indirect medical costs in Covid-19 patients with critical conditions hospitalized in the intensive care unit in Golestan province.

This descriptive-analytical study was a partial economic evaluation performed cross-sectionally, and included all hospitalized patients with critical conditions in the first 6 months of 2020 in a public hospital in the Covid-19 center (158 patients).The required data were collected from patients' records by the hospital information system. Data analysis and calculation of direct medical and indirect costs of the disease in this research study was carried out based on the incidence approach and bottom-up method from the perspective of the society.

The average direct medical cost per hospitalized patient in a critical condition was 214,926,500 rials. Hospitalization and pharmaceutical services accounted for the largest share of the costs. The average indirect cost for each patient in a critical condition was estimated at 959,577,714 rials.

The results of the study showed a huge economic burden of Covid-19 on society and the health system. The high prevalence of this disease has imposed huge economic damages on society and the country's health system.