Social Responsibility and Accountability: The Outcome of Integrating Health, Treatment, and Medical Education

Background: Following several challenges occurred in the country’s health system in the ۱۹۸۰s, including a severe shortage of specialized human resources and inadequate access to high-quality healthcare services in many regions of the country, the medical education and healthcare service delivery systems were integrated, resulting in the establishment of the Ministry of Health, Treatment, and Medical Education. One of the primary goals and features of this integrated system is accountability to the community health needs. Given that no coherent study has been found regarding the level of social accountability within the integrated health system in Iran. Objectives: The current research was conducted aiming to measure the level of accountability of the Iranian health system. Methods: This study sought to evaluate the level of accountability of Iranian integrated health system to societal needs. Following a literature review and holding the expert panel, a questionnaire was developed to measure the level of accountability of Iranian health system across four domains: Generalities, education, healthcare service delivery, and research. The questionnaire was distributed among the target population (faculty members, health system managers, healthcare service providers, and medical students selected in the Health System Management Olympiad of the Ministry of Health), and ۱۱ responses were received. Subsequently, the responses were analyzed using the Kruskal-Wallis and Mann-Whitney U tests. Results: The findings obtained from participants’ responses to the questionnaire revealed that the accountability of the Iranian health system to the community health needs was assessed to be at a moderate level. Furthermore, no significant difference was observed in accountability among the four mentioned domains. Conclusion: Indicators related to the quantitative development of human resource education and service delivery were associated with a reasonable level of success. However, it did not achieve significant success in the areas of improving the quality of medical education, promoting evidence-based decision-making, and making the educational programs community-oriented. According to the results, Iranian integrated educational system has not performed successfully in training non-specialized skills, such as communication, health education for other medical staff members and patients, critical thinking, and healthcare team leadership, as well as the teaching medical students to pay attention to the cost-effectiveness of treatment interventions and prescriptions. Similarly, in the field of medical research, the overall performance was not satisfactory, with the lowest scores had been related to the utilization of research findings in policy-making and improving the cost-effectiveness of services through research results.

کلیدواژه ها:

Integration ، Accountability ، medical education