The effect of Iran's health sector evolution plan on hospitals performance indicators: an interrupted time series analysis.

Background: The Health Sector Evolution Plan (HSEP) was set up in Iran's health system to respond to some of the main problems in hospitals and other health sectors. We aimed to compare the effect of the HSEP on teaching hospital performance before and after the implementation of the HSEP through the interrupted time series (ITS) analysis. Methods: With a cross-sectional design, data collection was performed in 17 teaching hospitals affiliated with the Kermanshah University of Medical Sciences (KUMS). We used the existing data on three indicators of hospitalization rate (per 10,000 population), Emergency Department Visits (EDVs) (per 10,000 population), and in-hospital mortality (per 10,000 population). The monthly data from 2009 to 2019 was analyzed by the ITS method 60 months before and 61 months after the HSEP. Results: We found a non-statistically significant decrease in the monthly trend of hospitalization rate relative to the period before the HSEP implementation (-0.084 per 10,000 population [95%CI: -0.269, 0.101](. There was a statistically significant increase in the monthly trend of EDVs rate compared to before the HSEP implementation (1.07 per 10,000 population [95%CI: 0.14, 2.01]). Also, a significant decrease in the monthly trend of in-hospital mortality compared to before the HSEP implementation [-0.003 per 10,000 population (95%CI: -0.006, -0.001)] was observed. Conclusion: Our study demonstrated a significant increasing and decreasing trend for EDVs and in-hospital mortality following the HSEP implementation, respectively. Regarding the increase in hospitalization rate and EDVs after the implementation of HESP, it seems that there is a need to increase investment in healthcare and improve healthcare infrastructure, human resources-related indicators, and the quality of healthcare.

Validity and reliability of the Persian version of the sedentary behavior questionnaire among office employees.

Objectives. This study aimed to evaluate the validity and reliability of the Persian version of the sedentary behavior questionnaire (SBQ) among university office employees in Kermanshah province in the west of Iran. Methods. A validation study was performed among 701 university office employees in Kermanshah province. The content validation process was conducted using interviews with content and lay experts. The intraclass correlation coefficient (ICC) was calculated as test-retest reliability. In addition, exploratory and confirmatory factor analyses were used to assess the validity of the questionnaire structure. Results. The scale content validity indices using two general agreement approaches and the mean approach were 88.88 and 97.77%, respectively. The ICC was estimated at 1.00 (95% confidence interval [0.99, 1.00]). The exploratory factor analyses suggested nine-factor solutions, and in the independent sample the confirmatory factor analysis fit indices showed that the model had acceptable fit to the data. Conclusion. The Persian version of the SBQ had acceptable reliability and validity for assessing sedentary behavior (SB) among office employees. This questionnaire is a simple and self-report tool for measuring SB in daily life and would be useful in the design and evaluation of preventive programs among administrative staff and for high-risk population surveillance.

Postpartum depression and suicide in Iran.

In Iran, postpartum depression is one of the common emotional symptoms which affects approximately 25% of the women who experienced childbirth. Iranian Forensic Medicine Organization (IFMO) and its branches across the country are the comprehensive sources of collecting data related to suicide deaths. In the data collecting form of suicide, there is not any item about the pregnancy of women at the time of suicide, having childbirth during the previous six weeks, and the time interval between delivery and suicide. It is suggested that, in addition to modifying the suicide registration forms by the IFMO, attention should be given to developing a mechanism that gives forensic physicians access to medical records information in the integrated health system as well as hospital information system.

Epidemiological status of suicide in the Middle East and North Africa countries (MENA) from 1990 to 2017.

BACKGROUND: Suicide is proposed as an important and growing issue in public health. The aim of this study is to compare suicide load in the Middle East and North Africa (MENA) countries in order to pave the way for correct health policy making. METHODS: The population included 21 MENA countries. The data of Global Burden of Diseases in 2017 that estimate death rate for 264 causes was used. The GBD considers suicide according to definition of the ninth and tenth editions of the international classification of diseases as death due to poisoning or intentional self-injury. All suicide-related analyzes were evaluated using these indicators in excel 2016. RESULTS: The highest percentage of total suicide DALY attributable to risk factors of Alcohol and drug use are related to United Arab Emirates and Afghanistan countries, respectively. Iran is the sole country without suicide DALY attributable to alcohol consumption risk factor. Moroccan women and Libya, Afghanistan and Yemen men have the highest DALY rates in terms of ASR in the region, respectively. Suicide incidence have an increasing trend until the age group of 20-24 and then a decreasing trend. This trend is on the rise again since the age of 65. DISCUSSION: The necessity to improve social, cultural and economic factors along with effective measures on suicide prevention especially among low and middle income countries, performing more studies and precise registration of the cases especially in the areas that suicide is considered social stigma and crime should be considered as high agenda in national and regional strategies.