RESUMEN
Background: The fair wage to specialist physicians and nurses can enhance their job motivation, quality of work, job satisfaction level, and improve the delivery of services to patients. The present study aimed to compare the proportion of changes in earnings of specialist physicians and nurses before and after implementing the Iran's New Tariffs Book and compare their average income with a number of selected countries. Methods: This descriptive-analytical study was conducted cross-sectional in the hospitals affiliated to Iran University of Medical Sciences (IUMS) in 2016. Six months before and after the announcement and implementation of the Iran's New Tariffs Book, the relative values of healthcare services were compared. Study population included all specialist physicians and nurses working in the hospitals affiliated to IUMS. Sample size was determined by sampling formula. Results: The proportion of changes in the income of medical specialists and nurses after establishing the book varied between 8% and 184%. Based on our findings, the highest increases were observed in internal medicine (184%), surgery (160%), gastroenterology (153%), and pediatrics (120%), whereas, the lowest ones belonged to ophthalmology (8%), emergency medicine (11%), neurology (24%) and anesthesia (32%). Nurses' income was surged by 43%. Conclusion: Pursuant to the findings, the income belonged to all examined medical specialists and nursing groups has increased after implementing the Iran's New Tariffs Book. The result suggested that income differences among groups have been broadened after the implementation of the Book. There was a wide and significant difference in specialist physicians' income vis-à-vis nursing groups' income before and after establishing the New Book.
RESUMEN
Background: Nosocomial infections represent a serious public health concern worldwide, and, especially, in developing countries where, due to financial constraints, it is difficult to control infections. This study aimed to review and assess the prevalence of nosocomial infections in Iran. Methods: Different databases were searched between January 2000 and December 2017. To determine the pooled prevalence, the stochastic DerSimonian-Laird model was used, computing the effect size with its 95% confidence interval. To examine the heterogeneity among studies, the I2 test were conducted. The reporting of observational studies in epidemiology (STROBE) checklist was used to assess the methodological quality of observational studies. To further investigate the source of heterogeneity, meta-regression analyses stratified by publication year, sample size and duration of hospitalization in the hospital were carried out. Results: 52 studies were included. Based on the random-effects model, the overall prevalence of nosocomial infection in Iran was 4.5% [95% CI: 3.5 to 5.7] with a high, statistically significant heterogeneity (I2=99.82%). A sensitivity analysis was performed to ensure the stability results. After removing each study, results did not change. A cumulative meta-analysis of the included studies was performed based on year of publication and the results did not change. In the present study, a high rate of infections caused by Klebsiella pneumoniae (urinary tract, respiratory tract, and bloodstream infections) was found. Conclusion: Preventing and reducing hospital infections can significantly impact on reducing mortality and health-related costs. Implementing ad hoc programs, such as training healthcare staff on admission to the hospital, may play an important role in reducing infections spreading.