Presenting a Quaternary Prevention Model for the Rural Family Physician Program in Iran with an Interpretive Structural Modeling Approach.

IF 1.7 Q2 MEDICINE, GENERAL & INTERNAL
International Journal of Preventive Medicine Pub Date : 2023-08-28 eCollection Date: 2023-01-01 DOI:10.4103/ijpvm.ijpvm_116_22
Rahil GhorbaniNia, Somayeh Noori Hekmat, Reza Dehnavieh, Kambiz Bahaadinbeigy, Morteza Arab-Zozani
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引用次数: 0

Abstract

Background: Due to its ethical approach and its protection of patients and their interests, quaternary prevention can increase the quality-of-service provision and decrease costs and the wastage of resources. The present study used interpretive structural modeling (ISM) to classify the effective factors and determine a quaternary prevention model for Iran's Rural Family Physician Program.

Methods: This study was a qualitative study with an ISM approach. Twenty-five health system experts and faculty members participated in the study. The interrelationships between the factors were determined using ISM, and after classification, the driving and dependence power of the factors were specified using MICMAC analysis.

Results: The 20 factors were classified into five levels. The results indicated that patient interest and vulnerable groups had the highest effectiveness, and officials' and policymakers' commitment to providing serious support for family physicians had the highest affectability. The factors were placed into the two groups of linkage and dependence based on the MICMAC analysis.

Conclusions: The new technologies are costly and sometimes only suitable for a specific group of patients. Costs and the issues of induced demand and defensive medicine necessitate a different view of health service distribution. The preventive and strategic view and the comprehensiveness of family physician services make quaternary prevention possible by providing high-risk and vulnerable groups with essential services based on patient needs and conditions with more benefit than harm.

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采用解释性结构建模方法,为伊朗农村家庭医生项目提出了四级预防模型。
背景:由于其伦理方法以及对患者及其利益的保护,四级预防可以提高服务质量,降低成本和资源浪费。本研究采用解释结构模型(ISM)对影响因素进行分类,并确定伊朗农村家庭医生项目的四级预防模型。方法:本研究采用ISM方法进行定性研究。25名卫生系统专家和教职工参与了这项研究。使用ISM确定因素之间的相互关系,分类后,使用MICMAC分析指定因素的驱动力和依赖力。结果:将20个因素分为5个层次。结果表明,患者利益和弱势群体的有效性最高,官员和政策制定者对为家庭医生提供认真支持的承诺最做作。根据MICMAC分析,将这些因素分为连锁和依赖两组。结论:新技术成本高昂,有时只适用于特定的患者群体。成本以及诱导需求和防御性医疗的问题需要对医疗服务分配有不同的看法。预防和战略观点以及家庭医生服务的全面性使四级预防成为可能,因为它根据患者的需求和条件为高危和弱势群体提供基本服务,利大于弊。
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来源期刊
International Journal of Preventive Medicine
International Journal of Preventive Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
4.80%
发文量
107
期刊介绍: International Journal of Preventive Medicine, a publication of Isfahan University of Medical Sciences, is a peer-reviewed online journal with Continuous print on demand compilation of issues published. The journal’s full text is available online at http://www.ijpvmjournal.net. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository. The journal will cover technical and clinical studies related to health, ethical and social issues in field of Preventive Medicine. Articles with clinical interest and implications will be given preference.
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