Assessing hospital performance by the pabon lasso model

The Pabon Lasso model was applied to assess the performance of six State-run hospitals in the province of Kohgilooyeh and Boyer-Ahmad, to produce information that used by policy makers in their attempt to make the health care system more productive. This cross-sectional study involved all the six public hospitals in the province, with 607 registered beds. Data collection accomplished by the use of two ad hoc questionnaires that dealt with both general information and admission data from various hospital wards. The statistical software SPSS-13 used to derive three basic performance indicators, namely average length of stay, bed occupancy rate and bed turnover, which analyzed in Pabon Lasso model. The overall average length of stay, bed occupancy and bed turnover rates were 2.99 days, 62.78% and 76.73 respectively. Two hospitals were in Zone III of the model, indicating a satisfactory level of efficiency. Three hospitals demonstrated inefficiency and underutilization of resources by falling into Zone I. one hospital placed in Zone IV. The best approach to address the existing inefficiencies would lie in stopping the expansion of the current facilities [e.g. not adding any more beds]. As any further expansion will only serve to make hospitals more inefficient. Future research should focus on why the performance is not at a desirable level and how the situation can be improved

[Reproductive correlates of female sexual dysfunctions in Kohgilouyeh-Boyerahmad province: a population-based study]

This study aimed to determine the prevalence of female sexual dysfunction [FSD] and its relationship with reproductive variables in married women in urban areas of Kohgilouyeh-Boyerahmad Province. This cross-sectional study covered urban areas of Kohgilouyeh-Boyerahmad Province. Using a quota sampling method, an ad hoc questionnaire containing items on demographic and reproductive variables, was administered to women attending primary health care delivery centers. Sexual dysfunctions were defined by the DSM-IV criteria. Data were analyzed using binary logistic regression. A total of 1540 married women residing in urban areas were studied. The mean age of the respondents was 33.2 [SD=9.4] years and most were housewives [84.5%]. The self-reported frequencies of different FSDs were as follows: loss of desire [35.1%], dyspareunia [34.9%, anorgasmia [34.5%] and loss of arousal [31.6%]. Binary logistic regression analysis showed the following risk factors for various FSDs: loss of desire: "age" [46 >/= y: OR=3.07 [1.58-5.99]], "pelvic surgery' [Cesarean Section: OR=1.57 [1.13-2.18]]. Loss of arousal: "age" [36-45y" OR=2.20 [1.27-3.79]], "contraceptive method" [depoprovera/norplant/withdrawal: OR = 1.81 [1.15-2.85]] anorgasmia: "age at marriage" [7-15y: OR =2.93 [1.33-6.42]], "contraceptive method" [depoprovera/norplant/withdrawal: OR = 1.62 [1.06-2.49]], dyspareunia: "age" [31-35y: OR 0.48 [0.29-0.77]], "education" [high school: OR =1.84 [1.10-3.07]], "contraceptive method" [condom: OR= 1.80 [1.02-3.18]]. The findings indicate that FSD is prevalent in the study population. The effects of demographic and reproductive variables should be considered in management of these disorders

[AIDS literacy among female high school students: a cross-sectional study from Iran]

Female high school students are among most vulnerable population groups with regard to AIDS because of their age and their high-risk behaviors. This study aimed to assess AIDS literacy among female high school students from two different socio-economic backgrounds in Tehran, Iran. A cross-sectional study was conducted to investigate about AIDS knowledge and attitudes among female students in Tehran, Iran. Two available high schools were identified and after obtaining consent from authorities, a brief questionnaire was administered to all students. In all, 581 students participated in the study. The mean age of the respondents was 15.3 [SD=0.94] years [ranging from 14 to 17y]. Data analysis showed that the subjects had a fairly good knowledge of AIDS. The percentage of correct answers ranged from 33.4% to 96.4%. Also, the majority of the respondents strongly agreed or agreed with statements that "AIDS is a public health problem and people should be informed about the disease" [95.9%] or "people with AIDS should receive support from family, community and the government" [89.0%]. Most students indicated that the mass media [including television and newspapers] were their main sources of information on HIV and AIDS [52.2%]. Thirty-seven percent said that they need more information on AIDS prevention followed by need for more general information about AIDS [22%] and information about AIDS transmission modes [17.0%]. Overall, those from affluent backgrounds showed a better understanding of the topic and there were significant differences in knowledge levels between the two high schools. The findings indicate that in general female students have a fairly good knowledge about AIDS and have positive attitudes towards people with AIDS. However, since female high school students are at greater risk, in order to enhance AIDS literacy among this population, implementation of further health education programs is recommended

Patterns of contraceptive use in urban areas of Kohgiluyeh-Boyerahmad in 2004

Achieving comprehensive reproductive health services, including family planning as the basis of family health and sexual health, has been internationally the main objective of governments and health policy makers in the past decades. Improving modern family planning facilities would lead to a promotion in population control. This study investigates family planning indices, its short comings and mean of reproductive variables in the urban areas of Kohgiluyeh-Boyerahmad province in comparison with the data from Demographic Health Survey carried out in Iran in 2000. Considering the high coverage of households by urban health centers in the province, 1540 married women were randomly selected from the list of names in each health center and they were interviewed during 2004. A researcher-devised questionnaire, [content validity determined by experts], was used consisting of demographic variables, family planning awareness status methods, the contraceptive method used by the couples and the number of a desired and live children. Using SPSS, version 13, the data were analyzed in a descriptive-analytical fashion with a significance level of 0.05. The mean age of the respondents was 33.2 +/- 9.4 years. The mean numbers of pregnancies and children were 3.7 and 3.2 respectively. There was a significant relation between the mean number of children and women's educational status and job [p-value <0.001]. A significant difference was also observed between the mean and the desired number of children [t=4.46, p-value <0.001]. The most common family planning methods were OCP and TL [40.4% and 18.7% respectively]. The highest knowledge about family planning methods was on OCP, condom and TL [94%, 65.4% and 45.2% respectively]. Highest number of women with one child and women with >/= 3 children were in the 21-30 and 31-40 age groups respectively. The findings indicate that family planning programs have had a relatively appropriate effectiveness on population control in Kohgiluyeh-Boyerahmad province and family dimension is relatively satisfactory but despite better knowledge about modern contraceptives, use of modern family planning methods is not desirable. Considering the high number of children by women from older age groups, the need for educating and promoting the use of modern contraceptives is still of importance

[Knowledge of married women in kohgilouyeh and boyerahmad urban areas on AIDS and sexualy transmitted infections]

Sexualy transmitted infections [STIs] and AIDS are the most common diseases worldwide. Women are more affected by STIs and AIDS due to gender-related factors such as biological, cultural and so on. This study was conducted to investigate knowledge about AIDS and STIs among married women in Kohgilouyeh and BoyerAhmad Province/Iran. This cross-sectional study was conducted in the urban areas of Kohgilouyeh and Boyerahmad province. Using stratifed cluster sampling, a valid questionnaire covering demographic variables and items related to knowledge about AIDS and STIs was administered to 1379 women covered by the urban PHC clinics. The mean age of the respondents was 33.3 [SD= +/- 9.3]. Most were household [%85] and the mean level of their formal education was 7.2 years [SD= +/- 4.8]. The results also showed that women had the most knowledge with the statements that "using condom protects against AIDS" [%63.9] and "asymptornatic persons would be as AIDS vectors" [%65.1]. There was a significant relation between education and recognizing AIDS as a sexualy transmitted infection [p=0.004]. Albeit, women were poorly familiar with the STIs, the most knowledge was found with gonorrhea [%40.5] and the least with chlamydia [%12.2]. The most knowledge was observed with the statements that "STIs would induce PID in women" and "using condom protects against all the venereal diseases" [both%61 .1]. A significant corelation was found between education and job and fimiliarity with STIs [p<0.001]. Findings showed limited knowledge on sexualy transmitted infections and fairely good knowledge on AIDS. There is need for the promotion of women's knowledge in sexual health field

Socio- economic health inequalities and their indices in epidemiologic studies

The term [health inequalities] is not a descriptive one: it refers to discrepancies in morbidity and mortality, life expectancy, disability life adjusted years, etc that are due to differences in such factors as socioeconomic status, gender and race/ethnicity. Socio-economic inequalities are the differences in health status [e.g. disease prevalence and incidence rates] across various socio-economic groups. In Europe, measuring socio-economic health inequalities has long been a major research topic. However, there have been relatively few experimental studies in Asia, especially in developing countries. In the social context, measurement of socio-economic status is based on income, educational level and employment status. Stratifying the socio-economic groups based on a hierarchy identifies the pattern of morbidity and mortality in each socio-economic stratum. It also shows the exact relationship between socio-economic status and health. The main data sources for determination of population health status and measuring health inequalities are registries and cross-sectional surveys. It seems that monitoring, prevention and evaluation of health inequalities, especially with a focus on socio-economic level has been neglected in developing countries, including Iran. Due to the lack of formal registries on population health status in these countries, designing cross-sectional and population-based studies would be a useful approach in the prevention and monitoring of health inequalities