Parinaz Doshmangir, Leila Doshmangir,
Volume 1, Issue 4 (2-2019)
Abstract
Introduction: Making medical interventions over the actual needs of patients, not only waste existing resources and cause more costs but also threaten people’s health. Identifying, removing and preventing factors affecting unnecessary medical interventions have a main role in its controlling. So, this study aimed to explore factors affecting this phenomenon from the viewpoints of Iranian health system experts.
Methods: To collect data, Focus Group Discussions, semi-structured face to face interviews were conducted. The participants were selected through purposeful sampling. Related documents were also collected. Content analysis (inductive-deductive) was used for data analysis.
Results: Four themes and 16 subthemes were extracted. Making evidence informed policy interventions in payment system, insurance system, tariff system and education system in the country, management of conflict interests, making culture and informing community are the factors that are influential on controlling and decreasing side effects of this phenomenon.
Conclusions: effort to identifying factors influential on unnecessary medical interventions can help establishing accurate supervision and reporting system and cause preventive interventions to reduce more unnecessary costs and inappropriate outcomes resulted from this phenomenon.
Masud Ferdosi, Mohammad Reza Rezayatmand, Maryam Barati,
Volume 2, Issue 3 (12-2019)
Abstract
Introduction: Proper tariff setting of health services in addition to reduction the health sector resources wastages, increases the healthcare providers’ incentives in delivering effective services. The purpose of this study was to identify the waste points of HTP hospital resources, and to offer some solutions in medical tariffs setting.
Methods: This is an original applied research conducted employing a content analysis method. In order to identify hospital resources wastages and cost control approaches, PubMed, Irandoc, SID, Google Scholar and Magiran databases were searched with keywords wastage- tariff- Health Transformation- Cost and Cost Control Plan. Related articles were extracted. The nominal group technique was used to classify the wastes, and a focus group discussion with 33 participatants of senior managers and experts of hospitals, insurance organizations and academic members of Isfahan University of Medical Sciences was used to confirm the solutions.
Results: The mos t important wastages caused by diagnostic and Therapeutic services tariffs were disparities in the income levels of some specialists, imbalances in the income of various specialist groups, imbalances in physicians’ earnings versus other medical personnel’s, and induced demand. The most important cost containment strategies included tariff review, reconstructing the health sector financial structures, and reinforcing accurate pricing, reducing induced demands, implementing family physician and referral systems, and tracing health services abuse.
Conclusion: The Iran HTP and any other reform plan in the health system will have its own costs, so that if the wasted resources are not identified and controlled, the success of the plan would be in danger.
