Factors Affecting the Acceptance of Referral System and Family Physician in Alborz Province, Iran

The implementation of the family physician program in Iran Health Insurance Organization will change the payment system, reduce payments at the first level of service provision, and create a referral system. This study has been conducted with the aim of investigating the factors influencing the adoption of the referral system and the family physician of health insurance, including the adoption of the referral system, the creation of infrastructure and reforms, management factors, public interests, appropriate health system policies, appropriate health insurance structure and satisfaction.

The current research is descriptive and correlational in terms of applied purpose and data collection method. 184 people were included in the study by census. The data collection tool is a questionnaire with closed questions. After confirming the face validity and construct validity and reliability of the research instrument (Cronbach’s alpha 0.848), data analysis was performed using structural equation modeling (PLS-SEM).

The findings of this research showed that the insurance structure in the health system was the most influential factor on the acceptance of the referral system and the family physician, and the effect path coefficient was estimated at 0.231. In addition to these policies included in the guidelines of the family physician program, infrastructure and reforms in society, management factors, public interest and satisfaction are other factors that have been confirmed to have an effect on the adoption of the family physician and referral system.

According to the findings, in addition to the appropriate health insurance structure, management and satisfaction factors are more important in accepting the referral system and the family physician. It seems that the insurance structure can create a sense of justice for people regarding health insurance because the plan of the referral system and family physician is based on necessities such as establishing proper access to the people of the country, equality in benefiting from health and treatment services, as well as the purposefulness of providing services and productivity. It is formed from the available human resources.