Healthcare Admnistration

As social health is a condition-driven, dynamic and fluid concept, it seems necessary to construct and obtain a national and relevant concept of it for every society. Providing an empirical back up for Iran's concept of social health was the aim of the present study. This study is an ecologic study in which available data for 30 provinces of Iran in 2007 were analyzed. In order to prove construct validity and obtain a social health index, an exploratory factor analysis was conducted on six indicators of population growth, willful murder, poverty, unemployment, insurance coverage and literacy. Following the factor analysis, two factors of Diathesis (made up of high population growth, poverty, low insurance coverage and illiteracy) and Problem (made up of unemployment and willful murder) were extracted. The diathesis and problem explained 48.6 and 19.6% of social health variance respectively. From provinces, Sistan & Baluchistan had the highest rate of poverty and violence and the...

‫ﻣﻘﺪﻣﻪ‬ : ‫ﺑـﺎ‬ ‫ﺗﻨﮕـﺎﺗﻨﮕﻲ‬ ‫و‬ ‫ﻣﺘﻘﺎﺑـﻞ‬ ‫راﺑﻄـﺔ‬ ‫ﻛـﺸﻮرﻫﺎ‬ ‫ﻳـﺎﻓﺘﮕﻲ‬ ‫ﺗﻮﺳﻌﻪ‬ ‫ﺳﻄﺢ‬ ‫و‬ ‫ﺳﻼﻣﺖ‬ ‫وﺿﻌﻴﺖ‬ ‫دارﻧﺪ‬ ‫ﻳﻜﺪﻳﮕﺮ‬ . ‫اﻗﺘـﺼﺎ‬ ‫ﺗﻮﺳﻌﺔ‬ ‫و‬ ‫رﺷﺪ‬ ‫اﻓﺰاﻳﺶ‬ ‫و‬ ‫اﺳﺖ‬ ‫ﭘﺎﻳﺪار‬ ‫ﺗﻮﺳﻌﺔ‬ ‫اﺳﺎس‬ ‫ﺳﺎﻟﻢ،‬ ‫اﻧﺴﺎن‬ ‫دي،‬ ‫ﻛﺸﻮرﻫﺎﺳﺖ‬ ‫ﺳﻼﻣﺖ‬ ‫وﺿﻌﻴﺖ‬ ‫ﺑﺮ‬ ‫ﻣﺆﺛﺮ‬ ‫و‬ ‫اﺻﻠﻲ‬ ‫ﻋﻮاﻣﻞ‬ ‫از‬ ‫ﻳﻜﻲ‬ . ‫روش‬ : ‫ﻛـﺸﻮرﻫﺎي‬ ‫در‬ ‫زﻧـﺪﮔﻲ‬ ‫ﺑﻪ‬ ‫اﻣﻴﺪ‬ ‫ﺑﺮ‬ ‫ﻣﺆﺛﺮ‬ ‫اﺟﺘﻤﺎﻋﻲ‬ ‫و‬ ‫اﻗﺘﺼﺎدي‬ ‫ﻋﻮاﻣﻞ‬ ‫ﻣﻄﺎﻟﻌﻪ،‬ ‫اﻳﻦ‬ ‫در‬ ‫واﻗﻊ‬ ‫رﮔﺮﺳـﻴﻮن‬ ‫ﻣـﺪل‬ ‫از‬ ‫اﺳـﺘﻔﺎده‬ ‫ﺑﺎ‬ ‫ﺟﻬﺎﻧﻲ،‬ ‫ﺑﻬﺪاﺷﺖ‬ ‫ﺳﺎزﻣﺎن‬ ‫آرام،‬ ‫اﻗﻴﺎﻧﻮس‬ ‫ﻏﺮب‬ ‫ﻣﻨﻄﻘﺔ‬ ‫در‬ ‫ﺑﻬﺮه‬ ‫ﺑﺎ‬ ‫و‬ ‫ﭼﻨﺪﮔﺎﻧﻪ‬ ‫ﺧﻄﻲ‬ ‫از‬ ‫ﮔﻴﺮي‬ ‫داده‬ ‫ﺗﺮﻛﻴﺒﻲ‬ ‫ﻫﺎي‬ ) 1995 ‫ﺗـﺎ‬ 2007 ( ‫ﺷـﺪ‬ ‫ﺑﺮرﺳـﻲ‬ . ‫ﺳـﭙﺲ‬ ‫ﺛﺎﺑﺖ‬ ‫اﺛﺮات‬ ‫روش‬ ) ‫ﻣﺠﺎزي‬ ‫ﻣﺘﻐﻴﺮﻫﺎي‬ ‫ﺑﺎ‬ ‫ﻣﺮﺑﻌﺎت‬ ‫ﺣﺪاﻗﻞ‬ ( ‫ﺑـﻪ‬ ‫ﻫﺎﺳﻤﻦ‬ ‫آزﻣﻮن‬ ‫ﻧﺘﺎﻳﺞ‬ ‫ﺑﺮاﺳﺎس‬ ‫ﮔﺮدﻳﺪ‬ ‫اﻧﺘﺨﺎب‬ ‫ﻣﺪل‬ ‫ﺑﺮآورد‬ ‫ﻣﻨﻈﻮر‬ . ‫ﻳﺎﻓﺘﻪ‬ ‫ﻫﺎ‬ : ‫و‬ ‫ﻣﺜﺒـﺖ‬ ‫اﺛـﺮات‬ ‫دﻫﻨـﺪة‬ ‫ﻧـﺸﺎن‬ ‫آرام،‬ ‫اﻗﻴﺎﻧﻮس‬ ‫ﻏﺮب‬ ‫ﻣﻨﻄﻘﻪ‬ ‫ﺑﺮاي‬ ‫ﻣﺪل‬ ‫ﺑﺮآورد‬ ‫ﻧﺘﺎﻳﺞ‬ ‫اﺷﺘ‬ ‫آﻣﻮزش،‬ ‫ﺳﺮاﻧﻪ،‬ ‫درآﻣﺪ‬ ‫ﻣﺘﻐﻴﺮﻫﺎي‬ ‫ﻣﻌﻨﺎدار‬ ‫اﻳﻤﻨـﻲ‬ ‫ﺳـﻼﻣﺖ،‬ ‫ﻣﺨﺎرج‬ ‫ﻐﺎل،‬ ‫ﺑﺮاﺑـﺮ‬ ‫در‬ ‫ﺳـﺎزي‬ ‫ﺳﺮﺧﻚ‬ ) 01 / 0 p< ( ‫ﺷﻬﺮﻧﺸﻴﻨﻲ‬ ‫و‬ ) 05 / 0 p< ( ‫ﺑﻮد‬ ‫زﻧﺪﮔﻲ‬ ‫ﺑﻪ‬ ‫اﻣﻴﺪ‬ ‫ﺑﺮ‬ . ‫ﺑﺤﺚ‬ : ‫ﺳﻴﺎﺳﺖ‬ ‫ﺑﻪ‬ ‫ﺗﻮﺟﻪ‬ ‫ﺑﺮﻧﺎﻣـﻪ‬ ‫و‬ ‫اﺟﺘﻤـﺎﻋﻲ‬ ‫و‬ ‫اﻗﺘـﺼﺎدي‬ ‫ﺗﻮﺳـﻌﻪ‬ ‫ﺑـﻪ‬ ‫ﻣﺮﺑﻮط‬ ‫ﻫﺎي‬ ‫ﺗﺜﺒﻴـﺖ‬ ‫ﻫـﺎي‬ ‫ﺳﻴﺎﺳﺖ‬ ‫ﻫﻤﭽﻨﻴﻦ‬ ‫و‬ ‫آﻣﻮزش‬ ‫ﺳﻄﺢ‬ ‫اﻓﺰاﻳﺶ‬ ‫و‬ ‫ﺑﻴﻜﺎري‬ ‫ﻛﺎﻫﺶ‬ ‫ﺗﻮﻟﻴﺪ،‬ ‫اﻓﺰاﻳﺶ‬ ‫ﻣﺜﻞ‬ ‫اﻗﺘﺼﺎدي‬ ‫ﻫـﺎي‬ ‫ار‬ ‫ﺑﻪ‬ ‫ﻣﺮﺑﻮط‬ ‫ﺳﻴﺴﺘﻢ‬ ‫ﻛﺎراﻳﻲ‬ ‫ﺗﻘﺎي‬ ‫ﺳﻼﻣﺖ‬ ‫ﻣﺮاﻗﺒﺖ‬ ‫ﻫﺎي‬ ‫وﻳﮋه‬ ‫ﺑﻪ‬ ‫ﺷﻴﻮه‬ ‫اﺻﻼح‬ ‫و‬ ‫ﻣـﺎﻟﻲ‬ ‫ﺗﺄﻣﻴﻦ‬ ‫ﻫﺎي‬ ‫راه‬ ‫ﺳﻼﻣﺖ‬ ‫ﺧﺪﻣﺎت‬ ‫اراﺋﺔ‬ ‫ﺑﻮد‬ ‫ﺧﻮاﻫﺪ‬ ‫ﻣﻨﺎﻃﻖ‬ ‫اﻳﻦ‬ ‫ﻛﺸﻮرﻫﺎي‬ ‫در‬ ‫ﻋﻤﺮ‬ ‫ﻃﻮل‬ ‫اﻓﺰاﻳﺶ‬ ‫ﮔﺸﺎي‬ . ‫واژه‬ ‫ﻛﻠﻴﺪ‬ ‫ﻫﺎ‬ : ‫ﻛﻨﻨﺪه‬ ‫ﺗﻌﻴﻴﻦ‬ ‫زﻧﺪﮔﻲ،‬ ‫ﺑﻪ‬ ‫اﻣﻴﺪ‬ ‫داده‬ ‫ﺳﻼﻣﺖ،‬ ‫اﺟﺘﻤﺎﻋﻲ‬ ‫ﻫﺎي‬ ‫ﻫﺎي‬ ‫ﺗﺮﻛﻴﺒﻲ‬ ‫آرام‬ ‫اﻗﻴﺎﻧﻮس‬ ‫ﻏﺮب‬ ‫ﻣﻨﻄﻘﺔ‬ ، .

Background: Health and nutrition are important aspects in the analysis of
households’ multidimensional poverty. The present research investigated poverty
in Tehran’s households through a cohort approach. In this regard, households’
financial participation about health costs and food intake calories were analyzed.
Methods: Households’ data of costs – income survey were then collected. Health
and nutrition poverty trend was investigated through generational approach, index
of poverty "Foster, Greer, Turbak", and in the period of 1984-2014 by dividing
Tehrany families into eight various age groups. Excell and Stata11 were applied to
process and calculate the indices.
Results: During the study years, the highest level of health poverty (29%) in 1999
was in age range of 21-26 and the highest level of nutrition poverty in 1984 (65%)
was in age range of 42-46. There has been an ascending trend of health and
nutrition poverty at the end of the Fourth Development Plan (2009) up to 2013 for
all age groups.
Conclusion: Generally, rate and severity of health and nutrition poverty had many
fluctuations among different age groups of Tehrani households’ heads. This rate
has raised during recent years which indicates lack of stable and coherent social
policies to reduce households’ exposures with catastrophic health care costs and
funding of the food aid needs

Background: Social health is a fundamental dimension of health, and plays an important role in promoting social well-being. Research in social health needs reliable and valid tools, which should be also applicable to any type of social context. This study was aimed to develop an effective social health questionnaire for the social context of Iranian society. Methods: The study was conducted in three phases: 1) A preliminary 43-item questionnaire was created based on an extensive literature review; 2) The questionnaire was validated. Firstly, social health experts evaluated content validity; secondly, an exploratory factor analysis and Cronbach's coefficient test were used; 3) The questionnaire was tested in a representative sample of 500 persons, who were selected through a multistage sampling in Tehran, Iran, in 2015. All analyses were carried out using SPSS software (version 22). Results: We developed the Iranian Social Health Questionnaire (IrSHQ) consisting of a 29-item questionnaire organized in seven subscales -'Social interaction', 'social responsibility', 'conscientiousness', 'attitude to society', 'empathy', 'family relationship', and 'social participation'−. Internal consistency using Cronbach's alpha coefficient was 0.86. Validity and reliability of our questionnaire were confirmed. Conclusion: Due to the size and diversity of participants, validity of results, compliance with Iranian culture, and its relative shortness, the IrSHQ appears to be a very useful instrument for measuring individual's social health in the Iranian social context. Introduzione: La salute sociale è una dimensione fondamentale della salute e gioca un ruolo importante nella promozione del benessere sociale. La ricerca sulla salute sociale necessita di strumenti validi ed affidabili, che dovrebbero anche essere applicabili in ogni tipo di contesto sociale. Questo studio è stato ideato per sviluppare un efficace questionario sulla salute sociale adatto al contesto sociale iraniano. Metodi: Lo studio è stata condotto in tre fasi: 1) una versione preliminare a 43 item del questionario è stata preparata sulla base di un' estesa revisione della letteratura. 2) Il questionario è stato validato. Per prima cosa, esperti del settore hanno valutato la validità del contenuto; poi sono state effettuate l'analisi fattoriale esplorativa ed il calcolo del coefficiente di Cronbach. 3) Il questionario è stato testato su di un campione rappresentativo della popolazione iraniana composto da 500 persone selezionate attraverso un campionamento multi-stadio effettuato nella città di Teheran, in Iran, nel 2015. Tutte le analisi sono state effettuate utilizzando il software SPSS (versione 22). Risultati: Abbiamo sviluppato il questionario "Iranian Social Health Questionnaire" (IrSHQ), composto da 29 item organizzati in sette sottoscale denominate "Interazione sociale", "Responsabilità sociale", "Coscienziosità", "Attitudine verso la società", "Empatia", "Relazioni familiari" e "Partecipazione sociale". La consistenza interna usando l'alpha di Cronbach è stata pari a 0,86. La validità e l'affidabilità del nostro questionario sono state confermate. Conclusione: In considerazione delle dimensioni del campione, della diversità dei partecipanti, della validità dei risultati, della conformità alla cultura iraniana e della sua relativa brevità, il questionario "IrSHQ" sembra essere uno strumento molto utile per misurare il grado di salute sociale dell'individuo nella società iraniana.

Iran's trends indicate that substantial reductions have been made in under-five mortality rates. Whether this progress has been accompanied by an increasing or decreasing of the under-five mortality inequality between socioeconomic quintiles is unknown.

Background: We aimed to measure changes in socioeconomic inequality in child mortality in Iran. Methods: A secondary data analysis of two Demographic and Health Surveys (DHS 2000 and was undertaken. Neonatal, infant and under-5 mortality rates were estimated directly from complete birth history. Economic quintiles were constructed using principal component analysis. Changes in inequality were measured using odds ratios, mortality rates, and concentration curves and indices. Results: Based on the compared measures, inequalities in neonatal, infant, and under-5 mortality declined between the two surveys. The poorest-to-richest neonatal, infant and under-5 mortality odds ratios in 2000 were 1.69 (95% CI= 1.3-2.07), 2.85 (95% CI= 1.96-4.1) and 1.98 (95% CI= 1.64-2.3), respectively. Whereas these mortality odds ratios in 2010 had fallen to 1.65 (95% CI= 0.95-2.9), 1.47 (95% CI=0.5-4) and 1.85 (95% CI=1.13-3), respectively. Moreover, mortality rates in all economic quintiles experienced a decreasing trend. Neonatal, infant, and under-5 mortality concentration indices in 2000 were -0.15, -0.26, and -0.17 respectively. Whereas concentration indices in 2010 had dropped to -0.13, -0.11, and -0.14, respectively. Concentration curves dominance test revealed that there was a statistically significant reduction in inequality in infant and under-5 mortalities. Conclusion: Despite substantial reduction in child mortality rates and narrowing of the gap between poor and rich people, socioeconomic inequality in child mortalities disfavoring worse-off groups still exists. Combination of child health-related efforts that aim to reach to those children born in poor households alongside with pro-equity programs in other sectors of society may further reduce infant, under-5, and particularly neonatal mortality across economic quintiles in Iran.

Kazim Hospital, Isfahan, Iran During a 4-year period. Materials and Methods: The current descriptive-analytic study was performed using data from all burned patients hospitalized in Imam Musa Kazem Hospital in Isfahan during 4 years between 2014-2017. The data used for the burn patients records and the HIS system were collected, prepared, and analyzed in two descriptive and inferential analyses. Results: Of the 3,290 burn patients, 22.49% died. The highest number of burns occurred in 2014 (27.08%) in 26-40 year-old (33.59%), married (49.91%), illiterate (30.42%), low income (48.63%), unemployed (34.66%), and Shia (98.24%) men (67.29%) patients. Moreover, most of patients came from cities from the other provinces (42.1%), lived in urban areas (54.59%), had social security insurance (41.52%), and third degree burns (98.33%), burnt at home (70.09%), and the total body surface area burned (TBSA) was ≤30% (49.76%). The correlation of all variables with mortality caused by burn were statistically significant (P<0.001) except for years of admission (P= 0.784) and religion (P= 0.516). Conclusion: The burning and the mortality caused by burn, in addition to healthcare and medicine aspects, is a social phenomenon. Therefore, the recognition of social factors as the causes behind the causes of burns can lead to the appropriate and effective policies aimed to reduce burns and related mortalities.

provincial level. It is vital to consider inequality in addition to average level of childhood development across Iranian provinces to reach a more comprehensive understanding of childhood development for public policy action in the country.

In hospitals, it is of high significance to give due attention to the behavioral and social status of nurses as the key staff of the medical environment, and this can guarantee the desirable quantity and quality in providing services for the patients. The present study was conducted to investigate the relationship between social health and work conscience in nurses working in the selected hospitals of Shiraz University of Medical Sciences in 2017. Methods: The sample of the present study includes 569 nurses working in the 5 selected hospitals located in Shiraz, Iran. The sampling was conducted with a random stratified sampling in proportion to the strata size. Questionnaires of work conscience and social health as well as the questionnaire of pairwise comparison and decision matrix were used for collecting the data. Structural equation modelling was applied to test the research questions using SmartPLS 3. Results: The findings indicated that there is a significant statistical relationship between social health and work conscience (0.483). Moreover, other findings of the present study indicated that there is a significant relationship between all 7 aspects of social health and work conscience. The effect of social responsibility, conscientiousness, family relationship, attitude to society, social participation, empathy, and social interaction on work conscience was 0.366, 0.209, 0.203, 0.299, 0.147, 0.126, and 0.473 respectively. Conclusion: Since social health and its aspects have significant effects on work conscience, the hospitals are required to give due attention to the nurses' social health.

Middle East/Africa, respectively . Another study reported an IBS prevalence of 10 to 15% and 5 to 10% in Western and Asian countries, respectively . A systematic review also reported that the prevalence of IBS ranged from 1.1 to 25% in Iran . IBS has various adverse effects on a patient's social life and work, such as increased absenteeism, reduced quality of life, and substantial medical costs .

There are several studies regarding the predictors or risk factors of unintended pregnancy, but only a small number of studies have been carried out concerning the socio-economic factors influencing the unintended pregnancy rate. This study aimed to determine the socioeconomic inequality of unintended pregnancy in Tehran, Iran, as a developing country. In this hospital based cross-sectional study, 5152 deliveries from 103 hospitals in Tehran (the capital of Iran) were included in the analysis in July 2015. Socioeconomic status (SES) was measured through an asset-based method and principal component analysis was carried out to calculate the household SES. The concentration index and curve was used to measure SES inequality in unintended pregnancy, and then decomposed into its determinants. The data was analyzed by statistical Stata software. The Wagstaff normalized concentration index of unintended pregnancy (- 0.108 (95% Confidence Interval (CI) = - 0.119 ~ - 0.054)) endorses that u...

To investigate associations between economic inequality in preterm delivery. The present secondary analysis included cross-sectional data collected in interviews with patients following delivery at 103 hospitals in Tehran, Iran, between July 6 and 21, 2015. Principal component analysis was used to measure the socioeconomic status of participants and the concentration index was used to measure inequalities in preterm delivery among patients of different socioeconomic status. Data were included from 5170 patients. The concentration index for preterm delivery was 0.087 (95% confidence interval 0.036-0.134), indicating that preterm deliveries were concentrated among patients with higher socioeconomic status. Higher socioeconomic status (94%), younger maternal age (29%), younger paternal age (21%), and being a homemaker (17%) had the highest positive contributions to the measured inequalities in preterm deliveries; vaginal delivery (-58%) had the highest negative contribution. Preterm de...

Objective:The present study aimed to assess and decompose the socio-economic inequality in unhealthy snacks consumption among adolescent students in Kerman, Iran.Design:The data were obtained from a cross-sectional study. Principal component analysis was done to measure the socio-economic status (SES) of the adolescents’ families and the normalized concentration index (NCI) was used to measure the inequality in unhealthy snacks consumption among adolescent students of different SES. The contributions of environmental and individual explanatory variables to inequality were assessed by decomposing the concentration index.Setting:Forty secondary schools of Kerman Province in Iran in 2015.Participants:Eighth-grade adolescent students (n 1320).Results:The data of 1242 adolescent students were completed for the current study. Unhealthy snacks consumption was unequally distributed among adolescent students and was concentrated mainly among the high-SES adolescents (NCI = 0·179; 95 % CI 0·0...

Background: While child health inequality is emerging as one of the main issues in child health policies, the identification of factors which intensify this kind of inequality via the qualitative method has attracted little attention. Objectives: The aim of the study was to identify the equality issues in child health policies in Iran. Methods: Data were collected using semi-structured interviews with 19 key informants from July 2015 to December 2016. A purposeful and snowball sampling method was used to select participants. Using MAXQDA 12, the recorded interviews were transcribed verbatim and thematically analyzed. Results: Four themes and fifteen subthemes were extracted in terms of equality issues in child health policies, including: (1) implementation of child health policies (rational distribution, addressing rural and underserved regions and full access), (2) strengths of child health policies (comprehensive and integrated healthcare, educating mothers, and targeting programs based on the burden of disease), (3) challenges of child health policies (health information system and faults in data registration, complications in child health education, traditional beliefs and believing in fate, and ignoring social determinants of health), and (4) priority actions (improving fathers' health literacy, promoting socioeconomic and cultural status, enhancing health information system, suburban and rural areas, and regional planning). Conclusions: Reliance on comprehensive and integrated care, health education and targeting program and diminishing challenges and weaknesses can be considered as a policy guide aiming to reduce inequality in child health outcomes. Also, besides addressing executive issues, challenges, and strengths; priorities as policy entry points should be considered simultaneously.