Suchergebnisse

Background: The health sector evolution plan was implemented in 2014 in government hospitals across the country as a part of the universal health coverage achievement programs. This study assessed the performance of hospitals before and after the implementation of this plan, using the Pabon Lasso model. Methods: The population of this study consisted of the hospitals of the country in the 2013-2015 time frame; overall, 874 hospitals (94.5% of the population) were included in the study. In order to assess performance, we used the Pabon Lasso model and hospital performance indicators (Average Length of Stay, Bed Turnover, and Bed Occupancy Rate). The data were collected from the Hospital Information System and provincial deputies of curative affairs and were then analyzed using the descriptive indicators of mean, frequency, and median in SPSS 22. Also, Paired Student T-test and ANOVA were used to compare the performance of different groups of hospitals before and after the implementation of the health sector evolution plan. Results: The implementation of the health sector evolution plan has led to a significant improvement in the three performance indicators in the hospitals of the country. Before the implementation of the health sector evolution plan, the most inefficient, inefficient, fairly efficient, and most efficient zones included 31%, 18%, 17%, and 33% of the studied hospitals, respectively. However, the implementation of the health sector evolution plan changed the percentages to 29%, 21%, 20%, and 30%, respectively. Teaching hospitals, which are governmental and are mostly located in capital cities of the provinces, were overall more inefficient than non-teaching hospitals. Conclusion: The number of the most efficient and most inefficient hospitals has decreased, and the number of average performance hospitals has increased after the implementation of the health sector evolution plan. Therefore, the health sector evolution plan has not led to an overall increase or decrease in the performance of ...

Background: Different factors affect Iran's health care financing system, and regardless of this impact, the future of this system will face fundamental challenges. In this environment, a health system is successful if it is able to anticipate the effects of these factors in the future of health care financing and preplan appropriate interventions towards health care financing system. The present study aims to identify these factors and trends. Methods: This study compiled a round view of the experts on the subject, with a future studies approach through a qualitative method. To collect data, a deep and semi-structured interview was performed. The results of the interviews were analyzed using content analysis method, and the primary and secondary themes were extracted using the Micmac software. Results: A total of 71 variables were identified in the form of 12 groups with titles of stewardship, service provision, resource gathering, purchasing and resource allocation, sociocultural, technological, environmental, economic, political, and managerial, and laws and values. Four variables, including distant-service provision, administrative bureaucracy, administrative focus and corruption, low-support decision-making, economic blockade, and sales of oil were among the influential factors and drivers. Conclusion: The findings showed Iran's financing system is relatively stable but fragile and 3 areas of technology, politics, and economics have the most impact on structuring Iran's financing system.