ABSTRACT
Objectives@#Aging is assumed to be accompanied by greater health care expenditures. The objective of this retrospective, bottom-up micro-costing study was to identify and analyze the variables related to increased health care costs for the elderly from the provider’s perspective. @*Methods@#The analysis included all elderly inpatients who were admitted in 2017 to a hospital in Tehran, Iran. In total, 1288 patients were included. The Mann-Whitney and Kruskal-Wallis tests were used. @*Results@#Slightly more than half (51.1%) of patients were males, and 81.9% had a partial recovery. The 60-64 age group had the highest costs. Cancer and joint/orthopedic diseases accounted for the highest proportion of costs, while joint/orthopedic diseases had the highest total costs. The surgery ward had the highest overall cost among the hospital departments, while the intensive care unit had the highest mean cost. No statistically significant relationships were found between inpatient costs and sex or age group, while significant associations (p<0.05) were observed between inpatient costs and the type of ward, length of stay, type of disease, and final status. Regarding final status, costs for patients who died were 3.9 times higher than costs for patients who experienced a partial recovery. @*Conclusions@#Sex and age group did not affect hospital costs. Instead, the most important factors associated with costs were type of disease (especially chronic diseases, such as joint and orthopedic conditions), length of stay, final status, and type of ward. Surgical services and medicine were the most important cost items.
ABSTRACT
Introduction: Justice and its realization has always been a goal of utopian reformers and leaders in various governments throughout the history. Achieving this goal is the most basic principle of social systems during different periods of human intellectual and social life. Inequities should be decreased between social subgroups in order to gain justice. Attention to inequalities are necessary to ensure all sections of society's access to health resources and optimum resource allocation. Because of the importance of pharmacies in delivering drugs to people and consequently preventing from intensity of diseases and reducing the days lost from work and increasing national production, in this paper the distribution of pharmacies has been studied in 2006-2011
Method: This survey was a retrospective practical study. Data was gathered from Statistical Center of Iran and Kerman Food and Drugs Administration of Kerman Medical University in 2006-2011. After entering the data into the software and sorting it from the lowest to the highest, the researchers calculated the share of population and sectors' share of pharmacies from the total of them and then cumulative percentage of the population and pharmacies. In the last section, Lorenz curve was plotted putting the cumulative percentage of variables against each other. Gini index was calculated using the software Stata 11
Results: Gini coefficient had a decreasing trend in Kerman in the period between 2006-2011. Gini index is about 0.4 during the period of 2006-2009 and 0.3 during 2009-2011. So the distribution of pharmacies was in equitable, and redistribution of some of them was necessary
Conclusion: Access to pharmacies to receive medicines for patients, especially in rural and deprived areas, are important. As reasons of the unequal distribution of pharmacies one can mention lack of attention to age and gender density and the burden of disease in the region and also paying too much attention to economic situation of communities. Government intervention and its participation in the investment with private sector in the establishment of pharmacies in underserved areas can reduce inequality and help timely access to drugs for people