The hospital performance indices after implementing the Universal Health Coverage in the Iran

Background: The health sector evolution plan (HSEP) was implemented in 2014 in Iran. The aim of present study was to evaluate the hospital performances indices after implementing the second phase of universal health coverage (UHC) comparing to before. Methods: In a cross-sectional study in 2019, the data of 58 hospitals were gathered from database in Statistics’ office in clinical deputy of Isfahan University of Medical Sciences (MUI), from 3 years before HSEP implementing to 3 years after that, between 2011 and 2017. Sampling was performed as census method. The data including the inpatient bed count in different type of hospitals (public hospitals affiliated to MUI, not for profit hospitals affiliated to the Social Security Organization (SSO), hospitals affiliated to military organizations, private and charity hospitals), the Bed occupancy rate (BOR), number of inpatients annually and the average length of stay (ALOS) in hospital, were collected and analyzed. Results: By comparing to before carrying out the HSEP, the available beds, particularly in private hospitals was increased significantly (83.22%) after implementing the HSEP. Moreover, the number of hospitalized patients was raised after HSEP, in a way that, the highest percentages have been seen in charity hospitals and private hospitals with the growth rates of 140% and 69.44% respectively. Also, the longest ALOS was seen in public hospitals as likely as 3.4 days. Conclusion: Following the implementing the HSEP, although the available beds and hospitalization rate have been increased significantly, however, the BOR and the ALOS have not been raised markedly

The incidence rate of chronic brucellosis following one-year antibiotic therapy in Koohrang district of Chaharmahal & Bakhtyari province

چکیده: زمینه و هدف: بروسلوز بیماری مشترک انسان و دام است که از نظر بالینی به حالت های مختلف از جمله بروسلوز مزمن ممکن است تظاهر نماید. هدف از اجرای این مطالعه، تعیین میزان بروز بروسلوز مزمن در بین بیماران درمان شده، بعد از یک سال پیگیری می باشد. روش بررسی: این پژوهش یک مطالعه آینده نگر است که بعد از شناسائی بیماران مبتلا به بروسلوز حاد و تکمیل پرسشنامه های مربوط به خصوصیات دمـــوگرافیک، چگونگی آلودگی آنها به بروسلوز، علایم و نشانه های بیماری و انجام تست های آگلوتیناسیون استاندارد رایت و 2ME (2 Mercapto Ethonol) تحت درمان داروئی قـــرار گرفتند. بعد از گذشت یک سال (1383) با مراجعه به منطقه از همان بیماران مجدداً معیـــار های فوق و میزان پاسخ به درمان های تجویز شده بر اساس علایم و نشانه های باقی مانده و وجود عیار سرمی رایت >160/1 و 2ME >160/1 بروسلوز مزمن قلمداد گردید. سپس داده های حاصل از آزمایشات و پرسشنامه های تکمیل شده، با استفاده از آزمون های آماری t، کای دو و آنالیز واریانس مورد تجزیه و تحلیل قرار گرفت. یافته ها: در طغیان بروسلوز در سال 1382، 119 نفر مبتلا به بروسلوز حاد شدند که 9/63 بیماران مرد و 3/30 آنها دامدار بودند. آرتریت با 7/88 و تب با 54/78 شایع ترین علایم و نشانه های بیماران بود. در پیگیری بعدی 97 نفر در سال بعد مجدداً شناسائی شدند. رژیم های دارویی استفاده شده برای بیماران عمدتاً ریفامپین و کوتریموکسازول (8/59) و داکسی سیکلین با ریفامپین (5/17) بود. 5/17 بیماران تیتر نهایی رایت و5/16 تیتر 2ME بالاتر از 160/1 داشتند. 5/15 دچار عود علائم شدند. با توجه به تیتراسیون مثبت رایت و 2ME و همچنین باقی ماندن علائم بیماری میزان بروز بروسلوزیس مزمن 5/16 بود. بین نوع داروی مصرفی و عیار نهائی سرمی تست های رایت و 2ME و همچنین سیر بالینی بیماران در یک سال بعد رابطه معنی دار آماری بود به طوری که استفاده از رژیم دارویی کوتریموکسازول - ریفامپین باعث بالا رفتن شانس مزمن شدن بیماری بروسلوز گردیده است (001/0

Risk factors of Atopic dermatitis in Shahrekord schoolchildren

Background and aim: Atopic dermatitis is one of the common skin diseases of childhood that creates considerable side effects on patients, their families and the health care system. This study was carried out to identify both prevalence rate and risk factors of the disease in Shahrekord schoolchildren in 2003. Methods: In a cross-sectional study from all Shahrekord schoolchildren, 1500 students (750 female, 750 male) were randomly selected and the questionnaires of atopic dermatitis were distributed among the selected students and then collected after being filled by their parents then all selected students were examined by a general physician. Suspected students were examined by a dermatologist and an ophthalmologist. The serum IgE of students with any evidence of AD was then serologically tested and the collected data were analyzed with both X2 and student-t test. Results: The mean ages of students participated in the survey was 9.2±1.4 years. According to AD criteria, the prevalence rate was 2.1 percent (32 students). There was no significant statistical relationship between sex and age with atopic dermatitis prevalence rate, but there was significant statistical relationship between AD prevalence rate and signs and symptoms of asthma, allergic renitis, family history of the atopic dermatitis and atopy (p<0.05). Conclusion: Our results showed that atopic dermitis was more frequently seen in those individual with asthema, allergic renitis, familial history for atopic eczema or familial history for atopic dermitis. But no relationship between atopic dermitis and age as well as sex was observed

The Participants' viewpoint of continuing medical education courses

Background: Continuing education is one of the most effective methods to empower the employees for challengesthey face on their jobs. Dramatic advances in medicine, rapid cultural and social changes, increasing cost of healthcare, development of diagnostic technology and a transition in the pattern of diseases, highlight the necessity ofcontinuing education in all medical groups. Purpose: To evaluate the effectiveness of continuing medical education (CME) programs in Shahr-Kord MedicalUniversityfrom 1996-2001

The seizure recurrence rate in epileptic patients following universal health coverage: A time-series study

Background: Epileptic patients (EP) should be free of seizure recurrence (SR). Universal Health Coverage (UHC) was implemented in 2005 in Iran, aiming to tackle obstacles in front of health services’ utilization. This study was done in order to assess the SR rate in EP after UHC implementation. &nbsp; Methods: This study was a prospective time series that was done in rural areas of Falavarjan district in Isfahan province in central Iran from March 2016 to March 2017. 245 patients who suffering from any type of epilepsy and whom epilepsy confirmed by a neurologist, registered. All epileptic patients monitored continuously every month through the study, and the signs or symptoms attributed to the suspected seizure were assessed and referred to a physician for additional assessment and consultation to improve treatment compliance.&nbsp; The patients’ data about their demographic characteristics, type of epilepsy, any SR attack, and their risk factors were gathered from their self-files based on the checklists. &nbsp; Results: Despite treatment schedules that were carried out for all EPs, during one year follow up, however, 37 (15.1%) patients displayed SR attacks. 19 (7.75%) patients who suffered RS were male with the mean age of 40 ± 13.5 years, without gender statistical difference (P=0.810). In patients who had RS, the main causes of lacking adherence to their treatment were forgetting to take medicines in 10 (55.6%), poverty in 3 (16.7%), and lacking motivation in 2 (11.1%) EPs. &nbsp; Conclusion: Following UHC implementation in the primary health delivery system, that neuropsychiatric health packages were integrated, the incidence rate of SR attack in EPs was low

Frequency and severity of Post Traumatic Stress Disorder and efficacy of mental health intervention in children and young adults from a rural region in Chaharmahal and Bakhtyari Province, Safilan

چکیده: زمینه و هدف: بلایا و حوادث همه ساله منجر به ایجاد معلولیت، صدمات مالی و مرگ در بسیاری از افراد می گردد. تلفات انسانی پس از حوادث غیر مترقبه منجر به ایجاد آثار روانی مانند استرس، اضطراب و شکایات جسمی می گردد. اختلال فشار روانی آسیب زاد یا اختلال پس از ضربه (PTSD) از جمله این آثار است که در پی مواجهه با فشار آسیب زای شدید ایجاد می گردد. از جمله حوادث تأسف بار در ایران می توان به واقعه آتش سوزی مدرسه ابتدایی روستای سفیلان از توابع استان چهارمحال و بختیاری اشاره نمود. پژوهش اخیر با هدف بررسی فراوانی و شدت عوارض روانی ناشی از حادثه در کودکان و نوجوانان روستا و تأثیر مداخلات روانی در آنان انجام گرفت. روش بررسی: در یک مطالعه نیمه تجربی کلیه کودکان 15-5 ساله روستای سفیلان (41 نفر) که در هنگام حادثه در روستای سفیلان حضور داشتند انتخاب شدند. از طریق مصاحبه چهره به چهره با والدین کودکان پرسشنامه اطفال یول (Yoll) بلافاصله بعد از واقعه آتش سوزی تکمیل و سپس مداخلات بهداشت روان شامل تشکیل گروههای کاری، بازگویی روانشناختی، شناخت افکار اجتماعی و راهکارهای درمانی به مدت دو هفته و طی 4 جلسه صورت پذیرفت. مجدداً پنج ماه بعد از حادثه و مداخله بهداشت و روان پرسشنامه مذکور تکمیل و داده ها از طریق آزمون های آماری t زوجی، t مستقل و آنالیز واریانس یک طرفه تجزیه و تحلیل گردید. یافته ها: در سنجش نوبت اول میانگین نمره PTSD 03/15±14/61 و در نوبت دوم 6/9±19/48 بود (001/0

Immunization following hepatitis B mass vaccination in the 18 years old students in Chaharmahal va Bakhtyari province in Iran

Background and aims: The main objective of immunization by hepatitis B vaccine is to generate adequate concentration of anti hepatitis B antibody (HBsAB) in the serum. This study was aimed to determine the effectiveness of hepatitis B vaccination campaign in 18 years old students in Chaharmahal va Bakhtiari province. Methods: In a cross- sectional study, 360 students with 18 years old (born in 1989) and have taken 3 doses of hepatitis vaccine in national vaccination campaign in 2007, were selected by cluster sampling. This study was performed in 2008 in Chaharmahal va Bakhtiari province in the central of I.R of Iran. The level of hepatitis B antibody was detected by quantitative ELIZA method using Dialab Kit. The collected data was analyzed using SPSS 16.0 software by X2 and t-test. Results: Of 360 students, 164(45%) cases were male and 174 (48/3%) cases were from urban areas. Just 349 students (96/95%) have acceptable immunization responses, (In those anti hepatitis B antibodies were more than 20 IU/ml). There was no significant relationship between the level of antibody and variables such as: sex, born places, smoking, contact history, previous disease and Hejamat (P>0.05). Conclusion: Considering the results of the present study and previous researches from others countries, we can emphasize that the mass vaccination has been effective in those 18 years old students and we can be sure that the vaccination has been performed perfectly in Chaharmahal va Bakhtiari province

The effect of Halothane on liver enzymes of operation room staff, Shahrekord, 2001

Halothane, as one of the most widely used anesthetics in general anesthesia, has been found to play a role in causing Halothane Hepatitis, raising liver enzymes as well as a number of congenital abnormalities under frequent exposure. In this case-control study the possible contamination of operation room was probed through the measurement of the probable changes in liver enzymes among the operation room staff. The study was conducted on two groups: 1) Case group consisted of 40 operation room staff and 2) Control group consisted of 40 ward staff. The results showed that halothane could affect liver enzymes among the operation room staff especially in women. It seems that exposure to Halothane vapor among the operation room can be regarded as a risk factor

Evaluation of healthcare usage rate in HIV/AIDS patients in Isfahan, Iran in 2018

Introduction: Universal health coverage (UHC) was introduced in Iran in 2014. The aim of this study was to evaluate the usage rate of health services by human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients after UHC implementation. Material and methods: In 2018, in a cross-sectional study, we evaluated the outpatients’ needs (within its previous month) and inpatients’ needs (within its previous 6 months) of HIV/AIDS patients in Isfahan province (the center of Iran). Concurrently, we estimated the essential health care services that HIV/AIDS patients have to receive regularly, including vaccination for hepatitis B, measurement of CD4, tuberculosis (TB) assessments and TB treatment, anti-retroviral therapy, examination of viral load, treatment approach, and drug side effects counseling. Two checklists were used for assessing the utilization of health services and essential health cares for HIV/AIDS patients, validated by the Ministry of Health and Medical Education of Iran. Data were analyzed by χ2 test, Pearson’s correlation coefficient, and Spearman’s correlation test. Results: Two hundred and thirteen HIV/AIDS patients completed the questionnaires. The mean age of participants was 41.14 ± 9.23. The outpatient service utilization rate was 31.94% in the previous month and the rate of hospitalization was 126 per 1,000 HIV/AIDS patients in the previous 6 months. The majority of HIV/AIDS patients received essential health services more often than the national standard goals estimation. Conclusions: After UHC implementation, the utilization rate of outpatients and inpatients services in HIV/AIDS patients was more than similar indices in the general population. In addition, HIV/AIDS patients received essential health services adequately

Effective strategies for empowerment of experts staff in health deputy of Shahrekord University of Medical Sciences, Iran, 2005

چکیده: زمینه و هدف: کارکنان، گرانبهاترین سرمایه یک سازمان هستند. تحول و پویایی هر سازمان، به میزان توانمندی نیروی انسانی آن سازمان بستگی دارد. این پژوهش با هدف شناسایی و اولویت‌بندی راهکارهای مؤثر در توانمندسازی کارشناسان حوزه معاونت بهداشتی دانشگاه علوم پزشکی شهرکرد انجام شد. روش بررسی: در یک مطالعه توصیفی - تحلیلی، در سال 1384، کلیه کارشناسان شاغل در ستادهای مرکز بهداشت استان و شبکه های بهداشت و درمان شهرستانهای تابعه استان (حدود 210 نفر) تحت مطالعه قرار گرفتند. ابزار اندازه گیری در این پژوهش پرسش‌نامه محقق ساخته بود. پرسش‌نامه پیمایش نیاز سنجی بر مبنای مقیاس لیکرت تهیه شد که شامل 60 سؤال بود. پس از جمع آوری اطلاعات و تایید مناسب بودن تحلیل عاملی توسط آزمون های بارتلت و کفایت نمونه (KMO)، تحلیل عاملی انجام و از میان 60 متغیر پنج عامل انتخاب گردید. به منظور تفسیر عوامل از روش چرخاندن واریماکس استفاده گردید. یافته ها: راهکارهای پنج گانه توانمندسازی به ترتیب آزادی عمل (راهکار اول) 25/42، مدیریت مؤثر منابع انسانی (راهکار دوم) 99/5، عامل انگیزش (راهکار سوم) 07/5، خود مدیریتی (راهکار چهارم) 71/3 و ارتقاء یادگیری سازمانی (راهکار پنجم) 84/2 از کل واریانس را به خود اختصاص دادند. نتایج بررسی و آزمون سؤال فرعی نشان داد که بین نظرات کارشناسان در مورد راهکار پنجم توانمندسازی ارتقاء یادگیری سازمانی و محل کار (01/0