The Overt and Covert Effects of Iranian Health Transformation Plan on Medicine and Medical Supplies

Abstract

Background and Objective: Recently in Iran, the Health Transformation Plan (HTP) was formulated by policy makers to reduce the amount of the out of pocket expenditures. The HTP caused different effects on medicines and medical supplies. The purpose of this paper was the identification of these effects. Methods: This study was a qualitative research performed in a 14-month interval in Iran during 2014 -2015. A total of 17 semi-structured interviews were used for data gathering. Participants were health authorities associated with the subject of the research and background in health executive management. They were aware of the HTP. Purposive sampling was done for data saturation. Criteria such as "Credibility", "Conformability", and "Dependability" were considered. Interviewees' anonymity was preserved. The data were transcribed, categorized, and then used the thematic analysis. Results: According to the thematic analysis, 6 themes and 21 sub-themes were found. Two main categories were identified. (I) The overt effects (3 themes) included optimizing the management of medicine and medical supplies, their cost controlling, and improving of supervision on distribution and consumption of them. (II) The covert effects (3 themes) included an increase in demand for hospitalization, a rise in total costs, and waste of hospital resources Conclusions: The HTP, besides positive and overt effects, had covert effects. The HTP increased not only in patients' inclination to stay more in hospitals, but also it increased total health expenditures and wasting resources. It could be suggested that, policy makers use this results to guarantee the success of the HTP.