Factors Affecting Health Policies for Older People in Iran.

Globally, the number and proportion of people aged 60 years and older is growing fast. As people age, health needs become more complex, and the health system's responsiveness to older people's needs requires evidence-informed policies. Hence, this study explores the factors affecting the health policy development process for older people in Iran. We conducted 32 interviewers with people aged 60 years and older and 21 interviews with key informants involved in policy making related to older people. Qualitative data were analyzed using thematic analysis. Actors and stakeholders, policy structure, selected health policy processes, the health care service delivery system, government financial support, and community and culture building are the most influential factors in health policy making for older people. Government policies and health priority interventions are needed to address these influential factors for older people to ensure healthy aging over the life course.

Payment system of urban family physician programme in the Islamic Republic of Iran: is it appropriate?

BACKGROUND: The payment system is pivotal in implementing policies in the health sector. Equitable access to healthcare is the main principle of the payment system. AIMS: This study aimed to investigate aspects of the payment system in the urban family physician programme (FPP) in the Islamic Republic of Iran. METHODS: This was a qualitative study. We obtained data from key informants and both formal and grey literature. We used content analysis for data analysis. RESULTS: A range of concepts was explored related to the payment system of the FPP. By merging similar expressions, we categorized the findings into four main themes including: payment method, payment criteria and incentives, payment process and amount of payment. CONCLUSIONS: FPP is required to follow convenient implementation methods. The mechanisms of payment in the health sector are weak and have no transparency. A blurred combination of criteria makes an unclear process for determining the payment mechanisms. It is recommended that the opinions of key stakeholders be taken into consideration prior to developing payment mechanisms and financial incentives.

Infrastructures Required for the Expansion of Family Physician Program to Urban Settings in Iran.

INTRODUCTION: Following the implementation of Family Physician (FP) Program in rural areas and cities with populations under 20000 in 2005, the Iranian Ministry of Health and Medical Education in 2012 decided to implement urban FP in large cities with populations more than 20000. Along with the development and implementation of urban FP in Iran, local websites and newspapers reflected the viewpoints of experts in various levels of health system regarding the various stages of Family Medicine (FM) development (from agenda setting to initial stages of implementation). This study aimed to explore the major infrastructures perceived to be required to achieve desirable implementation of urban FP through analyzing experts' viewpoints reflected in the media and interviews. METHODS: In a qualitative study, we analyzed the contents of health related national websites as well as transcribed interviews with key informants. Documents were collected from December 2011 to January 2014 and interviews were conducted from February 2014 to June 2015. We used mixed thematic approach (inductive and deductive) for analysis that was assisted by MAXQDA 12 software. RESULTS: Infrastructures needed for the implementation of FP were categorized in five main themes and 23 subthemes. The themes are: 'Stewardship/governance', 'Actors and stakeholders', 'structural infrastructure', 'technical infrastructure and needed resources', and 'information and communication infrastructure'. CONCLUSIONS: Expansion of FP program to urban settings needs appropriate attention to the principles of policy implementation as well as provision of robust infrastructures. Well-defined stewardship, revised approach to financial regulation and payment system, stakeholder's commitment to collaboration, policy for conflict resolution, and universal insurance coverage are pivotal for the expansion of family physician program to the urban settings in Iran.

Effects of Targeted Subsidies Policy on Health Behavior in Iranian Households: A Qualitative Study.

BACKGROUND: This study aimed to explore the effects of national targeted subsidies policy on health behavior of Iranian households. METHODS: In this qualitative study, data were collected between January 2012 and December 2013 through face-to-face interviews (23 experts in national and provincial levels of health system and 18 household heads) and through a comprehensive and purposive document analysis. The data was analyzed using a thematic analysis method (inductive-deductive) and assisted by Atlas-ti software. RESULTS: Rising health care costs, removing some food subsidies and the increase in price of most goods and services due to the implementation of economic policy of targeted subsidies have led to significant changes in the demand for health services, changes in the consumption trends of goods and services affecting health as well as changes in the health habits of households. CONCLUSION: Targeted subsidies and the cash subsidy policy have some negative effects on population health behavior especially among poor people. Hence, maintaining or increasing the cash subsidy is not an efficient allocation of resources toward health care system. So, it is necessary to identify appropriate strategies and policies and apply interventions in order to moderate negative effects and enhance positive effects resulted from implementing this economic reform on population health behavior.