Strategies for reducing expenditures in Iran's health transformation plan: A qualitative study

Rahmany, Keivan; Barati, Maryam; Ferdosi, Masoud; Rakhshan, Amir; Nemati, Ali

doi:10.14196/mjiri.32.102

Cited by 12 publications

(10 citation statements)

References 7 publications

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“…In fact, the rise of costs can be justified by the increase in the utilization of services after the launch of HTP [19][20][21]. On the other hand, this plan increased the share of health system in the general budget and raised health services tariffs based on publishing the book of relative value (which puts new values on health services tariffs), which resulted in a remarkable increase in health system expenditures [19,29]. Thus, the increase in health service costs can be attributed to the increase in the share of health from GDP and the increase in health care expenditures.…”

Section: Discussionmentioning

confidence: 99%

Effect of two major health reforms on health care cost and utilization in Fars Province of Iran: family physician program and health transformation plan

Bayati

Keshavarz

Lotfi

et al. 2020

BMC Health Serv Res

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Background: Family physician program (FPP) and health transformation plan (HTP) are two major reforms that have been implemented in Iran's health system in recent. The present study was aimed at evaluating the impact of these two reforms on the level of service utilization and cost of health care services. Methods: This longitudinal study was conducted on people insured by social security organization in Fars province during 2009-2016. The data on the utilization of services and costs of general practitioner visits, specialist visits, medications, imaging, laboratory tests, and hospitalization were collected. Interrupted time series analysis was used to analyze the effect of the two mentioned reforms. Results: FPP resulted in a significant reduction in the number of specialist visits, imaging, and laboratory tests in the short term, and in the number of radiology services, laboratory tests, and hospitalization in the long term. In contrast, HTP significantly increased the utilization of radiology services and laboratory tests both in the short term and long term. Concerning the costs, FPP resulted in a reduction in costs in short and long term except general practitioners' and specialist visit, and medication in long term. However, HTP resulted in an increase in health care costs in both of the studied time periods. Conclusions: FPP has been successful in rationalizing the utilization of services. On the other hand, HTP has improved people's access to services by increasing the utilization; but it has increased health care costs. Therefore, policymakers must adopt an agenda to revise and redesign the plan.

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Section: Discussionmentioning

confidence: 99%

Effect of two major health reforms on health care cost and utilization in Fars Province of Iran: family physician program and health transformation plan

Bayati

Keshavarz

Lotfi

et al. 2020

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…Moreover, it is pivotal to consider the roles of Health Technology Assessment in policy-making, in order to recognize the proper model of insurance coverage for these drugs, given that currently the health transformation plan is being undertaken in Iran. [35]…”

Section: Discussionmentioning

confidence: 99%

Insulin pen use and diabetes treatment goals: A study from Iran STEPS 2016 survey

et al. 2019

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Background Frequency of insulin pen use, despite its higher costs, is increasing to substitute the traditional use of insulin vials. This study aims to report insulin pen use frequency and its associated factors among participants of the STEPS survey 2016 in Iran, which was conducted based on the World Health Organization (WHO) STEPS methodology. Methods In this cross-sectional study, 19,503 (mean age of 46.03±0.13) out of 30,541 participants of the Iran STEPS survey were included (Inclusion criteria: aged >25 years old and availability of their demographic, clinical, and laboratory results for serum glucose, HbA1c, and lipid profile). Clinical and demographic characteristics, a frequency of use of each diabetes mellitus treatment type, and the association of insulin pen use with health outcomes are reported using descriptive analysis and propensity score modeling. Results There were 1,999(10.85%) individuals diagnosed with diabetes in the population, while 1,160(56.87%) cases were taking antihyperglycemic treatments. In this subset, 240(21.14%) individuals administered insulin with or without using oral agents at the same time. 52.28% of participants who were under insulin therapy used insulin pens. None of the socioeconomic determinants, including gender (p-value = 0.11), type of residential areas (p-value = 0.52), years of schooling (p-value = 0.27), wealth index (p-value = 0.19), marital status (p-value = 0.37), and insurance types (p-value = 0.72) were significantly different among groups using insulin pens and insulin vials. Moreover, in the propensity score modeling, pen usage was not associated with a lower heart attack and ischemic stroke histories, systolic blood pressure, serum lipid profile, blood glucose, or HbA1c levels. Conclusion Results showed that the use of the higher-costing insulin pens compared to traditional vials and syringes is not associated with improved glycemic control and better lipid profile in our sample. Future studies are needed to confirm these findings and to compare other aspects of insulin pen use, including adherence to treatment and cost-effectiveness.

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“…In fact, the rise of costs can be justified by the increase in the utilization of services after the launch of HTP (18)(19)(20). On the other hand, this plan increased the share of health system in the general budget and raised health services tariffs based on the book of relative value, which resulted in a remarkable increase in health system expenditures (18,28). Thus, the increase in health service costs can be attributed to the increase in the share of health from GDP and the increase in health care expenditures.…”

Section: Discussionmentioning

confidence: 99%

Effect of Two Major Health Reforms on Health Care Cost and Utilization in Iran: Family Physician Program and Health Transformation Plan

Bayati

Keshavarz

Lotfi

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: Family physician program (FPP) and health transformation plan (HTP) are two major reforms that have been implemented in Iran's health system in recent. The present study aimed at evaluating the impact of these two reforms on the level of service utilization and cost of health care services. Methods: This longitudinal study was conducted on people insured by social security organization in Fars province during 2009-2016. The data on the utilization of services and costs of general practitioner visits, specialist visits, medications, imaging, laboratory tests, and hospitalization were collected. Interrupted time series analysis was used to analyze the effect of the two mentioned reforms. Results: FPP resulted in a significant reduction in the number of specialist visits, imaging, and laboratory tests in the short term, and in the number of radiology services, laboratory tests, and hospitalization in the long term. In contrast, HTP significantly increased the utilization of radiology services and laboratory tests both in the short term and long term. Concerning the costs, FPP resulted in a reduction in costs in the short term, but in an increase in costs in the long term. However, HTP resulted in an increase in health care costs in both of the studied time periods. Conclusions: FPP has been successful in rationalizing the utilization of services. On the other hand, HTP has improved people’s access to services by increasing the utilization; but it has increased health care costs. Therefore, policy makers must adopt an agenda to revise and re-design the plan.

show abstract

Strategies for reducing expenditures in Iran's health transformation plan: A qualitative study

Cited by 12 publications

References 7 publications

Effect of two major health reforms on health care cost and utilization in Fars Province of Iran: family physician program and health transformation plan

Effect of two major health reforms on health care cost and utilization in Fars Province of Iran: family physician program and health transformation plan

Insulin pen use and diabetes treatment goals: A study from Iran STEPS 2016 survey

Effect of Two Major Health Reforms on Health Care Cost and Utilization in Iran: Family Physician Program and Health Transformation Plan

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