Arash Rashidian1, Mohammad Arab1, Mohammadreza Vaez Mahdavi2, Koimars Ashtarian3, Hakimeh Mostafavi4. 1. Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 2. Department of Physiology, School of Medicine, Shahed University, Tehran, Iran. 3. School of Law and Political Sciences, University of Tehran, Tehran, Iran. 4. Vice-Chancellor's Office in Treatment Affairs, Health Economy, Standard and Health Technology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract
BACKGROUND: Health systems have a set of limited resources for meeting the needs of communities. Health priority setting based on criteria and values is inevitable in such situation. This paper aims to identify the social values that are considered in Iranian health system. METHODS: This qualitative study was conducted in 3 steps including collecting national documents and literature review, interviewing key informants, and a 2 round Delphi. Interviews and documents were analyzed through thematic framework analysis. Statistical guidance was applied for determining consensus cut-off in Delphi technique. RESULTS: Five social values including freedom of choice, equity, solidarity, severity of disease(s), and burden of disease(s) were considered more important than other values in the health priority setting decisions. Moreover, 2 non-value based factors including conflict of interest and lobbying had a high effect on decision making. CONCLUSION: Most health policy makers decide based on Egalitarian school, but restriction of resources in the country decreases the outcome. Moreover, personal judgments and preferences sometimes affect their decisions. It seems that developing a value-based framework and making it as a national guidance could have affirmative effect on health administers decisions.
BACKGROUND: Health systems have a set of limited resources for meeting the needs of communities. Health priority setting based on criteria and values is inevitable in such situation. This paper aims to identify the social values that are considered in Iranian health system. METHODS: This qualitative study was conducted in 3 steps including collecting national documents and literature review, interviewing key informants, and a 2 round Delphi. Interviews and documents were analyzed through thematic framework analysis. Statistical guidance was applied for determining consensus cut-off in Delphi technique. RESULTS: Five social values including freedom of choice, equity, solidarity, severity of disease(s), and burden of disease(s) were considered more important than other values in the health priority setting decisions. Moreover, 2 non-value based factors including conflict of interest and lobbying had a high effect on decision making. CONCLUSION: Most health policy makers decide based on Egalitarian school, but restriction of resources in the country decreases the outcome. Moreover, personal judgments and preferences sometimes affect their decisions. It seems that developing a value-based framework and making it as a national guidance could have affirmative effect on health administers decisions.