Abbasian Mehdi, Shaghaghi Abdolreza
Elderly Health Section, Health Education & Promotion Department, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.
Risk Manag Healthc Policy. 2020 Aug 27;13:1365-1374. doi: 10.2147/RMHP.S258661. eCollection 2020.
Population ageing has been steadily rising in Iran and in the over 60-year-old population, the ratio increased from 5.4% in 1986 to 8.6% in 2016 which represents an increase of 4.3 million over the past three decades. The inevitable impacts of a growing elderly population on the demand-side of the health care provision (HCP) equilibrium call for an urgent revision of the current arrangements of the Iran's National health care system (INHS). The main aim of this study was to scrutinize the best available scientific evidence on the international integrated elderly health care governance (HCG) models to revamp health care practice and policy-making processes in Iran.
This multiphasic study consists of a scoping review of existent HCP modalities for the elderly population worldwide, and the disposition of an optimal HCP scheme for the elderly population and its application for the detection of the gaps in Iran. The final stage includes a Delphi-based consultation and consensus process which was reciprocated in three rounds and the key subjects were requested to give their judgment on the eventuated HCP layout designed to serve the ageing Iranian population.
The yielded model (IEHCG-IR) included four dimensions consistent with the four levels of prevention along with social support services. The structure and feasibility of the preliminary framework were approved by 83.6% of the study participants.
The study findings could have important implications for future policy making in the INHS and the suggested healthcare framework for the elderly Iranian population could be a preliminary model for health system re-engineering.
伊朗的人口老龄化一直在稳步上升,在60岁以上的人群中,这一比例从1986年的5.4%上升到2016年的8.6%,这意味着在过去三十年中增加了430万。老年人口增长对医疗保健服务(HCP)供需平衡的需求侧产生的不可避免影响,要求对伊朗国家医疗保健系统(INHS)的现有安排进行紧急修订。本研究的主要目的是仔细审查国际综合老年医疗保健治理(HCG)模式的最佳现有科学证据,以改进伊朗的医疗保健实践和决策过程。
这项多阶段研究包括对全球老年人口现有HCP模式的范围审查,以及为老年人口制定最佳HCP方案并将其应用于发现伊朗的差距。最后阶段包括一个基于德尔菲法的咨询和共识过程,该过程分三轮进行,要求关键主题对最终设计用于为老龄化伊朗人口服务的HCP布局做出判断。
产生的模型(IEHCG-IR)包括与四级预防以及社会支持服务一致的四个维度。初步框架的结构和可行性得到了8