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Volume 18, Issue 3 (2026)
Iran J War Public Health 2026, 18(3): 359-367 |
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Ethics code: IR.BMSU.REC.1400.141
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Received: 2026/08/5 | Accepted: 2026/09/25 | Published: 2026/09/30
Received: 2026/08/5 | Accepted: 2026/09/25 | Published: 2026/09/30
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Shokri N, Amiri-Ara M, Mehdizadeh P, Yaghoubi M. Geographical Distribution of Home Nursing Services and Its Associated Factors in Iranian Chemical Veterans. , Iran J War Public Health. 2026; 18 (3) :359-367
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1- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
Abstract (544 Views)
Aims: This study assessed the geographic distribution of home nursing utilization and costs, and their determinants, among Iranian chemical warfare veterans.
Instrument & Methods: In this cross-sectional study, we used a census of national health insurance administrative records from 2019–2020 for all chemical warfare veterans with complete data. Home nursing visit frequency was modeled using zero-inflated Poisson regression, and costs were modeled using multiple linear regression. The models were adjusted for age, gender, disability percentage, household size, and province of residence (with Tehran as the reference).
Findings: Veterans received a mean of 0.41 home nursing visits per year, at a mean annual cost of 870,661 IRR (USD 6.69) per veteran. Descriptive provincial averages varied widely: visit rates ranged from 1.28 in Zanjan to 0.13 in Sistan and Baluchestan, while mean costs ranged from USD 24.37 in Chaharmahal and Bakhtiari to USD 2.60 in Kerman. In the ZIP model, male veterans had higher odds of non-use; older age and 25–70% disability were associated with lower odds of non-use, while larger households were associated with lower service rates among users. Province was strongly associated with non-use and service rates: non-use odds were highest in Sistan and Baluchestan, Kermanshah, and Golestan, while service rates were highest in Zanjan, Chaharmahal and Bakhtiari, and North Khorasan.
Conclusion: Home nursing service utilization among Iranian chemical warfare veterans is low relative to their complex health needs and varies substantially by province, with disability severity and household and demographic factors also shaping utilization and costs.
Instrument & Methods: In this cross-sectional study, we used a census of national health insurance administrative records from 2019–2020 for all chemical warfare veterans with complete data. Home nursing visit frequency was modeled using zero-inflated Poisson regression, and costs were modeled using multiple linear regression. The models were adjusted for age, gender, disability percentage, household size, and province of residence (with Tehran as the reference).
Findings: Veterans received a mean of 0.41 home nursing visits per year, at a mean annual cost of 870,661 IRR (USD 6.69) per veteran. Descriptive provincial averages varied widely: visit rates ranged from 1.28 in Zanjan to 0.13 in Sistan and Baluchestan, while mean costs ranged from USD 24.37 in Chaharmahal and Bakhtiari to USD 2.60 in Kerman. In the ZIP model, male veterans had higher odds of non-use; older age and 25–70% disability were associated with lower odds of non-use, while larger households were associated with lower service rates among users. Province was strongly associated with non-use and service rates: non-use odds were highest in Sistan and Baluchestan, Kermanshah, and Golestan, while service rates were highest in Zanjan, Chaharmahal and Bakhtiari, and North Khorasan.
Conclusion: Home nursing service utilization among Iranian chemical warfare veterans is low relative to their complex health needs and varies substantially by province, with disability severity and household and demographic factors also shaping utilization and costs.
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