ArticleBMC public health2025
The agenda-setting process for urban family physician program within Iran's health insurance.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveSince 2005, health policymakers in Iran have focused on the rural family physician plan to minimize unnecessary specialist referrals and enhance both efficiency and equitable access to services. In September 2021, the urban family physician plan was launched, engaging various organizations, including insurance companies. A trustee was appointed to manage the implementation of the Iranian health insurance program. This study examines how Iran Health Insurance prioritized the urban family physician program on its agenda by applying Kingdon's agenda-setting model. MATERIALS AND
methodsThis descriptive qualitative study gathered data through semi-structured interviews with 13 stakeholders in Iran's urban family physician program, including planners, policymakers, and implementers. Purposive sampling, followed by snowball sampling, was used until data saturation was reached. Directed content analysis was applied, guided by Kingdon's multiple streams framework.
resultsThree themes emerged: problem, policy, and political streams. The problem stream for Iran's family physician plan included structural challenges (such as incomplete implementation, physician shortages, fragmented health data systems, poor stakeholder coordination), social-cultural barriers (including low public awareness, resistance to change), and economic issues (such as high treatment costs, inadequate insurance coverage). The policy stream proposed solutions such as electronic systems, standardized protocols, new technologies, expanded education, and improved physician working conditions. Strong government and parliamentary backing were identified as critical to addressing these challenges, emphasizing the need for sustained commitment and holistic strategies. DISCUSSION AND
conclusionThe WHO, Iranian Parliament, Ministry of Health, and health insurers can serve as policy entrepreneurs to advance the family physician program within Iran's health insurance system. The WHO can leverage global health data to emphasize Iran's healthcare challenges, while the Ministry of Health and insurers can pinpoint issues via national research. The Parliament can facilitate public voices to gather input from citizens and experts.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.