Abstract
BackgroundFamily physician program (FPP) and health transformation plan (HTP) are two major reforms that have been implemented in Iran’s health system in recent. The present study was aimed at evaluating the impact of these two reforms on the level of service utilization and cost of health care services.MethodsThis longitudinal study was conducted on people insured by social security organization in Fars province during 2009–2016. The data on the utilization of services and costs of general practitioner visits, specialist visits, medications, imaging, laboratory tests, and hospitalization were collected. Interrupted time series analysis was used to analyze the effect of the two mentioned reforms.ResultsFPP resulted in a significant reduction in the number of specialist visits, imaging, and laboratory tests in the short term, and in the number of radiology services, laboratory tests, and hospitalization in the long term. In contrast, HTP significantly increased the utilization of radiology services and laboratory tests both in the short term and long term. Concerning the costs, FPP resulted in a reduction in costs in short and long term except general practitioners’ and specialist visit, and medication in long term. However, HTP resulted in an increase in health care costs in both of the studied time periods.ConclusionsFPP has been successful in rationalizing the utilization of services. On the other hand, HTP has improved people’s access to services by increasing the utilization; but it has increased health care costs. Therefore, policymakers must adopt an agenda to revise and re-design the plan.
Highlights
Physician program (FPP) and health transformation plan (HTP) are two major reforms that have been implemented in Iran’s health system in recent
The number of specialist visits, imaging, and laboratory tests utilized by people were significantly decreased immediately after the initiation of Family physician program (FPP)
FPP has resulted in a reduction in the utilization of most services, and the number of radiology services, laboratory tests, and hospitalization decreased significantly
Summary
Physician program (FPP) and health transformation plan (HTP) are two major reforms that have been implemented in Iran’s health system in recent. Universal health coverage by 2030 has been the most important slogan of health systems [1, 2]. The countries across the world have different status in terms of the universal health coverage. Countries that are pioneer in this field have made various reforms in the domains of financing and health services delivery to achieve universal health coverage. In Iran, various reforms have been implemented to increase people’s access to quality services, reduce out-of-pocket payments, and increase population coverage. Two important reforms have been launched in the health system of Iran, including family physician program (FPP) and health transformation plan (HTP)
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