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- Title
Policy options to reduce patient visits in specialized service centers: A case study in speciality and subspeciality clinics in Iran.
- Authors
Doshmangir, Leila; Doshmangir, Parinaz; Beyrami, Hossein Jabbari; Alizadeh, Gisoo; Gordeev, Vladimir Sergeevich
- Abstract
Hospital congestion, delayed discharge, and bypassing primary care facilities are challenges facing the Iranian health‐care sector. We conducted a case study at the Sheikh al‐Rais Specialty Clinic, Tabriz, Iran, to find plausible, practical policy options for designing and implementing a referral system to reduce and regulate referral volumes to this clinic. We first reviewed the evidence on existing options of hospital congestion and unnecessary referral reduction by conducting a scoping literature review and then supplemented the findings with 18 semistructured interviews. We examined the perspectives of service users and experts in the field. Six practical policy options were identified: institutionalization of the referral system and family physician program, reinforcing gatekeeping system, use of telemedicine, utilization of educational algorithms, implementation of electronic health records, and establishing specialized clinics in different city areas. Local context adaptation, ensuring the availability of resources, political support, and feasibility are critical factors for successful policy implementation. Key points: Improving documentation using electronic health records, integrating electronic health records with referral systems, controlling and reducing the demand for unnecessary referrals through screening mechanisms, and the ability to refer patients to the most appropriate level of referral are crucial.The workload in (sub‐) specialized university clinics can be reduced by implementing the proposed policy options.Establishing an electronic health record system is pivotal in providing advanced and qualified health‐care services.
- Subjects
IRAN; TABRIZ (Iran); HEALTH facilities utilization; ELECTRONIC health records; LITERATURE reviews; SERVICE centers; DOCUMENTATION; ELECTRONIC records
- Publication
World Medical & Health Policy, 2023, Vol 15, Issue 2, p108
- ISSN
1948-4682
- Publication type
Article
- DOI
10.1002/wmh3.541