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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Iranian Journal of Pharmaceutical Sciences
- نوع مقاله: Journal Article
- کلمات کلیدی: Ulcerative colitis,Cost-effectiveness analysis,Economic Evaluation,Infliximab,Conventional treatments,Incremental cost-effectiveness ratio
- چکیده:
- چکیده انگلیسی: The aim of this study is to assess cost-effectiveness of infliximab, compared with conventional treatments in patients with moderate to severe Ulcerative Colitis (UC) in Iran. We developed an analytical decision model with a 5-year-time horizon to follow up 1000 hypothetical patients, in order to estimate treatment costs and outcomes. Hypothetical patients, were individuals with moderate to severe UC, that are resistant to conventional treatments. Remission rate, clinical response, and surgery, were selected as clinical outcomes. For estimating QALY, utility value related to each state, drive form published paper. We also estimated associated probabilities by using patients ’medical records and specialists’ opinion. Costs of treatment such as: Physician visit fee, laboratory tests, hospitalizations, surgery, and drugs were estimated based on the public sector tariffs and drug price list that set by pricing committee of food and drug administration. Infliximab costs at dosage of 5 mg /kg, were considered for UC patients with average weight of 75 kilogram. Incremental Cost-Effectiveness Ratio (ICER) of infliximab treatment in UC patients were 240,903 USD dollars per QALY gained, compared with conventional treatments. According to recommendation of World Health Organization for choosing cost-effective intervention, interventions with relative cost-effectiveness value less than 3 times of Gross Domestic Production (GDP) per capita, are cost–effective. Our result showed that the ICER value of infliximab, is approximately 51 times of Iran’s local GDP per capita, in 2014 – i.e. more than 3 time GDP per capita. Thus, for UC patients, our finding indicates, infliximab, is not a cost- effective treatment.
- انتشار مقاله: 30-07-1394
- نویسندگان: Najmeh Moradi,Shahram Tofighi,Marzieh Zanganeh,Ali Akbari Sari,Hossein Khedmat,Leila Zarei
- مشاهده
- جایگاه : پژوهشی
- مجله: International Journal of Community Based Nursing and Midwifery
- نوع مقاله: Journal Article
- کلمات کلیدی: Iran,palliative care,Educational Needs Assessment
- چکیده:
- چکیده انگلیسی: Background: By acceptance of palliative care as a part of health system of each country and due to increasing prevalence of cancer, special focus on stakeholder’s educational needs is of vital importance so that palliative care services are improved and the quality of life of patients is enhanced. This study was conducted to explore the educational needs of stakeholders of palliative care for cancer patients in Iran.Methods: This qualitative study with 20 semi-structured interviews was conducted from August 2016 to February 2017 in Shohadaye Tajrish and Emam Khomeini Hospitals of Tehran. Participants were selected through purposive sampling and included cancer patients and their family caregivers as well as healthcare providers, experts and policy-makers. The data were analyzed through Conventional Content Analysis of Landman and Graneheim using MAXQDA10 software. Statements of each main category of the study were summarized in SWOT categorizes.Result: A total of 546 codes were extracted from the analysis of the interviews and four main categories and four subcategories were identified. The four main identified categories included:”academic education planning”, “workforce education”, “public awareness”, and “patient and caregiver empowerment” that contained our subcategories as follows: “strengths”, “weaknesses”, “opportunities” and “threats” (SWOT).Conclusion: Meeting the educational needs of the stakeholders of palliative care requires policy-makers to identify the factors leading to strategies that are based on the use of opportunities, the removal of weaknesses, and coping with the threats to which the organization is faced.
- انتشار مقاله: 24-05-1396
- نویسندگان: Mojgan Ansari,Maryam Rassouli,Mohamad Esmaiel Akbari,Abbas Abbaszadeh,Ali Akbari Sari
- مشاهده
- جایگاه : پژوهشی
- مجله: International Journal of Pediatrics
- نوع مقاله: Journal Article
- کلمات کلیدی: children,Developing countries,Developed Countries,Costs,Acute Lymphocytic Leukemia
- چکیده:
- چکیده انگلیسی: Background
Pediatric acute lymphoblastic leukemia (ALL) is the most common, yet curable childhood malignancy within the pediatric cancers; but in most developed and developing countries cost of cancer treatment in children with ALL is high. So, we specified the range of expenses for the treatment of pediatric cancer and compared the results in developed and developing countries.
Materials and Methods
To evaluate treatment costs in childhood ALL, a review was taken place through published papers during the years 2000 to 2015. We searched multiple well known databases such as Medline, Scopus, ISI Web of Science and Google Scholar on January 2015 with "cost effectiveness", "cost utility", "cost minimization", "cost analysis", "economic evaluation", "childhood", "acute lymphoblastic leukemia", and "ALL" as our keywords.
Results
Regarding the reviewed evidence the essential result was that the total costs for treatment of pediatrics ALL in developing countries such as Asian countries were considerably lower than the costs reported from high income countries in Europe and North America. So different protocols were performed to treat ALL and this matter was significant due to the different durations of hospitalization.
Conclusion
According to the results, the total costs for treatment of pediatrics ALL in developing countries were considerably lower than the costs reported from high income countries.- انتشار مقاله: 08-08-1395
- نویسندگان: Hadi Hayati,Abbas Kebriaeezadeh,Mohammad Ali Ehsani,Shekoufeh Nikfar,Ali Akbari Sari,Mehdi Troski,Bereket Molla Tigabu
- مشاهده
- جایگاه : پژوهشی
- مجله: International Journal of Health Policy and Management
- نوع مقاله: Journal Article
- کلمات کلیدی: Iran,Health Insurance,attributes,preferences,Discrete Choice
- چکیده:
- چکیده انگلیسی: Background
The preferences of Iranians concerning the attributes of health insurance benefit packages are not well studied. This study aimed to elicit health insurance preferences among insured people in Iran during 2016.
Methods
A mixed methods study using a discrete choice experiment (DCE) approach was conducted to elicit health insurance preferences on a total sample of 600 insured Iranians residing in Tehran. The final design of the DCE included 8 health insurance attributes. Data were analyzed using conditional logistic regression models.
Results
The final model of this DCE study included 8 attributes, and the findings indicated statistically significant (P < .001) increase in the odds ratio (OR) of choosing health insurance at all levels of cost coverage except for the rehabilitation and para-clinical benefits, where at 70% cost coverage there was insignificant (P = .485) disutility (OR = 0.95). With the increase in cost coverage level, the probability of choosing health insurance was significantly (P < .001) the highest for the private hospitals’ benefits (OR = 2.82) followed by public hospitals’ benefits (OR = 2.02) and outpatient benefits (OR = 1.75), and the premium revealed statistically significant (P < .001) disutility (OR = 0.96).
Conclusion
Our findings revealed that participants would be willing to choose health insurance plans with higher cost coverage of healthcare services and with lower premiums. However, the demographic characteristics, income, and health status of the insured individuals affected their health insurance preferences. The findings can contribute to the design of better health insurance policies, improve the participation of individuals in health insurance, and increase the insured individuals’ utility from the insurance benefits packages.- انتشار مقاله: 12-04-1397
- نویسندگان: Ali Kazemi Karyani,Ali Akbari Sari,Abraha Woldemichael
- مشاهده
- جایگاه : پژوهشی
- مجله: International Journal of Health Policy and Management
- نوع مقاله: Journal Article
- کلمات کلیدی: lumbar spine,evidence,Shiraz,MRI Prescription,RAND Appropriateness Method,Clinical Practice Guideline
- چکیده:
- چکیده انگلیسی: Background
MRI is a new and expensive diagnostic technology, which has been used increasingly all over the world. Low back pain is a worldwide prevalent disorder and MRI technique is one of the several ways to diagnose it. This paper aims to identify the appropriateness of lumbar spine MRI prescriptions in Shiraz teaching hospitals using standardized RAND Appropriateness Method (RAM) criteria in 2012.
Methods
This study consisted of two phases. The first phase involved a qualitative enquiry and the second phase had a quantitative cross-sectional nature. In the first phase RAM was used for developing lumbar spine MRI indications and scenarios. In the second phase, the finalized scenarios were compared with the history and physical examination of 300 patients with low back pain. The rate of appropriateness of lumbar spine MRI prescription was then calculated.
Results
Of 300 cases of lumbar spine MRI prescriptions, approximately 167 (56%) were considered inappropriate, 72 (24%) were uncertain, and 61 (20%) were deemed to be appropriate. The economic burden of inappropriate prescriptions was calculated at 88,009,000 Rials. In addition, the types of expertise and physical examination were considered as related factors to appropriateness of prescriptions.
Conclusion
In conclusion, a large proportion of lumbar spine MRI prescriptions, which result in financial burden on the insurance companies and the patients alike is unnecessary. This study suggests that policy makers consider this evidence while decision-making. Our findings highlight the imperative role of Health Technology Assessment (HTA) and Clinical Practice Guidelines (CPGs). As a result, developing local clinical guidelines may create the commitment needed in physicians in prescribing appropriate prescriptions within the health sector. The study further recommends that appropriate scenarios should be considered as a criterion for payment and reimbursement.- انتشار مقاله: 20-11-1391
- نویسندگان: Hedayat Salari,Rahim Ostovar,Atefeh Esfandiari,Ali Keshtkaran,Ali Akbari Sari,Hossein Yousefi Manesh,Amir Rakhshan
- مشاهده
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: palliative care,Pediatric,regionalization,health system
- چکیده:
- چکیده انگلیسی: Background: Establishing palliative care services is a priority in the health system of Iran. Considering the necessity
of integrating these services into the health system, this study aimed to explore the stakeholders’ perceptions about the
provision of a conceptual framework for palliative care services for children with cancer according to the health system
in of Iran. Methods: The present qualitative study was conducted through in-depth semi-structured interviews held
with 29 participants including palliative care specialists, policy-makers, health care providers, the parents of children
with cancer selected through purposive sampling, between August 2016 and February 2017. Interviews continued
until saturation of data. All interviews were recorded, transcribed and analyzed using MAXQDA10 software. Results:
The codes extracted from interviews produced the main theme “ classes of palliative care services” with the two main
categories “comprehensive care” including, strengthening family shelter, maintaining the child in a familiar environment,
achieving stability and “establishing social justice” including, easy access to services, financial relief and quality care.
Conclusion: Presenting a framework based on level of palliative care services, the findings of this study paves the way
for integrating these services into Iranian health system.- انتشار مقاله: 09-08-1396
- نویسندگان: Leila Khanali Mojen,Maryam Rassouli,Peyman Eshghi,Kazem Zendedel,Ali Akbari Sari,Majideh Heravi Karimooi,Mamak Tahmasebi,Azam Shirin Abadi Farahani
- مشاهده