Designing a financial resource allocation model using goal programming approach

Background: Prioritization and resource allocation are the most important processes in managing and developing each organization. Given the high turnover and cost of hospitals in health system, this study aimed to provide a model for

financial resource allocation with the Goal Programming [GP] in Afzalipour teaching medical center in Kerman

Methods: This mixed method and case-study study was conducted in Afzalipour teaching medical center located in Kerman, south-eastern of Iran. Participating key informants and operation research experts, twelve focus group discussions [FGDs] were developed to extract a goal programming model. Then, the hospital accounting data were collected from 2010- 2013 according to the extracted model.The WinQSB software was used for running the model

Results: The findings of this study showed that the share of personnel costs of this hospital was 72% which 28% was devoted to fee-for-service [FFS] and contractual services, current and other costs were 6%, 2%, and 12%, respectively. However, the findings of goal programming model showed that the optimum and satisfactory amount of personnel costs must be 66%, 14% of which were allocated to the FFS cost. The share of contractual services, current and other costs must be 15%, 2%, and 17%, respectively

Conclusion: The results showed that resource allocation in the hospital follow merely the accounting perspective rather than optimum and satisfactory ones. It is suggested in order to achieve the optimum values, the board of trustees should be institutionalized in practice; moreover, the outsourcing services should be addressed more. Therefore, personal costs which include a large part of costs can be reduced

Pros and cons of the health transformation program in Iran: evidence from financial outcomes at the household level / 한국역학회지

OBJECTIVES: The health transformation program was a recent reform in the health system of Iran that was implemented in early 2014. Some of the program's important goals were to improve the equity of payments and to reduce out-of-pocket (OOP) payments and catastrophic health expenditures (CHE). In this study, these goals were evaluated using a before-and-after analysis.METHODS: Data on household income and expenditures in Guilan Province were gathered for the years 2013 and 2015. OOP payments for outpatient, inpatient, and drug services were calculated, and the results were compared using the propensity score matching technique after adjusting for confounding variables. Concentration indices and curves were added to quantify changes in inequity before and after the reform. The incidence of catastrophic expenditures was then calculated.RESULTS: Overall and outpatient service OOP payments increased by approximately 10 dollars, while for other types of services, no significant changes were found. Inequity and utilization of services did not change after the reform. However, a significant reduction was observed in CHE incidence (5.75 to 3.82%).CONCLUSIONS: The reform was successful in decreasing the incidence of CHE, but not in reducing the monetary amount of OOP payments or affecting the frequency of health service utilization.

Pros and cons of the health transformation program in Iran: evidence from financial outcomes at the household level / 한국역학회지

OBJECTIVES: The health transformation program was a recent reform in the health system of Iran that was implemented in early 2014. Some of the program's important goals were to improve the equity of payments and to reduce out-of-pocket (OOP) payments and catastrophic health expenditures (CHE). In this study, these goals were evaluated using a before-and-after analysis. METHODS: Data on household income and expenditures in Guilan Province were gathered for the years 2013 and 2015. OOP payments for outpatient, inpatient, and drug services were calculated, and the results were compared using the propensity score matching technique after adjusting for confounding variables. Concentration indices and curves were added to quantify changes in inequity before and after the reform. The incidence of catastrophic expenditures was then calculated. RESULTS: Overall and outpatient service OOP payments increased by approximately 10 dollars, while for other types of services, no significant changes were found. Inequity and utilization of services did not change after the reform. However, a significant reduction was observed in CHE incidence (5.75 to 3.82%). CONCLUSIONS: The reform was successful in decreasing the incidence of CHE, but not in reducing the monetary amount of OOP payments or affecting the frequency of health service utilization.

Factors affecting leave out of general practitioners from rural family physician program: a case of Kerman, Iran

Rural family physician program as the new reform in the Iranian health system has been implemented since 2005. Its success depends much on physicians' retention. The present study aimed to identify influential factors on physicians' willingness to leave out this program in Kerman province. The present cross-sectional study was performed in Kerman province in 2011. All family physicians working in this program [n = 271] were studied using a questionnaire. Data analysis was carried out using descriptive statistics and logistic regression through SPSS version 18.0. Twenty-six percent [70] of the physicians had left out the program in the past. In addition, 77.3% [208] intended to leave out in the near future. Opportunity for continuing education, inappropriate and long working hours, unsuitable requirements of salary, irregular payments, lack of job security and high working responsibility were regarded as the most important reasons for leaving out the program in the past and intention to leave out in future orderly. According to univariate logistic regression, younger physicians [odds ratio [OR] =2.479; 95% confidence interval [CI]: 1.261-4.872] and physicians who had older children [OR = 4.743; 95% CI: 1.441-15.607] were more willing to leave out the plan in the near future, however it was not significant in multivariate logistic regression. Physician retention in family physician program is faced with serious doubts due to different reasons. The success of the program is endangered because of the pivotal role of human resources. Hence, the revision of human resources policies of the program seems necessary in order to reduce physicians leave out and improving its effectiveness