Recent Iranian Health System Reform: An Operational Perspective to Improve Health Services Quality

Document Type: Debate

Authors

1 Tehran University of Medical Science, Tehran, Iran

2 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Science, Tehran, Iran

3 Department of Health Management & Economics, School of Public Health, Tehran University of Medical Science, Tehran, Iran

4 Social Security Research Institute, Tehran, Iran

Abstract

The operational management of healthcare services is expected to directly touch patient experiences. Iranian Ministry of Health and Medical Education (MoHME) for the first time, as such, has sought to improve the operational management of healthcare delivery within a reform agenda by setting benchmarks for ‘number of visit per hour’ and waiting time in outpatient clinics of about 700 affiliated hospitals. As a new initiative, it has faced with mixed reactions and various doubts have been cast on its successful implementation. This manuscript aims to shed some light on the operational challenges of the initiative and the requirements of its successful implementation.

Keywords

Main Subjects


  1. Africa SS. Financing for health: where there’s a will.... Lancet Glob Health.  2016;4(10):e663.   doi:10.1016/S2214-109X(16)30226-1
  2. Vissers J, Beech R. Health operations management: patient flow logistics in health care. Psychology Press; 2005.
  3. Kujala J, Lillrank P, Kronström V, Peltokorpi A. Time-based management of patient processes. J Heal Organ Manag. 2006;20(6):512-524.
  4. Soleimanpour H, Gholipouri C, Salarilak S, et al. Emergency department patient satisfaction survey in Imam Reza Hospital, Tabriz, Iran. Int J Emerg Med. 2011;4:2. doi:10.1186/1865-1380-1-2
  5. Sadjadian A, Kaviani A, Yunesian M, Montazeri A. Patient satisfaction: a descriptive study of a breast care clinic in Iran. Eur J Cancer Care (Engl). 2004;13(2):163-168.
  6. Health Sector Evolution, 2014. Iranian Ministry of Health and Medical Education website. http://www.behdasht.gov.ir/.
  7. Rezaei S, Rahimi Foroushani A, Arab M, Jaafaripooyan  E. Effects of the new health reform plan on the performance indicators of Hamedan university hospitals (Persian).
  8. Mohebbifar R, Hasanpoor E, Mohseni M, Sokhanvar M, Khosravizadeh O, Mousavi Isfahani H. Outpatient waiting time in health services and teaching hospitals: a case study in Iran. Glob J Health Sci. 2014;6(1):172–180.
  9. Heshmati B, Joulaei H. Iran’s health-care system in transition. Lancet. 2016;387(10013):29–30.      doi:10.1016/S0140-6736(15)01297-0
  10. Rad AM. A survey of total quality management in Iran: Barriers to successful implementation in health care organizations. Int J Health Care Qual Assur Inc Leadersh Health Serv. 2005;18(4-5):xii-xxxiv.
  11. Mosadeghrad AM. Obstacles to TQM success in health care systems. Int J Health Care Qual Assur. 2013;26(2):147-173. doi:10.1108/09526861311297352
  12. Mosadeghrad AM. Why TQM does not work in Iranian healthcare organisations. Int J Health Care Qual Assur. 2014;27(4):320-335. doi:10.1108/IJHCQA-11-2012-0110
  13. Moradi-Lakeh M, Vosoogh-Moghaddam A. Health sector evolution plan in iran; equity and sustainability concerns. Int J Health Policy Manag. 2015;4(10):637-640. doi:10.15171/ijhpm.2015.160
  14. Kavosi Z, Rashidian A, Pourreza A, et al. Inequality in household catastrophic health care expenditure in a low-income society of Iran. Health Policy Plan. 2012;27(7):613-623.
  15. Musgrove P, Creese A, Preker A, Baeza C, Anell A, Prentice T. Health Systems: Improving Performance. World Health Organization; 2000.
  16. Iranian National Institute of Health Research. Study of Healthcare Utilization in Iran. Tehran; 2014.
  17. Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50. doi:10.1186/1748-5908-4-50
  18. Koker A. Healthcare management engineering: What does this fancy term really mean? New York: Springer; 2012. Springer Briefs in Health Care Management and Economics.
  19. Brandenburg L, Gabow P, Steele G. Innovation and Best Practices in Health Care Scheduling. Institute of Medicine; 2015.
  20. Gupta D, Denton B. Appointment scheduling in health care: challenges and opportunities. IIE Trans. 2008;40(9):800-819.
  21. Bahadori MK, Mohammadnejhad SM, Ravangard R, Teymourzadeh E. Using queuing theory and simulation model to optimize hospital pharmacy performance. Iran Red Crescent Med J. 2014;16(3):e16807. doi:10.5812/ircmj.16807
  22. Agrrizi D, Agyemang G, Jaafaripooyan E. Conforming to accreditation in Iranian hospitals. Account Forum. 2016;40:106–124.
  23. Mahdavi M, Malmström T, van de Klundert J, Elkhuizen J. Generic operational models in health service operations management: a systematic review. Socioecon Plann Sci. 2013;47(4):271-280.
  24. Zonderland ME, Boucherie RJ, Litvak N, Vleggeert-Lankamp CL. Planning and scheduling of semi-urgent surgeries. Health Care Manag Sci. 2010;13(3):256-267.
  25. Cayirli T, Veral E. Outpatient scheduling in health care: a review of literature. Prod Oper Manag. 2003;12(4):519-449. doi:10.1111/j.1937-5956.2003.tb00218.x
  26. Hall R. Handbook of Healthcare System Scheduling. Springer Science+Business Media; 2012.
  27. Ben-Tovim DI, Dougherty ML, O’Connell TJ, McGrath KM. Patient journeys: the process of clinical redesign. Med J Aust. 2008;188(6 suppl):S14-S17.
  28. Cayirli T, Yang KK, Quek SA. A universal appointment rule in the presence of no-shows and walk-ins. Pord Oper Manag. 2012;21(4):682-697. doi:10.1111/j.1937-5956.2011.01297.x
  29. Cayirli T, Veral E, Rosen H. Designing appointment scheduling systems for ambulatory care services. Health Care Manag Sci. 2006 Feb;9(1):47-58