Background: Cutaneous leishmaniasis as a prevalent sandfly borne disease in many tropical and subtropical countries has adverse economic consequences for patients and health care systems. Objectives: The aim of present study was evaluation of the economic burden of cutaneous leishmaniasis on families and consequently the health care systems in all of 31 provinces of Iran for year 2017. Methods: This cross-sectional study was carried out based on available data from 14125 cutaneous leishmaniasis cases in all endemic foci of Iran in 2017. The direct and indirect costs paid by patients and government health care systems were extracted through accounting documents via patients and health staff in the office of zoonotic diseases control, CDC, Iranian Ministry of Health. The data was recorded in researcher-made forms. Activity based costing (ABC) is used to evaluate economic burden of health care services in Iran to patients with of CL. Two financial software suites namely Azarakhsh and Roozamad have been employed in addition to Excel V. 2010. Results: The incidence of cutaneous leishmaniasis in Iran was 17.82 per 100,000 people (14125/79,262,000). Economic burden of the disease was estimated at 291,046,430,125 Rials ($ 5,820,928). The average direct, indirect (overhead) and governmental costs paid for each case with CL was 10,631,250 Rials ($ 212.5), 9,653,807 Rials ($ 193) and 20,285,057 Rials ($ 405.5) respectively. The out of pocket for each patient was around 320 thousand Rials ($ 7). Total costs (governmental + out of pocket) during this period was estimated at 20,605,057 Rials ($ 412.5) expenditure per capita. Conclusions: Direct and indirect costs associated with diagnosis and treatment of CL in Iran that was provided by governmental health care systems and out-of-pockets are considerably high. It can have a great economic impact on families and consequently the health care systems. It seems adopting suitable preventive methods will be more affordable for people who live at risk of the disease.
Background: The novel coronavirus disease 2019 (COVID-19) has placed heavy direct and indirect economic burden on the people and the health system. Objectives: The present study aimed to estimate the economic burden of COVID-19 in Qom Province, using the step-down cost accounting (SDCA) method. Methods: This descriptive, cross-sectional study included all COVID-19 patients in Qom Province from February 19, 2020, to June 19, 2020. The patients’ data were collected in the form of major cost groups with integrated health system (IHS), health information system (HIS), and a financial software called Roozamad. The governmental, out-of-pocket, and opportunity costs paid by patients and hospitals were calculated and evaluated using SDCA in Microsoft Excel software. Results: The incidence of COVID-19 infection was 518 per 100,000 populations in Qom Province in the aforementioned period. The total government costs for the treatment of the patients were calculated to be 2,229,216,930,370 Rials (8,916,867 $). Among the major governmental cost groups, personnel costs accounted for the highest total expenditures. In addition, out-of-pocket costs of patients and their families equaled 30,038,013,060 Rials (120,152 $). The costs of final service departments accounted for more than half of the total costs. The opportunity costs were calculated as 420 billion Rials (15.68% of total costs). Conclusions: According to the findings, the direct and indirect costs associated with the treatment of COVID-19 patients can impose a heavy economic burden on the households and health care system. Therefore, disease prevention strategies such as observing health protocols are recommended to reduce the burden of the disease.
Background and Aim: Human cystic echinococcosis (CE) is an important, neglected zoonotic disease with worldwide distribution which has been reported in different regions of Iran, including the central areas (e.g. Qom Province). The disease is caused by the Echinococcus granulosus parasite living in the intestine of dogs and other canids as definitive hosts. This study aimed to investigate the epidemiology, burden, and geographical distribution of CE in Qom Province, Central Iran. Materials and Methods: In this descriptive-analytic study, the data of patients with diagnosed CE during 2011-2018 were collected from all urban and rural areas of Qom Province. The data of the epidemiological status of CE cases were extracted from the CE surveillance system in the Centers for Disease Control and Prevention in the Qom University of Medical Sciences which is owned and run by Iran's Ministry of Health and Medical Education. In addition, the economic burden of the disease was evaluated by Azarakhsh and Roozamad financial software; the geographical distribution of CE was obtained by ArcGIS 10.3 software (IBM Corp., Chicago, USA). Results: The results reveal that the incidence rate of CE was 6.81/100,000 people over the 8-year period of the study. More than half of the cases were females (57.95%), housewives (57.47%), and residents (89.77%). The majority of the cases were Iranian (88.77%) and the rest were from the two neighboring countries: Afghanistan and Pakistan. The economic burden of the human CE in the 8 years was estimated to be 3,761,352,526 rials (75,227 $). In terms of spatial distribution, the highest incidence rate of CE was observed in Salafchegan District in the southwest of Qom Province. Conclusion: The economic burden of human CE infection provided by governmental health-care systems or as out-of-pocket expenses is relatively high, and housewives, especially those living in Salafchegan District, are more likely to be affected. More studies are recommended on different epidemiological aspects and the definitive hosts of the parasite; besides, people at risk need to be warned and educated so that the incidence rate of the disease is reduced.
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