Financial Resource Allocation Techniques and Health Sector Payment Systems of Selected Countries: Designing a Model for Iran

摘要

Limitation of financial resources in the majority of healthcare systems throughout the world increases the competition in quality, service expansion, efficiency, efficacy and fairness. In response, governments employ different techniques of financial resource allocation and payment systems. The main objective of this study was to compare the variety of techniques of financial resource allocation and health sector payment systems in selected countries to provide a model for health system of Iran. Current operational systems of twelve selected countries were compared and through comparison with Iranian cultural, economy and infrastructure a tailor-made system was proposed for this country. Annual global budget is the basis of financial resource allocation and factors influencing this allocation are municipalities decisions, quality, cost of services, priorities and performance. The calculations of costs are based on estimated costs and payment system are based on pay-for-performance and capitation in the first level while pay-for-performance is the dominant payment system of other level. There is a no significant relationship between factors influencing financial resource allocation and payment systems. This finding is also proved to be true to Iran. Taking into consideration the low GDP and the proportional share of health sector in Iran justifies the combination of capitation and pay-for-performance for the service in first level and pay-for-performance for other levels, as the proper health system to be employed in Iran. This method of financial resource allocation to the health service makes the treatment providing organizations and insurers to bring the tariff of public and private section accordant which finally improves the efficiency, efficacy and fairness in health and treatment system of Iran.