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Volume 18, Issue 3 (2026)
Iran J War Public Health 2026, 18(3): 1001-1013 |
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Ethics code: IR.BMSU.REC.1400.141
History
Received: 2026/09/5 | Accepted: 2026/09/27 | Published: 2026/06/20
Received: 2026/09/5 | Accepted: 2026/09/27 | Published: 2026/06/20
How to cite this article
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) :1001-1013
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URL: http://ijwph.ir/article-1-1833-en.html
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Abstract (125 Views)
Aims
Home nursing services support long-term care for people with chronic disabilities, but their use depends on demographic, social, and geographic factors as well as clinical need. This study assessed the geographical distribution of home nursing utilization and costs, and their determinants, among Iranian chemical warfare veterans.
Methods
In this cross-sectional study, we used a census of DAY Health Insurance Organization records (2019-2020) for all chemical warfare veterans with complete data. Home nursing visit frequency was modeled with zero-inflated Poisson (ZIP) regression and costs with multiple linear regression, adjusting for age, gender, disability percentage, household size, and province of residence (Tehran as reference).
Findings
Veterans received a mean of 0.41 home nursing visits per year, at a mean annual cost of 870,661 IRR (about USD 6.69). Utilization and costs varied markedly by province, with the highest visit rates in Zanjan, Chaharmahal & Bakhtiari, and East Azerbaijan, and the lowest in Sistan & Baluchestan, Kermanshah, and Mazandaran. Higher disability percentage was associated with greater utilization and higher costs. Older veterans were less likely to receive no services at all, larger households used fewer services among users, and male veterans were more likely than female veterans to receive no home nursing services.
Conclusion
Home nursing service utilization among Iranian chemical warfare veterans is low overall and marked by substantial regional inequality, driven mainly by disability severity, household structure, and province of residence. Targeted, regionally tailored policies are needed to improve equitable access to home nursing care for this vulnerable population.
Home nursing services support long-term care for people with chronic disabilities, but their use depends on demographic, social, and geographic factors as well as clinical need. This study assessed the geographical distribution of home nursing utilization and costs, and their determinants, among Iranian chemical warfare veterans.
Methods
In this cross-sectional study, we used a census of DAY Health Insurance Organization records (2019-2020) for all chemical warfare veterans with complete data. Home nursing visit frequency was modeled with zero-inflated Poisson (ZIP) regression and costs with multiple linear regression, adjusting for age, gender, disability percentage, household size, and province of residence (Tehran as reference).
Findings
Veterans received a mean of 0.41 home nursing visits per year, at a mean annual cost of 870,661 IRR (about USD 6.69). Utilization and costs varied markedly by province, with the highest visit rates in Zanjan, Chaharmahal & Bakhtiari, and East Azerbaijan, and the lowest in Sistan & Baluchestan, Kermanshah, and Mazandaran. Higher disability percentage was associated with greater utilization and higher costs. Older veterans were less likely to receive no services at all, larger households used fewer services among users, and male veterans were more likely than female veterans to receive no home nursing services.
Conclusion
Home nursing service utilization among Iranian chemical warfare veterans is low overall and marked by substantial regional inequality, driven mainly by disability severity, household structure, and province of residence. Targeted, regionally tailored policies are needed to improve equitable access to home nursing care for this vulnerable population.
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