Provincial Disparities in the COVID-19 Burden: Hospital Data Analysis from Iran

Area of Science:

• Public Health
• Epidemiology
• Health Services Research

Background:

• The COVID-19 pandemic has had a profound effect on global health.
• Sub-national and regional variations in disease burden within Iran remain understudied.
• Understanding geographic disparities is crucial for effective public health interventions.

Purpose of the Study:

• To estimate key disease burden indicators for COVID-19 at the provincial level in Iran.
• To analyze incidence, mortality, case fatality rates, and disability-adjusted life years across Iranian provinces.
• To identify and compare geographic variations in COVID-19 impact during 2020-2021.

Main Methods:

• Utilized hospital billing records from the Iran Health Insurance Organization (IHIO) for COVID-19 admissions.
• Identified cases using ICD-10 codes U07.1 and U07.2.
• Calculated provincial-level incidence, mortality, case fatality rates, Years of Life Lost, and Years Lived with Disability.

Main Results:

• Significant interprovincial disparities in COVID-19 incidence and mortality were observed.
• Semnan and Yazd had the highest incidence rates, while Qom and Alborz reported the highest death rates.
• Case fatality rates varied, with Razavi Khorasan and Qom provinces exceeding the national average in 2020 and 2021, respectively.

Conclusions:

• The study highlights significant geographic, age, and sex-based disparities in COVID-19 burden in Iran.
• Future pandemic preparedness requires policies that acknowledge regional differences and ensure equitable resource distribution.
• Further research into health inequalities and social determinants of health is essential for addressing disparities in COVID-19 outcomes.