BackgroundHCV virus (HCV) is a significant global problem with wide-ranging socio-economic impacts. Because of the high morbidity and mortality associated with end-stage liver disease, cirrhosis, and hepatocellular carcinoma (HCC), the economic burden of HCV infection is substantial.ObjectivesThis study aimed to estimate the direct medical care costs of chronic HCV infection.Patients and MethodsFor this cross-sectional study, 365 courses of HCV treatment were extracted from medical records of 284 patients being referred to Tehran HCV clinic, a clinical clinic of Baqiyatallah Research Center for Gastroenterology and Liver diseases, from 2005 to 2010. All the patients had been diagnosed with HCV. Direct medical care costs for each course of HCV treatment have been calculated based on Purchasing Power Parity Dollar (PPP$).ResultsAverage direct medical costs for the courses treated with conventional interferon plus ribavirin (INF-RBV) were 4,403 PPP$, and 20,010 PPP$ for peg-interferon plus ribavirin (PEG-RBV) courses. There was an increase of the direct costs in both courses of treatment to achieve Sustain Viral Response (SVR). The costs amounted to 10,072 PPP$ in (INF-RBV) treatment and 34,035 PPP$ in (PEG-RBV). The significant difference between the costs of these two courses of treatment is attributable to high cost of Peg-interferon. This indicates that the medication costs are the dominant costs.ConclusionsAccording to the results, total direct medical costs for HCV patients in Iran exceeded 12 billion PPP$ in (INF-RBV) treatment and 55 billion PPP$ in (PEG-RBV).
Background: Nosocomial infections (NIs) are an important public health problem worldwide, particularity in the intensive care units (ICUs). Objectives: The current study aimed to detect and highlight NIs as the critical factor in increasing mortality and morbidity to clarify the current health priorities and challenges in Iran. Patients and Methods: It was a retrospective study on 376 selected patients admitted in ICU at a public hospital in Tehran, Iran, from 2012 to 2014. The major studied NIs included: ventilator associated pneumonia (VAP), central venous catheter related primary bloodstream infections (CRBSIs or BSI), surgical site infections (SSIs) and catheter associated urinary tract infections (CAUTI or UTI). NIs were defined based on the centers for disease control and prevention (CDC) definitions. Site specific NIs rates, mortality rate and the length of hospital stay and other demographic or clinical variables were extracted. Results: Three hundred-four patients were examined for NIs. NIs rate was 19.7% and mortality rates were 44.4% and 21.72% in infected and uninfected patients, respectively. The most frequent NIs was VAP and the highest observed rates of mortality were BSI in males (P = 0.050) and UTI in females (P = 0.05). The mortality rate in the infected patients was twice the other patients [2.187 (CI: %95: 1.154.13), P = 0.010]. The results showed that patients with cardiovascular respiratory dysfunction were exposed to higher risk of death. Infection rate increased in patients with diabetes and endocrine disease. Conclusions: To manage ICU patients, risk factors and causative procedures contributing to incidence and development of Nis should be considered. The most considerable points are accurate disinfection and more strict infection control procedure especially for prevent of VAP and BSI, which associated with the increasing of patient's mortality. This issue is more crucial in the cases of the cardiovascular respiratory and diabetic patients.
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