Determinants of catastrophic health expenditure in Iran

This study will provide detailed specification of those variables and determinants of unpredictable health expenditure in Iran, and the requirements to reduce extensive effects of the factors affecting households' payments for health and other goods and services inappropriately. This study aims to identify measures of fair financing of health services and determinants of fair financing contribution, regarding the required share of households that prevents their catastrophic payments. In this regard, analysis of shares of households' expenditures on main groups of goods and services in urban and rural areas and in groups of deciles in the statistics from households' expenditure surveys was applied. The growth of spending in nominal values within the years 2002-2008 was considerably high and the rate for out-of-pocket payments is nearly the same or greater than the rate for total health expenditure. In 2008, urban and rural households in average pay 6.4% and 6.35% of their total expenditure on health services. Finally three categories of determinants of unfair and catastrophic payments by households were recognized in terms of households' socioeconomic status, equality/inequality conditions of the distribution of risk of financing, and economic aspects of health expenditure distribution. While extending the total share of government and prepayment sources of financing health services are considered as the simplest policy for limiting out-of-pocket payments, indicators and policies introduced in this study could also be considered important and useful for the development of health sector and easing access to health services, irrespective of health financing fairness

Allocation of health resources according to the type and size of Iranian governmental hospitals

Due to consuming about 50%-80% of health resources, hospitals are the greatest and costly operational units in Iranian Health system. so allocation of resources specially human and space resources as the most expensive ones is really important for further controlling of costs, analysis of costs and making suitable policies for increasing the profitability and allocation of resources and improvement of quality. This paper intends to describe and analyze any allocation of resources in 530 university hospitals in Iran. The final goal of this research is to provide a data bank according which there is a basis for more scientific budget allocation of state's hospitals from the size and type of application points of view. The relevant index of person to bed was 2.04 for human resources. All hospitals more than 300 beds are located in benefiting areas from which 17 cases are educational and 2 cases are therapeutic. This is necessary to mention that the rate of management group forces to total personnel at deprived areas is about 2.5% more than benefiting areas. Because 60-80% of hospital costs are applied for human forces, all managers of hospitals are obliged to revise their policies in attraction and employment of human force in order to benefit from such a valuable resource and prevent from expensive costs. So any employment of personnel should be based upon real needs of hospital

[ investigation on the prevalence of medical emergencies during dental treatment]

Background and aim: the occurrence of medical emergency, among patients under dental treatment, is probable and upon the absence of readiness and in accurate diagnosis can endanger patients' life particularly for those with systemic problems. Dentist during his training career should become thoroughly familiar with emergency signs and their correct management. The purpose of this study was to identify the most prevalent kinds of medical emergencies and their relationship with different dental treatments

Materials and Methods: the present cross-sectional and descriptive study was conducted on all the patients, regardless of sex, referred to four departments in faculty of dentistry Tehran University of' Medical Sciences during one year [2001-2002]. The information were collected through a questionnaire. During this period totally 12660 patients underwent treatment in four studied departments including: surgery 4480 [35.4%], periodontics 2560 [20.2%], endodontics 2240 [17.7%] and operative dentistry 3380 [26.7%]

Results: the results of this study showed 72 emergency cases iranked as follows: surgery department [36.1%], periodontics department [23.6%], endodontics department [20.5%] and operative dentistry department [19.4%]. The most prevalent reported type of emergencies were vasovagal syncope [39 cases], Orthostatic hypotension [19 cases], hyper ventilation syndrome [3 cases], sensitivity to anesthetics [2 cases], hypoglycemia [2 cases], bronchospasm [1 case] and seizure [1 case]

Conclusion: it should be noted that emergency cases were mostly observed among females aged less than forty. Accurate diagnosis and proper therapeutic steps were taken in 100% of cases