ارزيابي شيوه هاي تامين مالي و نظام پرداخت به ارائه كنندگان خدمات سلامت در كشورهاي منتخب: ارائه الگو براي ايران

Assessing financing methods and payment system for health service providers in selected countries: designing a model for Iran

Introduction: Majority otʹhealth systems across the world are experiencing challenges in their performance, quality, equity, and efficacy becausc financial resources limitation. To deal with, they use different method of financial allocation resources and payment systems. Methods: This comparative descriptive research is dedicated to financing methods and payment systems to the health service providers in the health sector of 12 countries: Australia, United Kingdom, United State of America, Turkey, Sweden, Norway, Japan, Netherlands, Canada, Denmark, France, and Germany. The model, based on the operated common mechanisms in the aforementioned countries, is designed for health system of Iran and it is validated by the masters and recognized as Delphi method. Results: financing for health service providers in the selected countries mainly is annual global allocation budget; and the criterion of allocation especially in the current cost based on quality, cost, and performance. The calculation of cost is based on estimated cost. Payment system on the first level is based on per capita and fee for service; in other levels based on fee for services. Also the model was statistical ly confirmed the significant ofresults (p<0/05). Conclusiou: Given to the low rate ofGDP and low port ion of health sector from GDP in Iran, we recommended payment to the first level as combination of per capita and fee for service. The performance and justice of health system will promote with payment as fee for service for other of health service provider and indirect financial resources allocation to the health service providers (through insurance organizations) and make same tariff between public and private sector.