Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
BMC Health Serv Res. 2020 Apr 19;20(1):327. doi: 10.1186/s12913-020-05186-6.
Healthcare policy- and decision-makers make efforts to build and maintain high-performing and effective health systems, implementing effectiveness programs and health reforms. In May 2014, the Iranian Ministry of Health and Medical Education has launched a series of ambitious reforms, known as the Health Transformation Plan (HTP). This study aimed to determine the effect of the HTP on hospitalization rate in Iranian public hospitals affiliated to the Ministry of Health and Medical Education.
This study was designed as a quasi-experimental, counterfactual study utilizing the interrupted time series analysis (ITSA), comparing the trend of hospitalization rate before and after the HTP implementation in 16 hospitals in the Lorestan province. Data was collected from March 2012 to February 2019.
In the first month of the HTP implementation, an increase of 2.627 [95% CI: 1.62-3.63] was noted (P < 0.001). Hospitalization rate increased by 0.68 [95% CI: 0.32-0.85] after the HTP implementation compared to the first month after the launch of the HTP (P < 0.001). After the HTP implementation, monthly hospitalization rate per 1000 persons significantly increased by 0.049 [95% CI: 0.023-0.076] (P < 0.001).
The HTP implementation has resulted in an increased hospitalization rate. Health planners should continue to further improve this service. ITSA can play a role in evaluating the impact of a given health policy.
医疗保健政策制定者和决策者努力建设和维护高绩效和有效的卫生系统，实施效果计划和卫生改革。2014 年 5 月，伊朗卫生和医学教育部推出了一系列雄心勃勃的改革，称为卫生转型计划（HTP）。本研究旨在确定 HTP 对伊朗卫生部下属公立医院住院率的影响。
本研究设计为准实验、反事实研究，利用中断时间序列分析（ITSA），比较 HTP 实施前和实施后 16 家洛雷斯坦省医院住院率的趋势。数据收集于 2012 年 3 月至 2019 年 2 月。
HTP 实施的第一个月，住院率增加了 2.627[95%CI：1.62-3.63]（P<0.001）。HTP 实施后，与 HTP 启动后的第一个月相比，住院率增加了 0.68[95%CI：0.32-0.85]（P<0.001）。HTP 实施后，每月每 1000 人住院率显著增加 0.049[95%CI：0.023-0.076]（P<0.001）。
HTP 的实施导致了住院率的增加。卫生规划者应继续进一步改善这项服务。ITSA 可在评估特定卫生政策的影响方面发挥作用。
