Background Osteoporosis is a skeletal disease that is associated with a reduction in bone mass and microstructures and deterioration of bone tissue. It is also associated with an increased risk of fracture that is the most important complication of osteoporosis. Osteoporosis and consequent fractures not only have a major impact on the health and quality of life, but also impose a significant economic burden on the health system of countries. Objective Since the population of many countries around the world is aging, the incidence of fractures due to osteoporosis is increasing too. The knowledge about costs and economic aspects of osteoporosis plays an important role in making policies and planning measures for the prevention and management of this disease, hence, this study systematically investigated the available evidence on the costs associated with osteoporosis worldwide. Methods Considering language, year of publication, and the research question, electronic searches were conducted in multiple databases and different sources. After selecting articles based on inclusion and exclusion criteria, the data were extracted and the results were summarized. To prevent bias, the whole procedure was performed by three researchers. Results Of a total of 1989 papers, 28 papers were included in the study on the basis of inclusion criteria. Among the selected studies, 13 papers reported direct and indirect costs. Based on the data extracted from the mentioned studies, the mean age of people with osteoporotic fractures was 50 years, with the highest costs associated with hip fractures. Conclusion There is a paucity of studies investigating the burden of osteoporosis in the world. The available studies indicate a lack of standardization in the methodological approach of assessing the economic burden of this disease. It is necessary to highlight the importance of studies on osteoporosis to inform policymakers and enhance health care planning.
Background:
The Universal Health Coverage (UHC) is a very important and effective policy in the health system of countries worldwide. Using the experiences and learning from the best practices of successful countries in the UHC can be very helpful. Therefore, the aim of the present study is to provide a scoping review of successful global interventions and practices in achieving UHC.
Methods:
This is a scoping review study that has been conducted using the Arkesy and O'Malley framework. To gather information, Embase, PubMed, The Cochrane Library, Scopus, Scientific Information Database, and MagIran were searched using relevant keywords from 2000 to 2019. Studies about different reforms in health systems and case studies, which have examined successful interventions and reforms on the path to UHC, were included. Articles and abstracts presented at conferences and congresses were excluded. Framework Analysis was also used to analyze the data.
Results:
Out of 4257 articles, 57 finally included in the study. The results showed that of the 40 countries that had successful interventions, most were Asian. The interventions were financial protection (40 interventions that were categorized into 14 items), service coverage (31 interventions categorized into 7 items), population coverage (36 interventions categorized into 9 items), and quality (18 interventions categorized into 7 items), respectively. Also, the positive results of interventions on the way to achieving UHC were financial protection (14 interventions), service coverage (7 interventions), population coverage (9 interventions), and quality (7 interventions), respectively.
Conclusion:
This study provides a comprehensive and clear view of successful interventions in achieving the UHC. Therefore, with consideration to lessons learned from successful interventions, policymakers can design appropriate interventions for their country.
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