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Shiraz E Medical Journal
Article . 2016 . Peer-reviewed
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Coverage Decision-Making for Orthopedics Interventions in the Health Transformation Program in Iran: A Multiple Criteria Decision Analysis (MCDA)

Authors: Efat Mohamadi; Seyed Mousa Tabatabaei; Alireza Olyaeemanesh; Seyede Fateme Sagha; Marziyeh Zanganeh; Majid Davari; Jalal Arabloo; +2 Authors

Coverage Decision-Making for Orthopedics Interventions in the Health Transformation Program in Iran: A Multiple Criteria Decision Analysis (MCDA)

Abstract

Introduction: All governments, regardless of available resources, should move to establish a balance between the conflict of resource scarcity of health system and health care services required. This study applied a multi criteria decision analysis (MCDA) approach to contribute to priority-setting and the coverage decision-making on including uninsured orthopedics interventions in the healthcare transformation plan’s subsidized in Iran during year 2015. Methods: This study was conducted in four phases: a comprehensive review of studies related to the methods and criteria for prioritizing health services, identifying prioritization criteria, scoring and finalizing them, weighting of the criteria identified, and planning for a prioritized uninsured coverage for orthopedics intervention. Results: After screening the retrieved titles via PRISMA, from 350 papers, 12 studies were included. The main criteria used for the priority step in the health sector were as follows: safety, efficacy, need, existence of alternative procedures, life expectancy impact, cost, cost-effectiveness, catastrophic health expenditure, impact on the budget, acceptance of social/economic and equity in access. According to the viewpoint of the experts, the safety criteria had maximum weight (0.4) and equity in access had the least weight (0.03). Finally, ten uninsured orthopedics services were prioritized with a score of 9.01 to 5.01. Conclusions: This practical and real-life project significantly contributed to rational, apparent, and unbiased priority-setting practice by using the MCDA methodology. Prioritizing and weighting the criteria in this study indicated that the Iranian policymakers should pay more attention to clinical aspects and benefits of the service than financial issues. This could indicate that there are social perspective and health as the public right in the country.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
9
Top 10%
Average
Average
gold