Table 1 Possible states of descriptors
Descriptor | Variants | ||
|---|---|---|---|
A. Budget deficit of the health system | A1. Increasing the budget of the health system | A2. The stability of the budget of the health system | A3. Reducing the budget of the health system |
B. Economic sanctions against Iran | B1. Lifting Economic Sanctions on Iran | B2. The effect of sanctions decreases | B3. sanctions have more severe consequences. |
C. Informal payments or under-the-counter payment | C1. Such payments are impossible (eradicate informal payments). | C2. Medical staff are willing to receive an under-the-counter payment before treatment | C3.Informal payments are deeply ingrained in the health care sector |
D. Conflict of interests of Iran’s health system decision-makers | D1. No conflict of interest | D2. Moderate conflict of interest | D3.Severe conflict of interest |
E. Increasing consumption of expensive high-tech health care services | E1. Decreasing consumption of expensive high-tech health care services due to decreased access to advanced medical technologies and decrease in willingness to pay | E2. Consistency of consumption due to no change in willingness to pay for advanced technologies without changing access to them | E3. Increasing consumption of expensive high-tech health care services due to increased access to advanced medical technologies and increase in willingness to pay |
F. Inflation rate in health sector | F1. The inflation rate of the health system is reduced | F2. The inflation rate of the health system remains constant | F3. The inflation rate in the health sector increases at a rate twice higher as the prevailing inflation rates |
G. Induced demand (consumer or supplier) | G1. The decrease in induced demand | G2. The absence of substantial change in induced demand | G3. The increase in consumer surplus due to induced demand |
H. Lack of reliable and transparent electronic information systems in the health sector | H1. Developing integrated health information systems in the health sector | H2. Access to integrated and validated information for specific authorities | H3. Lack of access to up-to-date and integrated information systems. |
I. Lack of implementation of family physician plan (FPP)and referral system in the whole country | I1. Complete and successful implementation and performance of FPP and referral system in Iran | I2. Step-by-step implementation of the FPP and referral system in provinces | I3. The FPP and referral system are not implemented in Iran. |
J. The increase in the price of medicines and medical devices due to the increase in the exchange rate and the elimination of the preferential currency subsidy | J1. Not to eliminate preferential currency subsidies and expensive drugs were included in the basic health insurance benefit packages. | J2. A step-by-step approach to eliminating preferential currency subsidies and the price of medicines and medical devices is gradually increasing. | J3. Eliminate preferential currency subsidies and Sudden increase in medicines and medical devices prices. |