Financial challenges in the family physician programme in Iran: A systematic review of qualitative research

Heidarzadeh A 1 , Hedayati B 2 , Sirous S 3 , Huntington MK 4 , Alvandi M 5 , Arabi A 6 Show all authors , Farrokhi B 7 , Nojomi M 8 , Noori Hekmat S 9 , Mirkazemi R 10

Affiliations 

  • 1 MD, MPH, Medical Education Research Center, Department of Community and Family Medicine. School of Medicine. Guilan University of Medical Sciences, Rasht, Iran
  • 2 MPH, Research Department, Farzanegan Nik Andish Institute for the Development of Knowledge and Technology, Tehran, Iran
  • 3 MD, National Professional Officer and Unit Head, Universal Health Coverage/Health System, WHO Representative Office, Tehran, Iran
  • 4 MD, PhD, FAAFP Professor, Director, Sioux Falls, Family Medicine Residency program and founding Director, Pierre Rural, Family Medicine Residency program, University of South Dakota Sanford, School of Medicine, Vermillion, United States
  • 5 MD, Department of Public Administration, Faculty of Management, University of Tehran, Tehran, Iran
  • 6 Family Physician Specialist, National Center for Health Insurance, Research, Tehran, Iran
  • 7 MD, MPH, Executive Deputy, National Director for Family Medicine, Undersecretary for Health Affairs, Health Network Administration Center, Ministry of Health and Medical Education, Tehran, Iran
  • 8 MD, MPH, Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine. School of Medicine. Iran University of Medical Sciences, Tehran, Iran
  • 9 PhD, Associate Professor of Health Services Management, Leadership and Management in Medical Education Research Center, Kerman University of Medical Sciences, Kerman, Iran
  • 10 BSc, MSc, PhD, Founder and Managing Director of Farzanegan Nik Andish Institute for the Development of Knowledge and Technology, Tehran, Iran. Email: r.mirkazemi@gmail.com
Malays Fam Physician, 2023;18:59.
PMID: 38026574 DOI: 10.51866/rv.254

Abstract

INTRODUCTION: The family physician programme (FPP) was implemented nearly two decades ago as a major health reform. Since the health system and FPP function in a rapidly changing social and economic environment, successful expansion of the programme requires a detailed analysis of its multiple major challenges, including the crucial aspect of its funding system. This systematic review aimed to assess the challenges in the FPP relative to its financing.

METHOD: All published articles related to the FPP in Iran were included in this study. In particular, original qualitative studies published in English or Persian from 2011 to 2021 were included. In January 2022, international credible scholarly databases and Persian databases were searched. All selected articles were carefully studied, and the data were extracted using the sample, phenomenon of interest, design, evaluation and research type technique. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were used in preparing the study report.

RESULTS: Among 491 articles retrieved from the search strategy, 50 met the inclusion criteria after their titles and abstracts were screened. Twenty-nine studies were excluded after their full texts were reviewed. A total of 11 eligible empirical studies were finally included. Based on the results, six broad categories (budget and funding, insurance system, tariffs, payments, accountability and injustice) were identified as financial challenges.

CONCLUSION: This study identified the challenges associated with financing among family physicians, and the results could provide guidance for policy-making in the expansion of the FPP.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

Similar publications