Health Services Delivery by Non-physicians and Associated Factors in Iran: A Cross-sectional Study in 2023

Abstract

Background: The increasing demand for healthcare services and some associated factors including lack of physicians, lack of trust in physicians, ineffectiveness of treatments and high costs may be have led to a rise in non-physician-provided services. This study aims to assess health services delivery by non-physicians and its associated factors in Iran.

Methods: This study was a cross-sectional study conducted using a convenience sampling method in the Iranian community in 2023. A standard questionnaire with 45 questions was developed based on focus group discussions and a validation process to assess the status of receiving services in six medical areas including traditional medicine, abortion, traditional dentistry, obesity and slimming diets, bone setting, and addiction treatment. Data collection was carried out using online questionnaires on Iranian and non-Iranian social media platforms. Descriptive and analytical statistics were used to analyze the data, with logistic regression adjusting for various demographic factors.

Results: Out of 1713 participants, 53.9% (95% CI: 51.5%-56.3%) were women, and the majority were in the 30-40 age group. Traditional Islamic medicine was the most commonly sought service, with 56% (95% CI: 51.2%-60.8%) of users receiving it from non-physicians. Satisfaction with non-physician services varied, with 32.1% (95% CI: 25.8%-38.4%) reporting high satisfaction for traditional medicine, but only 49.4% (95% CI: 40.5%-58.3%) for experimental dentistry. Key reasons for choosing non-physician providers included the effectiveness of traditional treatments and fear of modern medicine's side effects.

Conclusion: The result showed that the use of non-physician services can be considerable and that necessary interventions should be designed to standardize treatments and deal with substandard providers who may be harmful to the health of the community.

Keywords: Healthcare services; Non-physician providers; Patient satisfaction; Traditional medicine.