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The effect of Iranian health system reform plan on payments and costs of coronary artery bypass surgery in private hospitals of Iran

The effect of Iranian health system reform plan on payments and costs of coronary artery bypass... In May 2014, a new reform in the health sector of Iran was implemented called “health evolution plan.” In the first phase of this reform, the government reduced out-of-pocket payments for service delivery by paying subsidies to the services and after that a revision was done to the medical services values book to improve equity and increase motivation of health professions. One of the affected services in this reform was coronary artery bypass surgery. The purpose of this paper is to show the effects of HEP on costs of coronary artery bypass surgery.Design/methodology/approachA before-after study was done for this purpose and 167 patients’ total costs and out-of-pocket payments were calculated for the years 2013 (before) and 2014 (after) the reform in three private hospitals of Rasht city, Iran. Econometrics models were estimated after adjustment of confounding variables.FindingsThe results of this study showed that surgery costs increased significantly from $1,643.3 to 2,119.5. Nursing and other costs increased significantly from $290.3 to 414.2 and anesthetize costs increased from $619.2 to 947.01. The results of regression model showed that total costs increased $3,008.6 after adjustment of confounders (p-value=0.037). However, no significant changes were found for out-of-pocket payments and out-of-pocket percentage.Originality/valueThe study findings revealed that HTP was not successful enough in financial protection in the private sector. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Human Rights in Healthcare Emerald Publishing

The effect of Iranian health system reform plan on payments and costs of coronary artery bypass surgery in private hospitals of Iran

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Publisher
Emerald Publishing
Copyright
© Emerald Publishing Limited
ISSN
2056-4902
DOI
10.1108/ijhrh-07-2018-0047
Publisher site
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Abstract

In May 2014, a new reform in the health sector of Iran was implemented called “health evolution plan.” In the first phase of this reform, the government reduced out-of-pocket payments for service delivery by paying subsidies to the services and after that a revision was done to the medical services values book to improve equity and increase motivation of health professions. One of the affected services in this reform was coronary artery bypass surgery. The purpose of this paper is to show the effects of HEP on costs of coronary artery bypass surgery.Design/methodology/approachA before-after study was done for this purpose and 167 patients’ total costs and out-of-pocket payments were calculated for the years 2013 (before) and 2014 (after) the reform in three private hospitals of Rasht city, Iran. Econometrics models were estimated after adjustment of confounding variables.FindingsThe results of this study showed that surgery costs increased significantly from $1,643.3 to 2,119.5. Nursing and other costs increased significantly from $290.3 to 414.2 and anesthetize costs increased from $619.2 to 947.01. The results of regression model showed that total costs increased $3,008.6 after adjustment of confounders (p-value=0.037). However, no significant changes were found for out-of-pocket payments and out-of-pocket percentage.Originality/valueThe study findings revealed that HTP was not successful enough in financial protection in the private sector.

Journal

International Journal of Human Rights in Healthcare – Emerald Publishing

Published: Jun 28, 2019

Keywords: Health system; Payments; Coronary artery bypass surgery; Private hospitals; Iran

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