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. 2020 Apr 19;20(1):327.
doi: 10.1186/s12913-020-05186-6.

The effect of the Iranian health transformation plan on hospitalization rate: insights from an interrupted time series analysis

Siavash Beiranvand  1 , Mandana Saki  1 , Meysam Behzadifar  2 , Ahad Bakhtiari  3 , Masoud Behzadifar  4 , Mohammad Keshvari  5 , Nicola Luigi Bragazzi  6   7
Affiliations

The effect of the Iranian health transformation plan on hospitalization rate: insights from an interrupted time series analysis

Siavash Beiranvand et al. BMC Health Serv Res. .

Abstract

Background: Healthcare policy- and decision-makers make efforts to build and maintain high-performing and effective health systems, implementing effectiveness programs and health reforms. In May 2014, the Iranian Ministry of Health and Medical Education has launched a series of ambitious reforms, known as the Health Transformation Plan (HTP). This study aimed to determine the effect of the HTP on hospitalization rate in Iranian public hospitals affiliated to the Ministry of Health and Medical Education.

Methods: This study was designed as a quasi-experimental, counterfactual study utilizing the interrupted time series analysis (ITSA), comparing the trend of hospitalization rate before and after the HTP implementation in 16 hospitals in the Lorestan province. Data was collected from March 2012 to February 2019.

Results: In the first month of the HTP implementation, an increase of 2.627 [95% CI: 1.62-3.63] was noted (P < 0.001). Hospitalization rate increased by 0.68 [95% CI: 0.32-0.85] after the HTP implementation compared to the first month after the launch of the HTP (P < 0.001). After the HTP implementation, monthly hospitalization rate per 1000 persons significantly increased by 0.049 [95% CI: 0.023-0.076] (P < 0.001).

Conclusions: The HTP implementation has resulted in an increased hospitalization rate. Health planners should continue to further improve this service. ITSA can play a role in evaluating the impact of a given health policy.

Keywords: Health policy; Health transformation plan; Hospitalization rate; Interrupted time series analysis; Iran.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Temporal trend of the hospitalization rate in the Lorestan governmental, public hospitals before and after the Health Transformation Plan implementation
Fig. 2
Fig. 2
Result of residuals from the OLS regression of hospitalization rate
Fig. 3
Fig. 3
Autocorrelation and partial autocorrelation function of the of hospitalization rate
See this image and copyright information in PMC

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