[Study the development level of provinces in Iran: a focus on health indicators]

Introduction: access to health care is one of the main goals in all societies. This study aimed to investigate the access level in provinces in Iran

Methods: this descriptive-applied and cross-sectional study was conducted in 2012. Statistical population consisted of all provinces in Iran. Data were collected through library and online research. The Ministry of Health and Medical Education and Statistics Center of Iran as authorities of Information, were referred to for collecting relevant data. Taxonomy techniques were used to assess the of development level of provinces, Shannon entropy techniques were used to determine the weights of indicators and TOPSIS techniques were employed to rank states in terms of access to health care

Results: based on Taxonomy technique from among 31 provinces, 12 provinces were considered to be developed, 9 semi-developed and 10 underdeveloped. Based on Shannon entropy, the ratio of the number of pharmacists to province population was the most important indicator. According to TOPSIS, in term of access to health services; Markazi and Ardabil provinces ranked the first and the last respectively

Conclusion: due to the large differences among provinces, planners and officials are recommended to allocate the funds according to the development level

[ survey of unmet health needs and the related barriers to access them]

Introduction: Unmet needs are defined as the difference between services judged necessary to deal appropriately with health problems and services actually received. Unmet needs are considered as simple tools in monitoring the accessibility and the extent of inequity in access and use of health care

Methods: This is a cross-section health survey. The sample consists of 792 households living in Tehran. Data were collected by the WHO [households] questionnaire in 2012, and were analyzed using Logistic Model and STATA12 software

Results: The outcomes show that economical problems, lack of time, self-treatment, long distance to reach health facilities, deprivation of insurance coverage, and lack of adequate information about the locations of health care centres are all factors affecting patients' willingness to refer to these centres. The socio-economic factors which can enhance the probability of fulfilment of health care needs were found to be settlement ownership and poverty reduction

Conclusion: Unmet needs can cause detrimental effects, such as worsening health situation and quality of life, increasing the risk of mortality and causing mental and psychosomatic disorders; therefore, policy makers should give high priority to eliminating socio-economic barriers, as lack of insurance coverage, as well as reducing the costs and economic inequalities, and payment systems reform

[ survey of health sector from the perspective of economics and its relationship with other sectors in Iran's economy]

Introduction: Health sector is one of the most important sectors in the economy of any country with its products being on demand by individuals and households. This study was done in order to survey the health sector in Iran's economy using input-output analysis

Methods: In this analytical study all economic sectors in Iran were compared using input-output Technique. Ultimately, linkages, importance index, dependency degree of health sector were computed among the 18 aggregated sectors

Results: Health sector does not have remarkable effect on other sectors because of low backward linkage. The low forward linkage has an inappropriate place in providing intermediate data. This sector has the highest degree of dependency on industry products and the lowest on the mining sector. The first sector depending on health is the health itself followed by education whereas the real estate sector has the lowest dependency on health

Conclusion: Having a coefficient less than one compared to other sectors, the health sector has a smaller role in inducing production processes and integrating the economy. Moreover, its motivation depends on other sectors' motivation. Also, the end products of health sector are consumed in final demand form

[Economic evaluation of students' screening program in the city of Komijan [Iran-2009]]

Background: Economic evaluation is one of the measures of decision making for providing efficient services

Objective: To calculate the cost outcome of students' screening program in the city of Komijan

Methods: This was a descriptive analytical study carried out on all first grade students of different educational courses including primary schools, guiding schools, and high schools. The cost-unit method was used to calculate the cost followed by analysis of data using the Excel software

Findings: Screening program showed that 0.1% of total students had diabetes, 0.2% cardio-vascular disorders, 0.26% asthma, 3.07% anemia, 32% pediculosis, 0.1% tinea, 18.33% dental caries, 0.54% hearing problems, 6.42% optic problems, 0.8% behavioral [otism] disorder. The total cost of students' screening program was 164495020 Rials and the average cost equal to 88773 Rials. The minimum cost of detection a single disorder among the students of primary, guiding, and high schools was associated with dental disorders which was equal to 4736, 7037, and 12268 Rials, respectively. The maximum detecting costs for a single disorder were for speech disorders among the students of primary schools [3500301 Rials] and hearing disorders in students of guiding schools [2075018 Rials] and high schools [3900784 Rials]

Conclusion: The students' health screening program within the rural and urban regions of the city of Komijan is cost-effective and thus could be continued

[Receivables collection and turnover period in selected hospital of the Qom university of medical sciences from insurance companies [2005-2009]]

Increasing the receivables collection period make problems in the payment of personal salaries, medicine fees and facilities under surveillance centers. It finally has negative effects on delivered services. At present economic circumstances, paying attention to liquidity and its present value is very important to doing economic activities and to decreasing receivables collection period. The aim of the study was calculating the receivables collection and turnover period in selected hospital of the Qom University of Medical Sciences. This is a descriptive research that conducted in the selected hospital of Qom university of medical sciences during the fourth national development program [2005-2009]. Data was Collected from information based on the financial documents of the kamkar hospital and registered into information sheets and analyzed by excel software. Results show that during the fourth national development program, Receivables turnover has gradually decreased and unlike the receivables collection period increased. Both of these relations showed an undesirable circumstances and graving with the contracting insurance companies in the payment of their obligation with the hospital. Findings indicated that the receivables collection period of insurance companies takes Long and taken a long way from its normal .It needs a serious monitoring and intervention in the large scale decision making, except by using the power of law during the fourth development national program which it hasn't a good impact in repayment approach of the policy makers in this issue that expected all of the general managers in the giving of services

[ analysis of education expenditure per capita in public health faculty of Qazvin University of medical sciences]

It is necessary for higher education institutes and organizations to use financial analysis for boosting productivity and optimal human and capital resources allocation. This cross-sectional study was conducted to calculate training expenses per capita in two public health faculties of Qazvin University of medical sciences in 2008-2009. The community research in this study was all of the educational groups in these two public health faculties of Qazvin University of medical sciences. Data was collected by information sheets using direct observation and interviews with the relevant staff. The cost centers are divided into 4 categories administrative, administrative- student, supportive and educational units. The findings show that the annual educational expenses per student in the health environments 194400529 Rls, professional health 12196607 Rls, public health 21951484 Rls, medical emergency 11481283 Rls, nursing of the operation room 13852267 Rls, anesthesia 12208699 Rls, medical laboratory 15937338 Rls, health care management 15320096 Rls and MPH was 14395964 Rls 62% of the total educational expenses were direct costs of educational groups and 38% of costs was the indirect ones. Student education in different disciplines is a costly issue. Determining standard indices to train the human resources and focusing on detecting the unnecessary costs and eliminating them is an important step to reduce the average costs

[Assessing the information management from the health houses to the health centers of Qazvin Province [2008]]

Efficient health information management can lead to timely and useful decision in the system. To assess health information management in health system of Qazvin Province. This cross-sectional study was conducted in 2008. The 3 levels of Health Care System of Qazvin were assessed. By targeted sampling; 10 Health Houses, 5 Rural Health Centers and Shahid Bolandian Health Center of Qazvin city were selected to study. Questionnaires and Checklists were used for data collection. The data were analyzed with spss 13 software. From 9262602 units of information were produced in health system, about 683563 units [7.3% of total information] were sent to higher levels. The frequency distribution views of experts which were gathered about situation of health system about data collection and information transfer were as: moderate [23.2%], fair [76.8%] and data processing and analyzing: weak [0%], moderate [15.9%] and fair [84.1%]. concerning the interpretation of information: weak [1.4%], moderate [23.2%] and fair [75.4%], and method of data control: moderate [21.7%] and fair [78.3%]. With respect to findings for effective decision making, it is necessary to pay attention to screening subject in low levels and educating of information interpretation methods to statisticians in these levels

[Strategic planning in health care systems]

Today surviving of the organization in variable environment and restructuring of the health system needs thoughtful and deliberate planning. Strategic planning gives direction to the organization for achieving goals and mission and improves organization efficiency. It recognized unused programs and repetitive efforts and eliminate them. Strategic planning focuses on resources for improvement of services and coordination of activities. It helps to organization for adaptation with external variable environment and helps to recognition of strengths, weaknesses and also opportunities, threats in the market. Thus synchronously with technology needs and increase of government participation in health care services, managers of health services should be especial attention to strategic planning for achievement of long term goals

[Effects of increasing hospital and medical services tariffs on price index in economical sectors by using input-output method [2007-2008]]

With respect to the fact that the levels of prices and tariffs are determined out of the market procedure, the method of determination and estimation of a balanced price and the necessity of a transparent follow-up on outcomes of increased prices is of vital importance for the politicians of this section. To determine the effects of increasing hospital and medical services tariffs on price index in other economical sectors. In this applicable study, the input-output table of the year 2001 of the Iran Statistics Centres was used as the statistical basis. Using three scenarios associated with increased tariffs marked as "weak" [approved tariff], "moderate" [based on inflation rate], and "strong" [proposed by the Medical Council], the effects of increased tariffs on price index in other economical sectors were evaluated. Two open and close supply approaches were used to analyze the inputs. Findings: The first, second, and third scenarios in open approach for increase in tariffs indicated a range of effects on price index in economical sectors calculated at 0.00001-13.81%, 0.00001-15.31%, and 0.00003-50.43%, respectively. In closed approach, the increase in tariffs in the first, second, and third scenario showed a range of effects on price index in economical sectors calculated at 0.02- 12.46%, 0.02-14.01%, and 0.06-46.14%, respectively. Finally, the agricultural section demonstrated the least positive sensitivity and the hospital and medical section the most positive sensitivity to increase in tariffs. The findings of present study indicated that changes in medical and hospital services tariffs have little effects in other sections and a small role in production process and economic integration. These sections fundamentally have marginal consumption nature. The results of open and close approaches in different scenarios showed that the tariffs of medical and hospital sections must be increased according to the inflation rate. Keywords: Tariff, Price Index, Input-output

[Total cost of services in diagnostic wards in Ghazvin medical university and health services based on activity based technique]

Challenges and obstacles in health system resources are the most important subjects in this area. Calculating the total cost of outputs [expenditures] by activity based technique is one step to improvement the performance. This study has performed for accounting the total cost of services in diagnostic wards in Ghazvin medical university and health services in 1386. This is a cross sectional and descriptive study. One hospital has been randomly selected from four hospitals in the city. Data was gathered by the ministry of health's standard forms. Data analyzed by activity based technique and total cost of each point [unit] were extracted. For each package of service, total cost was 57700R in Radiology and Sounography; and in Audiometry and EEG, 123800R. 68% of hospital activity expenditures were for personnel and the remained [32%] for nonpersonnel expenses. Extracting the total cost of expenditures with activity based technique helps hospital managers to prevent undesirable cost errors, to improve the services and to decrease the expenditures

Study economic efficiency of teaching hospitals of Qazvin university of medical sciences [1999-2007]

Hospitals as important sectors of health care system has special location in Health economic science. Increasing of the operational costs in hospital and limitation in financing cause that hospital as an economic firm use economic analysis and prepare effective using of resource and boost productivity. To analyze economic efficiency and resource allocation situation of teaching hospitals of Qazvin university of medical sciences [1999-2007]. This study was conducted in 2008. Need data [human and capital resource information] was collected from data center of research deputy of university and teacmg hospitals and registered at information sheets and then was analyzed by DEAP2 software and data evolvement analyze method. Average technical, pure and scale efficiency of centers during the period of study was appointedrespectively 0.90, 0.96 and 0.93 50 percent of centers were efficient for using of resource [Total Technical Efficiency [TTE]= 1]. Another 50 percent of centers had no efficient situation [TTE = 1]. Efficiency rate of studied centers was variable during the time of study and had not uniform trend. Human and capital resources were made 67 and 33 percent of total operational cast of centers respectively. The average of annual cost estimated per labor 30.1 xl0[6] and for capital resource 19.9 x 10[6] Rails. Labor and capital resources have more costs for hospital industry, therefore policy and decision makers must determine need for resource by using economic analysis and correct planning methods and then employ them, appoint optimal capacity for centers to service delivery, enhance positive efficiency indexes and distinguish the ways that is more effective in boosting of resource performance

[Cost analysis of information generation in Alborz healthcare]

Information economics analysis is important issue for creation of appropriate intelligence about information mobility, evidence based ondecision making and boosting of policy making process in system. To calculate the costs of information generation in Health Houses, Rural Health Centers and County Health Center of Alborz county health care system. This descriptive analytical study was conducted in 2008. The study population included Alborz county health center, 3 Rural Health Centers and 8 Health Houses. Data were collected through observation activities, checklists, costing forms and interviews. Activity Based Costing [ABC] method was used to analyze the costs. The costs of human resources, special and general materials, energy and general costs, capitals deprecation and repairmen in proportion to total costs were 70%, 3% and 2%, 8% and 17%respectively.The proportion of information cost to total operational costs in Health Houses, Rural Health Centers and County Health Center were 45.8%, 24.7% and 4.1% respectively. Average unit-cost of generated information in HHs, RHCs and CHCs were $0.76, $2.74 and $3.73 respectively. The total amount of generated information were 545180 units with total cost of $82000 Information generation cost was 15.6% of total operational costs in the system. Regarding the cost of information generation in this healthcare system, the need for using and screening information for evidence-based on decision making is obvious. Hence, more efforts have to done by managers and policymakers in healthcare system for implementation of a standard HMIS and to train personnel in order to generate optimum information by minimum costs

[Hotelling cost and financial variances in Shahid Rajaei hospital wards, city of Qazvin]

Increasing health care costs and appropriate resource usage have made financial analysis important. Defining the hotelling cost and financial variances in Shahid Rajaei Hospital wards in Qazvin city is the aim of this article. This is a Cross sectional and descriptive study carried out in 1384. Special forms and activity based costing method [ABC] were used to define hotelling cost and financial variance. Constitute and variable cost was 80 and 20 percent of total cost, respectively. Indirect costs had important share in Hotelling costs. ICU had maximum [896000R.] and surgery ward had minimum [280000R.] hotelling cost. Urology ward had the maximum [557000R.] and surgery ward had the minimum [200000R.] of financial variances. Referring to negative financial variances between real costs and governmental fees, hospital managers and decision makers should exhibit great effort to identify and improve waste operational costs and less optimized efficiency variances

Assessment of some potential risk factors of postpartum depression

Postpartum depression [PPD] has pathological consequences for mother and infant. This study examined some potential risk factors of PPD in Iran. This is a descriptive cross-sectional study which included patients attending two health centers at two months postpartum. They were screened for PPD using Edinburgh Postnatal Depression Scale [EPDS]. The participants were 27.93 +/- 5.31 years of age. The prevalence of positive screening test was 21.4%. Unwanted pregnancy material dissatisfaction, infant gender dissatisfaction, lower socioeconomic status, lower educational level, infant illness and previous depression were significantly higher [p<0.05] among women with high score on the EPDS. Women with positive test who have risk factors may warrant more detailed assessment program. A brief semi- structured psychiatric interview may be a more accurate assessment tools