RESUMO
Health management for special patients is a serious challenge for policy makers. Because of chronic nature of these diseases the community has to cope with huge expenses, and a considerable part of health funds is allocated for the continuing care of these patients. Therefore, designing appropriate policies for organizing, financing and providing optimal health-care is of special importance. In this study, our main objective was to design a model for special patients' health management in Iran by studying the management strategies of similar patients from selected countries. We scrutinized studies done in England, Australia, United state, and Canada and used these as suitable references from which we selected applicable strategies and submitted these for approval to relevant experts to sketch out a service management model for health care management of special patients. The final model was developed by the use of 3-stage Delphi technique. In almost all of our references we found that: o Health and welfare ministries along with the private sector provide decentralized health care to special patients. o Health care programs for special patients encompass free services for regular check ups, vaccinations, life style training, acute illness care, health advisors, health aids and equipment, and laboratory services. o Policies are made by a committee named as "committee of health of special patients" having its base at the supreme council of health. o Finances are provided mainly by governmental funds and, subsequently by societies and NGO's with some participation of the special patients themselves [as premium and franchise]. Our model for management of special patients includes formation of "committee of health of special patients" in the supreme council of health, establishment of office of health of special patients in the Ministry of Health and Medical Education, and provision of decentralized provincial services. Finances should be provided through taxes, charity aids and supports from international organizations. Nongovernmental and charity aids may be increased to decrease the financial burden on governments