سامانه همایش های دانشگاه آزاد اسلامی واحد نجف آباد

صفحه اصلی / اولین همایش بین المللی تحول خدمات سلامت: تلفیق مراقبت، درمان، بازتوانی و امیدبخشی

A Comparison of Health Service Delivery patterns in Iran and Europe: Experiences and Strategies for Improving the Health System

نویسندگان :

Yasaman Akbari Birgani¹ Aysan Aryan Manesh² Maliheh Jahromi³

1- گروه پزشکی، واحد نجف آباد، دانشگاه آزاد اسلامی، نجف آباد، ایران 2- گروه پزشکی، واحد نجف آباد، دانشگاه آزاد اسلامی، نجف آباد، ایران 3- گروه پزشکی، واحد نجف آباد، دانشگاه آزاد اسلامی، نجف آباد، ایران

کلمات کلیدی :

Health service delivery،primary health care،health system reform،universal health coverage،referral system،comparative study

چکیده :

Background: Achieving Universal Health Coverage (UHC) depends heavily on how health services are organized and delivered(1) . European Health Systems Typically have a more Coherent referral system (Gatekeeping), integrated financial resources, and broader coverage of outpatient service coverage. In contrast, Iran, despite its extensive primary care (PHC) network and progress in implementing the health services reforms, still faces structural challenges(2, 3). This study aimed to compare the strengths and challenges of health service delivery patterns in Iran and Europe while identifying the reforms needed in the Iranian Health system. Methods: The study conducted a critical comparative review on health systems in Iran and selected leading European countries, using the published studies between 2013 and 2025(3, 4). Findings: Compared with European Health systems, Iran possesses a distinctive strength in its community-centered primary healthcare network, which is supported by community health workers, prioritizes rural populations, and deliver public health services without direct charges(2). However, considerable direct payments, accounting for roughly 40% of health expenditure, as well as fee for service reimbursement, limited outpatient insurance protection, and the absence of mandatory referral mechanism represent significant challenges(2, 4, 5). On the other hand, Europe’s more coherent referral system and more integrated insurance infrastructure enables a more sustainable controls and financial support(3). Conclusion: Preserving and developing Iran’s primary health care network is essential. In addition to that, strengthening the family physician referral system, reducing fragmentation among insurance funds, controlling informal payments, and shifting from fee-for-service reimbursement to capitation may help reduce health inequalities and enhance the financial sustainability of Iran’s health system(1, 2).