M Mehrolhassani, B Najafi, V Yazdi Feyzabadi , Aa Haghdoost, M Abolhallaje, M Ansari, R Dehnavieh, M Ramezanian, F Kouhi, M Jafari, Lashkari M,
Volume 12, Issue 0 (3-2017)
Abstract
Background and Objectives: Out-of-pocket (OOP) expenditure is one of the main indicators in health financing, indicating risk pooling and risk spreading. This study aimed to calculate the total health expenditure (THE), the THE per capita and share of OOP in each province from 2008 to 2014.
Methods: The present cross-sectional study was done by collecting provincial health expenditure data from public and private organizations during 2008-2014. The data were approved by board of trustees or board of directors in each organization. The relevant data on household health expenditures were collected from the Statistical Centre of Iran, as well.
Results: Even though the absolute monetary value (IRR) of OOP in the study years showed an increase, it decreased from 51.9% in 2008 to 40.6% in 2014 in terms of share. The absolute monetary value (IRR) of THE and THE per capita increased about 3.5 times in all provinces. So, during the study years, Tehran and Sistan and Baluchistan Provinces had the highest and lowest absolute monetary values (IRR) in THE per capita and this difference increased from 2.12 million Rials in 2008 to 10.56 million Rials in 2014.
Conclusion: Although the share of OOP decreased in all provinces in the country during the study years, it is still far from the objective of the national development plans (30% OOP). In order to improve the study indices and reduce the provincial inequity, it is suggested to put more emphasis on prepaid-based mechanisms, insurance system improvement, and equitable distribution of financial resources should be compatible with the deprivation of the area and its infrastructures.
E Ghasemi, M Barooni, R Dehnavieh, M Jafari Sirizi , Mh Mehrolhassani,
Volume 12, Issue 0 (3-2017)
Abstract
Background and Objectives: Health insurance would guarantee people security against disease and health problems. Given the key role of health insurance in achieving the goals of justice and reducing the out-of-pocket payment, this study aimed to evaluate the performance of Iran health insurance using the DEA model in 2014.
Methods: This was a cross sectional study. The study population included all Iran health insurance organizations. DEA input and output criteria were selected by targeted library and documentary review and the data were collected accordingly. The determinants of efficiency were evaluated using liner regression.
Results: The mean technical, management, and scale efficiency of Iran health insurance head offices was 0.593, 0.761, and 0.721, respectively. Considering the findings, the capacity of efficiency promotion at these head offices was approximately 41%. Regarding technical efficiency, 5 head offices had the maximum efficiency (1), 7 head offices had efficiency between 0.5 and 1, and 19 head offices had efficiency less than 0.5. In addition, the variables of population and total number of institutions had a significant impact on efficiency.
Conclusion: Based on defined variables, input oriented AP-DEA model was appropriate. The results showed a great capacity for increasing technical efficiency in the Iranian health insurance organizations which could be increased by benchmarking efficient and reference organizations and also adjusting their input. For this purpose, downsizing and agility of the Iranian health insurance organizations based on the e-government clause are proposed for administrative system reform.
V Yazdi Feyzabadi , Mh Mehrolhassani, Aa Haghdoost, M Bahrampour,
Volume 12, Issue 0 (3-2017)
Abstract
Background and Objectives: One of the fair financial protection indexes in monitoring health systems is estimating impoverishment due to health care expenditure. The aim of this study was to measure the percentage of households impoverished due to out-of-pocket(OOP) payments in Iran provinces during2008-2014.
Methods: The present retrospective descriptive study was conducted based on data from Household Income and Expenditure Survey in both rural and urban households. The proportion of households that moved below the poverty line after deducting health care costs was calculated. The poverty line for urban and rural areas was calculated based on household food expenditure. To show the provincial dispersion of the index during this period, the coefficient of variation(CV) was used. Mann-WhitneyU test and descriptive statistics were used to analyze the data.
Results: Golestan, North Khorasan, and Kerman had the highest impoverishment rate due to OOP Moreover, Alborz, Tehran, and Bushehr had the lowest impoverishment rate due to OOP. In all the study years, the average impoverishment due to OOP was significantly higher in rural areas compared to urban areas. Provincial dispersion CV for this index did not have a constant trend.
Conclusion: The results of this study provide valuable evidence for policy-makers to estimate the impact of OOPs on household impoverishment. In order to reduce impoverishment due to OOP, supportive targeted interventions for vulnerable and low-income households, especially rural households, in addition to decreasing the share of OOP, are essential, such as developing health subsidies and improving insurance service packages.
F Esmaili, Mh Mehrolhassani, M Barooni, R Goudarzi ,
Volume 12, Issue 0 (3-2017)
Abstract
Background and Objectives: Productivity and efficiency are the most important and the most common mechanisms of evaluation and measurement of the performance of an enterprise including the Social Security Organization. In the past decades, performance evaluation of various economic sectors has been attractive to researchers in different disciplines. Thus, the aim of this study was to measure the efficiency of the direct treatment section of treatment management units of Social Security Organization by data envelopment analysis method.
Methods: This descriptive- analytic study was conducted to measure the efficiency of the direct treatment section of treatment management units of Social Security Organization through the data envelopment analysis (DEA) method in 2014. Data and relevant statistics were collected from the Statistical Center of Social Security Organization. The Deap2.1 software was used to calculate the efficiency and the EMS software was used to calculate the super efficiency. Then, the hypotheses of the research were studied using the Stata software.
Results: The average technical efficiency, managerial efficiency, and scale efficiency in 2014 was 0.924, 0.992, and 0.932, respectively. Twelve decision making units (DMUs) had the maximum technical efficiency (1), 16 DMUs had technical efficiency between 0.8 and 1, and 3 units had technical efficiency less than 0.8.
Conclusion: This study introduces a functional pattern to managers of Social Security Organization that enables them to have more accurate planning for the development and saving of resources.
V Yazdi Feyzabadi, M Bahrampour, A Rashidian, Aa Haghdoost, M Abolhallaje, B Najafi, Mr Akbari Javar , Mh Mehrolhassani,
Volume 12, Issue 0 (3-2017)
Abstract
Background and Objectives: Catastrophic health expenditure (CHE) is a key indicator for measuring households' financial protection in the health system. This study was conducted to measure the incidence and intensity of CHE in Iranian provinces 2008-2014.
Methods: When the out-of-pocket (OOP) spending of each household amounts to at least 40% of the household's capacity to pay, it is called a catastrophe. The incidence of CHE in Iranian provinces was estimated using the data obtained from household-expenditure-and-income-surveys. The intensity was calculated as the average extent to which OOPs exceeded the 40% threshold. Descriptive statistics and Mann-WhitneyU test were used for data analysis. The index of disparity(ID) was also calculated for geographical disparities across the provinces.
Results: On average, the lowest and highest CHE incidence and intensity were seen in Fars and South Khorasan provinces respectively. However, the highest and lowest rate for CHE households that actually experienced catastrophe at the 40% threshold belonged to Fars and Kurdistan provinces. The incidence of CHE in rural was more than urban areas. ID of CHE incidence for targeted amount was high and had no constant trend.
Conclusion: CHE incidence had a remarkable difference in different provinces and in the rural area compared to the urban area. Due to the importance of this index in promoting health financial protection, like indexes such as OOP, its distribution in rural and urban areas as well as in different provinces is considerable. It requires a structured format to identify the disadvantaged and low-income groups and provide financial-support and insurance for them.
Mh Mehrolhassani, M Emami, Ss Pourhosseini,
Volume 14, Issue 0 (1-2019)
Abstract
Concurrent with globalization, some changes have been created in the performance of the universities in developed countries that have turned them into a power source for economic development. In this study, generation changes of Iranian universities in the health sector were analyzed by the layer analysis (CLA) framework. The results showed that the status of universities in Iran is moving from the first and second university generations (i.e. education and research oriented) to the third generation (wealth creation). Too much concentration on indexes such as expert human resources training and number of papers and citations in the Iranian universities has led to stagnation in litany and structural layers. Obtaining scientific authority and technology development requires fundamental evolutions of sciences in deeper layers such as Islamic world view, governance of valuable contexts and evolution in the relationship among higher education and the research and technology system with other sectors.
Mh Mehrolhassani, R Goudarzi, V Yazdi Feyzabadi , Ss Pourhosseini, A Darvishi,
Volume 14, Issue 0 (1-2019)
Abstract
Background and Objectives: Improving the efficiency and productivity of the higher education, especially in the field of research on health sciences, is one of the characteristics of sustainable development in today's societies. This study aimed to measure the efficiency and productivity of Iran's Medical Sciences Universities (MSU) in the research function.
Methods: In a descriptive study, the research function of fourty five MSUs in Iran was evaluated using data envelopment analysis (DEA) method and Malmquist index in 2010, 2013, and 2016 years. Measurement of both efficiency and Malmquist index was developed and modeled based on the assumption of variable returns to scale (VRS) and output-oriented. Also, the ranking of efficient units was done using Anderson-Patterson's model.
Results: The mean research efficiency was estimated to be 0.86. Findings of Malmquist index showed that between 2010 and 2013, there was a 6% growth in the productivity; while the performance of universities had a 12% drop in research function from 2013 to 2016. Also, the average total productivity during two periods is 0.96, indicating 4% reduction in research efficiency which technology efficiency growth has dropped by 8% and other components of total productivity had a positive growth.
Conclusion: The results of the study showed that universities do not work efficiently and average productivity has been decreasing which was mainly due to a decline in the efficiency of technology, which despite the development of technology in recent years could be the result of the lack of effective use of it.
S Noori Hekmat, Aa Haghdoost, R Dehnavieh, R Ghorbani Nia,
Volume 14, Issue 0 (1-2019)
Abstract
Background and Objectives: In 1995, a huge revolution occurred in Iran’s health system when the entire medical-related educa-tion program was integrated into the Ministry of Health. This paper was conducted to provide a review of all studies investigating this integration and to synthesize their results.
Methods: This study was a systematic review and qualitative meta-synthesis of the papers on integration using the Walsh and Downe process. An extensive search of the databases of ScienceDirect, PubMed, EMBASE, ISI, Google Scholar, Scopus, SID, Magiran, and Irandoc revealed 187 articles of which 25 were selected. The content of the studies was analyzed and combined using the Walsh and Downe technique.
Results: The results showed 5 main concepts, including the goals and reasons of the medical education integration, integration achievements, challenges, and barriers to achieving the goals of integration, and the future of integration. The greatest success of the integration program was related to health services, while the least positive effects were related to medical education and research.
Conclusion: A review of available documents shows that not all dimensions of integration have been well analyzed and their economic, social, developmental and scientific effects have not been studied. The majority of the limited studies in this regard were surveys and overview studies and few studies used economic analysis and modeling. Therefore, the effects of the integration cannot be evaluated using the available studies.
V Yazdi Feyzabadi , Mh Mehrolhassani, Ss Pourhosseini,
Volume 14, Issue 0 (1-2019)
Abstract
Background and Objectives: Research plays an important role in solving health problems in the community. One main mission of higher education institutions is developing research tailored to the needs of the community by providing equal and fair opportunities for research sectors. The present study aimed to measure inequality in the rea of research in Iranian medical sciences universities.
Methods: In this descriptive study, the Gini Coefficient (GC) was used to measure inequality from 2010 to 2016. The indexes included the number of published papers, citations, citation per paper, self-citation, Scimago Journal Rank (SJR), Source Normalized Impact per Paper (SNIP), Citescore, Hirsch
(h-index), number of faculty members, number of students, and educational and research budget. Stata 14 software was used for data analysis.
Results: During the study years, the GC of SJR, SNIP, and Citescore varied from 0.65 to 0.73, 0.62 to 0.73, and 0.61 to 0.72, respectively. In addition, The GC of international papers, total articles, self-citation, citation per article, Hirsch index, and total citations varied from 0.62 to 0.70, 0.56 to 0.66, 0.22 to 0.27, 0.12 to 0.28, 0.33 to 0.39, and 0.57 to 0.72, respectively. The GC of the number of faculty members and budget ranged from 0.26-0.40 and 0.34-0.67, respectively.
Conclusion: Inequality in self-citation and citation per article was relatively fair, while Hirsh and the number of faculty members had intermediate inequality. Other indicators had a high and very high inequality. To reduce inequality, developing of the balanced research infrastructures in medical universities is recommended.
Mh Mehrolhassani, Mr Amiresmaili, M Iranmanesh,
Volume 14, Issue 0 (1-2019)
Abstract
Background and Objectives: Human resources is a key factor in achieving the Millennium Development Goals. Lack of indicators and standard tools for monitoring and evaluating human resources may cause limitations in achieving these goals. This study was done to develop evaluation indicators of human resources in the health sector.
Methods: The present study was carried out using the Delphi technique to extract the indicators of human resources evaluation in 2017. To conduct this study, three independent stages including a review of theoretical concepts, preparation of initial indicators of human resources evaluation, and consensus building were undertaken. The data were collected by a panel of 12 experts and representatives of related organizations in three rounds, with a scorecard designed to score from 1 to 10. In each round, the indexes that attained at least 8 out of 10 by two thirds of the experts were confirmed in the final model.
Results: In the first stage, 220 indicators were identified. The final model of human resources evaluation had 45 indicators in 11 main criteria. Four criteria were accepted at the stage of entrance to job market, (qualified applicants for health education, accreditation, capacity and outsourcing of health education institutions, approval and licensing). Five criteria were confirmed during the work (main indicators of availability and distribution, activity, productivity of labor force, waste and renewal, desirable governance on the information system of labor). Two criteria were accepted at the exit stage (transfer and withdrawal).
Conclusion: Despite the complexity of the human resources assessment, three different stages of the life cycle of the workforce (input, active labor force and output) should be considered for evaluation and monitoring. The indicators presented in this study make it possible to assess and monitor the health workforce.
Mh Mehrolhassani, R Goudarzi, V Yazdi Feyzabadi, Ss Pourhosseini, A Darvishi,
Volume 14, Issue 0 (1-2019)
Abstract
Background and Objectives: The higher education system plays an important role in the socio-economic development of the country due to its mission in training the required human resources. Therefore, performance evaluation of different sectors of higher education is of great importance. The present study was conducted to evaluate the educational efficiency and productivity changes of Iranian medical sciences universities.
Methods: This descriptive study was conducted in 2011, 2014, and 2017 to evaluating the performance of 43 Iranian medical universities using Data Envelopment Analysis and output oriented approach. In addition, productivity changes were measured using the Malmquist index. For this purpose, Deap 2.1 software was used. The Anderson Patterson Model and EMS software were also used to rate the units accurately.
Results: The average educational efficiency of medical universities was 0.97 in the study years. The average total productivity based on the Malmquist Index was 1.05, and educational productivity of the universities showed an average growth of 5% over the study years. This growth was 1% from 2011 to 2014 and 10% from 2011 to 2017.
Conclusion: The results of the study showed the acceptable efficiency of the education sector of Iranian medical sciences universities. Moreover, a positive increasing trend was observed in the productivity of the education sector during the study years. Further research using quality and quantity measures are necessary to assess the educational performance of medical universities more accurately.
E Ehsani Chimeh , A Ghadakchi, V Yazdi Feyzabadi, S Sadrossadat , A Mahi, Mh Mehrolhassani, M Iranmanesh,
Volume 14, Issue 0 (1-2019)
Abstract
Background and Objectives: Quantitative and qualitative improvement of human resources inequality have a significant effect on achievement to health system goals. The purpose of this study was to investigate the trend of geographic, supply, and gender distribution inequality of human resources of the Ministry of Health and Medical Education (MOHME) in Iran.
Methods: In this descriptive study, the trend of human resources of the Ministry of Health during the years 2009-2015 was investigated based on gender, level of education, and type of employment. In order to study the inequality, Lorenz curve and Gini coefficient index were used. Data were collected from the Human Resources Office of the Deputy of Management Development and Resources of the MOHME and analyzed by Excel 2013 and Stata-14 software.
Results: In the present study, women had the highest portion with a growth rate of 6.66% in 2015 and a Gini coefficient of 0.29 except in 2011. The highest and lowest growth rate compared to the base year in 2010 was related to specialist doctors (83.12) and general practitioners (-19.61), respectively. The lowest and highest Gini coefficient was related to the associate degree (0.26) and subspecialty (0.45), respectively.
Conclusion: The present study was the first study to investigate the trend of changes in the human resources characteristics of the MOHME at a national level. Since this study only considered the quantity of the trend of human resources changes, it is recommended that the quality of human resources be investigated in the future studies.
V Yazdi Feyzabadi, Mh Mehrolhassani, M Iranmanesh,
Volume 14, Issue 0 (1-2019)
Abstract
Background and Objectives: A significant portion of the total health expenditure is related to medicines. Evaluation of medication system indicators forms a basis for modifying the consumption pattern and cost containment. Therefore, the present study was conducted to investigate the trend of medication consumption indicators in Iran.
Methods: In this descriptive-cross-sectional study, medicine consumption per capita was calculated based on the medicine type, medicine form, and treatment category. The data were extracted from the Pharmacological Statistics of the Food and Drug Administration and the Statistics Center of Iran between 2012 and 2015. Catzung categorization was used for treatment categories. Data were analyzed using descriptive statistics and annual growth index by Excel 2013 software.
Results: During the study years, the highest medicine consumption per capita was related to metformin 500 (18.52), ranitidine 150 (15.45), and adult cold (15.29). The highest average consumption per capita in different treatment categories was related cardiac medications (97.65). The lowest and highest growth rates were related to glibenclamide 80 with -12% in 2014 and metformin 500 with 16.9% in 2013, respectively. Tablets were the most widely used form of medicine.
Conclusion: According to the results, medicine consumption per capita in Iran is higher than developed countries. Cardiac and diabetes medications have a high consumption per capita in Iran compared to other medications. Therefore, in order to rationalize drug prescription, strengthening the clinical evaluation system is recommended by developing and implementing clinical guidelines for common and high-cost diseases.
V Yazdi Feyzabadi, Mh Mehrolhassani, F Monajemi, Ss Pourhosseini,
Volume 14, Issue 0 (1-2019)
Abstract
Background and Objectives: Access to equal educational opportunities is one of the fundamental rights in each country, and elimination of inequalities, especially in the higher education system, is one of the most important priorities. This study aimed to measure educational inequality in the medical sciences sector in Iranian provinces.
Methods: In this study, educational inequality in medical sciences was measured using the Gini coefficient. The study indexes included the number of students, faculty members, staff, majors and educational budget. Data were analyzed using Stata 14 software.
Results: During the study years, the Gini coefficient of the number of female students, male students, and faculty members showed a more or less decreasing trend from 0.51 to 0.46, from 0.53 to 0.46, and from 0.59 to 0.53, respectively. However, the values of inequality in the number of personnel working in educational sector and educational budget showed a slight increasing trend from 0.49 to 0.50 and from 0.53 to 0.54, respectively. According to the academic majors, the lowest Gini coefficient was related to non-continuous bachelor’s degree that varied from 0.13 to 0.17, and the highest value was related to fellowship degree ranging from 0.66 to 0.69 in the study years.
Conclusion: Despite reduced inequality in some educational indicators, there is a high inequality in the number of academic majors of some postgraduate degrees, number of students by gender, and educational budget, which requires policy makers to focus more on balanced distribution of educational infrastructures among provinces to provide equal educational opportunities.
R Dehnavieh, Aa Haghdoost, S Noori Hekmat, M Bamir, A Masoud, A Poursheikhali, Mr Cheshmyazdan,
Volume 14, Issue 0 (1-2019)
Abstract
Background and Objectives: Before any development in scientific health activities, we have to observe its scope and compare it with health sector. Accordingly, the aim of this study was to determine the quality and quantity of the health-prioritized disciplines mentioned in the comprehensive health plan of Iran.
Methods: This scientometric cross-sectional study was done during 2010-2017. The study population was 26 prioritized areas in three categories of survival, excellence, and infrastructure according to comprehensive health plan of Iran in 2010. The data collection tool was the SCImago database. The number of documents, citation indicators, and h-index were analyzed by Excel.
Results: The findings of the research showed that the highest h-index of Iran in the excellence, survival, and infrastructure category was in Nano (90), infectious diseases (67), and systematic ecology (56), respectively. Moreover, the highest ranked citations in three categories of survival, infrastructure, and excellence were related to traditional medicine, family medicine, and dentistry with a global rank of 8, 9 and 15, respectively. In categories of excellence, survival and infrastructure; public health, bioinformatics, and infectious diseases had the highest number of products with 7045, 5371 and 5135 articles.
Conclusion: There has been a marked improvement in the quality and quantity of all the subject categories over time. The general domains of excellence, survival, and infrastructure categories had the highest mean H-index, and the highest average growth rate of scientific productions was related to excellence, infrastructure and survival categories, respectively.
R Dehnavieh, Aa Haghdoost, H Rahimi, A Poursheikhali, M Hasani, N Mirshekari, F Hoseinabadi, S Radmerikhi, Z Khajeh, N Khajehpour, A Masoud, M Balochi, S Noori Hekmat, K Nouhi,
Volume 14, Issue 0 (1-2019)
Abstract
Background and Objectives: Plagiarism is the most prevalent type of scientific misconduct, and various rules and strategies have been proposed to combat it in different countries. A review of other countries' experiences in this area contributes to good policymaking. The present study was conducted to introduce preventive interventions of plagiarism in the leading countries.
Methods: The present study was a qualitative review study of applied practices. In this study, preventive interventions of scientific plagiarism in the 27 European ::::::::union:::::::: countries were studied due to the appropriate coherence and structural similarity at national, organizational, and individual levels. The national-level interventions were analyzed using the content analysis method in mentioned countries.
Results: The results of analyzing the national-level interventions were categorized into eight main themes, including reaching a national agreement on examples of scientific plagiarism and misconduct; policy development; monitoring and supervision; financial support development; development of databanks and software; compiling educational programs for faculty members and students; dissemination and use of successful experiences; and eventually establishment of laws related to scientific misconduct, plagiarism, and punishments activities.
Conclusion: Using preventive interventions at a national level proves the commitment and determination of policymakers to control and prevent plagiarism. Proper use of preventive interventions at a national level strengthens the controlling and preventive infrastructures of this issue at the organizational level, and enhances moral commitment and professional skills among the country's researchers.
T Yousefinezhadi, H Soori, E Mohamadi,
Volume 14, Issue 3 (12-2018)
Abstract
Background and Objectives: The sustainable development goals include 17 goals, one of which is exclusively related to health. The aim of this study was to assess the status of indicators of sustainable development goals related to health in Iran compared to countries in the region and the WHO countries.
Methods: Secondary data were used to examine the status of indicators of sustainable development goals related to health. The data reported by the World Health Organization in 2017, the World Bank, and other available resources at the international levels such as the UN and UNICEF were addressed. The indicators according to which the situation in Iran was below the average of the region were selected for further exploration and analysis. A checklist, which met the research objectives, was used for data collection.
Results: The status of the maternal mortality ratio (25 in 100,000 people), incidence of tuberculosis) 16 in 100,000 people), and incidence of malaria (0.5 in 1000 people) was favorable. The indicators with an unfavorable status in Iran compared to the regional average were the mortality due to natural disasters, unintentional poisoning, road traffic injuries, and alcohol consumption per capita.
Conclusion: Iran has achieved many SDGs goals; however, there is a need for carefully designed plans for controlling and reducing some indicators. Prioritizing indicators in which Iran has had little success should be taken seriously by decision makers.
P Shiri, H Soori, A Razzaghi,
Volume 14, Issue 3 (12-2018)
Abstract
Background and Objectives: Human errors are the most important factors for RTIs, which have been addressed in few quantitative studies. The objective of this study was to calculate the annual population attributable fraction (PAF) of the most important human risk factor for RTIs in the streets and highways of the Great Tehran.
Methods: In this study, the data of 124518 individuals registered in the COM114 form of the Police Information and Communication Technology (ICT- FAVA) data system of the country were employed in 2014. A regression model was applied to estimate the magnitude of the impact of traffic violations of drivers with RTIs using the adjusted relative risk ratio. To estimate the PAF, the prevalence and effect size were calculated based on the risk ratio (RR) using the baseline method or the Miettinen formula.
Results: The PAF of driving in reverse gear and failure to observe safe distance was 1.98% and 1.93%, respectively. Driving in the reverse gear and failure to observe the safe distance increased RTIs by 22% and 23%, respectively. On the highways of the Great Tehran, the largest proportion of PAF was related to driving in reverse gear (1.96%), sudden movement of the car (1.90%), speeding (1.87%). Speeding increased the risk of RTIs by 23%.
Conclusion: Monitoring traffic violations can decrease road crashes by 10% in the streets. Moreover, on highways, use of strategies to prevent traffic violations can decrease RTIs by up to 15%.
H Hatami, H Namdaritabar, M Lotfaliany, S Akbarpour, N Zafari,
Volume 14, Issue 3 (12-2018)
Abstract
Background and Objectives: Hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infections could affect the prognosis of disease in patients with human immunodeficiency virus (HIV)/AIDS. We aimed to determine HBV/HCV co-infection in HIV-positive individuals; and to compare the characteristics of different subgroups of HIV/HBV/HCV.
Methods: In this cross-sectional study, 908 of 2134 newly-registered HIV-positive individuals in the Iranian Ministry of Health in 2016 were recruited. Participants were divided into four subgroups (HBV-/HCV-, HBV+/HCV-, HBV-/HCV+, and HBV+/HCV+). Demographic data and HIV transmission routes were compared between subgroups.
Results: Among908 participants, 505 (60.6%) were HBV-/HCV-, 20 (2.2%) were HBV+/HCV-, 318 (35%) were HBV-/HCV+, and 20 (2.2%) were HBV+/HCV+. Mean age of participants was 36.9 years; 67% were male and 47% were married. The commonest high-risk behaviors were unsafe sex (43.5%) and IV drug-abuse (34.4%). There was no statistically significant difference between the mean ages of subgroups. All HBV+/HCV+ ,92% of HBV-/HCV+, 50% of HBV+/HCV- and 52% of HBV-/HCV- were men and the difference between groups was statistically significant (p-value: <0.001). Seventy four percent of HBV-/HCV+ and 80% of HBV+/HCV+ reported IV drug-abuse. Thirty percent of HBV-/HCV- and 40% of HBV+/HCV- were spouse of HIV-positive or high-risk individuals.
Conclusion: More than 30% of newly registered HIV-positive individuals in the Iranian Ministry of Health in 2016 were co-infected with either HBV or HCV. Frequency of men, marital status and high-risk behaviors were different in various subgroups.
F Ebrahimzadeh, E Hajizadeh, M Birjandi, S Feli, Sh Ghazi,
Volume 14, Issue 3 (12-2018)
Abstract
Background and Objectives: Academic failure is of paramount importance for medical students because it might lead to a decline in scientific level of the community of physicians in the future. This study was conducted to investigate the predictors of academic failure in medical students of Lorestan University of Medical Sciences using classification tree.
Methods: In this cohort study, academic records of all medical students of Lorestan University of Medical Sciences during the academic years of 1999-2008 were selected by census and were followed up until September 2016. Academic failure was defined as having at least one of the components of appropriate grade point average, prolonged graduation, academic probation, dropout, expulsion, and any failure in ccomprehensive exams and the CART classification tree was adopted using the SPSS 22 software to predict it.
Results: The cumulative incidence of academic failure was 26.4% and the most prevalent components were prolonged graduation (21.7%) and academic probation (15.0%). The probability of academic failure was 0.449 in subjects taking guest courses, 0.220 in subjects with no history of guest courses admitted to courses with less than 40 students and admission quotas of zone 1 or 3, and 0.456 in subjects with no history of guest courses admitted to courses with more than 40 students and males.
Conclusion: With respect to identifying the predictors of academic failure, it is suggested that these students be referred to consulting centers of the university or educational supervisors’ moreover, the regulations of taking guest courses in other universities should be revised.
