The effect of family physician program and health transformation plan on utilization and cost of health services

Abstract Introduction Health system reforms are essential. In Iran, some of the most significant changes include the implementation of the Family Physician Program (FPP) and the Health Transformation Plan (HTP). The aim of this study was to assess the impact of these programs on the cost and use of...

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Main Authors: Zeynab Safarpoor, Farhad Lotfi, Mohsen Bayati, Hossein Moordzade, Zahra Goudarzi, Khosro Keshavarz
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Cost Effectiveness and Resource Allocation
Subjects:
Online Access:https://doi.org/10.1186/s12962-025-00637-5
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author Zeynab Safarpoor
Farhad Lotfi
Mohsen Bayati
Hossein Moordzade
Zahra Goudarzi
Khosro Keshavarz
author_facet Zeynab Safarpoor
Farhad Lotfi
Mohsen Bayati
Hossein Moordzade
Zahra Goudarzi
Khosro Keshavarz
author_sort Zeynab Safarpoor
collection DOAJ
description Abstract Introduction Health system reforms are essential. In Iran, some of the most significant changes include the implementation of the Family Physician Program (FPP) and the Health Transformation Plan (HTP). The aim of this study was to assess the impact of these programs on the cost and use of services. Methods This quasi-experiment targeted insured individuals under the Iranian Health Insurance Organization in Fars province from 2010 to 2021. ANOVA, T-tests, and interrupted time-series analysis were used to investigate the impacts of FPP and HTP on service utilization and cost changes before and after the introduction of these programs. Results FPP decreased specialist visits, drug utilization, and drug expenditure in the short run. But eventually, it resulted in more general practitioner (GP) consultations, laboratory services, and imaging, hospitalization, and drug spending. The HTP first resulted in more GP consultations, laboratory services, drug use, and hospitalization but less use of imaging services and more total service spending. Eventually, the HTP resulted in more GP consultations, fewer GP prescriptions, and less laboratory test and imaging service spending. Conclusion FPP was successful in achieving some initial goals, such as decreasing expenditure and service usage through a referral system. It was finally unsuccessful in the long run due to the dissolution of this system and lack of proper supervision. At the beginning, the HTP imposed significant costs to insurance providers; however, it ultimately led to a reduction in the cost for particular services over a prolonged interval.
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spelling doaj-art-61aec72003044b9dbdd6cf928a3f485f2025-08-20T02:10:38ZengBMCCost Effectiveness and Resource Allocation1478-75472025-06-0123111010.1186/s12962-025-00637-5The effect of family physician program and health transformation plan on utilization and cost of health servicesZeynab Safarpoor0Farhad Lotfi1Mohsen Bayati2Hossein Moordzade3Zahra Goudarzi4Khosro Keshavarz5Student Research Committee, School of Management and Medical Information Sciences, Shiraz University of Medical SciencesHealth Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical SciencesHealth Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical SciencesFars Health Insurance officeHealth Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical SciencesHealth Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical SciencesAbstract Introduction Health system reforms are essential. In Iran, some of the most significant changes include the implementation of the Family Physician Program (FPP) and the Health Transformation Plan (HTP). The aim of this study was to assess the impact of these programs on the cost and use of services. Methods This quasi-experiment targeted insured individuals under the Iranian Health Insurance Organization in Fars province from 2010 to 2021. ANOVA, T-tests, and interrupted time-series analysis were used to investigate the impacts of FPP and HTP on service utilization and cost changes before and after the introduction of these programs. Results FPP decreased specialist visits, drug utilization, and drug expenditure in the short run. But eventually, it resulted in more general practitioner (GP) consultations, laboratory services, and imaging, hospitalization, and drug spending. The HTP first resulted in more GP consultations, laboratory services, drug use, and hospitalization but less use of imaging services and more total service spending. Eventually, the HTP resulted in more GP consultations, fewer GP prescriptions, and less laboratory test and imaging service spending. Conclusion FPP was successful in achieving some initial goals, such as decreasing expenditure and service usage through a referral system. It was finally unsuccessful in the long run due to the dissolution of this system and lack of proper supervision. At the beginning, the HTP imposed significant costs to insurance providers; however, it ultimately led to a reduction in the cost for particular services over a prolonged interval.https://doi.org/10.1186/s12962-025-00637-5Family physicianProgramHealth transformation planUtilizationCost
spellingShingle Zeynab Safarpoor
Farhad Lotfi
Mohsen Bayati
Hossein Moordzade
Zahra Goudarzi
Khosro Keshavarz
The effect of family physician program and health transformation plan on utilization and cost of health services
Cost Effectiveness and Resource Allocation
Family physician
Program
Health transformation plan
Utilization
Cost
title The effect of family physician program and health transformation plan on utilization and cost of health services
title_full The effect of family physician program and health transformation plan on utilization and cost of health services
title_fullStr The effect of family physician program and health transformation plan on utilization and cost of health services
title_full_unstemmed The effect of family physician program and health transformation plan on utilization and cost of health services
title_short The effect of family physician program and health transformation plan on utilization and cost of health services
title_sort effect of family physician program and health transformation plan on utilization and cost of health services
topic Family physician
Program
Health transformation plan
Utilization
Cost
url https://doi.org/10.1186/s12962-025-00637-5
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