Evidence map›Paper›PMID 28728347›Full record

ArticleEpidemiology and health2017

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

Enayatollah Homaie Rad, Vahid Yazdi-Feyzabad, Shahrokh Yousefzadeh-Chabok, Abolhasan Afkar, Ahmad Naghibzadeh

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Epidemiology and health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Thematic analysis of the policies of Iran's health higher education.Journal of education and health promotion · 2021
    Article
  10. Article
  11. Article
  12. A critical analysis of Iran health system reform plan.Journal of education and health promotion · 2020
    Article
  13. Article
  14. Article
  15. Article
  16. Inpatient Out-of-Pocket in Iran After Health Transformation Plan.International journal of health policy and management · 2018
    Article
  17. Article
  18. Article
  19. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Enayatollah Homaie RadSocial Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran.ORCID 0000-0002-9064-0380
Vahid Yazdi-FeyzabadSchool of Management and Medical Informatics, Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.ORCID 0000-0002-8009-470X
Shahrokh Yousefzadeh-ChabokGuilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.ORCID 0000-0002-7780-1565
Abolhasan AfkarSocial Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran.ORCID 0000-0003-2641-8221
Ahmad NaghibzadehPhysiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.ORCID 0000-0002-2221-7302

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe 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.

methodsData 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.

resultsOverall 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%).

conclusionsThe 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.

Indexed as

Family CharacteristicsHealth Care ReformCatastrophic IllnessGoalsHealth ExpendituresHumansIncomeIranProgram EvaluationCatastrophic illnessesFinancial statementsHealth care reformHealth equityHealth expendituresIran’s health transformation program

Identifiers

PMID28728347
PMCPMC5675984

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.