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Ali Mohammad Mosadeghrad , Negar Mirzaee , Mahnaz Afshari , Alireza Darrudi ,
Volume 76, Issue 4 (July 2018)
Abstract

Background: Tariff setting in healthcare is an important control knob affecting the quality, access and cost of services. As part of Iran Health Transformation Plan (HTP) in 2014, the relative value of health care and services was increased to motivate healthcare providers to deliver high quality services. This study aimed to examine the impact of HTP on health services tariffs.
Methods: This descriptive and cross-sectional study used the data from California Tariff Book (2013 edition) and the new relative value book (2016 edition). The weighted average of the relative value of the anesthetic and surgical services in both books was calculated and compared.
Results: The California book and the new relative value book had 5281 and 3448 service codes respectively in 13 major medical specialties (34.7 percent reduction of service codes in the new tariff book). Overall, 64985.9 K and 125133.6 K were considered in the California book and the new relative value book (92.6% growth). The California book and the new relative value book considered 25,976 K and 22,307 K for anesthesia services, respectively in those 13 medical specialties (14.1% reduction). The HTP has increased the relative value of healthcare services tariff by 1.9 times in average.
Conclusion: The HTP has doubled the tariff of healthcare services. A rise in the relative value of healthcare services has incurred financial burden on Iranian public health insurance companies and made it difficult to finance health system of the country. A sustainable health financing system should be developed as well a change should be applied in provider payment system to control the cost and increase the health system efficiency.

Ali Mohammad Mosadeghrad, Hamed Dehnavi, Alireza Darrudi,
Volume 79, Issue 2 (May 2021)
Abstract

Background: Health equity is “having fair access to healthcare, utilizing it according to actual needs, paying for it based on financial capacity and finally, having an acceptable level of health”. Health equity is an underlying principle of the universal declaration of human rights. Equitable distribution of hospital beds increases people’s access to healthcare services and as a result, improves their health status. This study aimed to examine the equity in the geographic distribution of hospital beds in Tehran city, Iran.
Methods: The data for this descriptive and cross-sectional study were obtained from the Ministry of Health and the Iranian statistics center in April 2019. All hospitals in Tehran city were included in this study. Lorenz curve and the Gini coefficient were used to measure the equity in the geographic distribution of hospital beds. Excel software was used for data analysis.
Results: Tehran city had a population of 8,693,706, and 142 hospitals with 24,535 beds in 2016. There was 1.6 hospitals per 100,000 people and 2.8 hospital beds per 1000 people in this city. Nearly half of the hospitals were private (49%) and the remaining were public or semi-public. About 77% and 23% of hospitals were general and specialized respectively. Almost half of the hospitals are more than 40 years old.  The average number of beds in hospitals was 173. The Gini coefficient was 0.619 for hospital bed distribution among Tehran districts. Districts 6, 12 and 3 have had the highest hospital beds per 1000 people. Districts 6 had 23% of the total hospitals and 24% of the hospital beds.
Conclusion: The geographic distribution of hospital beds in Tehran city is not equitable. Hospital services should be accessible based on actual need rather than on the ability to pay. Achieving health equity is a prerequisite of universal health coverage. Hence, healthcare policymakers should reduce or eliminate the existing disparities and inequalities in access to hospital beds.


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