Background Demands for dental services seem to be beyond the capacities of most healthcare systems these days. Patient preferences have been increasingly emphasized to be considered in the joint decision-making process. Willingness-to-pay (WTP) is a recommended method for measuring the utility of health services; increasingly being used in recent decades. Taking these points into consideration, this article aims to provide an overview of the methodological aspects and policy implications of WTP studies in the field of oral health. Methods The research was conducted in ISPOR, PubMed and Google Scholar databases. In addition, reference lists of included articles were checked to identify the relevant studies. All studies published were included that were in the English language and reported using WTP for oral health-related goods and services. A data-charting form was developed by a focus group discussion panel of seven experts to derive the main methodological aspects of WTP. Also, Core policy suggestions were categorized through thematic content analysis of the included papers. Results The search strategy yielded 389 studies of which 52 were included. WTP studies in oral health show an increasing trend in global publications. The UK and Canada have a greater share in published material than in any other country. The dominant field of these researches is in restorative and prosthetic dentistry, and a wide range of different methodological aspects was documented. Policy suggestions were categorized in three main themes: (A) setting new tariffs or subsidizing the item, (B) provision of the item due to population preferences, and (C) improving literacy regarding the item. Conclusions An urgent need for a common framework regarding the design of WTP studies in dentistry seems paramount. Some policy suggestions seem not to be applicable, perhaps due to insufficient familiarity of the researchers with the complexities of the public policymaking process.

Health-related resource-allocative decisions are difficult to make, particularly in the oral health field where demands for services are beyond the capacities of health systems, especially in low-and middle-income countries. 1 For an evidencebased medical decision making, in addition to sound and clear evidence of the effectiveness of health services and clinical expertise, patient's preferences should be taken into account. 2 Moreover, priorities and demand for health care, as part of social services, need to be considered for informed service planning purposes. 3 There are several ways to measure the stated utility of health and health services, of which willingness to pay

Objective : Increasing social welfare and reducing poverty are to ensure the well-being of all classes of a society. Cities and villages are distinguished by cultural and economic disparities. The purpose of this study was to develop and present a comprehensive model on welfare and wealth components and their relationship with each other , as well as determining the contributing factors and variables affecting them by presenting a comprehensive model. Results : The Structural Equation Modeling ( SEM ) method was used to analyze the data and investigate the causal relationship of latent variables. Observed variables and latent variables of the model were analyzed and tested by using AMOS and SPSS (version 21) statistical methods, in two exploratory and confirmatory steps. Wealth and welfare were identified as two separate subjects in the conceptual model and in the final structural model for rural households. Unlike, in the urban community, they were recognized as a single category in the final structural model. The results of this study can provide the clear hints for effective policy making to break the cycle of deprivation and poverty in Iranian rural and urban population.

Background: Drug abuse is a critical health problem of human society. This study aimed to evaluate the prevalence and determinants of drug abuse among students in one of the medical universities of Iran. Methods: This cross-sectional study was performed in 2016 among a convenient sample of 800 undergraduate students from a medical university in the capital of Iran. Data were gathered by means of a self-administered questionnaire inquiring students’ age, gender, marital status, home city, living status, and drug used including history, frequency and types. Statistical evaluation included the Chi-square test and logistic regression models. Results: respondents’ mean age was 23.5; 67% were men, and 70% were single. Totally, 15% of the students reported to smoke cigarette and ≤6% use other drugs; more men than women (p<0.01). Alcohol use reported by 7% of the students more women than men (p=0.02). Older students, those spending their free time alone, and those without a job more frequently (p≤0.001) reported using all types of the drugs. Conclusion: The majority of the studied students did not report drug abuse. Considering the critical responsibilities of health care students, the prevalence is, however, needs to be reduced even further with purposeful preventive programs.

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Background Migration of skilled health workers could result in shortage of human resources and rising inequalities in service provision in source countries. To date, most of relevant papers are focused on rate and reasons of migration while the need for conducting studies on modelling of factors is more vividly felt. The aim of this review was to determine the factors influencing the migration decisions of medical and dental graduates migrating from developing countries and to introduce a practical conceptual framework for health worker migration. Methods Electronic databases PubMed, Google Scholar and relevant Journals were systematically searched for English language publications from January 2009 to April 2019. The inclusion criteria were: 1) article stated factors affecting migration decisions of medical doctors and/or dentists, 2) the source country in the study was a developing country, 3) participants’ primary qualification country was in a developing country,4) the study used primary data both qualitative or quantitative. Results The search identified 814 articles from which we included 23 full-text studies after applying eligibility checklist. Push and pull theory was the most popular model to describe the migration driving factors. Poor socio-economic situation, political instability, lack of professional and educational opportunities together with family concerns found as strong common push factors that perpetuate migration. The most influencing pull factors were desire for better quality of life, career and training opportunities and financial gain. Conclusions Despite the fact that health workers migrate for different reasons, they follow a same route for decision to stay or leave their own countries. Un-fulfillment of expectations in mother land in addition to media reconstructed reality of life in foreign land can develop a positive attitude for migration Which should be considered before weighing up the push and pull factors of both sides. Key messages A better understanding of the migration motives of health professionals will help health authorities to improve their workforce recruitment and retention strategies and health service planning. Our simple yet comprehensive framework can mainly identify the development of migration desire through combining different models and concepts of migration, behavioral change, values, needs and so on.

Objectives: This study aimed at assessing the influential factors on oral health status of the elderly Iranian population (65 to 74 years of age) by using Path analysis.   Methods: This study was conducted on 7,521 elderly individuals participating in the Iranian National Oral Health Survey in 2012. After data collection process, initially decayed, missing, and filled teeth (DMFT) index as well as functional health (FH) index were evaluated in this study by using clinical data.  The socio-economic status (SES), insurance type (IT), dental attendance pattern (DAP), reason of attendance (R of A), tooth cleaning (TC), and nutritional pattern (NP) were evaluated according to responses provided to the questions in the questionnaire by participant. Path analysis was applied to analyze the patterns between these variables and DMFT and FH index. Results: The participants’ mean DMFT was 26.6±8.03, and the median FH was 0 (0.10). Path analysis revealed that seniors with higher SES, and having a dental insurance with greater coverage had a direct effect on more regular DAP, and indirect effect on improvement of FH and reduction in DMFT index. More regular DAP had a direct effect on improvement of FH, and reduction of DMFT index. Also, NP with lower risk of caries had a direct effect on improvement of FH and reduction of DMFT index.   Conclusion: Out of all the evaluated factors, IT, SES, DAP, and NP demonstrated to be particularly important and significantly affecting DMFT and FH indices in the elderly population. Out of all aforementioned factors, IT in low SES individuals was more important for obtaining required oral healthcare services. Apparently, seniors’ oral health is absolutely in need of special attention with particular focus on providing access to early prevention and care.

Objectives: Dental specialties in Iran were first established in 1970s, and developed over time. Considering that information is essential for health policymaking, and lack of it is the main problem; therefore, policymakers require adequate knowledge about development and alterations of healthcare providers to recognize the influential factors on them. Regarding the information gap on development of dental specialties in Iran, this qualitative study aimed to assess it. Methods: This qualitative case study was conducted through 12 semi-structured interviews with the experts and pioneers of the oral healthcare system in Iran who were selected by purposive and snowball sampling. Data were analyzed by content analysis method, which included transcribing, identifying the meaning units, abstracting the content, sorting codes, and formulating themes using Atlas.ti software. Results: After data analysis, three main themes were extracted regarding development of dental specialties in Iran according to the interviewees: (A) trend of development, (B) challenges of development, and (C) necessities of development. Trend of development of dental specialties included two comprehensive phases, and one phase focusing on quantity and inadequate attention to quality. The challenges of development of dental specialties included management and policy-making problems, interactions outside the system, popularity of specialization, and process of admission to specialty programs. The necessity of need assessment, paying attention to the costs of healthcare interventions, defining the range of specialization, and revision of dental specialty programs are among the necessities of development of dental specialties. Conclusion: Dental specialties in Iran were developed at a time with inadequate attention to shortage of infrastructure based on political interactions. The popularity of specialization in dentistry and the associated high costs in a free educational system highlight the significance of need assessment regarding the number of specialists required in academic and therapeutic fields, and setting some criteria for development of specialty programs.