Financial protection of Iran's healthcare system during the COVID-19 pandemic and strategies for improvement.

IF 1.7 4区 医学 Q3 HEALTH POLICY & SERVICES
Fatemeh Gharaghieh, Ali Davati, Mohammad Amiri-Ara
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Abstract

Purpose: The conclusion of the COVID-19 pandemic provides an opportune moment to assess the performance of health systems in financial protection. This study aims to analyze the state of financial protection within Iran's healthcare system during the COVID-19 pandemic and propose practical solutions to enhance the system's financial protection.

Design/methodology/approach: This study, conducted in three stages, first assessed financial protection among 24,170 COVID-19 patients in three major Tehran hospitals, categorized by insurance status. We used dispersion indices to depict cost distribution and the Kruskal-Wallis test to analyze variations in out-of-pocket payments. In the second phase, ordinary least squares regression identified key factors affecting out-of-pocket payments. The third stage involved deriving strategies to improve health system financial protection using the Delphi technique and prioritizing them with the TOPSIS approach.

Findings: The average patient hospitalization cost was 512.41 US$, with patients covering 29.60% of total expenses while insurers handled 70.39%. Among Iran's basic health insurances, armed forces insurance exhibited the highest financial protection, with over 90% for insurers and less than 10% for the insured. The study highlights the significance of factors like prevention, equitable access, healthcare cost structuring and economic efficiency in enhancing financial protection. Priority for strengthening financial protection is given to promoting disease prevention and structuring demand through family doctor mechanisms and referral systems.

Originality/value: Enhancing financial protection requires attention to a wide range of measures, including health promotion and prevention, organizing healthcare demand, improving access structures, leveraging technological advancements and optimizing economic efficiency within the healthcare system.

2019冠状病毒病大流行期间伊朗卫生保健系统的财务保护及改进战略。
目的:2019冠状病毒病大流行结束为评估卫生系统在财务保护方面的表现提供了一个良机。本研究旨在分析2019冠状病毒病大流行期间伊朗医疗保健系统的财务保护状况,并提出切实可行的解决方案,以加强该系统的财务保护。设计/方法/方法:本研究分三个阶段进行,首先评估了德黑兰三家主要医院的24170名COVID-19患者的财务保护,按保险状况分类。我们使用离散指数来描述成本分布,并使用Kruskal-Wallis检验来分析自费支付的变化。在第二阶段,普通最小二乘回归确定了影响自费支付的关键因素。第三阶段涉及使用德尔菲技术制定改善卫生系统财务保护的战略,并使用TOPSIS方法对其进行优先排序。结果:患者平均住院费用为512.41美元,患者承担总费用的29.60%,保险公司承担总费用的70.39%。在伊朗的基本健康保险中,武装部队保险表现出最高的财务保障,保险人享有90%以上的保障,而被保险人享有不到10%的保障。该研究强调了预防、公平获取、医疗保健成本结构和经济效率等因素在加强财务保护方面的重要性。加强财政保障的重点是通过家庭医生机制和转诊制度促进疾病预防和结构需求。原创性/价值:加强财务保护需要关注广泛的措施,包括健康促进和预防、组织医疗保健需求、改善获取结构、利用技术进步和优化医疗保健系统内的经济效率。
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来源期刊
CiteScore
3.20
自引率
7.10%
发文量
72
期刊介绍: ■International health and international organizations ■Organisational behaviour, governance, management and leadership ■The inter-relationship of health and public sector services ■Theories and practices of management and leadership in health and related organizations ■Emotion in health care organizations ■Management education and training ■Industrial relations and human resource theory and management. As the demands on the health care industry both polarize and intensify, effective management of financial and human resources, the restructuring of organizations and the handling of market forces are increasingly important areas for the industry to address.
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