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Jahani M, Esmaeili R, Abbasi M, Nikbakht H, Azarbakhsh H, Roshandel G, Delavari S, Shojaie L, Mahmoudi G. Burden of upper gastrointestinal cancers in the east of Golestan province (Golestan cohort study). Cancer Rep (Hoboken) 2024; 7:e2001. [PMID: 38433617 PMCID: PMC10910303 DOI: 10.1002/cnr2.2001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/11/2023] [Accepted: 02/06/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Cancers, especially Upper Gastrointestinal Cancers (UGCs), pose a substantial burden on society, particularly in developing nations. Golestan province, Iran, is known for its high UGC rates globally. AIMS This study delves into the disease burden of UGCs in the eastern part of Golestan province. METHODS AND RESULTS This study was conducted using the results of the Golestan cohort study. 2711 patients participating in this cohort, who visited Atrak Clinic during 2001-2020, participated in this study. After excluding patients with incomplete records, 2481 patients were included in the study. To compute the metrics of years of life lost (YLL), years of life lived with disability (YLD), and disability-adjusted life years (DALY), we utilized the World Health Organization's standard life table, stratified by age and gender. The majority of UGC patients in our study were married (81.8%), had limited formal education (82.6%), and were predominantly male (61.1%). A substantial proportion resided in suburban areas (85.8%), and over half of the patients (52%) reported a history of drug addiction. The mean age at diagnosis for men was 65.76 years with a standard deviation of 11.34, while for women, it was 64.38 years with a standard deviation of 11.66. Regarding disease impact, YLL, YLD, and DALY for men were 21 240, 1956, and 23 196 (307.8 per 100 000), respectively. For women, these figures were 15 609 for YLL, 1367 for YLD, and 16 976 (223.1 per 100 000) for DALY. CONCLUSION After the increasing trend of the burden of UGCs in Golestan province in the early years of the study, this rate has been decreasing in recent years. Effective strategies necessitate collaborative efforts across various sectors to alleviate this burden, focusing on preventive measures, timely diagnosis, and well-coordinated therapeutic interventions.
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Affiliation(s)
- Mohammad‐Ali Jahani
- Social Determinants of Health Research CenterHealth Research Institute, Babol University of Medical SciencesBabolIran
| | - Raziyeh Esmaeili
- Health Services ManagementGolestan University of Medical SciencesGorganIran
| | - Mahdi Abbasi
- Department of Health Economics and ManagementSchool of Public Health, Tehran University of Medical SciencesTehranIran
| | - Hossein‐Ali Nikbakht
- Social Determinants of Health Research CenterHealth Research Institute, Babol University of Medical SciencesBabolIran
| | | | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and HepatologyGolestan University of Medical SciencesGorganIran
| | - Sahar Delavari
- Institute for the Developing Mind, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Layla Shojaie
- Division of GI/Liver, Department of MedicineKeck school of Medicine, University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Ghahraman Mahmoudi
- Hospital administration Research Center, Sari Branch, Islamic Azad UniversitySariIran
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Zhu D, Guo N, Wang J, Nicholas S, Chen L. Longitudinal Association of Salaries for Medical Staff With Medical Service Utilization and Expenditure in China, 2007-2016. Front Public Health 2021; 9:767541. [PMID: 34957021 PMCID: PMC8702650 DOI: 10.3389/fpubh.2021.767541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/15/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To test the hypothesis that higher salary levels of the medical staff are associated with lower medical service utilization and expenditure. Methods: Using longitudinal data from 31 Chinese provinces for the period 2007-2016, we constructed fixed effects models to analyze the association between the salary of medical staff and medical service utilization, medical expenditure, medication expenditure, and medication proportion. Results: A 10,000 CNY increase in medical staff's salaries was associated with a 0.89% decrease in the average number of annual inpatient admissions per person; 1.88 and 1.59% decreases in average expenditures per outpatient visit and inpatient admission, respectively; 3.05 and 2.66% decreases in drug expenditures per outpatient visit and inpatient admission, respectively; 0.58 percent point and 0.39 percent point decreases in the share of drug expenditure in outpatient and inpatient, respectively. When medical staff's salaries increased by 450,000 CNY, the turning point was reached when the maximum medical expenditure savings offset the medical staff salary increases, yielding a 634 billion CNY surplus from medical expenditure. Conclusions: Our results supported the hypothesis that higher salary levels of the medical staff are associated with lower medical service utilization and expenditure. Further studies are requested to test whether higher medical staff's salaries will attenuate over-treatment and that savings from reduced prescriptions and service charges will offset the increased salaries of medical staff.
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Affiliation(s)
- Dawei Zhu
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Na Guo
- China Population and Development Research Center, Beijing, China
| | - Jian Wang
- Dong Fureng Economic and Social Development School, Wuhan University, Beijing, China
| | - Stephen Nicholas
- School of Economics and School of Management, Tianjin Normal University, Tianjin, China
- Australian National Institute of Management and Commerce, Eveleigh, NSW, Australia
- Research Institute for International Strategies, Guangdong University of Foreign Studies, Guangzhou, China
- Newcastle Business School, University of Newcastle, Newcastle, NSW, Australia
| | - Li Chen
- Georgia Prevention Institute, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, United States
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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; 35:51. [PMID: 34268239 PMCID: PMC8271272 DOI: 10.47176/mjiri.35.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Indexed: 12/02/2022] Open
Abstract
Background: Health inequities are among debatable and challenging aspects of health systems. Achieving equity through social determinants of health approach has been mentioned in most upstream national plans and acts in Iran. This paper reports the findings of a systematic review of the current synthesized evidence on health equity in Iran.
Methods: This is a narrative systematic review. The relevant concepts and terminology in health equity was found through MeSH. We retrieved the relevant studies from PubMed/MedLine, Social Sciences Database, and Google Scholar in English, plus the Jihad University Database (SID), and Google Scholar in Farsi databases from 1979 until the end of January 2018. The retrieved evidence has been assessed primarily based on PICOS criteria and then Ottawa-Newcastle Scale, and CASP for qualitative studies. We used PRISMA flow diagram and a narrative approach for synthesizing the evidence.
Results: We retrieved 172 455 studies. Following the primary and quality appraisal process, 114 studies were entered in the final phase of the analysis. The main part (approximately 95%) of the final phase included cross-sectional studies that had been analyzed through current descriptive inequality analysis indicators, analytical regression, or decomposition-based approaches. The studies were categorized within 3 main groups: health outcomes (40.3%), health utilization (32%), and health expenditures (27%).
Conclusion: As a part of understanding the current situation of health equity in the policymakers’ need to refer the retrieved evidence in this study, they need more inputs specially regarding the social determinants of health approach. It seems that health equity research plan in Iran needs to be redirected in new paths that give appropriate weights to biological, gene-based, environmental and contextbased, economic, social, and political aspects of health as well. We advocate addressing the aspects of Social Determinant of Health (SDH) in analyzing health inequalities.
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Affiliation(s)
- Hesam Ghiasvand
- Health Economics Group, Medical School, Institute of Health Researches, South Cloister Building, University of Exeter, United Kingdom
| | - Efat Mohamadi
- Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Olyaeemanesh
- National Institute of Health Research, Tehran University of Medical Sciences (TUMS), Tehran, Iran.,Department of Management and Health Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehdi Kiani
- Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran.,Department of Global Health & Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Amirhossein Takian
- Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran.,Department of Management and Health Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Department of Global Health & Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Khodadost M, Yavari P, Khodadost B, Babaei M, Sarvi F, Khatibi SR, Barzegari S. Estimating the Esophagus Cancer Incidence Rate in Ardabil, Iran: A Capture-Recapture Method. IRANIAN JOURNAL OF CANCER PREVENTION 2016; 9:e3972. [PMID: 27413513 PMCID: PMC4934015 DOI: 10.17795/ijcp-3972] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 09/22/2015] [Indexed: 11/25/2022]
Abstract
Background: Accurate cancer registry and awareness of cancer incidence rate is essential in order to define strategies for cancer prevention and control programs. Capture-recapture methods have been recommended for reducing bias and increase the accuracy of cancer incidence estimation. Objectives: This study aimed to estimate the esophagus cancer incidence by capture-recapture method based on Ardabil population-based cancer registry data. Patients and Methods: Total new cases of esophagus cancer reported by three sources of pathology reports, medical records, and death certificates to Ardabil province cancer registry center in 2006 and 2008 were enrolled in the study. All duplicated cases between three sources were identified and removed using Excel software. Some characteristics such as name, surname, father’s name, date of birth and ICD codes related to their cancer type were used for data linkage and finding the common cases among three sources. The incidence rate per 100,000 was estimated based on capture-recapture method using the log-linear models. We used BIC, G2 and AIC statistics to select the best-fit model. Results: After removing duplicates, total 471 new cases of esophagus cancer were reported from three sources. The model with linkage between pathology reports, medical record sources and independence with the death certificates source was the best fitted model. The reported incidence rate for the years 2006 and 2008 was 18.77 and 18.51 per 100,000, respectively. In log-linear analysis, the estimated incidence rate for the years 2006 and 2008 was 49.71 and 53.87 per 100,000 populations, respectively. Conclusions: Based on the obtained results, it can be concluded that none of the sources of pathology reports, death certificates and medical records individually or collectively were fully covered the incidence cases of esophagus cancer and need to apply some changes in data abstracting and case finding.
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Affiliation(s)
- Mahmoud Khodadost
- Gastroenterology and Liver Diseases Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Department of Epidemiology, Faculty of Health, Iran University of Medical Sciences, Tehran, IR Iran
| | - Parvin Yavari
- Department of Health and Community Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran , IR Iran
| | - Behnam Khodadost
- Department of Epidemiology, Faculty of Health, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Masoud Babaei
- Health Deputy, Ardabil University of Medical sciences, Ardabil, IR Iran; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Fatemeh Sarvi
- Epidemiology and Biostatistics Department, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Seyed Reza Khatibi
- Department of Epidemiology, Faculty of Health, Iran University of Medical Sciences, Tehran, IR Iran
| | - Saeed Barzegari
- Department of Health Information Technology, Amol Faculty of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, IR Iran
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Pakzad R, Mohammadian-Hafshejani A, Khosravi B, Soltani S, Pakzad I, Mohammadian M, Salehiniya H, Momenimovahed Z. The incidence and mortality of esophageal cancer and their relationship to development in Asia. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:29. [PMID: 26889482 DOI: 10.3978/j.issn.2305-5839.2016.01.11] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Esophageal cancer is the most common cancer in less developed countries. It is necessary to understand epidemiology of the cancer for planning. The aim of this study was to evaluate the incidence and mortality of esophageal cancer, and its relationship with Human Development Index (HDI) and its components in Asia in 2012. METHODS This study was an Ecological study, which conducted based on GLOBOCAN project of WHO for Asian counters. We assess the correlation between standardized incidence rates (SIR) and standardized mortality rates (SMR) of esophageal cancer with HDI and its components with using of SPSS18. RESULTS A total of 337,698 incidence (70.33% were males and 29.87% females. Sex ratio was 2.37) and 296,734 death (69.45% in men and 30.54% in women. The sex ratio was 2.27) esophageal cancer was recorded in Asian countries in 2012. Five countries with the highest SIR and SMR of esophageal cancer were Turkmenistan, Mongolia and Tajikistan, Bangladesh and China respectively. Correlation between HDI and SIR was -0.211 (P=0.159), in men -0.175 (P=0.244) and in women -0.231 (P=0.123). Also between HDI and SMR -0.250 (P=0.094) in men -0.226 (P=0.131) and in women -0.251 (P=0.037). CONCLUSIONS The incidence of esophageal cancer is more in less developed and developing countries. Statistically significant correlation was not found between standardized incidence and mortality rates of esophageal cancer, and HDI and its dimensions, except for life expectancy at birth.
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Affiliation(s)
- Reza Pakzad
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 2 Epidemiologist, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran ; 3 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 4 Department of Microbiology, Medical School, Ilam University Of Medical Sciences, Ilam, Iran ; 5 Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran ; 6 Deputy of Health, Isfahan University of Medical Sciences, Isfahan, Iran ; 7 Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran ; 8 Students' Scientific Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 9 Qom University of Medical Sciences, Qom, Iran
| | - Abdollah Mohammadian-Hafshejani
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 2 Epidemiologist, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran ; 3 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 4 Department of Microbiology, Medical School, Ilam University Of Medical Sciences, Ilam, Iran ; 5 Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran ; 6 Deputy of Health, Isfahan University of Medical Sciences, Isfahan, Iran ; 7 Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran ; 8 Students' Scientific Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 9 Qom University of Medical Sciences, Qom, Iran
| | - Bahman Khosravi
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 2 Epidemiologist, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran ; 3 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 4 Department of Microbiology, Medical School, Ilam University Of Medical Sciences, Ilam, Iran ; 5 Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran ; 6 Deputy of Health, Isfahan University of Medical Sciences, Isfahan, Iran ; 7 Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran ; 8 Students' Scientific Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 9 Qom University of Medical Sciences, Qom, Iran
| | - Shahin Soltani
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 2 Epidemiologist, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran ; 3 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 4 Department of Microbiology, Medical School, Ilam University Of Medical Sciences, Ilam, Iran ; 5 Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran ; 6 Deputy of Health, Isfahan University of Medical Sciences, Isfahan, Iran ; 7 Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran ; 8 Students' Scientific Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 9 Qom University of Medical Sciences, Qom, Iran
| | - Iraj Pakzad
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 2 Epidemiologist, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran ; 3 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 4 Department of Microbiology, Medical School, Ilam University Of Medical Sciences, Ilam, Iran ; 5 Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran ; 6 Deputy of Health, Isfahan University of Medical Sciences, Isfahan, Iran ; 7 Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran ; 8 Students' Scientific Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 9 Qom University of Medical Sciences, Qom, Iran
| | - Mahdi Mohammadian
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 2 Epidemiologist, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran ; 3 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 4 Department of Microbiology, Medical School, Ilam University Of Medical Sciences, Ilam, Iran ; 5 Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran ; 6 Deputy of Health, Isfahan University of Medical Sciences, Isfahan, Iran ; 7 Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran ; 8 Students' Scientific Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 9 Qom University of Medical Sciences, Qom, Iran
| | - Hamid Salehiniya
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 2 Epidemiologist, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran ; 3 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 4 Department of Microbiology, Medical School, Ilam University Of Medical Sciences, Ilam, Iran ; 5 Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran ; 6 Deputy of Health, Isfahan University of Medical Sciences, Isfahan, Iran ; 7 Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran ; 8 Students' Scientific Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 9 Qom University of Medical Sciences, Qom, Iran
| | - Zohre Momenimovahed
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 2 Epidemiologist, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran ; 3 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 4 Department of Microbiology, Medical School, Ilam University Of Medical Sciences, Ilam, Iran ; 5 Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran ; 6 Deputy of Health, Isfahan University of Medical Sciences, Isfahan, Iran ; 7 Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran ; 8 Students' Scientific Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; 9 Qom University of Medical Sciences, Qom, Iran
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