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The impact of health transformation plan on hospitalization rates in Iran : An interrupted time series
Author(s) -
Piroozi Bakhtiar,
Rashidian Arash,
Takian Amirhossein,
Amerzadeh Mohammad,
Sakha Minoo Alipouri,
Faraji Obeidollah,
Moradi Ghobad
Publication year - 2018
Publication title -
the international journal of health planning and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.672
H-Index - 41
eISSN - 1099-1751
pISSN - 0749-6753
DOI - 10.1002/hpm.2645
Subject(s) - interrupted time series analysis , referral , medicine , health plan , payment , health care , interrupted time series , health services , medical emergency , health insurance , business , environmental health , emergency medicine , family medicine , nursing , finance , economic growth , population , statistics , mathematics , psychological intervention , economics
Summary Objective The study aims to assess the impact of health transformation plan (HTP) as a major health system reform on hospitalization rate in Iran. Health transformation plan adopted different measures to increase the coverage of basic health insurance, increase the quality of outpatient visit care, improve and expand the family physician program, expand health services to suburban areas, reduce out‐of‐pocket (OOP) payments for inpatient services, and update tariffs to more realistic ones. Methods We selected Kurdistan province, a province that was not a patient referral hub, for the collection of monthly hospitalization data over a period of 50 months. Interrupted time series (ITS) analysis was carried out, and segmented regression analysis was employed to assess the abrupt (or short‐term) and gradual (or long‐term) effects of HTP on hospitalization rate. Results Although before the intervention, there was no significant increase or decline in hospitalization rate in the Kurdistan province, after the implementation of HTP, a significant increase in the intercept and slope of hospitalization rate was observed ( P < 0.001). Conclusion Health transformation plan has improved the utilization of hospitalization care services in a province that historically had been suffering from underutilized hospital services.