Challenges and strengths of implementing urban family physician program in Fars Province, Iran

Fardid, Mozhgan; Jafari, Mehdi; Moghaddam, Abbas Vosoogh; Ravaghi, Hamid

doi:10.4103/jehp.jehp_211_18

Cited by 15 publications

References 10 publications

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Policy options to reduce patient visits in specialized service centers: A case study in speciality and subspeciality clinics in Iran

Doshmangir

Beyrami

Alizadeh

et al. 2022

World Med & Health Policy

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Hospital congestion, delayed discharge, and bypassing primary care facilities are challenges facing the Iranian health‐care sector. We conducted a case study at the Sheikh al‐Rais Specialty Clinic, Tabriz, Iran, to find plausible, practical policy options for designing and implementing a referral system to reduce and regulate referral volumes to this clinic. We first reviewed the evidence on existing options of hospital congestion and unnecessary referral reduction by conducting a scoping literature review and then supplemented the findings with 18 semistructured interviews. We examined the perspectives of service users and experts in the field. Six practical policy options were identified: institutionalization of the referral system and family physician program, reinforcing gatekeeping system, use of telemedicine, utilization of educational algorithms, implementation of electronic health records, and establishing specialized clinics in different city areas. Local context adaptation, ensuring the availability of resources, political support, and feasibility are critical factors for successful policy implementation.

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Policy options to reduce patient visits in specialized service centers: A case study in speciality and subspeciality clinics in Iran

Doshmangir

Beyrami

Alizadeh

et al. 2022

World Med & Health Policy

View full text Add to dashboard Cite

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Preferences of people in choosing a family physician in rural areas: a qualitative inquiry from Iran

Bazyar

Yazdi‐Feyzabadi

Bahmani

et al. 2022

Prim Health Care Res Dev

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Background: Creating a stable and long-term relationship called ‘longitudinality’ between the population and general practitioners is crucial for the family physician program. The constant change of family physicians (FPs) can deteriorate longitudinality. This study aims to reveal what factors people usually consider when choosing a new FP or changing their current FP. Method: A qualitative study with a thematic analysis approach was carried out in Ilam province, Iran, in 2019. Purposeful sampling with a maximum variation strategy was followed to select the key informants. We did 34 interviews with following groups: patients (rural residents); FPs; and experts from Iran Health Insurance Organization, Ilam University of Medical Sciences, and Health Network Development Center. Data were analyzed using a thematic analysis to identify and contextualize the preferences of people in choosing a FP in rural areas. All the processes related to data coding and emerging themes were carried out using MAXQDA 2012 software. Results: The content of the interviews was categorized into 2 main themes, 6 sub-themes, and 39 codes. The first theme was ‘family physician characteristics’ including four sub-themes: general behaviors, social and physical characteristics, professional expertise, and pharmaceutical prescriptions. The second theme was ‘health center’ consisting of two sub-themes including location and physical features and properties of the health center. Conclusion: Some of the factors extracted from the interviews may have a different effect on the choice of people with different demographics. For instance, patients may have different ideas about the age, gender, years of medical practice, and finally, language and origin of the birthplace of FPs. Quantitative studies are needed to rank the factors identified in this study according to their significance for choosing FP and reveal patients’ preferences for each factor.

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Health complaints in individual visiting primary health care: population-based national electronic health records of Iran

Khatami

Shariati

Abbasi

et al. 2022

BMC Health Serv Res

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Background The mission of medical schools is a sustainable commitment to orient education, research, and services based on the priorities and expectations of society. The most common complaints of patients from comprehensive health service centers (CHSCs) based on the data from electronic health records were assessed in order to determine primary health care (PHC) priorities for the educational planning of medical students in Iran. Methods A population-based national study was designed to assess clinical complaints of patients in all age groups who were referred to CHSCs at least once to be visited by physicians. All the data in the census were extracted from electronic health records in PHC system during 2015–2020, classified by the International Classification of Primary Care 2nd edition (ICPC-2e-English), and statistically analyzed. The total number of complaints that were recorded in the system was 17,430,139. Results 59% of the referring patients were women. The highest number of referrals was related to the age group of 18–59 years (56.9%), while the lowest belonged to the elderly people (13.3%). In all age and sex groups, the first ten complaints of patients with three top priorities in each category included process (follow-up, consultation, and results exam), digestive (toothache and gum complaint, abdominal pain, and diarrhea), respiratory (cough, sore throat, and runny nose), general (fever, pain, and weakness and fatigue), musculoskeletal (back pain, leg complaint, and knee injuries), endocrine and nutritional (weight gain, Feeding problem, and weight loss), cardiovascular (hypertension, palpitations, and Postural hypotension), neurological (headache, dizziness, and paralysis), sexual dysfunction (vaginal complaint, discharge, and irregular menstruation), and dermatological (pruritus, rash, and inflammation) problems. Conclusion High priorities in referring to PHC had a key role in assessing the country's health needs. Since this study was in line with the national pattern of complaints and patients' profile, the present findings can be helpful to amend policy-making, educational planning and curricula development in medical schools.

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Challenges and strengths of implementing urban family physician program in Fars Province, Iran

Cited by 15 publications

References 10 publications

Policy options to reduce patient visits in specialized service centers: A case study in speciality and subspeciality clinics in Iran

Policy options to reduce patient visits in specialized service centers: A case study in speciality and subspeciality clinics in Iran

Preferences of people in choosing a family physician in rural areas: a qualitative inquiry from Iran

Health complaints in individual visiting primary health care: population-based national electronic health records of Iran

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