Journal of Preventive Medicine and Public Health

Original Articles

Effects of Iranian Economic Reforms on Equity in Social and Healthcare Financing: A Segmented Regression Analysis: Hamed Zandian, Amirhossein Takian, Arash Rashidian, Mohsen Bayati, Telma Zahirian Moghadam, Satar Rezaei, Alireza Olyaeemanesh; J Prev Med Public Health. 2018;51(2):83-91. Published online February 6, 2018; DOI: https://doi.org/10.3961/jpmph.17.050

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Objectives
One of the main objectives of the Targeted Subsidies Law (TSL) in Iran was to improve equity in healthcare financing. This study aimed at measuring the effects of the TSL, which was implemented in Iran in 2010, on equity in healthcare financing. Methods: Segmented regression analysis was applied to assess the effects of TSL implementation on the Gini and Kakwani indices of outcome variables in Iranian households. Data for the years 1977-2014 were retrieved from formal databases. Changes in the levels and trends of the outcome variables before and after TSL implementation were assessed using Stata version 13. Results: In the 33 years before the implementation of the TSL, the Gini index decreased from 0.401 to 0.381. The Gini index and its intercept significantly decreased to 0.362 (p<0.001) 5 years after the implementation of the TSL. There was no statistically significant change in the gross domestic product or inflation rate after TSL implementation. The Kakwani index significantly increased from -0.020 to 0.007 (p<0.001) before the implementation of the TSL, while we observed no statistically significant change (p=0.81) in the Kakwani index after TSL implementation. Conclusions: The TSL reform, which was introduced as part of an economic development plan in Iran in 2010, led to a significant reduction in households’ income inequality. However, the TSL did not significantly affect equity in healthcare financing. Hence, while measuring the long-term impact of TSL is paramount, healthcare decision-makers need to consider the efficacy of the TSL in order to develop plans for achieving the desired equity in healthcare financing.

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Citations

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Prevalence and Determinants of Catastrophic Healthcare Expenditures in Iran From 2013 to 2019
Abdoreza mousavi, Farhad lotfi, Samira Alipour, Aliakbar Fazaeli, Mohsen Bayati
Journal of Preventive Medicine and Public Health.2024; 57(1): 65. CrossRef
Decomposition of Socioeconomic Inequality in Cardiovascular Disease Prevalence in the Adult Population: A Cohort-based Cross-sectional Study in Northwest Iran
Farhad Pourfarzi, Telma Zahirian Moghadam, Hamed Zandian
Journal of Preventive Medicine and Public Health.2022; 55(3): 297. CrossRef
Inequality in Private Health Care Expenditures: A 36-Year Trend Study of Iranian Households
Ehsan Aghapour, Mehdi Basakha, Seyed Hossein Mohaqeqi Kamal, Abolghasem Pourreza
Journal of Preventive Medicine and Public Health.2022; 55(4): 379. CrossRef
Socio-economic inequality in prevalence of type 2 diabetes among adults in north-west of Iran: a Blinder-Oaxaca decomposition
Farhad Pourfarzi, Satar Rezaei, Reza Malekzadeh, Arash Etemadi, Telma Zahirian Moghadam, Hamed Zandian
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Assessing unmet health-care needs of the elderly in west of Iran: A case study
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Mohammad Hossein Mehrolhassani, Vahid Yazdi-Feyzabadi, Marzieh Lashkari
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Equity in healthcare financing: a case of Iran
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Using Tobit Regression Analysis to Further Understand the Association of Youth Alcohol Problems with Depression and Parental Factors among Korean Adolescent Females.: Jorge Delva, Andrew Grogan Kaylor, Emily Steinhoff, Dong Eok Shin, Kristine Siefert; J Prev Med Public Health. 2007;40(2):145-149.; DOI: https://doi.org/10.3961/jpmph.2007.40.2.145

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Abstract PDF

OBJECTIVES
This study characterized the extent to which youth depressive symptoms, parental alcohol problems, and parental drinking account for differences in alcoholrelated problems among a large sample of adolescent females. METHODS: The stratified sample consists of 2077 adolescent females from twelve female-only high schools located in a large metropolitan city in the Republic of Korea. Students completed a questionnaire about alcohol use nd alcohol problems, their parents' alcohol problems, and a number of risk and protective factors. Data were analyzed using tobit regression analyses to better characterize the associations among variables. RESULTS: Almost two-thirds of students who consume alcohol had experienced at least one to two alcohol-related problems in their lives and 54.6% reported at least one current symptom of depression, with nearly one-third reporting two depressive symptoms. Two-thirds of the students indicated that at least one parent had an alcoholrelated problem, and that approximately 29% had experie nced several problems. Results of tobit regression analyses indicate that youth alcohol-related problems are positively associated with depressive symptoms (p<0.01) and parent drinking problems (p<0.05). Parental drinking is no longer significant when the variable parental attention is added to the model. Decomposition of the tobit parameters shows that for every unit of increase in depressive symptoms and in parent drinking problems, the probability of a youth experiencing alcohol problems increases by 6% and 1%, respectively. For every unit of increase in parental attention, the probability of youth experiencing drinking problems decreases by 5%. CONCLUSIONS: This study presents evidence that alcoholrelated problems and depressive symptoms are highly prevalent among adolescent females. Although a comprehensive public health approach is needed to address drinking and mental health problems, different interventions are needed to target factors associated with initiation of alcohol problems and those associated with increased alcohol problems among those who already began experiencing such problems.

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Parenting and Youth Psychosocial Well- Being in South Korea using Fixed-Effects Models
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A study on the attitude affecting the preventive behavior for hearing conservation.: Kyung Yong Rhee, Kwan Hyung Yi; Korean J Prev Med. 1996;29(2):371-384.

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Abstract PDF: The purpose of this study is to investigate attitude factor related to hearing conservation and to find attitude affecting the preventive behavior for hearing conservation. The research method used in this study was self-administered questionnaire samples of the study were composed of 353 workers exposed noise selected randomly in 10 ship-building manufacturing companies. Authors extracted following 9 factors related hearing conservation from 26 attitude propositions prepared from previous study results and health belief model; (l) general perceived susceptibility, (2) relative perceived susceptibility compared with colleagues, (3) concern to the personal protective devices, (4) perceived severity and concern to the hearing capacity, (5) concern to the hearing and noise assessment, (6) concern to the control noise and hearing conservation, (7) group pressure and reason of wearing protective devices, (8) apathy of hearing loss from noise, (9) knowledge about hearing conservation Attitude factors affecting the preventive health behavior were general perceived susceptibility, concern to the noise control and hearing conservation, and concern to the personal protective devices in the case of wearing personal protective devices. But in the case of avoiding noise exposure as preventive health behavior, perceived severity and concern to the hearing capacity was a significant attitude factor with knowledge about hearing conservation.; Summary

A Study on the Incidence of Diabetes and Its Risk Factors in the Impaired Glucose Tolerence.: Joo Hee Park, Yeon Gyo Shin, Joo Ja Kim, Taik Sung Nam, Byung Kook Lee; Korean J Prev Med. 1994;27(3):425-437.

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Abstract PDF: This is to study the incidence of Diabetes and its risk factors in the impaired glucose tolerance group. 1084 subjects who had been examined 3 times for regular check-up in one human dock center under the university hospital were studied between 1986~1993. The results are as follows; Prevalence rate of diabetes was 3.56%, and that of impaired glucose tolerance was 30.90% as of initial examination. The rate of diabetes was increasing with the age where 1.2% at age group 30~39, 3.21% at age group 40~49, 5.84% at age group 50~59, 14.28% at age group 60 and over. And also the rate of impaired glucose tolerance was increasing with the age where 21.29% at age group 30~39, 31.42% at age group 40~49, 38.91% at age group 50~59, 33.33% at age group 60 and over. Of the examinees who were initially examined, total incidence rate of diabetes who developed to obvious diabetes at the 3rd follow-up examination from the initially impaired glucose tolerance group was 4.63% and it was 11.3 times higher than from the normal group (0.41%). After controlling for the effects of both age and obesity, the risk of subsequent diabetes for subjects with impaired glucose tolerance remained significantly higher than for normal subjects (Relative Risk, 10.48). Test for trends for developing to diabetes by the increasing level of fasting blood sugar and 1 hr blood sugar at the initial examination were statistically significant in either normal and impaired glucose tolerance group. To determine the risk factor for developing to diabetes, logistic regression test was applied. Only fasting blood sugar and 1 hr blood sugar were predictors for developing diabetes from the impaired glucose tolerance group at initial examination.; Summary

An analysis of contributing factors to financial status of regional health insurance.: Jong Kook Moon, Myeong Ho Park, Yong Joon Kim; Korean J Prev Med. 1991;24(2):211-220.

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Abstract PDF: Finances of health insurance can be explained by factors determining benefit expense and premium collection. This study was conducted to analyze factors contributing to the financial status of rural health insurance. Nationwide 134 health insurance associations except the six pilot project counties were analyzed and obtained the followings. 1. In univariate analysis, statistically significant variables that explain 1) outpatient benefit expenditures include public health center utilization, proportion of pregnant women, premium and collection rate of premium 2) inpatient benefit expenditures include public health center utilization, proportion of old age, proportion of pregnant women, premium and collection rate of premium 3) profits include public health center utilization, proportion of old age, proportion of pregnant women and collection rate of premium. 2. In multiple regression analysis, statistically significant determinants in 1) outpatient benefit include premium and public health utilization 2) inpatient benefit include premium 3) profit include public health center utilization, premium and collection rate of premium.; Summary

Evaluation Studies

Evaluation of Fourier Transform Near-infrared Spectrometer for Determination of Oxalate in Standard Urinary Solution.: Yeong Eun Kim, Su Hyung Hong, Jung Wan Kim, Jong Young Lee; J Prev Med Public Health. 2006;39(2):165-170.

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Abstract PDF: OBJECTIVES
The determination of oxalate in urine is required for the diagnosis and treatment of primary hyperoxaluria, idiopathic stone disease and various intestinal diseases. We examined the possibility of using Fourier transform near-infrared (FT-NIR) spectroscopy analysis to quantitate urinary oxalate. The practical advantages of this method include ease of the sample preparation and operation technique, the absence of sample pre-treatments, rapid determination and noninvasiveness. METHODS: The range of oxalate concentration in standard urine solutions was 0-221 mg/l. These 80 different samples were scanned in the region of 780-1,300 nm with a 0.5 nm data interval by a Spectrum One NTS FT-NIR spectrometer. PCR, PLSR and MLR regression models were used to calculate and evaluate the calibration equation. RESULTS: The PCR and PLSR calibration models were obtained from the spectral data and they are exactly same. The standard error of estimation (SEE) and the % variance were 10.34 mg/l and 97.86%, respectively. After full cross validation of this model, the standard error of estimation was 5.278 mg/l, which was much smaller than that of the pre-validation. Furthermore, the MCC (multiple correlation coefficient) was 0.998, which was compatible with the 0.923 or 0.999 obtained from the previous enzymatic methods. CONCLUSIONS: These results showed that FT-NIR spectroscopy can be used for rapid determination of the concentration of oxalate in human urine samples.; Summary

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