الفهرس 
الفصل الاوليوجد فقط 14 صفحة متاحة للعرض العام
 |  | from | 177 |  |  |
| | | from | 177 | | |
المستخلص
Introduction:
Recently, changes in diet and lifestyle have appeared. With the spread of fast foods, the lack of food safety in some countries, the decline in physical activities, and the increasing number of smokers, all that have negative consequences on health and nutritional status of the population, that caused diseases related to or accompanied with malnutrition. These diseases represent the greatest burden on public health. Therefore, malnutrition needs to be prevented through spreading awareness of healthy and sustainable food systems that provide healthy food for all individuals today while protecting the ability of future generations to provide food for themselves.
Malnutrition leads to disease and causes general weakness or imbalance in energy, protein and other nutrients, causing significant health problems that reflect adverse physical and mental effects on patients, reduce self-reliance, and impair ability to prevent and control diseases. In addition, there are other problems caused by malnutrition such as postoperative complications, increased hospital stay, and even death. It is clear that the effects of treating malnourished patients increased the depletion of healthcare resources, as well as the high costs of treatment. Malnutrition therefore places great strain on the economy and sources of health and social care, and negatively affects the patient and caring stuff. (Julian F. Guest, 2011).
Sustainable development and public health quite strongly correlate, According to the report of the United Nations Economic and Social Council 2001, there is no way to achieve sustainable development with the spread of deadly diseases, and the health of the population cannot be maintained without environmentally sustainable development. As demonstrated by the study (Sustainable Development and Public Health: Evaluation of European Countries - 2013), public health represents a precondition for sustainable development, which should be continuously invested in and improved. Moreover, many reports and studies have shown that differences in indicators between countries are only the result of differences in economic and social development. Health is an end for development, and the ability to achieve the same development depends on health. This has been confirmed by the World Bank by encouraging the investment in human capital through considering itan essential requirement for sustainable health development (World bank report, 2018).
The estimated impact on the global economy could be as high as US$3.5 trillion per year, or US$500 per individual (Food and Agriculture Organization of the United Nations. State of Food and Agriculture 2013: Food systems for better nutrition. 2013 Rome, Italy). Moreover, sustainable care and health systems must operate through available social and environmental resources for the protection and improvement of existing and future health systems. While malnutrition is the greatest burden on public health, it is the greatest threat to sustainable development, resulting in increased treatment costs and increased consumption of available health resources due to increased treatment and hospital stay. Malnutrition, in all its forms, carries huge direct and indirect costs to individuals, families and to entire nations.
Despite its significant impact on economic development and public health, malnutrition is a neglected problem in most countries, whether developed or developing. There is a lack of practical studies on the amount of funds that can be saved in case of early examination and food support. Some studies have suggested that prevention is the key to addressing the problem of malnutrition. But it is important to understand the nature of the problem before supporting such public health programs. Therefore, the current study aims at examining consuming the resources and the costs that associate malnutrition in Egypt and measuring the effects on the sustainable development.
Study’s problem
The problem of research is that there is no measurements of the impact of the direct and indirect costs of malnutrition on sustainable development.
In light of the above problem formulation, the research objective can be determined in trying to answer the following questions.
Research questions
The main question is: How can the impact of economic costs of malnutrition on sustainable development in Egypt be measured?
The main question can be answered by answering the following sub-questions:
• How possible is it to measure the direct costs associated to malnutrition?
• How is malnutrition affecting sustainable development?
• How can society and health institutions cope with the burden of malnutrition?
Study’s importance
The importance of the study is to clarifying the environmental and economic impacts of malnutrition-related diseases that may result in increased treatment costs. And then try to find possible solutions to reduce those costs.
1. The study contributes to trying to reduce the cost of treatment, and to recognize the importance of preventive measures that may lead to reduced mortality and malnutrition.
2. The study tries to detect Prevalence rate of malnutrition in Internal Medicine hospital – Ain Shams university.
3. The study contributes to helping to achieve sustainable development by providing some solutions to preserve human resources and curative resources from deterioration and depletion due to diseases of malnutrition.
Study’s objectives
In light of the above research objectives, these objectives can be achieved through the following steps:
1. Focus attention on one of the problems that obstacle economic development.
2. Measure the impact of costs associated to malnutrition on sustainable development in Egypt.
3. Contribute to the improvement of the individual’s health status in order to help him/her earn and live and reduce the costs of treatment, thus increase national income and contribute to the achievement of sustainable development.
4. Benefit from previous studies and future visions that are suggested to help Egypt to combat malnutrition.
Study’s hypotheses
1. There is a significant relationship between malnutrition and the cost of treatment.
2. There is a significant relationship between the cost of treatment and the duration of residence at the level of different sections in the hospital.
3. There are significant relationships between the demographic variables (gender, marital status and occupational status) in the case of malnutrition.
4. There are significant relationships between the demographic variables (gender, marital status and occupational status) in the case of treatment cost.
5. There are significant relationships between the internal departments of the hospital according to malnutrition.
6. There are significant relationships between the internal departments of the hospital according to treatment cost.
7. There is a significant relationship between the nutrition status and the duration of stay in the hospital.
Study’s procedures
Study’s methods
The study will verify the validity of hypotheses and assess the impact of economic costs of malnutrition-related diseases on the economy and sustainable development depending on the theoretical approach by identifying the experiences of some developed countries as well as previous research and readings related to the assessment of the economic costs associated with diseases related to malnutrition and how to benefit from them. The study also will depend on the practical approach through a sample of 500 patients in the internal departments of Al Batinah Hospital - Ain Shams University Hospitals.
Study’s limitations
• Spatial limits: Countries in the search: Egypt, Ain Shams University Hospitals - Al Batinah Hospital.
• Time limits: 2006 to 2018.
The study relied on the results of previous studies in the estimation of the costs of treatment associated to malnutrition during the mentioned time series in addition to the practical study at Al Batinah Hospital - Ain Shams University in 2018 in order to identify the extent of the problem and achieve the research objectives.
Study’s sample
The research community consisted of patients in Al-Batinah Hospital - Ain Shams University with a population of 43316 patients. The sample was randomized from the research community and consists of 500 patients. The sample was selected according to the working age from 18 to 60 years. Children under the age of 18 and older persons over the age of 60 were excluded from this sample.
Study’s tool
The data were collected by designing a questionnaire to assess the nutritional status of Al Batinah Hospital - Ain Shams University Hospitals, which was completed through follow up cases during the period from March 2018 to June 2018.
Study’s results
• There is a statistically significant indication of the impact of malnutrition on treatment costs. Which confirms the validity of the first hypothesis, which provides a positive relationship between the state of malnutrition and the costs of treatment, which means that the costs of treatment increase whenever there is a state of malnutrition. While health is a indicator of sustainable development, malnutrition is shown to increased treatment costs, and thus it has a negative impact on sustainable development.
• There is a positive relationship between costs and duration of stay, there is more costs resulting from the longer stay in the hospitals. There is a direct relationship between costs and length of stay at the level of different sections.
• There was statistically significant difference between one of the demographic variables (gender, marital status and occupational status), which is occupational status in case of malnutrition.
• There was statistically significant difference between one of the demographic variables (gender, marital status and occupational status), which is occupational status in case of treatment cost.
• There are significant differences between the departments in the case of malnutrition. The results show that malnutrition was higher in the section of the rheumatic unit.
• The prevalence of malnutrition in the all sections is high, with 63.6% of the patients are at risk of malnutrition and 35.2% of the patients are suffer from acute malnutrition. This in turn affects sustainable development, through poor performance of workers due to illness, which leads to lower productivity.
• There are significant differences between the sections in treatment costs. It turns out that the cardiovascular department has recorded the highest costs.
• There were no statistically significant differences between periods of stay at the level of nutritional status, due to the nature of the selected sample. Previous studies indicate that malnutrition leads to increased hospital stay.
• Egypt spends 5.64% of GDP on health (WHO, 2016). The increase in treatment costs due to malnutrition affects this ratio. In other words, early intervention to treat malnutrition may positively affect this proportion, thus contributing to the improvement of sustainable development.
Study’s recommendations
• The need to pay attention to the Department of Health Costs in the faculties of commerce and economics in the Egyptian universities in order to spread awareness and culture among individuals and officials in the community to strive towards achieving a high health level while preserving health resources as much as possible and reducing the costs of treatment.
• The need to increase the proportion of spending on health in Egypt and directing a large part of it to fight malnutrition especially among children, where malnutrition affects them in the stages of achievement and their physical strength in working age, which negatively affects their productivity.
• Use the questionnaire in this study to detect early malnutrition in hospitals, which may have a significant impact on reducing the costs of treatment and the prevalence of malnutrition, and thus maintain the human resource, which is one of the most important factors to achieve growth and maintain sustainable development.
• Support future researches that are related to treatment costs associated to malnutrition, and studies related to analyze the effectiveness of early intervention, its impact on reducing treatment costs and providing better health for community members.