| Abstract
Background: Providing comprehensive and high-quality services is one of the most important goals of the health
systems and a basic principle for Universal Health Coverage (UHC). Fulfilling this important task would be feasible
through continuous evaluation and improvement of the health services quality. The aim of this study was to
develop a framework for quality assessment of Primary Health Care (PHC) in Iran’s health system.
Methods: This study is a literature review which continued by a qualitative research. The extracted quality dimensions
and indicators for initial screening were reviewed and discussed in two panel meetings attended by the experts with
regard to the current package of health system in Iran. Using Delphi method, the dimensions and Quality
Indicators(QIs) were evaluated and approved by 39 national health professionals in two rounds. Finally, after 4 panel
sessions at ministerial level, the selected QIs were categorized in form of the final dimensions of the quality of care.
Results: The literature review emerged 13 Primary Health Care Quality Assessment Frameworks (PHCQAF) including 20
and 698 QIs. Delphi study resulted in developing Iranian PHCQAF comprising 7 dimensions and 40 QIs. Among these,
8 QIs of the dimension of access and equity, 5 QIs of safety dimension, 2 QIs of efficiency dimension, 13 QIs of
effectiveness dimension, 2 QIs of patient-centeredness dimension, 3 QIs of governance dimension and 7 QIs of
appropriateness dimension were presented.
Conclusions: The presented PHCQAF can be used as a comprehensive and practical tool for continuous improvement
of the quality of PHC services at local, national and regional levels. Moreover, it can give some useful information to the
health managers and policy makers on how the services are provided. |