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Background and aims: Because of growing costs in health system, resource allocation has vital role in assignment of existing resources to health technologies in recent years. Therefore, health technology assessment (HTA) is a good tool for allocating the resources based on evidence in health sector. In line with evidence-based decision making, HTA program conducted in Iran since 2007 and in this article explores the main stakeholders in implementing the HTA program. Methods: At the first step the researchers searched the related articles, policy documents and secondary sources to identify the range of the stakeholders in this field. Then, semi-structured interview were conducted with all stakeholder from all categories and interpret according to the principles of the qualitative content analysis. Results: Stakeholder analysis has identified 10 main category of stakeholder (WHO, MOHME, The National Institute for Health Research, Graduates and researchers, Universities and research institutes, Department of Medical Equipment, Food and Drug Administration, Insurance agencies, Manufacturing and importer companies' of medicines and medical equipment, The Parliament Health Commission) in relation to HTA program. The MOHME and NIHR along with graduates and researchers who were educated abroad were the most powerful and supportive actors that had an important role in implementing this program. We found that Department of Medical Equipment and medicines and medical equipment companies were strongly opposition in implementing the HTA program. The presence of abroad graduates in the country at the time of implementation of the program was the most important factor in the successful implementation of this program. Conclusion: Conducting this program showed that the dialogue with opposition groups can enhance the possibility of the successful implementation of a program. Implementing these strategies at a country level will confidently decrease the knowledge gap between research and policy and increase health system outcomes in terms of resource allocation and EBM. [ABSTRACT FROM AUTHOR]

Objectives: This study was conducted to assess financial protection and equity in the healthcare financing system among slum dwellers with type 2 diabetes (T2D) in Iran in 2022., Design: Cross-sectional study., Setting: Primary care centres in Iran were selected from slums., Participants: Our study included 400 participants with T2D using a systematic random sampling method. Patients were included if they lived in slums for at least five consecutive years, were over 18 years old and did not have intellectual disabilities., Primary and Secondary Measures: A self-report questionnaire was used to assess cost-coping strategies vis-à-vis T2D expenditures and factors influencing them, as well as forgone care among slum dwellers., Results: Of the 400 patients who participated, 53.8% were female. Among the participants, 27.8% were illiterate, but 30.3% could read and write. 75.8% had income below 40 million Rial. There was an association between age, education, income, basic insurance, supplemental insurance and cost-coping strategies (p<0.001). 88.2% of those with first university degree used health insurance and 34% of illiterate people used personal savings. 79.8% of people with income over 4 million Rial reported using insurance to cope with healthcare costs while 55% of those with income under 4 million Rial reported using personal savings and a combination of health insurance and personal savings to cope with healthcare costs. As a result of binary logistic regression, illiterate people (adjusted OR=16, 95% CI 3.65 to 70.17), individuals with low income (OR 5.024, 95% CI 2.42 to 10.41) and people without supplemental insurance (OR 1.885, 95% CI 0.03 to 0.37) are more likely to use other forms of cost-coping strategies than health insurance., Conclusions: As a result of insufficient use of insurance, cost-coping strategies used by slum dwellers vis-à-vis T2D expenditures do not protect them from financial risks. Expanding universal health coverage and providing supplemental insurance for those with T2D living in slums are recommended. Iran Health Insurance should adequately cover the costs of T2D care for slum dwellers so that they do not need to use alternative strategies., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Identifying different groups of customers and their preferences and needs enable countries to gain a competitive advantage in the medical tourism market. We aimed to segment medical tourists from West Asian countries seeking medical services in Iran., Methods: This cross-sectional study was conducted on 596 medical tourists who sought medical services in Iran in 2021. Data were collected using a valid questionnaire. Segmentation was performed based on medical tourism attributes (medical, destination, and tourism attributes), using cluster analysis methods; wards, and K means. The segments ' evaluation and profiling were conducted using discriminant analysis, chi-square, and oneway ANOVA tests., Results: Our study divided the market into five segments: health seekers (3.8%), health and destination seekers (8.9%), tourism seekers (17.8%), infrastructure seekers (10.23%), and perfectionism (59.45%). In all segments, the health attributes were of high importance. The perfectionism segment registered the highest score in all three attributes (more than 5 of 6)., Conclusion: Improving health attributes and offering luxurious medical services can be the main strategy for Iran to attract the most medical tourists and achieve a good position in this marketplace. The implication of this study is policymaking for targeting the most profitable segment of this marketplace., (Copyright© 2024 Torkzadeh et al. Published by Tehran University of Medical Sciences.)