Abstract
Background:Primary health care is one of effective approaches for improving public health. Providing optimal cares requires supplication of various resources such as financial resources. “Fractions of incomes” in health centers is one of the remarkable problems for the domain of financial resources management in Iran. This study was aimed to identify bottlenecks and causes of fractions for incomes in health centers and solutions for their reduction.Methods:The current study was conducted in a qualitative phenomenology method in East Azerbaijan province of Iran in 2014. Data collection method was focus group discussion and semi-structured interview. Purposive sampling was used for selecting participants. Focus group discussions and interviews were conducted based on pre-prepared guidance and continued till data saturation. Validity of guidance was approved by qualitative studies experts. Data were analyzed using content analysis method.Results:Based on the opinions of participants, two and six themes were respectively extracted for bottlenecks of fractions and causes and solutions for their reduction. Themes for bottlenecks of fractions included cash (monetary) and non-cash (non-monetary) fractions and themes for causes and solutions included causes and solutions for fractions per capita, insurance deductions, fractions related to sending documents, registration fractions, discounts fractions, and incomplete deposit of cash incomes.Conclusion:All cash and non-cash incomes of health centers are subject to fractions. The causes of fractions are related to the whole process of converting services to incomes and insurance requirements. Identified solutions and interventions also focus on these areas.
Highlights
The main objective of health organizations is to improve health
Themes for bottlenecks of fractions included cash and non-cash fractions and themes for causes and solutions included causes and solutions for fractions per capita, insurance deductions, fractions related to sending documents, registration fractions, discounts fractions, and incomplete deposit of cash incomes
All cash and non-cash incomes of health centers are subject to fractions
Summary
One of the approaches of Iran's health system for health improvement is the establishment of primary health care that has a significant impact on providing health care services and health indicators (Asadi-Lari, Sayyari, Akbari, & Gray, 2003). According to world bank report in 2006, financial difficulties were one of the significant problems at the first level of providing services in Iran and essential interventions were needed to improve financial management of health sector (Abolhallaje, Jafari, Seyedin, & Salehi, 2014; Policy document to promote health care). The costs of health sector cannot be covered by its incomes because of the nature of health centers and providing non-profitable services by them (Stimpson, Li, Shiyanbola, & Jacobson, 2014). “Fractions of incomes” in health centers is one of the remarkable problems for the domain of financial resources management in Iran. This study was aimed to identify bottlenecks and causes of fractions for incomes in health centers and solutions for their reduction
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