Journal of Health Scope
Volume:10 Issue: 3, Aug 2021

This study aimed to systematically review the literature on the Iranian healthcare system in the time of increasing privatization.

A systematic literature review was conducted using MEDLINE, CINAHL, APA PschInfo, and Cochrane databases to identify various concepts in the literature concerning the privatization of healthcare in Iran between September and November 2020. All the included articles were assessed using the John Hopkins Nursing Evidence-Based Practice Research tool. In addition, grey literature was searched using Google targeted at academic websites and key organizations and online newspapers and magazines in the Persian language. This screening resulted in a total of 70 articles, reports, and documents. The PRISMA guidelines were followed for abstracting data and assessing the quality of the studies.

Six health-related items were identified at the time of increased privatization in the healthcare system. These items consisted of medical establishments, accessibility, and privatization, catastrophic health expenditure (CHE), out-of-pocket payment (OOP), health inequality, privatization, and healthcare providers, and the policy and finance of privatization.

The review identified that the process of privatization of the healthcare system in Iran occurred with poor monitoring and evaluation mechanisms. Privatization rested on neoliberal arguments, and for-profit care has worsened healthcare performance and created an unfair, expensive healthcare system of lower quality in Iran.

Noise pollution is a global problem causing changes in the secretion of various hormones and consequently affecting social well-being and quality of life in cities.

This study aimed to investigate the effect of noise pollution on the levels of testosterone, thyroid, and cortisol hormones in male rats.

In this experimental study, a total of 70 male Wistar rats (200 - 250 g) were randomly assigned into one control and six experimental groups, with 10 rats in each group. Experimental groups were exposed to noise with different intensity (dB) and time (min) as follows: (I) 60 dB, 30 min; (II) 60 dB, 60 min; (III) 85 dB, 30 min; (IV) 85 dB, 60 min; (V) 110 dB, 30 min; (VI) 110 dB, 60 min; (VII) controls. Animals in the experimental groups were exposed to noise in an acoustic chamber designed for this purpose for 50 days. The Noise.exe software was used to generate noise, and the sound level meter (model TES 1358) was used to determine the accuracy of the intensity and frequency of sound. To determine plasma levels of the hormones, appropriate research and commercial kits were used, which were based on the ELISA method. To determine the concentration of hormones other than TSH, human assay kits were used. All statistical tests were performed in SPSS software version 21.

Serum levels of cortisol in the 110-dB (30 and 60 min), 65-dB (60 min), and 85-dB (60 min) groups were significantly higher than the control group (P ≤ 0.05). Also, cortisol levels in the 65-dB and 85-dB (30 minutes) groups were higher than the control group; however, the increase was not significant (P > 0.05). The levels of T4, T3, and TSH in the 60-dB and 85-dB groups were significantly lower than in the control group (P ≤ 0.05). The serum levels of T4, T3, and TSH hormones in the 110-dB group were insignificantly lower than the control group (P > 0.05). The serum level of testosterone in the 110-dB group was significantly lower than the control group (P ≤ 0.05). The mean serum levels of testosterone in the 65-dB and 85-dB groups were insignificantly lower than the control group (P > 0.05).

Based on this study, exposure to noise pollution increased cortisol secretion and decreased T4, T3, TSH, and testosterone levels in rats. As this hormonal imbalance may create direct and indirect effects, studies and strategies are recommended to control the imbalance of hormones in the polluted environments.

Beta-thalassemia major (TM) is one of the most common genetic diseases in Iran. Despite some efforts to reduce the incidence of TM, its incidence is still relatively high in some areas of the country.

This cross-sectional study was performed on 635 families who had children with TM. The families that had more than one child with TM were enrolled. A demographic data questionnaire and a checklist containing queries about the reasons for the birth of the second or subsequent TM children were completed by each family. Finally, the data were analyzed using SPSS version 16.

Among the families that had more than one child with TM, 90, 23, and three families had two, three, and four children with the disease, respectively. Of the 261 patients studied, 125 (47.9%) and 136 (52.1%) had been born prior and after the implementation of the pre-marital screening program for beta-thalassemia in Iran, respectively. Also, in 29.4% of these families, parents were unaware of having thalassemia minor. In other cases, factors such as lack of knowledge about screening tests (14.0%), lack of financial compliance (13.2%), late referral for genetic tests (11.8%), and not undergoing screening tests despite recommendations (9.6%) were among the reasons declared by the families. In addition to these, religious and cultural reasons should also be mentioned as effective factors.

This study showed that in only about 30% of the studied families, the parents were unaware of having thalassemia minor, and in other families, miscellaneous reasons were involved in the birth of the second or subsequent child with TM. In some cases, despite sufficient parental knowledge about the possibility of giving birth to a child with TM, no action was taken to prevent this event.

The level of physical activity (PA) among middle-aged Iranians is less than optimal. This study will be carried out to analyze and recommend policy options to promote PA among urban middle-aged adults in Tabriz, one of the metropolitan cities in Iran.

This multi-method policy analysis study will include the following four phases: First, a qualitative content analysis to explore the reasons for lack of PA. Second, a comparative study of successful PA programs and policies in Iran and other similar developing countries. Third, a qualitative thematic analysis based on the policy triangle to analyses PA promotion policies using the key informants’ views. Fourth, analysis and prioritizing the policy options suggested by a panel of experts using the analytical hierarchy process (AHP) techniques.

Prospective policy analysis promises the systematic process of selecting potentially effective policy options to promote PA in metropolitan settings of developing countries. The results of this study will provide a comprehensive vision of the most appropriate policy options based on the criteria of acceptability, effectiveness, and feasibility for addressing PA at the local and national levels. Considerations on the challenges of PA policymaking cycle and the barriers to the implementation of current policies in the Iranian context will also be identified.

With the increasing number of the elderly suffering from chronic diseases and disabilities, elderly long-term care (LTC) has been the subject of attention by health and welfare policymakers. This study aimed to compare the components of LTC for the elderly in Iran and selected countries.

This comparative study was conducted in 2020. The search was conducted in three databases (PubMed, Scopus, and Web of Science), two search engines (Google Scholar and Google), and the websites of WHO and the Ministry of Health and Welfare of the selected countries from 2000 to 2020 to find relevant documents on the subject. The selection of countries was based on three criteria: the type of health system, having the highest percentage of the elderly population, and the development status. Finally, Germany, France, Sweden, Japan, South Korea, Turkey, Thailand, and Iran were included in the study. The findings were organized using a common LTC framework.

In this study, the common framework of LTC systems, including beneficiaries, benefits packages, providers, and financing, was used. The study results showed that developed countries had formal LTC systems with specific mechanisms, but each country had differences in the implementation of different components of this system. On the other hand, in most developing countries, sporadic measures were taken in this field.

In general, developed countries have adopted different LTC system approaches in the organization, financing, type of services, and generosity of benefits. In choosing the appropriate LTC model in developing countries, factors such as the health system, resource constraints, social, and cultural status should be considered.

The Coronavirus Disease 2019 (COVID-19) pandemic has caused a severe shock to the world economy and, consequently, healthcare systems.

The current study aimed to investigate changes in costs and revenues of an Iranian hospital before and after the COVID19 pandemic to answer the following question: "How can hospital costs and revenues change during the COVID-19 pandemic?"

This descriptive cross-sectional study was conducted retrospectively at the Masih Daneshvari Hospital in 2020. Accounting software available at the hospital (Azarakhsh for salary costs and PMQ for medical equipment costs) was used to collect cost information. Also, the hospital information system software was used to collect revenue information. The 2019 financial year was considered the base year, and the period February-August 2020 was considered the COVID-19 outbreak period. The data were entered into Excel software and analyzed using descrip tive statistics methods.

Before the COVID-19 outbreak, the Masih Daneshvari Hospital was facing many cost problems, and the new crisis added to the severity of the problems. In total, the hospital’s revenue declined by 9%, and its costs increased by 70%. Therefore, in the fiscal year ending in March 2020, the hospital balance was reported to be $-607,143 (-68,000 million Iranian Rial).

The soaring healthcare expenditures revealed that the hospital was not ready to deal with the disease. As the COVID-19 outbreak grows rapidly in Iran, there is a pressing need to increase medical capacities and inpatient beds to treat infected patients. Hospitals in the country face financial problems and should be supported by the Ministry of Health and Medical Education.

This study aimed to reflect on the participation status of charities at different levels (i.e., prevention, treatment, and rehabilitation) of Iran’s health care system.

This descriptive cross-sectional study was fulfilled in 2019 based on 40 charitable organizations involved in health care services delivery, which were randomly selected from the Iranian Charities Portal (ICP). Data were collected via a valid and reliable researcher-made questionnaire. SPSS software version 16.0 was used to analyze data.

Direct and indirect methods of service delivery were used in 63% of organizations. The most important sources of funding were associated with public donations. Furthermore, 94% of charities were evaluating the health care services with internal and external evaluation and customer satisfaction surveys.

The charities could be a precious contribution to the health care system. To use this potential as a synergistic factor of the health system, adopting such strategies as creating sustainable funding sources and establishing more coordination between organizations are essential

Motorcyclists are among the greatest vulnerable individuals of road accident victims. Their behavior has a significant correlation with increased injury and mortality rate. Determining the risky and unsafe behaviors of motorcycle drivers is necessary for preventing riders and other citizen from potential accident risks.

The aim of this study was to determine the risky driving behaviors of motorcyclists in Iran.

A cross-sectional study was done in 2019 in Sistan and Baluchestan Province as the second widest province of Iran. Using randomized sampling method, we included 613 motorcyclists from the province. To collect data, the Persian version of Motorcycle Riding Behavior Questionnaire (MRBQ), as a standard questionnaire, was used. For data analysis, descriptive and analytical statistics such as one-way analysis of variance (ANOVA), t-test, and linear regression were used by SPSS software version 21.

The age range of 57% of the motor riders was 15 - 30 years, and 50% of them did not use any safety equipment. About 58% of the subjects had started motorcycle riding under 18 years old, and 73% of them did not have a motorcycle riding license. Moreover, more than 50% of motorcyclists used mobile phones while driving. The mean score of driving behavior (106 ± 22) was desirable. Based on multivariate analysis, job, average amount of riding, lacking a riding license, type of motor, alert from police, non-fasting helmet band, exceeding speed limits, fatigue, and hand-free riding were the main predictors of risky riding score (P < 0.05).

According to our results, the riding behavior of motorcyclists was desirable; however, many people used motorcycles without a license and safety equipment, which increases high-risk behaviors. Considering the potential dangers of motor riders, it seems necessary to hold training courses to obtain motorcycle certification and how to use safety equipment

It is ensured that nurses’ error reporting and disclosing improve services to patients and are considered a movement toward creating a culture of transparency in the healthcare system.

This study aimed to investigate the nurses’ decisions on reporting and disclosing Medical Errors (MEs).

This research followed a mixed-method embedded design that was performed in five hospitals in Iran in 2018. A total of 491 nurses participated in the quantitative phase of the study with stratified sampling, followed by a simple random sampling technique. Also, 22 nurses joined the qualitative phase. Data were collected using a researcher-made questionnaire and semi-structured interviews through a scenario-based method. Quantitative data analysis was performed using descriptive and analytical statistics by SPSS 21.0 and Expert Choice 10.0 software. The qualitative data were analyzed based on the content analysis approach.

The most important perceived barriers with the highest impact coincided with educational (57.17%) and motivational (56.77%) factors based on SEM analysis (ES: 1.33, SE: 0.16). Regression analysis showed that error-reporting mechanisms, educational factors, and reporting consequences were significantly associated with age, sex, and work experience (P-Value ≤0.05). Error scenarios were thematized into three categories: Error perception (including ambiguity and weakness in error definition, the severity of the error, unawareness of guidelines, deviation from standards, and untrained staff), error reporting (including ineffective reporting system, hesitation in reporting to a formal system, increased workload, improper reaction, punitive responses, and concerns about consequences), and error disclosure (including no disclosure, partial disclosure, and full disclosure).

The obtained results contributed to a better understanding of the barriers to error reporting and disclosing. In addition, these results can help hospitals encourage error reporting and ultimately make organizational changes, which reduce the incidence of errors.

When an epidemic outspreads, the society engagement seems essential to make sure of the population’s preparedness for taking individual precautions.

The primary objective of this study was to examine public’s preventive behavioral responses to protective behaviors during the COVID-19 pandemic to provide a description of conceptual frameworks for deeper understanding of these behaviors.

A self-administrated questionnaire was used in this online survey through social networks during March 19th to 26th, 2020 (n = 2550). A Likert scoring scale was employed to investigate barriers and drivers affecting the participants’ preventive behaviors. Using personal protective equipment and good hand hygiene practices were identified as person-based measures. Social distancing and the restriction of social and economic activities during the past two months were determined as community-based measures. Univariate logistic regression and multiple - logistic regression were used to identify and assess influencing factors.

The study results indicated that 2426 (95.1%) of the participants intended to restrict their social and economic activities, and 1968 (72.2%), 1637 (64.2%), and 2492 (97.7%) persons intended to observe social distancing, use personal protective equipment, and have good hand hygiene, respectively. The most important barriers for preventive behaviors were the lack of risk perception, economic and financial barriers, lack of access, and cultural barriers, respectively. The perceived benefit was among the most significant driver. Intention for person-based measures was less affected by demographic and economic characteristics in comparison with community-based measures.

Considering the substantial impact of preventive behaviors onmanaging COVID-19 epidemic, this study findings have remarkable implications for governments tomanage future communications as well as interventions during this ongoing outbreak and subsequent national risk events.