fa شناسایی شاخص‌های شوک سلامت در کشورهای در حال توسعه: مرور نظام‌مند عمومى General مروري Review Article <div style="text-align: justify;"><span style="font-size:8pt"><span style="line-height:18pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-0.15pt"><b><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">زمینه و هدف:</span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"> سلامت بخش مهمی از سرمایه انسانی و از چالش&shy;های اساسی کشورهای درحال توسعه و در بین فقرا، به دلیل مخارج پرداخت از جیب بالاو دسترسی ضعیف به سیستم</span></span>&shy;<span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">های بیمه</span></span>&shy;<span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">ای است. هرگونه شوک وارده به سلامت خانواده می&shy;تواند عواقب بیشماری در سطح خرد وکلان ایجاد کند.</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">با توجه به تعاریف عملیاتی متعدد شوک سلامت و به منظور</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">دستیابی به منبعی جامع&shy; از معیارهای تعیین&shy;کننده آن، هدف از مطالعه حاضر شناسایی شاخص&shy;های</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">شوک</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">سلامت</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">درکشورهای درحال توسعه با به‌کارگیری روش کیفی مرور نظام‌مند است.</span></span></span></span></span></span></span></span><br> <span style="font-size:8pt"><span style="line-height:18pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-0.15pt"><b><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">روش‌: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">جستجو</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">با</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">استفاده از کلمات کلیدی و</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">بدون محدودیت زمانی در</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">پایگاه&shy;های</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">داده پابمد، ساینس دایرکت، وایلی، آکسفورد، امرالد،گوگل اسکالر و دواج انجام</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">و به استناد</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">معیارهای</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">شمول</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">و</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">حذف، مطالعات نهایی انتخاب و اطلاعات</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">مورد</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">نیاز</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">از</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">آن&shy;ها</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">استخراج</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">و</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">نتایج</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">به</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">شکل</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">نقلی</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">گزارش</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">شد</span></span>.</span></span></span></span></span></span><br> <span style="font-size:8pt"><span style="line-height:18pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-0.15pt"><b><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">یافته&shy;ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">از 1608مطالعه بازیابی شده،</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">براساس دستورالعمل پریزما و معیارهای ورود و خروج،</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">226مقاله</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">وارد</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">مرور شدند. هفت شاخص اصلی شوک سلامت شامل؛ بیماری، مرگ و میر، خوداظهاری، مخارج سلامت، بستری شدن و شاخص‌های توده بدنی و فعالیت&shy;های روزانه زندگی شناسایی شد که بیماری و مرگ‌ومیر رایج&shy;ترین و قابل استنادترین آن&shy;ها بودند. در 104 مقاله نیز چند شاخص استفاده شده بود.</span></span></span></span></span></span></span></span><br> <span style="font-size:8pt"><span style="line-height:18pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-0.15pt"><b><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">نتیجه‌گیری:</span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"> با توجه به پیامدهای زیان&shy;بار شوک سلامت،</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">شناسایی</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">شاخص&shy;های</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">آن</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">می&shy;تواند</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">در</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">مداخلات</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">و</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">برنامه‌ریزی‌های</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">ارتقا</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">سلامت</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">استفاده</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">شود؛ لذا دولت&shy;ها بایستی ضمن توجه به شدت شوک، وضعیت اقتصادی خانوارها و ویژگی&shy;های سیستم سلامت، سیاست&shy;های حمایتی و سازوکارهایی مانند بیمه را در برابر کاهش مصرف و از دست دادن درآمد خانوارها هنگام وقوع شوک تنظیم کنند.</span></span></span></span></span></span></span></span></div> <div style="text-align: justify;"><span style="font-size:12pt"><span style="line-height:12.0pt"><span style="tab-stops:436.5pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="letter-spacing:-.1pt">Background:</span></span></b><span style="font-size:10.0pt"><span style="letter-spacing:-.1pt"> Health is a central part of human capitaland an important challenge indeveloping countries. Due to high out-of-pocket payments and poor access to insurance systems, health issues aresignificant concerns, particularly for the poor. Therefore, any household health shock creates countless consequences at micro and macro levels. This study aims to identify indicators of health shock in developing countries via a qualitative systematic review.</span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:12.0pt"><span style="tab-stops:436.5pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="letter-spacing:-.1pt">Methods:</span></span></b><span style="font-size:10.0pt"><span style="letter-spacing:-.1pt"> A systematic search was performed in databases including PubMed, Science Direct, Wiley, Oxford, Emerald, DOAJ and Google Scholar by applying related keywords and without any time limit. Obtained srticles were selected based on inclusion and exclusion criteria. Subsequently, required information was extracted and results were reported narratively.</span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:12.0pt"><span style="tab-stops:436.5pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="letter-spacing:-.1pt">Results: </span></span></b><span style="font-size:10.0pt"><span style="letter-spacing:-.1pt">A total of 1608 studieswere retrieved, out of which164 were&nbsp;included in the reviewaccording to a PRISMA method and considering inclusion and exclusion criteria. Seven main indicators including, illness, mortality, self-reported health, health expenses, hospitalization, Body Mass Index(BMI)and Activities of Daily Living(ADL)were used to measure health shock, among which, illness and mortality were the most common and most cited. Ninety-sixof the articles used several indicators.</span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:12.0pt"><span style="tab-stops:436.5pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="letter-spacing:-.1pt">Conclusion: </span></span></b><span lang="EN" style="font-size:10.0pt"><span style="letter-spacing:-.1pt">Considering the adverse consequences of health shock, recognizing </span></span><span style="font-size:10.0pt"><span style="letter-spacing:-.1pt">its</span></span><span lang="EN" style="font-size:10.0pt"><span style="letter-spacing:-.1pt"> indicators is useful in establishing health promotion interventions and plans. Therefore, governments must focus on health shock indicators, taking into account the severity of the shock, economic status of households, and health system characteristics. Moreover, support policies and mechanisms such as insurance are necessary to compensate household consumption reduction and earning losses resulting from&nbsp;health shocks.</span></span><span lang="EN" style="font-size:10.0pt"></span></span></span></span></span></div> برنامه‌ریزی بهداشت جامعه, ارتقای سلامت, سیاست بهداشت, کشورهای در‌حال رشد, مرور نظام‌مند Community Health Planning, Developing Countries, Health Policy, Health Promotion, Systematic Reviews 704 713 http://ijhp.ir/browse.php?a_code=A-10-313-1&slc_lang=fa&sid=1 Bahareh Rezaei Abyaneh بهاره رضایی ابیانه Abyaneh566@gmail.com 10031947532846009509 10031947532846009509 No Health Economics, Faculty of Management and Economics,Tarbiat Modarres University, Tehran, Iran اقتصاد سلامت، دانشکده مدیریت و اقتصاد، دانشگاه تربیت‌مدرس، تهران، ایران Sajjad Faraji Dizaji سجاد فرجی دیزجی S_dizaji@modares.ac.ir 10031947532846009510 10031947532846009510 Yes Faculty of Management and Economics,Tarbiat Modarres University, Tehran, Iran دانشکده مدیریت و اقتصاد، دانشگاه تربیت‌مدرس، تهران، ایران Lotfali Agheli لطفعلی عاقلی aghelik@modares.ac.ir 10031947532846009511 10031947532846009511 No Faculty of Management and Economics, Tarbiat Modarres University, Tehran, Iran دانشکده مدیریت و اقتصاد، دانشگاه تربیت‌مدرس، تهران، ایران Ezatollah Abbasian عزت الله عباسیان e.abbasian@ut.ac.ir 10031947532846009512 10031947532846009512 No Faculty of Management, Tehran University, Tehran, Iran دانشکده مدیریت، دانشگاه تهران، تهران، ایران