From: The influential factors for achieving universal health coverage in Iran: a multimethod study
Financing | Payment system | Organization | Regulation and Supervision | Behavior | Others |
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▪ Financial risk protection ▪ Constraints and Structural barriers in Financial ▪ Methods of health system financing (specific tax to health, Sell resources, …) ▪ Sustainability of financing ▪ Health expenditure as % of GDP ▪ Out of pocket ▪ Method of Collecting ▪ Method of pooling money ▪ Strategic purchasing ▪ Health insurance system ▪ International assistance (donation, Charity) ▪ Benefit package ▪ Economic vulnerability in health ▪ International sanctions ▪ Costs Control ▪ Health service tariffs ▪ Per capita income ▪ The economic growth rate ▪ Inflation rate | ▪ Exemption or Subsidies for prepayments ▪ Contribution-based on payment capacity ▪ Prepayment mechanisms ▪ Payment systems ▪ Information and interaction of insurance deductions for health ▪ Informal payments ▪ Deductible | ▪ Health system Leadership ▪ Management in the health system (Resource management, human resources, Change management, …) ▪ Health infrastructure (technology, information system, …) ▪ The capacity of formulation and implementation of health policies ▪ Structural and functional reforms ▪ Distribution of health provider ▪ Decentralization in decision-making ▪ Non-governmental organizations (Civil society organizations: Private sector, NGOs and charities) participant ▪ Integration or Fragmented degree of the health system ▪ Equity in the distribution of health system resources ▪ Equity in access to health services ▪ Use of Appropriate technology in the health system ▪ The necessity for grading health service centers and giving the insured sufficient notice of this grading ▪ Bureaucratic obstacles ▪ Systematic perspective ▪ Inter and intra-sectoral collaboration ▪ teamwork ▪ Competency and Stability Management ▪ Policies and programs belonging to persons ▪ Effective Services Coverage ▪ Priority health services ▪ Overlaps in healthcare provision ▪ Involving all relevant stakeholders in the policy-making process | ▪ Health system efficiency ▪ Government commitment ▪ Have Legal commitment ▪ Problems of law ▪ Political commitment and not having politically look ▪ Good governance ▪ Hasty policy implementation by politicians ▪ Conflict of interest ▪ Quality of health care services ▪ Supporting revision projects and national health indicators development. ▪ Focus on, villagers, nomads, less populated cities poor, disadvantaged and marginalized groups ▪ Family Physician Program ▪ Referral system ▪ Strengthen the central government’s Ministry of Health ▪ Control demands ▪ Regular transparency of revenues, expenditures, and activities ▪ Implement the rules of the World Health Organization ▪ Administrative and employment regulation ▪ Regulate the market of medical equipment ▪ Reviewing job classification schemes according to the needs of the health system. ▪ Electronic Health Record (EHR) ▪ Overlap in population coverage ▪ The dual practice of physician and another health workforce ▪ Competitive space between the providers. ▪ Policy dynamism ▪ Use of clinical guidelines and standards ▪ Performance of Supreme Council of Insurance ▪ oversight parliament ▪ Supervision by the ministry and the university ▪ The presence of specialists in public hospitals ▪ Plan to support the retention of physicians in underserved areas ▪ Assessment and accreditation of the health system performance ▪ Evidence-based policymaking | ▪ Health promotion and education ▪ Culture-building ▪ Empowering community ▪ Perceived behavioral control ▪ Issues of urbanization ▪ Absence of obligation for health providers to contract with insurance organizations ▪ Negligence of social factors ▪ Social acceptability of health service ▪ public participation in health promotions programs ▪ Creating an incentive mechanism for behavior change ▪ The pattern of health service utilization | ▪ Poverty ▪ Reviewing other countries experiences ▪ The unemployment rate in the country ▪ Active primary health care ▪ International relationship ▪ Health status of health indicators ▪ Prevention and control plans of non-communicable and communicable diseases ▪ Demographic and epidemiologic transitions ▪ Provide community-based services ▪ Health system service preferences (prevention-oriented or treatment-oriented) ▪ Disease Pattern ▪ Knowledge translation |