Mh Mehrolhassani, B Najafi, V Yazdi Feyzabadi, M Abolhallaje, M Ramezanian, R Dehnavieh, M Emami,
Volume 12, Issue 0 (3-2017)
Abstract
Background and Objectives: Timely access to required health services without any financial hardship is necessary to achieve public health. Therefore, the aim of present study was to review the policies and plans adopted in the health financing system.
Methods: The qualitative study with a policy research approach reviewed upstream laws, policies, and plans in Iranian health financing. Then, by holding seven focused group discussions with 28 participants who represented various stakeholders, financing policies and programs were identified. Using framework analysis, the data were coded and categorized.
Results: In response to health financial protection indexes improvement, policies and plans in this field were defined in 10 themes and 4 categories: resources collection, resources management and pooling, resources allocation, and strategic purchasing of health services. The most important policies and plans were integration of insurance funds, increasing sustainable financial resources and targeted allocation of subsidies, services priority setting, establishment and improvement of a performance-based payment system with emphasis on integration of the professional element in the public and private sectors.
Conclusion: There is no gap for documented laws and policies in the Iranian health financing system. The main barriers are the method of implementation and adequate commitment to laws that have created major difficulties in relation to financial protection. Resolving these barrierrs requires sufficient political support and a common understanding between stakeholders at different levels of policymaking and implementation and designing programs based on the infrastructures.
R Dehnavieh, S Noorihekmat, A Masoud, Ma Moghbeli, H Rahimi, A Poursheikhali , M Hoseinpour, S Salari,
Volume 13, Issue 0 (3-2018)
Abstract
Background and Objectives: One of the decentralized models that has been formed based on universal health coverage is the model of health complexes in Tabriz. This study was conducted to evaluate the model.
Methods: This case study was conducted in 2017. Beside observation, 28 individuals, including informed experts in the field of establishment of health complexes in Tabriz University of Medical Sciences, were purposefully selected and semi-structured interviews were also conducted. To analyze the interviews and the results of observations, the framework analysis was used based on the components of the Primary Care Evaluation Tool (PCET) model.
Results: The strengths of the health complex model are decentralized planning, strengthening the private sector participation, have more appropriate methods for assessing the performance of the health team, creating a sense of delivering effective services in providers, using electronic information registration system, using the prospective payment method, strengthening the referral system, enhancing service continuity, and facilitating financial and geographical access, especially in marginalized areas. However, there are some problems such as lack of some facilities and equipment, lack of some workforces and high workload, financial instability, and lack of insurance organizations cooperation with the plan.
Conclusion: The health complex model has improved organizational, financial, and geographic access to health services. It seems that if the resources are more stable and by cooperation of basic insurances, the results of this project will be better.
