The economic burden of esophageal cancer in Iran

Background: Studies on economic burden demonstrate the impacts of some diseases and provide invaluable information for specifying priorities and resource needs when designing cancer control strategies. The current study aimed to estimate the cost of esophageal carcinoma (EC) in Iran in 2018. Methods: This study was conducted on the prevalence approach to estimate the economic burden of EC in Iran from a social perspective. The direct cost was estimated by summing the diagnosis, treatment, follow-up, terminal care, and transport costs. Additionally, a human capital approach was adopted to estimate productivity losses. Various resources were used for data collection, including the GLOBOCAN 2018 report, and the medical record in the Cancer Institute of Iran. Also, data such as exchange rates, employment, and housekeeping rates were extracted from the Central Bank of Iran Statistics. Results: The economic burden of EC in Iran was $69.2 million in 2018, of which $38.7 million is caused by indirect costs and $30.5 million by direct costs. The mortality cost accounted for 49% of the economic burden, followed by 34% direct medical cost, 10% direct non-medical cost, and 7% morbidity cost. Conclusions: Mortality and medical cost appeared to be the main contributor to the economic burden. Therefore, policy-makers are recommended to adopt early detection and effective treatment as a highly cost-effective strategy for controlling costs

[ survey of organizational health in university hospitals of Isfahan]

Background and Objectives: Hospitals, due to their role in improving the health of populations, should have adequate organizational health. Organizational health is critical for organizational productivity. This study aimed to evaluate the organizational health of university hospitals of Isfahan, Iran

Methods: This descriptive-analytic and cross- sectional study was conducted in 7 hospitals in 2015. A researcher-made questionnaire with 18 dimensions and 54 questions was used to gather data. A total of 283 hospital employees were randomly selected from seven hospitals. Data analysis was performed through SPSS21 and using descriptive statistics such as frequency, percent, mean +/- SD as well as inferential statistics like regression and ANOVA

Results: The mean score Mean score of organizational health in studied hospitals was 3.08 +/- 0.63 from 5. Organizational health was good in one hospital, moderate in five hospitals and poor in one hospital. Dimensions of morale, planning and formality had the highest and dimensions of justice, decision- making and control had the lowest scores. Intra-ward relationships, efficient use of resources, adaptability, leadership and independence showed the most effect on organizational health. Specialty hospitals had better organizational health compared to general hospitals. There was significant relationship between managers' work experience and organizational health

Conclusion: University hospitals of Isfahan have moderate organizational health and hospital managers should apply necessary activities for improvement of organizational health

Assessment of the perioperative period in civilians injured in the Syrian Civil War / Avaliação do período perioperatório em civis feridos na Guerra Civil Síria

BACKGROUND: wars and its challenges have historically afflicted humanity. In Syria, severe injuries occurred due to firearms and explosives used in the war between government forces and civilians for a period of over 2 years. MATERIALS AND METHODS: the study included 364 cases, who were admitted to Mustafa Kemal University Hospital, Medicine School (Hatay, Turkey), and underwent surgery. Survivors and non-survivors were compared regarding injury site, injury type and number of transfusions given. The mortality rate found in this study was also compared to those reported in other civil wars. RESULTS: the mean age was 29 (3-68) years. Major sites of injury included extremities (56.0%), head (20.1%), abdomen (16.2%), vascular structures (4.4%) and thorax (3.3%). Injury types included firearm injury (64.4%), blast injury (34.4%) and miscellaneous injuries (1.2%). Survival rate was 89.6% while mortality rate was 10.4%. A significant difference was observed between mortality rates in this study and those reported for the Bosnia and Lebanon civil wars; and the difference became extremely prominent when compared to mortality rates reported for Vietnam and Afghanistan civil wars. CONCLUSION: among injuries related to war, the highest rate of mortality was observed in head-neck, abdomen and vascular injuries. We believe that the higher mortality rate in the Syrian Civil War, compared to the Bosnia, Vietnam, Lebanon and Afghanistan wars, is due to seeing civilians as a direct target during war.

JUSTIFICATIVA: Historicamente, as guerras e seus desafios afligem a humanidade. Na Síria, lesões graves ocorreram devido às armas de fogo e explosivos usados na guerra entre as forças governamentais e civis durante um período de mais de dois anos. MATERIAIS E MÉTODOS: O estudo incluiu 364 pacientes, admitidos no Hospital da Universidade Mustafa Kemal da Faculdade de Medicina (Hatay, Turquia) e submetidos à cirurgia. Os sobreviventes e não sobreviventes foram comparados quanto ao local e tipo da lesão e número de transfusões administradas. A taxa de mortalidade encontrada neste estudo também foi comparada àquelas relatadas em outras guerras civis. RESULTADOS: A média de idade foi de 29 (3-68) anos. Os principais locais de lesão incluíram extremidades (56,0%), cabeça (20,1%), abdome (16,2%), estruturas vasculares (4,4%) e tórax (3,3%). Os tipos de lesões incluíram ferimento de arma de fogo (64,4%), lesão causada por explosão (34,4%) e ferimentos diversos (1,2%). A taxa de sobrevivência foi de 89,6%, enquanto a taxa de mortalidade foi de 10,4%. Observou-se uma diferença significativa entre as taxas de mortalidade neste estudo e aquelas relatadas para as guerras civis da Bósnia e Líbano; e a diferença ficou extremamente significativa quando comparada com as taxas de mortalidade relatadas para as guerras civis do Vietnã e do Afeganistão. CONCLUSÃO: Dentre as lesões relacionadas à guerra, a maior taxa de mortalidade foi observada em lesões de cabeça-pescoço, abdome e vasculares. Acreditamos que a maior taxa de mortalidade na Guerra Civil da Síria, em comparação com as guerras da Bósnia, Vietnã, Líbano Afeganistão, se deva ao fato de os civis terem sido vistos como alvo direto durante a guerra.

most important factors that patient chose public or private hospital in 1387 year

Introduction: the purpose of this study is to determine the most important factors that patient chose public or private hospital in 1386- 1387 year. Method; this research is a descriptive - comparative and sectional study. In this rescearch statically community include patient who are in-patients in private and public hospitals in Tehran, Iran, and Beheshli university Whit use of simple and randomly sampling a total of 360 patient assesscd through Random choose. assessment tools in this research war; researcher questionnaire which was made in 3 part. First pan include 25 questions that had 5 uprims from tikert system scoring nletllnd. Second part incllrdt 2 qucstions that had 2 options whicll was yes or no and third parlincludc 2 opcn questions which they validity obtained from content asscssmcnl. Corrclalion qucstionnairc nhtaincd 90. we used SPSS fur dara - smtistical trials such as - trials and T trials and Manwitny and Fridman and logistire regre SS IOn test. Results: bnsud on the linding. the most important factors in the chonse of puhlic hospital include: clipcticnccd physician. Rclat ionship knveen physician and patient and Frequent physician attendance, physiciatl popularity and the most important factors in the chousi: of private hospilals are uxpcrimrccd phsicirrn.Kclrrriunship that 5cm physician and patjmt and Frcquent physician attendance in wards. physician practice in hospital. And between empowerment fxtnrs fur the choose of public hospital arc [hospilal cosr: fitcrors 2] palicnt incomc factors and hetwcen cttlporrrerlnent factors for choose of privatc hospitals are 1] pnt ient income fkcror 2] huspihl cost faclots [p< 0.05]. Conclusion the patients uchv sclcer rhc privalc and govctintal hospitals say that there lnain rescan for this sclcction is the ailability of experieiced physicians. The treatment cost in hospitals and paticnts incum arc miin rcsciins Tor sdcclion of hospitals