Strategic Analysis of the Iranian Health Financing System: A Scoping Review

The health system financing is the process of collecting, pooling and managing financial resources and purchasing healthcare services. Health financing plays an important role in achieving the health system goals. The aim of this study was to strategically analyze the Iranian health financing system and recommend strategies to strengthen it.

The method in this research was the scoping review method. All the published studies about strengths, weaknesses, opportunities and threats of the Iranian health financing system were, using suitable keywords, searched in databases including "PubMed", "Scopus", "Science Direct", "Embase", "ProQuest", "SID" and "Magiran", as well as  the "National Database of Medical Science Theses" and two search engines, namely, "Google" and "Google scholar". Finally, 29 studies were selected and anlyzed using the framework analysis method, the software being MAXQDA. 

Increased population health insurance coverage, reduced out-of-pocket payments following the national health transformation plan, and increased healthcare tariffs were found to be the strengths of the Iranian health financing system. On the other hand, regressive financing, high out-of-pocket payments and increased health insurance funds were weaknesses of the national Iranian health financing system. Political sanctions, financial crises and increased healthcare demands by consumers were the threats, while supportive laws, the NGO’s financial participation/support, increased health services delivery centers and modern technologies were among the important opportunities in the health financing system. Increasing the health system financial resources through prepayments, structural and policy unification of health insurance system, health service tariff reform and increasing health system efficiency were found to be essential to strengthen the Iranian health financing system.

The Iranian health financing system is not resilient and faces several challenges. The health system policy-makers and senior managers should adopt the recommended strategies to strengthen the national health financing system.