Background: Determining the optimal number of hospital beds is a complex and challenging endeavor and requires models and techniques which are sensitive to the multi-level, uncertain, and dynamic variables involved. This study identifies and characterizes extant models and methods that can be used to determine the required number of beds at hospital and regional levels, comparing their advantages and challenges. Methods: A systematic search was conducted using Web of Science, Scopus, Embase and PubMed databases, with the search terms hospital bed capacity, hospital bed need, hospital, bed size, model, and method. Results: Twenty-three studies met the criteria to be included in the review. Of these studies, a total of 11 models and 5 methods were identified, mainly designed to determine hospital bed capacity at the regional level. Common determinants of the required number of hospital beds in these models included demographic changes, average length of stay, admission rates, and bed occupancy rates. Conclusions: There are no specific norms for the required number of beds at hospital and regional levels, but some of the identified models and methods may be used to estimate this number in different contexts. Moreover, it is important to consider alternative approaches to planning hospital capacity like care pathways to fix the limitations of "bed numbers".
Allopurinol and febuxostat are urate-lowering drugs used for the long-term treatment of gout through reducing the uric acid levels. More studies have indicated cost-effectiveness of febuxostat in reducing serum urate concentration and showed that it alleviates gout flares better than allopurinol. However, related studies have reported conflicting results about the cost-effectiveness of these drugs.
→What this article adds:Febuxostat is more cost-effective than allopurinol in all treatment sequences in studies which have used uric acid level as the measure of effectiveness. In addition, febuxostat has been shown to be more costeffective as the second-line treatment in studies with the quality of life as the measure of effectiveness.
Implementing CPW can affect different types of indicators such as input, process, output and outcome indicators, although outcome indicators capture more attention than other indicators. Patient-related indicators were dominant outcome indicators, whereas professional indicators and organizational factors were considered less extensively. WHAT IS KNOWN ABOUT THE TOPIC?: WHAT DOES THIS ARTICLE ADD?
Control of noncommunicable diseases (NCDs) requires the management of behavioral risk factors such as tobacco smoking and alcohol consumption. Alcohol consumption and tobacco use are the main risk factors of NCDs and account for about 1% and 13% of total deaths in Iran, respectively. This study aimed to analyze policies regarding tobacco use and alcohol consumption and understand their content, context, process, and actors in Iran. We conducted a case study design guided by the Walt and Gilson Policy Analysis Framework. This study was conducted in two phases: A review of policy documents on tobacco and alcohol, and scoping review of studies related to the policies identified in the first phase. The contents of tobacco and alcohol control policies are mostly in line with international recommendations including, the MPOWER policy package for tobacco and recommended target areas proposed by World Health Organization (WHO) for alcohol. Political commitment to health promotion, social and religious values, joining international treaties, and the high prevalence of NCDs have been significant factors in the agenda‐setting of alcohol and tobacco policies in Iran. Although the health governance structure and the primary health care system have provided opportunities for implementation of policies, weak cross‐sectoral collaboration and the lack of some stakeholders' support, including the tobacco industry, pose challenges to the successful implementation of tobacco and alcohol policies. Thus, a multi‐sectoral approach is essential to control NCDs in Iran.
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