Developing a model for strategic purchasing of health care in the Iran health system

Abstract

Abstract Introduction: considering large expenditures of health sector and people’s needs, health system have to move toward strategic purchasing of health services. Studies showed that implementing strategic purchasing has positive outcomes for health systems across the world. Despite all endeavors for improving health system in Iran so far no appropriate model has developed for successful strategic purchasing of health services. Objective: this research intended to develop a model for strategic purchasing of health care in the Iran health system. Method and materials: This is a mixed method which carried out at 2013 till 2017 in Tabriz University of medical Sciences. Quantitative and qualitative research methods were used for data collection and data analysis. Target populations in different stages of this study included eligible experts in strategic purchasing of health services. Results: characteristics of strategic purchasing were categorized in 7 themes: tariffing, stewardship perquisites, perquisites for purchasers, perquisites for providers, perquisites for contracting, perquisites for benefit package and perquisites for payment mechanisms. Also challenges of strategic purchasing were categorized in 5 themes: challenges of infrastructures, challenges of developing benefit packages, challenges of payment mechanisms, challenges of stewardship and stakeholders. Conclusion: successful implementation of strategic purchasing for Iran health system requires cooperation of all stakeholders, legitimate support for strong stewardship and clearing conflict of interests, in the way ministry of health as main steward of health system be able to put delivering healthcare services aside and focus of stewardship and tries to fulfill health needs of population.