Healthcare performance for patients with heart failure in Iran: addressing the tip of the iceberg

Abstract Background Chronic diseases, such as heart failure with reduced ejection fraction (HFrEF), remain significant factors in the healthcare burden in Iran. Healthcare systems must have comprehensive data on the current usage, costs, and quality of care to tackle these challenges and formulate s...

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Main Authors: Fateme Gorgani, Mohammadreza Naderian, Shahab Khatibzadeh, Ahmad Amin, Yosef Farzi, Mohammad Reza Beyranvand, Majid Haghjoo, Mitra Modirian, Nazila Shahbal, Mehrdad Azmin, Saeid Shahraz
Format: Article
Language:English
Published: BMC 2024-10-01
Series:BMC Health Services Research
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Online Access:https://doi.org/10.1186/s12913-024-11699-1
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author Fateme Gorgani
Mohammadreza Naderian
Shahab Khatibzadeh
Ahmad Amin
Yosef Farzi
Mohammad Reza Beyranvand
Majid Haghjoo
Mitra Modirian
Nazila Shahbal
Mehrdad Azmin
Saeid Shahraz
author_facet Fateme Gorgani
Mohammadreza Naderian
Shahab Khatibzadeh
Ahmad Amin
Yosef Farzi
Mohammad Reza Beyranvand
Majid Haghjoo
Mitra Modirian
Nazila Shahbal
Mehrdad Azmin
Saeid Shahraz
author_sort Fateme Gorgani
collection DOAJ
description Abstract Background Chronic diseases, such as heart failure with reduced ejection fraction (HFrEF), remain significant factors in the healthcare burden in Iran. Healthcare systems must have comprehensive data on the current usage, costs, and quality of care to tackle these challenges and formulate strategic plans effectively. Methods The study included 209 patients with a mean age of 58 years (SD = 16.5) who met the inclusion criteria of having an ejection fraction of less than 40% and a confirmed diagnosis of HFrEF. This study used nationally representative data to assess the healthcare usage, costs, and quality of HFrEF management in Iran. Results The most used services were medication dispensing (76%) and outpatient visits (53%), while rehabilitation (3%) and homecare (2%) were used less frequently. The annual per-patient direct medical cost was $1,464, with $308 (21%) paid out-of-pocket (OOP). Hospitalization accounted for most of the total cost (68%), and pharmacy expenses comprised the largest portion of OOP payments (46%). Echocardiography was performed for 91.1% of patients upon admission. Only 71.6% of patients had arrangements for a cardiology visit within seven days following hospital discharge. Additionally, only 67.5% of patients received prescriptions for angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and 85% were prescribed beta-blockers. Conclusion Patients with heart failure in Iran face challenges in accessing adequate cardiac care, including a lack of care continuity and advanced cardiac services. The study provided an essential benchmark for future healthcare reform.
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spelling doaj-art-ce0c15abf97f463285b23b0f4254e2e22025-08-20T02:18:24ZengBMCBMC Health Services Research1472-69632024-10-0124111110.1186/s12913-024-11699-1Healthcare performance for patients with heart failure in Iran: addressing the tip of the icebergFateme Gorgani0Mohammadreza Naderian1Shahab Khatibzadeh2Ahmad Amin3Yosef Farzi4Mohammad Reza Beyranvand5Majid Haghjoo6Mitra Modirian7Nazila Shahbal8Mehrdad Azmin9Saeid Shahraz10Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesHeller School of Social Policy and Management, Brandeis UniversityCardiogenetics Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical SciencesNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesDepartment of Cardiology, Taleghani Hospital, Shahid Beheshti University of Medical SciencesCardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical SciencesNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesSchool of Agriculture and Food Science, The University of QueenslandNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesTufts Medical Center, Institute for Clinical Research and Health Policy StudiesAbstract Background Chronic diseases, such as heart failure with reduced ejection fraction (HFrEF), remain significant factors in the healthcare burden in Iran. Healthcare systems must have comprehensive data on the current usage, costs, and quality of care to tackle these challenges and formulate strategic plans effectively. Methods The study included 209 patients with a mean age of 58 years (SD = 16.5) who met the inclusion criteria of having an ejection fraction of less than 40% and a confirmed diagnosis of HFrEF. This study used nationally representative data to assess the healthcare usage, costs, and quality of HFrEF management in Iran. Results The most used services were medication dispensing (76%) and outpatient visits (53%), while rehabilitation (3%) and homecare (2%) were used less frequently. The annual per-patient direct medical cost was $1,464, with $308 (21%) paid out-of-pocket (OOP). Hospitalization accounted for most of the total cost (68%), and pharmacy expenses comprised the largest portion of OOP payments (46%). Echocardiography was performed for 91.1% of patients upon admission. Only 71.6% of patients had arrangements for a cardiology visit within seven days following hospital discharge. Additionally, only 67.5% of patients received prescriptions for angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and 85% were prescribed beta-blockers. Conclusion Patients with heart failure in Iran face challenges in accessing adequate cardiac care, including a lack of care continuity and advanced cardiac services. The study provided an essential benchmark for future healthcare reform.https://doi.org/10.1186/s12913-024-11699-1Heart failureHealthcare utilizationHealthcare QualityHealthcare costsIran
spellingShingle Fateme Gorgani
Mohammadreza Naderian
Shahab Khatibzadeh
Ahmad Amin
Yosef Farzi
Mohammad Reza Beyranvand
Majid Haghjoo
Mitra Modirian
Nazila Shahbal
Mehrdad Azmin
Saeid Shahraz
Healthcare performance for patients with heart failure in Iran: addressing the tip of the iceberg
BMC Health Services Research
Heart failure
Healthcare utilization
Healthcare Quality
Healthcare costs
Iran
title Healthcare performance for patients with heart failure in Iran: addressing the tip of the iceberg
title_full Healthcare performance for patients with heart failure in Iran: addressing the tip of the iceberg
title_fullStr Healthcare performance for patients with heart failure in Iran: addressing the tip of the iceberg
title_full_unstemmed Healthcare performance for patients with heart failure in Iran: addressing the tip of the iceberg
title_short Healthcare performance for patients with heart failure in Iran: addressing the tip of the iceberg
title_sort healthcare performance for patients with heart failure in iran addressing the tip of the iceberg
topic Heart failure
Healthcare utilization
Healthcare Quality
Healthcare costs
Iran
url https://doi.org/10.1186/s12913-024-11699-1
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