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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

Rasoul Tabari-Khomeiran (Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, The Islamic Republic of Iran)
Sajad Delavari (School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, The Islamic Republic of Iran)
Satar Rezaei (Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, The Islamic Republic of Iran)
Enayatollah Homaie Rad (Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, The Islamic Republic of Iran)
Mostafa Shahmoradi (School of Public Health, Tehran University of Medical Sciences, Tehran, The Islamic Republic of Iran)

International Journal of Human Rights in Healthcare

ISSN: 2056-4902

Article publication date: 28 February 2019

Issue publication date: 28 June 2019

Abstract

Purpose

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/approach

A 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.

Findings

The 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/value

The study findings revealed that HTP was not successful enough in financial protection in the private sector.

Keywords

Citation

Tabari-Khomeiran, R., Delavari, S., Rezaei, S., Rad, E.H. and Shahmoradi, M. (2019), "The effect of Iranian health system reform plan on payments and costs of coronary artery bypass surgery in private hospitals of Iran", International Journal of Human Rights in Healthcare, Vol. 12 No. 3, pp. 208-214. https://doi.org/10.1108/IJHRH-07-2018-0047

Publisher

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Emerald Publishing Limited

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