Investigating the access barriers to oral and dental health services for children from the perspective of parents attending the health centers of Kerman.

Background: Oral health plays a key role in people's overall health. Dental caries is the most important problem in children's oral health. Despite significant advances made in the area of oral health around the world, there is inequality in access to oral health within Iran and abroad, and this is considered a public health challenge. This study was conducted to investigate the access barriers to children's oral health services from the perspective of parents attending the health centers of Kerman, Iran. Materials and Methods: The present descriptive-analytical study was carried out, as a cross-sectional survey, on 410 parents of children living in Kerman, Iran. The data were collected by access barriers questionnaire, and then were analyzed by SPSS software using descriptive statistical methods and the multiple linear regression test. Confidence interval (CI) in this study was 95% (95% CI). Results: The most common access barrier to children's oral health was the high treatment cost. The access barriers to children's oral health services were significantly associated with parental education (P = 0.00), maternal employment (P = 0.04), supplementary insurance (P = 0.00), and family income (P = 0.01). Parental satisfaction was also significantly correlated to the child's sex (P = 0.04), supplementary insurance (P = 0.04), and number of filled teeth (P = 0.04). The mean score of parental satisfaction was 1.83 ± 0.34; within the range of 1-3 from satisfied to dissatisfied. Conclusion: The cost of dental treatment services high and there are many barriers to accessing children's oral health.

A Fuzzy BWM-TOPSIS Framework for Identifying and Prioritizing Measures to Overcome Obstacles to the Regionalization of Iranian Healthcare Services.

Background: One of the most effective strategies to improve the access of community members to health services is to regionalize health services. The purpose of this study is to examine and prioritize measures that could help to counteract obstacles and problems in implementing the regionalization of healthcare in Iran. Methods: The study relied on a mixed research method, including qualitative and quantitative phases. First, by conducting semi-structured interviews and analyzing them through qualitative content analysis, the obstacles and measures were identified. In the quantitative phase, the obstacles identified were weighted using the fuzzy best-worst method (FBWM), and the measures were then prioritized through the fuzzy TOPSIS (FTOPSIS) method. Results: The obstacles were categorized into four main dimensions: "infrastructural," "political," "human resources," and "managerial." Among the 15 obstacles identified, "absence of performance guarantees" was the most important obstacle, while "insufficient education" was the least important obstacle to the regionalization of healthcare services in Iran. Meanwhile, the following eight measures that could help to overcome the obstacles were extracted from the interviews: "conducting a needs assessment," "providing clinical guidelines," "employing specialized human resources," "reinforcing the referral system," and "preparing electronic health records," "enhancing education and information dissimilation," "building executive support," and "providing cost-effective equipment and technology." "Employing specialized human resources" was also the most effective measure to overcome the obstacles. Conclusions: Iranian healthcare policy-makers can use the empirical findings of this investigation to accelerate the implementation of Iran's regionalization plan to improve the access of community members to healthcare services.

A national survey of Iranian general population to estimate a value set for the EQ-5D-5L.

OBJECTIVES: The main aim of this study is to estimate a national value set of the EQ-5D-5L questionnaire for Iran. METHODS: The composite time trade-off (cTTO) and discrete choice experiment (DCE) methods; and the protocol for EuroQol Portable Valuation Technology (EQ-PVT) were used to estimate the Iran national value set. 1179 face-to-face computer-assisted interviews were conducted with adults that were recruited from five Iran major cities in 2021. Generalized least squares, Tobit, heteroskedastic, logit, and hybrid models were used to analyze the data and to identify the best fitting model. RESULTS: According to the logical consistency of the parameters, significance levels and prediction accuracy indices of the MAE; a heteroscedastic censored Tobit hybrid model combining cTTO and DCE responses was considered as the best fitting model to estimate the final value set. The predicted values ranged from - 1.19 for the worst health state (55555) to 1 for full health (11111), with 53.6% of the predicted values being negative. Mobility was the most influential dimension on health state preference values. CONCLUSIONS: The present study estimated a national EQ-5D-5L value set for Iranian policy makers and researchers. The value set enables the EQ-5D-5L questionnaire to use to calculate QALYs to assist the priority setting and efficient allocation of limited healthcare resources.

Insurance and Improving Its Strategic Purchase in Iran.

As in most countries, patients, health care providers, and insurance organizations are key components of the health care system in Iran. High rates of growth and development in today's financial markets, have made the insurance industry with its unique calculations and models, a prominent player in this specialized economic sector.

Evidence based practice among healthcare providers: a cross-sectional study.

PURPOSE: Nowadays health systems in most of the countries are trying to build their healthcare provision system based on scientific knowledge based evidence. Evidence-based practice (EBP) is a crucial factor for quality improvement focusing on compliance with clinical standards. The purpose of this paper is to assess evidence-based knowledge and skills among healthcare providers in Qazvin hospitals in 2016. DESIGN/METHODOLOGY/APPROACH: This was a descriptive study conducted among 300 health professionals working in hospitals affiliated by Qazvin University of Medical Sciences in 2016. A self-administered questionnaire was used to gather data on health providers' attitude, knowledge and skill regarding EBP. Descriptive statistics and multiple linear regressions were used to analyze data using SPSS 16 software. FINDINGS: A total of 254 participants (84.6 percent) completed the questionnaire in which their attitude, knowledge and skill toward EBP were assessed at a low level. Study results indicated that among different occupational groups, physicians and those with greater awareness toward EBP terminology had a more positive attitude compared with others. Furthermore, a higher level of knowledge and skill toward EBP was associated with being a physician and having a positive attitude toward the issue. PRACTICAL IMPLICATIONS: Given the importance of EBP and due to insufficient knowledge of healthcare providers about the issue, it is necessary to hold appropriate educational courses to empower health workforce in implementing EBP principles. ORIGINALITY/VALUE: The authors applied a self-administered questionnaire to assess health workforce knowledge and skills toward EBP. The results obtaining from the analysis not only highlights weaknesses related to service providers' knowledge and capabilities to implement EBP but also reveals facilities required for realization of the subject in hospital settings.

Evidence- based medicine performance among health care providers in Iranian hospitals: A nationwide survey.

Background: Evidence- Based Medicine (EBM) refers to the ability and skill in the use and integration of the best evidence obtained from repeatable bias-free clinical trials with the patients' preferences and conditions. Considering this fact that few large-scale studies have been done in this field in Iran, the present study aimed at comprehensively reviewing the status of EBM performance among health care providers in Iranian hospitals. Methods: This cross-sectional study was conducted during 2014 and 2015. Study participants consisted of 2800 health care providers (physicians, nurses, midwives, and paramedical personnel) in active hospitals in Iran. Data collection tool was a self-made questionnaire. Content validity of the questionnaire was improved by comments of 10 experts. The reliability of the questionnaire was assessed using test-retest method (α= 0.85). Results: The results revealed that only 12.7% and 15.8% of the participants were highly familiar with EBM databases and terminologies, respectively. Most participants believed that EBM-related workshops and practical involvement in EBM-related programs and activities can have a more effect on the improvement of EBM performance. Most participants had a positive view of the EBM. About 47% of the participants reported that their EBM knowledge and skills is high. Among the demographic variables, there were only significant relationships between work experience and attitude, gender and attitudes, and between knowledge and skills (p<0.05). Conclusion: According to the results of the present study, it seems that holding EBM-related workshops and practical participation in EBP-related programs and activities as well as improving facilities such as manpower, equipment, and access can have a significant effect on improving EBM- related activities.