Ranking of Iranian provinces based on healthcare infrastructures: before and after implementation of Health Transformation Plan

Payam Shojaei · Najmeh Bordbar · Arash Ghanbarzadegan · Maryam Najibi · Peivand Bastani

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Healthcare Systems and Reforms Healthcare Quality and Management Healthcare Systems and Practices

Abstract

Abstract Background 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. Methods This 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. SPSS18and Excel2013software were used for data analysis. Results Based 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 (Pvalue < 0.05). Conclusions According 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.

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References

2003Compromise solution by MCDM methods: A comparative analysis of VIKOR and TOPSIS 2015Health Sector Evolution Plan in Iran; Equity and Sustainability Concerns 2003Expanding access to priority health interventions: a framework for understanding the constraints to scaling‐up 2002Regional Inequality and Regional Polarization in Russia, 1990–99 2015Multi Criteria Decision Making 2000Poverty and inequity: a proper focus for the new century.2017Out-of-Pocket and Informal Payment Before and After the Health Transformation Plan in Iran: Evidence from Hospitals Located in Kurdistan, Iran 2008Resource allocation and purchasing in the health sector: the English experience

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