Developing a conceptual model for the application of patient and public involvement in the healthcare system in Iran

Mohammad Azmal; Ali Akbari Sari; Abbas Rahimi Foroushani; Batoul Ahmadi

doi:10.19082/2506

Developing a conceptual model for the application of patient and public involvement in the healthcare system in Iran

Electron Physician. 2016 Jun 25;8(6):2506-14. doi: 10.19082/2506. eCollection 2016 Jun.

Authors

Mohammad Azmal¹, Ali Akbari Sari², Abbas Rahimi Foroushani³, Batoul Ahmadi⁴

Affiliations

¹ Ph.D. Candidate of Health Services Management, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
² Ph.D. of Health Policy and Management, Associate Professor, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
³ Ph.D. of Biostatistics, Professor, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
⁴ Ph.D. of Health Services Management, Associate Professor, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Women's Health Scientific Group, Iranian Academy of Medical Sciences, Tehran, Iran.

PMID: 27504165
PMCID: PMC4965200
DOI: 10.19082/2506

Abstract

Introduction: Patient and public involvement is engaging patients, providers, community representatives, and the public in healthcare planning and decision-making. The purpose of this study was to develop a model for the application of patient and public involvement in decision making in the Iranian healthcare system.

Methods: A mixed qualitative-quantitative approach was used to develop a conceptual model. Thirty three key informants were purposely recruited in the qualitative stage, and 420 people (patients and their companions) were included in a protocol study that was implemented in five steps: 1) Identifying antecedents, consequences, and variables associated with the patient and the publics' involvement in healthcare decision making through a comprehensive literature review; 2) Determining the main variables in the context of Iran's health system using conceptual framework analysis; 3) Prioritizing and weighting variables by Shannon entropy; 4) designing and validating a tool for patient and public involvement in healthcare decision making; and 5) Providing a conceptual model of patient and the public involvement in planning and developing healthcare using structural equation modeling. We used various software programs, including SPSS (17), Max QDA (10), EXCEL, and LISREL. Content analysis, Shannon entropy, and descriptive and analytic statistics were used to analyze the data.

Results: In this study, seven antecedents variable, five dimensions of involvement, and six consequences were identified. These variables were used to design a valid tool. A logical model was derived that explained the logical relationships between antecedent and consequent variables and the dimensions of patient and public involvement as well.

Conclusion: Given the specific context of the political, social, and innovative environments in Iran, it was necessary to design a model that would be compatible with these features. It can improve the quality of care and promote the patient and the public satisfaction with healthcare and legitimate the representative of people they served for. This model can provide a practical guide for managers and policy makers to involve people in making the decisions that influence their lives.

Keywords: Conceptual model; Healthcare system; Iran; Patient and public involvement.