Hospitalization Expenses and Influencing Factors for Inpatients with Ischemic Heart Disease in Iran: A Retrospective Study

Background: Ischemic heart disease (IHD) is the leading cause of death and disability worldwide and in Iran, which imposes a heavy financial burden both on patient’s family and society. Objectives: This study aimed to analyze the direct medical costs of inpatients with IHD and its influencing factors in Iran in 2020. Methods: The sample of this cross-sectional study included 41,357 patients with IHD selected from the hospital information system (HIS) of the Iran Health Insurance Organization from August 23, 2019, to June 20, 2020. The study used the claims data of these patients, which included their demographics, length of stay (LOS), intensive care unit (ICU) admission, hospital accreditation grade, hospital ownership type, and patient discharge status. The multiple linear regression model was employed to evaluate the relationship between hospitalization costs and the associated factors. All statistical tests were conducted at the significance level of P < 0.05 using the R 3.6.3 software. Results: The mean age of patients was 63.95 ± 12.63 years old, and most of them were male (54.4%). The mean hospitalization cost per patient and per day was 586.42 ± 472.51 USD and 103.64 ± 100.29 USD, respectively. Moreover, the mean LOS was 4.92 days. Drugs and consumable medical supplies, as well as nursing and hoteling services, had the highest shares of hospitalization costs (29.54% and 29.4%, respectively). The hospitalization costs of patients with IHD were higher among men (β = 1.24), age 61 - 70 years (β = 1.38), LOS ≥ 5 (β = 2.92), ICU admission (β = 1.62), Iranian health fund (β = 1.21), and private hospitals (β = 1.91). Top-grade and first-grade hospitals had higher costs compared to grade 2 (β = 0.67), grade 3 (β = 0.35), and grade 4 (β = 0.72) hospitals. Deceased patients had also higher costs than patients with complete recovery (β = 0.63), relative recovery (β = 0.59), follow-up (β = 0.51), transfer to other medical centers (β = 0.44), and discharge against medical advice (DAMA) (β = 0.62). Conclusions: According to the results, shortening the LOS and controlling the high costs of drugs and consumable medical supplies are among the main strategies to reduce high hospitalization costs.

Resilience Decoded: The Role of Firms, Global Value Chains, and the State in COVID-19 Medical Supplies

This article examines the impacts of the COVID-19 pandemic on resilience. Resilience is not a one-dimensional concept but has different meanings at the levels of the firm (operational efficiency), the global value chain (appropriate governance), and the nation-state (national security). It illustrates resilience dynamics through lessons from case studies of four medical supply products—rubber gloves, face masks, ventilators, and vaccines. It explores how each adjusted to disruptions caused by the COVID-19 pandemic and presents key strategies that can guide managers and policymakers in building resilience for future supply chain disruptions.

Improving Resiliency in Healthcare Service by Minimizing Unsatisfied Demand

Natural or manmade disasters can bring havoc to the healthcare industry in terms of poor services, out of stocks, cost overruns, and loss of lives. Specifically, the aftermath of disasters can be brutal if not managed properly. The quicker the healthcare providers recover, the lesser the impact would be. A resilient system has the potential to reduce the recovery time significantly. Healthcare providers under emergency scenarios may realize out-of-stock situations for their critical medical supplies. The out-of-stock supplies potentially cause poor patient care including death. COVID 19 is an unfortunate example where critical medical supplies were completely out for many medical providers and that had a serious negative impact on healthcare service deliveries. Healthcare providers needed to replenish their supplies from the overseas manufacturing plants, or central distribution centers, or unaffected regional distribution centers. Most of the times healthcare authorities struggle to secure critical medical supplies from other distribution centers due to operational and transportation issues. Depending on the disaster condition, sometimes many health care providers are beyond reach due to damaged transportation networks. This is the perfect time to share critical medical supplies from unaffected regions. Proven techniques like operation research can alleviate this situation. There are very few works that have been done in the field of healthcare service deliveries in case of a disaster. This chapter discusses the modeling techniques using operations research to improve the service levels while minimizing unsatisfied demand in the natural disaster-affected zones.

Role of Technological Innovations in Improving Manufacturing Resilience in the Post-Covid Era

Technological progress is critical for improving manufacturing resilience and achieving self-sufficiency in any nation. The COVID-19 crisis has shown the importance of, as well as the threats associated with, our new industrial processes. Manufacturing's critical position in both industrialized and emerging economies has been shown by shortages of medical supplies and disruptions in basic goods. These delays and market fluctuations have also highlighted the pitfalls of focusing solely on a globalized distribution system characterized by fragmented supply chains, the separation of engineering and manufacturing, and just-in-time production. Although globalisation was the trend before the COVID-19 pandemic, several countries realized the dangers and began to look inward, focusing on developing local manufacturing capacities. In addition, the automotive sector has established itself as a cornerstone of post-COVID-19 recovery strategies.

Worming the Circular Economy for Biowaste and Plastics: Hermetia illucens, Tenebrio Molitor and Zophobas morio

The negative impact of the modern-day lifestyle on the environment is aggravated during the COVID-19 pandemic through the increased use of single-use plastics from food takeaways to medical supplies. Similarly, the closure of food outlets and disrupted supply chains have also resulted in significant food wastage. As the pandemic rages on, the aggravation of increased waste becomes an increasingly urgent problem that threatens the biodiversity, ecosystems, and human health worldwide through pollution. While there are existing methods to deal with the organic and plastic waste, many of the solutions also cause additional problems. Increasingly proposed as a natural solution to man-made unnatural problems, there are insect solutions for dealing with the artificial and organic waste products towards a circular economy, making the use of natural insect solutions commercially sustainable. This review discusses the findings and how some of these insects, particularly the Hermetia illucens, Tenebrio molitor, and Zophobas morio, can play an increasing important role in food and plastics, with a focus on the latter.

COVID-19 and the Challenges in World’s Largest Vaccination Drive in India

COVID-19’s second wave has placed India into a state of emergency. Since the beginning of April 2021, the country has seen an extraordinary influx of corona positive cases. Due to COVID-19, our country is in the midst of the world’s worst crisis. Many reports and articles about the lack of hospital beds, oxygen cylinders, ICU beds, ventilators, and other medical supplies were published (both print and electronic) in this second wave, exposing the flaws in our country’s healthcare system. On January 16, 2021, the Indian government launched the world’s largest vaccination effort, but we still have a long way to go in vaccinating our 1.4 billion people. India, after China, is the world’s second-most populous country, accounting for approximately 17.5 percent of the global population. This post aims to emphasize the issues that our country is currently facing, as well as possible solutions to combat this deadly illness.

Evaluation and Classification Risks of Implementing Blockchain in the Drug Supply Chain with a New Hybrid Sorting Method

In blockchain technology, all registered information, from the place of production of the product to its point of sale, is recorded as permanent and unchangeable, and no intermediary has the ability to change the data of other members and even the data registered by them without public consensus. In this way, users can trust the accuracy of the data. Blockchain systems have a wide range of applications in the medical and health sectors, from creating an integrated system for recording and tracking patients’ medical records to creating transparency in the drug supply chain and medical supplies. However, implementing blockchain technology in the supply chain has limitations and sometimes has risks. In this study, BWM methods and VIKORSort have been used to classify the risks of implementing blockchain in the drug supply chain. The results show that cyberattacks, double spending, and immutability are very dangerous risks for implementation of blockchain technology in the drug supply chain. Therefore, the risks of blockchain technology implementation in the drug supply chain have been classified based on a literature review and opinions of the experts. The risks of blockchain technology implementation in the supply chain were determined from the literature review.

Corruption in the Healthcare Sector During the Covid-19 Pandemic: Causes, Consequences and Responses

The purpose of this article is to analyze the main causes of corruption in the healthcare sector during the COVID-19 pandemic. The study identified the main problems of national health during the pandemic, such as theft and resale of state-funded medicines, vaccines, and medical supplies (medical equipment), reduced availability and quality of medical services, low wages of medical workers, limited supervision and control (monitoring) in the healthcare sector and etc. As a result of the analysis, it was concluded that there is a need for additional work to identify cases of those types of corruption that are indicated in the article. Also, citizens should be involved in suppressing corruption in the health sector - documenting all cases of corruption that can be detected at the place of service delivery. They will serve as strong evidence to advocate for transparency and accountability mechanisms that guarantee more equitable access to health services. The authors argue that one of the important recommendations for preventing corruption in the health sector is investing in prevention as well as enforcing it: developing health system reforms and new health programs to reduce incentives and opportunities for corruption. The results showed that the method of statistical analysis is quite effective in the field of studying corruption. The study of the statistics of corruption crimes allows us to adequately characterize the level of corruption. The sources are statistical data of the Agency of the Republic of Kazakhstan for Combating Corruption, the Bureau of National Statistics, data from international organizations.

The Politics of the COVID-19 Pandemic in India

India responded to the COVID-19 measures abruptly and in a tough manner during the early stages of the pandemic. Its response did not take into consideration the socio-economic life of the majority of people in India who work in the informal sector and the sheer diversity of the country. The imposition of a nationwide lockdown using the Disaster Management Act 2005 enabled the Union Government to impose its will on the whole country. India has a federal system, and health is a state subject. Such an overbearing role on the part of the Central Government did not, however, lead to coordinated action. Some states expressed their differences, but eventually all complied with the central guidelines. The COVID-19 pandemic struck at a time when an agitation was going on in the country, especially in New Delhi, against the Citizen Amendment Act. The lockdown was imposed all of a sudden and was extended until May 31. This led to a humanitarian crisis involving a large number of domestic migrant workers, who were left stranded with no income for survival and no means of transport to go home. Indians abroad who were intending to return also found themselves trapped. Dissenting voices were silenced through arrests and detentions during this period, and the victims included rights activists, students, lawyers, and even some academics. Power tussles and elections continued as usual and the social distancing norms were often compromised. Since COVID-19 containment measures were carried out primarily at the state level, this paper will also selectively draw on their experiences. India also used the opportunity to burnish its credentials as the ‘pharmacy of the world’ by sending medical supplies to over a hundred countries. In the second wave, there were many deaths, but the government was accused of undercounting them and of not doing enough to deliver vaccines to Indians. This paper will deal with the conflicts, contestations and the foreign policy fallout following the onset of the pandemic and the measures adopted by the union government to cope with them, with less focus on the economic and epidemiological aspects of pandemic management. This paper looks at previous studies, press reports, and press releases by government agencies to collect the needed data. A descriptive and analytical approach is followed in the paper.