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Assessing the Appropriate Utilization of CT Scan in Triage Units
Dr Zahra Meidani, Gholamabas Moosavi, Dr Yaser Hamidian, Dr Mehrdad Farzandipour, Dr Akbar Aliasgharzadeh, Zahra Nazemi Bidgoli,
Volume 16, Issue 2 (7-2017)
Abstract

Background: Regarding to the importance of controlling health care expenditure, necessity for proper distribution of health care resources and appropriate utilization of hospital resources through inappropriate services reduction for patients, this study aimed to assess suitability of brain CT scans, based on American College of Radiologists (ACR) appropriateness criteria in Shahid Beheshti Hospital affiliated to Kashan University of Medical Sciences (KAUMS).

Materials and Methods: This cross sectional and retrospective study was conducted in internal and surgery triage unites of an academic hospital in KAUMS to determine the appropriateness of brain CT scans. A General physician reviewed 361 medical records of patients through the check list based on ACR appropriateness criteria. Collected data was classified in three areas including appropriate, possibly appropriate and inappropriate. Data was analyzed using SPSS through descriptive statistics such as Index of dispersion  and chi-square test.

Results: Study findings revealed that among delivered CT scans, 310 (85.9%) appropriate, 38(10.5%) possibly appropriate and 13(3.6%) were inappropriate. The maximum and the minimum inappropriate brain CT scans rate 4 (4.17 %) were related to patients with Ataxia and zero (0 %) were related to patients with Headache, respectively.

Conclusion: Based on ACR appropriateness criteria, Brain CT scans were not utilized appropriately. In order to depict utilization review of radiology procedure in Iran, Developing a national guideline is necessary. To detect the effective factors regarding formulating targeted intervention, more comprehensive studies in various hospitals, different specialty and radiology modality seems necessary. 


The utilization of healthcare services by refugees and migrants during the COVID-19 epidemic from health centers affiliated with Iran University of Medical Sciences
Asgar Aghaei Hashjin, Ali Nemati, Seyed Mohammad Tabatabaee Jabali, Pouria Farrokhi,
Volume 22, Issue 4 (1-2024)
Abstract
Background and purpose: Iran is ranked among the top ten nations in the world for hosting a large number of migrants and refugees. During the COVID-19 outbreak, refugees and migrants were among the most vulnerable groups. This study aimed to investigate the extent of healthcare service utilization by refugees and migrants during the COVID-19 pandemic in healthcare centers affiliated with Iran University of Medical Sciences
Methods: This quasi-experimental study was conducted in 2021 in Tehran. The research environment included all healthcare networks and general and specialized hospitals. Data were collected through document review and registered information in the Sina system. All provided services were categorized into four groups: primary care, outpatient, emergency, and inpatient services. Data analysis was performed using the Chow test and Interrupted Time Series model with the Wats and Sctest software packages in R version 4.3.0.
Results: The decrease in utilization of outpatient, emergency, and inpatient services by refugees and migrants was significant (P-value < 0.001), whereas the decrease in primary care services was not significant. Additionally, after the onset of COVID-19, only the utilization of inpatient services showed a significant increasing trend (P-value < 0.013).
Conclusion: During the COVID-19 pandemic, the utilization of all healthcare services by refugees and migrants, including primary, outpatient, emergency, and inpatient care, decreased. It is recommended to provide complete insurance coverage for refugees, offer free treatment for impoverished refugees, increase awareness among refugees to encourage greater use of health services, reduce existing social and economic barriers, and facilitate interaction between healthcare providers and refugees.
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