Payesh
Year:2018 | Volume:17 | Issue:2 |Papers Count:14

Objective (s): Understanding the behavior of drug demand in health sector is very important for health policy makers. In this regard, the present study aimed to estimat the pharmaceutical expenditure function during 1991 to 2010 in Iran.Methods: This was an analytical study. The study population was urban households in the country. The required data were collected from the published statistics of Iran Statistics Center for a time series of 20 years. The time series ARDL (Auto Regressive Distributive Lag) model, the Stationary Augmented Dickey Fuller Test and Bound Cointegration Test were applied to estimate the models. The Eviews 7 and Microfit5 software were used.Results: At short-term and long-term, impact of the price on expenditure of pharmaceutical was statistically insignificant. Income elasticity of pharmaceutical demand at short–term and long–term was 0.27 and 0.41, respectively (Pvalue ˂ 0.01). Elasticity of pharmaceutical expenditure with respect to expenditure of physician visit at short-term and long-term was more than 1.05 and 0.33, respectively, (Pvalue ˂ 0.01). Error Correction Coefficient [ecm (-1)] also was equal -0.66. Almost 66% of imbalance error disappeared in the first year after the imbalance (Pvalue ˂ 0.05).Conclusion: According to inelasticity of pharmaceutical demand to price and low elasticity to income, health policy makers should consider different issues (e.g. tariffs, household income and Subsidizing) when they make policy.

Objective (s): Treatment cost and lack of insurance are the principal reasons for patients absconding or leaving without permission from a hospital. Here we aimed to investigate the effect of the Health Transformation Plan (HTP) on patients absconding from a large general hospital in Tehran, Iran.Methods: In this descriptive study, we considered March 2011 to April 2014 as the period before and June 2014 to March 2017 as the period after the introduction of the HTP. The data of 701 absconded patients were collected. For data analysis, the Mann-Whitney test and Interrupted Time Series model were used in STATA.12 software.Results: The proportion of absconding patients immediately has decreased significantly since the implementation of the HTP (P=0.002, b=0.342). However, during the 3-year period after the implementation of the HTP, the patient absconding rate has increased monthly by 0.12% (p= 0.019). Investigating the difference in the patient absconding rate before and after the HTP, we found that the proportion of patients absconding has significantly increased since the HTP implementation (0.011 slope; p =0.019).Conclusion: Immediately after the implementation of the HTP, the proportion of patients absconding from hospital dropped significantly. This suggests that the HTP has been effective at reducing the patient absconding rate by creating insurance coverage and reducing costs. However, the reasons for a reversal of this trend during the third year of the HTP should be further investigated.

Objective(s): The relationship between social capital and health is well establishes. The present study aimed to investigate the relationship between social capital and its related factors in patients with type 2 diabetes.Methods: This was a cross-sectional study and conducted on 326 type 2 diabetes patients who referred to the Iranian Diabetes Society in 2016-2017. Data was collected by the Onyx and Bullen social capital questionnaire. This questionnaire has 36 items and 8 domains. The score range from 0 to 100. Data were analyzed by using statistical tests such as independent t-test, Pearson correlation coefficient, one-way ANOVA, and multiple regression.Results: The mean age of the patients was 55.33 (SD=11.32) years. The mean and (95% confidence interval) of the social capital score of participants was 45.72 (44.16- 47.30). Among the eight domains of social capital, the highest mean score was related to the work connections domain 68.06 (63.90- 72.22) and the lowest mean score was for the participation in the local communities domain 30.45 (27.97- 32.93). The results of multiple regression model showed that gender had a significant association with trust and security where women had lower trust and security score than men (b=- 7.88, P<0.001), also economic status had a significant and positive association with value of life domain and education with value of life, participation in the local communities, proactivity in a social context, family and friends connections and total social capital.Conclusion: The findings indicated that women, patients with lower educational level and poor financial status due to low social capital were at greater risk of non-compliance of treatment and therefore the lack of favorable glucose control.

Objective (s): In recent years, many studies have shown that social networks and health-related quality of life are highly related to each other. This study aimed to determine the relationship between social networks and health-related quality of life in adults in Tehran, Iran.Methods: This cross-sectional study was carried out in Tehran, Iran, in 2016. Study population included all people over 25 years old living in Tehran. Cluster sampling method was used to select 1900 samples. Social Network Index (SNI) was applied to determine the degree of participation in social networks and the Short Form Health Survey (SF-36) was used for assessing the health-related quality of life. Descriptive and inferential statistics were used for analyzing data. Multilevel analysis was applied to determine the association between social networks and health-related quality of life.Results: Out of 1, 900 study participants, 979 (51.5 %) were male and 921 (48.5 %) were female. The mean age (± SD) of participants was 41.2±13.1 years. The results of principal components analysis showed that 904 participants (47.6 %) reported good, 660 (34.7 %) fair and 336 (17.7 %) poor health. From all participants, 336 (17.7 %) had a strong, 945 (7.49 %) moderate and 619 (32.6 %) had a poor participation in social networks. Statistical tests showed that the differences in health in various groups in terms of participation in social networks was significant (P<0.0001). Also, the association among marital status (P< 0.0001), visiting relatives (P<0.0001) and friends (P=0.01), membership in religious groups (P=0.01), virtual social networks (P=0.01), age (P<0.0001), sex (P=0.03), family size (P<0.0001) and health-related quality of life was statistically significant.Conclusion: The study showed that participation in social networks and increasing communication among relatives and friends increases the quality of life.

Objective (s): Regular walking has a positive impact on diabetic patients’ health. The aim of this study was to evaluate the effect of regular walking for 3 months on some glycemic indexes and blood pressure in women with type 2 diabetes.Methods: 100 patients with type 2 diabetes were randomly assigned in 2 groups) regular walking group and the control group. The first group walked 3 months regularly for 30 minutes. The intensity of walking measured by Borg scale of perceived exertion. The control group had no regular walking regularly. Glycosylated hemoglobin, fasting blood glucose, systolic and diastolic blood pressure were measured before and after the intervention. Covariance analysis method and paired t-test were used.Results: There were no differences between two groups in the characteristics of patients including height, weight, age, and history of diabetes. Glycosylated hemoglobin, fasting blood glucose, systolic and diastolic blood pressure decreased significantly in regular walking group and fasting blood glucose and systolic blood pressure increased significantly in the control group (p£0.05). Comparison between two groups showed that changes in glycosylated hemoglobin (p<0.0001), fasting blood glucose (p=0.001), systolic and diastolic blood pressure (p<0.0001) between two groups was significant.Conclusion: The findings suggest that regular walking can improve glycemic indices in type 2 diabetic patients.

Objective (s): In the present study, the role of irrational health beliefs, health locus of control and health-oriented lifestyle was studied in predicting the risk of diabetes.Methods: This was a cross sectional study of 100 diabetics and healthy participants in Iranshahr, Iran. Data were collected using a number of questionnaires including the irrational health beliefs questionnaire, multidimensional health locus of control questionnaire and health-oriented lifestyle profile and were analyzed by logistic regression analysis using SPSS24 software.Results: The results demonstrated that the variables were able to predict diabetes in 0.92 of female (x2=45.45, df=10, p>0.001) and 0.90 of male (x2=88.70, df=10, p>0.001) with the disease. Overall, the model had a good fit according to the 0.89 correct prediction between healthy and diabetics participants.Conclusion: Irrational health beliefs, health locus of control and health-oriented lifestyle have the predictive power of diabetes and it seems that by changing the irrational beliefs, the health locus of control and changes in lifestyle of individuals the probability occurrence of diabetes will reduce.

Objective (s): Chronic Renal Failure (CRF) is one of the major public health problems, and since in most patients with chronic disease, quality of life is lower than the general population, and improving and maintaining quality of life in these patients requires serious family support, this study was to determine the effect of a family-centered empowerment model on quality of life in dialysis patients referring to a teaching hospital in Zahedan, Iran.Methods: This quasi-experimental study was performed on 100 hemodialysis patients referring to the dialysis department of a teaching hospital. Patients were randomly allocated to intervention and control groups. The intervention group received the family-centered empowerment model in four steps: perceive threat, self-efficacy through problem solving, self-esteem through educational participation and evaluation in four sessions. The data collected by Kidney Disease Quality of Life -Short Form questionnaire at baseline and one and two months after intervention by both groups. Data were analyzed by SPSS version 22 using Chi-square, independent t-test, ANOVA with repeated measures.Results: There was a significant difference between intervention group and control group in the mean score of specific dimensions (P=0.01) and total quality of life (P=0.005) in one and two months after the intervention and the mean score of the general dimensions of quality of life in two months after the intervention (P=0.006). The repeated measures analysis of quality of life showed that changes in quality of life score in the two groups were not the same and this indicated that the increase in the quality of life score in the intervention group was significantly higher than the control group (P<0.001).Conclusion: The implementation of the family-centered empowerment model could improve the quality of life of patients in hemodialysis patients.

Objective (s): Maternal health literacy, in addition to the quality of prenatal care, is a key factor in controlling the underweight baby. The purpose of this study was to investigate the effect of health literacy and adequacy of prenatal care on the outcome of birth weight.Methods: A cross sectional study was conducted on 860 pregnant women who were selected by random cluster sampling. The data were collected using the Health Literacy for Iranian Adults (HELIA) and the adequacy of care for pregnancy. The data were analyzed using SPSS windows version 20 by descriptive statistics and regression analysis.Results: The prevalence of low birth weight was 16.5%. The adequacy of the pregnancy index of 33% was inadequate and 67% of women had an average index. The mean level of health literacy was 65.97 ± 1.74 in pregnant women. The adequacy of care for pregnancy was the strongest predictor of birth weight (47%). Health literacy components: understanding (21%), appraisal (13%) and decision-making and applying information (12%) was predicted birth weight.Conclusion: Prenatal care adequacy index and health literacy were predictors of birth weight, which highlighted the need for more attention to prenatal care and health literacy in health promotion programs for pregnant women.

Objective (s): Aging perception is recognized as one of the important circles associated with the problems of the elderly. Aging perception Questionnaire (APQ) is one of the common tools that measures agin perception. The purpose of this study was to validate the Persian version of the APQ.Methods: This was a methodological study and was conducted on 200 elderly people. After translating and obtaining opinions of Persian literature and gerentologist experts, the content and face validity of the questionnaire were determined qualitatively. Then, the validity of the aging perception questionnaire was assessed through convergent validity (correlation test between the Persian version of the APQ and CASP-19 questionnaire) and known group comparison (comparing male and female perception). Reliability was evaluated using internal consistency (Cronbach's alpha) and stability (ICC).Results: The known group comparison showed that the instrument discriminated well between men and women where men significantly scored higher than women. Convergent validity showed a significant correlation between the Persian version of the APQ and CASP-19 questionnaires. Cronbach's alpha coefficient for the dimensions and total questionnaire was between 0.64 and 0.81. Test-retest reliability (ICC) of the questionnaire with a two-week interval was between 0.65 and 0.96.Conclusion: The findings indicated that the Persian version of the APQ Questionnaire is a valid instrument and can be used in a variety of situations, including clinical and research environments.