Introduction: Planning in the field of medical tourism is of particular importance. The main objective of this research was to identify and analyze the factors affecting the growth of medical tourism in Iran. It could be a small step toward promoting entrepreneurship and increasing non-oil revenues in the country. Methods: Studies published in the Persian and English language during the years 2006-2019 in Science Direct, ProQuest, Springer, Medline, Scopus, Ovid, and SID databases were reviewed, and the findings were then compared. Results: A total of 75 articles out of 2631 unique publications were included in this study. Most articles reported studies performed for all patients, including the whole country (Iran) (n=22, 30%), Shiraz only (n=11, 15%), Tehran only (n=11, 15%), Mashhad only (n=6, 8%), Isfahan only (n=5, 6%), and Ardabil only (n=4, 5%). Conclusion: Given the history of Iranian hospitals in attracting foreign patients and the analysis of their status, there are many limitations in achieving a proper standing in the medical tourism industry. Strategies offered by various managers and authorities in tourism can lead to increased attraction of medical tourists to public and private hospitals in Shiraz, relying on the capabilities and potential of Shiraz and its health sectors, including climate and nature, cultural and historical attractions, renowned practitioners, advanced equipment, facilities, and methods, and thereby generating more foreign exchange earnings and employment.

Background and objective: Saving blood products is an important public health issue especially in developing countries with limited financial resources. We aimed to suggest a new hypothetical model to make a change in the current blood transfusion policy in the newborn intensive care unit (NICU) to reduce wastage of blood supplies as well as the risk of exposure to multiple donors. Methods: In this cross-sectional study, all transfused neonates (n=70) who were admitted to NICU of Nemazee Hospital, a tertiary referral hospital in Southern Iran, were evaluated between March and June 2019. Based on the information of neonates’ transfusion during this study period and determined transfusion indices, a specific pediatric pack was suggested and the related total costs per transfusion, as well as the donor-exposure rate of the hypothetical and the current transfusion method, were compared. Results: Considering the mean number of transfusions per neonate: 4 and mean volume of transfused packed red cells: 20 ml per transfusion, the cost-analysis of pediatric and the adult pack was presented. Arithmetically, we proved a higher total cost per transfusion for using adult pack comparing to pediatric pack. Additionally, using a pediatric pack set leads to a 24% reduction in RBCs wastage per transfusion and a 68.13% reduction in donor-exposure rate.Conclusions: The assignment of a dedicated pediatric pack for neonates will be able to improve the cost-effectiveness by a substantial reduction in donor-exposure rate and blood wastage. This finding should be taken into consideration to generate economic growth and make improvements in child health status.

Background: In operating rooms, blood product wastage occurs with various reasons especially over-demand ordering during elective surgeries. Consequently, it imposes a heavy financial burden on health system. Therefore, managing blood consumption in the operating rooms is of special importance. Surgeons and anesthesiologists play a key role in blood transfusion practice in operating rooms. Objective: To investigate surgeons´ and anesthesiologists´ perspectives in regard to the effective strategies for better management of blood transfusion practice in operating rooms. Method: In this qualitative cross-sectional study, from January to March 2020, 60 surgeons and anesthesiologists were participated. All of them were working in surgical departments of the general hospitals affiliated with Shiraz University of Medical Sciences, in Shiraz, Southern Iran. Their viewpoints regarding the improvement of blood consumption management in operating rooms were recorded through interviews and several focus group sessions. Results: After content analysis, the most important recommendations with the highest scores were regular training programs for surgical team (23.3%), collaboration of surgeons, anesthesiologists, and managers of the surgical departments by arrangement of monthly meetings to estimate the number of required blood bags more accurately (23.3%), establishing a wellorganized electronic requesting and registration system (13.3%), promoting the ordering process by a comprehensive preoperative evaluation (11.6%), and updating transfusion protocols based on the standards and monitoring the adherence to these standards (10%). Conclusion: Implementing the proposed policies, which are based on the invaluable experiences of related experts would be effective in improving blood consumption management in operating rooms.

Background and objective Saving blood products is an important public health issue especially in developing countries with limited financial resources. We aimed to suggest a new hypothetical model to make a change in the current blood transfusion policy in the newborn intensive care unit (NICU) to reduce wastage of blood supplies as well as the risk of exposure to multiple donors. Methods In this cross-sectional study, all transfused neonates (n = 70) who were admitted to NICU of Nemazee Hospital, a tertiary referral hospital in Southern Iran, were evaluated between March and June 2019. Based on the information of neonates’ transfusion during this study period and determined transfusion indices, a specific pediatric pack was suggested and the related total costs per transfusion, as well as the donor-exposure rate of the hypothetical and the current transfusion method, were compared. Results Considering the mean number of transfusions per neonate: 4 and mean volume of transfused packed red cells: 20 ml per transfusion, the cost-analysis of pediatric and the adult pack was presented. Arithmetically, we proved a higher total cost per transfusion for using adult pack comparing to pediatric pack. Additionally, using a pediatric pack set leads to a 24% reduction in RBCs wastage per transfusion and a 68.13% reduction in donor-exposure rate. Conclusions The assignment of a dedicated pediatric pack for neonates will be able to improve the cost-effectiveness by a substantial reduction in donor-exposure rate and blood wastage. This finding should be taken into consideration to generate economic growth and make improvements in child health status.

Background and objective:In most developing countries, blood transfusions are routinely administered by adult red blood cells (RBCs) packs in infants leading to wastage of a large amount of blood supplies as well as having high donor exposure risk. We aimed to compare the cost-effectiveness of hypothetical pediatric pack compared to adult RBCs pack in neonates.Methods: In this cross-sectional study, all transfused neonates (n = 70) who were admitted to the newborn intensive care unit (NICU) of Nemazee Hospital, a tertiary referral hospital in Shiraz, Southern Iran, were evaluated between March and June, 2019. Based on the blood bank information during the study period and transfusion indices, a specific pediatric pack was suggested and cost-effectiveness of new and traditional transfusion methods was compared.Results: Considering the mean number of transfusions per neonate: 3.57 and mean volume of transfused packed red cells: 20 ml per transfusion during the study period; a quadruple pediatric pack (240 ml divided in 4 sub-packs) was purposed and cost-analysis of pediatric and adult pack was performed. Mathematically, we proved higher cost-effectiveness in using pediatric versus adult pack. Additionally, using pediatric packs leads to 13.74% reduction in RBCs wastage per transfusion and 68.13% reduction in donor exposure rate.Conclusions: Assignment of dedicated pediatric pack for infants will be able to substantially reduce donor exposure risk as well as wasted resources leading to higher cost effectiveness. This finding should be taken into consideration especially in developing countries in order to promote both economic situation and child health status.