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Retraction Note: Ergonomics Risk Management in a Manufacturing Company Using ELECTRE [Health Scope. 2016;5(4)] 撤回注:某制造企业使用ELECTRE的人体工程学风险管理[健康范围,2016;5(4)]
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2022-04-22 DOI: 10.5812/jhealthscope-126090
Ethics Committee
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引用次数: 0
At-risk COVID-19 Patients; Knowledge and Attitude of Those in Need of Transfer to Hospital and Consequences in Non-transferred Patients 高危新冠肺炎患者;需要转院者的知识态度及对非转院患者的影响
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2022-04-12 DOI: 10.5812/jhealthscope-119063
P. Saberian, Mina Hesami, N. Tavakoli, Parisa Hasani-Sharamin, Zohreh Ahmadi Hatami, F. Dadashi, Alireza Baratloo
Background: Knowledge, attitude, and practice of people, especially high-risk ones, are essential for managing COVID-19. Previous studies have shown that inappropriate knowledge and attitude may influence people's decisions. Objectives: This study aimed to evaluate the knowledge and attitudes of patients towards COVID-19 who called emergency medical service (EMS) while suffering from a chronic underlying disease, whether they were transferred to the hospital during the pandemic or not. Methods: This cross-sectional study was conducted from 21 May 2020 to 20 June 2020 in Tehran, Iran. Using the registered data in the databank of the Tehran EMS center, eligible participants were selected and divided into transferred and non-transferred groups based on the recorded data. A valid and reliable questionnaire comprising four parts (demographic information, patients' knowledge about COVID-19, patients' attitude towards COVID-19, and patients' fear) was used. A researcher-made checklist was also used for recording the consequences and reasons for refusal. Select eligible individuals who agreed to enter the survey were interviewed by telephone. Results: Totally, 201 transferred patients and 158 non-transferred patients were enrolled. The mean age of the transferred group was lower than that of the non-transferred one (57.1 ± 16.1 vs. 62.0 ± 17.4 years; P = 0.006). The mean knowledge score was not statistically different between transferred and non-transferred patients (28.8 ± 5.7 vs. 28.2 ± 5.4; P = 0.320). The mean attitude score was lower in the transferred group than in the non-transferred group (0.75 ± 3.7 vs. 2.2 ± 3.5; P = 0.001). The mean fear score was higher in the non-transferred group than in the transferred group, but the difference was not statistically significant (16.0 ± 5.1 vs. 15.0 ± 5.6; P = 0.101). Conclusions: Most participants in both transferred and non-transferred groups did not have sufficient knowledge of the disease, but the average attitude had a positive score.
背景:人们,尤其是高危人群的知识、态度和实践对于管理新冠肺炎至关重要。先前的研究表明,不恰当的知识和态度可能会影响人们的决策。目的:本研究旨在评估新冠肺炎患者在患有慢性基础疾病时呼叫紧急医疗服务(EMS)的知识和态度,无论他们是否在大流行期间被转移到医院。方法:这项横断面研究于2020年5月21日至2020年6月20日在伊朗德黑兰进行。使用德黑兰EMS中心数据库中的注册数据,选择符合条件的参与者,并根据记录的数据分为转移组和非转移组。使用了一份有效可靠的问卷,包括四个部分(人口统计信息、患者对新冠肺炎的了解、患者对新冠肺炎的态度和患者的恐惧)。研究人员制作的检查表也用于记录拒绝的后果和原因。通过电话采访了一些同意参加调查的合格人员。结果:共纳入201例转移患者和158例非转移患者。转移组的平均年龄低于未转移组(57.1±16.1 vs.62.0±17.4岁;P=0.006)。转移和未转移患者的平均知识得分没有统计学差异(28.8±5.7 vs.28.2±5.4;P=0.320)(0.75±3.7 vs.2.2±3.5;P=0.001)。非转移组的平均恐惧评分高于转移组,但差异无统计学意义(16.0±5.1 vs.15.0±5.6;P=0.101)。结论:转移组和非转移组中的大多数参与者对疾病没有足够的了解,但平均态度得分为正。
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引用次数: 2
Acoustical Performance of a Double-Expansion Chamber Muffler: Design and Evaluation 双膨胀室消声器的声学性能设计与评价
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2022-04-08 DOI: 10.5812/jhealthscope-103226
N. Damyar, Fariba Mansouri, A. Khavanin, Ahmad Jonidi Jafari, H. Asilian-Mahabadi, R. Mirzaei
Background: Exhaust noise is known to be a major pollutant in the environment and workplaces due to the development of industry and transportation. Exhaust noise can be reduced to normal levels by mufflers or silencers. A reactive muffler efficiently dampens noise at low frequencies by reflecting sound waves. Therefore, muffler design is of great importance in exhaust noise reduction. Transmission loss (TL) is an essential characteristic of mufflers, demonstrating their acoustical properties. Any acoustical appliance is selected based on its damping performance and reliability. Predicting TL through experimentation is different from theoretical calculations. Methods: In the present study, a double-expansion chamber muffler was designed as a reflective muffler on a laboratory scale by equations. Next, TL was evaluated by an impedance tube applying a 4-microphone technique to determine the acoustical performance of the designed muffler. Results: Findings revealed that the TL of the muffler at 312 Hz frequency obtained 27.5 dB agreement with the required TL of the muffler of 25 dB. In addition, the TL of the muffler against frequency attenuates noise in broadband frequencies. Conclusions: These results indicated that the built muffler provides desired TL for exhaust chambers. Therefore, equations can be used as a precise method for muffler design. Furthermore, multi-expansion chamber mufflers are useful for reducing noise at a wide range of frequencies.
背景:由于工业和交通的发展,废气噪声已成为环境和工作场所的主要污染物。排气噪音可以通过消声器或消声器降低到正常水平。反应消声器通过反射声波有效地抑制低频噪声。因此,消声器设计对降低排气噪声具有重要意义。传输损耗是消声器的一项重要特性,反映了消声器的声学性能。任何声学设备都是根据其阻尼性能和可靠性来选择的。通过实验预测TL不同于理论计算。方法:采用方程法在实验室条件下设计了一种双膨胀腔消声器作为反射消声器。其次,采用阻抗管测量四传声器技术来确定所设计消声器的声学性能。结果:在312 Hz频率下,消声器的声效达到27.5 dB,符合消声器要求的25 dB的声效。此外,消声器对频率的TL对宽带频段的噪声有衰减作用。结论:所建消声器能提供理想的排气室TL。因此,方程可以作为消声器设计的一种精确方法。此外,多膨胀腔消声器可用于在宽频率范围内降低噪声。
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引用次数: 1
Explanation of Experiences of Iranian Women on the Verge of Divorce Regarding Rationality 从理性的角度解释伊朗妇女濒临离婚的经历
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2022-03-29 DOI: 10.5812/jhealthscope.120007
S. Taghi, M. Nakhaei, S. Vagharseyyedin
Background: Rationality is a complex concept that plays a vital role in human choices and decisions. However, this issue has been less addressed in studies on marital life. Objectives: This study was performed to explain the experiences of Iranian women on the verge of divorce regarding rationality. Methods: According to the five-stage Granheim and Landman’s approach, an inductive conventional qualitative content analysis was used to collect and analyze women’s experiences on the verge of divorce. Seventeen women selected through purposive sampling entered the study, and qualitative information was collected using unstructured and semi-structured interviews. Information collection and analysis proceeded simultaneously. The information was saturated with 17 participants, and no new information was extracted. In this study, Lincoln and Guba’s criteria were used to ensure the robustness of the study. Results: After information analysis, two main themes were derived. Limited rationality in marriage was the first one with three main categories: Lack of intellectual preparedness for marital life, irrational marriage decision-making, and unrealistic positive thinking. Lack of marital issues understanding was the second one, categorized into reality shock and negative cognitive-emotional experiences. Conclusions: This qualitative study showed that limited rationality plays a vital role in the lives of women on the verge of divorce. However, learning skills, such as deep thinking and realistic thinking, can help women overcome limitations toward rationality and lack of marital issues understanding.
背景:理性是一个复杂的概念,在人类的选择和决策中发挥着至关重要的作用。然而,在关于婚姻生活的研究中,这个问题很少得到解决。目的:本研究旨在解释濒临离婚的伊朗妇女在理性方面的经历。方法:根据格兰海姆和兰德曼的五阶段方法,采用归纳的常规定性内容分析方法,收集和分析女性在离婚边缘的经历。通过有目的的抽样选出的17名女性参与了这项研究,并通过非结构化和半结构化访谈收集了定性信息。信息收集和分析同时进行。17名参与者的信息饱和,没有提取新的信息。在本研究中,使用Lincoln和Guba的标准来确保研究的稳健性。结果:经过信息分析,得出两个主要主题。婚姻中的有限理性是第一种,主要有三类:对婚姻生活缺乏智力准备、婚姻决策不合理和不切实际的积极思维。缺乏对婚姻问题的理解是第二种,分为现实冲击和负面认知情绪体验。结论:这项定性研究表明,有限的理性在濒临离婚的女性的生活中起着至关重要的作用。然而,学习技能,如深入思考和现实思维,可以帮助女性克服理性的局限性和对婚姻问题缺乏理解。
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引用次数: 0
Occupational Exposure to Manganese Among Welders: Association Between Airborne Manganese Concentration and Blood Manganese Levels 焊工职业性锰暴露:空气中锰浓度与血锰水平的关系
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2022-03-12 DOI: 10.5812/jhealthscope.120968
Solale Ramzany, N. Khanjani, M. Mohammadyan, E. Babanezhad, J. Yazdani-charati
Background: Manganese (Mn) is an essential element for the human body, but it can cause adverse effects on the Central Nervous System at high doses. Exposure to manganese fumes during welding can harm welders' health. Objectives: The current study aimed to measure manganese produced by shielded metal arc welding (SMAW) in the breathing zone air and blood of welders and investigate the relationship between manganese concentrations in air and blood. Methods: In this descriptive-analytical cross-sectional study, 35 welders were enrolled as the exposed group and 40 office workers as the control group. Manganese concentration in air was measured according to NIOSH method 7301. Air and blood sample analyses were carried out by ICP-OES. Statistical analysis was performed with MINITAB 17. Data were analyzed using Pearson correlation coefficient, one-sample t-test, paired t-test, and logistic regression. The significance level was set at P < 0.05. Result: The mean concentration of welding respirable particles and manganese fumes were 9.56 ± 1.67 and 0.45 ± 0.08 mg/m3, three and 22 times the exposure limit recommended by ACGIH, respectively. Average manganese was significantly higher in the welders’ blood (0.16 ± 0.02 µg/mL) than in the controls’ blood (0.04 ± 0.002 µg/mL). There were strong and significant correlations between the welding respirable particles and manganese concentration in welders’ breathing zone and blood manganese levels. Also, with each year of work experience, the manganese concentration in the welders’ blood increased by 1.5%. Conclusions: Welders are at risk of contamination with manganese. Manganese exposure reduction through more efficient ventilation systems, reducing welder’s exposure time, staff training, and appropriate respiratory protection equipment should be applied to reduce manganese exposure among welders and prevent health complications.
背景:锰是人体必需元素,但高剂量时会对中枢神经系统产生不良影响。焊接过程中接触锰烟雾会危害焊工的健康。目的:本研究旨在测量焊接工人呼吸区空气和血液中金属焊条电弧焊(SMAW)产生的锰,并探讨空气和血液锰浓度之间的关系。方法:在这项描述性分析横断面研究中,35名焊工被纳入暴露组,40名办公室工作人员被纳入对照组。根据NIOSH方法7301测量空气中的锰浓度。通过ICP-OES进行空气和血液样品分析。使用MINITAB 17进行统计分析。使用Pearson相关系数、单样本t检验、配对t检验和逻辑回归对数据进行分析。显著性水平设定为P<0.05。结果:焊接可吸入颗粒物和锰烟雾的平均浓度分别为9.56±1.67和0.45±0.08mg/m3,分别是ACGIH建议的暴露限值的3倍和22倍。焊工血液中的平均锰含量(0.16±0.02µg/mL)明显高于对照组血液中的锰含量(0.04±0.002µg/mL)。焊接可吸入颗粒物与焊工呼吸区锰浓度和血锰水平之间存在强烈且显著的相关性。此外,根据每一年的工作经验,焊工血液中的锰浓度都会增加1.5%。结论:焊工有被锰污染的风险。应通过更有效的通风系统、减少焊工的暴露时间、员工培训和适当的呼吸保护设备来减少锰暴露,以减少焊工的锰暴露并防止健康并发症。
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引用次数: 3
Evaluation of the External Ear and Head Anthropometric Dimensions Among Fars and Turk Workers for the Ergonomic Design of the Earmuffs Fars和Turk工人外耳和头的人体测量尺寸对耳罩人机工程学设计的评估
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2022-03-10 DOI: 10.5812/jhealthscope.100506
E. Hamamizadeh, H. Asilian-Mahabadi, A. Khavanin
Background: Anthropometry plays an important role in the ergonomic design of hearing protection equipment and its compatibility with the dimensions of the external ear and head of workers. Few studies have been conducted on the dimensions of the external ears and heads of workers in Iran with different ethnicities. Objectives: This study aimed to collect the anthropometric dimensions of the external ear and head of workers of two prominent ethnicities of Iran for the ergonomic design of earmuffs. Methods: Following a cross-sectional design, this study was performed on 300 male workers (150 Turk and 150 Fars) aged 20 - 60 years. Anthropometric dimensions of the external ear and head were measured using a spreading caliper, camera, tripod, and tape measure. Photographs were analyzed using Digimizer V5.3.5 software, and data were analyzed using SPSS 21. Results: The mean age of Turk and Fars workers was 33.51 ± 5.41 and 33.95 ± 6.05 years, respectively. The ear shape was oval in more than half of the male workers of the two studied ethnicities. There was a positive correlation between anthropometric dimensions of head and ears in both ethnicities. The 95th percentile of the length and width of the pinna in Fars and Turk workers was larger than the average dimensions of inner ring earmuffs. Conclusions: Hearing protection devices available in the Iranian market should be examined to fit the ear dimensions of different Iranian ethnicities. External ear anthropometric data obtained from this study can be used to redesign the earmuffs in Fars and Turk male workers.
背景:人体测量在听力保护设备的人体工程学设计及其与工人外耳和头部尺寸的兼容性方面发挥着重要作用。很少有人对伊朗不同种族工人的外耳和头部尺寸进行研究。目的:本研究旨在收集伊朗两个著名种族工人外耳和头部的人体测量尺寸,用于耳罩的人体工程学设计。方法:采用横断面设计,对300名20-60岁的男性工人(150名土耳其人和150名法尔斯人)进行研究。外耳和头部的人体测量尺寸使用游标卡尺、相机、三脚架和卷尺进行测量。照片使用Digimizer V5.3.5软件进行分析,数据使用SPSS 21进行分析。结果:土耳其和法尔斯工人的平均年龄分别为33.51±5.41和33.95±6.05岁。在所研究的两个种族中,超过一半的男性工人的耳朵形状是椭圆形的。两个种族的头部和耳朵的人体测量尺寸之间存在正相关。Fars和Turk工人耳廓长度和宽度的第95个百分位大于内环耳罩的平均尺寸。结论:应检查伊朗市场上可用的听力保护装置,以适应不同伊朗种族的耳朵尺寸。从这项研究中获得的外耳人体测量数据可用于重新设计法尔斯和土耳其男性工人的耳罩。
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引用次数: 0
Worldwide Prevalence of Hypertension in Patients with COVID-19: A Meta-analysis and Systematic Review COVID-19患者高血压的全球患病率:荟萃分析和系统评价
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2022-03-08 DOI: 10.5812/jhealthscope.115665
Malihe Sohrabivafa, R. Sadeghi, M. Feiz-Haddad
Background: This systematic review and meta-analysis aimed to assess the ratio of patients with hypertension for whom coronavirus disease 2019 (COVID-19) has been diagnosed in the world. In addition, the effect of COVID-19 on the outcomes of hypertension was evaluated. Methods: To find articles published by July 2020, a comprehensive systematic search was carried out in five electronic databases, including PubMed, Scopus, Embase, and Web of Science. The meta-analysis entailed all relevant articles on the clinical and epidemiological features of patients with COVID-19. Two researchers independently reviewed the eligible post-selection studies, and finally, the discrepancies between the opinions of the two researchers were resolved by a third arbitrator. Two researchers independently examined the risk of bias using the Newcastle-Ottawa Scale. Results: The pooled prevalence of high blood pressure in patients hospitalized with COVID-19 worldwide was obtained as 31% (95% CI: 23 - 38%). The changes for hypertension prevalence in different studies included in the meta-analysis varied from 2 to 64%. Moreover, the results of subgroups analysis based on different countries demonstrated that the prevalence of hypertension in patients with COVID-19 in China and other countries was 29% (95% CI: 24 - 34%) and 32% (95% CI: 19 - 46%), respectively. Conclusions: The evidence revealed that a health condition that commonly accompanies and affects the outcomes of COVID-19 is hypertension. Therefore, COVID-19 patients with hypertension should be given priority and benefit from a preventive, therapeutic approach. Furthermore, essential training should be provided by health policymakers.
背景:本系统综述和荟萃分析旨在评估世界范围内诊断为冠状病毒病2019 (COVID-19)的高血压患者的比例。此外,还评估了COVID-19对高血压结局的影响。方法:对PubMed、Scopus、Embase、Web of Science等5个电子数据库进行全面系统检索,查找2020年7月前发表的论文。荟萃分析纳入了有关COVID-19患者临床和流行病学特征的所有相关文章。两名研究人员独立审查了合格的后选择研究,最后,两名研究人员意见之间的差异由第三名仲裁员解决。两名研究人员使用纽卡斯尔-渥太华量表独立检查了偏见的风险。结果:全球COVID-19住院患者中高血压的总患病率为31% (95% CI: 23 - 38%)。meta分析中不同研究中高血压患病率的变化从2%到64%不等。此外,基于不同国家的亚组分析结果显示,中国和其他国家的COVID-19患者高血压患病率分别为29% (95% CI: 24 - 34%)和32% (95% CI: 19 - 46%)。结论:有证据表明,高血压是伴随并影响COVID-19预后的常见健康状况。因此,应优先考虑COVID-19高血压患者,并从预防和治疗方法中受益。此外,卫生政策制定者应提供必要的培训。
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引用次数: 0
Explaining the Role of Physicians in Urban Comprehensive Health Service Centers After Implementing Health Transformation Plan in Southeast of Iran: A Qualitative Study 解读伊朗东南部实施健康转型计划后医生在城市综合卫生服务中心的作用:一项定性研究
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2022-02-28 DOI: 10.5812/jhealthscope.121713
Abbas Shahabianmoghaddam, Mehdi Zanganeh Baygi
Background: Health transformation plan (HTP) in Iran was established in 2014 to promote primary health care through expanding and strengthening the first level of services in urban and rural areas. The activities of physicians and their colleagues in comprehensive health service centers have increased access and improved community health. Conducting various studies on the urban physicians’ roles can help policymakers achieve the goals. Objectives: This study aimed to explain the role of physicians working in urban, comprehensive health service centers after implementing the HTP. Methods: Participants in this qualitative study consisted of physicians, healthcare providers, managers, and experts, working in urban health centers selected by a purposive sampling method. The data were collected by semi-structured interviews. After data saturation, they were analyzed by conventional content analysis. Results: After interviewing 35 people and several stages of review, coding, and using the experience of experts, the data were classified into six main categories, 11 subcategories, and 33 codes. Factors influencing the role of physicians were service delivery, electronic health records, resources, community culture, monitoring, supervision, and practical suggestion. The participants expressed the workload, referral system, integrated electronic health record, financial resources, human resources, equipment, and public participation as some aspects related to the role of physicians. Conclusions: Based on the current study, human and financial resources should be managed to retain the physicians in this plan. In addition, increasing the quality of services, improving electronic health records, and attention to public culture can be considered.
背景:伊朗卫生转型计划(HTP)成立于2014年,旨在通过扩大和加强城市和农村地区的第一级服务来促进初级卫生保健。医生及其同事在综合健康服务中心的活动增加了获得服务的机会,改善了社区健康。对城市医生的角色进行各种研究可以帮助决策者实现这些目标。目的:本研究旨在解释在实施HTP后,在城市综合卫生服务中心工作的医生的作用。方法:这项定性研究的参与者包括在城市卫生中心工作的医生、医疗保健提供者、管理人员和专家,他们通过有目的的抽样方法进行选择。数据是通过半结构化访谈收集的。在数据饱和后,通过常规的内容分析对其进行分析。结果:在采访了35人,经过几个阶段的审查、编码和使用专家的经验后,数据被分为6个主要类别、11个子类别和33个代码。影响医生角色的因素包括服务提供、电子健康记录、资源、社区文化、监测、监督和实践建议。与会者表示,工作量、转诊系统、综合电子健康记录、财政资源、人力资源、设备和公众参与是与医生角色有关的一些方面。结论:根据目前的研究,应该管理人力和财力资源,以留住该计划中的医生。此外,还可以考虑提高服务质量、改进电子健康记录以及关注公共文化。
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引用次数: 1
Rabies: Repetition of an Old Tragic Story in Southeastern Iran 狂犬病:伊朗东南部一个古老悲剧故事的重演
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2022-02-13 DOI: 10.5812/jhealthscope.121232
J. Nejati, Mehdi Zanganeh Baygi, Said Salemroudi
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引用次数: 1
Hospitalization Expenses and Influencing Factors for Inpatients with Ischemic Heart Disease in Iran: A Retrospective Study 伊朗缺血性心脏病住院患者住院费用及影响因素回顾性研究
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2022-01-15 DOI: 10.5812/jhealthscope.117711
Maryam Shirvani Shiri, S. Emamgholipour, Rajabali Daroudi, Maryam Tatary, Z. Kazemi, H. Karami
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.
背景:缺血性心脏病(IHD)是全球和伊朗死亡和致残的主要原因,给患者的家庭和社会带来了沉重的经济负担。目的:本研究旨在分析2020年伊朗IHD住院患者的直接医疗费用及其影响因素。方法:这项横断面研究的样本包括从2019年8月23日至2020年6月20日伊朗健康保险组织医院信息系统(HIS)中选择的41357名IHD患者。该研究使用了这些患者的索赔数据,包括他们的人口统计数据、住院时间(LOS)、重症监护室(ICU)入院情况、医院认证等级、医院所有权类型和患者出院状态。采用多元线性回归模型评估住院费用与相关因素之间的关系。所有统计学检验均采用R 3.6.3软件进行,显著性水平为P<0.05。结果:患者的平均年龄为63.95±12.63岁,其中男性占54.4%,平均每位患者和每天的住院费用分别为586.42±472.51美元和103.64±100.29美元。此外,平均LOS为4.92天。药品和消耗性医疗用品以及护理和酒店服务在住院费用中所占比例最高(分别为29.54%和29.4%)。IHD患者的住院费用在男性(β=1.24)、年龄61-70岁(β=1.38)、LOS≥5(β=2.92)、ICU入院(β=1.62)、伊朗卫生基金(β=1.21)和私立医院(β=1.91)中较高。与二级(β=0.67)、三级(β0.35)和四级(β0.72)医院相比,顶级和一级医院的住院费用较高。死亡患者的费用也高于完全康复(β=0.63)、相对康复(β=0.059)、随访(β=0.51)、转移到其他医疗中心(β=0.44)和违背医嘱出院(DAMA)(β=0.62)的患者,缩短服务水平和控制药品和耗材的高成本是降低高住院成本的主要策略。
{"title":"Hospitalization Expenses and Influencing Factors for Inpatients with Ischemic Heart Disease in Iran: A Retrospective Study","authors":"Maryam Shirvani Shiri, S. Emamgholipour, Rajabali Daroudi, Maryam Tatary, Z. Kazemi, H. Karami","doi":"10.5812/jhealthscope.117711","DOIUrl":"https://doi.org/10.5812/jhealthscope.117711","url":null,"abstract":"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.","PeriodicalId":12857,"journal":{"name":"Health Scope","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49120783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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