Developing Iranian primary health care quality framework: a national study.

Autor: Rezapour R; Iranian Center of Excellence in Health Management, School of Health Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran., Tabrizi JS; Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran. js.tabrizi@gmail.com., Farahbakhsh M; Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran., Saadati M; Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran., Abdolahi HM; Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
Jazyk: angličtina
Zdroj: BMC public health [BMC Public Health] 2019 Jul 09; Vol. 19 (1), pp. 911. Date of Electronic Publication: 2019 Jul 09.
DOI: 10.1186/s12889-019-7237-8
Abstrakt: Background: Providing comprehensive and high-quality services is one of the most important goals of the health systems and a basic principle for Universal Health Coverage (UHC). Fulfilling this important task would be feasible through continuous evaluation and improvement of the health services quality. The aim of this study was to develop a framework for quality assessment of Primary Health Care (PHC) in Iran's health system.
Methods: This study is a literature review which continued by a qualitative research. The extracted quality dimensions and indicators for initial screening were reviewed and discussed in two panel meetings attended by the experts with regard to the current package of health system in Iran. Using Delphi method, the dimensions and Quality Indicators(QIs) were evaluated and approved by 39 national health professionals in two rounds. Finally, after 4 panel sessions at ministerial level, the selected QIs were categorized in form of the final dimensions of the quality of care.
Results: The literature review emerged 13 Primary Health Care Quality Assessment Frameworks (PHCQAF) including 20 and 698 QIs. Delphi study resulted in developing Iranian PHCQAF comprising 7 dimensions and 40 QIs. Among these, 8 QIs of the dimension of access and equity, 5 QIs of safety dimension, 2 QIs of efficiency dimension, 13 QIs of effectiveness dimension, 2 QIs of patient-centeredness dimension, 3 QIs of governance dimension and 7 QIs of appropriateness dimension were presented.
Conclusions: The presented PHCQAF can be used as a comprehensive and practical tool for continuous improvement of the quality of PHC services at local, national and regional levels. Moreover, it can give some useful information to the health managers and policy makers on how the services are provided.
Databáze: MEDLINE
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