Shahid Sadoughi University of Medical Sciences Evidence Based Health Policy, Management and Economics 2538-5070 2538-4716 4 4 2020 12 1 The Novel COVID-19 Infections in Iran: Management and Challenges 209 211 EN Shiva Kargar Student Research Committee, Zahedan University of Medical Sciences, Zahedan, Iran Shivakargar@yahoo.com Y 0000-0003-0050-7226 Mostafa Peyvand Student Research Committee, Zahedan University of Medical Sciences, Zahedan, Iran mp.peyvand@yahoo.com N 0000-0002-3213-2134 Fateme Hajizadeh Boshehr University of Medical Sciences, Boshehr, Iran hajizadehf93@gmail.com N 0000-0000-0000-0000 10.18502/jebhpme.v4i4.4884 Covid-19, Challenge, Management, Iran http://jebhpme.ssu.ac.ir/article-1-278-en.html http://jebhpme.ssu.ac.ir/article-1-278-en.pdf

Shahid Sadoughi University of Medical Sciences Evidence Based Health Policy, Management and Economics 2538-5070 2538-4716 4 4 2020 12 1 A Model for Determining the Number of Health Technologies in the Health Systems: An Approach Combining Multiple Attributes Decision Making and Goal Programming 212 216 EN Hosein Arman Department of Management, Najafabad Branch, Islamic Azad University, Najafabad, Iran hosein.arman@yahoo.com N 0000-0003-2451-3997 Efat Mohamadi Health Equity Research Center (HERC), Tehran University of Medical Sciences (TUMS), Tehran, Iran efat.mohamadi@gmail.com N 0000-0003-2297-7990 Mohammadreza Mobinizadeh National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran mr.mobini1986@gmail.com Y 0000-0003-3691-3744 10.18502/jebhpme.v4i4.4885 In recent years, health technology policy-making science has gone beyond just a health technology assessment or systematic review or economic evaluation study and the science of operational research in decision making, i.e. multi-attributes and multi-objective decision-making has been included. Hence, currently, health technology policy-making follows a seven-step process. After a technology undergoes these steps and is proven that it is useful for the health system, it must be determined how many of it is needed in the health system. Determining the required number of health technologies is a challenge that remains to be considered. Therefore, this study was designed to overcome this problem. The authors intend to introduce a multi-objective decision-making methodology considering the limited budget, to determine the number of technologies required to complete for the health technology policymaking cycle. Health technologies, Multi-attributes decision-making, Goal programming http://jebhpme.ssu.ac.ir/article-1-301-en.html http://jebhpme.ssu.ac.ir/article-1-301-en.pdf

Shahid Sadoughi University of Medical Sciences Evidence Based Health Policy, Management and Economics 2538-5070 2538-4716 4 4 2020 12 1 The Expense of Insulin in Individuals with Insulin-Dependent Diabetes in Fars Province based on Prescribed Prescriptions including Insulin 217 224 EN Sanaz Amiri Epidemiology Department, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran Amiri.sanaz987@gmail.com Y 0000-0001-9791-4279 Alireza Mirahmadizadeh Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran reza13441@gmail.com N 0000-0002-2254-4984 Saeed Seyfi Emergency Nursing Department, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran saeedseyfi@gmail.com N 0000-0003-1455-3354 10.18502/jebhpme.v4i4.4886 Background: Diabetes is considered one of the most prevalent chronic diseases in the world, and if it is not cured, it can have many side effects and expenses. The current study has been conducted to calculate the cost of insulin applied in patients with insulin-dependent diabetes who are younger than 19 years old in 2016 and 2017. Methods: The current study is a descriptive and cross-sectional study We investigated all registered prescriptions of social security and health insurance in this study. The price of each insulin was calculated through the official website of the Food and Drug Administration (FDA). Ultimately, the cost of insulin has been calculated based on gender, age group, and insurance types under the age of 19 in patients with insulin-dependent diabetes and those without insulin-dependent diabetes. Data has been analyzed using SPSS24. The frequency command is used to obtain the percentages. Results: In this study, 1135105 insured cases younger than 19 years old were investigated, which females consisted almost half of the insured cases (51 %), and most of them were in the age group of 2-7 years (34 %), and 50 % of the participants in this study were covered by social security insurance. The treatment of each patient with insulin-dependent diabetes included a cost of $ 1187 and $ 1309, respectively, in 2016 and 2017, and $ 1.4 and $ 1.7 respectively (1$ = 42,000 Rials), for each person under the age of 19 in the general population. Conclusion: The results achieved by the mentioned study explained that nearly remarkable cost is spent on preparing insulin for patients with Type 1 Diabetes Mellitus every year. This amount is increasing, and it is essential to predict insulin needs for the future according to the insulin consumption changes. Insulin, Diabetes, Type 1 diabetes, Diabetes mellitus, Cost http://jebhpme.ssu.ac.ir/article-1-303-en.html http://jebhpme.ssu.ac.ir/article-1-303-en.pdf

Shahid Sadoughi University of Medical Sciences Evidence Based Health Policy, Management and Economics 2538-5070 2538-4716 4 4 2020 12 1 Examining the Effect of Executing the Health Reform Plan on the Share of Insurances, Franchise, and Health Subsidies in Shahid Sadoughi University of Medical Sciences in Yazd in 2013-2016 225 233 EN Ahmad Reza Motalehi Shahid Sadoughi University of Medical Sciences, Yazd, Iran N 0000-0002-1088-2663 Elham Roshanian Trauma Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran E_roshanian1988@yahoo.com Y 0000-0002-6464-9920 Mohammad Reza Vafaeinasab Trauma Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran N 0000-0003-0663-8542 Masoud Saffari Shahid Sadoughi University of Medical Sciences, Yazd, Iran N 0000-00030908-9235 10.18502/jebhpme.v4i4.4887 Background: The Health Reform Plan was begun in 2014 as one of the most significant programs of the Ministry of Health to reduce hospitalization and out-of-pocket costs paid by people. Hence, we consider examining the economic consequences of this plan as one of the research priorities in this field. This study aimed to examine the effect of implementing the Health Reform Plan on the share of basic, supplementary insurances, franchise, and health subsidies from medical expenses in Shahid Sadoughi University of Medical Sciences in Yazd in 2013-2016. Methods: This study is a descriptive study conducted in a quantitative and cross-sectional method. The study population included patients' bills in hospitals affiliated to Shahid Sadoughi University of Medical Sciences in Yazd. All patient's hospitalization files were examined by the census method. Information was extracted from financial documents and data in the hospital's HIS system. We referred to the basic and supplementary insurance organizations of the province to complete the data. Descriptive statistics and were used to analyze the obtained data by using SPSS16 Software. Results: Generally, it was specified that the share of basic and supplementary insurances had not changed considerably due to the doubling of the whole costs of patients 'files, and basic insurances will pay on average 76 % of patients' costs. But, the patient's share of out-of-pocket payments has declined from 21 % to 11 %, which the Ministry of Health and Medical Education will pay this 10 percentage through the health subsidy to the affiliated centers. Conclusion: This study's results explained an increase in patient's health costs and a decrease in patient's out-of-pocket costs. Consequently, it is required to pay attention to methods to increase medical centers' efficiency to reduce health costs. Furthermore, large-scale/macro programs should be designed and implemented at the national level to reduce patient's out-of-pocket payments. Health reform plan, Out-of-Pocket payment, Expenses, Insurance, Hospital http://jebhpme.ssu.ac.ir/article-1-287-en.html http://jebhpme.ssu.ac.ir/article-1-287-en.pdf

Shahid Sadoughi University of Medical Sciences Evidence Based Health Policy, Management and Economics 2538-5070 2538-4716 4 4 2020 12 1 Survival Rate of Patients with Acute Leukemia: A Case Study in Iran 234 241 EN Mohammad Ranjbar Health Policy & Management Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran N 0000000156608048 Mohsen Barouni Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran N 0000000331428168 Vahid Moazed Clinical Research Unit, Shahid Bahonar Academic Center, Kerman University of Medical Sciences, Kerman, Iran N 0000000305254539 Hossein Fallahzadeh Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran N 000000016518366x Shiva Sheikholeslami Clinical Research Unit, Shahid Bahonar Academic Center, Kerman University of Medical Sciences, Kerman, Iran Shiva.sh.eslami@gmail.com Y 0000000292524770 10.18502/jebhpme.v4i4.4888 Background: Acute leukemia is a kind of aggressive disease that includes high rates of fatalities in the world, in particular in Iran. This research was done to determine the survival rate of patients with acute leukemia in Iran. Methods: 85 adult patients who were first diagnosed with acute leukemia in Shahid Bahonar hospital of Kerman during March 2012 until March 2013 were evaluated in a retrospective descriptive study to measure the death/life status in a 5-year period (2012-2017). The required data was gathered from medical records of patients, HIS system data, and the cancer registry system, and the Kaplan-Meier estimator and Log Rank test were used to calculate the survival rate using SPSS23. Results: Survival rate was completely 45.9 % for patients with acute adult leukemia. It was 47.08 % in acute myelogenous leukemia (AML) and it was 43.06 % in acute lymphocytic leukemia (ALL). The 1,2,3,4 and 5-year survival of acute leukemia was respectively 87.1 %, 69.4 %, 62.4 %, 56.5 % and 45.9 %. Conclusion: Iran's health system should design and plan to increase the survival of patients with acute leukemia by improving the methods and facilities to diagnose and treat it more quickly and more effectively. Acute leukemia, Survival, Hospital http://jebhpme.ssu.ac.ir/article-1-293-en.html http://jebhpme.ssu.ac.ir/article-1-293-en.pdf

Shahid Sadoughi University of Medical Sciences Evidence Based Health Policy, Management and Economics 2538-5070 2538-4716 4 4 2020 12 1 Survey of the Impact of Myocardial Infarction on Patients’ Quality of Life: A Single-Centre Cross-Sectional Study 242 253 EN Habib Jalilian Cardiovascular Research Centre, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran N 0000-0002-0409-0424 Ali Imani Cardiovascular Research Centre, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran N 0000-0002-4606-9631 Habibeh Mir Student Research Committee, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran N 0000-0002-7131-730X Elnaz Javanshir Cardiovascular Research Centre, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran N 0000-0003-4244-7735 Mehdi Mamene Faculty Member of Paramedical School, Ilam University of Medical Sciences, Ilam, Iran N 0000-0003-3805-1500 Somayeh Heydari Cardiovascular Research Centre, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran saeedehheydari5@yahoo.com Y 0000-0001-7260-7491 10.18502/jebhpme.v4i4.4889 Background: A heart attack is one of the most common cardiovascular diseases, affecting different dimensions of the patients’ quality of life due to the disease’s disabling and limiting nature. Therefore, this study aimed to examine the impact of myocardial infarction on patients’ quality of life referring to the Shahid Madani Medical & Training Hospital, in East Azerbaijan Province in 2017, in Iran. Methods: This was a cross-sectional study. A total of 220 patients with a heart attack were selected in this study. Sampling was conducted using the systematic random method. Data were collected using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Descriptive statistics (frequency, mean) and statistical analyses (Mann-Whitney test, Spearman correlation, and Generalized Linear Models Regression) were performed at a significance level of P-value < 0.05 using SPSS22. Results: In this study, the mean score of the total effect of a heart attack on the patients’ quality of life was 30.09 ± 17.73. The mean score of the effect of a heart attack on the patient’s quality of life in the physical, emotional, and general subscales was 34.85 ± 24.24, 26.63 ± 27.73, and 27.51 ± 17.83, respectively. There was a statistically significant association between education status (P-value = 0.006), income status (P- value = 0.000), and the mean score of the effect of a heart attack on the patient’s quality of life; also a positive and significant correlation was found between age (CC = 0.135, P-value = 0.046), the number of hospitalization (CC = 0.187, P-value = 0.006) and the mean score of the effect of a heart attack on the patient’s quality of life. Conclusion: A heart attack has a considerable impact on the patients’ quality of life, particularly on the physical dimension. Hence, health professionals should pay more attention to these vulnerable groups and offer rehabilitation services suitable to these groups to reduce the impact of the disease. Quality of life, Heart attack, Heart failure, Myocardial infarction, Minnesota questionnaire http://jebhpme.ssu.ac.ir/article-1-299-en.html http://jebhpme.ssu.ac.ir/article-1-299-en.pdf

Shahid Sadoughi University of Medical Sciences Evidence Based Health Policy, Management and Economics 2538-5070 2538-4716 4 4 2020 12 1 Unsuccessful Weight-Loss in Adults Admitted to Health Centers, Ahvaz, Khuzestan: A Phenomenological Study 254 262 EN Farzad Faraji Khiavi Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Department of Health Services Management, Faculty of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz , Iran N 0000-0001-8876-3739 Kurosh Djafarian Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Health Sciences, Tehran, Iran N 0000-0002-9134-7178 Mahbubeh Afrashtabar Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran mahbubeafrash@yahoo.com Y 0000-0003-1361-272x 10.18502/jebhpme.v4i4.4890 Background: Nowadays, obesity is one of the most important public health problems worldwide. There are so many various factors interfering with obesity that it is necessary to be studied separately in each population. Although many people can lose weight by observing low-energy diets, they often return to the former weight and even higher. The present study aimed to identify the causes of unsuccessful weight-loss in adults admitted to health centers in Ahvaz. Methods: This was a qualitative phenomenological study carried out in one of the health centers in western Ahvaz, 2017. The data collection tool for this study was semi-structured in-depth interview conducted face-to-face and individually. The interviews were recorded and transferred word-by-word on paper immediately. Then interviews were analyzed using the content analysis method. Results: Seven themes and 11 key concepts were extracted from the contents of the interviews.The following items led to a failure of keeping the diet and achieving the proper weight: Underlying diseases, the effects of drugs on overweightness and obesity, physical characteristics, lifestyle, affecting overweight and obesity behaviors, food habits, and psychological factors. Conclusion: Lifestyle and some diseases and medications can lead to a failure of overweight and obesity confronting programs. Provision of the educational and informational programs to the society with emphasis on the side effects of weight loss medications and lifestyle changes, especially the dietary habits, together with a consideration of the mental health dimension may affect the success of people in controlling obesity. Obesity, Weight-loss, Diet, Phenomenology http://jebhpme.ssu.ac.ir/article-1-300-en.html http://jebhpme.ssu.ac.ir/article-1-300-en.pdf

Shahid Sadoughi University of Medical Sciences Evidence Based Health Policy, Management and Economics 2538-5070 2538-4716 4 4 2020 12 1 Nursing Leadership Models in Promoting and Improving Patient’s Safety Culture in Healthcare Facilities; A Systematic Review 263 274 EN Yodang Yodang School of Nursing, Faculty of Science and Technology, Universitas Sembilanbelas November Kolaka, Indonesia yodang.usnkolaka@gmail.com Y 0000-0001-7154-0758 Nuridah Nuridah School of Nursing, Faculty of Science and Technology, Universitas Sembilanbelas November Kolaka, Indonesia N 0000-0001-8713-8851 10.18502/jebhpme.v4i4.4891 Background: Nurse leader has an important role in encouraging patient’s safety culture among nurses in the healthcare system. This literature review aims to identify the nursing leadership model and to promote and improve patient safety culture to improve patient outcomes in health care facilities including hospitals, primary health care, and nursing home settings. Methods: Searching appropriate journals through some journal databases were applied including DOAJ, GARUDA, Google Scholar, MDPI, Proquest, Pubmed, Sage Journals, ScienceDirect, and Wiley Online Library, which were published from 2015 to 2020. Results: Fourteen articles meet the criteria and are included in this review. The majority of these articles were retrieved from western countries, the US, Canada, and Finland. This review identifies three nursing leadership models that seem useful to promote and improve patient safety culture in health care facilities which are transformational, authentic, and ethical leadership models. Conclusion: The patient safety influences health care outcomes. The evidence shows the leadership has positive relation to patient satisfaction and patient safety outcomes improvement. The transformational, authentic, and ethical leadership models seem to be more useful in promoting, maintaining, and improving patient safety culture in health care facilities.   Leadership, Nurses, Patient safety, Patients satisfaction, Safety management http://jebhpme.ssu.ac.ir/article-1-302-en.html http://jebhpme.ssu.ac.ir/article-1-302-en.pdf