Journal of

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Background: The family physician program is considered to be one of the most remarkable reforms in the health care system which will probably Increase accessibility to physicians especially in deprived areas. This study aims to assess the strengths and weaknesses of family physician program in Fouman and Shaft cities in 1390.
Materials and Methods: This is a descriptive cross-sectional and applied study in which all of the health care team`s members including family physicians, midwives, health workers, experts, technicians and also 856 individuals of service recipients in these two cities were involved .Data collection method was questionnaire of which. Validity and reliability was verified.
Results: The most important strengths of family physician program and referral system from perspectives of service providers included: easy access of people to medical services and decreased medical cost for the patients and the main weaknesses were low salary for physicians, reverse referral and inaccessibility to family physicians round the clock. The main strengths from perspectives of service recipients were easy access to physicians and the main weaknesses were inappropriate reception of hospitals and lack of services through the 24 hours of the day.
Conclusion: In order to eliminate the weaknesses and improve the quality of services, training the health staff in different levels of referral system, more comprehensive supervision, periodic assessments and effective supervision on the performance of family physician process owners is suggested

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Abstract Background: Family physician plan is a form of health care delivery system which its correct implementation results in health promotion. Being aware of family physicians’ viewpoints towards their occupation would play an important role in its better implementation. The present study aims to to investigate family physicians` attitude who are working in health centers affiliated with Tehran University of Medical Sciences towards their profession. Materials and Methods: This qualitative study was conducted in 2011. In order to reach information saturation , the data were collected by performing two singular interviews and four focus group discussions among all 33 physicians working at health care centers of Tehran University of Medical Sciences. Eventually, data were analyzed using conceptual framework method. Results: Data analysis indicated three general concepts. The first issue is the factors that encourage physicians to choose family physician profession and continue doing it (including economical, cultural and environmental factors and work conditions). The second one is the study challenges (including preparation to implement the plan, work conditions and professional limits) and the final one is the reforms needed for its correct and proper implementation ( in policy making and administrative level). Conclusion: Regarding the issue that economical, cultural and environmental factors and work atmosphere have the main role in motivating family physicians, the most important challenges the plan confronts are also related to these factors and major and minor reforms are needed to overcome these challenges. Moreover preparing society’s culture would surely result in better implementation of the plan.

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Background: One of the key duties of family physician is to form health records and provided recording services. This study conducted to form health records and aevaluate health records in family physician program in Northern Province of Iran.

Materials and Methods: This cross-sectional study was carried out in second half  2011. 139 of centers implementing family physician program in three provinces of Golestan, Mazandaran and Gilan were selected using systematic random sampling, and assessed performance recording of all family physicians. A self- designed questionnaire was used which the validity and reliability of were confirmed. Data were analyzed by SPSS₁₈ at the significant level of p<0.05.

Results: Out of the 189 assessed family physicians, the profile of patients referred to the second level and its results were recorded in referral record forms by 43 physicians. Out of 1890 studied families, 1559 families had health record which had filled 892(57%) health record completely. Out of 5869 assessed family members, 4229 patients were examined periodically by their family physician at least once and 1919(46%) results filled entirely. during 559 were reported with health records, among which 892 were filled out completely. There was a significant difference between referral record rates to registered specialist between the Northern Province of Iran (P=0.001).

Conclusion: The quantity and quality of health record formation was not in the expectation level as well and appropriate interventions are needed. 

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Background: The Family Physician Program, one of the most important efforts of the Iran health system to establish a referral system, was developed and implemented in several provinces, but it faced challenges due to several reasons that prevented the program's progress. So This study was conducted to analyze the family physician program to identify the causes and challenges of the program failure.
Materials & Methods: This retrospective study of policy analysis is a qualitative study with Purposive sampling. Semi-open interviews and document analysis were used for data collection. Data analysis was performed through thematic analysis in the policy triangle framework using MAXQDA software.
Results: According to the study framework, the challenges of the Family Physician Program in the context are conflict of interest, dependency of plans to oneself, instability in management and plans, insufficient attention to culture, resources, and infrastructure. In terms of content include disproportionate executive approach, Lack of localization, selection of inappropriate tools, insufficient transparency, and ambiguity in goals, tasks, and responsibilities; The challenges of the process were examined based on the policy cycle.
Conclusion: The implementation of the family physician program is influenced by cultural, social, political, managerial, and economic factors. As the Ministry of Health officials has re-introduced this crucial program, reviewing the content and methods of program implementation seems necessary.

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Introduction: The present study qualitatively investigated the main components that should be considered for the implementation of the referral system in Bojnord city.
Methods: In this study, data were collected through doing interviews with experts, and finally, the importance of all the extracted components was evaluated using a researcher-made questionnaire. Also, the exploratory factor analysis method was used to classify the components in main sets. Kolmogorov-Smirnov, one-sample t-test, performed in Excel and SPSS software, was used for statistical analysis.
Results: The most frequent noted components by the experts included "empowerment (knowledge, skill, psychological) of human resources involved in the referral system", "paying attention to the motivation of human resources involved in the referral system", and "developing suitable processes for the referral system and re-engineering the processes to meet the conditions". Finally, the main requirements in the referral system of Bojnord city were divided into three categories included organizational and management, manpower, and technology-based requirements.
Conclusion: Briefly, some components may lead to improvement of the referral system, which can be categorized into organizational and management, manpower, and technology-based requirements. Detailed planning to improve the referral system can lead to the improvement of the health system.