6/24/2023 0 Comments Foresight family physicians![]() in a qualitative study identified seven underlying factors that affect the family physician program, including inadequate motivational mechanisms, poor educational effectiveness, low comprehensiveness of instructions, the inadequacy of per capita and its allocation, low efficiency of health information management systems, defects in the referral chain, and insufficient culture building. Moreover, 53% of the patients in level 2 have been referred from general practitioners’ (GP) private offices and clinics. also showed that there are serious problems in levels 1 and 2 of the referral system, and sending records from family physicians to health centers has taken place in only 12.5% of the cases. referred to the role of literacy as a key underlying factor and considered information sharing and education of low-literacy people as major factors in the implementation of the family physician program. Due to the infancy of the program in urban areas, few studies have examined this topic.Īlidosti Alidosti et al. ![]() However, few studies have been conducted on the implementation of the family physician program, and studies in Iran have principally focused on rural family physicians. Planners must, therefore, decide about the expansion of this program to other provinces based on comprehensive scientific evidence. Nevertheless, this program is still limited to these two provinces and has not expanded throughout the country. ĭespite many discussions about the success and problems of the rural family physician program in scientific texts, this program was also piloted in the cities of Fars and Mazandaran provinces in 2012 in accordance with Articles 32 and 35 of the Fifth Developmental Plan. ![]() He or she is responsible for providing comprehensive services, service continuity, health management, research and coordination with other departments, And is obliged to provide the desired services to the target group within the service package. Family physician is a person with a general practitioner degree who provides services with his or her team of graduates of family health, public health, nursing, and midwifery. The family physician program and referral system has been implemented since 2005 in rural areas of Iran. Therefore, to expand this program to other provinces in Iran, the identified factors should be carefully considered so that sufficient confidence and commitment can be guaranteed for all stakeholders.Īccording to the recommendations of the World Health Organization (WHO), the implementation of family physician programs is an effective strategy to improve service delivery, reduce costs, and establish equity in healthcare delivery. The challenges associated with program implementation included budget provision and interaction with insurance organizations. The major challenges pertaining to underlying factors included international pressure for reforms and precipitancy in program implementation due to management changes. For program implementation, most challenges included a diversity of insurance organizations, budget allocation, referral system, electronic file, educational system, and culture building. Most challenges related to underlying factors included precipitancy, economic sanctions, belief in traditional medicine, belief in the expertise of previous physicians, and global ranking of countries. ResultsĪ total of 10 categories, 18 sub-categories, and 29 codes were formed. ![]() A triangulation method was adopted for this purpose. The data were managed in MAXQDA 2020 and analyzed by directed content analysis. This qualitative study was conducted on 44 policy-makers and managers at national and provincial levels selected via snowball and purposive sampling with maximum variation. This study aimed to explain the underlying factors and challenges of implementing the urban family physician program in Iran. However, despite its pivotal role in the health system, this program has not progressed according to the policies. The family physician program was launched in 2005 in rural areas of Iran and then piloted in 2012 in the cities of Fars and Mazandaran provinces due to insufficient health coverage in these cities.
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