Showing 4 results for Health Sector
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Volume 10, Issue 4 (2-2012)
Abstract
Background: Medical tariff is one of the most important tools for health policy making in a country
that influences equity, efficiency, quality and accountability of service deliveries. If relative values for
different services are not determined correctly, it may have negative consequences on availability and
sustainability of care. This study was designed to assess the challenges and respective solutions of the
tariff system in Iranian health sectors.
Materials & methods: This is a qualitative study, involving nine face to face interviews with health
managers, policy makers and researchers at the Ministry of Health and Medical Education and relevant
organizations, as well as public and private institutions and service providers who had experiences in
medical tariff. We used the thematic framework method for analyzing qualitative data.
Results: The problems and respective solutions were classified into stewardship power, policy
making and surveillance for tariff setting, structural organization of medical tariff system, methods and
principles of setting the tariffs, medical costs recording systems and other concepts related to the
medical tariff system in the health sector.
Conclusion: To improve medical tariffs system in the country, one need to have a deep
understanding of the current challenges and potential solutions in different levels. It is advisable to
follow a clear model based on focus on policy-making and stewardship of medical tariffs system as an
important cornerstone of any effort to rectify the current situation.
Dr Ehsan Zarei, Dr Behrooz Pouragha, Dr Soheila Khodakarim, Alireza Moosazadeh Nasrabadi,
Volume 16, Issue 3 (11-2017)
Abstract
Background: One of the main goals of health sector evolution plan is reducing the amount of out of pocket payment by patients receiving hospital services in public sectors. This study aimed to assess the amount of out of pocket payment by inpatients in public hospitals affiliated to Shahid Beheshti University of Medical Science in Tehran city in 2015.
Materials and Methods: In this cross-sectional study, 405 discharged patients from four public and teaching hospitals were selected using convenient sampling method. Data were collected using a researcher made checklist and investigating the hospital bills. In order to data analysis, descriptive statistics and regression analysis were utilized through SPSS Software version16.
Results: The amount of out of pocket payment was 10.2 percent included 9.9 percent formal payment, 0.2 percent bought & brought goods and 0.1 percent informal payment. The most portion of the hospital costs was related to medical supplies and pharmaceuticals, surgeries services and hosteling with 32.6, 20.6 and 17.36, respectively. Type of hospital, having surgery, average length of stay, family size and gender had significant effect on the out of pocket payment amount (p ≤ 0.05).
Conclusion: The amount of out of pocket payment by inpatient in public hospitals was in accordance with goal of the health sector evolution plan, which reveals the appropriate government support. It is recommended to tailor and implement enormous plans regarding outpatients and private sector in national level to attain sustained reduction in out of pocket payment.
Abbas Jahangiri, Dr Hojjat Rahmani, Shiva Tolouei Rakhshan,
Volume 18, Issue 2 (8-2019)
Abstract
Background: Iranian health system transformation plan has been implemented since 2014 with the aim of financial protection of people, equity establishment in access to health services and quality improvement of hospital services. Hospital performance evaluation is essential in order to monitor the health system transformation plan. One of the tools for evaluating hospital performance is the dynamic multi-attribute decision-making method. The purpose of this study was to use the dynamic multi-attribute decision-making method to evaluate the performance of the hospital before and after the implementation of the health system transformation plan.
Materials and Methods: In this cross-sectional study, the performance of Shariati Hospital in Tehran was evaluated for 48 consecutive months (24 months before and 24 months after the Health System Transformation plan, 2012-2016). Each month was addressed as an option in the decision-making matrix and ,with considering six important health indicators, the hospital performance was dynamically assessed using the weighted aggregated sum product assessment and through EXCEL software 2010.
Results: Hospital performance scores had some fluctuations over time; however, in general, it had an increasing trend over forty-eight months. The highest and lowest values were for months 42 and 13 (0.4932 and 0.9408, respectively). In addition, in the first month of the solar year, the hospital performance score declined significantly for each year.
Conclusion: Changes in hospital performance scores during the study period show improvement in hospital performance. Nevertheless, this incremental process cannot be considered as a positive outcome of the health system transformation plan. Therefore, while improving the current process, continuing the hospital performance evaluation can lead to the hospital's performance promotion.
Yahya Salimi, Ali Kazemi-Karyani, Shahin Soltani, Farid Najafi, Zhila Azimi, Bahman Roshani, Sina Ahmadi, Satar Rezaei,
Volume 21, Issue 1 (5-2022)
Abstract
Background: The aim of this study was to evaluate the effect of health sector evolution plan (HSEP) on the prevalence of cesarean section and vaginal delivery in public hospitals in Kermanshah province.
Methods: In the present study, cesarean section (C-section) and vaginal delivery data were collected and evaluated in 17 public hospitals from 2009 to 2019. The main variables of this study included the prevalence of C-section and the prevalence of vaginal delivery for 121 months, both were obtained by dividing the number of deliveries by C-section and vaginal delivery by the total number. Interrupted time series analysis was used to examine the effect of HSEP on the prevalence of cesarean and vaginal delivery rates.
Results: The prevalence of C-section before and after the HSEP was 42.5% and 43.2%, respectively. Months before the intervention, the rate of C-section was increasing by 0.13%, which was statistically significant. In the first month after the intervention, the prevalence of C-section decreased by 3.6% that was statistically significant. The share of C-section in the months after the implementation of the HSEP showed a monthly increase of 0.12% compared to before the intervention, which was statistically significant.
Conclusions: The results of the study showed that the HSEP has led to a significant reduction in C-section in short term, but in the months after the implementation of the plan, the prevalence of C-section has increased again.
