مجله تحقیقات نظام سلامت حکیم
سال بیست و چهارم شماره 4 (پیاپی 95، زمستان 1400)

Food safety has an essential role on people’s health. Agricultural products of any kind constitute a big part of food; and have a special place in Iranian food culture. Therefore, considering safety in these products is of great importance. Providing healthy food is a government responsibility emphasized in our country legislation. Currently, there are various dispersed acts and regulations approved for controlling factors affecting healthy agriculture, like water, soil, fertilizers, and pesticides. Also, different organizations have been determined responsible for enforcing legislations. The situation induces many challenges regarding inter-sectoral cooperation and accountability of responsible organizations. It is necessary to adopt a holistic approach to more clarify and merge related regulations; and integrate responsibilities in one accountable organization. So that, agricultural products’ safety would be more guaranteed.

Infertility causes major social, psychological and financial problems for infertile couples. Most infertility treatments are costly and increase the likelihood of facing catastrophic health expenditure. This study aimed to calculate the infertility treatment costs using medically assisted reproduction in Iran.

In this study, the bottom-up approach was used to estimate the cost of infertility treatment through Intrauterine insemination (IUI), In_vitro fertilization (IVF), and Intracytoplasmic sperm injection (ICSI) method. Costs of each method was broken down into expenses for the lab tests, main intervention, supplementary services, medicine, and medical consumables. The required data were extracted from 411 patients’ records. Excel and STATA 15 software were used to describe and analyze data.

The costs of per cycle of infertility treatment in FET, IUI, IVF_ET and IVF_FET methods were 46,608,000, 60,852,000, 169,999,000 and 184,144,000 Rials, respectively. The estimated costs of per cycle of infertility in ICSI_ET and ICSI_FET methods were also 213,330,000 and 227,475,000 Rials. Overall, the main intervention, medical supplies and medicine were the main determinants of costs. (Costs based on purchasing power parity: FET, $ 1,569.1; IUI, $ 2,048.6; IVF-ET, $ 5,723.1; IVF-FET, $ 6,199.2; ICSI-ET, $ 7,181.8; and ICSI-FET, $ 7,658.)

Based on the results of this study, the costs of infertility treatment in Iran are significant. Therefore, to provide financial support for infertile couples, the government should be fully aware of the costs of treatments and consider the sustainability of financial resources.

Monitoring the performance of hospitals is one of the most important actions of the insurer in order to cost control. The aim of this study was to investigate the effect of Monitoring in reducing the average length of hospital stay through the control of services and unnecessary hospitalizations in hospitals contracted supplementary insurance company.

this study is a semi-experimental type, that was conducted using before and after design in 22 provinces. presence at the 15,721 patient’s bedside in 103 hospitals, insurance experts examined the medical records and the treatment process using a researcher-made questionnaire. According to the initial results, supervisory interventions were carried out in two ways: “ hospital discharge “ or “ non-approval of medicine and consumables “. before and after data of the study were analyzed through paired t-test using R-Studio version 9.2 software.

According to the findings, 85.3% (n=13,401) of the hospitalizations did not require supervisory intervention and 14.7% (2320 patients) had supervisory interventions. Based on the ownership, the highest rate of unnecessary hospitalization was in private hospitals (80درصد; (n=1850)) and the highest rate of monitoring interventions was related to discharge from the hospital (46% of the financial savings of monitoring interventions). Non-approval of medicine and consumables has been the most frequent (1,102; 47.5%). The average length of stay and standard deviation were 23.74 and 48.58 before the intervention and 10.69 and 12.14 after the intervention.

continuous monitoring of hospitals, especially using the appropriateness evaluation protocol, will significantly reduce the average length of stay of patients.

With the ever-increasing development of providers and users of electronic health services, the need to formulate strategies and laws compatible with innovations has become necessary. Understanding the current situation through the identification of challenges in different sectors can provide useful information in the field of legislation for policy makers.

The present study was qualitative research. The data was obtained through interviews with business managers in the field of e-health. Purposeful sampling was performed in 2022 among service providers include Provider of telemedicine services, online health information, mhealth and online pharmacies. Data were analyzed using standard qualitative content analysis with MAXQDA v.10 software.

After analyzing the data, 29 codes related to legal and ethical challenges were obtained. These items were classified into 8 main categories: Regulatory and legislation, responsiveness and responsibility, competence, user opinions, super applications, standard of care, patient benefits, patient data and records. Suggestions were also provided in each case.

In the field of electronic health governance, there are challenges that should be addressed by policy makers. Legal issues are one of the main obstacles and challenges for businesses in this area. If ethical and legitimate businesses are out of competition, users may seek online services from unlicensed or unprofessional providers. This creates serious problems for the health system.

since 2021, one of the most important global public health challenges has been the COVID-19 coronavirus pandemic. Three of the drugs that have been introduced to treat patients with COVID-19 in mild to moderate stage include paxlovid, molnopyravir and fluoxamine. The aim of this study was to evaluate the effectiveness of these drugs in the treatment of patients with COVID-19 in mild to moderate stage.

This study was done through umbrella review and in order to conduct a systematic review in PubMed, CoChrane and Google Scholar databases with appropriate vocabulary. The articles were evaluated for quality using the CASP checklist. The study extracted outcomes related to the drugs, such as hospitalization and death rates due to COVID-19, as well as any side effects reported in the studies.

Based on the findings, Paxlovid reduced the risk of death and the likelihood of hospitalization by about 88% while fluvoxamine reduced the likelihood of hospitalization by about 31%. The use of Molnopyravir reduces the risk of hospitalization or death by about 30%. However, the efficacy of this drug decreased with the expansion of the omecaron strain.

Paxlovid drug is effective in reducing the possibility of hospitalization and mortality of patients with covid-19 in the mild to moderate stage. However, regarding the effectiveness of Molnopiravir and Fluxamine, the level of evidence is low and more research is needed.

Health financing system is the process of collecting, pooling and managing financial resources to purchase healthcare services and promote, restore or maintain people health. An increase in health expenditure and the governments’ inability to commit sufficient resources introduces challenges to the sustainability of health system financing. This study was conducted to identify sustainable health financing methods in developed countries.

This study was a scoping review research. All studies related to the sustainable health financing solutions in developed countries were searched using appropriate keywords in “PubMed”, “Scopus”, “Science Direct”, “Web of Science”, “Magiran”, “SID” and “Iranmedex” databases and two search engines “Google” and “Google scholar”. Finally, 38 studies were selected and analyzed using the framework analysis method and MAXQDA software.

Overall, 30 solutions were identified for sustainable financing of the health system of developed countries and categorized into three sections: collecting financial resources, pooling and managing financial resources, and purchasing healthcare services. Strategic purchasing, reducing induced demand, using prospective payment methods, consolidating multiple insurance funds, using an efficient patient referral system, using clinical guidelines, public-private partnerships, value based health services package and introducing new innovative health insurance schemes were the most frequent solutions for sustainable health system financing in developed countries.

Innovative solutions are used to strengthen the sustainability of the health financing system in developed countries. Iran’s policymakers can sustain the country’s health system financing by adopting and adapting these solutions.