Analysis of social functions in Iran’s public hospitals: pattern of offering discounts to poor patients

Abstract

Purpose Exemption from hospital charges may appear as an essential policy in order to support the poor. Such policies can function for the fulfillment of governments’ social- and justice-based responsibilities in public hospitals. The purpose of this paper is to investigate the pattern of offering discounts to the poor and the effect of Iran’s recent Health Sector Evolution Plan on it. Design/methodology/approach The authors conducted analytical research longitudinally on the data related to cash discounts offered to the poor within a teaching hospital. Data were collected through the period of four months, September to December 2013, before the establishment of the Health Sector Evolution Plan, and in the similar months through 2014, after the establishment of the Health Sector Evolution Plan, in order to compare the amount of cash discounts. The type of insurance, length of stay, amount of discounts offered to patients, and total costs of hospital charges were studied and compared by referring to the social working department. Data were analyzed using the χ2-test, Mann-Whitney U test, ANOVA, and regression analysis aided by SPSS 20. Findings The number of patients offered discounts or exempted from payment in 2014 reduced compared to the number in 2013. The highest rate of demand for discounts was related to patients covered by Emdad Committee followed by those who had no insurance. The ratio of discount to cost in the oncology ward was higher than other groups. Originality/value The results of the present study can contribute to the plans of health system policy makers in organizing measures for supporting poor patients toward accessing healthcare services.

Which groups of the poor are supported more by the law? Pro‐poor health policy network in Iran

“…In spite of the great emphasis on the coverage of different disadvantaged groups in proportion to the cause and type of poverty in the documents and laws, the practical implementation manner of the policies and coverages diverges significantly from the laws, as it is evidenced by the fact that there are only 4.5 million people covered by Imam Khomeini Relief Committee, an institution that is legally responsible to cover a wide range of the poor, including unsupported women and children, people with no income, families of poor prisoners, and other groups, while 9 million people live in extreme poverty. This indicates that many poor unemployed and disabled individuals are not under its insurance coverage . All these show the lack of comprehensiveness in the policies.…”

“…This indicates that many poor unemployed and disabled individuals are not under its insurance coverage. 36 All these show the lack of comprehensiveness in the policies.…”

Have the poor been considered in the Health Sector Evolution Plan? A qualitative study of the Iranian health system

“…The highest rate of demand for discounts was related to the patients covered by the IKRC. He noted the lack of funding in HSEP for the social work department of hospitals and the lack of motivation to finance the cost of the hospital HSEP to help the needy as two main challenges (Aryankhesal et al , 2016). Moreover, in examining pro-poor policies, Bennett mentions that the user fee system does not have the incentive to exempt or waiver for the poor.…”

Integrating rehabilitation services into primary health care: policy options for Iran

“…The MOHME mainly finances and delivers primary healthcare, whereas public secondary and tertiary care services are financed through insurance schemes. The private sector plays a significant role in healthcare provision in Iran and mainly focuses on secondary and tertiary healthcare services in urban areas [25]. The primary healthcare system in rural areas functions well, but only meets the healthcare needs of a minority of the country's population as most people in Iran live in the main cities.…”