Challenges of Iran Health Transformation Plan about Inpatients Payment: Viewpoint of Experts

Ferdosi, Masoud; Kabiri, Shohreh; Keyvanara, Mahmoud; Yarmohammadian, Mohammad H.

doi:10.5812/jhealthscope.14388

Cited by 16 publications

(24 citation statements)

References 2 publications

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“…In Iran, the Ministry of Health and Medical Education began a series of reforms under the 'Health Transformation Plan' (HTP) since 2014 with a particular focus on financial protection. This plan consists of 8 service packages (18) and one of it's goals is to reduce and eliminate informal payments in health system (19). In this regard, the government is committed to reducing informal payments by increasing medical tariffs, increasing its own share in health system financing and expanding insurance coverage (13).…”

Section: Introductionmentioning

confidence: 99%

Informal Payments for Inpatient Services and Related Factors: A Cross-Sectional Study in Tehran, Iran

et al. 2018

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Background: Informal payments, as one of the components of out-of-pocket (OOP) payments, are often a form of corruption and outside the official bill. The purpose of the present study was to investigate the frequency of informal payments for inpatient services and its related factors in Tehran, Iran. Methods: In this cross-sectional study, the samples included 450 patients who were admitted to hospital's clinics affiliated to Shahid Beheshti University of Medical Sciences in Tehran, to receive follow-up and post-surgical care. After obtaining patient consent, data were collected via a 28-item questionnaire included two parts of patient's demographic characteristics and informal payments experience that it's validity and reliability were confirmed. Data were analyzed using descriptive statistics and regression analyses in SPSS 16 software. Results: The findings showed 21.1% of the patients had informal payments, paid voluntarily, mostly in cash, for service's staff, in public hospitals, after discharge and, due to the employees' proper behavior and attention. The average informal payments per patient were 5,304,630 IRR (175.4 USD). There was no significant relationship between the informal payment behavior and the patient demographics characteristics (P > 0.05). Conclusions: Despite the efforts made in the HTP to eliminate informal payments in inpatient services, the goal has not been fully realized. A part of the payments was paid at the provider's request and before the patient's admission that these compulsory informal payments are illegal and unethical and therefore, must be controlled and eradicated. Policymakers can take steps to reduce informal payments by improving the healthcare quality, supervision, setting salary and benefits, enforcing laws, and increasing staff incentives.

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Section: Introductionmentioning

confidence: 99%

Informal Payments for Inpatient Services and Related Factors: A Cross-Sectional Study in Tehran, Iran

et al. 2018

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“…However, it was attempted to minimize these problems through shortening the recall period and also reconfirming the studied expenditure data by randomly contacting the households who had completed the 6 Health Scope. In Press(In Press):e62316.…”

Section: Discussionmentioning

confidence: 99%

“…Financial catastrophic and impoverishment due to health spending are among the greatest problems worldwide, particularly in developing countries where out of pocket (OOP) payment is the main part of financing (6). Impoverishing payment in most cases pushes an individual or household under the poverty line.…”

Section: Introductionmentioning

confidence: 99%

“…After that, to decrease the financial burden of the households, the Iranian government initiated the Iran's Health Transformation Plan (HTP) in 2014. HTP was implemented in May 5, 2014, with 8 service packages (6). The main factors of the reform, which was introduced by experts in the health system are as follows: increasing health care costs, increasing public expectations, resources limitation and increasing public demand from the government due to poor governance, corruption and inefficiency of power, and bureaucratic inhibitors (8,9).…”

Section: Introductionmentioning

confidence: 99%

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The Households Health Spending and Impoverishment: A Study After Iran's Health Transformation Plan

et al. 2018

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Background: Iran's Health Transformation Plan (HTP) was implemented to decrease households' out of pocket and protect them from facing catastrophic health expenditure and impoverishment from 2014. It is needed to assess the effect of HTP; therefore, the study aimed to examine the households' impoverishment due to health expenditure after HTP. Methods: A household survey was carried out in 2017 in Sistan and Baluchestan province in southeast Iran. About 2400 households were selected as the study sample using a multi-stage sampling technique. The household section of the World Health Survey questionnaire was used to collect data. Independent variables contained households' characteristics, household income, chronic illness status, the use of health services, and health spending. The dependent variable was whether the household was faced with health spending impoverishment. Mixed effects logistic regression was used to assess the effect of the independent variables on the impoverishment using SPSS software 21. Results: About 7.5% of the households had no basic insurance and 757 (31.6) heads' of the households were unemployment. The results showed that about 5.4% of the households impoverished due to health expenditure. The households in the furthest region were forced with impoverishment more than other regions (23.0%). Living in a rural area, unemployment, economic status, and inpatients and outpatient costs were the main determinates on impoverishment (P < 0.05). In addition, having supplementary insurance was a protective factor in facing impoverishment (P = 0.05). Conclusions:In general, despite the implementation of HTP, healthcare expenditures leading to impoverishment of high percent of the households and Iranian development goals have not been fulfilled in this region. Economic poverty of the people may also be an important factor in this regard. It is recommended that outpatient services are covered by health insurances.

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“…It is also propounded that a staggering demand exists for some of the medical procedures, among them search for rhinoplasty and caesarean section in case of uncomplicated deliveries are paramount (16,24). Recent revamp in the Iranian national health system (INHS), which had been labeled as health transformation plan (HTP) since its commencement from Oct 2014, was also blamed to have an unfavorable effect on induced health care demands (25,26).…”

Section: Introductionmentioning

confidence: 99%

Consumer Instigated Unnecessary Medicalization in Iran: A Qualitative Thematic Analysis of the Health Professionals’ Conjectures

Shaghaghi

2018

Health Scope

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Background: Medicalization of the natural lifelong socio-biological phenomena is one of the epitomes of challenges in front of modern societies. Empirical research findings have reveled that demand for some of the health care services is expanding, especially after commencement of the Health Transformation Plan (HTP) in Iran. Given the evidence about the precedents and probable streamline role of the sovereign market and consumers' demands on the country's surging medicalization trend, this study was aimed at exploring the healthcare professionals' (HCPs) prospects about the demand side portrayal of the phenomenon. Methods: Purposive and snowball sampling method were used to recruit a total of 31 key national informants to participate in 14 semi-structured interviews and 3 focus group discussions that were planned to acquire data and insights that were not accomplished during the interview sessions. The data were collected, transcribed, and analyzed from March 2016 to February 2017 using content analysis (inductive and deductive) approach to identify certain concepts and explore the underlying facts behind the discourses. The transcribed texts were indexed and codes were extracted and categorized into subthemes and themes. MAXQDA 12 software was used for better organizing and managing the data. Results: Data were organized in 4 categories and 10 subcategories. Factors relating to national/provincial health policies and plans, healthcare consumers, the public expectations about health care professionals' affluence, and community context were considered as key sets of factors to infuriate unnecessary medicalization in Iran with the HTP having considerable role as a suitable platform to boost the incongruous phenomenon. Conclusions:The socio-cultural context and health policy making mechanisms could have a significant role in over utilization of health services and unrestrained medicalization in Iran. The dilemma should be regarded as a multidimensional embarrassment and until a multifaceted approach was not applied for its control, no major success could be expectable.

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Challenges of Iran Health Transformation Plan about Inpatients Payment: Viewpoint of Experts

Cited by 16 publications

References 2 publications

Informal Payments for Inpatient Services and Related Factors: A Cross-Sectional Study in Tehran, Iran

Informal Payments for Inpatient Services and Related Factors: A Cross-Sectional Study in Tehran, Iran

The Households Health Spending and Impoverishment: A Study After Iran's Health Transformation Plan

Consumer Instigated Unnecessary Medicalization in Iran: A Qualitative Thematic Analysis of the Health Professionals’ Conjectures

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