ABSTRACT
Background and Aims: Implementing diagnosis-related groups (DRGs) in different countries increases the efficiency of healthcare services, improves treatment quality, and reduces treatment costs. Due to the lack of a coherent model for its implementation, the present study aimed to develop a DRGs-based implementation action plan Model for Iran. Methods: The present study was an applied, descriptive cross-sectional study conducted in three stages. In the first stage, a review of studies conducted in different countries was carried out. In the second stage, a model was designed for an action plan to implement the DRGs in Iran. In the third stage, the model was validated based on the Delphi technique. Results: The DRGs-based implementation action plan model in Iran was designed in three primary axes, including the strategic approach of the DRGs-based implementation action plan, technical dimensions, and executive institutions involved in the DRGs-based implementation action plan. Validation of the designed model showed the agreement of experts (94%) for the mentioned axes. Conclusion: The significance of tailoring a DRGs-based implementation action plan to each country's unique context is well-established. Given the intricacies of the Iranian healthcare system, we recommend an initial pilot implementation of DRGs at the hospital level, followed by a gradual national rollout.
ABSTRACT
BACKGROUND: Hepatitis C virus (HCV) is a major cause of liver disease and a potential cause of substantial morbidity and mortality. This study aims to provide a comprehensive evidence on HCV Infection in Iranian hemodialysis (HD) patients we conducted a systematic review. MATERIALS AND METHODS: In this systematic review and meta-analysis, through a comprehensive search of literature until January of 2016, we estimated the pooled prevalence of hepatitis C infection in Iranian HD patients. Using Medical Subject Headings terms, Emtree, and related equal Persian key words for Iranian databases and also international databases of PubMed and NLM Gateway (for MEDLINE), and SCOPUS. Interest outcome of HCV infection prevalence was confirmed based on positive hepatitis B surface antigen of blood samples. Random effect meta-analysis was used to estimate pooled prevalence of HCV infection in Iranian HD patients, date and language, HD patients, in adult HD patients, Institute of Scientific Information, Iran-doc, irrespective of age, living in Iran. Searches run through main domestic databanks of Iran-Medex, renal transplantation, Scientific Information Database, the relevant literature-searched concentrating on HCV infection. RESULTS: Through searching steps, 305 publications were found from them following the excluding duplicates and overlapping studies 54 studies relevant to HCV prevalence in Iranian HD zcxw patients, with number of 23921 participants, remained in our analyses. The overall results of test of heterogeneity demonstrate sever heterogeneity between reported prevalence (I2 = 96.62%, Chi-square = 1566, P < 0.001). Due to sever heterogeneity results of random effect meta-analysis showed that the estimated pooled prevalence was 11% (95% confidence interval [CI] =10%-13%). The pooled prevalence base on polymerase-chain reaction, recombinant immunoblot assay, and enzyme-Linked Immunosorbant Antibody method were 11% (95% CI = 6%-15%), 9% (95% CI = 5-13) and 12% (95% CI = 10-14), respectively. In line with previous studies, the present finding shows the significant variation in the rate of HCV in dialysis units among the regions in Iran. CONCLUSION: Present paper is the comprehensive updated systematic review on HCV prevalence in the Iranian HD patients. Our findings provide the reliable evidence for promotion of policies and interventional programs.
