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irje 2018, 13 - Vol.13, (Special Issue): 48-58 |
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Yazdi Feyzabadi V, Mehrolhasani M, Baneshi M, Mirzaei S, Oroomiei N. Association between Pilot Urban Family Physician Program and Health Financial Protection Measures in Fars and Mazandaran Provinces. irje 2018; 13 :48-58
URL: http://irje.tums.ac.ir/article-1-5976-en.html
URL: http://irje.tums.ac.ir/article-1-5976-en.html
1- Assistant Professor, PhD in Health Policy, Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
2- Associate Professor, PhD in Health Services Management, Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
3- Associate Professor, PhD in Biostatistics, Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
4- PhD Student in Health Policy, HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
5- PhD Student in Health Policy, Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran ,n_oroomiei@yahoo.com
2- Associate Professor, PhD in Health Services Management, Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
3- Associate Professor, PhD in Biostatistics, Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
4- PhD Student in Health Policy, HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
5- PhD Student in Health Policy, Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran ,
Abstract: (4572 Views)
Background and Objectives: Urban family physician program(UFPP), a program for improving equity in access to, financing, and quality of health services, is piloting in two provinces of Fars and Mazandaran, Iran since 2012. This study aimed to examine the association between the implementation of program and financial protection measures.
Methods: This cross-sectional, ecological study was performed on aggregated data of financial protection measures and some independent variables in the above provinces from 2008 to 2015. At first, the Lasso regression model was used for selecting independent variables affecting financial protection indexes. After adjusting the selected independent variables, in separate models, the association between the UFPP and financial protection measures, as outcome variables, was examined using a backward linear regression model.
Results: The percentage of households facing catastrophic health expenditure(CHE) in the years of UFPP implementation was 1.82% higher than the years before implementation(P<0.05). This increase was 1.37% in rural areas. the percentage of medical impoverishment in the two provinces increased by 0.83% during the implementation years than the years before(P<0.05). Finally, no significant relationship was observed between UFPP implementation and the Kakwani index and out of pocket payment(as % of total health expenditure) in the two provinces(P>0.05).
Conclusion: Despite the achievements attained by UFPP in improving physical access to health services, it seems that this program has had no success in improving financial protection measures and equitable health care financing. However, further research is warranted in this regard.
Methods: This cross-sectional, ecological study was performed on aggregated data of financial protection measures and some independent variables in the above provinces from 2008 to 2015. At first, the Lasso regression model was used for selecting independent variables affecting financial protection indexes. After adjusting the selected independent variables, in separate models, the association between the UFPP and financial protection measures, as outcome variables, was examined using a backward linear regression model.
Results: The percentage of households facing catastrophic health expenditure(CHE) in the years of UFPP implementation was 1.82% higher than the years before implementation(P<0.05). This increase was 1.37% in rural areas. the percentage of medical impoverishment in the two provinces increased by 0.83% during the implementation years than the years before(P<0.05). Finally, no significant relationship was observed between UFPP implementation and the Kakwani index and out of pocket payment(as % of total health expenditure) in the two provinces(P>0.05).
Conclusion: Despite the achievements attained by UFPP in improving physical access to health services, it seems that this program has had no success in improving financial protection measures and equitable health care financing. However, further research is warranted in this regard.
Keywords: Urban family physician, Financial protection, Out of pocket, Catastrophic expenditures, Iran
Type of Study: Research |
Subject:
General
Received: 2018/07/1 | Accepted: 2018/07/1 | Published: 2018/07/1
Received: 2018/07/1 | Accepted: 2018/07/1 | Published: 2018/07/1
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