Factors Affecting Fair Access to Outpatient Services in Iranian Healthcare System Using Dematel Approach

Razieh Malmir; Mehrnoosh Jafari; Ali Maher; Seyed  Mojtaba Hosseini; Khalil  AliMohammadzadeh

doi:10.18502/jimc.v4i4.8469

Razieh Malmir Department of Health Services Management, Faculty of Management, Islamic Azad University, North Tehran, Tehran, Iran
Mehrnoosh Jafari Department of Health Services Management, Faculty of Management, Islamic Azad University, North Tehran, Tehran, Iran
Ali Maher School of Management and Medical Education, Department of Health Policy and Management Economics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Seyed Mojtaba Hosseini Department of Health Services Management, Faculty of Management, Islamic Azad University, North Tehran, Tehran, Iran
Khalil AliMohammadzadeh Department of Health Services Management, Faculty of Management, Islamic Azad University, North Tehran, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v4i4.8469

Keywords: Public sector, Iran, Public health, Delivery of health care, Outpatient services, Fairness, Access

Abstract

Background: Outpatient services constitute a major part of healthcare services. Fair access to these services plays an important role in promoting the community health status. Therefore, the purpose of the current study was investigating the factors affecting fair and equitable access to outpatient services in the Iranian healthcare system.

Methods: This applied study was descriptive using a mixed method (qualitative-quantitative) approach. Semi-structured interviews and a pairwise comparison matrix were used to collect data. The validity and reliability of the interviews were obtained through Lincoln and Guba methods and the validity and reliability of the pairwise comparison matrix were determined based on the inconsistency rate which was less than 0.1. In the first phase, research population included policy makers and health professionals, and in the second phase, hospital managers and faculty members, who were selected by purposive sampling method. The data collected in the first phase were prioritized using MaXQDA software and coding method and in the second phase, using Excel software and Dematel approach.

Results: Based on the findings of the study, the following indicators had the highest to lowest significance in the fair access to outpatient services in the Iranian healthcare system, respectively. They were physical (effective), financial (effective), manpower (influential), demographic (influential), facilities and equipment (influential), political (influential) factors.

Conclusion: Policymakers, managers, and planners need to pay special attention to the development of physical infrastructure and the allocation of adequate funding to the outpatient services in the public sector.