Abstract
BackgroundHealth Transformation Plan (HTP) was occurred in 2014 to improve access and equity and reduce out of pocket payments in Iranian Health Care System. In this regard the aim of this study is evaluating and ranking the service provider’s infrastructures among the country provinces as an indicator of equity before and after implementation of the HTP.MethodsThis cross sectional study is conducted in 2017. The study population included 31 provinces of the country. Data related to 4 years from 2012 to 2016 were included from the data bases of Ministry of Health and Medical Education as well as the statistics yearbook of the country. The obtained results of multi-criteria decision-making methods were analyzed as well. SPSS18 and Excel2013 software were used for data analysis.ResultsBased on the VIKOR method, in 2012, Mazandaran, Tehran and Fars provinces and in 2013, the provinces of Tehran, Fars and Isfahan ranked from first to third respectively. Similarly after HTP, in 2015, the provinces of Tehran, Khorasan Razavi and Fars and in 2016 the provinces of Tehran, Fars and Khorasan Razavi have ranked from first to third respectively. Paramedic, dentist, pharmacist, medical institutions and hospital bed had a significant difference before and after the implementation of Health Transformation Plan, so that the number of these indicators increased after implementation of the HTP (P value < 0.05).ConclusionsAccording to the results, there are many differences between the provinces and these disparities have not decreased significantly after HTP. Consequently, it is suggested to the health sector policy makers to make regional plans and allocate the budget of HTP, based on the status of the provinces. In addition, responding to these inequalities requires a transparent and systematic approach to provide the budget for allocating to the population, health needs, and the lack of development and geographical isolation of regions.
Highlights
Health Transformation Plan (HTP) was occurred in 2014 to improve access and equity and reduce out of pocket payments in Iranian Health Care System
Unequal distribution of health services is a major barrier to provision of improving health and treatment in the health systems across the world, and there is a link between access to health care resources and health status [27]
The findings of this study indicate that in 2012 and 2013, as the years before implementation of the Health Transformation Plan, the provinces of Mazandaran, Tehran and Fars in 2012 and Tehran, Fars, Isfahan in 2013 in terms of investigating the developing indicators have been in a better position respectively
Summary
Health Transformation Plan (HTP) was occurred in 2014 to improve access and equity and reduce out of pocket payments in Iranian Health Care System In this regard the aim of this study is evaluating and ranking the service provider’s infrastructures among the country provinces as an indicator of equity before and after implementation of the HTP. Against the emphasis on fair allocation of the resources, the results of various studies indicate the unequal distribution of rural health houses in the provinces of Iran [7], unequal distribution of primary care physicians in different regions of Greece and Albania [8], and unequal distribution of physicians in rural areas of the United States in 2005 [9]. The outbreak of chronic diseases in Iran and the accumulation of health centers in large cities have resulted in poor accessibility or even lack of access to services in other deprived areas [15]
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