Informal payments for health care in Iran

2018 ◽  
Vol 23 (3) ◽  
pp. 205-215 ◽  
Author(s):  
Mohammad Meskarpour Amiri ◽  
Abbas Assari ◽  
Mohammadkarim Bahadori ◽  
Ramin Ravangard ◽  
Sayyed Morteza Hosseini-Shokouh
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Sector ◽  
Nationwide Survey ◽  
Cross Sectional Study ◽  
Outpatient Services ◽  
Cross Sectional ◽  
Informal Payments ◽  
Content Type ◽  
One Year

PurposeReducing informal payments (IPs) for health services has always been a top priority for health policymakers all over the world. As the newest attempts to reduce IPs, Iran’s Government applied a set of reforms in the health care system in 2014 called “Health Sector Evolution Plan” (HSEP). The purpose of this paper is to investigate the prevalence and nature of IPs one year after implementing this plan.Design/methodology/approachThis descriptive and cross-sectional study was a nationwide survey on Iran's health sector informal payments carried out in 2016. To do this, a sample of 1,112 Iranain households was selected from all over the country using a multistage cluster-stratified sampling method. The prevalence and nature of IPs were determined through conducting face-to-face interviews using a standard questionnaire.FindingsOne year after implementing the HSEP, about 27.7 percent of sampled Iranians had at least one experience of IPs for health services. The prevalences of compulsory and voluntary IPs were 21.4 and 11.5 percent, respectively. IPs were reported by 26.1 and 12.5 percent in the inpatient and outpatient services, respectively.Originality/valueAccording to the results, compulsory IPs are still prevalent in both the outpatient and inpatient services of Iran’s health system and it seems that the HSEP has not been completely successful in achieving the goal of eradicating IPs. It can be said that the HSEP has been the first step toward eradicating IPs in Iran and should not be the last one. The study provides useful results of the prevalence and nature of IPs after implementing the HSEP, which should be considered in designing the next steps.

Health system responsiveness in Iran: a cross-sectional study in hospitals of Mazandaran province

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Roya Malekzadeh ◽  
Samereh Yaghoubian ◽  
Edris Hasanpoor ◽  
Matina Ghasemi
Keyword(s):  
Health Care ◽  
Social Security ◽  
Health Care System ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Mazandaran Province ◽  
Cross Sectional ◽  
Content Type ◽  
System Responsiveness ◽  
Care System

Purpose Responsiveness is a reaction to the reasonable expectations of patients regarding ethical and non-clinical aspects of the health-care system. Responsiveness is a characteristic of health-care system and the observance of the patient’s rights. The purpose of this study is to compare the responsiveness of the health-care system based on the hospital ownership in Mazandaran province in Iran. Design/methodology/approach The cross-sectional study design was used on 1,083 patients referred to public and private hospitals and hospitals affiliated to social security organization in Mazandaran province in 2017. The World Health Organization’s responsibility questionnaire was used to collect data. Data were analyzed by using SPSS version 21. Descriptive statistics and one-way ANOVA results are presented is the results section. Findings All responsiveness dimensions were salient for respondents. The response rate in the selected hospitals was very close, which ranged from 85.7 to 90.2%, and there was no significant difference between public, private and social security hospitals (p > 0.05). The most crucial responsiveness dimension in hospitals was autonomy. Originality/value In the current study, the dimensions of communication and confidentiality were identified as priority dimensions based on the least score for breeding actions to improve the responsiveness of the health-care system. At the end, some useful recommendations such as re-engineering the processes, training to engage the employees with patients and encouraging them to fill the gap were suggested.

Current situation of stress, anxiety, and depression of the health care workers working at the Health Care Center of Soc Son district, Hanoi, Vietnam, 2019

2021 ◽  
Vol 30 (9) ◽  
pp. 91-98
Author(s):  
Vu Ngoc Ha ◽  
Mac Dang Tuan ◽  
Nguyen Thanh Trung ◽  
Nguyen Ngoc Huan ◽  
Luu Thi Lien ◽  
...  
Keyword(s):  
Health Care ◽  
Mental Disorders ◽  
Health Care Workers ◽  
Care Center ◽  
Health Sector ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Cross Sectional ◽  
Health Care Center ◽  
Care Workers

A cross-sectional study using DASS21 was performed in June 2019 on staff working at the commune health stations (CHSs), regional general clinics and district general clinics in Soc Son district, Hanoi to assess the mental disorders of the health care workers are working here. Among the 355 health care workers (HCWs) who participated, women accounted for 75.5%. People aged under 30 accounting for 33.5% of HCWs. Physicians, nurses take up 54.4%, and HCWs in the Soc Son district have worked in the health sector for more than ten years, accounting for 45.1%. The study shows that the rates of stress, anxiety, and depression were 13.8%, 25.4% and 16.6%, respectively. 31% of HCWs have at least one mental disorder, 8.2% of study subjects have all three manifestations of mental disorders, 8.4% of study subjects have two symptoms and 14.4% of the study subjects had only one manifestation. The rates of stress, anxiety, and depression were initially screened from the research results. The development of research directions for defnitive diagnosis and support for improving health care workers’ mental health should be integrated.

scholarly journals Patient Satisfaction in the Peruvian Health Services: Validation and Application of the HEALTHQUAL Scale

2020 ◽  
Vol 17 (14) ◽  
pp. 5111
Author(s):  
Fernando Barrios-Ipenza ◽  
Arturo Calvo-Mora ◽  
Félix Velicia-Martín ◽  
Fernando Criado-García ◽  
Antonio Leal-Millán
Keyword(s):  
User Satisfaction ◽  
Health Sector ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Healthcare Personnel ◽  
Attractive Alternative ◽  
Path Modeling ◽  
Outpatient Services ◽  
Cross Sectional ◽  
The Relationship

During recent years, public–private partnerships (PPPs) in the health sector have been an attractive alternative for improving healthcare services in developing countries such as Peru. Therefore, it is fundamental to consider a comprehensive set of healthcare qualities, like the HEALTHQUAL scale, when we measure dimensions of healthcare service quality. Currently, no studies have applied HEALTHQUAL in Peruvian hospitals. The purposes of this study were to (1) validate and evaluate the application of the HEALTHQUAL scale to measure user satisfaction in outpatient services at two PPP hospitals in Peru; and (2) test the relationship between user satisfaction, efficiency, and loyalty. A descriptive, cross-sectional study based on the HEALTHQUAL scale was carried out at the end of 2018. The measurement items were satisfaction with healthcare personnel, satisfaction with nonhealthcare personnel, satisfaction with facilities and equipment, perception of efficiency, and trust. The scale was administered to a nonprobability sample of 250 users who attended one of two PPP hospitals—Barton and Kaelin. The application of partial least squares path modeling significantly impacted on the perceived efficiency in the items of healthcare personnel, nonhealthcare personnel, and facilities and equipment. The HEALTQUAL scale demonstrated sufficient validity and thus can be applied for measuring user satisfaction in PPP hospitals.

scholarly journals Impact of COVID-19 and mitigation plans on essential health services: institutional experience of a hospital in Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Firaol Dandena ◽  
Berhanetsehay Teklewold ◽  
Dagmawi Anteneh
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Cross Sectional Study ◽  
Vital Role ◽  
Treatment Center ◽  
Cross Sectional ◽  
Poor Countries ◽  
Care Services ◽  
The Impact

Abstract Background Health systems around the world are being challenged by an on-going COVID-19 pandemic. The COVID-19 pandemic and associated response can have a significant downstream effect on access to routine health care services, and indirectly cause morbidity and mortality from causes other than the disease itself, especially in resource-poor countries such as Ethiopia. This study aimed to explore the impact of the pandemic on these services and measures taken to combat the effect. Methods The study was conducted at St. Paul’s hospital millennium medical college (SPHMMC) from December 15, 2020 to January 15, 2021 using a comparative cross-sectional study design. We collected data on the number of clients getting different essential health care services from May to October 2019 (Pre COVID) and the same period in 2020 (during a COVID-19 pandemic) from the patient registry book. The analysis was done with SPSS version 24 software. Result Overall, the essential services of SPHMMC were affected by the COVID-19 pandemic. The most affected service is inpatient admission, which showed a 73.3% (2044 to 682) reduction from the pre-COVID period and the least affected is maternal service, which only decreased by 13% (3671 to 3177). During the 6 months after the COVID-19 pandemic, there was a progressive increment in the number of clients getting essential health services. Conclusion and recommendation The establishment of a triple setup for fighting against COVID-19, which encompasses non-COVID services, an isolation center and a COVID-19 treatment center, played a vital role in preserving essential health services.

scholarly journals Delays and Disruptions in Cancer Health Care Due to COVID-19 Pandemic: Systematic Review

2021 ◽  
pp. 311-323
Author(s):  
Rachel Riera ◽  
Ângela Maria Bagattini ◽  
Rafael Leite Pacheco ◽  
Daniela Vianna Pachito ◽  
Felipe Roitberg ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Services ◽  
Methodological Quality ◽  
Data Extraction ◽  
Cross Sectional Study ◽  
Routine Activity ◽  
Cross Sectional ◽  
Cancer Services ◽  
The Impact

PURPOSE There has been noteworthy concern about the impact of COVID-19 pandemic on health services including the management of cancer. In addition to being considered at higher risk for worse outcomes from COVID-19, people with cancer may also experience disruptions or delays in health services. This systematic review aimed to identify the delays and disruptions to cancer services globally. METHODS This is a systematic review with a comprehensive search including specific and general databases. We considered any observational longitudinal and cross-sectional study design. The selection, data extraction, and methodological assessment were performed by two independent reviewers. The methodological quality of the studies was assessed by specific tools. The delays and disruptions identified were categorized, and their frequency was presented. RESULTS Among the 62 studies identified, none exhibited high methodological quality. The most frequent determinants for disruptions were provider- or system-related, mainly because of the reduction in service availability. The studies identified 38 different categories of delays and disruptions with impact on treatment, diagnosis, or general health service. Delays or disruptions most investigated included reduction in routine activity of cancer services and number of cancer surgeries; delay in radiotherapy; and delay, reschedule, or cancellation of outpatient visits. Interruptions and disruptions largely affected facilities (up to 77.5%), supply chain (up to 79%), and personnel availability (up to 60%). CONCLUSION The remarkable frequency of delays and disruptions in health care mostly related to the reduction of the COVID-19 burden unintentionally posed a major risk on cancer care worldwide. Strategies can be proposed not only to mitigate the main delays and disruptions but also to standardize their measurement and reporting. As a high number of publications continuously are being published, it is critical to harmonize the upcoming reports and constantly update this review.

scholarly journals Utilization of maternal health services in rural Thawang, Rolpa district of Nepal: a community-based cross-sectional study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jahirul Hushen ◽  
Arpaporn Powwattana ◽  
Chockchai Munsawaengsub ◽  
Sukhontha Siri
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Local Level ◽  
Maternal Health Services ◽  
Cross Sectional Study ◽  
Local Context ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Content Type

PurposeThis study aimed to identify the proportion and factors influencing the use of maternal health services (MHS) in rural Thawang, Rolpa, Nepal.Design/methodology/approachThis was a community-based cross-sectional study conducted among 417 mothers who had given birth in the previous two years. Bivariate and multivariate logistic regression was applied to identify associations and predictors.FindingsThe results showed that the use of maternal health services was 50.8%. Adjusting for all other factors in the final model, age group 25–30 years (AOR: 2.30; 95% CI: 1.199–4.422), spouse communication (AOR: 7.31; 95% CI: 2.574–20.791), high accessibility (AOR: 2.552, 95% CI: 1.402–4.643) and high affordability (AOR: 10.89; 95% CI: 4.66–25.445) were significant predictors.Research limitations/implicationsThis is a community-based cross-sectional study, and hence cannot establish causal relationships. The research was conducted in a limited rural area mid-Western Nepal, and this may limit the generalization of results to other settings of the country.Practical implicationsThis research supports to local level government and district health authority to develop and implement need based action to increase maternal health service in the local context.Originality/valueUnderutilization of maternal health services is the result of socioeconomic dynamics, poor access to health services and other physical developments. To increase utilization of maternal health services in rural areas, there is a need to tackle the root cause of health inequality such as reducing poverty, increasing female education, involving women in employment and increasing access to health as a priority development agenda by government authorities. This research supports local level government and district health authorities to develop and implement needs-based action to increase MHS in the local context.

scholarly journals Evaluation of QuantiFERON-TB Gold-Plus in Health Care Workers in a Low-Incidence Setting

2017 ◽  
Vol 55 (6) ◽  
pp. 1650-1657 ◽  
Author(s):  
Hee-Won Moon ◽  
Rajiv L. Gaur ◽  
Sara Shu-Hwa Tien ◽  
Mary Spangler ◽  
Madhukar Pai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Health Care Workers ◽  
Cross Sectional Study ◽  
Low Risk ◽  
Cross Sectional ◽  
Content Type ◽  
Care Workers ◽  
Low Incidence ◽  
Positive Results

ABSTRACT Although launched in 2015, little is known about the accuracy of QuantiFERON-TB Gold-Plus (QFT-Plus) for diagnosis of latent M. tuberculosis infection (LTBI). Unlike its predecessor, QFT-Plus utilizes two antigen tubes to elicit an immune response from CD4 + and CD8 + T lymphocytes. We conducted a cross-sectional study in low-risk health care workers (HCWs) at a single U.S. center to compare QFT-Plus to QuantiFERON-TB Gold in-tube (QFT). A total of 989 HCWs were tested with both QFT and QFT-Plus. Risk factors for LTBI were obtained from a questionnaire. QFT-Plus was considered positive if either antigen tube 1 (TB1) or TB2 tested positive, per the manufacturer's recommendations, or if both TB1 and TB2 tested positive, using a conservative definition. Results were compared using Cohen's kappa and linear regression, respectively. Agreement of QFT with QFT-Plus was high, at 95.6% (95% confidence interval [CI], 94.3 to 96.9; kappa, 0.57). The majority of discordant results between QFT and QFT-Plus TB1 (84.8%) and QFT and QFT-Plus TB2 (88.6%) fell within the range of 0.2 to 0.7 IU/ml. The positivity rate in 626 HCWs with no identifiable risk factors and no self-reported history of positive LTBI tests was 2.1% (CI, 1.0 to 3.2) and 3.0% (CI, 1.7 to 4.3) with QFT and QFT-Plus, respectively. A conservative definition of a QFT-Plus-positive result yielded a positivity rate of 1.0% (CI, 0.2 to 1.7; P value of 0.0002 versus QFT-Plus and 0.07 versus QFT). On follow-up testing, of 11 HCWs with discordant QFT-Plus results, 90.9% (10/11) had a negative QFT result. The QFT-Plus assay showed a high degree of agreement with QFT in U.S. HCWs. A conservative interpretation of QFT-Plus eliminated nearly all nonreproducible positive results in low-risk HCWs. Larger studies are needed to validate the latter finding and to more clearly define conditions under which a conservative interpretation can be used to minimize nonreproducible positive results in low-risk populations.

The disparity in geographical accessibility to healthcare resources in Iran: the comparison of two cross-section

2016 ◽  
Vol 9 (2) ◽  
pp. 86-94
Author(s):  
Sara Emamgholipour Sefiddashti ◽  
Ali Kazemi Karyani ◽  
Sadegh Ghazanfari
Keyword(s):  
Health Sector ◽  
Health Resources ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Access To Healthcare ◽  
Cross Sectional ◽  
Healthcare Resources ◽  
Policy Makers ◽  
Content Type ◽  
Study Population

Purpose – Accessing adequate healthcare to all people is one of the main goals of the health sector. The purpose of this paper is to investigate healthcare services access development of the provinces in Iran during 2007 and 2013. Design/methodology/approach – This is a descriptive cross-sectional study. The study population included all the provinces in Iran. The data for 13 variables, including physical and human health resources, was collected from the Ministry of Health and Medical Education and the Statistics Center of Iran. Taxonomy technique was used to determine the degree of healthcare services access development in the provinces. Findings – The findings show that Semnan was the province with the most developed healthcare services access with development score of 0.342 while Sistan Balocehstan province was the least developed with development score of one in 2007. In the year 2013, Chahar-Mahal Bakhtiari and Sistan Baluchestan were the least and most developed provinces with scores of 0.551 and 0.989, respectively. The mean and standard deviation of the development scores in access to healthcare services in 2007 and 2013 were 0.7463±0.1268 and 0.7766±0.1058, respectively. Originality/value – Most previous studies that examined disparities in access to healthcare resources in Iran only considered one resource. This study applied a taxonomy technique to investigate the disparity and changes in access using 13 main healthcare resources. This approach helped the authors to investigate whether the decisions of the policy makers were intended to eliminate the disparities.

scholarly journals A cross sectional study on needle stick and sharp injuries among health care providers in tertiary centers, Tamil Nadu

2018 ◽  
Vol 5 (3) ◽  
pp. 982 ◽  
Author(s):  
Archana Lakshmi P. A. ◽  
Ashrof Raja ◽  
Meriton Stanly A. ◽  
Christina Mary Paul ◽  
Gladius Jennifer H.
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Tamil Nadu ◽  
Cross Sectional Study ◽  
Hypodermic Needle ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Needle Stick ◽  
One Year

Background: Health care workers are at risk of acquiring life threatening blood borne infections through needle stick and sharp injuries (NSSI) in their work place. This study was planned to highlight some important factors responsible for NSSI and possible measures to reduce it. The objective of the study was to assess the factors associated with NSSI and reasons for under-reporting. Methods: A cross sectional study was done during November 2014 to April 2015 in two tertiary health care institutions. All health care providers (Doctors, nurses and lab technicians) who had more than one year experience and gave informed consent were included. Data collected by pretested structured questionnaire. Data analysis was done using SPSS 20v and summarized by descriptive statistics. Proportion and Chi-square was calculated at 5% α. Results: Among 950 health care providers (HCPS), 649 (68.3%) had NSSI during their carrier, 335 (35.3%) in last one year. Females 225 (67.2%) experienced more NSSI. This study shows that, 98 (29.3%) HCPs had sustained injury once. Among the doctors, 51.4% Anaesthetist (p=0.001) and its more among the nurses (38.4%) followed by doctors (36.6%) (p=0.002). NSSI was more common among HCP who work between 30-40 hrs (p=0.00001). Majority of them sustained injury while performing the procedure 134 (40%), commonest place of injury was OT 149 (44.5%) and commonest item responsible was hypodermic needle 141 (42.1%). Only 50 (14.9%) reported to the concerned authority and follow up action was taken. Conclusions: The study shows high prevalence of NSSI, emphasizing the need for safe measures for handling sharps to prevent transmission of infection. 

scholarly journals Early diagnosis of tuberculosis in the health services in different regions of Brazil

2013 ◽  
Vol 21 (spe) ◽  
pp. 190-198 ◽  
Author(s):  
Tereza Cristina Scatena Villa ◽  
Maria Amélia Zanon Ponce ◽  
Anneliese Domingues Wysocki ◽  
Rubia Laine de Paula Andrade ◽  
Tiemi Arakawa ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Early Diagnosis ◽  
Daily Practice ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Secondary Sources ◽  
North East ◽  
Primary Health

OBJECTIVE: To analyze the infected person's first contact with the health services, for the early diagnosis of tuberculosis (TB) in different regions of Brazil. METHOD: a cross-sectional study undertaken in 6 municipalities in the South-east, South and North-east regions of Brazil. Data collection involved secondary sources and interviews with the patients. The data was analyzed using descriptive techniques and multiple correspondence factor analysis. RESULTS: Primary Health Care (PHC) presented the longest time to diagnosis and the lowest proportion of diagnoses. The services associated with diagnosis in the first consultation were the specialized services and the Tuberculosis Control Programs, which offer consultations and tests on-site. CONCLUSION: For the control of TB, it is necessary to organize the work in an integrated way between the different services' teams. In Primary Health Care, it is also necessary to observe the extent of incorporation and sustainability in the implementation of these actions into the health services' daily practice.

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