伊朗卫生部门改革第二阶段实施后与实施前相比的院内死亡率。
Intrahospital Mortality Rate after the Implementation of the Second Phase of the Health Sector Reform in Comparison with Before that in Iran.
作者信息
Iravani Mojtaba, Khadivi Reza
机构信息
Community and Family Medicine Department, Medical Faculty, Isfahan University of Medical Sciences, Isfahan, Iran.
出版信息
Int J Prev Med. 2024 Aug 12;15:33. doi: 10.4103/ijpvm.ijpvm_288_23. eCollection 2024.
BACKGROUND
The second phase of the health sector reform, called the Health Sector Evolution Plan (HSEP), has been implemented in Iran since 2014, aims to improve the equity and quality of health services. In the present study, we aimed to measure the trend of hospitalization and the crude intrahospital mortality rate from 1 year before the HSEP implementation (2013) to 5 years after the HSEP implementation (2018) in public hospitals compared with profit, nonprofit, and charity hospitals, which are affiliated with the Isfahan University of Medical Sciences (MUI).
METHODS
In a prospective, cross-sectional study, the data related to the frequency of hospitalized patients and intrahospital mortality during the time of hospitalization were collected through census sampling from 39 public hospitals as the hospitals and 20 profit, nonprofit, and charity hospitals as the hospitals.
RESULTS
After HSEP implementation, the frequency of hospitalization increased in public hospitals by 50.45% compared with the previous period. Although the crude intrahospital mortality rate increased from 12.61 to 12.93 per 1000 hospitalized patients (an increase of 2.54%) in public hospitals, the raise was not significant ( value = 0.348). The frequency of hospitalization increased in Social Security Organization's (SSO) hospitals as well as charity hospitals. However, the percent of decrease in the intrahospital mortality rates were -42.96%, -34.76%, and -18.47% in the private, charity, and SSO hospitals, respectively, but was not significant ( value > 0.05).
CONCLUSIONS
The crude intrahospital mortality rates in public hospitals affiliated with MUI did not change significantly after the implementation of the HSEP.
背景
伊朗自2014年起实施卫生部门改革的第二阶段，即《卫生部门发展计划》（HSEP），旨在提高卫生服务的公平性和质量。在本研究中，我们旨在衡量从HSEP实施前1年（2013年）到HSEP实施后5年（2018年），与伊斯法罕医科大学（MUI）附属的盈利性、非营利性和慈善医院相比公立医院的住院趋势和院内粗死亡率。
方法
在一项前瞻性横断面研究中，通过普查抽样从39家公立医院（即 医院）和20家盈利性、非营利性和慈善医院（即 医院）收集住院患者频率和住院期间院内死亡率的数据。
结果
HSEP实施后，公立医院的住院频率较上一时期增加了50.45%。尽管公立医院每1000名住院患者的院内粗死亡率从12.61上升至12.93（增加了2.54%），但升高并不显著（ 值 = 0.348）。社会保障组织（SSO）医院以及慈善医院的住院频率也有所增加。然而，私立、慈善和SSO医院的院内死亡率下降百分比分别为-42.96%、-34.76%和-18.47%，但均不显著（ 值 > 0.05）。
结论
MUI附属公立医院在实施HSEP后，院内粗死亡率没有显著变化。
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