Evaluation of Urban Family Physician Program in Iran Using Primary Care Evaluation Tool

Abstract

Background and Objectives: Due to lack of proper health system coverage in cities, the urban family physician program began as pilot in two provinces in Iran. Decision on developing the program to other provinces requires a comprehensive assessment. The study aimed to evaluate the program in Iran. Methods: This cross-sectional study was conducted in 2015 and 2016 in two provinces (Fars and Mazandaran). The data of 141 family physicians working in health centers and 710 patients were collected using a questionnaire. A multi-stage sampling method was used for the samples. Data analysis was performed using descriptive and inferential statistical methods. Results: 81% of the workload of family physicians in a week was patient visits. Co-payment in second and third levels was a real obstacle for some patients. The majority of the patients could receive their required healthcare facilities in up to 40 minutes. Software programs were infrequently used. Patients were visited by their physicians 5.5 times in a week. The mean duration of each patient visit was less than 10 minutes in 80% of the cases. Referral rate was reported by 14% (Fars= 21.8%, Mazandaran= 4%). 30 out of 45 medical devices were available to family physicians on average. Conclusion: Although the program has been successful in areas such as access to health services and comprehensiveness of care, there are some challenges in coordination and continuity of care. Therefore, it is suggested that the root causes of these challenges be resolved prior to extending this program to other provinces.

Keywords

• urban family physician
• evaluation
• accessibility of care
• continuity of care
• coordination of care
• comprehensive of care