Background: Carotid artery stenting (CAS) and carotid endarterectomy (CEA) are two standard methods for the prevention and treatment of cerebrovascular accidents.
Objectives: This study compared these two methods using an economic evaluation analysis.
Methods: One hundred patients with carotid occlusive disease at Razi Hospital in Rasht, Iran, were analyzed in a retrospective cost-utility study using the SF-12 Questionnaire to calculate quality-adjusted life year (QALY) and costs from a societal perspective. This study employed Monte Carlo simulation and sensitivity analysis for data analysis.
Results: Of the 100 patients, 61 were male, and 64 underwent CEA treatment. The incremental cost-effectiveness ratio (ICER) of CAS versus CEA was US$ 213.6 (± 111.2). The ICER increased to US$ 1625.6 when governmental currency exchange subsidies were excluded from the cost calculations of the two methods.
Conclusions: Both the costs and QALY of CAS are higher than those of CEA. The CAS is cost-effective when the preferred currency rate is applied to medical equipment pricing [compared to the willingness to pay (WTP) threshold of US$ 1431.85]. However, it is not cost-effective when government subsidies are removed.

Background: Medication management plays a critical role in the quality of delivered treatments and patient safety.
Objectives: The present study aimed to develop a national accreditation model for medication management within the Iranian primary health care (PHC) system.
Methods: The primary standards were developed by considering existing accreditation models worldwide, reviewing available medication management documentation in Iran’s PHC system, and obtaining expert opinions in this field. The developed standards and measures were incorporated into a Delphi Questionnaire and evaluated by experts based on two criteria: Importance and feasibility, using a 9-point scale. The Delphi panel consisted of 20 experts, and the technique was implemented over two rounds. Of the 20 experts, 18 completed the questionnaire, with response rates of 90% and 100% in the first and second rounds, respectively.
Results: The study was conducted in 2021 - 2022. In the first round of the Delphi process, 55 out of 65 primary measures reached a quorum and were accepted. The remaining ten measures were approved by experts in the second round. The model developed in this study comprises five main standards: “Provision of resources for activities in the field of medication management”, “development and consideration of the list of authorized medications for prescribing in the form of a pharmacopoeia”, “safety in prescription and medication use”, “ordering, storing, and dispensing systems of medications” and “educating the community about the correct use of medications”. The total mean scores for all measures in terms of importance and feasibility were 8.32 and 7.68, respectively.
Conclusions: Given the high consensus among experts on the importance and feasibility of the developed standards, there is optimism that utilizing this model can lead to continuous improvement in the quality and safety of medication management in the Iranian PHC system.

Background: Knowledge-based companies often prioritize the scientific and technical aspects of their products, while marketing considerations receive less attention. However, to achieve a competitive advantage, it is essential to address both technological and marketing dimensions. Fan markets emerge as valuable tools to facilitate technology development activities and strengthen the technology market.
Objectives: The present study aimed to provide a model for the health technomart with the approach of marketing knowledge-based products.
Methods: This research is qualitative and was conducted using the grounded theory method with the Glaser approach. Data were collected through semi-structured interviews with 10 purposefully selected health experts. Data analysis was performed in three stages: Open, selective, and theoretical coding, using MAXQDA version 2020 software.
Results: Data analysis resulted in the extraction of 156 open codes, 21 sub-categories, and 7 main categories. The results indicated that management of technology development and transfer, technology development infrastructures, technology policy, technology market management, technological product development, institutional factors related to technology development, and improving the technological business environment are the main categories of health technomart with the approach of marketing knowledge-based products.
Conclusions: The presented model can help improve the performance of technomarts and the marketing and sales of knowledge-based and technology-oriented products in the health field.

Context: Supplementary medical insurance plays a key role in enhancing access to healthcare services and improving the overall quality of life for individuals. In healthcare system of Iran, these insurance companies face various legal and operational challenges that impact their effectiveness in providing adequate coverage and service delivery.
Objectives: The present study aimed to systematically investigate the roles, responsibilities, and legal framework governing supplementary medical insurance companies in Iran. The goal was to analyze how these companies operate within the health system and their interactions with service providers, as well as to identify the key policies and regulations that influence their operations.
Data Sources: A comprehensive review of all relevant documents related to supplementary insurance companies in Iran was conducted. These documents, published in Persian, included policies, laws, and guidelines governing the sector. No time limitations were applied, and the documents were sourced from governmental and regulatory bodies.
Study Selection: The study included 10 documents based on inclusion and exclusion criteria. These documents were selected for their relevance to the legal and regulatory framework of supplementary insurance in Iran, particularly those outlining the duties and responsibilities of insurance companies.
Data Extraction: Content analysis techniques were employed to extract and categorize the data from the selected documents. The analysis focused on identifying the main themes related to the operational duties of supplementary insurance companies in the Iranian health system.
Results: The study identified eight central themes regarding the legal requirements and responsibilities of supplementary insurance companies: (1) Interactions with service providers, (2) document handling processes, (3) electronic procedures, (4) contracts with healthcare providers, (5) service packages and coverage, (6) insurance premiums, (7) financial resources, and (8) monitoring and evaluation. The results revealed that the supplementary insurance landscape in Iran is highly fragmented, with a diverse range of policies and regulations. This diversity suggests a need for a more unified framework to streamline operations and ensure efficient service delivery.
Conclusions: The findings underscore the necessity of establishing a standardized, unified structure for supplementary insurance companies in Iran. Streamlining regulations and practices would not only reduce confusion but also enhance the effectiveness of supplementary insurance in improving healthcare access and quality. Further reforms in the regulatory framework are recommended to support the long-term sustainability and efficiency of supplementary insurance within healthcare system in Iran.

Background: Today, despite the complex environment of businesses, the development of strategic thinking has become one of the important factors in gaining a sustainable competitive advantage in organizations; so that its application by managers leads to increased organizational performance and improved competitive conditions.
Objectives: This investigation focused on determining the strategic cognition model used in Iran’s health industry.
Methods: This study adopts a mixed-methods (qualitative-quantitative) approach with an applied research objective. The target population includes all health industry experts in Iran. The research process began with a comprehensive literature review, followed by in-depth interviews with 17 seasoned professionals to qualitatively identify and validate the key drivers of strategic thinking in Iran’s healthcare sector. Subsequently, a quantitative phase was implemented, during which expert surveys were used to construct the structural selfinteraction matrix (SSIM). Following the interpretive structural modeling (ISM) methodology, the initial and final reachability matrices were derived, enabling the classification of research components and the development of the structural model. Additionally, MICMAC analysis was performed to evaluate variable dependence and penetration.
Results: All the components and codes of this research are summarized within the framework of four main factors: Obstacles, national infrastructures, scientific insight, and foresight. After obtaining these results, and in order to quantitatively verify and achieve the structuralinterpretive model, the main components of the research were tested using the structural-interpretive modeling method, and finally, the final model of the research was extracted.
Conclusions: It is suggested that managers and all trustees of the health industry analyze the competitive and political-legal environment of their industry and organization as a first step. Using trend analysis and maintaining a forward-looking vision can help managers better understand the future environment.

Background: The application of artificial intelligence (AI) in the field of healthcare has paved the way for improved diagnostic accuracy, personalized treatment regimens, and overall enhancement in patient outcomes. The AI-related technologies are increasingly being applied in the healthcare sector, with the potential to bring about significant transformations in patient care and routine administrative operations, linking patients, providers, and society at large.
Objectives: The current article seeks to explore the perceptions of Indian doctors and nurses regarding the implementation of AI in their respective work areas.
Methods: Focused group discussions (FGDs) and individual in-depth interviews (IDIs) were conducted separately with the target respondents (doctors: FGD: n = 13, IDI: n = 9; nurses: FGD: n = 25, IDI: n = 16) to identify their perspectives and real-time experiences regarding AI integration in everyday workplace practices. The study design is qualitative in nature, with open-ended questions asked to the target respondents. Purposive sampling was used to recruit participants for the study.
Results: Two main themes and seven subthemes were identified. The findings suggest that while AI certainly demonstrates potential for enhancing healthcare services, it is important to carefully consider its possible impact on healthcare workforce motivation, patient care, perceptions of patients, and the need to redesign existing healthcare practices.
Conclusions: Artificial intelligence has significant scope and application in the healthcare industry. Indian healthcare professionals, including doctors and nurses, perceive that intelligent automation can effectively enhance the management of repetitive workflows. However, a section of respondents also expressed concern about potential job losses due to AI integration.

Context: Transparency is a crucial factor in addressing information asymmetry and inefficiencies within health systems. However, its outcomes can vary significantly.
Objectives: This study aims to explore the applications and consequences of transparency in health systems.
Methods: A scoping review was conducted, searching databases including PubMed, MEDLINE (Ovid), Scopus, Web of Science, ProQuest, and Google Scholar up to 2023. The six-step protocol by O’Malley and Arksey for scoping reviews was employed, adhering to the PRISMA-ScR reporting checklist. Data were extracted and summarized using a data collection form, then entered into MaxQDA software for coding, categorization, and synthesis.
Results: The review included 97 documents published between 1994 and 2022, predominantly from the United States. The studies identified various applications of transparency, such as quality and safety, pricing and costs, personal health records (PHR), prescriptions, payments, insurance, waiting times, staffing, and statistical data. A total of 137 positive outcomes were reported, including improved quality, efficiency, empowerment, satisfaction, and competition. Conversely, there were 37 instances of no effect and 34 instances of negative outcomes, such as risk aversion, reduced quality, increased costs, and misinterpretation.
Conclusions: The variability in the outcomes of public reporting can be attributed to the type and level of reporting, the structure of the health system, and the economic and cultural contexts. To enhance transparency effectively, it is essential to consider its outcomes and implement it in a principled and precise manner to maximize benefits and minimize potential harms.

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