The impacts of health transformation plan on physiotherapy sector in Iran: a qualitative study using five control...

Area of Science:

• Health Policy and Management
• Rehabilitation Sciences
• Socioeconomics of Healthcare

Background:

• The Health Transformation Plan (HTP) in Iran aimed to reform the healthcare system.
• Understanding the impact of such large-scale reforms on specific sectors like physiotherapy is crucial for effective policy adjustment.
• Physiotherapy plays a vital role in rehabilitation and preventive care, making its sector's health critical to overall public health outcomes.

Purpose of the Study:

• To investigate the experiences of physiotherapists, academics, and policymakers regarding the impacts of the Health Transformation Plan (HTP) on the physiotherapy sector in Iran.
• To identify the key challenges and areas of concern within the physiotherapy sector following HTP implementation.
• To gather insights for improving future health reforms and their integration with existing healthcare structures.

Main Methods:

• A qualitative study employing in-depth, semi-structured interviews.
• Purposive and snowball sampling strategies were used to ensure maximum diversity among participants.
• Thematic content analysis, following Braun and Clarke's methodology, was applied to analyze the collected data until data saturation was achieved.

Main Results:

• The HTP implementation led to significant challenges in five key areas: financing (reduced budgets, inadequate insurance coverage), payment (delayed reimbursements, low ceilings), professional behaviors (decreased motivation, increased misconduct), organizational issues (difficulties in clinical education, neglect of preventive care), and regulation (lack of stakeholder input, policy inconsistencies).
• Specific issues included a decline in government budgets and insufficient health insurance coverage, leading to delayed payments and tight reimbursement ceilings.
• Physiotherapists experienced reduced motivation and a tendency towards misbehaviors, while clinical education and the preventive role of physiotherapy were overlooked.

Conclusions:

• The Health Transformation Plan has presented substantial challenges to Iran's physiotherapy sector.
• Recommendations include increasing government budgets, improving insurance coverage, ensuring timely payments, and modifying reimbursement limitations.
• Strategies to enhance physiotherapist motivation, address training issues, emphasize preventive care, and increase stakeholder participation in policy-making are essential for mitigating these challenges and strengthening the sector.