The effect of Iranian health system reform plan on payments and costs of coronary artery bypass surgery in private hospitals of Iran
Purpose In May 2014, a new reform in the health sector of Iran was implemented called “health evolution plan.” In the first phase of this reform, the government reduced out-of-pocket payments for service delivery by paying subsidies to the services and after that a revision was done to the medical s...
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| Veröffentlicht in: | International journal of human rights in healthcare 2019-07, Vol.12 (3), p.208-214 |
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| container_title | International journal of human rights in healthcare |
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| creator | Tabari-Khomeiran, Rasoul Delavari, Sajad Rezaei, Satar Rad, Enayatollah Homaie Shahmoradi, Mostafa |
| description | Purpose
In May 2014, a new reform in the health sector of Iran was implemented called “health evolution plan.” In the first phase of this reform, the government reduced out-of-pocket payments for service delivery by paying subsidies to the services and after that a revision was done to the medical services values book to improve equity and increase motivation of health professions. One of the affected services in this reform was coronary artery bypass surgery. The purpose of this paper is to show the effects of HEP on costs of coronary artery bypass surgery.
Design/methodology/approach
A before-after study was done for this purpose and 167 patients’ total costs and out-of-pocket payments were calculated for the years 2013 (before) and 2014 (after) the reform in three private hospitals of Rasht city, Iran. Econometrics models were estimated after adjustment of confounding variables.
Findings
The results of this study showed that surgery costs increased significantly from $1,643.3 to 2,119.5. Nursing and other costs increased significantly from $290.3 to 414.2 and anesthetize costs increased from $619.2 to 947.01. The results of regression model showed that total costs increased $3,008.6 after adjustment of confounders (p-value=0.037). However, no significant changes were found for out-of-pocket payments and out-of-pocket percentage.
Originality/value
The study findings revealed that HTP was not successful enough in financial protection in the private sector. |
| doi_str_mv | 10.1108/IJHRH-07-2018-0047 |
| format | Article |
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In May 2014, a new reform in the health sector of Iran was implemented called “health evolution plan.” In the first phase of this reform, the government reduced out-of-pocket payments for service delivery by paying subsidies to the services and after that a revision was done to the medical services values book to improve equity and increase motivation of health professions. One of the affected services in this reform was coronary artery bypass surgery. The purpose of this paper is to show the effects of HEP on costs of coronary artery bypass surgery.
Design/methodology/approach
A before-after study was done for this purpose and 167 patients’ total costs and out-of-pocket payments were calculated for the years 2013 (before) and 2014 (after) the reform in three private hospitals of Rasht city, Iran. Econometrics models were estimated after adjustment of confounding variables.
Findings
The results of this study showed that surgery costs increased significantly from $1,643.3 to 2,119.5. Nursing and other costs increased significantly from $290.3 to 414.2 and anesthetize costs increased from $619.2 to 947.01. The results of regression model showed that total costs increased $3,008.6 after adjustment of confounders (p-value=0.037). However, no significant changes were found for out-of-pocket payments and out-of-pocket percentage.
Originality/value
The study findings revealed that HTP was not successful enough in financial protection in the private sector.</description><identifier>ISSN: 2056-4902</identifier><identifier>EISSN: 2056-4910</identifier><identifier>DOI: 10.1108/IJHRH-07-2018-0047</identifier><language>eng</language><publisher>Bingley: Emerald Publishing Limited</publisher><subject>Adjustment ; Age ; Anesthesia ; Cardiovascular disease ; Coronary artery bypass surgery ; Coronary vessels ; Costs ; Econometrics ; Health care policy ; Health insurance ; Health services ; Heart surgery ; Hospitals ; Medical personnel ; Motivation ; Nursing ; Patients ; Payments ; Personal expenditure ; Private hospitals ; Private sector ; Professions ; Public sector ; Reforms ; Subsidies ; Surgery ; Tariffs ; Value ; Veins & arteries</subject><ispartof>International journal of human rights in healthcare, 2019-07, Vol.12 (3), p.208-214</ispartof><rights>Emerald Publishing Limited</rights><rights>Emerald Publishing Limited 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c317t-ee1abfbb492699fb0b1f8c19807671080b1da5a4ba7e5240c3c3422d4845ee03</citedby><cites>FETCH-LOGICAL-c317t-ee1abfbb492699fb0b1f8c19807671080b1da5a4ba7e5240c3c3422d4845ee03</cites><orcidid>0000-0002-9064-0380</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2247507673/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2247507673?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,967,11635,12740,12846,21695,27866,27924,27925,30999,35805,44329,52689,53244,74861</link.rule.ids></links><search><creatorcontrib>Tabari-Khomeiran, Rasoul</creatorcontrib><creatorcontrib>Delavari, Sajad</creatorcontrib><creatorcontrib>Rezaei, Satar</creatorcontrib><creatorcontrib>Rad, Enayatollah Homaie</creatorcontrib><creatorcontrib>Shahmoradi, Mostafa</creatorcontrib><title>The effect of Iranian health system reform plan on payments and costs of coronary artery bypass surgery in private hospitals of Iran</title><title>International journal of human rights in healthcare</title><description>Purpose
In May 2014, a new reform in the health sector of Iran was implemented called “health evolution plan.” In the first phase of this reform, the government reduced out-of-pocket payments for service delivery by paying subsidies to the services and after that a revision was done to the medical services values book to improve equity and increase motivation of health professions. One of the affected services in this reform was coronary artery bypass surgery. The purpose of this paper is to show the effects of HEP on costs of coronary artery bypass surgery.
Design/methodology/approach
A before-after study was done for this purpose and 167 patients’ total costs and out-of-pocket payments were calculated for the years 2013 (before) and 2014 (after) the reform in three private hospitals of Rasht city, Iran. Econometrics models were estimated after adjustment of confounding variables.
Findings
The results of this study showed that surgery costs increased significantly from $1,643.3 to 2,119.5. Nursing and other costs increased significantly from $290.3 to 414.2 and anesthetize costs increased from $619.2 to 947.01. The results of regression model showed that total costs increased $3,008.6 after adjustment of confounders (p-value=0.037). However, no significant changes were found for out-of-pocket payments and out-of-pocket percentage.
Originality/value
The study findings revealed that HTP was not successful enough in financial protection in the private sector.</description><subject>Adjustment</subject><subject>Age</subject><subject>Anesthesia</subject><subject>Cardiovascular disease</subject><subject>Coronary artery bypass surgery</subject><subject>Coronary vessels</subject><subject>Costs</subject><subject>Econometrics</subject><subject>Health care policy</subject><subject>Health insurance</subject><subject>Health services</subject><subject>Heart surgery</subject><subject>Hospitals</subject><subject>Medical personnel</subject><subject>Motivation</subject><subject>Nursing</subject><subject>Patients</subject><subject>Payments</subject><subject>Personal expenditure</subject><subject>Private hospitals</subject><subject>Private sector</subject><subject>Professions</subject><subject>Public sector</subject><subject>Reforms</subject><subject>Subsidies</subject><subject>Surgery</subject><subject>Tariffs</subject><subject>Value</subject><subject>Veins & arteries</subject><issn>2056-4902</issn><issn>2056-4910</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><sourceid>7TQ</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>LD-</sourceid><sourceid>QXPDG</sourceid><recordid>eNptkU1LxDAQhoMouOj-AU8Bz9VJmm7aoyzqriwIsveQthPbpW1qkhX27g83dVUQPM28ZN75eELIFYMbxiC_XT-tXlYJyIQDyxMAIU_IjEO2SETB4PQ3B35O5t7vAIDJnBc5m5GPbYMUjcEqUGvo2umh1QNtUHehof7gA_bUobGup2MXX-xAR33ocQie6qGmlfUxi9bKOjtod6DaBYyhPIzae-r37nWSbfS59l0HpI31Yxt0538mXpIzEyXOv-MF2T7cb5erZPP8uF7ebZIqZTIkiEyXpixFwRdFYUoomckrVuQgFzKCiLrWmRallphxAVVapYLzWuQiQ4T0glwf247Ovu3RB7WzezfEiYpzIbOpTRqr-LGqctb7eLqKe_fxMMVATbzVF28FUk281cQ7mtjRhD063dX_e_78UfoJdVODxg</recordid><startdate>20190719</startdate><enddate>20190719</enddate><creator>Tabari-Khomeiran, Rasoul</creator><creator>Delavari, Sajad</creator><creator>Rezaei, Satar</creator><creator>Rad, Enayatollah Homaie</creator><creator>Shahmoradi, Mostafa</creator><general>Emerald Publishing Limited</general><general>Emerald Group Publishing Limited</general><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>7QJ</scope><scope>7TQ</scope><scope>7X7</scope><scope>7XB</scope><scope>8C1</scope><scope>8FI</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DHY</scope><scope>DON</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>LD-</scope><scope>M0T</scope><scope>M2R</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>QXPDG</scope><orcidid>https://orcid.org/0000-0002-9064-0380</orcidid></search><sort><creationdate>20190719</creationdate><title>The effect of Iranian health system reform plan on payments and costs of coronary artery bypass surgery in private hospitals of Iran</title><author>Tabari-Khomeiran, Rasoul ; Delavari, Sajad ; Rezaei, Satar ; Rad, Enayatollah Homaie ; Shahmoradi, Mostafa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c317t-ee1abfbb492699fb0b1f8c19807671080b1da5a4ba7e5240c3c3422d4845ee03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adjustment</topic><topic>Age</topic><topic>Anesthesia</topic><topic>Cardiovascular disease</topic><topic>Coronary artery bypass surgery</topic><topic>Coronary vessels</topic><topic>Costs</topic><topic>Econometrics</topic><topic>Health care policy</topic><topic>Health insurance</topic><topic>Health services</topic><topic>Heart surgery</topic><topic>Hospitals</topic><topic>Medical personnel</topic><topic>Motivation</topic><topic>Nursing</topic><topic>Patients</topic><topic>Payments</topic><topic>Personal expenditure</topic><topic>Private hospitals</topic><topic>Private sector</topic><topic>Professions</topic><topic>Public sector</topic><topic>Reforms</topic><topic>Subsidies</topic><topic>Surgery</topic><topic>Tariffs</topic><topic>Value</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tabari-Khomeiran, Rasoul</creatorcontrib><creatorcontrib>Delavari, Sajad</creatorcontrib><creatorcontrib>Rezaei, Satar</creatorcontrib><creatorcontrib>Rad, Enayatollah Homaie</creatorcontrib><creatorcontrib>Shahmoradi, Mostafa</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>PAIS Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Ethnic NewsWatch</collection><collection>Healthcare Administration Database</collection><collection>Social Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Diversity Collection</collection><jtitle>International journal of human rights in healthcare</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tabari-Khomeiran, Rasoul</au><au>Delavari, Sajad</au><au>Rezaei, Satar</au><au>Rad, Enayatollah Homaie</au><au>Shahmoradi, Mostafa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effect of Iranian health system reform plan on payments and costs of coronary artery bypass surgery in private hospitals of Iran</atitle><jtitle>International journal of human rights in healthcare</jtitle><date>2019-07-19</date><risdate>2019</risdate><volume>12</volume><issue>3</issue><spage>208</spage><epage>214</epage><pages>208-214</pages><issn>2056-4902</issn><eissn>2056-4910</eissn><abstract>Purpose
In May 2014, a new reform in the health sector of Iran was implemented called “health evolution plan.” In the first phase of this reform, the government reduced out-of-pocket payments for service delivery by paying subsidies to the services and after that a revision was done to the medical services values book to improve equity and increase motivation of health professions. One of the affected services in this reform was coronary artery bypass surgery. The purpose of this paper is to show the effects of HEP on costs of coronary artery bypass surgery.
Design/methodology/approach
A before-after study was done for this purpose and 167 patients’ total costs and out-of-pocket payments were calculated for the years 2013 (before) and 2014 (after) the reform in three private hospitals of Rasht city, Iran. Econometrics models were estimated after adjustment of confounding variables.
Findings
The results of this study showed that surgery costs increased significantly from $1,643.3 to 2,119.5. Nursing and other costs increased significantly from $290.3 to 414.2 and anesthetize costs increased from $619.2 to 947.01. The results of regression model showed that total costs increased $3,008.6 after adjustment of confounders (p-value=0.037). However, no significant changes were found for out-of-pocket payments and out-of-pocket percentage.
Originality/value
The study findings revealed that HTP was not successful enough in financial protection in the private sector.</abstract><cop>Bingley</cop><pub>Emerald Publishing Limited</pub><doi>10.1108/IJHRH-07-2018-0047</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-9064-0380</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2056-4902 |
| ispartof | International journal of human rights in healthcare, 2019-07, Vol.12 (3), p.208-214 |
| issn | 2056-4902 2056-4910 |
| language | eng |
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| source | PAIS Index; Diversity Collection; Emerald A-Z Current Journals; Ethnic NewsWatch; Applied Social Sciences Index & Abstracts (ASSIA); Standard: Emerald eJournal Premier Collection |
| subjects | Adjustment Age Anesthesia Cardiovascular disease Coronary artery bypass surgery Coronary vessels Costs Econometrics Health care policy Health insurance Health services Heart surgery Hospitals Medical personnel Motivation Nursing Patients Payments Personal expenditure Private hospitals Private sector Professions Public sector Reforms Subsidies Surgery Tariffs Value Veins & arteries |
| title | The effect of Iranian health system reform plan on payments and costs of coronary artery bypass surgery in private hospitals of Iran |
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