جایگزینی کتاب کالیفرنیا، اولین مرجع تعیین تعرفه تشخیص و درمان در کشور: بررسی دیدگاه خبرگان

Introduction: Continous use of Clinical and Diagnosis Tariffs Reference book (known as ‘California’
book), published in the early of 1970s, and caused many challenges in the health sector. In order to correct
some of these challenges, experts from the Ministry of Health and Medical Education in Iran have developed
new tariff book entitled’ relative values of clinical and diagnosis services “in 2008. Due to the importance
and great impact of this book on health system costs and income of delivery units, this study intended to
study experts’ points of views about these tariff references.
Method: This is a qualitative study, involving face to face interviews with policy makers at the Ministry
of Health and related organizations, and experts who had experiences about medical tariffs. All interviews
were recorded and written. We used the thematic framework method for analyzing qualitative data.
Results: Presenting relative values for most of clinical services, establishing good balance between
relative values of interdisciplinary and intradisiplinary services, and provision of up-to-date tariffs based on
health technologies are the advantages of the new tariff book. On the Other hand the new book has some
disadvantages such as: doubtful adjustment to information and financial system of country and adaptation
with the payment system of the health service sectors. The usage of ‘California’ book is suggested by some
experts but its improper impacts on medical education and delivery of health care services in the country
are the most disadvantages of the former book.
Conclusion: It seems substitution of ‘California’ book with new tariff book and use of new tariff book in
2008, have a total positive effect on health system of country. Future efforts should consider correcting of
the new book’s potential weaknesses and reforming the payment system in the country.