روش هاي تخصيص مبتني بر نياز منابع نظام سلامت و ارزيابي وضع موجود تخصيص منابع به استان هاي ايران

Methods of Resource Allocation Based on Needs in Health Systems, and Exploring the Current Iranian Resource Allocation System

Introduction: This study aims to explore the applicability of a needs-based resource allocation method in Iran and to compare healthcare resources currently allocated to Iranian provinces using this method. Methods: MEDLINE and Google Scholar were searched and experts were contacted to identify methods of resource allocation based on needs; in addition, experts were interviewed to explore which methods are more appropriate in Iran according to the level and accuracy of data available. A combination of indicators was used to estimate the relative amount of resources each province should receive and compare it with the exact amount each province received. Results: The main indicators were population, mortality rate, socio-economic indicators, costs of prevalent diseases, extra costs for rural areas, previous budget, costs of family physician services, hospital services and drugs. In Iran reliable data about population, mortality and the level of deprivation is available for each province. Comparing the two methods, 12 provinces have received a relatively high budget, 14 a relatively low budget and in 4 provinces the budget was relatively balanced. Conclusion: Using a good combination of indicators has the potential to improve allocation of Iranʹs healthcare resources based on needs. There are currently significant differences between the amount of budget allocated to each Iranian province and the amount should have been allocated according to the needs- based method used in this study. This method has the potential to be further developed for allocating resources, although any change should be implemented gradually and over time.