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Table 1 Categorization of extracted factors based on an expert panel on Health system Control knob in Iran

From: The influential factors for achieving universal health coverage in Iran: a multimethod study

Financing

Payment system

Organization

Regulation and Supervision

Behavior

Others

▪ Financial risk protection

▪ Constraints and Structural barriers in Financial

▪ Methods of health system financing (specific tax to health, Sell resources, …)

▪ Sustainability of financing

▪ Health expenditure as % of GDP

▪ Out of pocket

▪ Method of Collecting

▪ Method of pooling money

▪ Strategic purchasing

▪ Health insurance system

▪ International assistance (donation, Charity)

▪ Benefit package

▪ Economic vulnerability in health

▪ International sanctions

▪ Costs Control

▪ Health service tariffs

▪ Per capita income

▪ The economic growth rate

▪ Inflation rate

▪ Exemption or Subsidies for prepayments

▪ Contribution-based on payment capacity

▪ Prepayment mechanisms

▪ Payment systems

▪ Information and interaction of insurance deductions for health

▪ Informal payments

▪ Deductible

▪ Health system Leadership

▪ Management in the health system (Resource management, human resources, Change management, …)

▪ Health infrastructure (technology, information system, …)

▪ The capacity of formulation and implementation of health policies

▪ Structural and functional reforms

▪ Distribution of health provider

▪ Decentralization in decision-making

▪ Non-governmental organizations (Civil society organizations: Private sector, NGOs and charities) participant

▪ Integration or Fragmented degree of the health system

▪ Equity in the distribution of health system resources

▪ Equity in access to health services

▪ Use of Appropriate technology in the health system

▪ The necessity for grading health service centers and giving the insured sufficient notice of this grading

▪ Bureaucratic obstacles

▪ Systematic perspective

▪ Inter and intra-sectoral collaboration

▪ teamwork

▪ Competency and Stability Management

▪ Policies and programs belonging to persons

▪ Effective Services Coverage

▪ Priority health services

▪ Overlaps in healthcare provision

▪ Involving all relevant stakeholders in the policy-making process

▪ Health system efficiency

▪ Government commitment

▪ Have Legal commitment

▪ Problems of law

▪ Political commitment and not having politically look

▪ Good governance

▪ Hasty policy implementation by politicians

▪ Conflict of interest

▪ Quality of health care services

▪ Supporting revision projects and national health indicators development.

▪ Focus on, villagers, nomads, less populated cities poor, disadvantaged and marginalized groups

▪ Family Physician Program

▪ Referral system

▪ Strengthen the central government’s Ministry of Health

▪ Control demands

▪ Regular transparency of revenues, expenditures, and activities

▪ Implement the rules of the World Health Organization

▪ Administrative and employment regulation

▪ Regulate the market of medical equipment

▪ Reviewing job classification schemes according to the needs of the health system.

▪ Electronic Health Record (EHR)

▪ Overlap in population coverage

▪ The dual practice of physician and another health workforce

▪ Competitive space between the providers.

▪ Policy dynamism

▪ Use of clinical guidelines and standards

▪ Performance of Supreme Council of Insurance

▪ oversight parliament

▪ Supervision by the ministry and the university

▪ The presence of specialists in public hospitals

▪ Plan to support the retention of physicians in underserved areas

▪ Assessment and accreditation of the health system performance

▪ Evidence-based policymaking

▪ Health promotion and education

▪ Culture-building

▪ Empowering community

▪ Perceived behavioral control

▪ Issues of urbanization

▪ Absence of obligation for health providers to contract with insurance organizations

▪ Negligence of social factors

▪ Social acceptability of health service

▪ public participation in health promotions programs

▪ Creating an incentive mechanism for behavior change

▪ The pattern of health service utilization

▪ Poverty

▪ Reviewing other countries experiences

▪ The unemployment rate in the country

▪ Active primary health care

▪ International relationship

▪ Health status of health indicators

▪ Prevention and control plans of non-communicable and communicable diseases

▪ Demographic and epidemiologic transitions

▪ Provide community-based services

▪ Health system service preferences (prevention-oriented or treatment-oriented)

▪ Disease Pattern

▪ Knowledge translation