مجله تحقیقات نظام سلامت حکیم
سال بیست و چهارم شماره 3 (پیاپی 94، پاییز 1400)

Health is generally considered as the basic right in all societies, which governments are entrusted to maintain, restore and promote while facilitating its provision to any single individual. A plethora of organizations play a role in providing health services in this country. The question is whether this multiplicity and diversity will improve the provision of services or it might lead to more confusion and inequity and inequalities. This issue could give a rise to various challenges which need to be addressed.

The primary health care system is the first point of contact for individuals, families and society with the health system, where basic and essential health services are provided in a place close to where people live or work. The primary health care system plays a critical role in responding to epidemics and should be strengthened. This study aimed to strategically analyse the Iranian primary health care system in responding to epidemics and to provide solutions to strengthen it.

This research was carried out using scoping review method. All studies related to the strengths, weaknesses, opportunities and threats of Iran’s primary health care system in responding to epidemics, indexed in PubMed, Scopus, Web of Science and ProQuest, SID and Magiran databases and Google Scholar search engine were searched using appropriate keywords and search strategies. Finally, 52 documents were selected and analyzed using framework analysis method.

Overal, 18 strengths, 10 weaknesses, 17 opportunities and 14 threats were identified for Iran’s primary health care system in responding to epidemics. Besides, 62 actions were suggested to strengthen Iran’s primary health care system in responding to the epidemics, which were grouped into six categories: governance and leadership, financing, health workers, equipment and medicine, health information system, and primary health care delivery. Using the military health staff for deprived areas, home quarantine of the infected, training health workers, social and psychological support for workers and using tele-medical services are necessary to strengthen Iran’s primary health care system.

Iran’s primary health care system is facing many challenges in responding to epidemics. Policy makers and senior managers of the health system should strengthen the country’s primary health care system using the suggested strategies.

the present study evaluated the implementation of legal materials related to health in the Sixth Development Plan.

The present study was a triangulation combined study in 2022. The first stage was carried out with the aim of identifying the measures including documentary analysis, using the data collection form, and the data collected by the research team were refined separately and using contract content analysis. In the second stage, the evaluation indicators including the review of documents and the data collection form, the calculated indicators were sent in the form of a researcher-made questionnaire, and using experts meeting through the discussion framework. The third stage was conducted with using questionnaire approved and completed by three groups including the apparatus and its affiliated units, foreign experts and supervising experts.

Based on the findings, 122 indicators were used separately for legal clauses. The highest distribution of foreign experts’ scores was in percentages of less than 25 and 26 to 50, and this distribution was largely similar for observer experts. On average, the rate of progress of the verdicts was 49%, foreign experts 43% and the opinion of the apparatus with a large difference of 87%. About 60% of the opinion of the supervising experts and evaluators were similar. The focus of foreign experts has been more on outcome indicators. About 43% of the 122 indicators were part of the support document or quantitative indicators with the documents provided by the executive body.

Reviewing and evaluating the progress of development plans, depending on their generalities and details, can include very small to large indicators. Also, the use of three groups of evaluators, the use of different sources to enumerate the indicators, relying on official documents such as supporting documents and monitoring devices, as well as presenting the progress of program implementation separately for each of the legal materials are other strengths of this research.

The present study aimed to evaluate Islamic Republic of Iran’s scientific productions in the field of Breast Cancer during 2000 to 2020.

This was a survey-descriptive study (sectional) and Scientometrics approach was used. The statistical population include 6870 articles and documents in the field of Breast cancer (Subject) which were published in Scopus’ scientific journals during 2000-2020. We used SPSS (version 19), NodeXL and VOSviewer (version 1.6) to draw graphs and analysis data.

Finding shows that Iranian scientific outputs in the field of Breast Cancer increase from 7 in 2000 to 1181 in 2020 and have 29% growth every year. We fended that Tehran University of Medical Science and United States as the most important center and co-worker in publishing scientific production.

Although Iranian scientific production in the recent years has shown a great growth, but articles are not published in very valid and high quality journals. Policy making, proper planning, and supporting the studies of faculty members, researches, students, and departments of universities, and another related factors can be effective in the improvement of quantitative and qualitative levels of researches.

As the population ages, chronic diseases increase and the elderly who have insufficient health literacy are one of the risk groups related to high blood pressure. This study was conducted with the aim of determining the relationship between health literacy and self-care ability in the elderly with hypertension.

The current study is a cross-sectional study that was conducted on 301 elderly people who referred to specialized polyclinics of social security in Tehran in 2021. The data was collected by simple sampling method using short cognitive test tools, self-care ability questionnaire of elderly people, health literacy questionnaire of Iranians. Then it was analyzed by descriptive statistics, frequency distribution table and inferential and correlation statistical tests with SPSS version 22 software.

The mean and standard deviation of the age of the participants was 68.88 ± 7.2 years. The mean and standard deviation of the self-care index of people is 58.51 ± 9.1 and the mean and standard deviation of the health literacy score is 110.74 ± 33.98. Pearson correlation analysis showed a positive and significant relationship between the two variables of health literacy level and self-care ability (p>0.001). Also, the average score of health literacy for men was significantly higher than that of women (P=0.001).

The results show that interventions to improve health literacy are important to increase the ability of self-care behaviors in the elderly, it is necessary to improve health literacy in the elderly with high blood pressure and provide them with intervention and educational information.

In almost all societies and at all ages, men have a higher mortality rate than women. In this study, the contribution of the main causes of death in the increase of male mortality in the provinces of Iran in 2016 has been analyzed.

Provincial death data by age group, sex and causes of death were obtained from the registration system of the Ministry of Health and Medical Education. After correcting the under registration of death data, using the standard life table technique, life expectancy at birth was calculated for men and women in the provinces of Iran. Finally, the role of the main causes of death in the sex differences of life expectancy at birth was calculated.

The increase in women’s life expectancy in Iran ranged from 2 years in Kohgoluyeh and Boyer-Ahmad provinces to 4 years in Fars and Hamedan provinces in 2016. This figure was 3 years in Iran. Unintentional accidents, cardiovascular disease, and cancers and tumors are the most important causes of sex differences in life expectancy at birth in favor of women. However, there are significant differences in the share of major causes of death in sex differences in life expectancy at the provincial level.

Behavioral and lifestyle factors are the most important factors of sex difference in life expectancy at birth in Iran, which due to its preventability, with proper planning, can reduce the sex difference in death and help increase life expectancy.

Due to increasing costs of the health sector and the inefficiency of the public sector, granting autonomy to hospitals was implemented in the independent hospital program.The aim of this study was to investigate the effect of establishing an independent hospital program on the performance indicators of pilot hospital in Qazvin.

The status of eight functional indicators of the pilot hospital was collected in the period of 2017-2020 before and after the establishment of the independent hospital program. Data were analyzed using paired t-test and Wilcoxon and interrupted time series at a significant level (p<0/05) and analyzed by SPSS24 STATA15 software.

The result of paired t-test and Wilcoxon-Neschein test shows that the establishment of an independent hospital program has had effect on the average active bed, active day bed and discharge number. Based on the analysis of the interrupted time series model, the average active bed with 55.96 units, active day bed with 1576.51 units, occupied day with 3357.14 units, percentage of bed occupancy with 40.63 unit and the number of surgeries with 736.60 units had an increasing average and the number of discharges with 47.92 units and average stay with 1.42 units, shows a decreasing average.

The present study does not show a significant change in performance indicators. It is suggested that managers and policy makers of the health system, if they wish to expand the plan, conduct comprehensive and detailed studies in this field.

In recent years, the online sale of medicines and supplements has become widespread in many countries. Although the online sale of health products can have numerous advantages, the lack of oversight can have serious public health consequences. The purpose of this study is to examine the challenges, legal approaches, and executive policies in different countries to help make appropriate policy decisions in this area in Iran.

A systematic search of PubMed, Google Scholar, and Scopus databases was performed. Finally, 29 studies and national and international regulations were reviewed.

Online pharmacies face challenges in ensuring patient safety. Among others, uncontrolled online distribution of medicines can lead to counterfeit products, drug misuse, misdiagnosis, lack of patient monitoring, and self-medication. For these reasons, leading countries in the online pharmacy sector are seeking to institutionalize regulatory and accreditation laws so that adverse consequences are minimized. In Iran, due to the increasing prevalence of illegal online pharmacies, it is necessary to make appropriate decisions more quickly so that, in addition to taking advantage of new technologies, the rights and health of patients and citizens are protected in the best possible way.

E-commerce of pharmaceutical products will be crucial to the development of healthcare systems in the future. Therefore, a strategic and comprehensive approach is likely to help regulators to regulate e-commerce of pharmaceutical products more effectively.

Time-Driven Activity-Based Costing is one of the best ways to allocate resource costs which is rarely used in Iran. The purpose of this study was to compare the cost of an ICU Day bed based on timely activity and its comparison with the traditional cost of absorbing in Khansari Arak hospital in Arak

This is an applied, cross-sectional study. To calculate the cost of an ICU Day bed the financial statements for the year of 2015 Khansari Hospital were used. Data collected using Excel and SPSS 16 software was calculated and with Man whiny test was analyzed.

Calculate the cost of an ICU Day bed based on time-based costing Indicates the existence of unused capacity in this section, meaningful discrepancy with price. The cost was a traditional absorption and there was a significant difference between the Ministry of Health’s appropriateness. The comparison of costing based on time-oriented activity was 13,190,589 Rials with the traditional absorption costing method was 13,904,248 Rials, which had no significant difference (p=0.684). The total cost of an ICU day bed on a time-based basis has decreased more than the traditional absorption cost.

The cost of services provided based on time-based activity provides more realistic information about costs, and hospitals can achieve greater efficiency and reduce costs while obtaining unused capacities.