Healthcare services utilization in Iran: a systematic review and meta-analysis

IF 1.2 Q4 HEALTH POLICY & SERVICES

International Journal of Human Rights in Healthcare Pub Date : 2022-03-08 DOI:10.1108/ijhrh-11-2021-0202

B. Ahadinezhad, Omid Khosravizadeh, S. Rafiei, Aisa Maleki

{"title":"Healthcare services utilization in Iran: a systematic review and meta-analysis","authors":"B. Ahadinezhad, Omid Khosravizadeh, S. Rafiei, Aisa Maleki","doi":"10.1108/ijhrh-11-2021-0202","DOIUrl":null,"url":null,"abstract":"\nPurpose\nIt can be said that the most important function of the health system is to provide health-care services. This directly affects society’s health and justice. To the best of the authors’ knowledge, this study is the first study that has meta-analyzed the percentage of health services utilization among Iranians to answer this question “How much is the percentage of health-care services utilization in Iran?”\n\n\nDesign/methodology/approach\nThis study is a systematic review and meta-analysis conducted in 2020. The literature review was done by searching the databases of Google Scholar, Scopus, PubMed, Web of Science, Science Direct, SID, Magiran and Irandoc from January 2010 to August 2020. Pooled utilization percentage (UP) was estimated by STATA 15 through random-effects meta-analysis with 95% confidence interval. The I2 statistic was used to investigate the possibility of heterogeneity of articles (I2 ≥ 50% indicate heterogeneity). A forest plot was applied to report the results. A funnel plot exploited due to publication bias assessment.\n\n\nFindings\nApproximately 22% of the reviewed articles have been done at the national level of Iran. Most studies have examined the utilization of outpatient and inpatient services. Based on the random effects method, the pooled value of UP was obtained at 47.82%, (95% CI: 39.33–56.31). Also, the pooled percentage of utilization was statistically significant (Test of UP = 0, Z = 456.44, p = 0.000).\n\n\nPractical implications\nPolicymakers can improve the level of utilization from health services by expanding universal coverage, expanding insurance coverage and removing direct and indirect barriers.\n\n\nOriginality/value\nTo the best of the authors’ knowledge, this is the first systematic review and meta-analysis on health services utilization in Iran that completely considers the utilization rate in all health services and states the practical solutions to cope with utilization deficiencies and barriers.\n","PeriodicalId":14129,"journal":{"name":"International Journal of Human Rights in Healthcare","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Human Rights in Healthcare","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1108/ijhrh-11-2021-0202","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose It can be said that the most important function of the health system is to provide health-care services. This directly affects society’s health and justice. To the best of the authors’ knowledge, this study is the first study that has meta-analyzed the percentage of health services utilization among Iranians to answer this question “How much is the percentage of health-care services utilization in Iran?” Design/methodology/approach This study is a systematic review and meta-analysis conducted in 2020. The literature review was done by searching the databases of Google Scholar, Scopus, PubMed, Web of Science, Science Direct, SID, Magiran and Irandoc from January 2010 to August 2020. Pooled utilization percentage (UP) was estimated by STATA 15 through random-effects meta-analysis with 95% confidence interval. The I2 statistic was used to investigate the possibility of heterogeneity of articles (I2 ≥ 50% indicate heterogeneity). A forest plot was applied to report the results. A funnel plot exploited due to publication bias assessment. Findings Approximately 22% of the reviewed articles have been done at the national level of Iran. Most studies have examined the utilization of outpatient and inpatient services. Based on the random effects method, the pooled value of UP was obtained at 47.82%, (95% CI: 39.33–56.31). Also, the pooled percentage of utilization was statistically significant (Test of UP = 0, Z = 456.44, p = 0.000). Practical implications Policymakers can improve the level of utilization from health services by expanding universal coverage, expanding insurance coverage and removing direct and indirect barriers. Originality/value To the best of the authors’ knowledge, this is the first systematic review and meta-analysis on health services utilization in Iran that completely considers the utilization rate in all health services and states the practical solutions to cope with utilization deficiencies and barriers.

查看原文本刊更多论文

伊朗医疗保健服务利用:系统回顾和荟萃分析

目的可以说，卫生系统最重要的功能是提供医疗保健服务。这直接影响到社会的健康和正义。据作者所知，这项研究是第一项对伊朗人利用医疗服务的百分比进行元分析的研究，以回答“伊朗的医疗服务利用百分比是多少？”设计/方法/方法这项研究为2020年进行的系统综述和元分析。2010年1月至2020年8月，通过搜索Google Scholar、Scopus、PubMed、Web of Science、Science Direct、SID、Magiran和Irandoc的数据库进行了文献综述。STATA 15通过95%置信区间的随机效应荟萃分析估计汇集利用率（UP）。I2统计量用于研究文章异质性的可能性（I2 ≥ 50%表示异质性）。应用森林图来报告结果。由于发表偏倚评估而利用的漏斗图。发现大约22%的审查文章是在伊朗国家层面上完成的。大多数研究都考察了门诊和住院服务的利用情况。基于随机效应法，UP的汇总值为47.82%（95%CI:39.33–56.31）。此外，汇总利用率具有统计学意义（UP=0，Z=456.44，p=0.000）。实际意义决策者可以通过扩大全民覆盖范围来提高卫生服务的利用水平，扩大保险范围，消除直接和间接障碍。原创性/价值据作者所知，这是第一次对伊朗卫生服务利用情况进行系统回顾和荟萃分析，全面考虑了所有卫生服务的利用率，并提出了应对利用不足和障碍的切实可行的解决方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Human Rights in Healthcare HEALTH POLICY & SERVICES-

CiteScore

2.90

自引率

7.10%

发文量

期刊介绍： nternational Journal of Human Rights in Healthcare (IJHRH) is an international, peer reviewed journal with a unique practical approach to promoting race equality, inclusion and human rights in health and social care. The journal publishes scholarly and double blind peer-reviewed papers of the highest standard, including case studies and book reviews. IJHRH aims include: -To explore what is currently known about discrimination and disadvantage with a particular focus on health and social care -Push the barriers of the human rights discourse by identifying new avenues for healthcare practice and policy internationally -Create bridges between policymakers, practitioners and researchers -Identify and understand the social determinants of health equity and practical interventions to overcome barriers at national and international levels. The journal welcomes papers which use varied approaches, including discussion of theory, comparative studies, systematic evaluation of interventions, analysis of qualitative data and study of health and social care institutions and the political process. Papers published in IJHRH: -Clearly demonstrate the implications of the research -Provide evidence-rich information -Provoke reflection and support critical analysis of both challenges and strengths -Share examples of best practice and ‘what works’, including user perspectives IJHRH is a hugely valuable source of information for researchers, academics, students, practitioners, managers, policy-makers, commissioning bodies, social workers, psychologists, nurses, voluntary sector workers, service users and carers internationally.