Fatemeh Tajari; Ghahraman Mahmoudi; Fatemeh Dabbaghi; Jamshid Yazdani-Charati
Volume 24, Issue 8 , 2022
Abstract
Background: Electronic referral system (e-Referral system) in Iran was launched to increase access to care and improve interaction.
Objectives: The present study aimed to design an appropriate model for evaluating the performance of the e-Referral system in Iran.
Methods: This study was conducted in ...
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Background: Electronic referral system (e-Referral system) in Iran was launched to increase access to care and improve interaction.
Objectives: The present study aimed to design an appropriate model for evaluating the performance of the e-Referral system in Iran.
Methods: This study was conducted in three stages: 1) review of literature related to electronic referral systems, 2) qualitative phase, and 3) quantitative phase. Participants in the qualitative phase included 42 managers, policymakers of the Ministry of Health, medical universities, service providers, and recipients who were purposively selected for this study. Data were analyzed through content analysis. In the quantitative phase, the target group consisted of 604 staff of medical universities implementing the e-Referral system. Data were analyzed using the EQS (version 6.3) and SPSS (version 20) software. Chi-square test, degree of freedom, the goodness of fit index, root mean square error, adjusted goodness of fit index, and the Friedman test were used to investigate the suitability of the model.
Results: Fourteen main themes were identified and classified for the model design Based on the results of the present study. The components of developing rules and regulations, stakeholder advocacy, economic evaluation, and quality of health services had average ratings of 13.99, 13.00, and 11.35, respectively, regarding their role in designing the evaluation model for the e-Referral system in Iran.
Conclusion: The results of structural equation modeling showed that the components play an essential role in designing the performance evaluation model of e-Referral in the Iranian health system. This study addressed various aspects affecting the e-Referral and provided the possibility of performance evaluation in the health sector in a principled and systematic format. Health managers and policymakers can use the present study findings to discover the strengths and weaknesses of the e-Referral performance.
esmaeil rezazadeh; gahraman mahmoudi; Fatemeh Dabaghi
Volume 23, Issue 1 , 2021
Abstract
Background: The health transformation plan was implemented in Iran with eight service packages in 2014. However, it has faced various problems and barriers since no pilot programs were launched.
Objectives: The present study aimed to investigate the challenges of the out of pocket payment in the health ...
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Background: The health transformation plan was implemented in Iran with eight service packages in 2014. However, it has faced various problems and barriers since no pilot programs were launched.
Objectives: The present study aimed to investigate the challenges of the out of pocket payment in the health system of Iran.
Methods: The required data for this applied qualitative study were collected through semi-structured interviews with 30 policymakers and planners of the health system of Iran in 2020. It must be noted that the participants were selected using the purposeful sampling method. The obtained data were entered into MAXQDA software (version 10) and analyzed through the content analysis approach.
Results: The data analysis resulted in five themes: 1) weakness in the structure of health expenditure management, 2) weakness in the structure of policy and plan development, 3) low effectiveness and efficiency of the health system, 4) lack of opportunities to identify the challenges facing the Ministry of Health, 5) consequences of the program. They were categorized into 12 concepts and 79 sub-themes, and the challenges were extracted from them.
Conclusion: By identification of the opportunities and challenges of the out-of-pocket payment, the results of this study can provide a suitable framework for observation and evaluation of the payment reduction program in the health system of Iran. Moreover, the findings offer good suggestions for policymakers and planners in different stages of the program.
