The study findings showed that the public health expenditures in the EMR countries improved health outcome, while the private health expenditures did not have any significant relationship with health status, so often increasing the public health expenditures leads to reduce IMR. But this relationship was not significant because of contradictory effects for poor and wealthy peoples.

Background: End-stage Renal Disease is considered a health problem due to the high prevalence and economic burden on society and the health system. This study utilizes a cost-utility analysis to evaluate the costs and outcomes of the Iranian End Stage Renal Disease patients. Methods: A Markov model-based economic evaluation with a societal perspective, and a lifetime horizon performed to quantify the costs and health-related outcomes in terms of QALY. Direct medical costs obtained from hospital billing and medical records and direct non-medical costs, and indirect costs derived from interviews with patients. Three policy options, the hemodialysis, peritoneal dialysis and kidney transplantation were compared. Most of the Transplants from deceased and rest were from Live Related Donors. One-way and probabilistic sensitivity analyses were performed to study uncertainty. Results: Annual average cost of hemodialysis is $13477 cost of peritoneal dialysis is $12865, and cost of Transplantation is $16450.The Transplantation arm gained 9.43 QALY compared with peritoneal dialysis and hemodialysis with 6.95 and 6.04 QALY respectively. When Transplantation was compared with peritoneal dialysis, Incremental Cost-Effectiveness Ratio was $1744 per QALY. ICER value suggests that Transplantation is cost-effective compared with peritoneal dialysis at a willingness-to-pay threshold of $12,400, and hemodialysis was dominated. Conclusion: This study suggests that kidney transplantation is a better option over hemodialysis and peritoneal dialysis. We conclude that serious efforts ought to be made to foster potential brain-dead donors and altruistic kidney donation and promote peritoneal dialysis as a superior alternative to hemodialysis for eligible patients.

Introduction:Successful health system planning and management is dependent on well informed decisions, so having complete knowledge about medical services’ utilization is essential for resource allocation and health plans. The main goal of this study is identification of factors effecting inpatient and outpatient services utilization in public and private sectors.Methods:This study encompasses all regions of Tehran in 2011 and uses Urban HEART questionnaires. This population-based survey included 34700 households with 118000 individuals in Tehran. For determining the most important factors affected on health services consumption, logit model was applied.Results:Regarding to the finding, the most important factors affected on utilization were age, income level and deciles, job status, household dimension and insurance coverage. The main point was the negative relationship between health care utilization and education but it had a positive relationship with private health care utilization. Moreover suffering from chronic disease was the most important variable in health care utilization.Conclusions:According to the mentioned results and the fact that access has effect on health services utilization, policy makers should try to eliminate financial access barriers of households and individuals. This may be done with identification of households with more than 65 or smaller than 5 years old, people in low income deciles or with chronic illness. According to age effect on health services usage and aging population of Iran, results of this study show more importance of attention to aged population needs in future years.

Background:Drug costs in Iran accounts for about 30% of the total health care expenditure. Moreover, pharmaceutical business lies among the world’s greatest businesses. The aim of this study was to analyze Iran’s comparative advantage and intra-industry trade in pharmaceuticals so that suitable policies can be developed and implemented in order to boost Iran’s trade in this field.Methods:To identify Iran’s comparative advantage in pharmaceuticals, trade specialization, export propensity, import penetration and Balassa and Vollrath indexes were calculated and the results were compared with other pharmaceutical exporting countries. The extent and growth of Iran’s intra-industry trade in pharmaceuticals were measured and evaluated using the Grubel-Lloyd and Menon-Dixon indexes. The required data was obtained from Iran’s Customs Administration, Iran’s pharmaceutical Statistics, World Bank and International Trade Center.Results:The results showed that among pharmaceutical exporting countries, Iran has a high level of comparative disadvantage in pharmaceutical products because it holds a small share in world’s total pharmaceutical exports. Also, the low extent of bilateral intra-industry trade between Iran and its trading partners in pharmaceuticals shows the trading model of Iran’s pharmaceutical industry is mostly inter-industry trade rather than intra-industry trade. In addition, the growth of Iran’s intra-industry trade in pharmaceuticals is due to its shares of imports from pharmaceutical exporting countries to Iran and exports from Iran to its neighboring countries.Conclusions:The results of the analysis can play a valuable role in helping pharmaceutical companies and policy makers to boost pharmaceutical trade.

Background: Cerebral Palsy is a group of disorders that affect the development and growth of the movement leading to the determination in the activities of the body, especially related to movements. These disorders occur as a result of damage or deterioration in certain parts of the brain. Objective: To evaluate the effectiveness of horse riding simulator with strengthening training program on children with spastic diplegic cerebral palsy and comparing it with conventional physiotherapy program which is used in rehabilitation. Patients and Methods: Thirty participants were recruited in this study, who were diagnosed with spastic diplegic cerebral palsy. Their ages between four and twelve years old, the children were randomly classified into three groups of interventions Horse Riding Simulator with Strengthening Training, Horse Riding Simulator with conventional physiotherapy and control group with conventional physiotherapy).for each intervention, the children receive 24 sessions three times a week, [Gross Motor Function Measure-66, pediatric balance scale, and Modified Modified Ashworth Scale] were used to evaluate children in all groups both pre and post each intervention.