Search

Objectives Considering the rapid growth of the aged population and given that older people are the main consumers of health services, it is important to address the effects of population ageing on the health system function. Therefore, this study aims to review the evidence related to the impacts of population ageing on various functions of the health system, including stewardship, financing, resource development, and service provision. Methods & Materials This is a systematic review study. The data were collected through searching in PubMed, Web of Science, ProQuest and Google Scholar for articles published from 2000 to 2022, using the related keywords. Quality assessment of selected articles was done using the STROBE checklist. To analyze the extracted data, the World Health Organization’s health system performance assessment framework was used. Results Of 1954 identified articles, 23 were finally selected based on inclusion and exclusion criteria. In the function of stewardship, the impacts were related to the managerial and policy aspects and the increased need to respond to the growing health needs of the elderly. In the function of financing, the impacts included the increase of financial burden on the health system and the need to provide financial resources. In the resource generation function, the impacts were categorized into human, information and physical resources. In the function of service provision, the impacts were on the demand for services, the complexity of service provision, and the method of service provision to elderly. Conclusion The impacts of population ageing on the functions of the health system, especially the financing function, are inevitable. The increase in the aged population is associated with the increase in health costs. Policy makers and managers of the health system should use practical strategies to strengthen the health system against the effects of population ageing.

Objectives Considering the rapid growth of the aged population and given that older people are the main consumers of health services, it is important to address the effects of population ageing on the health system function. Therefore, this study aims to review the evidence related to the impacts of population ageing on various functions of the health system, including stewardship, financing, resource development, and service provision. Methods & Materials This is a systematic review study. The data were collected through searching in PubMed, Web of Science, ProQuest and Google Scholar for articles published from 2000 to 2022, using the related keywords. Quality assessment of selected articles was done using the STROBE checklist. To analyze the extracted data, the World Health Organization's health system performance assessment framework was used. Results Of 1954 identified articles, 23 were finally selected based on inclusion and exclusion criteria. In the function of stewardship, the impacts were related to the managerial and policy aspects and the increased need to respond to the growing health needs of the elderly. In the function of financing, the impacts included the increase of financial burden on the health system and the need to provide financial resources. In the resource generation function, the impacts were categorized into human, information and physical resources. In the function of service provision, the impacts were on the demand for services, the complexity of service provision, and the method of service provision to elderly. Conclusion The impacts of population ageing on the functions of the health system, especially the financing function, are inevitable. The increase in the aged population is associated with the increase in health costs. Policy makers and managers of the health system should use practical strategies to strengthen the health system against the effects of population ageing. [ABSTRACT FROM AUTHOR]

One of the serious challenges regarding interactions between Iran’s social security system and health system is basic health insurance stewardship. It has existed for a long time and has been given a special place concerning the related laws and policies in recent years. In this regard, it seems that approving of rules conflicting with upstream laws and policies has increased existing conflicts. This is done by creating ambiguity in the position of basic health insurance. But, it should not be forgotten that the main goal is universal health coverage and effective insurance protection against financial risks caused by illness. Therefore, any decision in these areas should be made with respect to the social, cultural, economic and political conditions of the country and according to the historical experiences and structural characteristics.

Background and Objectives: One of the decentralized models that has been formed based on universal health coverage is the model of health complexes in Tabriz. This study was conducted to evaluate the model. Methods: This case study was conducted in 2017. Beside observation, 28 individuals, including informed experts in the field of establishment of health complexes in Tabriz University of Medical Sciences, were purposefully selected and semi-structured interviews were also conducted. To analyze the interviews and the results of observations, the framework analysis was used based on the components of the Primary Care Evaluation Tool (PCET) model. Results: The strengths of the health complex model are decentralized planning, strengthening the private sector participation, have more appropriate methods for assessing the performance of the health team, creating a sense of delivering effective services in providers, using electronic information registration system, using the prospective payment method, strengthening the referral system, enhancing service continuity, and facilitating financial and geographical access, especially in marginalized areas. However, there are some problems such as lack of some facilities and equipment, lack of some workforces and high workload, financial instability, and lack of insurance organizations cooperation with the plan. Conclusion: The health complex model has improved organizational, financial, and geographic access to health services. It seems that if the resources are more stable and by cooperation of basic insurances, the results of this project will be better.

Background and Aim: Stewardship and delivery of health services are considered as the most important areas in the healthcare system of the Islamic Republic of Iran in 1404. This study was conducted to investigate the main challenges in medical education stewardship because of its importance in the management and leadership of education from the viewpoint of education process providers. Materials and Methods: This qualitative research was conducted using thematic and framework analyses to obtain the collective view of faculty members of Medical Sciences Universities in Iran. The data were collected applying deep semi-structured interviews. To increase the acceptability of the study, four criteria of Lincoln and Gupta were used. Codes, categories and themes were extracted by expert researchers of qualitative studies who had no conflict of interests with the topic. Results: Of the 24 faculty members interviewed, 7 were females and 17 were males. They comprised 5 full professors, 8 associate professors, 9 assistant professors and 2 lecturers. The findings of the interviews were categorized in three main lines of stewardship in health system in the form of main and sub themes so that there were 2, 2 and 5 main themes in each line, respectively. Conclusion : Since many of the challenges extracted from the present interviews are considered as essential interventions for achieving the stewardship functions of health system -- and, as a result, medical education -- , it is important to pay more attention to these challenges and at the same time conduct more complete studies to get more practicable solutions to these problems.

Background: Medical tariff is one of the most important tools for health policy making in a country that influences equity, efficiency, quality and accountability of service deliveries. If relative values for different services are not determined correctly, it may have negative consequences on availability and sustainability of care. This study was designed to assess the challenges and respective solutions of the tariff system in Iranian health sectors. Materials & methods: This is a qualitative study, involving nine face to face interviews with health managers, policy makers and researchers at the Ministry of Health and Medical Education and relevant organizations, as well as public and private institutions and service providers who had experiences in medical tariff. We used the thematic framework method for analyzing qualitative data. Results: The problems and respective solutions were classified into stewardship power, policy making and surveillance for tariff setting, structural organization of medical tariff system, methods and principles of setting the tariffs, medical costs recording systems and other concepts related to the medical tariff system in the health sector. Conclusion: To improve medical tariffs system in the country, one need to have a deep understanding of the current challenges and potential solutions in different levels. It is advisable to follow a clear model based on focus on policy-making and stewardship of medical tariffs system as an important cornerstone of any effort to rectify the current situation.