A Descriptive-Comparative Study of Implementation and Performance of Family Physician Program in Iran and Selected Countries

  • Bita SEPEHRI Gastroenterology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
  • Reza GHAFFARI Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
  • Alireza JEDDIAN Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  • Fariba SALEK Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
  • Robabeh EMROUZI Department of Medical Education, Tabriz University of Medical Sciences, Tabriz, Iran
  • Saeideh GHAFFARIFAR Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
  • Flora BAGHBAN REZVAN Department of Medical Education, Tabriz University of Medical Sciences, Tabriz, Iran
Keywords:
Implementation, Performance, Family physician program, Comparative study

Abstract

Background: The implementation of Family Physician Program (FPP) in Iran during the past decade, despite of its numerous achievements, has faced many challenges. We aimed to compare the implementation and the performance of FPP in Iran with selected countries, in order to analyze those challenges and suggest potential solutions.

Methods: This current descriptive-comparative study was conducted in 2015. The implementation and the performance of the FPP in Iran and six countries (Canada, Australia, United Kingdom, Denmark, United States and the Netherlands) were described and compared. The criteria for selection of these countries were the existence of well-established FFPs and ease of access to data required to conduct the research. A documentation checklist of the implementation status and FPP practice was prepared. The checklist’s content validity was established by an independent 10 member expert panel, specializing in the field of Family Medicine. The conclusive checklist was finalized for each country, based on inter-rater agreement of the three researchers and used as a basis for this comparative study.

 Results: This study revealed significant differences in implementation of the FPP and relatively low differences in FPP performance between Iran and the selected countries.

Conclusion: Implementation and performance of FPP and patient referral system in Iran struggles with serious challenges and burdens, in contrast with the selected reviewed countries. As such, modification of the FPP in Iran seems to be a must. Such modification may include developing educational programs for FPs, clearly defining the duties and practices of FPs, and revising their reimbursement and employment status.

References

1. Ghoharinejhad S (2007). Health system de-centralization on Iran University and medical science. Proceeding of 5th National Congress of Healthcare Administration Student.
2. Afkar A, Pourrza A, Mehrabian F (2013). Family physician performance from the perspective of Gilani customers. Hospital, 12(1):39-48.
3. Jolaee H, Alizadeh M, Falah Zadeh M et al (2010). Evaluation of clinical skills of family physicians In Fars province by means of observed structured clinical evaluation. Strides in Development of Medical Education, 7(2):92-8.
4. Sans-Corrales M, Pujol-Ribera E, Gene-Badia J et al (2006). Family medicine at-tributes related to satisfaction, health and costs. Fam Pract, 23(3):308-16.
5. Jaturapatporn D, Dellow A (2007). Does Family Medicine training in Thailand af-fect patient satisfaction with primary care doctors? BMC Fam Pract, 8(1):14.
6. Kersnik J (2000). An evaluation of patient satisfaction with family practice care in Slovenia. Int J Qual Health Care, 12(2):143-7.
7. Nasrollahpour Shirvani SD (2014). The Im-plementation of family physician pro-gram in I.R. Iran: achievements and chal-lenges. Journal of Babol University of Medical Sciences, 15-26.
8. Tandon A, Murray CJL, Lauer JA, Evans DB (2000). Measuring overall health sys-tem performance for 191 countries, GPE Discussion Paper Series: No. 30, EIP/GPE/EQC, World Health Organi-zation. http://www.who.int/healthinfo/paper30.pdf
9. Martin DP, Diehr P, Price KF, Richardson WC (1989). Effect of a gatekeeper plan on health services use and charges: a randomized trial. Am J Public Health, 79(12):1628- 1632.
10. Anbari Z, Mohammadbeigi A, Mohammad-salehi N, Ebrazeh A (2014). Health ex-penditure and catastrophic costs for in-patient- and out-patient care in Iran. Int J Prev Med, 5(8):1023-8.
11. Ferdosi M, Vatankhah S, Khalesi N et al (2012). Designing a referral system man-agement model for direct treatment in social security organization. Iranian Journal of Military Medicine, 14(2):129-35.
12. Iranian Society General practitioners (2015). http://isgp.ir/1094
13. Health Promotion Programs, Mashhad University of Medical Sciences Deputy of Health (2015) Available from: http://www.mums.ac.ir/shares/fpp/bahrainis3/pdf/gozareshat.pdf
14. What are the advantages and disadvantages of restructuring a health care system to be more focused on primary care services? (2004). Health Evidence Network (HEN), World Health Organization. http://www.euro.who.int/__data/assets/pdf_file/0004/74704/E82997.pdf
15. Jatrana S, Crampton P, Richardson K. (2011). Continuity of care with general practitioners in New Zealand: results from SoFIE-primary care. N Z Med J, 124(1329): 16-25.
16. Notification of Urban family physician (2015). http://noushahr.mazums.ac.ir
17. Wilson MA, Blondefield PJ (2007). Teaching “Doctoring”: A Model Curriculum for Family Medicine. J Am Osteopath Assoc, 107(1): 30-34.
18. Bohumil S, Igor S, Tiik M et al (2008). Per-spective of family medicine in Central and Eastern Europ. Fam Pract, 25(2): 113-118.
19. Karimi I, Nasiripour AA, Maleki MR, Mokhtare H (2006). Assessing financing methods and payment system for health service providers in selected countries: designing a model for Iran. Journal of Health Administration, 8(22):15-24.
20. Vatankhah S, Khalesi N, Ebadi Fard Azar F et al (2013). Study of payment methods to Doctors in the referral system in se-lected countries and suggestions for Ira-nian social security organization- Direct medical service provision. Journal of Hospi-tal, 11(2):77-86.
21. Takian A, Doshmangir L, Rashidian A (2013). Implementing family physician programme in rural Iran: exploring the role of an existing primary health care network. Fam Pract, 30:551-9.
22. Khadivi R, Kor A, Foruzandeh E (2014). Comparing the main reproductive health indices in rural areas of Isfahan province, Iran, before and after family physician program intervention during 2001-2011. Journal of Isfahan Medical School, 32(286): 712-25
23. Family Physicians: What’s and Whys-Capacity Building in Health Network (2015). Available from: http://familymed.sbmu.ac.ir/uploads/family_physicians_-_whats_and_whys.pdf
24. Changiz T, Fakhari M, Jamshidian et al (2015). Systematic review of studies in the field of competencies of new or soon to be-graduate general physicians in Iran. Strides in Development of Medical Education, 12(2): 325-343.
25. ACGME Program Requirements for Grad-uate Medical Education in Family Medi-cine (2015). https://www.acgme.org/Portals/0/PFAssets/ProgramResources/120_Reasons_that_Guided_the_Revisions.pdf?ver=2015-11-06-120653-853
26. Rosoff AJ (2012). The role of clinical prac-tice guidelines in healthcare reform: an update. Ann Health Law, 21: 20-33.
27. Family Medicine: Physicians Find Abundant Career Options, Rewards in an Evolving Specialty (2015). Available from: https://www.nejmcareercenter.org/article/family-medicine-physicians-find-abundant-career-options/
28. Poissantl L, Pereira J, Tamblyn R, Kawasumi Y (2005). The Impact of electronic health records on time efficiency of physicians and nurses: a systematic review. J Am Med Inform Assoc, 12(5): 505-516.
29. Electronic Health Records (2015). http://www.medscape.com/viewarticle/778161_2
30. E-Health Records in Iran (2015). http://behdasht.gov.ir/index.aspx?siteid=101&pageid=20350
31. Electronic Medical Record (2015). http://www.blogfa.com/
Published
2020-03-03
How to Cite
1.
SEPEHRI B, GHAFFARI R, JEDDIAN A, SALEK F, EMROUZI R, GHAFFARIFAR S, BAGHBAN REZVAN F. A Descriptive-Comparative Study of Implementation and Performance of Family Physician Program in Iran and Selected Countries. Iran J Public Health. 49(3):539-548.
Section
Original Article(s)