Measuring Equity of Geographical Distribution of Specialist Physicians in Iran’s Health System

Reza Moradi, Alireza Olyaeemanesh, Ali Mohammad Mosadeghrad, Iraj Harirchi, Bagher Larijni

Abstract


Background: Equitable distribution of health care sector resources is one of the most important goals of health systems in all countries. The purpose of this study is to measure equity of geographical distribution of active specialist physicians in Iran’s health system. Methods: The present study was a descriptive‑cross‑sectional. The statistical population included: all active specialist physicians working in the public, private, social insurance organization, military, charity, and the other health service providers in Iran in 2019. Studied demographic data were collected from Iran’s national statistic center. Also, information of specialist physicians was obtained from several databases. Finally, duplicated records were removed, and the number of specialist physicians extracted. Data analysis was performed using Stata V.16 and ArcGIS 10.4 software. Results: The results showed that the number of specialist physicians per 100,000 population who worked in Iran’s health system was 46.81. The provinces of Tehran had the highest and Sistan and Baluchestan had the lowest number of specialist physicians. Also, 52.63% of active specialist physicians provide health services in four provinces, whereas these provinces are 37.13% of the country’s population. Total Gini coefficient of the distribution of active physicians in Iran in 2019 was 0.23. Conclusions: Distribution of specialist physician was different but somewhat equitable in the provinces. However, in some provinces, the ratio of specialist physicians to the population was still low. Therefore, when the number of specialist physicians increased, their distribution should be considered concurrently

Keywords


Equity; geographical distribution; health system; Iran; specialist physicians

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References


Rabbanikhah F, Moradi R, Mazaheri E, Shahbazi S, Barzegar L,

Karyani AK. Trends of geographic distribution of general

practitioners in the public health sector of Iran. J Educ Health

Promot 2018;7:89.

Navarro V. The Underdevelopment of Health or the Health of

Underdevelopment: An Analysis of the Distribution of Human

Health Resources in Latin America. In: Imperialism, Health and

Medicine. Routledge; 2020. p. 15‑36.

Taderera BH. Decision space and its contribution to the pursuit

of human resources for health reform in local health systems:

An exploratory review of literature. Int J Healthcare Manag

;14:621‑8.

Matsumoto M, Inoue K, Bowman R, Kajii E. Self‑employment,

specialty choice, and geographical distribution of physicians

in Japan: A comparison with the United States. Health Policy

;96:239‑44.

Mobaraki H, Hassani A, Kashkalani T, Khalilnejad R,

Ehsani‑ Chimeh E. Equality in distribution of human resources:

The case of Iran’s Ministry of Health and Medical Education.

Iran J Public Health 2013;42:161‑5.

Simforoosh N, Ziaee SA, Tabatabai SH. Growth trends in

medical specialists education in Iran; 1979 ‑ 2013. Arch Iran

Med 2014;17:771‑5.

Bayat M, Shokri A, Mirbahaeddin E, Khalilnezhad R,

Khatibi SR, Fattahi H, Zalani GS, Seproo FG, Khodadost M.

Geographic distribution of active medical specialists in Iran:

A three‑source capture‑recapture analysis. Arch Iran Med

;23:15‑22.

Ravaghi H, Taati E, Abdi Z, Meshkini A, Sarvarizadeh S. Factors

influencing the geographic distribution of physicians in Iran: a

qualitative study. Rural and Remote Health. 2015;15:29-39.

Olsen OE, Ndeki S & Norheim OF. Human resources for

emergency obstetric care in northern Tanzania: Distribution of

quantity or quality? Hum Resour Health 2005;3:5.

Mistretta MJ. Differential effects of economic factors on

specialist and family physician distribution in Illinois: A county‐

level analysis. J Rural Health 2007;23:215‑21.

Cook DA, Price DW, Wittich CM, West CP, Blachman MJ.

Factors influencing physicians’ selection of continuous

professional development activities: A cross‑specialty national

survey. J Contin Educ Health Prof 2017;37:154‑60.

Rad EH, Karyani AK, Zandian H. Access and necessity for road

emergency sites. Trauma Mon 2017;22:2.

Sefiddashti SE, Arab M, Ghazanfari S, Kazemi Z, Rezaei S,

Karyani AK, et al. Trends of geographic inequalities in the

distribution of human resources in healthcare system: The case

of Iran. Electron Physician 2016;8:2607‑13.

Doty MM, Tikkanen R, Shah A, Schneider EC. Primary care

physicians’ role in coordinating medical and health‑related

social needs in eleven countries: Results from a 2019 survey of

primary care physicians in eleven high‑income countries about

their ability to coordinate patients’ medical care and with social

service providers. Health Aff 2020;39:115‑23.

Gile PP, Buljac‑Samardzic M, Van De Klundert J. The effect

of human resource management on performance in hospitals in

Sub‑Saharan Africa: A systematic literature review. Hum Resour

Health 2018;16:34.

Mosadeghrad AM, Hashempour R, Veisy M. Equity in

geographical distribution of medical specialists in Iran. J Health

Based Res 2017;3:25‑37.

Taati‑ Keley E, Meshkini A, Khorasani‑ Zavareh D. Distribution

of Specialists in Public Hospitals of Iran. Health Inf Manage

;9:48‑557.

Shahabi M, Tofighi S, Maleki M. The nurse and specialist

physicians manpower distribution by population and its

relationship with the number of beds at public hospitals in Iran’s

‑2006. J Health Adm 2010;13:7‑15.

Ono K, Hiratsuka Y, Murakami A. Geographical distribution

of ophthalmologists before and after the new postgraduate

training program in Japan. Ophthalmic Epidemiol

;17:125‑30.

Nishiura H, Barua S, Lawpoolsri S, Kittitrakul C, Leman MM,

Maha MS, et al. Health inequalities in Thailand: Geographic

distribution of medical supplies in the provinces. Southeast Asian

J Trop Med Public Health 2004;35:735‑40.

Matsumoto K, Seto K, Fujita S, Kitazawa T, Hasegawa T.

Population aging and physician maldistribution: A longitudinal

study in Japan. J Hosp Admin 2016;5:29‑33.

Ünal E. How the government intervention affects the distribution

of physicians in Turkey between 1965 and 2000. Int J Equity

Health 2015;14:1‑13.

Hazarika I. Health workforce in India: Assessment of availability,

production and distribution. WHO South East Asia J Public

Health 2013;2:106‑12.

Meliala A, Hort K, Trisnantoro L. Addressing the unequal

geographic distribution of specialist doctors in Indonesia: The

role of the private sector and effectiveness of current regulations.

Soc Sci Med 2013;82:30‑4.

Vali L, Kafian Tafti A, Sourasrafil A, Ataallahi F. Factors

affecting the density of general practitioners and specialists in

the country’s cities. J Healthcare Manage 2013;5:7‑14.

Goudarzi R, Meshkani Z, Barooni M. Jahanmehr N, Moalemi S.

Distribution of general practitioners in the health system of Iran

using equity indices. J Health Dev 2015;4:247‑58.