The implementation of electronic health (e-Health) in healthcare organizations consistently encounters numerous challenges. These barriers hinder the widespread adoption of this promising technology within healthcare settings. This study addresses the challenges of implementing e-Health across various hospitals and also aims to evaluate the maturity of hospital information systems (HIS) in Iranian hospitals based on the electronic medical record adoption model (EMRAM). Through two rounds of literature review and case studies,
a comprehensive understanding of these previously unexplored issues has been developed. The findings identify 13 social and technical challenges, including the lack of standard applications, high costs associated with e-Health and training, legal issues, security concerns, inconsistencies and diversities in perceived e-Health benefits and barriers, lack of proficiency, and difficulties healthcare professionals face in integrating e-Health into their daily tasks. There are also negative perceptions among physicians and patients regarding the use of
e-Health software, the lengthy implementation times for HIS systems, technical difficulties due to platform diversity, resistance to change, and the limited use of pilot projects, particularly in Iran. Moreover, the maturity of hospital cases in Iran is at 3 stages, in contrast to the 7 stages of EMRAM. These results underscore the need to develop an effective strategy to address the challenges identified in this research. Additionally, a specific program should be implemented for developers to enhance the maturity of HISs and advance them to higher stages of EMRAM.

Providing pre-hospital emergency services is accessible in Iran but costly for the country’s health system. This study calculated the willingness to pay (WTP) for pre-hospital emergency services in Iran. Discrete choice experiment (DCE) was used to measure the population’s WTP for ambulance services focusing on time, price, and quality of services. Four hundred and sixty people in Rasht city, Iran, participated in this online survey. Participants preferred lower transfer fees (β = -0.7, P˂ 0.05), lower time of reaching to the scene (β = -0.061, P˂ 0.05), lower time to arrive to the hospitals (β = -0.038, P ˂ 0.05), Private ambulance (β = -0.151, P ˂ 0.05), and emergency medical services (EMS) technicians (β = 0.209, P ˂ 0.05). Patients’ WTP in selecting EMS services can help policymakers to provide the best services.

Background: The prevalence of non-communicable diseases such as diabetes tends to rise with age, peaking among the elderly population. Objectives: This study aimed to estimate the economic burden of type 2 diabetes mellitus (T2DM) among the elderly in Tehran province.
Methods: This research employs a descriptive-analytical approach, focusing on T2DM patients who attended the specialized diabetes clinic of Tehran province in 2019. A total of 1256 cases were included in the study. Data collection involved reviewing hospital records and accessing information from the accounting department. Data analysis was conducted using Excel software.
Results: The economic burden of T2DM amounted to 432,471,301,510 Rials. Among this, 230,841,323,930 Rials (53.3%) were attributed to the costs of diagnosis and treatment, while 180,365,897,580 Rials (41.7%) were associated with treating disease complications. Additionally, 9,043,200,000 Rials (2%) accounted for non-medical direct costs (NMDC), and 12,220,880 Rials (0.3%) were attributed to NMDC due to complications.
Conclusions: Given the substantial financial burden incurred by elderly T2DM patients and the constraints on healthcare resources, it is imperative to prioritize preventive and therapeutic measures for this demographic. Comprehensive efforts are needed to mitigate the costs and consequences of this disease within the healthcare system.

Background: Poor oral and dental health significantly affects public health, impacting over half the world’s population. Dental caries can undermine children’s academic success and career prospects. Social inequities result in unequal access to oral healthcare, particularly among populations with lower socioeconomic status (SES). National policies that improve access to oral health can reduce these disparities.
Objectives: This study aims to compile policies implemented by various countries to achieve universal health coverage (UHC) for pediatric dental services.
Methods: This scoping review was conducted according to Arksey and O’Malley’s framework and is reported using the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines. A systematic search was conducted on databases including Scopus, PubMed, Magiran, SID, Irandoc, Google Scholar, the WHO website, and the databases of Iran’s Ministry of Health. The search aimed to identify literature discussing governmental steps taken to achieve UHC for pediatric dental health, published between January 1, 2011, and December 31, 2022. The results were charted and presented in a table.
Results: This review included 22 studies. Six themes were identified based on the roles played by key players in this field, including schools, government policy and support, community-oriented preventive plans, insurance support, parents’ awareness, and inequality in accessing dental services.
Conclusions: A comprehensive policy that reduces barriers to access, increases utilization, and engages all stakeholders—including parents, schools, and community centers—can effectively achieve UHC for pediatric dental health.

Background: Healthcare decision-making is a complex process that involves evaluating the value, efficacy, and accessibility of medical technologies and interventions. Health Technology Assessments (HTA) in high-income countries (HICs) have become a cornerstone of evidence-based healthcare decision-making. This systematic evaluation framework, exemplified by its robust, impartial examination of various medical technologies, plays a pivotal role in establishing the clinical effectiveness and cost-effectiveness of health technologies.
In contrast, low and middle-income countries (LMICs) frequently contend with resource constraints and intricate healthcare systems characterized by fragmentation and limited access to advanced medical technologies. As formalized HTA processes may be less established, limiting comprehensive evaluations, decision-making may rely on regulatory approval, clinical guidelines, or international recommendations in LMICs.
Similarly, access to medical care in high-income settings, such as the presence of universal healthcare coverage and well-developed health systems, contributes to equitable access to a wide range of medical services. In LMICs, challenges related to healthcare infrastructure, funding, and health workforce shortages hinder access to essential medical care, leading to inequities in health outcomes. This short review aims to compare the approaches to healthcare decision-making in high-income and low/middle-income countries, with a specific focus on HTAs and access to medical care.

Background: Health technology assessment (HTA) plays a crucial role in enhancing equity within universal health coverage (UHC) by making sure that health technologies are accessible, effective, and affordable for all groups, including those historically underserved. HTA informs policy-making concerning the adoption and prioritization of health technologies to fulfill the needs of the populace, particularly those afflicted with rare ailments and those residing in low- and middle-income nations. Through assessing both the clinical and costeffectiveness of health technologies, HTA identifies the most appropriate options for the needs of the community, thereby facilitating a fairer allocation of resources. Furthermore, HTA ensures the development and evaluation of health technologies are conducted impartially, incorporating the viewpoints and necessities of at-risk groups such as women, children, and the elderly. HTA is instrumental in mitigating healthcare disparities by pinpointing and tackling the elements that hinder equal access to health technologies. For instance, it evaluates the availability and accessibility of health technologies across various regions and demographic groups, identifies obstacles to access, and formulates recommendations to overcome these challenges. HTA is vital in advancing equity in UHC, ensuring that health technologies meet the accessibility, effectiveness, and affordability needs of all, particularly marginalized groups. By addressing healthcare disparities and considering the perspectives of vulnerable populations, HTA promotes transparency and accountability in decision-making and suggests ways to rectify inequities in access to health technologies.