بررسی اثرات آموزش تدابیر حفظ سلامت بر پایه طب ایرانی (حفظ الصحه) بر هزینه‌های درمان بیمه‌شدگان سازمان بیمه سلامت ایران

نویسندگان

1 گروه طب سنتی، دانشکده پزشکی ، دانشگاه شاهد ، ایران

2 گروه طب سنتی ، دانشکده پزشکی شاهد، دانشگاه شاهد، تهران ، ایران

3 مرکز تحقیقات سنجش سلامت ، پژوهشکده علوم بهداشتی جهاد دانشگاهی ، تهران ، ایران

4 گروه پزشکی اجتماعی ، دانشکده پزشکی شاهد، دانشگاه شاهد، تهران ، ایران

5 گروه آمار زیستی، دانشکده علوم پزشکی، دانشگاه تربیت مدرس، تهران، ایران

چکیده

مقدمه و هدف:  تغیر سبک زندگی انسان‌ها باعث کاهش سلامت جسم و روان آن‌ها و به تناسب آن افزایش بار مراجعات و هزینه‌های سنگین درمان و ایجاد مشکل برای دولت‌ها برای تأمین هزینه‌های درمان شهروندان خود شده است.
 لذا این مطالعه با هدف بررسی آموزش حفظ الصحه بر هزینه‌های درمان بیمه‌شدگان بیمه سلامت که هزینه بالا (صدک ۵۰ تا ۷۰) داشتند، انجام پذیرفته است.
 
مواد و روش‌ها: این مطالعه تجربی دو گروهی با هدف بررسی آموزش حفظ الصحه بر هزینه‌های درمان بیمه‌شدگان بیمه سلامت در شهر تهران (ایران) طی سال ۱۳۹۶ انجام پذیرفته است. در این مطالعه گروه مداخله بصورت حضوری و مجازی مورد آموزش حفظ الصحه بر پایه طب سنتی ایرانی مبتنی بر مدل اعتقاد بهداشتی قرار گرفتند. گروه کنترل نیز آموزش خاصی را طی زمان مطالعه دریافت ننمودند.
 
نتایج: این مطالعه بر روی ۱۰۱ نفر از بیمه‌شدگان سازمان بیمه سلامت (۵۰ نفر مرد و ۵۱ زن) در دو گروه ۵۰ و ۵۱ نفری انجام گردید. دو گروه از نظر ویژگی‌های دموگرافیک با یکدیگر یکسان بودند. نتایج نشان داد که گروه مداخله در هزینه‌های آزمایشگاه (72/26-%،38/2-% 001/0 P<)، رادیولوژی (92/27-%.02/5-% 001/0 P<)، داروخانه (64/23-%. 88/3% 001/0 P<)، ویزیت (52/30-%.16/16-% 001/0 P<) و همچنین هزینه کل (52/36-%. 16/1-% 001/0 P<) نسبت به گروه کنترل دارای کاهش معنی‌دار بوده است.
 
نتیجه‌گیری: با توجه به نتایج این مطالعه می‌توان آموزش حفظ الصحه را به عنوان راهکار مناسب در کنترل هزینه‌های درمان توصیه نمود.

کلیدواژه‌ها


عنوان مقاله [English]

Effect of health education based on Iranian Traditional Medicine (Hefz-Alsehe) on treatment costs of the Iranian Health Insurance Organization

نویسندگان [English]

  • Mohamad Bagher Hadavand 1
  • Seyed Saeid Esmaeili Saber 2
  • Ali Montazeri Moghadam 3
  • Farhad Jafari 4
  • Mohamad Gholami Fesharaki 5
  • Mostafa Abedi 1
چکیده [English]

Background and Objective: Lifestyle changes have reduced the physical and mental health of humans and increased burden and cost of treatment and subsequently created a problem for governments to provide treatment for their citizens. Therefore, we conducted this experimental study for examining the effect of hygiene education on the treatment costs for health insured patients with high cost (50 to 70 percentile).
 
Materials and Methods: This empirical study was conducted on two groups with the aim of examining hygiene education on health care insurance costs in Tehran, Iran in 2017. In this study, the intervention group received face-to-face and virtual hygiene education according to traditional Iranian medicine based on the health belief model. The control group did not receive any special training during the study period.
 
Results: This study was conducted on 101 health insurers, including 50 men and 51 women in intervention and control groups. The two groups were similar in terms of demographic characteristics. The results showed significantly lower laboratory (-26.72%, -2.38%, P <0.001), drug (-23.64%, 3.88%, P <0.001), radiology (-27.92%, -5.02%, P < 0.001), visit (-30.52%, -16.16%, P <0.001) and total costs (-36.52%, -1.16%, P <0.001) for intervention group as compared with control group.
 
Conclusion: Results of the current study show that health education could be recommended as a proper way to control the cost of treatment.

کلیدواژه‌ها [English]

  • Cost of treatment
  • Traditional medicine
  • Education
  • Health maintenance
1. Akhaveini M R, hedayato lelmotalemin fel teb. Iran: Mashhad Ferdowsi University; 1992 2. Ibn sina A H. Ghanon fel teb. Beirut: Ezodin; 1987 3. Shams M. Constitution of the Islamic Republic of Iran.tehran: Omide enghlab; 2017 4. Iran's Health Insurance Organization. Report on the Performance of 2013. Iran: Iran's Health Insurance Organization; 2013 5. Iranian Statistics Center. Iranian National Health Accounts. Iran; 2008 6. Rakhshandehro s,Heidarnia A,Rajab A, The Effect of Health Education on Quality of Life in Diabetic Patients. Daneshvar mediecine 2006; 13(63):15 - 20 7. Shams S, Zaker M. Effect of Self-management educative package on Quality of Life among Diabetic patients in uremia diabetes centers in 2013. Journal of Urmia Nursing and Midwifery Faculty 2016; 13 (10):863-868 8. Farsi z,Jabari M, Ebadi A. Application of Health Belief Model in Change of Self Care Behaviors of Diabetic Patients. Iran Journal of Nursing 2009; 22(60): 61-72. 9. Shamsi M, Sharifi Gh. The Effect of Walking Training on Blood Glucose Control in Female Patients with Type 2 Diabetes Based on Health Belief Model. Journal of Endocrinology and Metabolism of Iran 2009; 11(47): 490 - 499 10. Sadeghi Jahan A, Sobhi A,Hejazi M. The Effect of Life Skills Training on Reducing Anxiety and Depression in drug Dependent subjects. Zanjan University of Medical Sciences Journal 2016; 24(104): 20 – 29 11. Ahmad Boukani S,Meharban S,Sohrabnejad S, Valizade R. Effectiveness of Cognitive Behavioral Based Stress Management Training on Depression of MS Female Patients Journal of Ilam University of Medical Sciences 2015; 23(5): 91 – 98 12. Mosavinejad N, Shahmohammadi S, Aminshokravi F. Impact of Cognitive Skills Training on Reducing Depression Among Clients During Pregnancy & Postpartum Referring to Health Centers. Iranian Journal of Health Educati on and Health Promotion. 2015; 3(1): 39-4 13. Kargar M,MOatari M, Jamalimoghadam N. The Effect of Osteoporosis Prevention Education by Peers and Health personnel on Self-efficacy of Adolescents with Nephrotic Syndrome. Iranian Journal of Nursing 2013; 26(81): 44-53 14. Hazavehei S M M,Shahabadi S Hashemi Z. The Role of Health Education in Reducing Cardiovascular Diseases Risk Factors. Journal of Knowledge and Health 2014; 9(1): 30 - 42 15. Zhu LX, Ho SC, Wong TK. Effectiveness of health education programs on exercise behavior among patients with heart disease. a systematic review and meta-analysis. Journal of Evidence-Based Medicine 2013; 6(4): 265–301 16. Rossi AM, Moullec G, Lavoie KL, Gour-Provencal G, Bacon SL. The evolution of a Canadian Hypertension Education Program recommendation- the impact of resistance training on resting blood pressure in adults as an example. Canadian Journal of Cardiology 2013; 29(5): 622-7 17. Hazeri A, Farahzadi H, The Effectiveness of Sleep Health Education on Improving Sleep Disorders in the Blind of Shahid Sadooghi Hospital in Yazd Publications of Health 2015; (50):47 – 56 18. Ghofranipor F,Davami M H, Rafiyi M. The Effect of Health Education on Reducing the Intestinal Parasitic Infections in Mothers Referred to Health Centers in Arak. Journal of Daneshvar medicine 2004; 11(50): 21 – 30 19. Harati K, Saqeb S A, Hoseyni S M R, Mazlum S R, Chamanzari R, Zarqi N, et al. Evaluation of Temperament–based Diet Intervention on the Symptoms of Gastro esophageal Reflux Disease. Journal of Mazandaran University of Medical Sciences 2016; 26(140):45-59 20. Ministry of Health and Medical Education. Curriculum Training Ph.D Traditional Medicine, approved by Seventh Session of the Supreme Council for the Planning of Medical Sciences dated 2008 21. Saborian R,et al. Investigation of health care principles related to the prevention and control of diabetes based on Iranian Traditional Medicine and modern medicine. Journal of Iranian Traditional Medicine 2015; 6 (3): 230-240 22. Tapp S, Lasserson TJ, Rowe Bh. Education interventions for adults who attend the emergency room for acute asthma. Cochrane Database of Systematic Reviews 2007; 18(3) 23. Mahdizadeh M, Peyman N, Mahdizadeh M. Evaluation of education in promoting healthy lifestyle behaviors among adolescent girls, according to the Health Belief Model. Journal of Sabzevar University of Medical Sciences 2014; 21(1):164-174 24. Jacobs-van der Bruggen. Cost-Effectiveness of Lifestyle Modification in Diabetic Patients Diabetes Care 2009; 32(8): 1453–1458 Published online. 25. Tol A, Tavassoli E, Shariferad G, Shojaezadeh D.The Relation between Health-Promoting Lifestyle and Quality of Life in Undergraduate students at School of Health, Isfahan University of Medical Sciences, Iran. Journal of Health Research 2011; 7(4) 26. Abedi P, Huong soo lee M,Kandiah M,Yassin Z,ShozaeEzadeh D,Hosseini M. Lifestyle Change Using the Health Belief Model to Improve Cardiovascular Risk Factors among Postmenopausal Women.Journal of Health Systems Research 2011; 7(1):127 – 137 27. Nasrabadi T,Goodarzizadeh N, Shahrjerdi A,Hamta A. The Effect of Education on Life Style among Patients Suffering from Ischemic Heart Disease. Journal of Mazandaran University of Medical Sciences 2010; 20(79): 72 -79. 28. Besharat M, Hoseini S A, Bahrami ehsan H,Jahed h,Nikpajoh A. Educational intervention model based on public lifestyle and heart health. Journal of Research in Educational Systems 2012; 9(29):7 -29 29. Mansourian M Association between life style and hypertension in rural population of Gorgan. Journal of Health Promotion Management 2012; 19(2):23- 28 30. Hazavehei M S,Orugi M A, Charkazi A, Hasanzadeh A The effect of health education intervention based on PRECEDE framework on modification of vegetable oils onsumption habits in families under the cover of healthcenters in Mani Shahr of Khomein. Arak Medical University Journal 2011; 13(4): 133-142 31. Xu LJ, Meng Q, He SW, Yin XL, Tang ZL, Bo HY, Lan XY. The effects of health education on patients with hypertension in China: a meta-analysis. Health Education Journal 2014; 73(2): 137-149 32. Anderson L1, Brown JP, Clark AM, Dalal H, Rossau HK, Bridges C, Taylor RS. Patient education in the management of coronary heart disease. Cochrane Database of Systematic Reviews 2017 jun. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28658719