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Introduction: Undesirable working conditions, insufficient professional development and other labour market pressures have significantly impacted the status of general practitioners (GPs). This study aimed to conduct a situational analysis of GPs in Iran using a forecasting approach until 2025. Methods: Data were collected concurrently through direct contact, data matching among databases and tracking among graduates from four clusters of medical science universities over the past decade. This retrospective longitudinal study determined the status of GPs over consecutive years. Multi-state Markov and binary logistic regression analyses were performed using R and Stata 14. Results: Of 430 graduates over the past decade, 94% were successfully identified. Only 20% of the graduates remained active as GPs. The greatest fluctuations in transfer occurred in the third year after graduation, with the remaining proportion of GPs dropping to less than 50%. The probability of remaining as GPs was 0.76 per year, while the highest transition was observed towards specialisation (0.12). Additionally, 2% of the GPs chose not to work, and less than 1% transitioned to a different specialty. Based on the transfer matrix for 2025, only 19% of the GPs were projected to remain, with the majority (59%) transitioning to specialisation. Conclusion: The transfer probability varies across different years, indicating higher flow rates among GPs. However, only a limited number of GPs are projected to remain until 2025. A comprehensive set of interventions should be considered, spanning the pre-medical stage, during education and after graduation, to mitigate the factors contributing to GPs leaving their profession.
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BACKGROUND: Cesarean section (C-section) rates, deemed a critical health indicator, have experienced a historical increase. The advent of the COVID-19 pandemic significantly impacted healthcare patterns including delays or lack of follow-up in treatment and an increased number of patients with acute problems in hospitals. This study aimed to explore whether the observed surge is a genuine consequence of pandemic-related factors. METHODS: This study employs an Interrupted Time Series (ITS) design to analyze monthly C-section rates from March 2018 to January 2023 in Kurdistan province, Iran. Segmented regression modeling is utilized for robust data analysis. RESULTS: The C-section rate did not show a significant change immediately after the onset of COVID-19. However, the monthly trend increased significantly during the post-pandemic period (p < 0.05). Among primigravid women, a significant monthly increase was observed before February 2020 (p < 0.05). No significant change was observed in the level or trend of C-section rates among primigravid women after the onset of COVID-19. CONCLUSION: This study underscores the significant and enduring impact of the COVID-19 pandemic in further increasing the C-section rates over the long term, the observed variations in C-section rates among primigravid women indicate that the COVID-19 pandemic had no statistically significant impact.