Policy Analysis of Family Physician Plan and Referral System in Iran Using Policy Analysis Triangle Framework
 
Mehtarpour Mojtaba¹, Tajvar Maryam^2*

2. Assistant Professor, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences Tehran, Iran
*Correspondence: School of Public Health, Tehran University of Medical Sciences, Poursina Ave., Qods St., Enghelab Sq., Tehran, Iran
Tel: 009821- 42933055                                         Email: mtajvar@tums.ac.ir

Background & Objectives: Establishment of a “referral system” in Family Physician plan has been recommended by WHO, in order to better respond to population health needs and achieving the goals of health system. This study aimed to analyze the family physician plan and referral system in Iran and to provide a number of recommendations for improvement of this plan.
Methods: This study was a retrospective policy analysis study which was conducted based on the Walt and Gilson's policy analysis triangle framework. In order to analyze the Family Physician plan and referral system in Iran various methods including documentary analysis and reviewing the existing evidence were applied. Then, a qualitative study based on a phenomenology approach was used through semi-structured interviews with 6 experts in order to validate the earlier findings.  
Results: The results of this study showed that the performance of most actors who were involved in the establishment and implementation of the Family Physician plan had not improved this plan. Other important challenges that have been identified in terms of content, context, and process were lack of priority setting in objectives of this policy, frequent changes of decision-makers, impetuosity in implementation without careful planning, multiplicity of insurance systems, and poor quality of feedback. 
Conclusion: Improvement of the position of family physician and referral system and advertising the advantages of this plan through public media, establishment of electronic health records for patients, providing required education in the curriculum of general medicine as well as considering the interests of all stakeholders would significantly help in successful implementation of this plan in the country.
 
Key­words: Analysis of policy, Case study, Referral system, Family physician, Health system, Iran
 
­Citation: Mehtarpour M, Tajvar M. Policy Analysis of Family Physician Plan and Referral System in Iran Using Policy Analysis Triangle Framework. Journal of Health Based Research 2018; 4(1): 31-49.