Original Article

Health Complex Model as the Start of a New Primary Healthcare Reform in Iran: Part B: The Intervention Protocol

Abstract

Background: For overcoming the existing problems and finding a pathway for realization of universal health care, health complexes were implemented in the form of a pilot project in Tabriz suburban area.

Methods: Tabriz Health Complex Project was designed in 2013 in the provincial health center of East Azerbaijan. In terms of execution schedule, this intervention had 4 phases including 1) study phase, 2) planning phase, 3) pilot phase, and 4) implementation phase. Each health complex covers a population of 40,000 to 120,000 in a defined geographic area and consists of a Comprehensive Health Center (CHC) including health centers and a management center, which usually located in CHC. The important features of this project are as follows: people-centered primary health care, special attention to health promotion and prevention and establishment of a referral system within the region (organic connection between the first and second levels).

Results: An accountable and responsive health care system has been established to deliver integrated care services to people in a defined catchment area against identified per capita payment, under district health centre policies and regulations. Each health team consisted of a general practitioner and a family health nurse who covered around 4000 people to deliver prevention, promotion, and treatment services especially in and NCDs field.

Conclusion: Health complex as a model of public-private participation and practical solution to address many of the problems in the primary care system of the country. The project can organize the PHC system and family medicine program.

 

1. World Health Organization (‎1988)‎. From Alma Ata to the year 2000 : reflections at the midpoint. Geneva : World Health Organization. http://www.who.int/iris/handle/10665/39323
2. Shadpour K (2000). Primary health care networks in the Islamic Republic of Iran. East Mediterr Health J,6(4):822–825.
3. Takian A, Rashidian A, Kabir MJ (2011). Expediency and coincidence in re-engineering a health system: an interpre-tive approach to formation of family medicine in Iran. Health Policy Plan,26(2):163–173.
4. Rivo M L (2000). Practicing in the New Mil-lennium: Do You Have What It Takes? Fam Pract Manag,7(1):35-40.
5. Khayatzadeh-Mahani A, Takian A (2014). Family physician program in Iran: Considerations for adapting the policy in urban settings. Arch Iran Med, 17(11): 776 – 778.
6. Farahbakhsh M, Sadeghi-Bazargani H, Nikniaz AR et al (2012). Iran’s Experience of Health Cooperatives as a Public-Private Partnership Model in Primary Health Care: A Comparative Study in East Azerbaijan. Health Promot Perspect, 2(2):287-98.
7. Field JE, Peck E (2003). Public-private partnerships inhealthcare: The managers’ perspective. Health Soc Care Community,11(6):494-501.
8. Michael RR (2002). Public-private partnerships for public health. Harvard series on population and international health. Harvard University press. USA.
9. Jeong HS (2005). Health care reform and change in Publicprivatemix of financing: A Korean case. Health Policy,74(2):133-45.
10. Farahbakhsh M, Nikniaz AR, Tabrizi JS, Zakeri A(2012). Comparing the performance of cooperatives and public health centers. Journal of Zahedan Medical Sciences,14(2):117-21.
11. WHO (2008).The World Health Report 200: primary health care. World Health Organization, Geneva.
12. Cashin C, Ankhbayar B, Phuong HT et al (2015). Assessing Health Provider Payment Systems: A Practical Guide for Countries Moving Toward Universal Health Coverage. Joint Learning Network for Universal Health Coverage,pp: 13-19.
13. WHO (2010).The World Health Report 2010: Health systems financing: the path to universal coverage. World Health Organization, Geneva.
14. Espigares JLN, Torres EH(2009). Public Private Partnership as a new way to deliver healthcare services. http://dialnet.unirioja.es/descarga/articulo/2942101.pdf
15. Pal R, Pal S (2009). Primary health care and public-private partnership: An indian perspective. Ann Trop Med Public Health, 2:46-52.
16. Thomson S, Osborn R, Squires D, Jun M(2017). International Profiles of Health Care Systems. Available from: https://www.commonwealthfund.org/publications/fund-reports/2017/may/international-profiles-health-care-systems
17. Figueras J, Robinson R, Jakubowski E(2005). Purchasing to improve health systems performance. European Observatory on Health Systems and Policies Series.
18. Center for healthcare quality & payment reform(2016). Which healthcare payment system is best? Paths to healthcare payment reform. http://www.chqpr.org/downloads/whichpaymentsystemisbest.pdf
19. Naghavi M, Shahraz S, Sepanlou SG et al (2014). Health transition in Iran toward chronic diseases based on results of Global Burden of Disease 2010. Arch Iran Med,17(5):321 - 35.
20. Tabrizi JS, Farahbakhsh M, Sadeghi-Bazargani H et al (2016). Effectiveness of the Health Complex Model in Iranian primary health care reform: the study protocol. Patient Prefer Adherence,10:2063-2072.
Files
IssueVol 48 No 1 (2019) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v48i1.803
Keywords
Health complex model Primary health care Reform Iran

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
TABRIZI JS, KARAMOUZ M, SADEGHI-BAZARGANI H, NIKNIAZ A, NIKNIAZ L, HASANZADEH R, HANAEE J, FARAHBAKHSH M. Health Complex Model as the Start of a New Primary Healthcare Reform in Iran: Part B: The Intervention Protocol. Iran J Public Health. 2019;48(1):147-155.