1- Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran , pouriafarrokhi73@gmail.com
2- Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
3- Department of Health Policy and Management, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
2- Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
3- Department of Health Policy and Management, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
Abstract: (24 Views)
Introduction: The transformation of health system models reflects adaptation to global changes and emerging health challenges, and understanding these models can support the design of efficient and responsive health systems. Accordingly, the present study was conducted to identify and analyze health system models in the global literature.
Methods: This scoping review was conducted using Arksey and O’Malley’s framework. Relevant studies published up to 2024 were retrieved from PubMed, Web of Science, Scopus, Science Direct, SID, Magiran, and Irandoc. In total, 97 studies met the inclusion criteria. Data were analyzed through thematic analysis using MAXQDA software.
Results: The identified components of health system models were grouped into five dimensions: governance, financing, human resources, infrastructure, and health service delivery. Governance included policy-making, planning, stewardship, organization, regulation, control, and community participation. Financing comprised resource mobilization, pooling of funds, and purchasing of health services. Human resources involved policy-making and planning, education and development, workforce distribution, and retention and motivation, while infrastructure included pharmaceuticals and medical equipment, health information and technology, and physical infrastructure. Health service delivery covered structured service delivery, coordination improvement, and community-based services. Financing, service delivery, governance, equity, and access were the most frequently emphasized components across models.
Conclusion: Health system models are primarily structured around four core dimensions including governance, financing, human resources, and service delivery. The proposed integrated model, by combining structural and functional approaches, provides an analytical framework to guide context-sensitive reforms, prioritize interventions, and improve the performance of health systems.
Methods: This scoping review was conducted using Arksey and O’Malley’s framework. Relevant studies published up to 2024 were retrieved from PubMed, Web of Science, Scopus, Science Direct, SID, Magiran, and Irandoc. In total, 97 studies met the inclusion criteria. Data were analyzed through thematic analysis using MAXQDA software.
Results: The identified components of health system models were grouped into five dimensions: governance, financing, human resources, infrastructure, and health service delivery. Governance included policy-making, planning, stewardship, organization, regulation, control, and community participation. Financing comprised resource mobilization, pooling of funds, and purchasing of health services. Human resources involved policy-making and planning, education and development, workforce distribution, and retention and motivation, while infrastructure included pharmaceuticals and medical equipment, health information and technology, and physical infrastructure. Health service delivery covered structured service delivery, coordination improvement, and community-based services. Financing, service delivery, governance, equity, and access were the most frequently emphasized components across models.
Conclusion: Health system models are primarily structured around four core dimensions including governance, financing, human resources, and service delivery. The proposed integrated model, by combining structural and functional approaches, provides an analytical framework to guide context-sensitive reforms, prioritize interventions, and improve the performance of health systems.
Keywords: Health system models, Health governance, Health financing, Health service delivery, Scoping review
Type of Study: Review |
Subject:
Health Services Management
Received: 2025/06/1 | Accepted: 2026/06/11
Received: 2025/06/1 | Accepted: 2026/06/11
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