Extent and nature of dual practice engagement among Iran medical specialists

Human Resources for Health

Gholamhossein Salehi Zalani¹  Mahboubeh Bayat¹  Mahmoud Khodadost²  Mehdi Yaseri³  Ali Akbari-Sari⁴  Ebrahim Jaafaripooyan⁴  Iraj Harirchi⁵  Roghayeh Khalilnezhad⁶  Azad Shokri⁷  Elmira Mirbahaeddin⁸ 

[1] Center for Health Human Resources Research & Studies, Ministry of Health and Medical Education;Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences;Department of Epidemiology, School of Public Health, Tehran University of Medical Sciences;Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences;Department of Surgery, School of Medicine, Tehran University of Medical Sciences;Health Management and Economics Research Center, Iran University of Medical Sciences;Social Determinants of Health Research Center, Kurdistan University of Medical Sciences;Telfer School of Management, University of Ottawa;

关键词: Medical specialists;    Dual practice;    Multiple jobs holding;    Iran;   

DOI  :  10.1186/s12960-018-0326-4

来源: DOAJ

【 摘 要 】

Abstract Background Dual practice (DP) by medical specialists is a widespread issue across health systems. This study aims to determine the level of DP engagement among Iran’s specialists. Methods A pre-structured form was developed to collect the data about medical specialists worked in all 925 Iran hospitals in 2016. The forms were sent to the hospitals via medical universities in each province. The data were merged at the national level and matched using medical council ID codes, national ID codes, and eventually a combination of the first name, surname, and father’s name. Results A total of 48 345 records were collected for 30 273 specialists from 858 (93%) hospitals out of total 925 hospitals. Sixteen thousand eight hundred forty-nine (69% of) specialists were non-faculty members and 6317 (26% of) specialists were employed on a contract basis. Eleven thousand six hundred and thirty-eight (47.7% of) specialists were engaged in DP on total. Female specialists had 0.78 times less DP chance; faculties compared to non-faculties had 0.65 times more DP chance and full-time geographic specialists compared to non-full-time specialists had 0.15 times more DP chance. DP was more frequent in specialists with higher age and more job experience and in provinces with more population, deprivation, and higher number of specialists per facility (P < 0.05). Conclusions The level of DP is relatively high among Iran medical specialists, especially in geographic full-time specialists. However, they are totally banned and they receive extra payment for being full-time; restrictive regulations and financial incentives without considering other factors might not eliminate DP in specialists and it should be addressed based on conditions of each country and regions inside the country.

【 授权许可】

Unknown