Volume 25, Issue 1 (3-2022)
jha 2022, 25(1): 80-91 |
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Mohammadi manesh G, Ahmadnejad E, Nemati A, Asadi-Lari M. Equity on access to health care services among COVID-19 cases and related deaths in Iran: a sub-national survey. jha 2022; 25 (1) :80-91
URL: http://jha.iums.ac.ir/article-1-3961-en.html
URL: http://jha.iums.ac.ir/article-1-3961-en.html
1- M.Sc, Onychopathology Research Center, Iran University of Medical Sciences, Tehran, Iran.
2- Associate Professor, National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran.
3- Ph.D, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
4- Professor,Onychopathology Research Center, Iran University of Medical Sciences, Tehran, Iran. ,mohsen.asadi@yahoo.com
2- Associate Professor, National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran.
3- Ph.D, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
4- Professor,Onychopathology Research Center, Iran University of Medical Sciences, Tehran, Iran. ,
Abstract: (1684 Views)
Introduction: Health inequalities can determine the risk of diseases and the measures employed to prevent and treat diseases when they occurs. The COVID-19 pandemic has played an important role in creating and reinforcing numerous health inequalities across the globe. This study aimed at investigating inequalities in access to health services in patients with COVID-19 and mortality caused by it at the provincial level of Iran.
Methods: This descriptive cross-sectional study assessed all provinces of Iran for a number of hospital measures, including total hospital beds, ICU beds, the number of CT scans, and the number of specialists and nurses. To determine the effect of hospital infrastructure and facilities on death and hospitalization, the Pearson correlation coefficient was used. Multivariate linear regression was employed to determine the relationship and significance of the variables, and the Gini coefficient and the Lorenz curve were used to measure inequalities in the distribution of facilities and infrastructures.
Results: The results showed that on the basis of hospital facilities, the rate of hospitalization and death due to COVID-19 can be predicted by 96%. Increasing ICU beds increased hospitalization and death by 1.16 and 0.97 respectively. Also, for every increase in the number of doctors and nurses, the chance of hospitalization increased by 0.423 and decreased by 0.741 respectively. Isfahan, West Azerbaijan, Yazd, Kermanshah and Zanjan provinces had the lowest Gini coefficient in bed distribution.
Conclusion: The distribution of resources among provinces is not fair. Therefore, in order to achieve universal health coverage and comply with the leveling of service provision, it is necessary to make policies and plans according to the needs of the society and allocate resources based on the needs and burden of the disease.
Methods: This descriptive cross-sectional study assessed all provinces of Iran for a number of hospital measures, including total hospital beds, ICU beds, the number of CT scans, and the number of specialists and nurses. To determine the effect of hospital infrastructure and facilities on death and hospitalization, the Pearson correlation coefficient was used. Multivariate linear regression was employed to determine the relationship and significance of the variables, and the Gini coefficient and the Lorenz curve were used to measure inequalities in the distribution of facilities and infrastructures.
Results: The results showed that on the basis of hospital facilities, the rate of hospitalization and death due to COVID-19 can be predicted by 96%. Increasing ICU beds increased hospitalization and death by 1.16 and 0.97 respectively. Also, for every increase in the number of doctors and nurses, the chance of hospitalization increased by 0.423 and decreased by 0.741 respectively. Isfahan, West Azerbaijan, Yazd, Kermanshah and Zanjan provinces had the lowest Gini coefficient in bed distribution.
Conclusion: The distribution of resources among provinces is not fair. Therefore, in order to achieve universal health coverage and comply with the leveling of service provision, it is necessary to make policies and plans according to the needs of the society and allocate resources based on the needs and burden of the disease.
Type of Study: Research |
Subject:
Health Services Management
Received: 2021/12/3 | Accepted: 2022/03/19 | Published: 2022/08/1
Received: 2021/12/3 | Accepted: 2022/03/19 | Published: 2022/08/1
References
1. Mishra V, Seyedzenouzi G, Almohtadi A, Chowdhury T, Khashkhusha A, Axiaq A, et al. Health inequalities during COVID-19 and their effects on morbidity and mortality. J Healthc Leadersh. 2021; 13:19-26. [DOI:10.2147/JHL.S270175]
2. Khammarnia M , Peyvand M, Setoodezadeh F. Intensifying health challenges in low-income provinces: The impact of the Corona pandemic. Journal of Jiroft University of Medical Sciences. 2021;8(1):543-4.
3. Cooper WW, Seiford LM, Zhu J. Handbook on data envelopment analysis. 2nd ed. Springer; 2011. [DOI:10.1007/978-1-4419-6151-8]
4. Motevallizadeh S, Zakiyani Sh. Allocation of limited resources. Journal of Babol University of Medical Sciences. 2006;8(5):105-9. [In Persian]
5. Chu TB, Lui TC, Chen CS, Tsai YW, Chiu WT. Household out-of-pocket medical expenditures and National Health Insurance in Taiwan: Income and regional inequality. BMC Health Serv Res. 2005;5:1-9 [DOI:10.1186/1472-6963-5-60]
6. Tofighi Sh, Maleki M, Shahabi M, Delpasand M, Nafis A. Distribution of specialized physicians and active beds in the Iranian government hospitals between 2001 and 2006. J Sch Publ Health Inst Publ Health Res. 2010;8(3):1-10. [In Persian]
7. Ghiasvand H, Mohamadi E, Olyaeemanesh A, Kiani MM, Armoon B, Takian A. Health equity in Iran: A systematic review. Med J Islam Repub Iran. 2021;35(1):1-15. [DOI:10.47176/mjiri.35.51]
8. World Health Organization. Strengthening NCD service delivery through UHC benefit package : Technical meeting report. Geneva: World Health Organization; 2020 Jul 14-15. 48 p.
9. Zeitoun JD, Faron M, Lefèvre JH. Impact of the local care environment and social characteristics on aggregated hospital fatality rate from COVID-19 in France: A nationwide observational study. Public Health. 2020;189:104-9. [DOI:10.1016/j.puhe.2020.09.015]
10. Becher T, Frerichs I. Mortality in COVID-19 is not merely a question of resource availability. Lancet Respir Med. 2020;8(9):832-3. [DOI:10.1016/S2213-2600(20)30312-X]
11. Janke AT, Mei H, Rothenberg C, Becher RD, Lin Z, Venkatesh AK. Analysis of hospital resource availability and COVID‐19 mortality across the United States. J Hosp Med. 2021;16(4):211-4. [DOI:10.12788/jhm.3539]
12. Sen-Crowe B, Sutherland M, McKenney M, Elkbuli A. A closer look into global hospital beds capacity and resource shortages during the COVID-19 pandemic. J Surg Res. 2021;260:56-63. [DOI:10.1016/j.jss.2020.11.062]
13. Tchicaya A, Lorentz N, Leduc K, De Lanchy G. COVID-19 mortality with regard to healthcare services availability, health risks, and socio-spatial factors at department level in France: A spatial cross-sectional analysis. PLoS One. 2021;16(9):1-19. [DOI:10.1371/journal.pone.0256857]
14. Lei Q, Li G, Ma X, Tian J, Wu WF, Chen H, et al. Correlation between CT findings and outcomes in 46 patients with coronavirus disease 2019. Sci Rep. 2021;11(1):1-6. [DOI:10.1038/s41598-020-79183-4]
15. Abdollahi I, Nabahati M, Javanian M, Shirafkan H, Mehraeen R. Can initial chest CT scan predict status and clinical outcomes of COVID-19 infection? A retrospective cohort study. Egypt J Radiol Nucl Med. 2021;52(1):1-10. [DOI:10.1186/s43055-021-00538-6]
16. Kabiri Naeini M, Elahi Z , Moghimi Esfandabadi A. Providing a model for the optimal allocation of hospital beds based on markov chain approach (case study: Shiraz-Shahid-Faghihi Hospital). Management Strategies in Health System. 2021;6(1):18-27. [In Persian] [DOI:10.18502/mshsj.v6i1.6505]
17. Mosadeghrad AM, Janbabaei Gh, Kalantari B, Darrudi A, Dehnavi H. Equity in distribution of hospital beds in Iran. Scientific Journal of Kurdistan University of Medical Sciences. 2020;24(6):12-36. [In Persian] [DOI:10.29252/sjku.24.6.12]
18. Tofighi Sh, Maleki MR, Shahabi M, Delpasand M, Nafisi A. Distribution of specialized physicians and active beds in the Iranian government hospitals between 2001-2006. J Sch Publ Health Inst Publ Health Res. 2010;8(3):1-10. [In Persian]
19. Shahraki M, Ghaderi S. Inequality in distribution of physician and general practitioner in Sistan and Baluchestan province, Iran (2009-2017). Payesh. 2020;19(2):177-86. [In Persian] [DOI:10.29252/payesh.19.2.177]
20. Zangane M, Omrani A, Barkati H, Shahabi M, Alikhani M, Gharlipour Z, et al. The nurse manpower distribution at state hospitals of Iran by Lorenz Curve and Gini index during 2001-2006. Journal of Ilam University of Medical Sciences. 2013;21(6):174-81. [In Persian]
21. Tian F, Pan J. Hospital bed supply and inequality as determinants of maternal mortality in China between 2004 and 2016. Int J Equity Health. 2021;20:1-15. [DOI:10.1186/s12939-021-01391-9]
22. Matsumoto M, Inoue K, Bowman R, Noguchi S, Toyokawa S, Kajii E. Geographical distributions of physicians in Japan and US: Impact of healthcare system on physician dispersal pattern. Health Pol. 2010;96(3):255-61. [DOI:10.1016/j.healthpol.2010.02.012]
23. Olsen OE, Ndeki S, Norheim OF. Human resources for emergency obstetric care in northernTanzania: Distribution of quantity or quality? Hum Resour Health. 2005;3:1-12. [DOI:10.1186/1478-4491-3-5]
24. Mostafavi H , Aghlmand S, Zandiyan H, Alipoori Sakha M, Bayati M, Mostafavi S. Inequitable distribution of specialists and hospital beds in west Azerbaijan province. Payavard. 2015,9(1):55-66. [In Persian]
25. Mosadeghrad AM, Esfahani P, Nikafshar M. Hospitals' efficiency in Iran: A systematic review and meta-analysis of two decades of research. Payavard. 2017;11(3):318-31. [In Persian]
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