تشریح تغییرات رفتار پزشکان نسبت به پرداخت غیررسمی (زیرمیزی) بر اساس طرح تحول سلامت در ایران: یک مطالعه کیفی

عنوان انگليسی

Exploring the changes of physicians' behaviour toward informal payment based on Health Transformation Plan in Iran: A qualitative study

خلاصه انگلیسی

ByimplementationoftheHealthTransformationPlan(HTP),a revised tariff system for healthcare services was executed in Iran. This study explores the changes in physicians' behaviour in facing informal payment (IP) based on HTP implementation in Iran. We conducted in-depth semi-structured interviews with 15 purposefully selected physicians and policy makers to explore the changes (positive, negative and no) in physicians' behaviours with and without the implementation of HTP. The interviews were conducted individually and face to face. The conventional content analysis for data analysis by MAXQDA ver.10 was used. Based on the results, regardless of the HTP implemented, market competitiveness could control physicians' demand for IP. However, unreal tariffs, irregular payments, inflation, expensive healthcare and comparing income with other occupations increase physicians' demand for IP as negativebehaviour.Thisstudyexploredthreepatternsofphysicians' behavioural change because of HTP implementation: 1—positive behavioural change with four factors; 2—negative behavioural changes with two factors; and 3—no behavioural change with four factors. Various factors influenced physicians' behaviour towards IP with and without the HTP. To combat IP more efficiently, we recommend strengthening the HTP's positive interventions, compensation of physicians'

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