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Zandian H, Olyaeemanesh A, Takian A, et al. Contribution of Targeted Subsidies Law to the Equity in Healthcare Financing in Iran: Exploring the Challenges of Policy Process. Electron Physician. 2016;8(2):1892-903doi: 10.19082/1892.
Zandian, H., Olyaeemanesh, A., Takian, A., & Hosseini, M. (2016). Contribution of Targeted Subsidies Law to the Equity in Healthcare Financing in Iran: Exploring the Challenges of Policy Process. Electronic physician, 8(2), 1892-903. https://doi.org/10.19082/1892
Zandian, Hamed, et al. "Contribution of Targeted Subsidies Law to the Equity in Healthcare Financing in Iran: Exploring the Challenges of Policy Process." Electronic physician vol. 8,2 (2016): 1892-903. doi: https://doi.org/10.19082/1892
Zandian H, Olyaeemanesh A, Takian A, Hosseini M. Contribution of Targeted Subsidies Law to the Equity in Healthcare Financing in Iran: Exploring the Challenges of Policy Process. Electron Physician. 2016 Feb 25;8(2):1892-903. doi: 10.19082/1892. eCollection 2016 Feb. PMID: 27053996; PMCID: PMC4821302.
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Electron Physician. 2016 Feb 25;8(2):1892-903. doi: 10.19082/1892. eCollection 2016 Feb.

Contribution of Targeted Subsidies Law to the Equity in Healthcare Financing in Iran: Exploring the Challenges of Policy Process.

Electronic physician

Hamed Zandian, Alireza Olyaeemanesh, Amirhossein Takian, Mostafa Hosseini

Affiliations

  1. Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
  2. Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; National Institute of Health Research, Group of Payment and Financial Resources of the Health System, Tehran University of Medical Sciences, Tehran, Iran.
  3. Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; College of Health and Life Sciences, Brunel University London, Uxbridge, UK.
  4. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

PMID: 27053996 PMCID: PMC4821302 DOI: 10.19082/1892

Abstract

INTRODUCTION: The Targeted Subsidies Law (TSL) was implemented in 2010 with a platform of improving equity in the Iran's society. One of the objectives of the TSL was improving equity in Healthcare Financing (HCF), but a significant change has not occurred since then. The aim of this study was to analyze the challenges of the TSL to equity in the HCF in Iran.

METHODS: In this interpretive qualitative study, 31 policy makers and health system experts were interviewed face to face from September 2014 to June 2015. A purposeful and snowball sampling method was used to select participants. Also, a document analysis was conducted on upstream documents. Assisted by MAXQDA 10, recorded interviews were transcribed verbatim and analyzed based on Framework Approach.

RESULTS: Content analysis identified two themes and five sub-themes. Lack of justice in the healthcare system and lack of equity in the total socioeconomic structure of Iran were sub-themes identified as barriers to equity in HCF. Shortcomings in the formulation, implementation, and evaluation of the TSL were sub-themes identified as barriers in the policy process. The TSL did not achieve its intended objectives in the health sector because of the above-mentioned barriers.

CONCLUSION: The TSL, according to established goals, had no effect on the equity in HCF in Iran because of problems in the structure of the health system, socioeconomic status, and the policy process. To reach a more equitable HCF, it is advised that, when defining the related policies, various barriers be considered, such as those identified in our research.

Keywords: government subsidy; health planning support; healthcare financing; policy making; socioeconomic factors

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