Volume 19, Issue 5 (September - October 2020)
Payesh 2020, 19(5): 511-522 |
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Javad Kabir M, Heidari A, Jafari N, Khatirnamani Z, Honarvar M R. Dimensions and Components for Designing the Basic Health Services Package in Iran: Exploratory and Confirmatory Factor Analyses. Payesh 2020; 19 (5) :511-522
URL: http://payeshjournal.ir/article-1-1512-en.html
URL: http://payeshjournal.ir/article-1-1512-en.html
Mohammad Javad Kabir1 
, Alireza Heidari * 1, Nahid Jafari1 , Zahra Khatirnamani1 , Mohammad Reza Honarvar1
, Alireza Heidari * 1, Nahid Jafari1 , Zahra Khatirnamani1 , Mohammad Reza Honarvar1
1- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
Abstract: (2835 Views)
Objective (s): The basic health services package is the minimum set of essential health services that all people should have access to it, but there is no consensus on the services included in a package or the services to be included. The aim of this study was to identify the dimensions and components for designing a basic package in Iran.
Methods: This was a mixed method study. In qualitative phase 25 in-depth individual interviews were conducted with experts from the Ministry of Health, incurrence organization and the Planning and Budget Organization, and the data were analyzed using content analysis method. In the quantitative phase 285 managers and faculty members were selected from the Ministry of Health, insurance organizations, and 12 universities of medical sciences. Data were collected using a two-part questionnaire, including demographic characteristics and evaluation of 58 criteria, and analyzed using SPSS.23 and Smart-pls.3.2.8 software for exploratory and confirmatory factor analyses.
Results: 8 Dimensions of community health priority, structure and potential capacity of service delivery system, people's demands, cost effectiveness, benefits, funding, social acceptance of service, and governance obligations and requirements for designing a basic health services package were identified, of which 57 components were classified under these eight factors. According to the goodness of fit index in factor analysis, the overall performance of the model was strong (GOF = 0.8).
Conclusion: It is important to design a basic health service package. The basic health services package needs to be comprehensive and accessible so that all individuals are willing and satisfied to use the services.
Methods: This was a mixed method study. In qualitative phase 25 in-depth individual interviews were conducted with experts from the Ministry of Health, incurrence organization and the Planning and Budget Organization, and the data were analyzed using content analysis method. In the quantitative phase 285 managers and faculty members were selected from the Ministry of Health, insurance organizations, and 12 universities of medical sciences. Data were collected using a two-part questionnaire, including demographic characteristics and evaluation of 58 criteria, and analyzed using SPSS.23 and Smart-pls.3.2.8 software for exploratory and confirmatory factor analyses.
Results: 8 Dimensions of community health priority, structure and potential capacity of service delivery system, people's demands, cost effectiveness, benefits, funding, social acceptance of service, and governance obligations and requirements for designing a basic health services package were identified, of which 57 components were classified under these eight factors. According to the goodness of fit index in factor analysis, the overall performance of the model was strong (GOF = 0.8).
Conclusion: It is important to design a basic health service package. The basic health services package needs to be comprehensive and accessible so that all individuals are willing and satisfied to use the services.
Keywords: Basic Health Service Package, Exploratory Factor Analysis, Confirmatory Factor Analysis, Mixed Method Study
type of study: Descriptive |
Received: 2020/07/28 | Accepted: 2020/08/31 | ePublished ahead of print: 2020/10/20 | Published: 2020/10/24
Received: 2020/07/28 | Accepted: 2020/08/31 | ePublished ahead of print: 2020/10/20 | Published: 2020/10/24
References
1. Babazadeh Gashti A, Jafari N, Kabir M J, Heidari A, Behnampour N, Honarvar M R, et al . Assessing Rural Family Physicians Performance According to Healthcare Managers, Family Physicians, and Patients in Golestan Province, Iran. Journal of Mazandaran University of Medical Sciences 2016; 25:23-32 [Persian]
2. Pisani E, Kok MO, Nugroho K. Indonesia's road to universal health coverage:a political Journey. Health Policy Plan 2017;32:267-76 [DOI:10.1093/heapol/czw120]
3. Glassman A, Giedion U, Sakuma Y, Smith PC. Defining a health benefits package: what are the necessary processes? Health Systems & Reform 2016;2:39-50 [DOI:10.1080/23288604.2016.1124171]
4. Hayati R, Bastani P, Kabir MJ, Kavosi Z, Sobhani G. Scoping literature review on the basic health benefit package and its determinant criteria. Globalization and Health 2018;14:26. [DOI:10.1186/s12992-018-0345-x]
5. Al-Hasnawi S. A Basic Health Services Package for Iraq, Ministry of Health. Globalization and health 2009 [Available from: https://www.ecoi.net/en/file/local/1325683/1930_1392811695_emropd-2009-109.pdf]
6. The Essential Benefit Package Recommendations of the Oregon Health Fund Board's Benefits Committee [Available from: http://www.oregon.gov/OHPPR/HFB/docs/BenefitCommitteeFinal.pdf?ga=t]
7. Kabir MJ, Vatankhah S, Delgoshaei B, et al. Determinant criteria for designing health benefit package in selected countries. Life Science Journal 2013;10:1392-1403
8. Mahmudi H. Develop strategies for package of basic health insurance services; Methodology Group of Developing Package of Basic Insurance Services. 1st Edition, Iran, Tehran: Ministry of Welfare publication: Iran, 2007 [Persian]
9. Dehnavieh R, Rahimi H. Basic health insurance package in Iran: revision challenges. Iranian Journal of Public Health 2017;46:719-720
10. Baltussen R, Niessen L. Priority setting of health interventions:the need for multi-criteria decision analysis. Cost Effectiveness and Resource Allocation 2006; 21:14 [DOI:10.1186/1478-7547-4-14]
11. Wong H, Bitran R, Shepard DS, Thompson MS. Designing a benefits package: cost-effectiveness analysis in health: first principles. 1st Edition, The World Bank: Washington DC, 1999
12. Eri M, Jafari N, Kabir M J, Mahmoodishan G, Moghassemi M J, Tahanian M, et al . Concept and Challenges of Delivering Preventive and Care Services in Prehospital Emergency Medical Service: A Qualitative Study. Journal of Mazandaran University of Medical Sciences 2015; 25:42-57 [Persian]
13. Etemad K, Heidari A, Panahi MH, Lotfi M, Fallah F, Sadeghi S. Challenges of Access to Data of Ministry of Health from the Perspective of Policy-makers, Producers, and Consumers of Data: A Qualitative Study. Iranian Journal of Epidemiology 2017; 13: 174-182 [Persian]
14. Damari B, Hajebi A, Bolhari J, Heidari A. Developing a Training Course for Spiritual Counselors in Health Care: Evidence from Iran. Indian Journal of Palliative Care 2018; 24:145-149 [DOI:10.4103/IJPC.IJPC_207_17]
15. Heidari A, Arab M, Etemad K, Damari B. challenges of implementation of the national phenylketonuria screening program in Iran: a qualitative study. Electronic Physician Journal 2016;8: 3048 [DOI:10.19082/3048]
16. Heidari A, Arab M, Etemad K, Damari B, lotfi M. National phenylketonuria screening program in Iran; why and how. Journal of School of Public Health and Institute of Public Health Research 2018; 16:148-163 [Persian]
17. Jayasinghe KS, De Silva D, Mendis N, Lie RK. Ethics of resource allocation in developing countries: the case of Sri Lanka. Social Science & Medicine 1998;47:1619-25 [DOI:10.1016/S0277-9536(98)00110-5]
18. Dehnavieh R, Rashidian A, Maleki MR. Challenges of determining basic health insurance package in Iran. Health Monitor Journal of the Iranian Institute for Health Sciences Research 2011;10:273-83 [Persian]
19. Mohammadi E, Olyaee Manesh A, rashidian A, hasanzadeh A, razavi M. Policy Analysis, Problem Identification and Proposing Policy Options for Health Insurance Benefit Package in Iran. Hakim Research Journal 2018; 21:153-172 [Persian]
20. Moccero D. Delivering cost-efficient public services in health care, education and housing in Chile. ISSN: 18151973 (online) 2008 [Available from: [DOI:10.1787/18151973] https://doi.org/10.1787/18151973]
21. Schreyogg J, Stargardt T, Velasco-Garrido M, Busse R. Defining the "health benefit basket" in nine european countries. The European Journal of Health Economics 2005;6:2-10 [DOI:10.1007/s10198-005-0312-3]
22. Bernfort L. Decisions on inclusion in the Swedish basic health care package-roles of cost-effectiveness and need. Health Care Analysis 2003;11:301-8 [DOI:10.1023/B:HCAN.0000010059.61453.8e]
23. Ensor T, Dave-Sen P, Ali L, Hossain A, Begum SA, Moral H. Do essential service packages benefit the poor? Preliminary evidence from Bangladesh. Health Policy and Planning 2002;17:247-56 [DOI:10.1093/heapol/17.3.247]
24. The United Republic of Tanzania. National Package of Essential Health Interventions in Tanzania. 1st Edition, Ministry of Health Publication; Dar es Salaam, Tanzania, 2000
25. Greß S, Niebuhr D, Rothgang H, Wasem J. Criteria and procedures for determining benefit packages in health care: a comparative perspective. Health Policy 2005;73:78-91 [DOI:10.1016/j.healthpol.2004.10.005]
26. Kabir MJ, Heidari A, Jafari N, Honarvar MR, Behnampour N, Mirkarim S-K. Developing basic health services packages: Defining a prioritization of effectiveness criteria. International Journal of Healthcare Management. 2019:1-6 [Available from:
https://doi.org/10.1080/20479700.2019.1684666 [DOI:10.1080/20479700.2019.1684666]]
27. Kapiriri L, Norheim OF. Criteria for priority-setting in health care in Uganda: exploration of stakeholders' values. Bulletin of the world Health Organization 2004;82:172-9
28. Frost LJ, Reich MR. Access: How do good health technologies get to poor people in poor countries? 1st Edition,: Harvard Center for Population and Development Studies: Cambridge, USA, 2008
29. Opon SO. Provision of essential health package in public hospitals: a case of Homabay County hospitals, Kenya. Pan African Medical Journal 2016; 24: 1-8 DOI:10.11604/pamj.2016.24.8.9280 [DOI:10.11604/pamj.2016.24.8.9280]
30. Yousefvand M, Olyaeemanesh A, Arab M, Jaafaripooyan E. The behavior of basic health insurance Organizations after the implementation of Relative Value of Health Services book in Iran: A qualitative study. Medical Journal of the Islamic Republic of Iran 2018;32:110 [DOI:10.14196/mjiri.32.110]
31. Saravi N, Zaboli R, Hassanzadeh A, Najafipour F, Rezapour A, Rezai-Rad M, et al. Developing criteria for complementary health insurance (CHI) benefit packages for a medical Service Insurance Organization in Iran: a qualitative content analysis. International Journal of Travel Medicine and Global Health 2015;3:171-8 [DOI:10.20286/ijtmgh-030485]
32. Ahmed S, Creanga AA, Gillespie DG, Tsui AO. Economic status, education and empowerment: implications for maternal health service utilization in developing countries. PloS one 2010;5:e11190 [DOI:10.1371/journal.pone.0011190]
33. Alahmad G, Al-Jumah M, Dierickx K. Review of national research ethics regulations and guidelines in Middle Eastern Arab countries. BMC Medical Ethics2012;13:34 [DOI:10.1186/1472-6939-13-34]
34. Sedighi S, Hesam S, Maleki MR. Factors Affecting the Establishment of Basic Health Insurance in Iran. Healthcare Management 2012;4:7-19
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