Sex and age Differences in Hospitalization and Mortality Rates Due to COVID-19 from 20 March 2020 until 20 March 2022 in Iran: A Population-based Study

Introduction: This study aimed to identify the effect of differences in age-sex structure in COVID-19 hospitalizations and death rates among men and women in Iran. Accordingly, we calculated the SARS-CoV-2 hospitalized patients and mortality rates, stratified by sex, age, and demographic distribution. Materials and Methods: This was a cross-sectional study, where the target population was the total population from 20 March 2020 until 20 March 2022 in Iran, over the two-time periods, 20 March 2020 until 20 March 2021 [first year], and 20 March 2021 until 20 March 2022 [second year]. The chi-squared test was used for analysis. Results: During the first year, 493220 cases were hospitalized with 258209 (52%) men, in addition 61,586 deaths occurred, where 34,849 [57%] were men. The overall hospitalization rate per 100,000 population in men and women was 607.77 and 565.57, respectively, and the mortality rate per 100,000 population in men and women was 82.03 and 64.34, respectively. During the second year, 652893 cases were hospitalized, where 340344 (52%) were women. The overall hospitalization rate per 100,000 population in men and women was 727.98 and 809.67, respectively, in addition to 54,740 deaths, where 29,172 [53%] were men. The overall mortality rate per 100,000 population in men and women was 67.95 and 60.83, respectively. Conclusion: The findings showed a higher hospitalization in the first year in men, whilst the opposite was evident in the second year. The mortality rate increased with age and was most predominant in men, 50 years of age or older. Therefore, there is a need for policy makers to be acutely aware of the discrepancies in mortality according to age and sex groups, and have different, and complementary, strategies for controlling the pandemic by age and sex groups

Investigating the Causes of Hospitalization of Children under 15 Years Old during the COVID-19 Pandemic in Southern Iran

Introduction: Children are the future of any community and identifying their pattern of diseases is a reflection of the health status of that region. This study was conducted to investigate the frequency of hospitalization causes in children under 15. Materials and Methods: This cross-sectional study was performed among 360 children under 15 in the pediatric ward of Imam Khomeini Hospital in Jiroft in 2020. Data were collected by a pre-designed checklist according to the patients' files. Data were analyzed by SPSS software using descriptive statistics and a chi-square test. Results: The most common causes of hospitalization in both sexes were gastrointestinal disease (44.11%) and fever of unknown origin (FUO) (36.7%), and a significant relationship was observed between gender and the cause of hospitalization of children (P <0.001). In the age group of one month to one year, the most common cause of hospitalization was FUO (27%) followed by gastrointestinal diseases (25%). Otitis media (23%) was the most common cause of hospitalization in children aged 1 to 3 years, gastrointestinal diseases in children aged 3 to 6 years (16.4%) and 6 to 12 years (25%), respectively. There was also a statistically significant relationship between pediatric age and hospitalization causes (P <0.001). Conclusion: Due to the high prevalence of diseases such as gastrointestinal diseases and FUO among the causes of hospitalization of children, epidemiological studies and the provision of preventative health services for said diseases in children seem necessary

Estimating the Cost of Prevention and Control of Rabies: A Case Study in the Northwest of Iran

Background: The significance of rabies is due to high mortality rate, economic damage caused by livestock loss, and high costs of treatment. Considering the economic problems in developing countries as well as the lack of resources and facilities, economic assessments will be very useful in obtaining the necessary financial information. Therefore, the present study aims to estimate the cost of prevention and control of rabies in Ahar, East Azarbaijan, during 2010-2011 and 2011-2012. Methods: This is a descriptive, cross-sectional study conducted in Ahar, East Azarbaijan. This study was carried out using available documents (Vaccine registries, Human Resources Department records, Staff daily wages) and data collection (Ministry of Health and Medical Education, Taxi Administration, Municipality Office and the Veterinary Network) to estimate the cost of prevention and control of rabies during 2010-2011 and 2011-2012. The societal perspective was taken into account to estimate costs. Data was entered into SPSS version 20 and the total cost was calculated. Also, the Mann-Whitney U test was used for data analysis. Results: The total financial burden of preventing and controlling rabies in Ahar during 2010-2011 and 2011-2012 was about 803 and 850 million rials respectively. The loss of the patient's income (240 and 260 million rials during 2010-2011 and 2011-2012), cost of rabies vaccine (approximately 231 and 237 million rials during 2010-2011 and 2011-2012), and staff costs (approximately 118 and 247 million rials during 2010-2011 and 2011-2012) had the largest share of the cost, while cost of tetanus vaccine (1.3 and 1.2 million rials during 2010-2011 and 2011-2012) had the smallest share. Conclusion: The present study showed that the prevention and control of rabies put a significant financial burden on the government through direct medical expenses, rabies control program for dogs, and care of the disease. It put a burden on the people, as well, through the loss of productivity and income, and transportation costs

Medical Errors and Barriers to Reporting in Ten Hospitals in southern Iran

Background [International research has shown that medical errors are a major threat to patient safety.] Aims [The present study aimed to determine the frequency and barriers to reporting medical errors in Shiraz public hospitals, Iran. ] Method [This retrospective analytical study was conducted in Shiraz public hospitals in 2013. Using the standardized checklist of Shiraz University of Medical sciences and Uribe questionnaire, the data were gathered from 10 public hospitals. Then, the data were entered into the SPSS statistical software (v. 16) and analyzed using descriptive statistics, Spearman, chi-square, one-way ANOVA, and T test. ] Results [During 365 days, 4379 medical errors were recorded in 10 hospitals. The highest frequency was related to systematic errors. Besides, most of the errors had occurred in larger hospitals, internal wards, and morning shifts. The results revealed a significant relationship between medical errors and wards and hospitals. Moreover, individual and organizational factors were the barriers to reporting medical errors in the study hospitals. Also, a significant correlation was observed between the medical errors reporting barriers and the participants’ job experiences (

Relationship Between the Leadership Styles of Nursing Managers and Teamwork of Nurses in University Hospitals of Mashhad and Zahedan, Iran

Introduction and purpose: Policymakers can enhance personnel performance and consequently, improve the quality of healthcare by evaluation of suitable leadership styles for health organizations and establishment of effective team groups. This study aimed to determine the relationship between the leadership styles of nursing managers and the teamwork of nurses. Methods: This descriptive-analytic study was conducted among 500 nurses working in eight selected university hospitals in Mashhad and Zahedan, Iran (2022). Data were collected using two standard questionnaires on leadership styles and teamwork through interviews. Descriptive statistical methods, such as the mean and standard deviation, were employed to determine leadership style and teamwork scores. Additionally, Pearson's and Spearman's correlation coefficients were used to investigate the relationship between these two variables. Results: The dominant leadership style among the participants was transformational leadership (37.6%). The overall mean teamwork score was 3.66±0.48, with 91.8% of nurses scoring teamwork 3 or higher. Transformational and passive leadership styles exhibited the highest and lowest relationships with teamwork, respectively (P<0.05). Additionally, the mean teamwork score among nurses with managers exhibiting a transformational leadership style was higher, compared to other styles (P<0.05). Conclusion: Managers and executive supervisors can positively impact teamwork and consequently, the performance indicators of their unit by adopting a transformational leadership style and enhancing their leadership knowledge. To achieve this goal, it is suggested to conduct in-service training courses. Additionally, selecting supervisors of centers who promote teamwork and designing a mechanism to collect feedback from hospital personnel regarding the leadership style of their direct managers are recommended

Cost-effectiveness of Anemia Screening in Vulnerable Groups: A Systematic Review

Background: Anemia is the most common blood disorder observed in vulnerable groups and affects their efficiency in their everyday activities. Possible complications of the disease may be reduced or prevented by screening of patients. Screening programs impose certain costs upon the health system, which may offset their positive effects. Whether the positive impacts of screening outweigh its costs is a subject of debate among policy-makers. In this research, we have conducted a systematic review of the cost-effectiveness of anemia screening. Methods: The Pubmed, Science Direct, SCOPUS, EMBASE, and CINAHL databases were searched for relevant results dating between 1962-2010 using key words. The references of the related articles were gone over manually. In the end, Persian databases were also examined for results. Results: Using data from the four mentioned databases, a total of 722 articles were elected, which, after evaluation, were narrowed down to 4. Of these, 3 focused on newborns and infants. Disparity existed among obtained results, such that no two articles were similar, and this made making comparisons between them cumbersome and sometimes even impossible. Only one study evaluated cost-effectiveness of anemia screening in vulnerable target groups. Conclusions: Research findings show that there is not enough evidence of cost-effectiveness of screening for decision-making. Bearing in mind the importance of the matter to health policy-makers, due to high prevalence of iron-deficiency anemia in low- and middle-income countries, conduction of research in this field seems necessary

Rational Prescription of Drug in Iran: Statistics and Trends for Policymakers

Background: Medicine is considered as strategic goods worldwide and, therefore, a huge amount of health care budget is spent on it. To prepare universal access to appropriate health services and achieve the health-related millennium development goals, rational use of drugs is an essential goal in the health system. This study aimed to investigate the proportion of drug prescription in three categories of injections, antibacterials agents and corticosteroids in a 10 year period. Methods: This is a descriptive study using data from an Iranian national insurance organization and National Center of Drug Use. The data about prescribed drugs during 2003 to 2013 were collected and analyzed by Excel Microsoft software, version 2010. Result: Results indicated that injections were decreased from 49.25% in 2003 to 46% in 2013; also, antimicrobials had a decrease from 64.25% in 2003 to 42.2% in 2013. Totally, it was reduced about 16% in the period of 10 years. Corticosteroids increased 10 % from 13% to 23% in 2013. Conclusion: According the present findings that indicate irrational and increasing use of corticosteroids and antimicrobials, it seems necessary for Iranian policy makers to pay specific attention to customizing clinical and pharmaceutical guidelines along with improvement of medical education system and rational prescription, holding scientific committees of prescription supervision, arranging continuous and effective education of health personnel, and improving public culture and community education

Household financial burden associated with out-of-pocket payments for healthcare in Iran: insights from a cross-sectional survey

Background: One of the key functions and ultimate goals of health systems is to provide financial protection for individuals when using health services. This study sought to evaluate the level of financial protection and its inequality among individuals covered by the Social Security Organization (SSO) health insurance between September and December 2023 in Iran. Methods: We collected data on 1691 households in five provinces using multistage sampling to examine the prevalence of catastrophic healthcare expenditure (CHE) at four different thresholds (10%, 20%, 30%, and 40%) of the household's capacity to pay (CTP). Additionally, we explored the prevalence of impoverishment due to health costs and assessed socioeconomic-related inequality in OOP payments for healthcare using the concentration index and concentration curve. To measure equity in out-of-pocket (OOP) payments for healthcare, we utilized the Kakwani progressivity index (KPI). Furthermore, we employed multiple logistic regression to identify the main factors contributing to households experiencing CHE. Findings: The study revealed that households in our sample allocated approximately 11% of their budgets to healthcare services. The prevalence of CHE at the thresholds of 10%, 20%, 30%, and 40% was found to be 47.1%, 30.1%, 20.1%, and 15.7%, respectively. Additionally, we observed that about 7.9% of the households experienced impoverishment due to health costs. Multiple logistic regression analysis indicated that the age of the head of the household, place of residence, socioeconomic status, utilization of dental services, utilization of medicine, and province of residence were the main factors influencing CHE. Furthermore, the study demonstrated that while wealthy households spend more money on healthcare, poorer households spend a larger proportion of their total income to healthcare costs. The KPI showed that households with lower total expenditures had higher OOP payments relative to their CTP. Conclusion: The study findings underscore the need for targeted interventions to improve financial protection in healthcare and mitigate inequalities among individuals covered by SSO. It is recommended that these interventions prioritize the expansion of coverage for dental services and medication expenses, particularly for lower socioeconomic status household

Evaluation of the Effect of Oral Vitamin B1 on Pain Due to Corneal Neuropathy after Cataract Surgery

Introduction: Cataracts are the leading cause of low vision and blindness in the world, and the only effective treatment for cataract vision impairment is surgery, which has common complications such as eye pain and burning, inflammation, and postoperative headache. The aim of this study was to evaluatethe effect of vitamin B1 on oral pain on corneal neuropathy after cataract surgery in Jiroft.Method and Materials: This randomized clinical trial study was performed on cataract patients who were candidates for surgery and referred to Imam Khomeini Hospital in Jiroft in 2020. Demographic information was collected through a designed checklist and the Numerical Pain Scale (NRS) was used to measure postoperative severity in the eye. The collected data were analyzed using SPSS-V21 software.Results: In this study, 130 patients with cataracts (intervention group: 65 and control group: 65) were studied. The intervention group consisted of 27 men (41.5 %) and 38 women (58.5 %) and the control group consisted of 25 men (38.5 %) and 40 women (61.5 %). On the third day and one week after surgery, there was no significant difference in the amount of eye pain and irritation caused by surgery in the intervention and controlgroups, and in the three months after surgery, the intervention group had mild eye pain and irritation.Conclusion: The results of this study showed that taking vitamin B1 orally affects eye irritation and pain caused by corneal neuropathy after cataract surgery and reduces eye irritation and pain intensity during 3months