Intrahospital Mortality Rate after the Implementation of the Second Phase of the Health Sector Reform in Comparison with Before that in Iran.

IF 1.7 Q2 MEDICINE, GENERAL & INTERNAL International Journal of Preventive Medicine Pub Date : 2024-08-12 eCollection Date: 2024-01-01 DOI:10.4103/ijpvm.ijpvm_288_23
Mojtaba Iravani, Reza Khadivi
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Abstract

Background: The second phase of the health sector reform, called the Health Sector Evolution Plan (HSEP), has been implemented in Iran since 2014, aims to improve the equity and quality of health services. In the present study, we aimed to measure the trend of hospitalization and the crude intrahospital mortality rate from 1 year before the HSEP implementation (2013) to 5 years after the HSEP implementation (2018) in public hospitals compared with profit, nonprofit, and charity hospitals, which are affiliated with the Isfahan University of Medical Sciences (MUI).

Methods: In a prospective, cross-sectional study, the data related to the frequency of hospitalized patients and intrahospital mortality during the time of hospitalization were collected through census sampling from 39 public hospitals as the exposed hospitals and 20 profit, nonprofit, and charity hospitals as the control hospitals.

Results: After HSEP implementation, the frequency of hospitalization increased in public hospitals by 50.45% compared with the previous period. Although the crude intrahospital mortality rate increased from 12.61 to 12.93 per 1000 hospitalized patients (an increase of 2.54%) in public hospitals, the raise was not significant (P value = 0.348). The frequency of hospitalization increased in Social Security Organization's (SSO) hospitals as well as charity hospitals. However, the percent of decrease in the intrahospital mortality rates were -42.96%, -34.76%, and -18.47% in the private, charity, and SSO hospitals, respectively, but was not significant (P value > 0.05).

Conclusions: The crude intrahospital mortality rates in public hospitals affiliated with MUI did not change significantly after the implementation of the HSEP.

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伊朗实施第二阶段卫生部门改革后与改革前的院内死亡率对比。
背景:伊朗自 2014 年起开始实施名为 "卫生部门发展计划"(HSEP)的第二阶段卫生部门改革,旨在提高卫生服务的公平性和质量。在本研究中,我们旨在测量伊斯法罕医科大学(MUI)附属公立医院与营利性医院、非营利性医院和慈善医院相比,从 HSEP 实施前 1 年(2013 年)到 HSEP 实施后 5 年(2018 年)的住院趋势和粗院内死亡率:在一项前瞻性横断面研究中,通过普查抽样收集了 39 家公立医院作为暴露医院和 20 家营利性、非营利性和慈善医院作为对照医院的住院患者频率和住院期间院内死亡率的相关数据:结果:HSEP 实施后,公立医院的住院频率比之前增加了 50.45%。虽然公立医院每 1000 名住院病人的院内粗死亡率从 12.61 上升至 12.93(上升了 2.54%),但上升幅度并不大(P 值 = 0.348)。社会保障组织(SSO)医院和慈善医院的住院频率有所增加。然而,私立医院、慈善医院和社会保障机构医院的院内死亡率下降率分别为-42.96%、-34.76%和-18.47%,但下降率并不显著(P 值 > 0.05):结论:实施 HSEP 后,妇幼保健院附属公立医院的粗略院内死亡率变化不大。
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来源期刊
International Journal of Preventive Medicine
International Journal of Preventive Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
4.80%
发文量
107
期刊介绍: International Journal of Preventive Medicine, a publication of Isfahan University of Medical Sciences, is a peer-reviewed online journal with Continuous print on demand compilation of issues published. The journal’s full text is available online at http://www.ijpvmjournal.net. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository. The journal will cover technical and clinical studies related to health, ethical and social issues in field of Preventive Medicine. Articles with clinical interest and implications will be given preference.
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