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Financial Protection Indexes and the Iranian Health Transformation Plan: A Systematic Review Pubmed



Darvishi B1 ; Behzadifar M1 ; Ghanbari MK2 ; Ehsanzadeh SJ3 ; Bakhtiari A4 ; Behzadifar M1 ; Azari S5 ; Bragazzi NL6
Authors
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Authors Affiliations
  1. 1. Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
  2. 2. Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
  3. 3. School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Health Economics and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Hospital Management Research Center, Iran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Health Sciences (DISSAL), School of Public Health, University of Genoa, Genoa, Italy

Source: Yale Journal of Biology and Medicine Published:2021


Abstract

Background: On May 5, 2014, the Iranian Ministry of Health and Medical Education launched the Health Transformation Plan (HTP) as a major healthcare reform to curb out-of-pocket (OOP) expenses and protect people from catastrophic health expenditures (CHEs). Therefore, in this study, we conducted a comprehensive literature search with the aim of systematically investigating the impacts of HTP on OOP and CHE after the implementation of the plan. Method: Web of Science, PubMed, Scopus, Embase, and Iranian bibliographic thesauri and repositories such as MagIran, Elmnet, and Scientific Information Database were searched. Studies published between May 2014 and December 2020 that reported the impact of HTP on the financial indicators under investigation in this study (OOP and CHEs) that were conducted in Iran. Estimated pooled change both for OOP and CHEs was calculated as effect size utilizing meta-analytical techniques. Also, heterogeneity among studies was assessed with the I2 statistics. Results: Seventeen studies were included, nine of which evaluated the OOP index, six studies assessed the CHEs index, and two studies examined both the OOP and CHEs indexes. The OOP was found to decrease after the implementation of the HTP (with an estimated decrease of 13.02% (95% CI: 9.09-16.94). Also, CHEs experienced a decrease of 5.80% (95% CI: 3.85-7.74). Conclusion: The findings show that the implementation of HTP has reduced health costs. In this regard and in order to keep reducing the costs that many people are unable to pay, the government and other organizations involved in the health system should provide sustainable financial resources in order to continue running HTP. However, there remain gaps and weaknesses that can be solved through discussion with all the actors involved. © 2021 Institute of Electrical and Electronics Engineers Inc. All rights reserved.
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