- Effects of Iranian Economic Reforms on Equity in Social and Healthcare Financing: A Segmented Regression Analysis
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Hamed Zandian, Amirhossein Takian, Arash Rashidian, Mohsen Bayati, Telma Zahirian Moghadam, Satar Rezaei, Alireza Olyaeemanesh
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J Prev Med Public Health. 2018;51(2):83-91. Published online February 6, 2018
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DOI: https://doi.org/10.3961/jpmph.17.050
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 Abstract
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- Objectives
One of the main objectives of the Targeted Subsidies Law (TSL) in Iran was to improve equity in healthcare financing. This study aimed at measuring the effects of the TSL, which was implemented in Iran in 2010, on equity in healthcare financing. Methods: Segmented regression analysis was applied to assess the effects of TSL implementation on the Gini and Kakwani indices of outcome variables in Iranian households. Data for the years 1977-2014 were retrieved from formal databases. Changes in the levels and trends of the outcome variables before and after TSL implementation were assessed using Stata version 13. Results: In the 33 years before the implementation of the TSL, the Gini index decreased from 0.401 to 0.381. The Gini index and its intercept significantly decreased to 0.362 (p<0.001) 5 years after the implementation of the TSL. There was no statistically significant change in the gross domestic product or inflation rate after TSL implementation. The Kakwani index significantly increased from -0.020 to 0.007 (p<0.001) before the implementation of the TSL, while we observed no statistically significant change (p=0.81) in the Kakwani index after TSL implementation. Conclusions: The TSL reform, which was introduced as part of an economic development plan in Iran in 2010, led to a significant reduction in households’ income inequality. However, the TSL did not significantly affect equity in healthcare financing. Hence, while measuring the long-term impact of TSL is paramount, healthcare decision-makers need to consider the efficacy of the TSL in order to develop plans for achieving the desired equity in healthcare financing.
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Citations
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Journal of Preventive Medicine and Public Health.2024; 57(1): 65. CrossRef - Decomposition of Socioeconomic Inequality in Cardiovascular Disease Prevalence in the Adult Population: A Cohort-based Cross-sectional Study in Northwest Iran
Farhad Pourfarzi, Telma Zahirian Moghadam, Hamed Zandian
Journal of Preventive Medicine and Public Health.2022; 55(3): 297. CrossRef - Inequality in Private Health Care Expenditures: A 36-Year Trend Study of Iranian Households
Ehsan Aghapour, Mehdi Basakha, Seyed Hossein Mohaqeqi Kamal, Abolghasem Pourreza
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International Journal of Human Rights in Healthcare.2021; 14(5): 452. CrossRef - Measuring inequalities in the selected indicators of National Health Accounts from 2008 to 2016: evidence from Iran
Mohammad Hossein Mehrolhassani, Vahid Yazdi-Feyzabadi, Marzieh Lashkari
Cost Effectiveness and Resource Allocation.2020;[Epub] CrossRef - Analysis of the Health Sector Evolution Plan from the perspective of equity in healthcare financing: a multiple streams model
Telma Zahirian Moghadam, Pouran Raeissi, Mehdi Jafari-Sirizi
International Journal of Human Rights in Healthcare.2019; 12(2): 124. CrossRef - The effect of Iranian health system reform plan on payments and costs of coronary artery bypass surgery in private hospitals of Iran
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International Journal of Human Rights in Healthcare.2019; 12(3): 208. CrossRef - Explaining the challenges of academic professional ethics training from the perspective of faculty members at Ardabil University of Medical Sciences: a qualitative study
Shahram Habibzadeh, Hamed Zandian, Hasan Edalatkhah, Mohammad Mehrtak
International Journal of Human Rights in Healthcare.2019; 12(2): 138. CrossRef - Equity in healthcare financing: a case of Iran
Faride Sadat Jalali, Abdosaleh Jafari, Mohsen Bayati, Peivand Bastani, Ramin Ravangard
International Journal for Equity in Health.2019;[Epub] CrossRef
- A Qualitative Inquiry Into the Challenges of Medical Education for Retention of General Practitioners in Rural and Underserved Areas of Iran
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Sajad Delavari, Mohammad Arab, Arash Rashidian, Saharnaz Nedjat, Rahmatollah Gholipour Souteh
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J Prev Med Public Health. 2016;49(6):386-393. Published online November 1, 2016
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DOI: https://doi.org/10.3961/jpmph.16.062
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9,148
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- Objectives
General practitioners (GPs) retention in rural and underserved areas highly effects on accessibility of healthcare facilities across the country. Education seems to be a critical factor that affects GPs retention. Thus, the present study aimed at inquiry into medical education challenges that limit their retention in rural and underserved areas.
Methods
A qualitative approach was applied for the aim of this study. Data were gathered via 28 semi-structured interviews with experts at different levels of Iran’s health system as well as GPs who retained and refused to retain working in rural settings. Interviews mainly were performed face-to-face and in some cases via telephone during 2015 and then coded and analyzed using content analysis approach.
Results
Iran’s medical education is faced with several challenges that were categorized in four main themes including student selection, medical students’ perception about their field of study, education setting and approach, curriculum of medical education. According to experts this challenges could results in making GP graduates disinterested for practicing in rural and underserved areas.
Conclusions
Challenges that were found could have negative effects on retention. Modification in student’s perception about rural practice could be done via changing education setting and approach and curriculum. These modifications could improve GPs retention in rural and underserved areas.
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