Evaluating the Implementation of Family Physician Program in Urban and Rural Areas of Mazandaran Province Based on Process Approach

Abstract

BACKGROUND AND OBJECTIVE: Assessing health systems paves the way for reforms in structures and processes to achieve better results. Therefore, the present study was conducted to evaluate the implementation of family physician program in urban and rural areas of Mazandaran province using process approach. METHODS: This cross-sectional study was conducted in 2017 among 238 managers, health experts and health insurance experts who were selected by census from 12 cities. Data were collected and evaluated using a researcher-made questionnaire with high validity and reliability, which evaluates urban and rural family physician program in three domains of structure, process and outcomes. FINDINGS: The mean score of the domain of structure (4.27±27.38), process (4.33±0.41) and outcomes (4.31±0.39) of rural family physician program was significantly higher than urban family physician program (p<0.001). In the urban family physician program, the most important dimension in the domain of structure was equipment (3.35±0.76), in the domain of process was care for non-communicable diseases (3.15±1.06) and in the domain of outcomes was reasonable prescription of medicine (3.07±1.02). In the rural family physician program, the most important dimension in the domain of structure was physical space (4.41±0.60) and in the dimensions of process and outcomes, the health of mothers and children (4.20±0.90) and the improvement of health promotion indicators (4.33±0.76) were more important, respectively. CONCLUSION: Based on the results of this study in three domains of structure, process and outcomes, the rural family physician program was relatively better than the urban family physician program.

Keywords

• family physician
• urban population
• rural population
• process evaluation.