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Article
Publication date: 31 July 2021

Amjad Mohamadi-Bolbanabad, Farman Zahir Abdullah, Hossein Safari, Satar Rezaei, Abdorrahim Afkhamzadeh, Shina Amirhosseini, Afshin Shadi, Jamal Mahmoudpour and Bakhtiar Piroozi

The purpose of this study was to assess the self-perceived need, seeking and use of dental care and its main determinants in Kurdistan province, Iran.

Abstract

Purpose

The purpose of this study was to assess the self-perceived need, seeking and use of dental care and its main determinants in Kurdistan province, Iran.

Design/methodology/approach

A total of 1,056 adults in Kurdistan province were included in this cross-sectional study. Multistage sampling approach was used to select the samples. Data on sociodemographic characteristics, economic status, self-perceived need, seeking and use of dental care were collected using a self-administrated questionnaire. Multivariate logistic regression model was used to assess factors affecting the use of dental care. In addition, socioeconomic inequality relating to dental care needs and use of dental care were examined using concentration curve and concentration index.

Findings

In this study, unmet dental care need was 62.7%. There was a perceived need for dental care among 13.7% (n = 145) of the participants in the past month, with only 39.3% (n = 57) seeking the care. The most important reasons for unmet dental care need were “Could not afford the cost” and “Insurance did not cover the costs.” Multivariate logistic regression showed that supplementary insurance status and household economic status were identified as main determinants affecting dental care-seeking behavior. The result of concentration index revealed that seeking dental care was more concentrated among the rich, whereas the perceived dental care need is more prevalent among the poor.

Originality/value

This study demonstrated that the prevalence of unmet dental care needs is high in the study setting. Also, financial barrier was identified as the main determinant of unmet dental care needs.

Details

International Journal of Human Rights in Healthcare, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-4902

Keywords

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Article
Publication date: 1 October 2018

Ali Kazemi Karyani, Satar Rezaei, Behzad Karami Matin and Saeed Amini

Poor health-related quality of life (HRQoL) is one of the important issues in the health sector. The purpose of this paper is to investigate the prevalence and…

Abstract

Purpose

Poor health-related quality of life (HRQoL) is one of the important issues in the health sector. The purpose of this paper is to investigate the prevalence and socio-economic inequality in poor HRQoL in Tehran city, Iran.

Design/methodology/approach

In total, 562 adults were included in this cross-sectional study. The cluster sampling method was used for data collection from May to June, 2016 in Tehran city, Iran. Data on HRQoL, using EuroQol 5-dimensions questionnaire, and data on socio-economic and demographic variables were gathered. Convenience regression method was performed to measure the concentration index (CI). Decomposition analysis was performed to determine the contribution of variables on socio-economic inequality in poor HRQoL. All analyses were performed by Stata v.14.

Findings

The prevalence of poor HRQoL was 28.3 percent. The value of CI for “poor HRQoL” was −0.299 (95% confidence interval: −0.402 to −0.195). Socio-economic status (SES) was the largest contributor to socio-economic inequality in poor HRQoL (69.44 percent of inequality was explained by SES). Age, obesity and race had a positive contribution to socio-economic inequality in poor HRQoL among the participants. Nonetheless, sex and smoking intensity had a negative contribution to inequality in poor HRQoL.

Originality/value

There is little evidence about the prevalence of poor HRQoL in insured people. This study provided new evidence in this area through the investigation of socio-economic inequality in poor HRQoL and its determinants among people with health insurance in Iran using decomposition analysis.

Details

International Journal of Human Rights in Healthcare, vol. 12 no. 1
Type: Research Article
ISSN: 2056-4902

Keywords

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Article
Publication date: 15 June 2021

Bakhtiar Piroozi, Farman Zahir Abdullah, Amjad Mohamadi-Bolbanabad, Hossein Safari, Mohammad Amerzadeh, Satar Rezaei, Ghobad Moradi, Masoumeh Ansari, Abdorrahim Afkhamzadeh and Jamshid Gholami

The purpose of this study is to investigate the status of perceived need, seeking behavior and utilization of health services in the elderly population of Sanandaj (west of Iran).

Abstract

Purpose

The purpose of this study is to investigate the status of perceived need, seeking behavior and utilization of health services in the elderly population of Sanandaj (west of Iran).

Design/methodology/approach

This is a cross-sectional study conducted on 800 elderly people in Sanandaj. Subjects were selected using multistage sampling and data were collected using self-report questionnaires. A multivariate logistic model with odds ratios (ORs) was used to determine the relationship of independent variables with seeking perceived need. Also, the concentration index was used to measure the inequality in using health services.

Findings

The perceived need for outpatient (during the last 30 days) and inpatient health-care services (during the past 12 months) was 69.7% and 29.7%, respectively. Among them, the unmet need for outpatient and inpatient health-care services was 46.6% and 17%, respectively. Having health insurance (adjusted OR 12.08; 95% confidence interval [CI] 1.04–140.11), middle economic status (adjusted OR 5.18; 95% CI 1.30–20.51) and being in an age group of 65–70 years (adjusted OR 7.60; CI 1.42–40.61) increased the chance of seeking inpatient care. Also, being in an age group of 60–65 years (adjusted OR 0.41; 95% CI 0.18–0.95) reduced the chance of seeking outpatient care. There was also a pro-rich inequality in using outpatient health services.

Originality/value

The elderly population suffers from unmet health-care needs, especially in outpatient services. The most important reason for not seeking outpatient and inpatient services was financial barriers and self-medication, respectively. So, designing targeted policies and interventions to address barriers in the conversion of need to demand in the elderly population is essential.

Details

International Journal of Human Rights in Healthcare, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-4902

Keywords

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Article
Publication date: 20 September 2019

Enayatollah Homaie Rad, Leyla Amirbeik, Mohammad Hajizadeh, Shahrokh Yousefzadeh-Chabok, Zahra Mohtasham-Amiri, Satar Rezaei and Anita Reihanian

Mental health is an inevitable and vital dimension when it comes to providing a global definition for the appropriate health status. This highlights the importance of…

Abstract

Purpose

Mental health is an inevitable and vital dimension when it comes to providing a global definition for the appropriate health status. This highlights the importance of investigating factors influencing utilization and out-of-pocket payments (OOP) for mental health services. Thus, the purpose of this paper is to assess the determinants of the utilization and OOP for psychiatric healthcare in Iran.

Design/methodology/approach

A total of 39,864 households were included in this cross-sectional study. Data on the utilization and OOP for psychiatric healthcare as well as all their determinants (e.g. wealth index of households, geographical area, household size, etc.) were extracted from the Household Income and Expenditure Survey (HIES). The HIES was conducted by the Statistical Center of Iran in 2016. A zero-inflated Tobit model was used to identify the main factors affecting utilization and OOP for psychiatric healthcare utilization.

Findings

The average of utilization and OOP for psychiatric services was found to be 14.67 times per 1,000 households and $7.783 per month for service users, respectively. There were significant positive relationships between income and utilization (p=0.0002) and OOP (p<0.0001) for psychiatric services. Significant negative associations were found between the number of illiterate people in the household and OOP (coefficient=−1.56) and utilization (coefficient=−0.2002) for psychiatric services. Utilization and OOP for psychiatric services were statistically significantly higher among households with higher wealth status.

Originality/value

Despite the higher rate of mental disorders, the utilization of psychiatric services in Iran is very low. Due to financial barriers and insufficient insurance coverage, high socioeconomic status (SES) households utilize more psychiatric services than low-SES households. Thus, the integration of mental health services in public health programs is required to improve the utilization of psychiatric services in Iran.

Details

Journal of Public Mental Health, vol. 19 no. 2
Type: Research Article
ISSN: 1746-5729

Keywords

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Article
Publication date: 17 December 2018

Satar Rezaei, Mohammad Hajizadeh, Ali Kazemi Karyani, Shahin Soltani, Heshmatollah Asadi, Mohammad Bazyar, Zahra Mohammadi, Neshat Kazemzadeh and Bijan Nouri

Appropriate access to formally-trained health workers for people living in rural and underdeveloped areas is a continuing challenge worldwide. The purpose of this paper is…

Abstract

Purpose

Appropriate access to formally-trained health workers for people living in rural and underdeveloped areas is a continuing challenge worldwide. The purpose of this paper is to investigate the willingness of formally-trained health workers to practice in underdeveloped areas and its main determinants among medical students in the western provinces of Iran.

Design/methodology/approach

A total of 753 medical students from four provinces in western Iran (Kermanshah, Ilam, Lorestan and Kurdistan) were surveyed cross-sectionally in 2017. A self-administrated questionnaire was used to collect data on sociodemographic characteristics, willingness to practice in underdeveloped areas, intrinsic (e.g. desire to help others and self-interest in medicine) and extrinsic (e.g. the high income of physicians and social prestige) motivations of the study population. Multivariable logistic regression was used to identify the main determinants of willingness to practice in underdeveloped areas among medical students after their graduation.

Findings

The results indicated that 58.3 percent of students were willing to practice in underdeveloped areas. While 59 percent of the study population had a strong extrinsic motivation to study medicine, the remaining 41 percent of the study population had a strong intrinsic motivation to study medicine. The logistic regression results indicated that low parental professional and educational status, an experience of living in rural areas and having strong intrinsic motivation were associated with greater willingness to practice in underdeveloped areas.

Originality/value

This is the first study to investigate the willingness to practice in underdeveloped areas and its main determinants among medical students in the west of Iran.

Details

International Journal of Health Governance, vol. 24 no. 1
Type: Research Article
ISSN: 2059-4631

Keywords

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Article
Publication date: 19 July 2019

Bakhtiar Piroozi, Bushra Zarei, Bayazid Ghaderi, Hossein Safari, Ghobad Moradi, Satar Rezaei, Mahfooz Ghaderi, Shina Amirhosseini and Amjad Mohamadi-Bolbanabad

The right to health for all people means that everyone should have access to the needed healthcare services without suffering from severe financial hardship. The purpose…

Abstract

Purpose

The right to health for all people means that everyone should have access to the needed healthcare services without suffering from severe financial hardship. The purpose of this paper is to investigate the prevalence as well as the effective factors on facing catastrophic health expenditures (CHE) among gastrointestinal cancer patients and families in Kurdistan province in west of Iran after the implementation of Health Transformation Plan (HTP).

Design/methodology/approach

A cross-sectional study was carried out on 189 households with gastrointestinal cancer patients in Kurdistan province in 2018. Data were collected using World Health Survey questionnaire. A method developed by World Health Organization with the threshold of 40 percent household’s capacity to pay was used in order to measure the proportion of households facing CHE. Also, logistic regression was applied for identifying the effective factors on household’s exposure to CHE. Data were analyzed using STATA version 13.

Findings

Almost 73 percent (72.7 percent) of the households (n=117) faced the CHE. Not having supplementary health insurance (adjusted odds ratio (AOR): 3.8; 95% confidence interval: 1.3–10.8 (and having low socio-economic status (AOR: 7.1; 95% CI: 1.8–28.1) were the significant factors affecting the households’ exposure to CHE. In total, 57 and 1 percent of the studied households reported that having a gastrointestinal cancer patient at home had a significant effect on refraining from using health services by other family members.

Originality/value

The proportion of the studied households facing CHE was very high. This may indicate the weakness of health system as well as health insurance or the weakness of HTP in financial protection of fragile population.

Details

International Journal of Human Rights in Healthcare, vol. 12 no. 4
Type: Research Article
ISSN: 2056-4902

Keywords

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Article
Publication date: 19 December 2016

Satar Rezaei, Esmail Ghahramani, Mohammad Hajizadeh, Bijan Nouri, Sheno Bayazidi and Fatemah Khezrnezhad

Oral health is a major public health problem, both in developed and developing countries. The purpose of this paper is to examine the utilization of dental care and…

Abstract

Purpose

Oral health is a major public health problem, both in developed and developing countries. The purpose of this paper is to examine the utilization of dental care and identify the main socioeconomic factors affecting the use of these services in the city of Sanandaj, west of Iran, in 2015.

Design/methodology/approach

A cross-sectional survey using multistage sampling was conducted to obtain information on the dental care visits of 520 head of households in Sanandaj. A self-administered questionnaire was used to collect data on the utilization of dental visits. Multivariable logistic regression was used to identify the main socioeconomic factors affecting the utilization of dental care in Sanandaj.

Findings

Results showed that 61.3 percent of the respondents visited a dentist at least once in the last year, of which 45 percent visited dentist for restoration, 27.9 percent had extraction and 10.3 percent had a dental checkup. The average number of dentist visits by respondents was 1.9. Regression results indicated a significant association between socioeconomic factors (e.g. income, educational level and employment status) and utilization of dental care.

Originality/value

This study suggested that dental care visit was influenced by socioeconomic status of households. Therefore, strategies aimed at improving dental care utilization for socioeconomically disadvantaged households (e.g. dental health insurance) are required to promote oral health among socioeconomically disadvantaged groups.

Details

International Journal of Human Rights in Healthcare, vol. 9 no. 4
Type: Research Article
ISSN: 2056-4902

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Article
Publication date: 20 August 2018

Satar Rezaei, Abraha Woldemichael, Mohammad Hajizadeh and Ali Kazemi Karyani

Protecting households against financial risks of healthcare services is one of the main functions of health systems. The purpose of this paper is to provide a pooled…

Abstract

Purpose

Protecting households against financial risks of healthcare services is one of the main functions of health systems. The purpose of this paper is to provide a pooled estimate of the prevalence of catastrophic healthcare expenditures (CHE) among households in Iran.

Design/methodology/approach

Both international (PubMed, Scopus and Clarivate Analytics (previously known as the Institute for Scientific Information)) and Iranian (Scientific Information Database, Iranmedex and Magiran) scientific databases were searched for published studies on CHE among Iranian households. The following keywords in Persian and English language were used as keywords for the search: “catastrophic healthcare costs,” “catastrophic health costs,” “impoverishment due to health costs,” “fair financial contribution,” “prevalence,” “frequency” and “Iran” with and without “health system”. The I2-test and χ2-based Q-test suggested heterogeneity in the reported prevalence among the qualified studies; thus, a random-effects model was used to estimate the overall prevalence of CHE among households in Iran.

Findings

A total of 24 studies with a cumulative sample of 301,097 households were included in the study. The estimated pooled prevalence of CHE among households was 7 percent (95 percent confidence interval: 6–8 percent). Meta-regression analysis indicated that the prevalence of CHE was inversely related to the sample size (p<0.05). The results did not suggest a significant association between the prevalence of CHE and the year of data collection.

Originality/value

The findings revealed that the prevalence of CHE among Iranian households is significantly higher than 1 percent, which is the goal set out in Iran’s fourth five-year development plan. This warrants further policy interventions to protect households from incurring CHE in Iran.

Details

International Journal of Human Rights in Healthcare, vol. 12 no. 2
Type: Research Article
ISSN: 2056-4902

Keywords

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Article
Publication date: 19 June 2018

Satar Rezaei, Yahya Salimi, Telma Zahirian Moghadam, Tiba Mirzarahimi, Mohammad Mehrtak and Hamed Zandian

There are so many studies which evaluated the maternal quality of life based on their delivery type with different results. The purpose of this paper is to evaluate the…

Abstract

Purpose

There are so many studies which evaluated the maternal quality of life based on their delivery type with different results. The purpose of this paper is to evaluate the effect of type of delivery on the maternal QOL systematically.

Design/methodology/approach

In this systematic review, which was conducted for 15 years (2000-2016), the international databases including PubMed, Scopes and ISI and the Persian databases were searched using the following words: quality of life or health-related quality of life, vaginal delivery, cesarean delivery or cesarean section. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was adopted for this study. The quality of articles was assessed by a checklist that has been used in previous studies. All of the data analysis was performed using STATA ver.12.

Findings

In total, 13 articles were included in the present systematic review and meta-analysis. The overall sample included 8,136 women (3,990 cesareans vs 4,146 vaginal). The results of the random effect model for eight QOL dimensions based on SF-36 questionnaire showed that there was no significant difference between two groups in terms of QOL. But this model for four QOL dimensions of WHOQOL showed that the maternal in two groups had a significant difference in two dimensions of QOL (mental health and total health) and insignificant difference in other dimensions.

Research limitations/implications

The results of the study may have been affected by the selection of few databases. Therefore, researchers are encouraged to test the proposed propositions in further databases.

Practical implications

The study results could be helpful to design appropriate policies for maternal based on their type of delivery.

Originality/value

This systematic review showed that despite the insignificant difference between women with vaginal delivery vs women with cesarean delivery in some aspects of QOL, it can be concluded that health status of women with vaginal delivery is better than women with cesarean delivery, so it should be considered in the setting of appropriate policies and implementation framework to encourage women for choosing the appropriate delivery type.

Details

International Journal of Human Rights in Healthcare, vol. 11 no. 3
Type: Research Article
ISSN: 2056-4902

Keywords

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Article
Publication date: 28 February 2019

Rasoul Tabari-Khomeiran, Sajad Delavari, Satar Rezaei, Enayatollah Homaie Rad and Mostafa Shahmoradi

In May 2014, a new reform in the health sector of Iran was implemented called “health evolution plan.” In the first phase of this reform, the government reduced…

Abstract

Purpose

In May 2014, a new reform in the health sector of Iran was implemented called “health evolution plan.” In the first phase of this reform, the government reduced out-of-pocket payments for service delivery by paying subsidies to the services and after that a revision was done to the medical services values book to improve equity and increase motivation of health professions. One of the affected services in this reform was coronary artery bypass surgery. The purpose of this paper is to show the effects of HEP on costs of coronary artery bypass surgery.

Design/methodology/approach

A before-after study was done for this purpose and 167 patients’ total costs and out-of-pocket payments were calculated for the years 2013 (before) and 2014 (after) the reform in three private hospitals of Rasht city, Iran. Econometrics models were estimated after adjustment of confounding variables.

Findings

The results of this study showed that surgery costs increased significantly from $1,643.3 to 2,119.5. Nursing and other costs increased significantly from $290.3 to 414.2 and anesthetize costs increased from $619.2 to 947.01. The results of regression model showed that total costs increased $3,008.6 after adjustment of confounders (p-value=0.037). However, no significant changes were found for out-of-pocket payments and out-of-pocket percentage.

Originality/value

The study findings revealed that HTP was not successful enough in financial protection in the private sector.

Details

International Journal of Human Rights in Healthcare, vol. 12 no. 3
Type: Research Article
ISSN: 2056-4902

Keywords

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