Inequality in the Distribution of Bone Densitometer Devices in Iran



Hajivalizadeh F¹ ; Sanjari M² ; Fahimfar N² ; Khalagi K² ; Mansourzadeh MJ² ; Hesari E² ; Larijani B² ; Ghajari H³ ; Darman M¹ ; Ostovar A² Show Affiliations
Source: Iranian Journal of Epidemiology Published:2023

Abstract

Background and Objectives: In Iran, a substantial number of individuals at risk of osteoporosis lack access to osteoporosis diagnostic services, highlighting a significant gap in the diagnosis and subsequent treatment of osteoporosis. This study aims to investigate the distribution of bone densitometer devices in Iran. Methods: Bone densitometry devices across the country in 2018 were assessed through a comprehensive census. Information regarding these devices was gathered based on their location (urban or rural), ownership (government or private), adherence to standards, and years of operation. To calculate the inequality index in the distribution of devices among cities within a province, the frequency of devices in the provincial center was compared to those outside the center. To assess the inequality in the distribution of devices among the provinces of the country, the Lorenz curve and concentration index were utilized. All values were calculated per one million people over 50 years of age. Results: Of the total 492 bone density measurement devices in the country, 399 devices (81.0%) were located in provincial centers. Out of these, 103 (20.9%) devices were in government-owned centers, while 389 (79.0%) devices were in privately-owned centers. For every one million individuals over 50 years old, the total number of devices, standard devices, standard devices with less than 10 years of operation, and devices in government-owned centers were calculated as 33.4, 20.3, 9.9, and 7, respectively. The inequality index in the distribution of devices in the cities was found to be 4.7. Furthermore, the inequality index in the distribution of devices between provinces was estimated as 0.13 (95%CI: 0.005-0.25) (P value=0.05). Conclusion: There exists a significant disparity in the distribution of bone densitometry devices across the provinces and cities within the country. © 2023 The Authors. Published by Tehran University of Medical Sciences.