A study protocol for the macro-analysis of Iran's health system with system dynamics approach

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Emami, Mozhgan and Haghdoost, AliAkbar and Yazdi-Feyzabadi, Vahid and Khedmati Morasae, Esmaeil and Mehrolhassani, Mohammad Hossein (2025) A study protocol for the macro-analysis of Iran's health system with system dynamics approach. Medical journal of the Islamic Republic of Iran, 39. pp. 862-871. ISSN 1016-1430 (https://doi.org/10.47176/mjiri.39.95)

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Abstract

Background: The health system (HS) is characterized by its complexity and the interconnectivity of its various components, which can lead to unpredictable outcomes when faced with changes in the environment. Understanding these interactions is crucial for effective management and improvement of the system. To navigate this complexity, this study emphasizes the importance of adopting a real-world perspective and utilizing system modeling techniques. These approaches allow for a thorough analysis of the current state of the HS and enable the testing of different policy alternatives to identify potential improvements. Ultimately, the aim of the research is to pinpoint the key components and drivers within the HS. By modeling the dynamics of these elements, the study aims to provide insights that can inform better decision-making and enhance the overall effectiveness of health care delivery. Methods: We designed a mixed methods study in 4 phases, consisting of sequential quantitative and qualitative analyses. In the first phase, to create a comprehensive and holistic view, we will identify key variables and indicators in the HS within the framework of the Balanced Scorecard framework (BSC), which includes population & population health; service delivery; financing; growth & development; and governance & leadership, through a review of documents and a scoping review. In the second and third phases of the study, using a foresight and systemic approach, expert opinions will be purposefully gathered through cross-impact analysis (CIA) and scenario writing to identify key drivers and levers of Iran's HS and obtain compatible future scenarios. Finally, in the quantitative phase of the study, based on the outputs of the previous phases, a dynamic model of the HS will be designed in the Vensim software, and the current situation along with other possible scenarios for the system will be examined for a period of 10 years. Conclusion: It is anticipated that the results of this study could offer a methodological foundation for formulating the health component of the Islamic Republic of Iran’s economic, social, and cultural development plan, intended for use by the Ministry of Health, Treatment, and Medical Education.

ORCID iDs

Emami, Mozhgan, Haghdoost, AliAkbar, Yazdi-Feyzabadi, Vahid, Khedmati Morasae, Esmaeil ORCID logoORCID: https://orcid.org/0000-0003-2172-9653 and Mehrolhassani, Mohammad Hossein;
CORE (COnnecting REpositories)