Background: Appropriate allocation of resources is an important issue in the delivery of services that can reduce the health system costs. The inappropriateness of healthcare services is one of the problems that increase the pressure on hospitals and patients. Methods: In this study, the data were collected using the appropriateness evaluation protocol by a medicine specialist at Rasoul Akram Hospital. In total, 248 participants were selected through systematic sampling. To calculate the financial burden simultaneously with the evaluation of inappropriate hospitalization days, the medicine and facility costs along with the cost of bed-day were estimated. Data were analyzed by SPSS software. Results: The type of treatment was surgery in 56.8% of the patients and 43.2% of them were admitted to the hospital for internal medicine. The mean length of stay was 4 ± 6 days. The inappropriate admission rate was estimated at about 6% and the rate of inappropriate hospital stays was 21.5%. The most important factors influencing the inappropriateness of hospitalization were delayed medical consultations, delayed surgery, conservative practitioner, and the follow-up of clinical test results. The sum of the direct financial burden of inappropriate hospitalization for the patients was estimated at around 1060 dollars. Conclusions: The findings of this study indicated that inappropriate hospitalization and admission imposed a huge financial burden on the health system and community. Hospital authorities by considering issues such as delayed medical consultations and delayed surgery can decrease the financial burden of inappropriate hospitalization to a large extent.

Introduction: Provision of unnecessary medical services is one of the problems that have driven up health care budgets. The condition of Emergency department and sometimes patients 'unreasonable expectations may lead to ED staff burnout and increase the provision of unnecessary services. Methods: In this study, the Hospital Urgencies Appropriateness Protocol (HUAP) was used to assess the appropriateness of services provided in the ED. The sample size of this study consisted of 445 patients who were selected among the patients admitted in Rasoul Akram and Firouzgar hospitals by stratified sampling. Chi-square and logistic regression tests were used to analyze the data. Results: The rate of inappropriate admission in the ED of the studied hospitals was measured at about 13%. Patients admitted to the Firouzgar ED showed a higher probability to inappropriate admission. Among considered factors, gender and Interval between the onset of symptoms and ED admission are affecting factor in inappropriate admission. Conclusion: The rate of in appropriate admission is somehow high in this study. Gender and Interval between the onset of symptoms and ED admission can be considered as predictors of the provision of unnecessary services. So it is significant to provide operational and evidence-based solutions regarding the issues related to the provision of unnecessary services in the ED.

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Background: Different countries have used different methods to reduce trauma-related mortality and its complications. Objectives: Splint is a temporary and conventional method of fixing an injured organ. Therefore, evaluating the quality of life in trauma patients with splint immobilization is important. Methods: This prospective study was performed on 287 trauma patients with splint immobilization in two baseline periods and one month later in Haft-e-Tir and Rasoul-e-Akram hospitals. The Data collection tool was the SF-36 quality of life questionnaire. Paired t-test was used to assess the changes in the quality of life. SPSS version 21 was used for statistical analysis. Results: The mean quality of life in the study's first phase was 76.31 ± 9.42, and one month after splint immobilization was 76.13 ± 8.98, and there was no significant difference between the two phases. The Splint immobilization of the patients significantly affected the quality of life in 5 out of 8 dimensions. Still, the intervention increased the scores in 3 dimensions and decreased scores in 2 dimensions. The results showed that social performance (P = 0.01), energy and vitality (P < 0.001), and emotional health (P < 0.001) increased, and physical performance (P = 0.01) and general health (P = 0.001) decreased, and they were significantly different in the two phases. There were no significant differences between emotional limitation, physical limitation, and pain in the two phases of the study. Conclusions: Splint immobilization of patients improved the quality of life in 5 out of 8 dimensions. After a month, the trauma-related mental and physical shock did not disappear, and even the patients were more sensitive to quality-of-life questions due to time spent with splint immobilization and familiarity with its limitations. The patients tried to reflect on their dissatisfaction with splint immobilization.