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改善家庭医学项目融资的策略:来自伊朗的证据。

Strategies for improving the financing of family medicine program: Evidence from Iran.

作者信息

Kabir Mohammad Javad, Moeini Sajad, Heidari Alireza

机构信息

Health Management and Social Development Research Center Golestan University of Medical Sciences Gorgan Iran.

Department of Health Services Management, School of Health Management & Information Sciences Iran University of Medical Sciences Tehran Iran.

出版信息

Health Sci Rep. 2024 Jan 9;7(1):e1813. doi: 10.1002/hsr2.1813. eCollection 2024 Jan.

Abstract

BACKGROUND AND AIMS

The impact of health financing on the performance of the entire health system, including access, quality, and efficiency of healthcare, has been emphasized in the Astana Declaration, and the need to strengthen primary healthcare (PHC) and policy integration has been emphasized. After about two decades, the family medicine (FM) program in Iran is still facing great challenges. The aim of this study is to explore strategies for strengthening financing of the FM program in Iran, a vital component of PHC.

METHODS

A qualitative study was conducted in 2021. Purposeful sampling was used to select 34 policymakers, managers, and experts from various levels of the Ministry of Health, Iran universities of medical sciences, plan and budget organization of Iran, and health insurance organization in Iran. Thirty-four semistructured interviews were conducted to collect data, which were analyzed by content analysis.

RESULTS

Through the analysis of interviews, our study has identified five strategies (identification and management of sustainable resources, pooling of sustainable resources, modeling of service provision, payment system model and its implementation process, and FM management structure), and 13 actions for strengthening financing of the FM program in Iran.

CONCLUSION

Our study has identified five strategies and 13 actions for strengthening the financing of the FM program in Iran. These strategies and actions should be considered by policymakers during the review of the FM program in Iran. Without implementation of the suggested strategies and action, allocated resources may be wasted.

摘要

背景与目标

《阿斯塔纳宣言》强调了卫生筹资对整个卫生系统绩效的影响,包括医疗服务的可及性、质量和效率,并强调了加强初级卫生保健(PHC)和政策整合的必要性。大约二十年后,伊朗的家庭医学(FM)项目仍面临巨大挑战。本研究旨在探索加强伊朗FM项目筹资的策略,FM项目是初级卫生保健的重要组成部分。

方法

2021年进行了一项定性研究。采用目的抽样法,从伊朗卫生部、伊朗医科大学、伊朗计划与预算组织以及伊朗健康保险组织的各级挑选了34名政策制定者、管理人员和专家。进行了34次半结构化访谈以收集数据,并通过内容分析进行分析。

结果

通过对访谈的分析,我们的研究确定了五项策略(可持续资源的识别与管理、可持续资源的汇集、服务提供模式、支付系统模式及其实施过程、以及FM管理结构),以及13项加强伊朗FM项目筹资的行动。

结论

我们的研究确定了五项策略和13项行动以加强伊朗FM项目的筹资。伊朗政策制定者在审查FM项目时应考虑这些策略和行动。如果不实施建议的策略和行动,分配的资源可能会被浪费。

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