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Delivery of Health Care , Global Health , World Health OrganizationABSTRACT
Studies show that in recent years, mental disorders have increased in various communities. Because of continuity of social sciences, study of combined socioeconomic factors can lead to important policy recommendations. The purpose of this study was to determine the effect of socioeconomic factors on mental health of Iranian people. This analytical descriptive study was performed using data from 30 provinces of Iran from 2007 to 2011 and the effect of social and economic incentives on mental health of Iranian people was evaluated. All data were obtained from Statistical Center of Iran. In this study, the suicide rate was used as an indicator [proxy] of mental health. Generalized panel with fixed effects and taking into consideration the heteroscedasticity was used to estimate coefficients. Coefficients for Iranian men and women are estimated and results are as follow: Enrolment rate 0.019 and -0.092, urbanization rate -0.34 and 0.11, unemployment rate 0.048 and 0.025, income inequality rate -0.37 and -0.06, crime rate 0.081 and 0.067 and inflation rate 0.074 and 0.022. All variables e men's enrolment rate had significant relationship with suicide rates [P<0.01]. Unemployment, crime and inflation rates and income inequality had significantly equal effect on suicide rate of men and women. The first three factors have negative and the fourth has positive effect and other factors [urbanization, divorce and enrolment rates] have distinguished effects
ABSTRACT
The clinical effectiveness of heart valve replacement surgery has been well documented. Mechanical and homograft valves are used routinely for replacement of damaged heart valves. Homograft valves are produced in our country but we import the mechanical valves. To our knowledge the cost-effectiveness of homograft valve has not been assessed. The objective of the present study was to compare the cost-effectiveness of homograft valve replacement with mechanical valve replacement surgery. Samples were selected from 200 patients that underwent homograft and mechanical heart valve replacement surgery in Imam-Khomeini hospital [2000 - 2005]. In each group we enrolled 30 patients. Quality of life was measured using the SF-36 health survey and efficacy was measured in QALYs. For each group we calculated the price of heart valve and hospitalization charges. Finally the cost-effectiveness of each treatment modalities were summarized as costs per QALYs gained. Forty males and 20 females participated in the study. The mean score of quality of life was 66.06 [SD= 9.22] in homograft group and 57.85 [SD= 11.30] in mechanical group [P< 0.05]. The mean QALYs gained in homograft group was 0.67 more than mechanical group. The incremental cost-effectiveness ratio [ICER] revealed a cost savings of 9,604,440 IRRials for each quality-adjusted life year gained in homograft group. Despite limitation of this introductory study, we concluded that homograft valve replacement was more effective and less expensive than mechanical valve. These findings can encourage healthcare managers and policy makers to support the production of homograft valves and allocate more recourse for developing such activities