Hospital
بیمارستان
jhosp
Medical Sciences
http://jhosp.tums.ac.ir
211
godadmin
2008-1928
2228-7450
000
000
000
000
000
fa
jalali
1402
10
1
gregorian
2024
1
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22
4
online
1
fulltext
fa
بررسی بهرهمندی پناهندگان و مهاجران از خدمات بهداشتی درمانی در دوره همهگیری کرونا از مراکز ارائهدهنده خدمات سلامت تحت پوشش دانشگاه علوم پزشکی ایران
The utilization of healthcare services by refugees and migrants during the COVID-19 epidemic from health centers affiliated with Iran University of Medical Sciences
سیاست گذاری ، برنامه ریزی و رهبری و مدیریت در بیمارستان
سیاست گذاری ، برنامه ریزی و رهبری و مدیریت در بیمارستان
مقاله ی اصیل
Original Article
<span style="font-size:11.5pt"><span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">زمینه و هدف</span></span></span></b><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">: کشور ایران یکی از 10 کشور جهان از منظر میزبانی از جمعیت پناهندگان و مهاجران در جهان محسوب میگردد. پناهندگان و مهاجران از مهمترین گروه</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">های آسیب</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">پذیر در همه</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">گیری کرونا بودند. مطالعه حاضر باهدف بررسی میزان بهره-مندی پناهندگان و مهاجران از خدمات سلامت در همه</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">گیری کرونا در مراکز بهداشتی درمانی وابسته به دانشگاه علوم پزشکی ایران انجام گرفت.</span></span></span></span></span></span></span></span><br>
<span style="font-size:11.5pt"><span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">مواد و روش</span></span></span></b><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"></span></span></span></b><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">ها</span></span></span></b><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">: این مطالعه نیمه تجربی در سال 1400 در شهر تهران انجام گرفت. محیط پژوهش شامل تمام شبکه</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">های بهداشت و درمان، بیمارستان</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">های عمومی و تخصصی بود. داده</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">ها از طریق بررسی اسناد و اطلاعات ثبتشده در سامانه سینا جمعآوری شدند. کل خدمات ارائهشده در چهار گروه خدمات مراقبت</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">های اولیه، سرپایی، اورژانس و بستری بیمارستانی دستهبندی شدند. برای تحلیل دادهها از آزمون </span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:150%">chow</span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"> و مدل </span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:150%">Interrupted time series</span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"> با استفاده از بسته</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">های نرمافزاری </span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:150%">Wats</span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"> و </span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:150%">Sctest</span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"> با نرمافزار</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:150%">R</span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"> نسخه4.3.0 انجام گرفت.</span></span></span></span></span></span></span></span><br>
<span style="font-size:11.5pt"><span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.1pt">نتایج: </span></span></span></span></b><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.1pt">با شروع همهگیری کرونا، کاهش در میزان بهرهمندی پناهندگان و مهاجران از خدمات سرپایی، اورژانس و بستری بیمارستانی معنیدار (001/0</span></span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:150%"><span style="letter-spacing:-.1pt">P-value</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.1pt"><</span></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.1pt">) بوده است درحالیکه این کاهش برای خدمات مراقبتهای اولیه معنیدار گزارش نشد. همچنین بعد از شروع همهگیری کرونا فقط میزان بهرهمندی از خدمات بستری (013/0</span></span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:150%"><span style="letter-spacing:-.1pt">P-value<</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.1pt">) یکروند افزایشی معنیدار را نشان داد.</span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11.5pt"><span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">نتیجه</span></span></span></b><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"></span></span></span></b><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">گیری</span></span></span></b><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">: با شیوع همه</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">گیری کرونا میزان بهره</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">مندی پناهندگان و مهاجران از کلیه خدمات سلامت شامل مراقبت</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">های اولیه، سرپایی، اورژانس و بستری کاهشیافته است. پوشش بیمه</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">ای کامل پناهندگان، درمان رایگان پناهندگان کمبضاعت، افزایش آگاهی پناهندگان برای استفاده بیشتر از خدمات سلامت، کاهش موانع اجتماعی اقتصادی موجود و تسهیل تعامل بین ارائهدهندگان و پناهندگان پیشنهاد می</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">گردد.</span></span></span></span></span></span></span></span>
<span style="font-size:11.5pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:14.5pt"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span style="letter-spacing:-.2pt">Background and purpose</span></b><span style="letter-spacing:-.2pt">: 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</span></span></span></span></span></span></span><br>
<span style="font-size:11.5pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:14.5pt"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span style="letter-spacing:-.2pt">Methods</span></b><span style="letter-spacing:-.2pt">: 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</span><span b="" dir="RTL" lang="FA" style="font-family:" zar=""><span style="letter-spacing:-.2pt">.</span></span><span style="letter-spacing:-.2pt"></span></span></span></span></span></span></span><br>
<span style="font-size:11.5pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:14.5pt"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span style="letter-spacing:-.2pt">Results</span></b><span style="letter-spacing:-.2pt">: 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).</span></span></span></span></span></span></span><br>
<span style="font-size:11.5pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:14.5pt"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span style="letter-spacing:-.2pt">Conclusion</span></b><span style="letter-spacing:-.2pt">: 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</span><span b="" dir="RTL" lang="FA" style="font-family:" zar=""><span style="letter-spacing:-.2pt">.</span></span><span style="letter-spacing:-.2pt"></span></span></span></span></span></span></span>
بهرهمندی, خدمات بهداشتی درمانی, کرونا, پناهندگان, مهاجران
Utilization, Healthcare Services, Covid-19, Refugees, Migrants
367
383
http://jhosp.tums.ac.ir/browse.php?a_code=A-10-1723-1&slc_lang=fa&sid=1
Asgar
Aghaei Hashjin
عسگر
آقایی هشجین
aghaei.a@iums.ac.ir