Developing Iranian primary health care quality framework: a national study.

Area of Science:

• Health Services Research
• Quality Improvement Science
• Public Health Policy

Background:

• High-quality healthcare services are crucial for Universal Health Coverage (UHC).
• Continuous evaluation and improvement are essential for health system performance.
• Assessing Primary Health Care (PHC) quality is vital for effective health system management.

Purpose of the Study:

• To develop a comprehensive framework for assessing the quality of Primary Health Care (PHC) services in Iran.
• To establish a practical tool for continuous quality improvement in the Iranian health system.
• To provide actionable insights for health managers and policymakers regarding PHC service delivery.

Main Methods:

• A mixed-methods approach combining literature review and qualitative research.
• Expert panel meetings and Delphi method involving 39 national health professionals.
• Iterative refinement and categorization of quality dimensions and indicators through ministerial-level sessions.

Main Results:

• Identification of 13 existing PHC Quality Assessment Frameworks (PHCQAFs) from literature review.
• Development of the Iranian PHCQAF, comprising 7 dimensions and 40 Quality Indicators (QIs).
• Specific QIs were defined across dimensions including access, safety, efficiency, effectiveness, patient-centeredness, governance, and appropriateness.

Conclusions:

• The developed Iranian PHCQAF serves as a comprehensive tool for ongoing PHC quality improvement.
• The framework is applicable at local, national, and regional levels within Iran's health system.
• It offers valuable data for health managers and policymakers to understand and enhance service provision.