Healthcare System Functions in Iran and Successful Developing Countries Regarding Access to Universal Health Coverage: A Comparative Study

Abstract

Background: Universal health coverage is considered a prerequisite for human health and security. Objectives: Therefore, the current study aimed to evaluate and compare the healthcare system functions in Iran with those in successful developing countries in terms of universal health coverage (UHC). Methods: In this comparative study, three developing countries, namely Turkey, Thailand, and China were selected based on former studies, and the model presented by the World Health Organization in 2000 was used to compare and analyze the data. The required information from the selected countries was collected through searching the Pub Med and Scopus databases using the following keywords: “Health system review”, “Health system transition”, “International profiles of healthcare systems”, “Financing”, “Resource generation”, “Service provision”, “Universal health coverage”, and “Health system reform”. Results: The evaluation of the healthcare system’s function in four countries showed that the public sector’s share of total health expenditures was much higher than the private sector in both Thailand and Turkey. The issues that need to be addressed include the integration of insurance funds and risk accumulation, as well as the existence of a strong buyer organization. The comparison of the payment system in the studied countries indicated that the per capita method was used in all domains of primary care, and the inpatient diagnostic group (diagnosis-related group), fee for service, and salaries and rewards were more focused in the context of hospitalization. The majority of hospitals in the studied countries were state-owned; however, the important point was the presence of different non-university public hospitals in these countries, compared to Iran. Conclusion: In general, one way to reach the UHC is to utilize the experiences of successful countries in establishing and maintaining this issue.