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Introduction: During the past decade, neonatal mortality rate in Iran has not decreased satisfactorily. Regionalization of perinatal care services is a potential solution to improve the access of those in need to the best quality care within economic and administrative constraints. This study aims to develop a framework for optimized and efficient distribution of perinatal care services at different levels of care provision.

Methods: We utilized small area analysis in an iterative process to divide the country into service areas of Perinatal Care Regions (PCRs), to distribute three levels of perinatal services and hospital beds in PCRs, to minimize patients’ traveling distances, and to fit the facilities to the needs while incurring minimum changes to the current administrative borders and available infra-structure.

Results: We divided the country into 33 PCRs. A total of 1256 level-III (Neonatal Intensive Care Unit) beds and 3768 level-II neonatal beds were required in the country and distributed to the districts. One level-III district was designated as the center for each PCR. Sixty one districts were identified as level-III and 104 as level-II. Level-I and Ib districts were allocated to the nearest next level districts. Our proposed model decreased the average distance of districts from the center from 125 to 109 km. The average distance and the distance weighted by population of the districts from the PCR center also reduced to 79 and 42 km, respectively.

Conclusion: Our model reduced the distance between levels of care provision and balanced the care facilities with population needs at the district level. Implementing this model requires resources. It may encounter some resistance in practice. Such resistance should be tackled with setting regulations, monitoring, training, advocacy, and appropriate incentives. A sustainable national regionalization model should be developed centrally, and customized to the specific needs and circumstances of each region.

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  Hakim Research Journal 2008 11(2): 1- 11.

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Comparative Study of Hospitals’ Transparency in Eight Countries
Hossein Bouzarjomehri¹, Ali Akbari-Sari^2*, Ebrahim Jafari-Pooyan³, Yasaman Herandi⁴, Soheila Rajaie^5
1M.Sc. in Healthcare Management, Health Economics and Management Group, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran
²Professor, Ph.D. in Healthcare Management & Health Policy, Health Economics and Management Group, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran
³Associate Professor, Ph.D. in Healthcare Management, Health Economics and Management Group, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran
⁴Pharm.D., Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
⁵M.Sc. Student in Health Economics, Iran University of Medical Sciences, Tehran, Iran
Abstract
Introduction: Information asymmetry leads to less informed patients in choosing healthcare providers. Therefore, countries have moved forward to increase providers’ transparency, information symmetry and patients’ power. This study was designed to compare countries’ experiences about hospitals’ transparency.
Methods: The list of countries in this comparative study was prepared with the help of the Global Open Data Index and Open Data Barometer. Searching for official websites with keywords like “hospital transparency” and “hospital comparing tool,” the final websites were obtained. Finally, indicators and types of organization of these websites were compared.
Results: Websites from eight countries were selected. The number of indicators for comparing hospitals was variable, from 17 in Australia to 195 in the UK. Type of indicators could be categorized into several groups, including waiting times, length of stay, patients’ experience, staff’s experience, treatment outcomes, infection control, and price of care. Studied experiences showed that countries developed hospitals’ transparency due to their needs and limitations. Some countries like the UK and the US were pioneers but there is a global trend to develop transparency in the health system.
Conclusion: By increasing public awareness, governments moved forward to develop transparency and the health sector was not an exception. Although private companies and startups are engaged in these innovations, governments have the main role to build the legal, political, and data infrastructures. Therefore, it is recommended that Iranian policymakers and politicians develop transparency of hospitals and health systems gradually using global experiences and considering domestic conditions and capacities.
Keywords: Transparency; Access to Information; Choice Behavior; Public Reporting; Information Symmetry; Hospital

Please cite this article as follows: Bouzarjomehri H, Akbari-Sari A, Jafari-Pooyan E, Herandi Y, Rajaie S. Comparative study of hospitals’ transparency in eight countries. Hakim Health Sys Res. 2019; 22(4): 273-283.

*Corresponding Author: Department of Health Management and Economics, 4th Floor, New Building, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2188989128, Fax: +98-2188989129, Email: akbarisari@tums.ac.ir