Key Indicators for Monitoring the Efficiency of Iranian Health System: A Synthesized Design Study

Ebrahim  Jaafaripooyan; Rajabali  Daroudi; Soheila  Damiri; Abdoreza  Mousavi; Efat Mohamadi; Amirhossein  Takian; Alireza  Olyaeemanesh

doi:10.18502/ijph.v53i3.15152

Ebrahim Jaafaripooyan Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Teh-ran, Iran
Rajabali Daroudi Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Teh-ran, Iran
Soheila Damiri Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Teh-ran, Iran
Abdoreza Mousavi Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Teh-ran, Iran
Efat Mohamadi Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran
Amirhossein Takian Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Teh-ran, Iran
Alireza Olyaeemanesh Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijph.v53i3.15152

Keywords: Efficiency; Health system; Key indicators; Iran

Abstract

Background: A significant share of medical care, primary health care, and health-related education and research in Iran is provided by the Ministry of Health and its affiliated universities of medical sciences. We aimed to identify a set of key metrics for monitoring their efficiency in the four areas of medical care, primary health care, education and research.

Methods: A combination of scoping review, expert panel and Delphi method was used. First, the relevant keywords were searched in the appropriate databases between 2000 and 2020. The final extracted indicators then reviewed, reduced and refined through the expert panel meetings. The last metrics were established following a three-stage Delphi study.

Results: Out of 2327 studies, 155 were selected following the different screening stages of scoping review. After summarizing and refining the indicators via several expert panel meetings and the Delphi method, a total of 36 key indicators were considered appropriate for measuring efficiency of the health system, 23 of which were for the sub-systems of public health (4 indicators), medical services (10 indicators), education (4 indicators) and research (5 indicators) and 13 indicators for the whole system efficiency.

Conclusion: The set of indicators presented representing both the technical and allocative efficiency, might be a reliable basis for designing information systems and management dashboards for periodic monitoring of health system efficiency at national, regional and local levels.