Kalroozi Fatemeh, Mohammadi Nooredin, Farahani Mansoureh Ashghali, Aski Behzad Haghighi, Anari Ali Manafi
Ph.D. Student of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
Nursing Care Research Center, Iran University of Medical Sciences, Iran, Law School, Flinders University, Australia.
J Educ Health Promot. 2020 Dec 29;9:364. doi: 10.4103/jehp.jehp_493_20. eCollection 2020.
Iran's Health System Reform Plan (HSRP) were initiated in public and hospitals affiliated to Medical Sciences Universities in June 2015. The purpose of the present paper is to provide a critical analyse of the HSRP and its outcomes.
The study was carried out as a review critical analyse in 2019. The pertinent articles were searched for in Science Direct, PubMed, Ovid, and Google Scholar using keywords "health sector," "reform plan," "health system reform," "health services," "health care system," and "Iran." Published articles in scientific national and international journals in Persian and English language, of which the full-texts were available, were entered into the study. Finally, from a total of 75 articles obtained, 45 studies were carefully reviewed.
Several factors, which impact in the success of Iran's HSRP such as social-economic and political outlooks, lack of official information and a comprehensive management system, in addition to failure to extend continuous performance control, economic sanctions against Iran. Other factors are limitations on financial transactions between Iran and the rest of the world due to the sanctions, relying merely on a few instructions, and negligence of the required infrastructures. In terms of advantages of the plan, relative decrease in patient's share in medical expenses, improvement of emergency wards, and relative decrease in the rate of C-section operations are notable.
Better implementation of Iran's HSRP entails the provision of resources and facilities such as stable and adequate resources, proper management of available resources, payment mechanisms reform, attracting, and facilitating private sector's participation.
伊朗卫生系统改革计划(HSRP)于2015年6月在公立机构及医科大学附属的医院中启动。本文旨在对HSRP及其成果进行批判性分析。
本研究于2019年作为一项批判性分析综述开展。使用关键词“卫生部门”“改革计划”“卫生系统改革”“卫生服务”“医疗保健系统”和“伊朗”在科学Direct、PubMed、Ovid和谷歌学术中搜索相关文章。将波斯语和英语的科学国内和国际期刊上发表的、可获取全文的文章纳入研究。最后,从总共获得的75篇文章中,仔细审查了45项研究。
影响伊朗HSRP成功的几个因素,如社会经济和政治前景、缺乏官方信息和全面的管理系统,此外还有未能扩展持续绩效控制、对伊朗的经济制裁。其他因素包括由于制裁导致伊朗与世界其他地区之间金融交易的限制、仅依赖少数指令以及对所需基础设施的忽视。就该计划的优势而言,患者医疗费用份额的相对降低、急诊病房的改善以及剖腹产手术率的相对降低值得注意。
更好地实施伊朗的HSRP需要提供资源和设施,如稳定和充足的资源、对可用资源的适当管理、支付机制改革、吸引并促进私营部门的参与。