Evidence Based Health Policy, Management and Economics

Iran Military Health Network: An Optimal Governance Approach

Mohammadreza Sheikhy-Chaman — 2024-10-05

The Article Abstract is not available.

Reduced Hospital Admission, Emergency Department Visit, and Urgent Surgeries and its Correlation with Non-COVID-19 Mortality

Mohammad Ranjbar — 2024-10-05

Background: The reduction of hospital admissions, emergency visits, and urgent surgeries during the COVID-19 pandemic were reported in various countries. The present study aimed to evaluate these changes in Iran.

Methods: A retrospective study of regional secondary utilization and mortality data from multiple official sources was performed. The data were collected from hospitals located in the center of Iran (Yazd) between March 1st, 2020 (before COVID-19) and February 30th, 2021 (after COVID-19). The data were analyzed using Microsoft Excel® and SPSS₂₄ The Mann-Whitney test was utilized to compare the variables’ changes before and after COVID-19 pandemic. Spearman's correlation coefficient was used to evaluate the connection between non-COVID-19 mortality and the quantity of urgent surgeries conducted in hospitals.

Results: The percentage changes in hospital admissions, emergency department visits, and urgent surgeries following COVID-19 were 33.7%, 39%, and 23%, respectively. The correlation between the number of urgent surgeries and the non-COVID-19 mortality during the pandemic was negative(r=-0.9).

Conclusions: Our results provide empirical support for concerns about the widespread public health impact of the COVID-19 pandemic. The development of novel technologies including telemedicine, consultations and online visits, as well as the use of remote monitoring technology could lead to improved access to health care during a pandemic, particularly for vulnerable populations.

Investigating the Challenges of Infertility Treatment Development in Centers of Iran University of Medical Sciences and Health Services

Fatemeh Najafi Pourmoghadam — 2024-10-05

Background: The desire for the survival of the generation, although it is a non-physical need, cannot be achieved without physical health. With the reduction of the country's population growth to less than one percent, the concern about the future of the country's population has become more serious. This study was conducted with the aim of investigating the challenges in the field of infertility treatment in centers affiliated to Iran University of Medical Sciences and Health Services.

Methods: The current research was conducted with a qualitative, practical and semi-structured survey method to identify the challenges of infertility treatment in Iran University of Medical Sciences and Health Services. The statistical population includes all experts and practitioners in the field of infertility treatment of Iran University of Medical Sciences and Health Services, and information was collected by targeted sampling until data saturation. Interviews have been conducted with 20 experts in the field of infertility treatment at the University of Iran. After formal and content validity by experts, coding of information was done according to Strauss' opinion and the results were presented.

Results: 4 general categories including political, social and Economic and financial situation ,structural and internal organizational status (bureaucratic, administrative, and Regulatory measures), participation (bureaucratic procedure, Effective interaction between government departments, Adoption of strategy, operational plan according to functionality and facilities (Deficiency of facilities, drugs and equipment) were identified as infertility treatment challenges in Medical Sciences and Health Services.

Conclusion: For the development of infertility treatment at the level of Medical Sciences and Health Services, It is necessary to evaluate the effective factors and the barriers ahead, using the experiences and information received, to find appropriate solutions to solve the problems and facilitate the provision of specialized infertility treatment.

Impact of Social Media Use on the Development of Health Literacy

Mohammadreza Fathi — 2024-10-05

Background: Using social media to produce and present the content of the health literacy program can be effective in improving and promoting public health. This study was carried out to determine the impact of social media use on the development of health literacy.

Methods: This cross-sectional study was conducted in the winter of 2022. The statistical population included all visitors to the health care centers of Ahvaz metropolis in the southwest of Iran, in which a total of 250 people participated. The standard health literacy questionnaire and the standard social media questionnaire were used to collect data. SPSS₂₅ software was also used for data analysis.

Results: The total score for using social media was 55.14 ± 14.14, and for health literacy, it was 64.18 ± 15.80, which was in the average range (upward and close to good). There was a statistically significant relationship between age (P-value < 0.001) and education (P-value = 0.005) and using social media (P-value < 0.001). In addition, the results showed that using social media affected health literacy (P-value=0.034). This study also showed that an increase in the development of health literacy decreased the use of social media (and vice versa). In addition, people who used social media asked fewer questions (regarding their health or illness) of doctors and healthcare workers (P-value < 0.001).

Conclusion: The results showed that using social media affected people's health literacy, and people with low health literacy used social media more to promote and improve their health literacy. It is necessary to make the required plans for the optimal use of the potential capacities of these networks for the development of health literacy in society.

Critical Factors Influencing Successful Implementation of Health System Policies

Naser Mahmoudi — 2024-10-05

Background: Health system policy implementation (HSPI) plays a crucial role in determining the effectiveness of healthcare systems worldwide. Understanding the factors that influence the success of HSPI is essential for policymakers, healthcare professionals, and stakeholders. This research aims to investigate and analyze these influential factors using a combination of thematic analysis and Analytic Hierarchy Process (AHP) methodology.

Methods: The research utilizes a mixed-methods approach, combining thematic analysis and AHP to comprehensively explore the factors influencing the success of HSPI. The present study is a descriptive-survey with an applied nature and a cross-sectional design. Information was collected using the survey method, classifying it as field research. The statistical population consisted of 15 professors from the Faculty of Medicine at Najaf Abad Azad University, selected through purposive sampling. The data collection tool is a pairwise comparison questionnaire. Data analysis was performed using the AHP method and Expert Choice 11 software.

Results: The thematic analysis reveals a range of factors affecting the success of HSPI, including but not limited to stakeholder engagement, resource allocation, political commitment, organizational capacity, public awareness, and socio-cultural factors. These factors are further analyzed and prioritized using the AHP method to determine their relative importance and impact on policy implementation success. The main factors in order of priority are stakeholder engagement (weight = 0.145), resource availability (weight = 0.133) and policy design and planning (weight = 0.124).

Conclusion: The integration of thematic analysis and AHP provides a comprehensive framework for understanding and assessing the factors influencing the success of HSPI. By identifying and prioritizing these factors, policymakers and healthcare stakeholders can develop targeted strategies and interventions to enhance the effectiveness and efficiency of HSPI, ultimately leading to improved health outcomes and healthcare delivery systems.

Investigate the Relationship between Occupational Stress and the General Health of Nurses Affiliated with Shahid Sadoughi Hospital of Yazd City during the COVID-19 Pandemic

Seyedeh Zahra Khorrami — 2024-10-05

Background: One of the global challenges in the management of infectious diseases has been the management of the coronavirus, which has put considerable pressure on health care and medical systems. Nurses have borne the brunt of these pressures as the most important human resource in these organizations. Therefore, the present study aimed to investigate the relationship between occupational stress and the general health among nurses affiliated to Shahid Sadoughi as the teaching hospital of Yazd city during the COVID-19 pandemic in 2022.

Methods: The current investigation is a descriptive-correlational study conducted on 160 nurses working at Shahid Sadoughi hospital of Yazd city. Two standard questionnaires were utilized to collect data, including the Parker and DeCotiis Occupational Stress Questionnaire and the Goldberger and Hiller General Health Questionnaire. Data analysis was performed using T-test, Mann-Whitney, and Pearson correlation tests in SPSS₂₆ software .

Results: There was a positive correlation between job stress and the general health of nurses (r=0.515, P-Value=0.001). The findings revealed a significant and positive correlation between occupational stress and general health dimensions in nurses. Additionally, the results proved a significant positive correlation between time pressure and anxiety in the Occupational Stress Questionnaire with physical symptoms, anxiety and insomnia, and depression dimensions in the General Health Questionnaire.

Conclusion: The results of this research suggest that an increase in occupational stress scores leads to a rise in general health scores. Therefore, the findings indicate that higher levels of occupational stress in nurses result in a less favorable general health status. Consequently, several nurses might struggle to provide effective and high-quality care to patients, which can endanger the overall health of the community.

Effect of Covid-19 on the Pattern of the Patients Referring to the Emergency Department of Shahid Sadoughi Hospital in Yazd in 2019-2021

Mohammadali Jafari — 2024-10-05

Background: Covid-19 was first declared to be a pandemic in 2020. Once it occurred, hospitals as well as emergencies were encountered scores of challenges, including a large number of patients with a new contagious viral disease on the one hand, and the importance of continuing to provide adequate and complete services to non-covid patients who daily referred to the emergencies, on the other. Moreover, as a result of the emerging crisis, the pattern and rate of visits to the emergency department by non-covid patients underwent several alterations. Therefore, the current study was designed to evaluate the effect of covid-19 on the referral pattern of non-covid patients to the emergency department of Shahid Sadoughi Hospital in Yazd.

Methods: This is an analytical cross-sectional investigation through which all the patients referred to the emergency department of Shahid Sadoughi Hospital in Yazd in April, August and November of 2018 and 2019 (before and after the outbreak of Covid-19) were examined. The variables of the study included age, gender, reason for the patient's visit, hospital service, type of discharge from the emergency room, status and time of the visit. The collected data were then entered into SPSS₂₆ and analyzed using Chi-square and T-test.

Results: The study included 11,587 patients aged 1 to 101 years, 58.4% men and 41.6% women. The number of emergency ward visits decreased significantly following the outbreak of the covid-19 disease. A statistically significant difference was identified between the frequency distribution of all the investigated variables at the desired times (P-value=0.002 for gender and P-value=0.0001 for other variables). Therefore, the number of the male patients within the age range of 20 to 65 years in infectious and pulmonary wards increased, but hospitalization in the orthopedics and internal neurology centers and referrals due to headache, abdominal pain, and nervous tension faced the greatest decrease. Among the types of discharge, hospitalization in and transfer to the ward lowered the most.

Conclusion: Predicated on the current study, the emergence of covid-19 has triggered a significant reduction in the number of patients visiting the emergencies; the findings of this study can thus assist senior managers how to make policies as new epidemics arise in order to treat the patients and decrease mortality.

Predictors of Post-COVID-19 Recovery: A Single-Center Study

Najme Rahimi — 2024-10-05

Background: The average duration of recovery time in COVID-19 patients after contracting can be affected by various factors. Understanding the average duration of recovery time is important in formulating preventive measures/interventions. This study aims to assess predictors of post-COVID-19 recovery.

Methods: This observational longitudinal study was conducted among COVID-19 patients admitted to Vasei Hospital in Sabzevar, Iran in 2021. Data were extracted from the Hospital Information System. COVID-19 Experiences (COVEX) questionnaire was used to assess the type and severity of symptoms. Patients who were admitted to the hospital were assessed at baseline and were followed up one month and two months after discharge through telephone calls. Chi-square test was used to examine the association between demographic variables, clinical variables, disease symptoms, and time to recovery.

Results: A total of 250 COVID-19 cases were followed up for 30 and 60 days after discharge. The mean duration of recovery from COVID-19 was significantly higher in women, old patients, those with higher BMI, cases without physical activity, those with severe chest CT scan results, patients with severe diseases, and those who were discharged after 30 days (P-Value< 0.05). Patients with dry cough and chest pain were less likely to make a full recovery after 30 days. The cases with dry cough, headache, dyspnea, and chest pain were less likely to make a full recovery after 60 days than those without (P-Value< 0.05).

Conclusion: Health providers in healthcare centers should give priority to high-risk groups (e.g. those with severe chest radiography results, and those with severe disease severity). The presence of dry cough and chest pain was found to be a risk factor for delayed recovery. Initial assessment of COVID-19 patients, such as chest CT scans, can predict the severity of the disease and unfavorable outcomes. Moreover, it seems the management of comorbidities can play a vital role in recovery from COVID-19.