National Center for Health Insurance Research Iranian Journal of Health Insurance 2645-8225 5 4 2022 12 1 Types and principles of conducting economic evaluation studies in health sector 248 259 FA Rajabali Daroudi National Center for Health Insurance Research, Tehran, Iran Abdoreza Mosavi Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Omid Emami Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran Ali Akbarisari Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Amin Mohammadi Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran In recent decades, due to the increasing health expenditures and resource constraints, the economic evaluation studies results have been increasingly used to prioritize health interventions and resource allocation in most countries, especially in high-income countries. Economic evaluation studies allow health system policymakers and decision makers, including physicians, to select the most appropriate intervention scientifically and systematically by comparing the costs and consequences of different treatment interventions. In Iran, The results of economic evaluation studies are used to decide on the arrival of new drugs in the country as well as insurance coverage for medical interventions since a decade ago. However, many researchers and clinical professionals still do not have enough information about the types of economic evaluation studies and the principles of conducting these studies. In this article, while defining economic evaluation studies, the difference between these studies and other studies in health sector is stated. Then the main types of economic evaluation studies including cost-effectiveness, cost-utility and cost-benefit are described and the differences between these methods are expressed. Finally, the general principles of conducting economic evaluation studies in the health sector are explained.  Understanding these principles and their implementation by researchers, while improving the quality of economic evaluation studies, provides the opportunity for policy makers and decision makers in health system to compare the results of these studies with each other and their findings to make decisions about the allocation of resources between different health interventions

National Center for Health Insurance Research Iranian Journal of Health Insurance 2645-8225 5 4 2022 12 1 Health system financing assessment tools: a systematic review 260 267 FA Irvan Masoudi Asl National Center for Health Insurance Research, Tehran, Iran Mohammad Moradi-Joo Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran Tayebeh Moradi National Center for Health Insurance Research, Tehran, Iran Introduction: Evaluating the state of health financing of countries helps to check the efficiency of the health system and the optimal use of the limited resources of their health system. This study was conducted with the aim of reviewing health financing evaluation tools and the functional area of each of them so that more effective and efficient reforms can be applied in the path of achieving universal health coverage. Methods: This study was a systematic review that used Scopus and PubMed databases and World Health Organization and World Bank databases to find tools and articles related to health financing evaluation. Articles and tools published in English have been reviewed without time limit. Data analysis was done by content analysis method. Results: A total of 35 articles and 9 tools were included in the study. After a complete review, finally, 6 tools (national health accounts, health system assessment approach, health sector situation analysis, organizational assessment to improve and strengthen health financing, health system review, health financing progress matrix) were analyzed. And all of them were examined from 9 dimensions of health financing assessment. Conclusion: In this study, the evaluation tools of health system financing were identified and their characteristics were stated. Among the health financing evaluation tools during the last few decades, the health financing progress matrix can provide a more complete and comprehensive road map to identify the dimensions and performance of the health system financing area in the path of achieving universal health coverage.

National Center for Health Insurance Research Iranian Journal of Health Insurance 2645-8225 5 4 2022 12 1 Designing, implementing and evaluating the economic impact of the new distribution policy of medicines for hemophilia patients covered by the General Health Insurance Department of Tehran Province 268 275 FA Mehdi Farahpour Department of Health Services Management, School of Management North Tehran Branch, Islamic Azad University, Tehran, Iran Khalil Alimohammadzadeh Department of Health Services Management, School of Management North Tehran Branch, Islamic Azad University, Tehran, Iran Seyed Mojtaba Hosseini Department of Health Services Management, School of Management North Tehran Branch, Islamic Azad University, Tehran, Iran

National Center for Health Insurance Research Iranian Journal of Health Insurance 2645-8225 5 4 2022 12 1 The Impact of the Covid-19 on Hospitals Visits: A Case Study from Tehran 276 285 FA Javad Sajjadi Khasraghi Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran Mahmood Salesi Mahmood Salesi: Chemical injuries research center, systems biology and poisonings institute, Baqiyatallah University of Medical Sciences, Tehran, Iran Mohammad Meskarpour Amiri Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran Background: The outbreak of the Covid-19 pandemic has had a devastating effect on the provision and receipt of health services around the world. The present study was conducted with the aim of investigating the effects of this disease on referrals and services of one of the hospitals in Tehran. Methods: In this historical cohort study, the number of referrals and services in 26 hospital departments in the first 6 months of 2018 and the first 6 months of 2018 were investigated and analyzed. The data in the form of a pre-designed Excel form received from the statistics unit and quality improvement unit of the hospital were entered into SPSS software version 26 and analyzed using non-parametric Wilcoxon test. Results: The load of referrals and services of the studied hospital was reduced by 30 percent during the Covid-19 epidemic. The highest rate of decrease was related to clinics and clinics (55/07 percent) and the lowest rate of decrease was related to emergency services (7/67 percent). CT scan services and referrals increased by 84/5 percent on average. These changes were statistically significant. Conclusion: The reduction of the burden of referrals and services of the studied hospital is evaluated as medium to high. Healthcare providers should monitor hospital activity and develop strategies to mitigate the indirect effects of the COVID-19 pandemic resulting from reduced overall hospital activity

National Center for Health Insurance Research Iranian Journal of Health Insurance 2645-8225 5 4 2022 12 1 The impact of inequality on the financing of household health costs 286 291 FA Shaghayegh Vahdat Department of Health Services Management, South Tehran Branch, Islamic Azad University, Tehran, Iran Asieh Khaleghi Department of Health Services Management, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran Arsalan Gholami Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran Korosh Soltanieh Zanjani Department of Children and Infants, Mofid Hospital, Tehran, Iran Farhad Lotfi National Center for Health Insurance Research, Tehran, Iran Abstract Introduction: Lack of financial protection in health is known as a disease of health systems. Households suffer not only from the burden of disease but also from the burden caused by the destruction and economic poverty, in other words, facing back-breaking costs and poverty caused by financing their health. The aim of the current research is to investigate the impact of different dimensions of inequality on the financial financing of household health.  method: This is a descriptive, cross-sectional, and applied study, which examines the impact of inequality on the financing of household health expenses. The research tool is the financing inequality questionnaire (2008) by Saito. All out-of-pocket costs related to inpatient care, outpatient care, diagnostic tests, and medical expenses due to illness have been estimated for one year. Experts have confirmed validity and reliability. Findings: The dimensions of inequality among households in Tehran are higher than the average (1.329), which has a significant impact on the financing of household health expenses. The direct effect of justice on the financing of household health expenses is rejected. With the increase in the back-breaking cost, equal opportunity, economic status, insurance coverage, and financing of household health expenses increases. According to P<0.001 and P=0.005, the age of the head of the household is not related to justice and gender in the financing of household health expenses. Conclusion: There is a direct relationship between back-breaking expenses, equal opportunity, economic status, insurance coverage, and financing of household health expenses.  

National Center for Health Insurance Research Iranian Journal of Health Insurance 2645-8225 5 4 2022 12 1 Live Hospital Information system: A Novel Real-time Bed Management Approach from Admission to Discharge 292 301 FA Somayeh Abedian Department of Information Technology Management, Faculty of Management and Accounting, Islamic Azad University, Qazvin Branch, Qazvin, Iran Mohammadreza Sanaei Department of Information Technology Management, Faculty of Management and Accounting, Islamic Azad University, Qazvin Branch, Qazvin, Iran Ahmad Rahchamani Department of Business Management, Faculty of Management and Accounting, Islamic Azad University, Qazvin Branch, Qazvin, Iran Hospital management issues have been one of the most important concerns of governments. These challenges involve medical staff and health policymakers more than ever during crises such as the Covid-19 epidemic. Lack of hospital beds and special-care facilities, medical staff shortage, and immediate reduction of drug inventory are among the most important problems in critical situations. Designing technological management solutions and using existing potentials to evaluate the condition of hospitals at the macro level can greatly reduce the incidence of such problems. In this study, an attempt is made to prevent the aforementioned problems using a technological solution in HISs, where a directorial analysis in evaluating the facilities and limitations of medical centers on the one hand, and the architecture of the HER, on the other hand, is performed. Establishing an online system for sending and receiving the live status of beds in the HIS and HER systems is the first step, and adopting macro-management approaches to use the available treatment capacities for optimal patient coverage is the second step. This system is launched nationally based on the current platform of Iran's EHR at a low cost. Collecting patient data during the stages of admission, treatment, and discharge, while facilitating the monitoring of the hospital beds, helps to enrich the content of the EHR, as well as the launch of online management-monitoring dashboards. Patient status monitoring, bed vacancy, and the discharge rate of hospitals could be monitored offline and lately, and we improved it by providing a novel model.

National Center for Health Insurance Research Iranian Journal of Health Insurance 2645-8225 5 4 2022 12 1 Investigating the type, causes and amount of health insurance deductions in teaching hospitals of Ferdows city 302 309 FA Aliakbar Gerami Sadeghian Health Information Technology Department, Ferdows School of Paramedical and Health, Birjand University of Medical Sciences, Birjand, Iran Zohreh Javanmard Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran Introduction: One of the effective ways to improve the quality-of-care services is to prevent the wastage of resources in health-treatment centers and hospitals by identifying the relevant causes. This study was conducted with the aim of investigating the type, causes, and amount of health insurance deductions in the teaching hospitals of Ferdows city. Methods: The current descriptive research is a study that was conducted in 2021 in two teaching hospitals in Ferdows city. The research population included the inpatient and outpatient medical records of these two hospitals. The data collection tool was a checklist made by the researchers, confirming its validity. The collected data were analyzed using Excel software and descriptive statistics. Results: Most deductions and their causes in the reviewed cases are respectively related to the laboratory (due to the absence of a technical officer), and consumables (due to the lack of insurance commitment for some equipment and price increase requests). The lowest deductions in the investigated cases are related to medicine (due to the request for an excessive amount of medicine), anesthesia (due to the demand for an additional amount of anesthesia), and prosthetics (due to the request for an additional price). Findings showed that in both hospitals, the highest number of deductions are related to inpatient cases. Conclusion: Correct information in medical files and also the presence of the technical officer in different hospital departments play important roles in reducing hospital deductions. Therefore, a proper decision and policy should be made in this regard.

National Center for Health Insurance Research Iranian Journal of Health Insurance 2645-8225 5 4 2022 12 1 Necessity of neuronavigation tariffing in neurosurgery in health insurance 310 311 FA Alireza Namazi Shabestari Mohammad Effatpanah National Center for Health Insurance Research, Tehran, Iran Leila Ghamkhar National Center for Health Insurance Research, Tehran, Iran