Lost productivity among military personnel with cardiovascular disease.

OBJECTIVE: Cardiovascular disease (CVD) is associated with significant productivity loss among all occupational groups. However, the increased occupational requirements of military personnel pose physical and psychological demands that could lead to greater lost productivity of CVD. The aim of this study was to determine the economic cost of lost productivity of military patients with CVD. METHODS: A prospective cross-sectional study was undertaken on all military patients attending a specialist CVD clinic in Tehran, Iran. All participants were interviewed using face-to-face questioning using a Valuation of Lost Productivity questionnaire. Data captured included paid and unpaid time lost due to CVD, military job characteristics and their work environment. Ordered logistic regression was used to examine the determinants of lost productivity. RESULTS: The mean time of lost productivity was 118 hours over a 3-month period, of which 70 and 48 hours were paid and unpaid work, respectively. The average cost per patient of total lost productivity was estimated to be US$303 over a 3-month period. CONCLUSIONS: CVDs are associated with significant lost productivity among military personnel. There is a statistically significant relation between some military occupation characteristics and lost productivity from CVD. Level of income, teamwork and physical activity have the greatest effects on lost productivity. Military workers who were suffering from other chronic conditions (in addition to CVD) were four times more likely to lose productivity. A supportive work environment should be created for military personnel with emphasis on developing teamwork, improving worker's attitudes towards disease and giving priority to workers with comorbidities.

The assessment of inequality on geographical distribution of non-cardiac intensive care beds in iran.

BACKGROUND: The purpose of the present study was to evaluate the inequality of geographical distribution of non-cardiac intensive care beds in Iran using the Gini coefficient. METHODS: The population information of Iran's provinces in 2006 was obtained from The Statistical Center of Iran and the number of non-cardiac intensive care beds (including ICU, PostICU and NICU beds) in all provinces was taken from published information of Ministry of Health and Medical Education of Iran in the current year. The number of beds per 100,000 populations of each province and the Gini coefficients for each bed were calculated. RESULTS: Iran's population was 70,495,782. The total number of ICU, PostICU and NICU beds were 3720, 291 and 1129, respectively. Tehran had the highest percentage of each bed among all provinces. The number of each bed was 5.3, 0.4 and 1.6 per 100,000 populations of country, respectively. The calculated Gini coefficients for each bed were 0.17, 0.15 and 0.23, respectively. CONCLUSION: The findings of this study showed that, according to the Gini coefficients, non-cardiac intensive care beds have an almost equal geographical distribution throughout the country. However, the numbers of beds per population are less than other countries. Since such studies can be used as a base for health systems planning about correction of inequality of health services distribution, similar studies in other health care services are recommended which can be conducted at the national or provincial level.